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Guided bone regeneration with titanium membrane : A preliminary study. 길병원 치과 센터. Introduction. Sufficient volume & quality of alveolar bone Esthetics & function in implant dentistry . Guided tissue regeneration.

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Guided bone regeneration with titanium membrane : A preliminary study

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Guided bone regeneration with titanium membrane a preliminary study

Guided bone regeneration with titanium membrane : A preliminary study

길병원 치과 센터



  • Sufficient volume & quality of alveolar bone

  • Esthetics & function in implant dentistry

Guided tissue regeneration

Guided tissue regeneration

  • The use of membranes to guide bony tissue formation by separating the underlying bone from the overlying connective tissue

    & by creating a space into which the desirable bone cells can migrate

    - by Dahlin C. 1994

Indication of gbr

Indication of GBR

  • Extraction site

    - Prevention of crestal bone loss

    especially when 1 or more wall missing

  • Correction of inadequate ridge width or shape

    - Atrophic alveolar bone reconstruction for implant


Indication of gbr1

Indication of GBR

  • Dehicence defects

  • Apical fenestration

  • Residual intraosseous defects

    - Fresh or incompletely repaired extraction site

Historical review of gbr

Historical review of GBR

  • Regeneration of alveolar bone beneath cellulose acetate filler implant

    - by Boyne PJ. 1964

  • Healing of bone defects by GTR

    - by Dahlin C et al. 1988

Historical review of gbr1

Historical review of GBR

  • Bone formation utilizing titanium-reinforced barrier membrane

    - by Jovanovic. 1995

  • Augmentation of intramembraneous bone beyond the skeletal envelope using an occlusive titanium barrier

    - by Lundgren D. 1995

Basic mechanism of gbr

Basic mechanism of GBR

  • Prevention of fibroblasts filling the defect

  • Prevention of contact inhibition by heterotophic cell interaction

  • Exclusion of cell-derived soluble inhibitory factors

Requirement of gbr barrier membrane

Requirement of GBR barrier membrane

  • Biocompatibility & safety

  • Cell occlusiveness

  • Space-making ability

  • Tissue integration

  • Clinical manageability & cost effectiveness

    - by Teparat T et al. 1998

Consideration of selecting membrane

Consideration of selecting membrane

  • The creation & maintenance of sufficient space underneath the barrier is an important factor for a successful results

Classification of barrier membrane

Classification of barrier membrane

  • Nonresorbable membrane

  • Resorbable membrane

Nonresorbable membrane

Nonresorbable membrane

  • Expanded polytetrafluoroethlene ( e-PTFE )

    - Goretex

  • Nonexpanded polytetrafluoroethlene

    - Tef Gen-FD

Nonresorbable membrane1

Nonresorbable membrane

  • Titanium-reinforced expanded


  • Titanium membrane with microperforation

    - FRIOS®Bone shield

Resorbable membrane

Resorbable membrane

  • Collagen barriers

    - Bio-Guide, Bio-Mend, Colla Tape

  • Synthetic polymers

    - Vicryl Mesh, Resolut, Resolut XT

Resorbable membrane1

Resorbable membrane

  • Biologically active membrane:

    Platelet-rich plasma

  • Other barrier materials

    - Capset, Lambone

Characteristics of titanium membrane

Characteristics of titanium membrane

  • Mechanical property of rigidity

  • Smooth titanium surface with laserbeam-derived microperforation

  • Lateral marginal slit for fixation & shaping

Advantage of titanium membrane

Advantage of titanium membrane

  • Effective fixation of grafting materials

  • Optimal mechanical stability

  • Easy & durable shaping

  • Maximum biocompatibility

  • Easier fixation by membrane tacks

Disadvantage of titanium membrane

Disadvantage of titanium membrane

  • Increase in the number of exposure with mucosal perforation

  • Refrain from the placement of intermediate dentures

  • Technical sensitivity



  • The purpose of this preliminary study is to present clinical results of titanium membrane used for GBR in implant dentistry



  • Patients: 6 patients ( Since 2000.11 )

  • Sex: Male ( 4 ), Female ( 2 )

  • Age: 16-42years







  • 2 Patients: Uneventful healing of GBR site & retrieval of membrane after adequate healing period

  • 4 Patients: Membrane exposures after primary healing of mucosal incision

Consideration of selecting membrane1

Consideration of selecting membrane

  • Most flexible membranes do not have enough rigidity & tend to collapse

  • More rigid nonresorbable membrane is needed



  • The time between operation & exposure of the membrane is critical point

  • The rigidity of the titanium membrane leads to an increase in the number of exposure



  • The rigidity of titanium membrane makes the barrier able to maintain space

  • Careful soft tissue management & avoid directing loading by intermediate denture is essential to prevent wound dehiscence

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