To use or not to use a membrane in GBR?

Membrane should be used in GBR horizontal or vertical defects, main purpose is to keep bone graft in place and avoid migration of non disared cells and tissues. I don’t use them in socket preservation, and sometimes in sinus lifts

Barriers are needed when the flap is partial thickness, there is no primary closure or the surgeon wants a definitive separation. Periosteum is a great barrier. If that is intact a barrier is not needed.

A membrane functions to prevent particulate graft loss/ migration, and the bone graft is essentially a barrier /space maintainer against gingival ingrowth until autogenous bone can develop. It makes a big difference with socket grafting. I've always used membranes for horizontal ridge augmentation so I can't speak for periosteum alone as a predictable barrier against graft migration.

No membrane required with Ethoss

As has been said a barrier is just that-a physical presence to hold in place unstable particulates and maybe prevent soft tissue in growth. There are numerous bone grafts available it in Europe, USA and rest of World that are highly porous Si clot stabilising or self stabilising (cement like, putty like or self binding) when these are used in periosteum preserving minimal flap techniques they replace the need for additional stabilisation.

Hello I am not a dentist or student of dentistry but I have a question. Is there anything available for someone who has had 2 implants fail due to bone loss even after attempts to rebuild the bone? Today I have an upper denture that I HATE after pulling the teeth required to prepare for the implants that eventually failed . Thank you in advance.

I was trained to think that the membrane is a BARRIER. It's function is to EXCLUDE unwanted ( faster growing and migrating) cells from the scaffold we want osteoblasts to occupy. Since there are no teeth in GBR concepts, there is no long junctional epithelum to worry about. So, which cells we want to exclude? Fibroblasts from periosteum? Some doctors say, if you put membrane, you will gain more bone tissue, if you don't, you will gain less. So, there are only nuances with fibroblasts, according to aforementioned doctors....does this feel right?

I agree with Peter, My patients bring their own membrane is called periosteum. For socket grafting y place the grafting material and the coagulum keeps it from extruding out of the socket. There is epithialization over the graft after 21 days the same as what happens with an extraction. If a flap is done in order to cover the graft as long as periosteum is what is covering the graft there is no soft tissue growth into the graft. If connective tissue is covering the graft then there may be soft tissue ingrowth into the graft

If you target GBR as augmataion technique you should use a membrane otherwise not important to cover bone with a barrier in each single case So according to the case !! Abdusalam Libya

Having read this I believed it was really enlightening. I appreciate you taking the time and energy to put this information together. I once again find myself spending way too much time both reading and leaving comments. But so what, it was still worthwhile!