GBR

GBR

GBR

Product catalog summary
Introduction to Guided Bone Regeneration (GBR): Guided Bone Regeneration (GBR) is a technique used to reconstruct atrophied jaw regions, often necessary before or during dental implant insertion. It serves both mechanical purposes and aesthetic restoration without the need for pink ceramic material. The document explores whether GBR is a viable alternative to autogenous block bone graft transplants and outlines success factors.
Traditional vs. GBR Techniques: Historically, autogenous bone blocks were the gold standard for large-volume augmentations, offering osteoconductive and osteoinductive properties. However, they often resulted in high resorption rates and significant co-morbidity. GBR, using non-resorbable PTFE membranes, initially showed superior results but had high exposure rates leading to bacterial contamination and reduced bone regeneration.
Resorbable Membranes in GBR: Resorbable membranes have become more effective due to better tissue compatibility and easier handling. They do not require secondary intervention for removal and show high cell compatibility. Resorbable collagen membranes, particularly those of animal origin, are widely used in Germany, offering high success rates and stable barrier functions.
Clinical Application of GBR: The GBR technique is straightforward and minimally invasive, with high success rates. It is crucial for achieving stress-free primary wound closure and stable positioning of augmentation material. The document details the use of autogenous bone chips combined with Bio-Oss® and covered by Remaix/creos™ xeno.protect membranes for large augmentations.
Case Studies: The document includes several patient case studies demonstrating the application of GBR in various scenarios, such as socket preservation and large horizontal and vertical augmentations. These cases highlight the use of bone substitute materials and resorbable membranes to achieve successful outcomes.
Conclusion: GBR is a viable alternative to traditional bone grafting methods, offering high success rates and reduced patient morbidity. The use of resorbable membranes, particularly Remaix/creos™ xeno.protect, provides stability and compatibility, making GBR a preferred method in dental implantology.
Overview: The document discusses the use of zirconium dioxide augmentations and GBR (Guided Bone Regeneration) techniques in dental implant procedures. It highlights the effectiveness of modern materials and techniques in reducing the need for invasive bone grafting procedures.
Specifications and Procedures: The document describes the use of NobelProcera zirconium dioxide for augmentations and the application of the Remaix/creos™ xeno.protect membrane in GBR techniques. The membrane is noted for its stability and ease of handling during surgery, particularly when fixed with titanium pins.
Outcomes and Success Rates: The practice reports a high implant success rate of approximately 98.9% over five years, with a dehiscence rate of about 10% using the Remaix/creos™ xeno.protect membrane. This is significantly lower than rates reported for non-chemically cross-linked membranes.
Recommendations and Observations: The document suggests that modern GBR materials can often prevent the need for more invasive procedures, such as iliac crest transplantations. However, it notes the need for further randomized clinical studies to validate long-term success and bone remodeling outcomes.
Figures and Data: The document includes several figures illustrating the surgical process, including occlusal views, operation sites, and postoperative images. These figures support the text by providing visual evidence of the procedures and outcomes discussed.
Contact Information: Dr. med. dent. Bastian Wessing is listed as the contact for further information, with contact details provided.
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Catalog excerpts

GBR-1

Jahrbuch Implantologie SPECIAL PRINT Edition 2014 • Volume 20 What is Guided Bone Regeneration (GBR) capable of today? Dr med. dent. Bastian Wessing, Dr med. dent. Martin Emmerich,MSc

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GBR-2

What is Guided Bone Regeneration (GBR) capable of today? GBR is frequently necessary to reconstruct atrophied jaw regions before and/or during insertion of dental implants. It may be necessary not only for mechanical reasons i.e. the secure stabilisation of the implants in the insertion area, but also for the restoration of the “red-white aesthetics” without using pink ceramic material. Here the authors answer the question as to whether GBR is a viable alternative to autogenous block bone graft transplants, and further describe the relevant success factors. Dr med. dent. Bastian Wessing, Dr med....

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GBR-3

ture, as well as a significantly higher collagenase stability of the Remaix/creos™ xeno.protect membrane compared to the–also non-chemically cross-linked– reference membrane, Bio-Gide® (Geistlich Pharma AG, Wolhusen, Switzerland).35 Exploring stability of decomposition with bacterial collagenase in an experimental model allowed for conclusions to be drawn regarding the degradation behaviour of the collagen membranes when exposed to periodonthopathogenic germs in the oral cavity.23–26 At our practice the Remaix/ creos™ xeno.protect membrane proved successful as a new resorbable collagen membrane...

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GBR-4

Fig. 5: Metal-reinforced long-term temporary appliance, i.e. bonded bridge. – Fig. 6: Implant insertion after four months (note the completely maintained buccal volume of the jaw ridge). – Fig. 7: Occlusal “emergence profile” after conditioning with a temporary appliance (figure shows screw-connected gingival shaper). – Fig. 8: Position of the customised zirconium dioxide abutment (NobelProcera). There is no ischemia of gingiva due to individualisation of impression post. – Fig. 9: En-face view of completed zirconium dioxide crown at insertion (tooth 11 also treated with Procera crown). move...

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GBR-5

post surgery, the patient did not experience any further pain. However, pain control during the initial stage was achieved with regular administration of ibuprofen 400 mg 2–3 times per day. After healing of the augmentation material, the operation site showed a wide jaw ridge with vital, newly formed bone (bleeding with pilot drilling and removal of Bio-Oss® particles in the surface region). After a healing time of six months, two NobelReplace® Conical Connection (Nobel Biocare AG, Zurich, Switzerland) measuring 4 x 11.5 mm were inserted in the areas 12 and 21. The implants were inserted with...

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GBR-6

Patient case 3 Fig. 18: Occlusal view: in the region of the missing teeth 36, 37 and 45, 46 there is a highly atrophied, sharp jaw ridge. – Fig. 19: Operation site with atrophied jaw bone. – Fig. 20: Drilling through compact bone into cancellous bone for yielding of “bone blood”. – Fig. 21: Applied mixture of autogeneous bone chips and Bio-Oss® – Fig. 22: Remaix™/creos™ xeno.protect membrane (Matricel GmbH, Herzogenrath, Germany) fixed by titanium pins for stabilisation of augmentation material. – Fig. 23: Postoperative OPG image. – Fig. 24: Occlusal view after removal of suture three weeks after...

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