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Guided Bone Regeneration: biological principle and therapeutic applications

TLDR
The authors conclude that future research should focus on the investigation of the molecular mechanisms underlying the wound healing process following GBR application and the evaluation of the pathophysiology of the GBR healing process in the presence of systemic conditions potentially affecting the skeletal system.
Abstract
The Guided Bone Regeneration (GBR) treatment concept advocates that regeneration of osseous defects is predictably attainable via the application of occlusive membranes, which mechanically exclude non-osteogenic cell populations from the surrounding soft tissues, thereby allowing osteogenic cell populations originating from the parent bone to inhabit the osseous wound. The present review discusses the evolution of the GBR biological rationale and therapeutic concept over the last two decades. Further, an overview of the GBR research history is provided with specific focus on the evidence available on its effectiveness and predictability in promoting the regeneration of critical size cranio-maxillo-facial defects, the neo-osteogenesis potential and the reconstruction of atrophic alveolar ridges before, or in conjunction with, the placement of dental implants. The authors conclude that future research should focus on (a) the investigation of the molecular mechanisms underlying the wound healing process following GBR application; (b) the identification of site and patient related factors which impact on the effectiveness and predictability of GBR therapy and (c) the evaluation of the pathophysiology of the GBR healing process in the presence of systemic conditions potentially affecting the skeletal system.To cite this article:Retzepi M, Donos N. Guided Bone Regeneration: biological principle and therapeutic applications.Clin. Oral Impl. Res. 21, 2010; 567-576.doi: 10.1111/j.1600-0501.2010.01922.x.

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Recent advances in the development of GTR/GBR membranes for periodontal regeneration--a materials perspective.

TL;DR: It is hypothesized that the next-generation of guided tissue and guided bone regeneration (GTR/GBR) membranes for periodontal tissue engineering will be a biologically active, spatially designed and functionally graded nanofibrous biomaterial that closely mimics the native extra-cellular matrix (ECM).
Journal ArticleDOI

Guided bone regeneration: materials and biological mechanisms revisited.

TL;DR: Experimental data suggest that different modifications of the physicochemical and mechanical properties of membranes may promote bone regeneration, Nevertheless, the precise role of membrane porosities for the barrier function of GBR membranes still awaits elucidation.
Journal ArticleDOI

Drug loaded homogeneous electrospun PCL/gelatin hybrid nanofiber structures for anti-infective tissue regeneration membranes

TL;DR: The potential for using MNA-loaded PCL/gelatin electrospun membranes as anti-infective GTR/GBR membranes to optimize clinical application of GTR-GBR strategies is indicated.
Journal ArticleDOI

The role of barrier membranes for guided bone regeneration and restoration of large bone defects: current experimental and clinical evidence

TL;DR: Before clinical applications can be recommended, future research should aim to establish the 'ideal' barrier membrane and delineate the need for additional bone grafting materials aiming to 'mimic' or even accelerate the normal process of bone formation.
Journal ArticleDOI

Electrospun microfiber membranes embedded with drug-loaded clay nanotubes for sustained antimicrobial protection.

TL;DR: The sustained release of metronidazole from the membranes prevented the colonization of anaerobic Fusobacteria, while eukaryotic cells could still adhere to and proliferate on the drug-loaded composite membranes.
References
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Journal Article

The long-term efficacy of currently used dental implants: a review and proposed criteria of success.

TL;DR: Criteria for the evaluation of dental implant success are proposed and an attempt has been made to standardize the basis for comments on each type of implant.
Journal ArticleDOI

New attachment following surgical treatment of human periodontal disease.

TL;DR: The hypothesis that new connective tissue attachment may form on a previously periodontitis involved root surface provided cells originating from the periodontal ligament are enabled to repopulate the root surface during healing is tested and the concept that theperiodontitis affected root surface is a major preventive factor for new attachment is invalid.
Journal ArticleDOI

Healing of bone defects by guided tissue regeneration.

TL;DR: Using a membrane technique, fibroblasts and other soft connective-tissue cells are prevented from entering the bone defect so that the presumably slower-migrating cells with osteogenic potential are allowed to repopulate the defect.
Journal Article

Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement

TL;DR: The maxillary sinus augmentation procedure has been well documented, and the long-term clinical success/survival (> 5 years) of implants placed, regardless of graft material(s) used, compares favorably to implants placed conventionally, with no grafting procedure.
Journal ArticleDOI

New attachment formation as the result of controlled tissue regeneration

TL;DR: The test surfaces exhibited considerably more new attachment than the control surfaces, indicating that the placement of the membrane favoured repopulation of the wound area adjacent to the roots by cells originating from the periodontal ligament.
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