Regeneration of Intrabony Defects Using a Novel Magnesium Membrane

Abstract

Background and Objectives: Due to their specific morphology, the regeneration of intrabony defects (IBDs) represents one of the greatest challenges for clinicians. Based on the specific properties of a magnesium membrane, a new approach for the surgical treatment of IBD was developed. The surgical procedure was described using a series of three cases. Materials and Methods: The patients were healthy individuals suffering from a severe form of periodontitis associated with IBD. Based on radiographic examination, the patients had interproximal bone loss of at least 4 mm. Due to its good mechanical properties, it was easy to cut and shape the magnesium membrane into three different shapes to treat the specific morphology of each IBD. In accordance with the principles of guided bone regeneration, a bovine xenograft was used to fill the IBD in all cases. Results: After a healing period of 4 to 6 months, successful bone regeneration was confirmed using radiological analysis. The periodontal probing depth (PPD) after healing showed a reduction of 1.66 ± 0.29 mm. Conclusions: Overall, the use of the different shapes of the magnesium membrane in the treatment of IBD resulted in a satisfactory functional and esthetic outcome.

Keywords: NOVAMag membrane; intrabony defects; magnesium; resorbable metal.

Figure 1

Case report of a patient who presented with a combined vertical and horizontal bone defect on the distal surface of tooth 12 (FDI Dental Numbering System for adults). (A) Baseline clinical situation. A probing depth of 9 mm was measured with the UNC probe. There was a gingival black triangle (GBT) in the interdental space between teeth 22 and 23. (B) Initial radiographic examination. Combined vertical and horizontal bone loss distal to the root of tooth 22 was noted. (C) After debridement, a magnesium membrane was shaped with special instruments to match the shape of the IBD. (D) The defect was filled with bovine xenograft and covered with magnesium membrane to fill the interdental space and elevate the interdental papilla. (E) The flap was adapted and sutured. (F) Clinical situation 10 days postoperatively. (G) Clinical situation after 6 months of healing. Note the healthy appearance of the interdental tissue and the minimization of the GBT between teeth 22 and 23. (H) Radiological examination 4 months postoperatively. Note the bone formation on the distal surface of tooth 22.

Figure 2

Case report of a patient who presented with an IBD between the distal root surface of tooth 23 and the mesial root surface of tooth 24. (A) Initial clinical situation. There was bone loss and associated loss of interdental soft tissue between teeth 23 and 24. (B) Initial radiographic examination. Combined vertical and horizontal bone loss was noted. (C) Flap elevation confirmed the radiographic findings. (D) After debridement, bovine xenograft was used to fill the IBD. (E) The magnesium membrane was cut in a T-shape to match the shape of the defect. (F) The defect was covered with the membrane. Note how the vertical line of the T-shaped membrane fitted into the interproximal space where the pre-existing papilla was located. (G) The flap was repositioned and sutured with single sutures. (H) Radiological examination after 6 months of healing. The radiological examination revealed satisfactory bone gain.

Figure 3

A case report of a 35-year-old female with combined vertical and horizontal defect in the esthetical zone of the maxilla. (A) The radiographic examination revealed severe bone loss. (B) Sulcular and vertical incisions were performed to elevate the flap, and the defect site was exposed. (C) The magnesium membrane was cut into an M-shape to cover interdental spaces between the teeth. (D) The defect was filled with bovine xenograft and covered with magnesium membrane that was previously shaped according to the defect. (E) The flap was repositioned and sutured using monofilament sutures. (F) Postoperative check-up after 6 months of healing. Note the healthy appearance of the soft tissues around the teeth and minimization of GBT. (G) Final radiological examination six months postoperatively revealed satisfactory bone healing.