Implant Tribune U.S. No. 5, 2011
Bone harvesting: nice and easy / Industry Events
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[1] =>
IMPLANT TRIBUNE
The World’s Dental Implant Newspaper · U.S. Edition
May 2011
www.implant-tribune.com
Hands-on workshops create additional learning opportunities at
the Osteogenics’ 2011 Global Bone
Grafting Symposium. (Photo/Provided by Osteogenics Biomedical)
Clinicians
gather for
Osteogenics’
Global Bone
Grafting event
More than 350 clinicians from 10
countries gathered in Scottsdale, Ariz.,
on April 1 and 2 to attend Osteogenics’ 2011 Global Bone Grafting Symposium, a continuing education event
focused on dental bone grafting and
treatment planning.
At the event, hosted by Osteogenics
Biomedical, world-renowned speakers led lectures, interactive treatment
planning sessions and optional handson workshops offering a variety of
treatment perspectives and protocols.
This year’s speakers included Drs. Paul
Fugazzotto, Suzanne Caudry, Barry
Bartee, Tom Wilson, Paulo Coelho,
Sascha Jovanovic, Istvan Urban, Dan
Cullum and Craig Misch.
“This year’s symposium attracted a
record group of doctors,” said Shane
Shuttlesworth, Osteogenics’ president.
“The growing success of our annual
symposium is in a large part thanks
to the quality, credibility and variety
of speakers that we have been able to
partner with.”
“Every year the program is unique,”
said Dr. Stephen Folson, a periodontist
from Peoria, Ariz. “They bring speakers in worldwide, and I take home to
my office on Monday morning applications that I have gleaned from the
meetings on an annual basis.”
New to the symposium this year,
clinicians had the option to choose
one of three pre-symposium handson workshops. The limited attendance
workshops, led by Caudry, Cullum
and Jovanovic, sold out weeks prior to
the symposium. Based on the positive
feedback from attendees, Osteogenics
plans to offer pre-symposium workshops again next year.
g IT page 9B
Vol. 6, No. 5
Bone harvesting:
nice and easy
By Dr. Steffen Hohl and
Dr. Anne Sophie Brandt Petersen
Introduction
The desire to use bone from your
own body to build new bone in
another place may be almost as old
as humanity itself. We call this procedure autologous bone grafting.
In the case of autologous bone
grafting, the bone is removed from
the same organism that the graft is to
be incorporated in. The body’s own
bone cells have the greatest potency
for rebuilding of bones and are the
gold standard in oral augmentation
surgery. Donor areas are: the tuber
maxillae, the retromolar space, the
chin region or the iliac crest, the ribs
or the shin.
Gaining the required quantity is
sometimes elaborate (large surgical
interventions, in-patient stay) and
afflicted with particular problems,
Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
g IT page 2B
Figs. 1, 2: Initial situation. State
three months after the removal of
the teeth. The vestibular lamella
has completely collapsed.
Fig. 3: Noticeably visible three-wall
bone defect.
Fig. 4: After drilling the implant
shafts, the areashowed to be
significantly atrophied.
Fig. 5: The implant shafts are
dilated using condensers and the
periimplantational bone is condensed.
Fig. 6: Implant insertion. It is visible that a vestibular augmentation
must take place.
Fig. 7: The implant body must be
vestibularly covered with autologous bone over about two-thirds of
its surface.
Fig. 8: Retromolar stab incision
with an 11 scalpel.
Fig. 9: A conventional implant drill
is used to drill directly in the area
of the inea obliqua through the
stab incision. A “two-spade drill”
is excellently suited to bone extraction.
Fig. 10: Bone excavation via simple shaft drilling with the conventional “two-spade drill.”
[2] =>
2B
Clinical
Fig. 11: Additional bone excavation
by hollowing out the shaft drill hole
in the linea obliqua with the excavator.
Fig. 12: Implants and autologous
bone augmentation in situ. In order
to achieve this result, it was necessary
to drill only into the retromolar.
Fig. 13: Covering the implants
and augmentations with a simple
collagen membrane.
