Guided bone regeneration, or GBR, is a bone regenerative technique that uses physical means such as barrier membranes to seal off an anatomic site where bone is to be regenerated. The goal is to direct bone formation and prevent other tissues, including connective tissue, from interfering with osteogenesis. Guided bone regeneration is often used to increase the alveolar ridge where there has been bone resorption. Without GBR procedures, stable implant placement would not be possible for many patients as their remaining bone would not support an implant. There are two different approaches for guided bone regeneration. The first is known as the simultaneous approach where the placement of the implant and GBR take place at the same time. The second is the staged approach in which GBR is performed prior to implant placement. Regardless of the approach, the use of barrier membranes is essential to the success of the GBR process.
Glossary
Guided sleeve
A guided sleeve, also known as a guided cylinder, is a round metal cylinder usually five millimeters in length and available in various diameters, which is incorporated into a surgical or stereolithographic guide to precisely position the drill and subsequently the dental implant during surgery. Guided sleeves often come as part of a guided drilling set and allow for the accurate placement of a dental implant. The length of the guided cylinder helps in placing the implant at the right depth in the bone and ensures the drill follows the correct path and angulation through the bone for successful implant placement. The use of guided sleeves in oral surgeries and implant procedures ensures a much higher rate of accuracy than if the practitioner were to perform the surgery free hand. Recent studies have shown that the use of longer sleeves and drill keys also play a crucial role in achieving the highest level of accuracy.
Guided Tissue Regeneration (GTR)
GTR, or guided tissue regeneration, is a type of dental surgical procedure that uses barrier membranes to direct the growth of new bone and gingival tissue. It is employed at sites with insufficient volumes or dimensions of bone or gingiva for proper function, esthetics, or prosthetic restoration. Guided tissue regeneration uses a membrane at the surgical site to prevent soft tissue cells from growing into and over the new bone. This allows the bone to integrate without interference from other cells or pathogens that might otherwise disrupt the process. Bone grafts are often needed for implant patients who have insufficient bone for the process. The graft will provide new bone for the support, strength, and anchorage of the implant once it is placed. This gives the implant greater stability and an increased longevity. The use of GTR following a bone grafting procedure enhances the new bone’s ability to heal and create a strong foundation for the implant.