Leaving the membrane exposed: when is this possible?
I have just started surgically installing implants. I have seen some cases involving grafting or bone augmentation where the membrane covering the graft was exposed and failure of the graft occurred. I have also seen cases where the membrane was exposed but the graft succeeded. Which graft materials can become exposed and still create a successful graft? Which membranes can become exposed and still have a successful graft? Are there graft materials that do not require a covering membrane?
4 Comments on Leaving the membrane exposed: when is this possible?
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CRS
7/3/2013
Cytoplast teflon membranes are left exposed, and Bioxclude (chorion) can be exposed and bio collagen technique with Bioguide can be exposed. The other membranes will break down sooner. Those are the ones I'm familiar with. The bone needs to be covered for best result an extraction site has a clot which can heal secondariy. Hope this helps.
Cliff Leachman
7/9/2013
A-PRF membranes can be left exposed. See site below.
http://www.a-prf.com/en/
Vipul G Shukla
7/9/2013
Teflon membranes are tougher to resorb and can occasionally be left exposed. Most collagen membranes resorb in about 4-6 weeks, some longer than others. When placing a resorbably collagen membrane to help hold the graft in place, it is inevitable in some cases, e.g. extraction sockets of large molars that some membrane will stay exposed, as primary closure is not possible. If they are sutured correctly and the graft particles are infused with good fresh blood, things should work out fine. Exception being heavy smokers.
Anyways, these days, I avoid placing membranes where I have good full thickness flap over graft site. I find I have better results. Blood supply from the periosteum sometimes is restricted with a membrane, however well placed.
In general, if the grafted particles receive good blood supply, and stay immobile during the healing phase, things will go well.
Good Luck!
CRS
7/10/2013
Cliff as always you are wise beyond your years I forgot about my PRGF membranes, since I don't trust my patients I usually will close primarily if I am not concerned about the vestibule. I have gotten some very nice preliminary results with the chorionic membranes also and am excited about using more of them!
