Cytoflex Tefguard Textured PTFE Membrane

Cytoflex® Tefguard® is a non-resorbable expanded PTFE material membrane for use as a space-making barrier in guided tissue regeneration procedures. Composed of a proprietary micro-porous polytetrafluoroethylene ePTFE) thin film, Cytoflex® Tefguard® has a surface texture and porosity suitable for adhesion of host cells to the material while preventing passage and integration of bacteria within the interstices of the material. The supple membrane conforms easily to tissue contours, and yet offers sufficient stiffness to maintain a space over the bony defect.

Cytoflex ® Tefguard ® - Clinical Case Review

MINIMALLY INVASIVE IMPLANT SITE GRAFTING TECHNIQUE Jenchun Chen DDS

This is a 38 year-old female who presented with a crown-root fracture of the mandibular first molar and a thin gingival biotype. An immediate implant placement following tooth extraction was planned. A flapless, minimally invasive extraction and implant placement combined with guided tissue regeneration was employed to minimize soft and hard tissue recession.

The tooth root was extracted with an intrasucular incision and a periosteal elevator. The extraction socket was curetted to remove all soft tissue remnants. After an implant was placed into the extraction site, the gap between the implant and the socket wall was filled with bone graft particles (Figures 1 & 2). A Tefguard® ePTFE membrane was trimmed to extend 3 mm beyond the socket walls and then tucked subperiosteally under the lingual flap, the buccal flap and underneath the interdental papilla using a curette.

The membrane was allowed to rest passively over the socket (Figure 3), and was stabilized with a criss-cross absorbable PGA monofilament suture without primary closure (Figure 4). After one-week post operation, the graft site was uneventful, and the suture was removed (Figure 5). At three-week post-operation, the soft tissue overlying the exposed membrane demonstrated healing without signs of inflammation. An inadvertent fold in the membrane (introduced during membrane placement) was found at the distal buccal corner (Figure 6).

The decision was made to remove the membrane early to prevent potential complications as a result of the folding of the membrane. After applying topical anesthetic, the membrane was easily removed by grasping with a tissue forcep. A dense, vascular connective tissue matrix was found underlying the membrane in the extraction socket upon membrane removal. Figure 7 shows the site at one week after membrane removal.

Following membrane removal, keratinized gingiva began to form over the grafted socket. At six-week post-operation, the soft tissue was stable with preserved interproximal papillae and natural mucogingival architecture (Figure 8). This case demonstrates the use of a less invasive grafting technique using a micro porous ePTFE barrier.