"PASS" principles for predictable bone regeneration

Guided bone regeneration is a well-established technique used for augmentation of deficient alveolar ridges. Predictable regeneration requires both a high level of technical skill and a thorough understanding of underlying principles of wound healing. This article describes the 4 major biologic principles (i.e., PASS) necessary for predictable bone regeneration: primary wound closure to ensure undisturbed and uninterrupted wound healing, angiogenesis to provide necessary blood supply and undifferentiated mesenchymal cells, space maintenance/creation to facilitate adequate space for bone ingrowth, and stability of wound and implant to induce blood clot formation and uneventful healing events. In addition, a novel flap design and clinical cases using this principle are presented.