What It Is
GBR is used, most commonly in conjunction with bone grafting, because there is a substantial amount of bone loss in the jaw bone. Bone regeneration is recommended following tooth extractions and the addition of implants, to fill the cavity where a tooth previously was if no implants are used, or when periodontal disease is present and has caused substantial bone loss.
During this procedure, a bone graft is used to fill in missing bone. As time passes, new bone grows around the graft. Immediately following the bone graft, barrier membranes are placed between the grafted area and the gum tissue. This membrane creates space needed to accommodate new bone growth without interference from gum tissue growth.
Before the procedure, an x-ray is taken to determine what dental care is necessary, including the removal of infected tissue and tooth extractions. These efforts must be completed first. After this work is completed and underlying issues are under control, the dentist will determine which type of graft will be used. An allograft uses human donor bone, while an alloplast uses synthetic, lab-create materials. Xenografts use bone pieces from an animal such as a pig or cow. Most commonly, an autograft is used. With an autograft, the patient’s own bone is used for the graft. It is the most commonly chosen because it presents the highest healing success due to the presence of the patient’s live bone marrow cells. The surgery to harvest the bone in an autograft is done before the GBR.
The GBR procedure begins with the administration of a local anesthesia, and often a sedative. A small cut in the gum is made to expose the area needing the graft. The harvested bone is then placed into the target area of the jaw bone. A barrier membrane is placed between the gum and the graft material to provide space and stabilization while the bone regenerates. The open gum area is then stitched closed.
Follow Up Care
Full healing and bone regeneration ranges between six months and one year. For the first few days, patients should avoid putting any pressure on the affected area. In this same time period, the patient should limit food intake to those that are liquid or more soft. A strictly soft food diet is generally recommended for at least six weeks following the procedure. It is also recommended to avoid foods that are too hot or cold during the first few days. Patients will be prescribed antibiotics to prevent infection. The dentist will also most likely prescribe an antibacterial gargle and pain medication. Within about a week, if healing is progressing satisfactorily, stitches can be removed if the dentist used non-dissolving stitches.
Once the area has healed properly, an x-ray is taken to determine if the bone regeneration has occurred as expected. If the procedure was successful, the dentist can begin preparations for additional restoration procedures such as artificial tooth implantation. Regeneration success is dependent on how well the patient follows the dentist’s instructions for follow up care.
Healing will depend on each individual’s natural ability to heal. In some instances, the dentist may recommend using some of the patient’s own platelets and plasma to accelerate healing in a process called Platelet Rich Plasma therapy. At the time of surgery, a small amount of the patient’s blood is drawn and run through a machine that separates the platelets from the blood. It is then given back to the patient.