Abstract: Guided bone regeneration constitutes a cornerstone technique for addressing alveolar bone insufficiency in oral implantation，and its success critically depends on the stable establishment of a regenerative microenvironment，especially space‑maintenance capacity. With the continuous expansion of implant indications，the proportion of unfavorable bone defects，encompassing vertical defects，combined horizontal‑vertical defects，and anterior aesthetic zone deficiencies，has increased substantially，thereby imposing formidable challenges on the spatial support capacity of guided bone regeneration modalities. Although resorbable collagen membranes possess favorable biocompatibility and operative convenience，their intrinsic biomechanical limitation，namely，precipitous early‑phase degradation in tensile strength，precludes effective counteraction of protracted soft tissue compression throughout the months‑long bone healing cascade，causing regenerative compartment collapse，particularly in vertical augmentation. Non‑resorbable membranes，represented by titanium mesh and high‑density polytetrafluoroethylene membranes，have emerged as indispensable methods in tackling unfavorable bone defects because of their superior mechanical rigidity and sustained spatial stability. This review begins with an exposition of the biological foundations of guided bone regeneration and the PASS principles，proceeds to systematically delineate the standardized clinical workflow and the distinctive resorption patterns inherent to routine guided bone regeneration，and provides an in‑depth analysis of the supportive inadequacies of resorbable membranes in complex situations. In addition，the article gives emphasis to the introduction of the application strategies，clinical performance，and complication management of membrane‑supporting guided bone regeneration in vertical and combined defects. Finally，a prospect is made on the development trend of the techologies including digitalization and biofunctionalization，with the aim of providing references for clinical decision‑making.

Key words: guided bone regeneration, unfavorable bone defects, membrane-supporting strategy, space maintenance, vertical bone augmentation

摘要： 引导骨再生是解决口腔种植区骨量不足的核心技术之一，其成功高度依赖于再生微环境的稳定构建，尤其是空间维持能力。随着种植适应证的不断拓展，垂直骨缺损、联合骨缺损及前牙美学区骨缺损等不利型骨缺损的比例显著增加，对引导骨再生技术的空间支撑提出了严峻挑战。可吸收胶原膜虽具有良好的生物相容性和操作便利性，但其早期力学性能衰减过快，难以在长达数月的骨愈合周期内有效对抗软组织压力而导致再生空间塌陷，这在垂直骨增量中尤为突出。以钛网和高密度聚四氟乙烯膜为代表的不可吸收膜，凭借其优异的刚性支撑和长期空间稳定能力已成为攻克不利型骨缺损的关键手段。文章从引导骨再生的生物学基础与PASS原则出发，系统阐述常规引导骨再生的标准化临床流程与骨吸收规律，深入分析可吸收膜在复杂场景中的支撑局限性，并重点介绍在垂直及联合骨缺损中膜支撑引导骨再生的应用策略、临床效果与并发症管理，最后展望数字化、生物活性化等技术的发展趋势，以期为临床决策提供参考。

关键词: 引导骨再生, 不利型骨缺损, 膜支撑策略, 空间维持, 垂直骨增量