Guided bone regeneration (GBR) is a technique used in dentistry to rebuild part of the bone in the jaw, if necessary, before performing implants and fitting other dental appliances. This technique encourages new bone to replace areas of damage in the jaw and can be used alongside guided tissue regeneration (GTR) to rebuild soft tissue in a patient's mouth. The technology and practice behind these techniques is subject to constant refinement and clinical studies are also used to explore the possibility of applying these techniques in other regions of the body.
Chronic dental disease and tooth loss often leads to loss of hard tissue in the jaw. People with missing teeth can experience resorption, where part of the jaw dissolves away. Other patients may have infections and inflammation eating into the bone of the jaw and breaking it up, causing parts of the jaw to disappear over time. These can cause unsightly disfigurements in addition to making a patient uncomfortable, and they may complicate fitting of implants and other appliances.
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In guided bone regeneration, the area of interest is carefully cleaned to remove dead and infected material and a membrane is placed over the bone. The membrane will not allow soft tissue like epithelial cells to pass, allowing hard tissue to develop under the membrane without interference or intrusion. New bone will fill in the hole in the jaw over time, and the dentist can perform the next step in an implant procedure.
Soft tissue tends to fill in much faster than bone, making the use of a membrane critical, as otherwise the gap in the bone will fill in with new gum growth. The membrane may be resorbable in some procedures, gradually melting away as the new bone grows in, or it can be permanent, requiring another procedure to pull it out once the patient's jaw is sufficiently rebuilt. The process of guided bone regeneration can be monitored with periodic physical exams and X-rays to check on bone growth.
It takes time for the replacement bone to grow in. While waiting, the patient may have temporary dental appliances to wear, but can experience some discomfort and may need to eat a modified diet. Once the GBR is over, additional time may be needed to fit appliances properly to the jaw. A doctor can provide an estimate on how long the guided bone regeneration process will take from start to finish during an initial patient meeting to help patients plan ahead.