Guided Bone Regeneration Flashcards
1
Q
Ridge Augmentation Techniques
A
- Distraction Osteogenesis
- high risk of infection & failure
- Guided Bone Regeneration (GBR)
- Block Autograft
- Block Allograft
- Ridge Split Techniques
- Combination
2
Q
GBR vs GTR
A
- GBR
- on edentulous ridges
- GTR
- around teeth
3
Q
Guided Bone Regeneration
A
- Use barrier membranes to direct growth of new bone & soft tissue
- sites w/insufficient volumes or dimensions
- used for fxn, esthetics, or restoration
- Based on Guided Tissue Regeneration (GTR) principles
- Introduced by Dahlin
- rats
- 1988
4
Q
GBR Regeneration Process
A
- Blood Clot
- Angiogenesis
- develop new blood vessels
- Granulation Tissue
- Osteogenic cells migrate
- periphery→center
- Deposits woven bone
- Lamellar bone forms
- Remodeling
- resembles bone growth
5
Q
GBR: PASS Principle
A
- Primary Closure
- periosteal releasing incision
- remove membranes after 4-6 mos
- Angiogenesis (Blood Flow)
- formation of new BVs
- Stability
- Suture and anchor membrane and flaps
- Space Maintenance
- membrane b/w bone graft and gingiva
6
Q
What is the Principle of Combination Therapy
A
- Membrane
- provides barrier
- Graft
- scaffold
- space maintenance
7
Q
Ideal Membrane Characteristics
A
- Biocompatible
- Cell Occlusiveness
- Tissue Integration
- protect blood clot
- wound stabilized
- Space making
- for progenitor cells
- Manage Clinical
- Facilitate migration and proliferation of progenitor cells
- Bacterial infection resistant
8
Q
Types of Barrier Membranes
A
- Non-Resorbable
- ePTFE, dPTFE
- socket grafting)
- Millipore
- Cellulose acetate
- Titanium
- ePTFE, dPTFE
- Resorbable:
- Collagen
- Synthetic: PLA, PGA, PLGA
- ADM
9
Q
New Membranes
A
- Alginate
- New degradable copolymers
- Hybrid or nanofibrous membranes
- Amniotic membranes
10
Q
Porosity Principle
A
-
Porosity
- 50-100 um → Bone ingrowth
- > 100 um (101-150)→ High vascular tissue
- > 150 um→ Bone with osteons
11
Q
GBR: Other Principles
A
-
Thin layer of soft-tissue ingrowth
- under the membrane
- initial blood clot shrinks→air entrapped or membrane micromovement
-
Micromovement:
- Fibrous Tissue
12
Q
Osteogenesis
A
- cells in graft form new bone
13
Q
Osteoinduction
A
- Chemical Process
- BMPs convert neighboring cells→ osteoblasts→form Bone
- BMPs=molecules in graft
14
Q
Osteoconduction
A
- Physical Effect
- Graft Matrix forms scaffold
- outside cells penetrate the graft → form new bone
15
Q
Osteopromotion
A
- Materials that support:
- wound healing
- tissue regeneration
- do not initiate de novo tissue formation