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Home·Expertise·Bone Grafting & GBR
Bone Regeneration

Guided Bone
Regeneration

Bone augmentation for implant sites with insufficient volume — horizontal, vertical, or combined deficiencies. Simultaneous or staged with implant placement, and frequently combined with soft tissue augmentation in a single surgical session.

Book a ConsultationFull-arch rehabilitation
At a Glance
ApproachSimultaneous or staged
Healing4–9 months
Combined withCTG / Implants
Guided byCBCT planning
Indications

When bone volume
is the limiting factor

Bone deficiency is the most common reason implant placement is deferred or deemed impossible without prior surgery. GBR expands what is achievable — in a single session where possible, staged where necessary.

I
Horizontal deficiency · Most common
Horizontal Bone Augmentation

Loss of buccal plate width — most commonly after extraction, trauma, or infection — results in a ridge too narrow for implant placement. Guided bone regeneration with a particulate graft and resorbable or non-resorbable membrane re-establishes the bone volume required. Simultaneous implant placement is possible where primary stability can be achieved.

II
Vertical deficiency · More demanding
Vertical Bone Augmentation

Vertical bone loss — following severe resorption or long-term edentulism — is more technically demanding than horizontal augmentation. Staged surgery is generally required: regeneration first, followed by implant placement after confirmed integration. Non-resorbable membrane fixation and tension-free wound closure are the critical technical requirements.

III
Posterior maxilla · Specific anatomy
Sinus Augmentation

Pneumatisation of the maxillary sinus following upper posterior tooth loss reduces available bone height for implant placement. Transcrestal (osteotome) sinus lift for moderate deficiencies, or lateral window sinus augmentation for severe deficiencies. Both approaches are well-supported by the evidence base and predictable in experienced hands.

IV
Combined approach · Single session
Simultaneous GBR + CTG

Where both bone volume and soft tissue architecture are deficient, addressing both in a single surgical session reduces total treatment time and anaesthetic exposure — while ensuring that the hard and soft tissue outcomes are planned as a unit. The critical technical requirement is tension-free primary closure over both the membrane and the graft.

Timing

Simultaneous or
staged — it depends

The decision between simultaneous and staged GBR is one of the most consequential in implant treatment planning. It is made in the digital planning phase — not at the surgical visit.

Simultaneous GBR — placing the implant and regenerating bone in the same surgical session — is possible when sufficient primary stability can be achieved despite the bone deficiency, and when the defect is contained and amenable to membrane management without risk of exposure.

The advantage is reduced total treatment time. The requirement is a rigorous pre-operative CBCT assessment confirming that the bone available at the planned implant apex will support adequate primary stability, and that the defect morphology supports membrane adaptation.

Staged GBR — regenerating bone first, then placing the implant after confirmed integration — is indicated when primary stability is not achievable, when the defect is large or irregular, or when the surgical complexity of simultaneous management would compromise the result of either procedure.

Staged surgery adds 4–6 months to the overall timeline but is the more conservative and predictable option for complex defects. The decision is not about preference — it is made on the CBCT data at the planning consultation.

Typical Timeline

What to expect
at each stage

Planning
CBCT, DSD, Treatment Plan

Digital assessment of bone volume, defect morphology, and implant positioning. Decision: simultaneous or staged. Full treatment timeline confirmed.

Surgery
GBR ± Implant Placement

Membrane placement, graft material, tension-free closure. Implant placed simultaneously where indicated. Local anaesthesia.

4–6 months
Healing and Integration

Radiographic assessment of bone regeneration. For staged cases: implant placement when integration confirmed. For simultaneous: loading assessment.

Final
Provisionalization and Restoration

Implant loading, emergence profile development, and final restoration delivery. Outcome assessment at 12 months.

FAQ

Common questions

Will I need a bone graft before my implant?
Not necessarily. Many implant placements proceed without any bone augmentation. Whether GBR is required is determined by CBCT analysis at the planning consultation — assessing the available bone volume at the planned implant site. If bone volume is sufficient, no augmentation is needed.
Where does the graft material come from?
Most GBR procedures in this practice use xenograft (bovine-derived) particulate combined with an autogenous bone component and a barrier membrane. Autogenous bone harvested from the surgical site is mixed with the particulate where available. The choice of materials is based on the defect type and the clinical evidence base.
Is bone grafting painful?
The procedure is carried out under local anaesthesia and is not painful during surgery. Post-operative discomfort is typically moderate and managed with standard analgesics for 3–5 days. Swelling is expected, particularly for lateral sinus augmentation — most patients manage this without significant impact on daily activity.
Can bone grafting fail?
GBR success rates in the clinical literature are high for horizontal defects. Vertical augmentation carries a higher risk of partial or complete failure due to membrane exposure — the most common complication. Smoking, inadequate soft tissue management, and wound dehiscence are the primary risk factors. These are discussed at the planning consultation.
Related Procedures

Often combined

Full Arch
Full-Arch FP1 Rehabilitation

GBR is frequently part of full-arch rehabilitation — addressing bone deficiencies identified in the digital planning phase before or during the surgical session.

 Soft Tissue
Mucogingival Surgery

Simultaneous GBR and CTG in a single session — addressing both hard and soft tissue deficiencies together where the tissue architecture allows.

 Digital
Guided Implant Surgery

The GBR plan is integrated into the same digital workflow as the implant placement — ensuring the regenerated volume is designed around the prosthetic outcome.

Bone volume assessed
before any commitment.

The planning consultation includes CBCT analysis confirming whether GBR is needed, what approach is indicated, and what the realistic timeline is — before any surgical commitment.

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