Guided bone regeneration - a guide for patients
Your dentist may have recommended guided bone regeneration (GBR), but what actually is it?
Following a dental implant, the implant will go through a fusing process known as ‘osseointegration’. This is whenever the implant material has fully integrated and fused with the bone structure beneath the gum. This is an essential process required for strong and stable dental implants and sufficient bone volume should exist at the site of implantation to ensure long term success of the implant.
Bone loss or insufficient bone volume is a feature of many diseases involving the teeth and gums. GBR is a surgical process used to combat this issue and allow an implant to be fully integrated to the individual’s jaw bone.
This blog will explore what GBR is, how and when it is performed, the materials used, its benefits and risks and how to prepare for it.
What is guided bone regeneration?
Guided bone regeneration is a procedure that encourages the growth of new bone to build up and support areas of insufficient bone volume around dental implants and other restorative dental procedures. In this way you can liken it to a cement that fills any areas of bone defect in the jaw, allowing dental implants to be placed into a stable environment. It has been estimated that over ⅓ of patients having a dental implant may need a degree of GBR to augment the bone structure at the site of implantation.
GBR sites have been shown to result in similar implant success rates when compared with implants at sites of perfect natural bone condition.
What materials are used for guided bone regeneration?
The process of guided bone regeneration typically involves the placement of a bone graft material in the area of bone defect, which is then covered by a ‘barrier membrane’.
The bone graft is firstly used to fill the space, but also as a scaffold to promote the growth of new bone. The barrier membrane that covers the graft is used to prevent the invasion of non-bone tissues (e.g. gum and connective tissue) into the site of the bone graft. These soft non-osteogenic tissues are faster growing than bone tissue. The membrane therefore acts as a shield to help protect the site from these tissues and allows the slower-growing bone cells to populate the site. This creates a stable and secure environment for bone regeneration.
When is guided bone regeneration indicated?
GBR is typically recommended in bone defects ≥2mm.
It can be performed in several scenarios, including:
Dental Implant placement: If there is a low bone volume around the site of the implant, a bone graft and barrier membrane can be used as a scaffold to promote new bone growth and enhance the stability of the implant.
Periodontal Disease: In cases of severe gum disease where bone loss has occurred, GBR can help regenerate the lost bone around teeth.
Trauma: GBR can help restore the bone structure after facial injuries or trauma.
Tooth Extraction prior to implants: Following the extraction of teeth, especially in the posterior areas of the jaws, GBR can be used to preserve the bone for future dental implants.
What are the benefits of guided bone regeneration?
The benefits of GBR are numerous and include:
Improved stability for implants: promoting the growth of lost bone, GBR can provide strong foundations to help integrate implants into our jaw bones.
Improved Function: Restoring bone volume can improve chewing and speaking functions, enhancing the patient’s quality of life.
Prevention of Bone Loss: By regenerating bone, GBR can prevent further bone loss and the associated complications.
Versatility: GBR can be used in various clinical situations, making it a versatile tool in dental and maxillofacial surgery.
What are the risks of guided bone regeneration?
While GBR is generally safe and effective, like all procedures it does come with some risks, including:
Infection: As with any surgical procedure, there is a risk of infection.
Failure: In some cases, the bone may restore as expected, requiring additional procedures.
Pain and Swelling: Patients may experience pain and swelling at the surgical site, which can usually be managed with pain medication and ice.
Rejection of Materials: Very rarely, the body may reject the materials used for the membranes or bone grafts. This is minimised by using high quality, biocompatible materials that are commonplace in dentistry.
Your dentist will walk you through what the procedure will involve before the day of the surgery. Each dentist will have a slightly different approach, however in general the procedure will involve
Local anaesthesia or sedation: this will ensure the patient is comfortable throughout the procedure. It involves a small injection of medication directly into the site of regeneration +/- into their veins.
Expose the Bone Defect: A small incision is made so your surgeon can see the area of defect. Note this procedure may be done prior to, during, or after your dental implant.
Bone Grafting: In some cases, bone grafting material is placed under the membrane to support bone regeneration. The bone graft is a cement that promotes new bone growth.
Place the Barrier Membrane: The barrier membrane is placed over the defect to protect it from soft tissue invasion.
Close the Incision: The gum tissue is stitched back into place to cover the membrane and bone graft.
Conclusion
Guided Bone Regeneration is a valuable technique in modern dentistry, providing solutions for patients with insufficient bone volume for dental implants and other restorative procedures. While it comes with risks, the benefits often outweigh them when there is a large bony defect. They can offer improved function, aesthetics, and ultimately quality of life. As always, consult with your dental professional to determine if GBR is the right option for your needs.
Contact us at The Harley Street Implant Centre to book in for a consultation that will involve a CBCT scan to assess your bone volume. As a quality implant centre, we ensure all implants are given the best opportunity to succeed through methods such as guided bone regeneration, sinus lifting and bone grafting.