Scientific Literature



The rehabilitation of the severely resorbed posterior mandible remains a challenge. Even if many techniques of bone regeneration were tested with success in this area, they remain difficult surgeries and no consensus or standard have been raised yet. Because of the thick cortical bone of the mandible body, the alveolar bone regeneration or integration of a grafting material is often compromised. Moreover, the management of a regenerative compartment in this area is always difficult due to mechanical constraints and risk of soft tissue dehiscence.


In this series of article, we developed and illustrated the concept of Screw-Guided Bone Regeneration (S-GBR), with excellent results in the posterior mandible. In this form of GBR, the barrier between the bone and gingival compartment is supported and protected through the presence of screws, serving both as tent pegs to maintain the regenerative chamber space and as bone growth pillars.


Many combinations of bone materials and membranes are possible to get adequate results with various healing times, but the use of Leukocyte- and Platelet-Rich Fibrin (L-PRF) membranes as interposition, healing and maturation material became a common standard for us. L-PRF (Intra-Spin system and Xpression kit, Intra-Lock, Boca-Raton, FL, USA) is an optimized blood clot or membrane, which concentrates most of the platelets and half of the leukocytes of a blood sample.


Through the release of growth factors and the effect of fibrin, this material promotes - among other effects - quick soft tissue healing and maturation and is considered as a form of barrier for Guided Bone Regeneration. In this article, we describe a modification of the S-GBR protocol termed Fast Screw- Guided Bone Regeneration (FS-GBR), where the severely resorbed posterior mandible was treated mostly with screws, allograft material and L-PRF membranes in order to reduce significantly the healing and regeneration times of the alveolar ridges.

The concept of Screw-Guided Bone Regeneration (S-GBR). Part 3: Fast Screw-Guided Bone Regeneration (FS-GBR) in the severely resorbed preimplant posterior mandible using allograft and Leukocyte- and Platelet-Rich Fibrin (L-PRF): a 4-year follow-up



POSEIDO. 2013;1(2) Screw-­-Guided Bone Regeneration (S-­-GBR). Part 3 93


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