Clinical Classification of Healing Complications and Management in Guided Bone Regeneration Procedures with a Nonresorbable d-PTFE Membrane

Since the introduction of guided bone regeneration (GBR) using nonresorbable membranes, membrane exposure has been categorized as one of the major complications associated with the procedure. Expanded polytetrafluoroethylene (e-PTFE) has a long history of use in GBR, and now the use of high-density PTFE (d-PTFE) is commonly reported in the literature. The major structural difference between these two materials is their permeability to bacteria: e-PTFE has an open-pore microstructure and is permeable to bacteria, while d-PTFE is not. Thus, there are fundamental differences in the two materials if premature exposure occurs. Protocols for classification and management of exposure specific to e-PTFE have been published and were well-received by clinicians, but these protocols do not necessarily apply to d-PTFE exposures. Because of the fundamental structural differences between these two PTFE materials, a protocol specific to the classification and management of d-PTFE membrane healing complications is required and is thus presented in this paper.