Best Membrane to Use when Grafting with Mineralized FDBA?
Dr. B. asks:
I would like to get some opinions on which membrane to use when I graft with mineralized freeze dried bone allograft material [mineralized FDBA]. If the extraction socket has intact walls, which membrane would work best? For contiguous multiple extraction sites, which membrane would work best? If one or more walls is missing which membrane would work best? If I use mineralized FDBA, are there any circumstances where I would not have to use a membrane to cover the graft? I have experience with resorbable membranes but have not used a non-resorbable membrane. Are there specific indications for using a non-resorbable membrane instead of a resorbable membrane?
5 Comments on Best Membrane to Use when Grafting with Mineralized FDBA?
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SBoral surgeon
5/2/2011
This topic is too broad for one string. There are so many good CE classes out there. Take some!!! This is not rocket science, but you need to learn by good teachers.
Pankaj Narkhede, DDS; MDS
5/3/2011
Dr. B. You are asking us to write a book :-). If you are well experienced in Implant dentistry - Check out BioXclude - That may help you with intact walls after extraction.
Try PTFE sutures (non resorbable). In short- nonresorbable sutures last long and can be used when you need them for a while.
Q-where I would not have to use a membrane to cover the graft?
Ans: Mostly cases where periosteum will act as a membrane. This will all depend on the case.
The rest of the answer please read Dr. SBoral's comment :-)
Dr GK
5/4/2011
What's wrong with all the doctors being acrimonious to each other???anyway, when u have intact walls just use an inexpensive collagen plug from ace. When u miss a wall try the sclar technique with any slowly resorbable collagen membrane that is soft and never those hard ones. Now for using graft without barrier please swift from allograft to a putty graft such as novabone putty which contains phosphosilicate. It is really superior from dfdba and a million times faster in giving new bone growth than fdba. Hope I helped.
PS Dr Narkhede do u have any literature that will show that periosteum can act as a barrier for a particle graft? Tarnow says that when the periosteum is lifted from the bone it loses its bone forming capacity
alper
5/6/2011
This is my receipt for membranes;
For socket preservation (intact walls): Graft + Osteogenics txt-200 (Non resorbable d-Ptfe ideal for open healing)
For dehisens and fenestration around implants: Graft + Resorbable collagen membrane (Bio-gide or Mem-Lok)
Multiple extraction walls missing: Graft + more rigid and long lasting membrane (mem-Lok)
Really need to thicken hard tissue: Titanium reinforced non-resorbale membranes
Dr Mario Marcone
5/6/2011
Dr GK,
This reference may be helpful ...
Journal of Implants and Advanced Clinical Dentistry ...
JIACD, Vol 1, No 4, 2009
Go to www.jiacd.com and click on "issue archive"
Best Wishes.
