Guided bone regeneration
Encyclopedia
Guided bone regeneration or GBR, and guided tissue regeneration or GTR are dental
surgical procedures that utilize barrier membrane
s to direct the growth of new bone and gingival tissue at sites having insufficient volumes or dimensions of bone or gingiva for proper function, esthetics or prosthetic restoration.
GBR is similar to guided tissue regeneration (GTR) but is focused on development of hard tissues in addition to the soft tissues of the periodontal attachment
. At present, guided bone regeneration is predominantly applied in the oral cavity to support new hard tissue growth on an alveolar ridge
to allow stable placement of dental implant
s. Used in conjunction with sound surgical technique, GBR is a reliable and validated procedure.
and Jorgen Slotshttp://www.ncbi.nlm.nih.gov/pubmed/7615319.
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...
surgical procedures that utilize barrier membrane
Barrier membrane
A barrier membrane is a device used in oral surgery and periodontal surgery to prevent epithelium, which regenerates relatively quickly, from growing into an area in which another, more slowly-growing tissue type, such as bone, is desired...
s to direct the growth of new bone and gingival tissue at sites having insufficient volumes or dimensions of bone or gingiva for proper function, esthetics or prosthetic restoration.
GBR is similar to guided tissue regeneration (GTR) but is focused on development of hard tissues in addition to the soft tissues of the periodontal attachment
Periodontium
Periodontium refers to the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. The word comes from the Greek terms peri-, meaning "around" and -odons, meaning "tooth." Literally taken, it means that which is "around the tooth"...
. At present, guided bone regeneration is predominantly applied in the oral cavity to support new hard tissue growth on an alveolar ridge
Alveolar ridge
An alveolar ridge is one of the two jaw ridges either on the roof of the mouth between the upper teeth and the hard palate or on the bottom of the mouth behind the lower teeth. The alveolar ridges contain the sockets of the teeth....
to allow stable placement of dental implant
Dental implant
A dental implant is a "root" device, usually made of titanium, used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth....
s. Used in conjunction with sound surgical technique, GBR is a reliable and validated procedure.
History
Use of barrier membranes to direct bone regeneration was first described in the context of orthopaedic research 1959. The theoretical principles basic to guided tissue regeneration were developed by Melcher in 1976, who outlined the necessity of excluding unwanted cell lines from healing sites to allow growth of desired tissues. Based on positive clinical results of regeneration in periodontology research in the 1980s, research began to focus on the potential for re-building alveolar bone defects using guided bone regeneration. The theory of Guided tissue regeneration has been challenged in dentistry. Most frequently by Hessam NowzariHessam Nowzari
Hessam Nowzari is the Director of the University of Southern California Advanced Periodontics program, since 1995, and is a Diplomate of the American Board of Periodontology.-Biography:...
and Jorgen Slots
Overview
Four stages are used to successfully regenerate bone and other tissues, abbreviated with the acronym PASS:- Primary closure of the wound to promote undisturbed and uninterrupted healing
- Angiogenesis to provided necessary blood supply and undifferentiated mesenchymal cells
- Space creation and maintenance to facilitate space for bone in-growth
- Stability of the wound to induce blood clot formation and allow uneventful healing
In dentistry
The first application of barrier membranes in the mouth occurred in 1982 in the context of regeneration of periodontal tissues via GTR, as an alternative to resective surgical procedures to reduce pocket depths.Indications
There are several uses of bone regeneration:- building up bone around implants placed in tooth socketsDental alveolusDental alveolus are sockets in the jaws in which the roots of teeth are held in the alveolar process of maxilla with the periodontal ligament. The lay term for dental alveoli is tooth sockets...
after tooth extraction or to prepare for future implantation of false teeth or prosthetics - filling of bone defects after removing the root of a toothToothTeeth are small, calcified, whitish structures found in the jaws of many vertebrates that are used to break down food. Some animals, particularly carnivores, also use teeth for hunting or for defensive purposes. The roots of teeth are embedded in the Mandible bone or the Maxillary bone and are...
, cystectomyCystectomyCystectomy is a medical term for surgical removal of all or part of the urinary bladder. It may also be rarely used to refer to the removal of a cyst, or the gallbladder. The most common condition warranting removal of the urinary bladder is bladder cancer. After the bladder has been removed, an...
or the removal of impacted teethTooth impactionImpacted and embedded teeth are the two main types of unerupted teeth found in the mouth, and can sometimes be confused with each other.In cases of both impacted and embedded teeth, the teeth remain below the surface of the gum and sometimes bone, rather than erupting into an exposed position... - repairing bone defects after a the reopening of a woundWound dehiscenceWound dehiscence is a surgical complication in which a wound breaks open along surgical suture. Risk factors are age, diabetes, obesity, poor knotting or grabbing of stitches, and trauma to the wound after surgery.-Symptoms:...