Maintaining Primary Closure After Guided Bone Regeneration Procedures: Introduction of a New Flap Design and Preliminary Results

Abstract

Various flap designs have been proposed by numerous authors for the maintenance of passive primary soft tissue closures following guided bone regeneration (GBR) procedures. A previous publication by the present author documented the maintenance of passive soft tissue primary closures 96.1% of the time at least 6 months after GBR therapy in all areas of the mouth. Although seemingly impressive, a 96.1% success rate means that there is premature membrane exposure 3.9% of the time. A new flap design is introduced for use in conjunction with previously described flap designs to lessen the incidence of premature membrane exposure. A total of 173 sites treated with GBR therapy were examined up to 6 months postoperatively to assess the ability to maintain passive soft tissue primary closure. Any membrane exposure during this 6-month postoperative period was deemed a failure, even if the site was successfully treated with an implant placement and restoration. A total of 171 of 173 GBR-treated sites demonstrated the maintenance of a soft tissue passive primary closure 6 months postoperatively, yielding a success rate of 98.8%. The introduction of the proposed flap design for use in conjunction with previously described flap designs significantly reduced the incidence of premature membrane exposure after a variety of GBR procedures.