Localized bone reconstruction as an adjunct to dental implant placement.

Advances in bone reconstructive techniques, including the potential of barrier membrane usage for osteogenesis, have increased the indications for implant placement. This review discusses the critical biologic and clinical criteria involved in achieving a predictable success with barrier membranes. Experimental and clinical findings have shown that the type of adjunctive grafting material used, healing time of the membrane site, type and size of bone defect, and membrane exposure all influence the end result. Small bony defects like implant fenestrations and intact extraction sites seem not to depend on the application of membranes to regenerate bone membranes. Large bone grafts used for ridge reconstruction purposes might benefit from membranes, because they reduce the inevitable resorption of bone grafts when used alone. New developments in material and tissue engineering have introduced the use of resorbable membranes, xenografts, and osteoinductive proteins, such as recombinant human bone morphogenic protein, that are likely to play a role in the treatment of localized ridge deficiencies.