[Diagnostic / Planning]  Extraction of Failed Bridge and GBR

Good Morning everyone,

Teeth 45 & 47 will be extracted.  I am planning to do GBR  sticky bone once the teeth and infection has been removed.

I would like to grow a decent tumour in this site and was wondering if anyone could make a few suggestions to ensure success.  I have done a few dozen of these with a surederm membrane sandwiched between L-PRF membranes housing the graft.  Some have turned out great while others have been less than impressive.  Just want to make sure I'm doing it technically correct.  I haven't used screw tacks or non-resorbable membranes yet but suspect this could make a big difference in my results.

Thanks for any insights/advice you all may have



by Anand Choubal at Wed, May 23, 2018 6:43 AM

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Ho-Young Chung Replied at Wed, May 23, 2018 4:37 PM

how long are you planning on waiting after exos prior to performing GBR for 45-47 sites?  I'm not sure of your exact plan but I suggest extract first.  then perform GBR after 2 months at minimum so that soft tissue has formed over the sockets.  This way you can achieve primary closure and also gain KT.  

one of the critical factors in success of GBR is primary closure.  Yes, tacks or screws are great and I use them for most GBR cases but without proper handling of soft tissue, we are doomed for failure.  This includes suturing as well.  

I wouldn't use non-resorbable membrane in this case.  Use collagen membrane but make sure it does not get exposed.  This may seem like a simple concept getting primary closure but most GBR failures are due to improper technique.  

We covered all these details at the last GBR course a couple weeks ago at Bites.  next course is coming up on Saturday, September 29 at Bites in Burnaby.