Efficacy of a Novel Synthetic GBR Membrane (Inox Nanoksa G-Plus) for Horizontal Ridge Augmentation: A Case Series

Alveolar ridge resorption following tooth loss frequently results in insufficient bone width or height for ideal dental implant placement, affecting more than 40% of patients seeking implant therapy. Guided Bone Regeneration (GBR) is a well-established surgical technique for reconstructing these deficient ridges using barrier membranes. However, existing membranes present significant limitations: non-resorbable expanded polytetrafluoroethylene (e-PTFE) membranes require a second surgery for removal and carry high exposure-related complication rates, while resorbable collagen membranes often lack adequate mechanical stability and degrade unpredictably, particularly in vertical or large horizontal defects.

The Inox Nanoksa G-Plus membrane is a novel, non-resorbable hybrid nano-ceramic material containing nano-carbon and nano-zirconia within a methacrylate-based high-performance polymer matrix. While the manufacturer claims high strength, wear resistance, and biocompatibility for prosthetic applications, and recent in vitro studies have characterized its mechanical properties, no published clinical study has evaluated its safety or efficacy as a barrier scaffold for GBR in human patients. This knowledge gap forms the basis for the present investigation.

This study is designed as a prospective, single-arm, interventional clinical trial conducted at the Department of Periodontics, Faculty of Dentistry, Cairo University. No randomization or comparator group is included, as this is an initial clinical evaluation of a novel device. All eligible and consenting participants will receive the same standardized intervention.

Study Population: Systemically healthy adult patients (ASA class I or II), aged 18 years or older, presenting with partial edentulism in the maxilla or mandible and requiring horizontal (residual ridge width < 5 mm) or vertical (residual ridge height < 8 mm above vital structures) ridge augmentation prior to dental implant placement. Key exclusions include untreated periodontitis, bisphosphonate therapy, heavy active smoking (>10 cigarettes/day), and pregnancy or lactation.

Intervention: Participants will undergo a single GBR procedure using the Inox Nanoksa G-Plus membrane. The standardized surgical protocol involves a mid-crestal incision with full-thickness flap elevation, cortical perforations to enhance vascularization, placement of a particulate bone graft to fill the defect, and trimming and adaptation of the membrane to extend 3-5 mm beyond the defect margins. The membrane will be secured with titanium micro-screws, and the flap will be closed primarily with a tension-free, double-layer suture technique to achieve complete membrane coverage. Post-operatively, participants will receive prophylactic antibiotics (5-7 days), analgesics, and chlorhexidine mouth rinses for 14 days. Sutures will be removed at 10-14 days.