Early suture breakage on bone graft: how to proceed?

Question was the intent of the membrane to obtain primary closure to hold the bone graft in? Cytoplast can be exposed to allow tissue to be guided. The membrane may fall out depending on how deeply it is placed. I trim them back as the tissue is healing then pull it out @ 4-6 weeks depending on what you are trying to do. This probably did not need primary closure if the implant is stable. If you really need primary closure a well elevated flap with periosteal release to cover with a resorbable membrane is probably better unless you were trying to regenerate the buccal plate.

Had a thought what kind of suture did you use?

Go back to sleep.... You have nothing to fear, the membrane is there to initially shield the surgical site from the oral cavity......but shortly after the surgery, an osteoid starts to form and the particulate graft will be incorporated into it.......PTFE membranes almost always get uncovered early on.......

I would not have used chlorhexidine if there will be some secondary intention healing as several studies in the literature show that CH retards fibroblast growth

Remove an implant because the sutures holding Cytoplast on top came loose after one week? As Dr. Rudick says, Go back to sleep. Worse things have happened and a properly placed fixture with good initial stability has weathered the storm.

I think CRS is saying that he pulls out the membrane not the implant and yes go back to sleep

Misch says, "God loves you. Leave it alone!" Even without a membrane it may heal well, so it your Cytoplast stays for 4-6 weeks (or more) your odds only improve.

I agree with Dr. T No chlorhexidine after any type of surgery. It alters bone and soft tissue formation. If you want to use it, have the patient rinse well and then also rinse well before surgery. If there is an infection after surgery then that is a different story Raul

The flap probably had tension. If the base of the flap were cut the sutures would not have loosened. I like to use a bis acryl stent since it holds and protects the flap. Tension free closure is paramount.

Dennis, You are right when closing a flap there should be no tension Raul