Dome barrier – Guided bone regeneration
Bioresorbable dome barrier bone graft
Dome barrier bone grafting technique is a guided bone regeneration tenting procedure. It uses slow resorbing pieces of suture material and a membrane to tent the soft tissue and allow the bone to form under. The dental code for the dome barrier grafting is the same as GBR, which is D7950
Step by step for dome barrier guided bone regeneration
- First of all, you must do a flap to expose the you wish to graft.
- Step two is decortication of area same as other GBR procedures.
- Next drill 4-5mm deep holes for suture ends to sit in.
- Cut lengths of suture and place in holes
- Pack bone graft under the dome barrier
- Place a collagen membrane over the bone graft
- Finally, suture flap, however, do not use the PDS suture. We use PTFE, PGA, gut, or nylon.
- Healing will vary but 3-7 months healing for GBR is what we wait, depending on how much of the implant will be in the graft.
In addition to the information found on this post, a very helpful DT thread is found here.
Suture material for dome barrier technique
This is really the only thing that is different from many other guided bone regeneration techniques. The suture materiel to create the dome barrier must be thick and strong enough to maintain the dome shape but flexible enough to bend into the access holes. PDS*II (polydioxanone) 2-0 is the suture of choice.
Research on dome barrier bone grafting.
I believe most of the research is from Italians and consequently not all of the articles are in English. Parma-Benfenati 2014 Int J Peri Rest Dent article is showing the dome device for bone growth around dental implants. The article by Tinti 2001 Int j Peri Rest Dent shows the dome bone grafting technique around teeth to help treat gingival recession. This article by many of the same people shows some amazing photos of steps but the article is in Italian. Despite the fact the last article is in Italian, you may notice the authors are all the same, therefore I expect the content to be redundant.
Photos of dome barrier grafting in action.
Finally is the photos and to start directly below is a photo from the Italian article. Below that is my own photos but I think their photos are better than mine.
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