GBR with slow resorbable membrane

  • GBR with slow resorbable mambrane
    Narrow alveolar ridge
  • GBR with slow resorbable membrane
    GBR with cerabone and Jason® membrane
  • GBR with slow resorbable membrane
    Implantation after regeneration
GBR is a technique used for the regeneration of lost alveolar bone by the help of a bone graft material and a barrier membrane. The defect is filled with a bone subsitute material (allogeneic-, xenogeneic- or alloplastic bone substitute material) that serves as a scaffold for ingrowth of bone forming cells and blood vessels (osteoconduction) and prevents collapse of the overlying barrier membrane. The membrane acts as a barrier against ingrowth of fast proliferating connective tissue cells, hence, giving the bone forming cells time and space for the osseous regeneration of the defect. Moreover, the membrane stabilizes the bone graft material and prevents the migration of particles. For more extended horizontal defects as well as combined or vertical defects and defects outside the ridge contour a slowly resorbable membrane such as the Jason® membrane provides the necessary safety for a successful outcome.
botiss cerabone® & Jason® membrane for horizontal augmentation - Clinical case by Dr. M. Steigmann

Three implants placed in a narrow posterior mandible

Maxillary bone reconstruction in the anterior area with cerabone and Jason membrane - Dr. P.-Y. Gegout & Prof. O. Huck

Pre-operative: loss of interdental papilla between 12 and 11 associated with gingival inflammation and pus

GBR in aesthetic zone with maxgraft® and Jason® membrane - 5 year follow up - Dr. A. Jones

Clinical situation at baseline: Situation after tooth extraction UR1 due to a failed endodontic treatment 3 months previously

GBR with Jason membrane® and cerabone® - D. Fontana

Lateral view of the defect in the posterior right maxilla.

Regeneration of a 9 mm vertical bone defect with cerabone®, autologous bone and S-PRF –  Dr. A. Eslava

Initial x-ray showing bone loss around implants placed 5 years ago in another dental clinic

GBR with cerabone® and Jason® membrane in the front tooth region - Dr. H. Maghaireh

Initial clinical situation with gum recession and labial bone loss eight weeks following tooth extraction

Regenerative corticotomy to compensate lower incisor malocclusion with cerabone® and mucoderm®

Initial view of the clinical case: Class III malocclusion
Treatment plan: Regenerative corticotomy (PAOO)

Simultaneous GBR and implantation using maxgraft® granules and autologous bone

Initial situation - endodontically failing tooth 22, very thin biotype, high lip line and esthetic expectations

Treatment of vertical bone loss by using cerabone®, autologous bone and Jason® membrane - Prof. Rafael Ortega Lopes

The patient presented with severe pain in the lateral incisor and a deficient adhesive provisional. Bruxism resulted in canine loss and premature contact in the lateral incisor.

Fixation of Jason® membrane

The Jason® membrane exhibits a remarkable multi-directional tear resistance. Therefore, it can easily be pinned, sutured or even screwed without rupturing.

Membrane application

The Jason® membrane can be applied dry or pre-hydrated in sterile saline solution or blood from the defect. The initial placement of the dry membrane with subsequent application of the graft material is particularly advantageous for lateral augmentations. After rehydration the membrane can be folded over the defect. If needed, the membrane can easily be repositioned.

Membrane exposure

Exposure of the Jason® membrane should be avoided, since fast bacterial resorption significantly reduces the barrier function of the thin Jason® membrane. In case of an unstable soft tissue situation or if you expect a wound dehiscence to occur, it is recommended to cover the membrane with a Jason® fleece (where applicable, soaked in antibiotics) to protect the healing area.

Mixing with autologous bone

Mixing of a bone substitue material with autologous bone is always beneficial, as it confers a biological activity (osteo-inductive and osteo-genetic properties of autologous bone) that supports faster regeneration and improved formation of new bone.

GBR mit cerabone® und Jason® membrane - Dr. S. Stavar

Jason® membrane is a native pericardium membrane. Due to the distinctive and preserved collagen structure of pericardium, the Jason® membrane exhibits a slowed degradation with resulting prolonged barrier function. Therefore, Jason® membrane provides a sufficient barrier for the undisturbed regeneration even of larger defects and increasing the treatment success in more demanding situations.

In particular for the regeneration of larger horizontal defects and more extended augmentative procedures a grafting material with a high biologic potential such as maxgraft® granules should be preferred. Mixing the  allogeneic bone chips with the long-term stable cerabone® particles is especially beneficial. By mixing cerabone® with maxgraft® granules the advantages of both materials may be combined; the biological potential of maxgraft® based on preserved mineralized collagen along with the long-term stability of cerabone®. The combined application of both materials lead to fast regeneration and formation of vital, strong bone. For those who prefer to work with synthetic materials, the biphasic calcium phosphate maxresorb® offers a valid alternative. Nevertheless, it is always recommended to mix bone substitute materials with autologous bone chips, in particular in case of more extended or vertical defects.

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