Figs. 14, 15: The stab incision of
the retromolar extraction region is
glued with cyanoacrylate. Hereby the
patient only incurs a microscopic
extraction defect.
Implant Tribune | May 2011
IMPLANT TRIBUNE
The World’s Newspaper of Implantology · U.S. Edition
Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Fig. 11
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Fig. 12
Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com
Editor in Chief
Sascha A. Jovanovic, DDS, MS
sascha@jovanoviconline.com
Managing Editor/Designer
Implant, Endo & Lab Tribunes
Sierra Rendon
s.rendon@dental-tribune.com
f IT page 1B
especially when it comes from regions
far away from the oral cavity (e.g., the
iliac crest).
The extraction of autologous bone
grafts from the retromolar space find
the best acceptance with patients.
Particularly in implantology, lateral
augmentations are necessary in more
than 75 percent of cases. These augmentative measures mostly require
low bone volumes of less than 0.3 mg.
If the decision is made intraoperatively
that the patient’s own bone must be
used, as a rule the following question
must be asked: “Which region should
the bone be taken from and how can it
AD
Fig. 13
Managing Editor/Designer
Ortho Tribune & Show Dailies
Kristine Colker
k.colker@dental-tribune.com
Fig. 14
Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
be removed quickly?”
The retromolar space is chosen
here in more than 70 percent of cases.
Until now, block grafts have been used
exclusively,
Account Manager
Humberto Estrada
h.estrada@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com
Case description
The 36-year-old patient wants the gaps
in his teeth to be filled with implants
due to his otherwise intact dentition.
However, in this situation, the question
is raised of whether implantation and
necessary augmentation of the crestal
Marketing & Sales Assistant
Lorrie Young
l.young@dental-tribune.com
Fig. 15
jaw line can occur synchronously.
It was planned for the patient to
have autologous bone adhered in the
region of the 031 vestibular. Hereby
the right retromolar space and the right
tuber area were considered as donor
areas.
The patient was assured preoperatively that an extraction defect would
only involve minor postoperative
symptoms. Interoperatively, the crestal
incision was begun in the areas 031
and 041.
After forming a minimally invasive mucoperiosteal flap, region 031
in particular showed strong vestibular
atrophies. Initially implant drilling was
carried out and the bore shaft was
extended using a bone condenser, i.e.,
the periimplantational bone was condensed.
Subsequently, the implant bodies
were inserted. Here it became obvious that the implant was two-thirds
exposed on its vestibular side in region
031. Both implants were primarily stable.
After measuring the missing bone
volume, a stab incision was made in
the right retromolar. Then a conventional implant drill was driven through
the gums and drilled precisely 9 mm
deep. When withdrawing the drill, the
bone meal was retained.
Additionally, further spongiose bone
was extracted with a mini-excavator.
The transplant bone was able to be
adsorbed into the implant body in an
ideal manner. Finally, a thin collagen
membrane was applied for complete
coverage.
The soft-tissue defects were closed
with absorbable materials. The stab
incision in the retromolar was glued
with cyanoacrylate. In regions 031/041,
the wound closure was carried out
using absorbable suture material and
g IT page 6B
C.E. Manager
Julia Wehkamp
j.wehkamp@dental-tribune.com
International C.E. Sales Manager
Christiane Ferret
c.ferret@dtstudyclub.com
Dental Tribune America, LLC
116 W. 23rd St., Suite #500
New York, NY 10011
Phone: (212) 244-7181, Fax: (212) 244-7185
Published by
Dental Tribune America
© 2011 Dental Tribune America.
All rights reserved.
Dental Tribune makes every effort
to report clinical information and
manufacturer’s product news accurately, but cannot assume responsibility for the validity of product
claims, or for typographical errors.
The publishers also do not assume
responsibility for product names
or claims, or statements made by
advertisers. Opinions expressed by
authors are their own and may
not reflect those of Dental Tribune
International.
