Overview
Guided bone regeneration (GBR) uses a membrane to keep soft-tissue cells out of a graft site while slower-growing bone cells regenerate underneath. The membrane choice — resorbable collagen vs. non-resorbable PTFE — depends on the defect type, the need for space maintenance, and the surgeon's preference.
The PTFE family
- Expanded PTFE (e-PTFE, the original Gore-Tex): microporous, often titanium-reinforced for space maintenance; must remain submerged or risk infection.
- Dense PTFE (d-PTFE, e.g., Cytoplast): non-porous, tolerates intentional exposure to the oral cavity, ideal for socket preservation without primary closure.
- Resorbable collagen membranes: easier to place; no second surgery for removal; less space-maintenance capacity.
Choosing the right membrane
- Contained intrabony defect with stable graft: resorbable collagen often sufficient.
- Socket preservation when primary closure isn't possible: d-PTFE left intentionally exposed for 3–4 weeks, then removed.
- Large vertical augmentation: titanium-reinforced e-PTFE for space maintenance under primary closure.
- Patient at high risk of dehiscence: d-PTFE designed for exposure.
What the evidence shows
Cochrane reviews of horizontal and vertical augmentation report that membrane-based techniques are effective; clinical choice depends on defect geometry, patient compliance, and surgical expertise rather than a single 'best' membrane[1].
Frequently asked questions
Scientific references
- 1. Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. (2009). The efficacy of horizontal and vertical bone augmentation procedures for dental implants — a Cochrane systematic review. Eur J Oral Implantol. 2(3):167-84. View source