Is it necessary to use a membrane in bone grafting?

A membrane is a barrier placed over bone graft to keep the bone from growing into the bone cavity. Resorbable and non-resorbable membranes are barrier membranes used in guided bone regeneration procedures.
 
The use of membrane in the bone grafting process depends on the graft material and the defect.
 
To answer the question: Is it necessary to use a membrane in bone grafting? We first need to know what problem the use of membrane tries to solve:
 
i. Use of substitutes with little porosity for an invasion of fibroblast can be used in preventing soft tissue in growth.
ii. Other methods can be used to enhance the stability of graft e.g. setting of the graft.
 
For the most predictable result the use of membranes is recommended. However some dentist and implant specialist do not use a membrane but the final result may not be as predictable. You may be forced to go through the procedure a second time.
 
Every type of membrane has properties that are unique to it. Say:
 

  • Polytetrafluoroethylene (PTFE) membrane prevent epithelial down growth and prevent bacterial invasions to the graft. This membrane can be left exposed
  • Resorbable membranes are cell occlusive and do require primary closure so the membrane is not exposed to the oral saliva and bacteria.

 
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