GUIDOR® Bioresorbable Matrix Barrier: Patient-Friendly Support for Implant Placement
Sebastiano Andreana, DDS, MS, uses GUIDOR® Bioresorbable Matrix Barrier in his private practice for the many advantages it offers him as an implant dentist who performs guided bone and tissue regeneration procedures. Although the dental school does not endorse any specific product, he teaches his techniques at the University at Buffalo, where he is Associate Professor and Director of Implant Dentistry in the Department of Restorative Dentistry.
The GUIDOR matrix barrier is a synthetic, translucent bioresorbable bone grafting membrane used by implant doctors in guided tissue regeneration and guided bone regeneration procedures performed prior to or at the time of implant placement. Its composition is based on bioresorbable polylactic acid blended with a citric acid ester, compounds that have been safely used in the food and medical industries for more than 20 years, Andreana notes. Its barrier function is maintained for a minimum of 6 weeks to allow for regeneration of lost tissues, providing space for regeneration, thereby allowing for growth of newly formed tissues. “With GUIDOR, gingival connective tissue from the gingival flap integrates with the matrix to create the optimum conditions for regeneration,” he says.
The use of GUIDOR for implant patients, Andreana comments, typically may involve two clinical scenarios. In “borderline” cases, it is possible to place the implant; however, additional bone may be needed. In such a case, he says he uses GUIDOR to protect the bone graft that is around the implant. “It resorbs after 6 to 8 weeks, depending on the particular situation, which gives my bone graft time to start turning into live bone,” he explains.
However, when implant placement is not indicated due to deficient bone, he takes a two-step approach. “If I try to place an implant in an area where the bone is deficient, the implant won’t be stable. Therefore, I need to build up the bone first.” In this case, he says, he performs the bone grafting first, then protects the bone graft with the GUIDOR membrane. Then, 4 to 6 months later, depending on the size of the defect, he places the implant.
Because the product is resorbable, there’s no need to bring the patient in for a second procedure to retrieve the membrane, Andreana says. This makes it more convenient for both patients and practitioners and avoids morbidity that may be associated with a second procedure, including gingival recession, particularly in patients with a thin biotype.
Andreana especially appreciates the handling properties of the material, which he says easily adapts to the defect shape and can be cut and shaped to precisely cover the area, offering control and predictability. “The material is stiff but not overly so. At body temperature, it becomes softer and malleable, so it drapes over the area of the bone I need to grow, yet it’s firm enough to be easily moved,” he asserts.
GUIDOR can be left exposed to the oral environment, Andreana adds, because it retains its mechanical barrier effect. He says it is also “tissue-friendly” since “there is no irritation or inflammatory process due to the degradation of the membrane because of the particular chemical composition of the membrane itself.”
According to Andreana, approximately 2.5 million implants are placed each year and the number is growing. This is a trend that he believes is certain to continue, especially now that dental students are exposed to implant dentistry in their dental school curriculum. “This was not the case in the past when implant placement was restricted to a limited number of practitioners,” he explains.
While Andreana notes that there is a learning curve involved in mastering the use of any new material, the GUIDOR membrane, he says, is designed to help clinicians avoid incorrect placement of the membrane, since it is mechanically engineered and designed to clearly differentiate the bone and soft-tissue sides. In fact, the side that should be facing soft tissue is marked with an “S,” making it “nearly error-proof.” It’s a solution, he adds, that is both doctor- and patient-friendly.
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