Editorial Advisory Board
Dr. Sascha Jovanovic, Editor in Chief
Dr. Bernard Touati
Dr. Jack T. Krauser
Dr. Andre Saadoun
Dr. Gary Henkel
Dr. Doug Deporter
Dr. Michael Norton
Dr. Ken Serota
Dr. Axel Zoellner
Dr. Glen Liddelow
Dr. Marius Steigmann
[3] =>
[4] =>
[5] =>
Implant Tribune | January 2011
IT
Digital Imaging 5B
[6] =>
6B
Fig. 16
Fig. 20
AD
Clinical
Implant Tribune | May 2011
Fig. 17
Fig. 21
Fig. 18
Fig. 22
Fig. 19
Figs. 16, 17: The soft tissue in
the implant region is closed with
absorbable suture material. The
neighboring teeth (#43, #42, #32,
#33) are lingually cauterized.
Figs. 18, 19: Insertion of a Maryland provisional prosthesis directly
after the augmentative-implantological intervention.
Fig2. 20–22: Digital volume tomography of the excavation defect.
f IT page 2B
horizontal mattress stitches.
Finally, as a provisional restoration,
a Maryland temporary prosthesis was
affixed, which additionally ensured
good soft-tissue stabilization. A digital
volume tomography (DVT) was produced in order to evaluate the removal
defect and document the augmentative result.
Summary
Autologous bone grafting represents
the gold standard in augmentation
surgery. Particularly with implant
operations, it is often only shown
intraoperatively that a small quantity
of autologous bone is needed for augmentation.
In this situation, a quick reaction is
often indicated. The retromolar space
is frequented most often for this purpose. As the patient should have the
least possible discomfort because of
the bone extraction, minimally invasive
procedures are the means of choice.
The technique presented above
is a new method, which is impressive due to its minimally invasive and
simple characteristics. The procedure
is especially ideal for augmentation
planning with volumes up to 0.5 mg.
Of course, larger bone volumes can
also be extracted using this minimally
invasive method.
Soft tissues can be closed discreetly using adhesive techniques that
are hardly noticeable to the patient.
Minimally invasive procedures in
implantology can be perfectly planned
and executed by including modern
3-D-diagnostics (DVT). IT
IT
Contacts
Dr. Steffen Hohl
DIC Dental Implant
Competence
Estetalstr. 1
21614 Buxtehude, Germany
www.dr-hohl.de
Dr. Anne Sophie Brandt Petersen
Tandlaegerne i Kogade
Kogade 4
6270 Tonder, Denmark
www.dentist.dk
[7] =>
Implant Tribune | April 2011
Industry 7B
[8] =>
00
Folio
Implant Tribune | September 2009
[9] =>
Implant Tribune | May 2011
Industry Events 9B
f IT page 1B
Osteogenics Biomedical established Osteogenics Clinical Education
in 2008 with a mission of providing
interactive hands-on clinical education in bone grafting and implant dentistry. Since then, Osteogenics Clinical Education has hosted the Global
Bone Grafting Symposium annually
every spring. Each year the symposium offers clinicians the opportunity
to improve their comprehensive treatment planning skills and integrate
the latest technologies, materials and
techniques into their treatment planning process.
About Osteogenics Biomedical
Headquartered in Lubbock, Texas,
Osteogenics Biomedical is a leader in
the development of innovative dental bone-grafting products serving
periodontists, oral and maxillofacial
surgeons and clinicians involved in
regenerative and implant dentistry
throughout the world. Osteogenics
offers a complete line of bone grafting products including enCore™ Combination and Mineralized Allografts,
Cytoplast® PTFE membranes, Cytoplast® collagen membranes, Cytoplast® PTFE suture and the Profix™ Precision Fixation System.
IT
(Source: Osteogenics Biomedical)
Dr. Sascha Jovanovic, world-renowned speaker and editor in chief of Implant Tribune, lectures on horizontal and
vertical ridge augmentation at the Osteogenics’ 2011 Global Bone Grafting Symposium in April in Arizona. (Photo/
Provided by Osteogenics Biomedical)
AD
[10] =>
10B
Industry
Implant Tribune | March 2011
IT
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