Is a membrane always recommended over xenograft?
I have attended various lectures, such as Pikos, etc. Although I usually always place a GBR type membrane (i.e., collagen) over bone graft to prevent epithelial ingrowth, I have seen cases with Bioss and similar xenografts where no membrane was placed. I understand that an intact mucoperiosteum can work as a great membrane itself. Especially in the case of a fenestration with implant threads exposed (i.e., facial or buccal plate) and there is decortication with placement of xenograft, is it acceptable to omit the membrane placement in this circumstance?
8 Comments on Is a membrane always recommended over xenograft?
New comments are currently closed for this post.
Leal
11/29/2014
If you really like xenografts, try mixing them 60:40 (+/-) with CaSO4 (and not 1:2 like Bondbone states) wait for it to set and place the CaSO4 (1mm layer minimum) on top of the mixture. NEVER with membrane.
peter Fairbairn
11/29/2014
After 12 years following this protocol I think you are correct Leal....but you must follow this if you are not using a traditional collagen type to ensure the result you want ..
Leal
12/1/2014
Peter, just curious, do you know the ratio of CaSO4.1/2H2O to CaSO4.2H2O present in BondBone (or any other biphasic)? The brochure pictures suggest a 1/1 ratio but I would guess it is 95% hemi to 5% di. Do you have a clue?
peter Fairbairn
12/2/2014
Leal e-mail me .
Regards
Peter
neamat kolahquchi
11/30/2014
The use of membrane for the gbr is essential.indeed memberane protection lead to suceesful regeneration.
CRS
12/2/2014
I think a membrane is useful to contain particulate graft and to prevent epithelial ingrowth. If I am placing Bio oss I just close primarily; if no space maintenance is needed i.e. Over implant threads then just a membrane. There is nothing magic about it just away of keeping the particles from dispersing or if you want to prevent ingrowth or slow down the healing. Teflon membranes are nice to guide the granulation tissue. These are not really grafts, some tissue ingrowth occurs some regeneration the xeno grafts stay around forever. Nothing new similar to the old hydroxyapatite technique thirty years ago. I define a graft where actual bone cells or tissue is placed. It all works depending on what you want to achieve.
Ian Braby
12/3/2014
Agreed, CRS! It really depends upon the defect. If you are treating a 4-walled defect a membrane should not always be necessary as your graft material is contained and the access for soft tissue is limited. In 2- or 3-walled defects the access for soft tissue ingrowth is much greater and so a membrane would always be recommended!
Ian B
Doug
4/28/2015
Even in individuals who have superior teeth for delivering anchorage, the tension that's placed on the teeth by dentures could damage them.
