The Art and Science of Guided Bone Regeneration

Abstracts

Guided bone regeneration (GBR) is one of the foundational ridge augmentation techniques facilitating prosthetically driven implant site development. This technique allows endosseuos implant therapy in deficient alveolar ridges and prevents loss of alveolar bone after dental extractions. GBR was directly derived from its forerunner of guided tissue regeneration (GTR). The fundamental basis of GBR is exclusion of rapidly growing tissues from an osseous defect allowing adequate time for consolidation of mature bone preventing soft tissue ingrowth.

GBR allows the relatively slow growth of bone to occur in a site by utilizing a barrier membrane to exclude rapidly proliferating epithelial cells and fibroblast from osseous defects, stabilization of clot and grafting material, maintenance of space, and tension-free primary wound closure. These tenets allow osteoblasts and osteoprogenitor cells a competitive advantage in the wound healing process in the confines of the barrier protected defect. Numerous bone grafting materials can be utilized for adequate space maintenance, osteoinduction, osteogenesis, and osteoconduction.

Barrier membranes are classified as resorbable and non-resorbable. The main advantage of resorbable barrier membranes is the avoidance of additional surgical procedures for its removal. Non-resorbable membranes, with or without physical reinforcement, are typically used for larger defects requiring additional rigidity for space maintenance and diminishing micromovement which impede vascular ingrowth and osseous regeneration.

While the concepts of GBR are straightforward and universally accepted, the implementation of the technique can vary greatly due to the nature of the patient’s defect and provider preferences.