Guided bone regeneration in implant dentistry: a systematic review

Abstract

Introduction: The rehabilitation of the dental arch with osseointegrated implants makes it possible to improve the quality of life of patients. Guided bone regeneration (GBR) has been applied to replace lost bone to allow the implant to be fully integrated and maintained during functional loading. GBR is considered one of the most commonly applied methods to reconstruct alveolar bone and to treat peri-implant bone deficiencies. Objective: It was to develop a systematic review to highlight the main approaches of guided surgery to promote bone regeneration in implant dentistry. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from March to May 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 1977 (Golden pattern - Bra°nemark et al. ) to 2023. Results and Conclusion: A total of 117 articles were found, 38 articles were evaluated and 28 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 15 studies that did not meet GRADE. It was concluded that the application of a membrane to prevent nonosteogenic tissues from interfering with bone regeneration is a fundamental principle. Membrane properties and biological outcomes drive bone regeneration in membrane-covered defects. Barrier membranes play the role of preventing the invasion of soft tissue by exiting the mucosa and creating an underlying space to support bone growth. Collagen membranes have excellent biological properties and bone regeneration results. While collagen membranes do not provide sufficient mechanical protection of the covered bone defect, titanium-reinforced membranes, and non-resorbable membranes need to be removed in a second surgery.