GBR = Guided Bone Regeneration
Guided Bone Regeneration (GBR) is a bone grafting technique that uses a barrier to create space for the patient’s native bone to form. Guide bone regeneration can use resorbable collagen membranes, titanium reinforced ePTFE, tiyanium mesh, and/or tenting screws.
Guided Bone Regeneration ADA dental code
The GBR dental code is D7950.
GBR healing time
Typical GBR healing time is 6-7 months before reentry.
Guided Bone Regeneration – Vertical
Vertical deficiency – dehiscence, fenestration, and post extraction defects treated simultaneously
vGBR complication rate 25%
rhBMP-2/ACS with cancellous bone and PRP is = autogenous but more edema 1
Tenting with cortical bone pin = “Alabama graft” using BonePin
Guided Bone Regeneration – Horizontal
Horizontal deficiency – Staged approach most common
hGBR 18% complication rate
ERE most common complication buccal plate fracture
GBR v. ERE 96-100% v 87-100%
Need decortication? Greenstein 2009 JPerio The role of bone decortication in enhancing the results of guided bone regeneration: a literature review. Lit review Maybe not but seems some benefits
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What is Sausage bone augmentation technique?
Use native animal collagen membrane not long lasting so blood can get through BioGide is one he uses 30×40 need a big one! In his article in Perio and Rest Dent 2017 Urban utilizes a Ti reinforced PTFE membrane. 50/50 auto with bone scaper from ramus area and bovine. Horizontal matress suture and then interrupted to close edges of the flap. PTFE single interrupted sutures from apical to coronal to close the vertical releases. 6-8 months heal then implant and then load @14 months once in sausage should be able to push with finger and feel firm.
First of all place pins 1-3 before placing any bone graft. Follow the numbering sequence up to #7. Finally place pin #8 if the membrane is not stable enough. Be sure to pull membrane down tight before placing pin #8.
Bioresorbable dome barrier bone graft
We have a entire post on the dome barrier technique, hence I will not write anymore here about it.
Khoury Block technique
An autogenous block graft of sorts. Using cortical graft as a shield for the area wish to one graft.
Bone ring GBR technique
Guided Bone Regeneration using the bone ring technique is an interesting concept but not the most useful. Therefore, you will not see a lot of information on it but you can find a nice CE course on bone ring technique on botiss.