Guided Bone Regeneration in implant dentistry

Guided Bone Regeneration in implant dentistry

378 J. Dent. 1995; 23: No. 6 to understand, the first chapter deals with the theoretical basics. Chapters 2-5 are about the classical indications fo...

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378

J. Dent. 1995; 23: No. 6

to understand, the first chapter deals with the theoretical basics. Chapters 2-5 are about the classical indications for their use as cements, luting restorative cements and lining cements, while Chapter 6 focuses on modified cavity designs. Chapters 7 and 8 give valuable practical advice on handling these materials for both the dentist and dental assistant. The appendix contains a list of instruments to be used as well as a reading list. The author has addressed the needs of the practising dentist and also has valuable information for dental assistants; his book should therefore find a place in any practice. Most of all, its value lies in its excellent illustrations. Approximately 200 colour photographs are of clinical sequences showing how the cements are to be used in daily practice. The documentation of long term studies emphasises that excellent results can be achieved. As well as the classic indications, the repair of inlay and crown margins and of fillings and broken cusps is described. A critical evaluation of the controversial tunnel preparation and sandwich fillings in class II cavities would be desirable, and the etching of glass-ionomer cements as base materials is also controversial. In the third edition, Figures 5.23 and 5.30 should be reversed because the etching has been too extensive. In conclusion, this atlas impressed this reader with its excellent illustrations and comprehensive text and can therefore be warmly recommended to dentists and students as a practical aid. The colour photographs justify the cost. V. Fritz Guided Bone Regeneration in Implant Dentistry. D. Buser, C. Dahlin and R. K. Schenk. Pp. 270. 1994. New Malden, Quintessence. Hardback, g92.00 ISBN 0 86715 249 4. The description of the principles of osseointegration has led to one of the most exciting and successful developments in dentistry in recent years, that of dental implantology. As the indications for their use have expanded, problems are sometimes encountered in the lack of adequate bone for implant placement. This book describes the development, scientific background and clinical application of techniques of Guided Bone Regeneration (GBR) whereby an occlusive membrane such as expanded polytetrafluoro-ethylene (ePTFE, Gore TexTM) is placed in surgical sites in order to overcome many of these problems and promote new bone formation. The editors have assembled an impressive list of authors to give a comprehensive and authoritative account of this technique and produced an easily readable, comprehensively and beautifully illustrated book of the highest quality. The book is organised conceptually into two halves, the first dealing with the background and scientific rationale of GBR, and the second with specific clinical indications and methods. The book opens with a short account

Of basic anatomical, surgical and aesthetic considerations in implant dentistry and establishes some of the problems that can be encountered. Chapter 2 is titled the “Scientific Basis of Guided Bone Regeneration” and is an account of its development, and includes much of the early experimental evidence obtained using animal models. This is followed by an appropriately lengthy chapter on the biological basis of bone regeneration which is a most commendable distillation of an enormous scientific literature and is presented in terms which the clinician should find readily accessible. Chapter 4 deals with design criteria for suitable membranes and is a thoughtful discussion of the requirements for successful materials. Some may be disappointed that the use of restorable membranes is not given more attention here, but the chapter accurately reflects the current status of knowledge and emphasises the wide experience now available with the use of Gore TexTM membranes. The next three chapters deal with specific uses of GBR for bone promotion in immediate extraction sockets, in dehiscence defects and for localised ridge augmentation. These chapters have a similar format, giving the background and the specific indications, a detailed description of the surgical techniques employed, and the presentation of data from clinical studies in support of the success of the method. The discussion of clinical problems and treatment failures encountered during the development of the techniques is particularly valuable and informative. Many of the techniques described advocate the combined use of GBR with autogenous bone grafting to maintain space beneath the membrane. Intellectually, it would have been interesting to address in more detail whether in these circumstances the graft acts primarily as a space maintainer, or the membrane to retain the graft. The final chapter deals clearly with the use of GBR in complex surgical problems in conjunction with bone grafts, including the sinus and nasal floor mucosal lift procedure. The text is complemented throughout by copious colour illustrations of the highest quality, including detailed serial clinical photographs. The extensive histology deserves special mention for its clarity, illumination of the text and general technical excellence. The references are comprehensive which adds to the authoritative overview of the subject matter and the editors are to be commended for the uniformity of the text. Given the rather specialised subject matter, this is not a textbook for every dentist, but would be a wise acquisition for any clinician or researcher in the field. It should find a home in all good dental libraries. Further, if you are an admirer of well produced books, are curious about developments in this area, and have f92 to spare, then I can thoroughly recommend it. F.J. Hughes