Guided Bone Regeneration (GBR) 

Guided Bone Regeneration (GBR)

Guided Bone Regeneration (GBR) is a bone augmentation technique based on the principle of a biological barrier. Bone graft material is placed into an area of deficiency and covered with a specialized membrane that separates the regenerative space from the surrounding soft tissues.

Soft tissues heal more rapidly than bone. Without a membrane, connective tissue may invade the defect and occupy the space intended for new bone formation. The membrane creates a protected environment in which bone can regenerate without competition from faster-growing tissues.

At Iskusstvo Clinic in Moscow, GBR is performed both as a standalone procedure and in combination with dental implant placement.

Indications for GBR

• Bone deficiency around a dental implant, including exposure of implant threads
• Reconstruction of bone volume after tooth extraction before implant placement
• Filling of osseous defects after removal of cysts or granulomas
• Preservation of the extraction socket after tooth removal (ridge preservation)
• Horizontal ridge augmentation in cases of insufficient bone width
• Vertical ridge augmentation in cases of insufficient bone height

Components of GBR

Bone Graft Material

The defect is filled with a grafting material that serves as a scaffold for new bone formation.

Materials may include:

• Autogenous bone harvested from the patient
• Xenogeneic grafts, such as Bio-Oss®
• Synthetic substitutes
• Combinations of these materials

The graft maintains volume and provides a framework into which the patient’s own bone-forming cells can migrate.

Barrier Membrane

A membrane is placed over the graft to isolate the regenerative site from the surrounding soft tissues.

Two categories of membranes are commonly used:

Resorbable membranes

Examples include Bio-Gide® and similar collagen membranes. These gradually degrade within the body and do not require surgical removal.

Non-resorbable membranes

Titanium-reinforced or PTFE membranes provide greater rigidity and space maintenance in larger defects. They require removal during a second-stage procedure, usually after six to nine months.

Procedure

GBR is performed under local anaesthesia.

The surgeon elevates a flap, exposes the defect, places the graft material, covers it with a membrane and closes the site with sutures.

When resorbable membranes are used, treatment is completed in a single stage.

With non-resorbable membranes, a minor second procedure is necessary after six to nine months to remove the membrane.

The procedure generally takes between 30 and 90 minutes, depending on the size of the defect.

In many cases, GBR can be carried out simultaneously with implant placement.

Recovery

Swelling typically persists for five to seven days, while mild discomfort may last for one to two weeks.

Patients are advised to follow a soft diet for approximately two to three weeks.

Careful oral hygiene is essential, although vigorous rinsing should be avoided during the first 24 hours.

Sutures are usually removed after 10–14 days.

Bone maturation generally requires four to six months, after which implant placement may be performed if it has not already been completed.

Contraindications

GBR may not be suitable in the presence of:

• Active oral infections
• Uncontrolled diabetes mellitus
• Treatment with bisphosphonates
• Other systemic conditions affecting bone healing

Smoking significantly reduces the predictability of bone regeneration and is strongly discouraged.

The final decision regarding treatment is made by the surgeon after clinical examination and imaging assessment.

Frequently Asked Questions

How Is GBR Different From Conventional Bone Grafting?

GBR is a form of bone augmentation that specifically relies on the use of a barrier membrane.

Conventional grafting procedures may be performed without a membrane when surrounding tissues provide adequate containment.

GBR is indicated when graft material requires stabilization or when the regenerative area must be protected from soft tissue invasion.

Does the Membrane Need to Be Removed?

Resorbable membranes do not require removal because they degrade naturally within three to six months.

Non-resorbable membranes, such as titanium-reinforced or PTFE membranes, must be removed surgically after approximately six to nine months. This is usually a straightforward procedure performed under local anaesthesia.

Can an Implant Be Placed at the Same Time as GBR?

Yes.

Simultaneous implant placement and GBR is highly effective in cases involving small or moderate defects and reduces the total treatment time.

For larger defects, it is often preferable to regenerate the bone first and place the implant after healing.

How Long Does the Result Last?

When performed correctly and followed by appropriate postoperative care, the regenerated bone remains stable for many years.

Once the graft has matured, timely implant placement is recommended, as prolonged delay may lead to partial resorption of the newly formed bone.

Book a Consultation

Book a consultation. The surgeon will evaluate your CT scan, determine the extent of bone deficiency and recommend the most appropriate regenerative approach for your clinical situation.