Guided Bone RegenerationBone augmentation for implants

When a tooth has been missing for a while, or was lost to infection or injury, the jaw bone there shrinks. Guided bone regeneration (GBR) rebuilds it, so an implant can be placed in the right position, with enough bone around it to last.

Why Bone Has to Be Rebuilt

The bone that held a tooth exists to support that tooth. Once the tooth is gone, the bone narrows and loses height, fastest in the first months after extraction. Gum disease, a failed implant, a long-standing infection or an injury can leave a larger defect still. An implant placed into too little bone is either placed in the wrong position, which shows in the final tooth, or left with a thin wall of bone that is prone to recession and failure.

GBR places bone graft material where bone is missing and covers it with a membrane that keeps the gum out, so the jaw grows new bone into the graft over the following months.

Horizontal and Vertical Augmentation

Horizontal augmentation widens a ridge that has become too thin. It is the most common form and the most predictable.

Vertical augmentation restores lost height. It is technically more demanding, takes longer to heal, and carries a higher rate of complications, but it is often the difference between an implant tooth of natural length and an unnaturally long one, or an implant that is not possible at all. Dr. Samadian treats both, along with combined defects left by failed implants, trauma and advanced gum disease.

The Materials

Each case uses a combination chosen for the size and shape of the defect:

Bone graft: your own bone, donor bone, processed animal-derived bone, or a mix
Sticky bone: graft particles bound with your own i-PRF into one moldable mass (see PRF)
Membranes: resorbable collagen, or non-resorbable PTFE, titanium-reinforced membranes or titanium mesh where the graft must hold a shape on its own
Tenting screws and tacks: small titanium supports that hold the membrane up over the graft so it is not compressed while it heals
Growth factors: PDGF or rhBMP-2 in larger or slower-healing defects (see growth factors)

Grafting and Implants: Together or Staged

Where there is enough bone to hold an implant steady, the implant can be placed and the missing bone grafted around it in the same surgery. Where there is not, the bone is grafted first and the implant placed once it has healed, usually several months later. Your plan states which applies to you and the expected timeline.

Soft Tissue Matters Too

A rebuilt ridge also needs enough healthy gum over it. Thin gum over an implant shows gray, recedes and is harder to keep clean. Dr. Samadian often thickens the gum with a soft-tissue graft or substitute at the time of grafting or at implant uncovering. See soft-tissue grafting.

Recovery

Expect swelling and bruising for several days, more with larger and vertical grafts, managed with prescribed medication. You will be asked not to wear a removable appliance that presses on the area, to eat on the other side, and not to smoke. Sutures stay for about two weeks. The graft then matures under the gum for several months before an implant is placed or uncovered.

Risks

Swelling, pain, bruising and bleeding; infection; exposure of the membrane or graft through the gum, which may mean removing part of it and re-grafting later; less bone gained than planned; numbness or altered sensation of the lip or chin after lower-jaw grafting, usually temporary but occasionally lasting; and, in the upper jaw, involvement of the sinus. Smoking and uncontrolled diabetes increase the risk of failure. These are explained in writing before treatment.

Related Treatments

Guided Bone Regeneration FAQ

What is guided bone regeneration?

GBR is a procedure that rebuilds missing jaw bone by placing a bone graft where bone has been lost and covering it with a membrane, so new bone grows into the space instead of gum tissue. It is usually done to prepare for, or alongside, a dental implant.

What is the difference between GBR and ridge augmentation?

Ridge augmentation describes the goal: rebuilding a jaw ridge that has shrunk. GBR is the technique most often used to achieve it, with a graft and a membrane.

How long does GBR take to heal?

The gum heals in about two weeks. The new bone takes several months to mature, longer for larger and vertical grafts. Your plan gives the expected timing before an implant can be placed.

Is bone grafting painful?

It is done under local anesthetic, with sedation available. Swelling and soreness for several days afterwards are normal and are managed with prescribed medication.

Can I get an implant if I've been told I don't have enough bone?

Often, yes. Missing width and height can usually be rebuilt with guided bone regeneration, a sinus lift in the upper back jaw, or both. Send your CBCT scan or X-rays for a review.

What happens if the membrane becomes exposed?

A small exposure is managed with careful cleaning and closer follow-up; a larger one may mean removing part of the membrane and some graft early. It can reduce the amount of bone gained, and in some cases a second graft is needed.

Treating patients throughout San Francisco. Dr. Samadian specializes in treatments such as smile makeovers, porcelain veneers, digital reconstructions, aesthetic dentistry, and dental implants. Focusing on regeneration and restoring tooth structure, bone loss, and gum recession utilizing the latest LANAP laser technology.