From Defect to Regeneration: Strategies for Predictable Bone Augmentation

Achieving predictable bone regeneration is a fundamental challenge in implant dentistry, particularly in the esthetic zone, where both functional and biological outcomes must meet demanding expectations. This lecture will explore contemporary strategies for horizontal bone augmentation, with a focus on Guided Bone Regeneration (GBR) in esthetically demanding sites. Emphasis will be placed on clinical decision-making, defect assessment, case selection, and the principles that determine regenerative predictability. The lecture will provide a step-by-step approach to GBR, covering surgical principles, flap design, defect management, graft stabilization, membrane selection and fixation, soft-tissue management, and primary closure. Different biomaterials and regenerative materials will be discussed, including their biological properties, indications, advantages, and limitations. Clinical cases will illustrate how to translate biological principles and scientific evidence into predictable surgical protocols, highlighting key factors that can influence the success and stability of horizontal augmentation. The presentation will be supported by a critical review of the current literature, focusing on evidence-based protocols and long-term clinical outcomes. The goal is to provide clinicians with a practical and scientifically grounded framework for transforming challenging horizontal defects into predictable regenerative outcomes and stable foundations for implant rehabilitation.

Learning objectives:

1. Identify and assess horizontal bone defects in esthetically demanding areas and select appropriate augmentation strategies based on clinical and biological factors.
2. Understand the biological principles of Guided Bone Regeneration (GBR)and the evidence supporting different regenerative approaches.
3. Apply a step-by-step surgical protocol for horizontal augmentation, including flap design, defect management, graft selection, membrane stabilization, and soft-tissue closure.
4. Select and use appropriate biomaterials and regenerative materialsbased on their properties, indications, and the current scientific evidence to achieve predictable outcomes.