"Efficacy of Non Perforated Titanium Foil Versus Collagen Membrane on Guided Bone Regeneration for Ridge Augmentation"

Dental extractions can result in the loss of alveolar bone, leading to a decrease in both bone height and width, which may limit space for implant placement, particularly when taking aesthetic and prosthetic aspects into account.1 Various techniques have been developed for augmenting alveolar ridges, includes Guided Tissue Regeneration (GTR), Guided Bone Regeneration (GBR), onlay grafting, Distraction osteogenesis, which utilizes osteoconductive (scaffold-providing), osteoinductive (stimulating bone-forming cells), and osteogenetic (bone-producing cell-containing) properties.2 GBR membrane plays a vital role as a selective barrier that regulates cellular repopulation at the defect site. It prevents the rapid migration of soft tissue cells such as fibroblasts and epithelial cells, which could otherwise hinder bone regeneration. By excluding these cells, the membrane preserves a protected space that supports the slower infiltration and activity of osteogenic cells responsible for bone formation. Positioned between soft and hard tissues, it ensures a favourable environment for targeted bone regeneration by permitting only bone-forming cells to populate the area.3 GBR membranes are mainly categorized based on their degradation characteristics into non-resorbable (N-RES) and resorbable (RES) varieties. N-RES membranes such as titanium meshes, titanium foil and PTFE membranes offer reliable and enduring results. RES membranes are made from either natural or synthetic polymers, including xenogeneic native collagen, polyglycolide and polylactide polymers.4,5 The collagen membrane is utilized in guided bone regeneration because it can stimulate adhesion, chemotaxis and its own degradation along with that of its progenitor.6 The collagen membrane aids in wound healing by stabilizing clots, maintaining wound stability and hemostasis. It also serves as a scaffold that improves primary wound coverage to attract fibroblasts through its chemotactic properties.7,8 Its main drawbacks are rapid degradation rate and lack of stiffness, which can lead to a collapse of the barrier over the bone defect and diminish the space essential for bone regeneration.9,10 To reduce the risk of bacterial colonization at the graft site, the use of non-permeable occlusive titanium barriers (OTB) has recently been proposed as a promising alternative in reconstructive implant surgeries. These titanium barriers are designed to provide a completely sealed environment that effectively isolates the bone graft from the surrounding soft tissue and oral cavity, thereby minimizing microbial contamination. In addition to their superior biocompatibility and structural rigidity, OTBs offer the advantage of enhanced space maintenance and mechanical stability, which are crucial for successful bone regeneration in complex defects.11 This study aims to evaluate the effectiveness of non perforated titanium foil in comparison to traditional collagen membranes in ridge augmentation procedures, assessing their respective abilities to facilitate predictable and successful bone regeneration.

MATERIALS AND METHODS TRIAL DESIGN The trial was designed as randomized controlled clinical trial, to clinically and radiographically evaluate the efficacy of titanium foil and collagen membrane in ridge augmentation.

PARTICIPANTS AND ELIGIBILITY CRITERIA Subjects for the study were selected from the outpatient section of the Department of Periodontology, Sri Venkata Sai Institute of Dental Sciences, Mahbubnagar, Telangana and were followed up for over six months period after the procedures. Approval from Institutional Ethics Committee (SVSIDS/PERIO/4/2022) was obtained and informed consent was taken from the patients.

SELECTION CRITERIA:

Inclusion criteria: