GBR with non-resorbable membrane

  • GBR with non-resorbable membrane
    Narrow alveolar ridge
  • GBR with non-resorbable membrane
    GBR using a bone graft and a non-resorbable membrane
  • GBR with non-resorbable membrane
    Implant insertion after regeneration
GBR is a technique used for the regeneration of lost alveolar bone by the help of a grafting material and a barrier membrane. The defect is filled with a bone graft material (allogeneic-, xenogeneic- or alloplastic bone substitute materials) that serves as a scaffold for ingrowth of bone forming cells (osteoconduction) and blood vessels, and prevents collapse of the overlying membrane and soft tissue. The membrane acts as a barrier agains 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. In particular, for the regeneration of defects outside the ridge contour, the use of a non-resorbable, volume stable membrane is recommended.
Implant placement and bone augmentation in the aesthetic zone using maxgraft® and permamem® - Dr. A. Puišys

Implant placed in the deficient site. permamem® in place for covering.


Initial situation - A young female 34 years old lost her front teeth in an surfing accident and she had a 5 unit bridge supported by her upper left lateral and right canine. The restoration failed and both supporting crowns have exposed and leaking margins.


permamem® can be easily manipulated and applied thanks to its thin character (thickness ~ 0.08 mm). The rounded edges of the membrane avoid traumatization of the soft tissues. permamem® can be cut to the desired shape and size with a pair of scissors or a scalpel while maintaining sterility. The blue color allow for easy recovery of the membrane.

Application & Fixation

To ensure membrane stability and protection of the bone grafting material, permamem® should be placed in such a way that the membrane extends three to four millimeters beyond the edges of the bone defect. A minimum distance of one millimeter to the adjacent teeth should be maintained. It is recommended to fix permamem® by sutures, screws or pins.

GBR with permamem® - Dr. Stavros Pelekanos
GBR with permamem® - Dr. Stavros Pelekanos

PTFE membranes like permamem® are the most commonly used non-resorbable membranes. The synthetic, inert nature of permamem® allows for its longer use without any negative side effects. permamem® maintains its structural integrity during implantation and over time. Moreover, permamem® has superior space-maintaining properties (as compared to collagen membranes) and capacity for cell occlusion. Due to its small pore size, permamem® acts as an efficient barrier against bacterial penetration, and is therefore advantageous in situations where primary closure cannot be achieved.

In particular for more demanding augmentative procedures mixing cerabone® with autologous bone or allogeneic bone chips (maxgraft® granules) is beneficial. By mixing bovine and allogeneic granules, the advantages of both materials may be combined; the biological potential of maxgraft® along with the long-term stability of cerabone® 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.

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