Contributing Factors to Bone Graft Loss in Guided Bone Regeneration: A Case Report

Guided bone regeneration (GBR) is one of the most commonly used techniques for alveolar ridge augmentation. With the increasing demand for implant treatments and ridge augmentation, the prevalence of GBR complications has also increased. Herein, we discuss the factors affecting particulate graft integration in the GBR technique, and describe re-treatment of a failed site.

GBR with particulate xenograft bone material was performed in a systemically healthy young female. After 6 months, the re-entry surgery revealed failed graft integration despite the clinically normal appearance of the site, and uneventful healing period. The failed site was re-treated successfully with cortical tenting technique, and re-entry revealed integrated graft after 5 months from the second surgery.

In addition to the PASS principle to achieve successful results in GBR, the graft particle properties, compaction force of the graft particles, defect characteristics, and waiting time for graft maturation are some of the factors that may affect the results of GBR. Cortical tenting could be a predictable technique for subsequent grafting in failed GBR sites.