Impact of Biomaterials on GBR Procedures Simultaneous to Implant Placement: A Systematic Review and Meta-Analysis

Abstract

  This systematic review evaluates the effectiveness of various bone biomaterials and barriers used in Guided Bone Regeneration (GBR) procedures performed simultaneously with implant placement. The study aims to compare bone augmentation outcomes achieved with different materials and assess the incidence of barrier exposure. From an initial pool of 881 publications two independent reviewers selected 30 studies to be included in the final analysis. The review revealed significant data heterogeneity, allowing for only three meta-analyses on pairs of studies. Results: Despite this limitation, key findings emerged: all evaluated biomaterials (autologous, homologous, heterologous, engineered, and synthetic) and barriers (collagen, expanded polytetrafluoroethylene (PTFE), polyelectrolyte complex (PEG), poly (lactic-co-glycolic acid) (PLGA), and titanium mesh) were effective in achieving positive bone regeneration outcomes. Among the meta-analyses, collagen membranes showed a statistically significant superiority over PTFE membranes, while no significant differences were observed between heterologous and engineered bone or between collagen and PEG membranes. Barrier exposure was consistently associated with reduced bone augmentation. While this review confirms the suitability of various biomaterials and membranes in GBR procedures it emphasizes the need for additional high-quality comparative studies to address current data gaps and better inform clinical decision-making. From the results of the current literature review it appears that GBR outcomes are independent from the specific materials used, and the right biomaterials to be employed should be balanced based on the surgeon’s preferences and specific clinical scenarios.