Comparative Evaluation of Guided Bone Regeneration Using Different Barrier Membranes Around Dental Implants

Abstract

Aim:

To compare the clinical and radiographic outcomes of guided bone regeneration performed using collagen membranes and expanded polytetrafluoroethylene (ePTFE) membranes in patients undergoing dental implant therapy.

Materials & Methods:

This prospective comparative clinical study included 40 patients requiring guided bone regeneration in conjunction with dental implant placement. Participants were equally allocated into two groups: Group I received a collagen membrane (n = 20), while Group II received an ePTFE membrane (n = 20). Clinical outcomes assessed included ISQ, soft tissue healing, membrane exposure, wound dehiscence, postoperative infection, postoperative complications, and implant survival. Radiographic assessments comprised horizontal bone gain, vertical bone gain, and marginal bone loss at scheduled follow-up visits over a 12-month period. Statistical analyses were performed using the independent-samples t-test, paired-samples t-test, repeated-measures Analysis of Variance (ANOVA), and Chi-square/Fisher's exact tests, with statistical significance established at p < 0.05.

Results:

The two study groups were comparable at baseline with respect to demographic characteristics, implant site distribution, and alveolar defect morphology (p > 0.05). The ePTFE membrane group demonstrated significantly greater horizontal bone gain at 6 months (3.91 ± 0.67 mm vs. 3.42 ± 0.61 mm; p = 0.020) and 12 months (3.82 ± 0.64 mm vs. 3.31 ± 0.58 mm; p = 0.012). Likewise, vertical bone gain was significantly greater in the ePTFE group at both 6 months (2.63 ± 0.57 mm vs. 2.18 ± 0.52 mm; p = 0.013) and 12 months (2.55 ± 0.54 mm vs. 2.09 ± 0.49 mm; p = 0.008). Implant stability improved significantly over time in both groups (p < 0.001), with no statistically significant differences between the groups at any follow-up interval (p > 0.05). Marginal bone loss remained minimal and comparable throughout the study period. The collagen membrane group demonstrated significantly superior soft tissue healing, with a greater proportion of participants exhibiting excellent healing (80.0% vs. 55.0%; p = 0.048). Although membrane exposure, wound dehiscence, postoperative infection, and overall postoperative complications occurred more frequently in the ePTFE group, these differences were not statistically significant (p > 0.05). Implant survival was high in both groups, with survival rates of 100% in the collagen membrane group and 95% in the ePTFE membrane group (p = 1.000).

Conclusion:

Both collagen and ePTFE membranes proved to be effective barrier membranes for guided bone regeneration associated with dental implant placement, producing favorable clinical and radiographic outcomes. The ePTFE membrane provided superior horizontal and vertical bone augmentation, whereas the collagen membrane was associated with enhanced soft tissue healing and fewer membrane-related complications. Implant stability, marginal bone preservation, and implant survival were comparable between the two treatment modalities. These findings suggest that membrane selection should be individualized according to the regenerative requirements of the defect and the desired soft tissue healing characteristics.