Christer Dahlin: Site preservation and site build-up

Based on over 20 years experience and as one of the pioneers of this technique, Dr Dahlin reviews history, principles and potential future developments of guided tissue regeneration (GBR). Illustrated by clinical examples, Dr Dahlin discusses physiological bone resorption patterns after tooth extraction, with the bundle bone being a tooth related structure, and in relation to the gingival biotypes and gender influences, as well as the reaction of the biological width. The classical use of GBR was as a barrier to prevent soft tissue cells to enter the bone defect area, and working as a graft container. Today GBR is a restoration driven augmentation technique and used in over 40 % of implant surgery procedures globally. Tissue cells respond differently to the various types of membranes available. Future approaches in using GBR membranes will therefore be more proactive in order to support tissue response, blood vessel formation and early wound healing. Dr Dahlin discusses a new membrane type, Xeno protect, which offers improved handling characteristics and enhances angiogenesis in the augmentation area to support the wound healing process. Dr Dahlin concludes that barrier membranes play a more active role in the healing phase than previously thought.