To use or not to use a membrane in GBR?

When should we use or not use a membrane for GBR [Guided Bone Regeneration]? Are there any any indications, guidelines, or decision-making protocols for when to use a membrane or not in this situation?

12 thoughts on: To use or not to use a membrane in GBR?

  1. Alex Barragan says:

    Membrane should be used in GBR horizontal or vertical defects, main purpose is to keep bone graft in place and avoid migration of non disared cells and tissues. I don’t use them in socket preservation, and sometimes in sinus lifts

  2. Dennis Flanagan DDS MSc says:

    Barriers are needed when the flap is partial thickness, there is no primary closure or the surgeon wants a definitive separation. Periosteum is a great barrier. If that is intact a barrier is not needed.

  3. Leo A. says:

    A membrane functions to prevent particulate graft loss/ migration, and the bone graft is essentially a barrier /space maintainer against gingival ingrowth until autogenous bone can develop. It makes a big difference with socket grafting. I’ve always used membranes for horizontal ridge augmentation so I can’t speak for periosteum alone as a predictable barrier against graft migration.

    • Peter Fairabirn says:

      Yes have not used a membrane in my last 5,000 grafts , seems the periosteum is the miracle and we see that in millions of fracture healings over thousands of years . Host healing is a miracle why impede it .
      But you do need a stable graft that is biocompatible with no giant cell host reaction .

  4. Robert Teague says:

    As has been said a barrier is just that-a physical presence to hold in place unstable particulates and maybe prevent soft tissue in growth. There are numerous bone grafts available it in Europe, USA and rest of World that are highly porous Si clot stabilising or self stabilising (cement like, putty like or self binding) when these are used in periosteum preserving minimal flap techniques they replace the need for additional stabilisation.

  5. Joyce Gant says:

    Hello I am not a dentist or student of dentistry but I have a question. Is there anything available for someone who has had 2 implants fail due to bone loss even after attempts to rebuild the bone? Today I have an upper denture that I HATE after pulling the teeth required to prepare for the implants that eventually failed . Thank you in advance.

    • dr. gerald rudick says:

      To Joyce Gant :

      OsseoNews is a forum where dental professionals discuss implantology and ask questions, give explanations,etc…… it would be nice to help you…but you need to give us more information, including xrays, your health, age, etc…. and then we can see the situation and offer suggestions.

      Gerald Rudick dds Montreal, Canada

  6. Alex says:

    I was trained to think that the membrane is a BARRIER. It’s function is to EXCLUDE unwanted ( faster growing and migrating) cells from the scaffold we want osteoblasts to occupy. Since there are no teeth in GBR concepts, there is no long junctional epithelum to worry about. So, which cells we want to exclude? Fibroblasts from periosteum? Some doctors say, if you put membrane, you will gain more bone tissue, if you don’t, you will gain less. So, there are only nuances with fibroblasts, according to aforementioned doctors….does this feel right?

  7. Raul R Mena says:

    I agree with Peter,
    My patients bring their own membrane is called periosteum.
    For socket grafting y place the grafting material and the coagulum keeps it from extruding out of the socket.
    There is epithialization over the graft after 21 days the same as what happens with an extraction.
    If a flap is done in order to cover the graft as long as periosteum is what is covering the graft there is no soft tissue growth into the graft.
    If connective tissue is covering the graft then there may be soft tissue ingrowth into the graft

  8. Abdusalam Alrmali says:

    If you target GBR as augmataion technique you should use a membrane otherwise not important to cover bone with a barrier in each single case
    So according to the case !!
    Abdusalam Libya

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