BioMend : Features & Benefits

Postoperative Protocol

Potential Complications

Very few complications were encountered with BioMend membrane during clinical investigation.*

Possible complications with any periodontal surgery include swelling of the intraoral tissue, thermal sensitivity, gingival recession, excessive gingival bleeding, dehiscence of the flap, resorption or ankylosis of the treated root, some loss of crestal bone height, infection, pain or complications associated with anesthesia.

Spontaneous exfoliation of the material may occur in the immediate post-operative period if the absorbable collagen membrane is not adequately covered by the gingival flaps. This has been observed with other GTR membranes and is not related specifically to the use of BioMend membrane.

If the membrane becomes exposed, the patient should be monitored closely. Rinsing with 0.12 percent chlorhexidine gluconate is recommended. Re-epithelialization over the membrane may occur due to the unique environment that BioMend membrane provides.

Postoperative Protocol

The following items should be considered in treating the GTR patient postoperatively:

A broad-spectrum antibiotic may be prescribed following surgery to reduce bacterial populations associated with infection. During clinical trials, patients were prescribed tetracycline for 10 days following surgery. Tetracycline is a broad spectrum antibiotic known to be effective on gram-negative bacteria commonly associated with degenerative periodontal conditions. Prescribing an antibiotic regime is left to the discretion of the clinician.
Periodontal packing may be applied to the wound site. This is a matter of clinician preference, and care must be taken not to over-compress the area.
Patients should rinse with one-half ounce of 0.12 percent chlorhexidine gluconate twice daily for four weeks following surgery. The wound site may additionally be swabbed with a cotton-tipped applicator dipped in chlorhexidine which may be prescribed following surgery to reduce bacterial populations associated with infection.
The patient should refrain from brushing the treated area for two weeks following surgery. After this period, the patient may be instructed to gently brush the area with a soft toothbrush. Instruction will be dependent on an evaluation of wound healing. Care should be taken not to irritate the gingival tissues or cause micro-movements to the membrane. For the same reasons, dental floss should not be used at the site prior to four weeks following surgery. The patient should be seen seven to ten days following surgery for wound evaluation and removal of any closing sutures or periodontal packing. These follow-up visits should be repeated every two weeks there after, up to six to eight weeks following surgery. At this point, the patient may return to a normal oral hygiene regimen.
Coronal scaling and prophylaxis can be performed at follow-up visits, if indicated.
The GTR membrane should be completely absorbed eight weeks following surgery. However, probing and subgingival scaling should not be performed prior to six months following surgery to prevent damage to immature regenerated tissues. Although radiographs maybe taken at six months following surgery, any regenerated bone will be very immature and lack radio density. It is suggested that radiographs be repeated at a later time in order to truly assess the bone fill. Other assessments of clinical health may be repeated including plaque, bleeding, and tooth mobility indices.

*Yukna CN, Yukna RA. Multi-center evaluation of bioabsorbable collagen membrane for guided tissue regeneration in human Class II furcations. J Periodontol 1996;67:650-657.