Case: Next Paradigm in Bone regeneration

Hi CV , It is undergoing FDA approval at the moment , so will take a short while but DDSGadget sells some nice CS products which are FDA approved and follow the protocol that we have published ...... Regards Peter

Where can I find the published protocol

Can only post 5 pictures at a Time .... but can post rads ..... Regards Peter

To post more photos, simply post the case again with the additional photos and we'll add the new photos to the case. Please be sure to use the same email you used when you first posted the case so we can identify you.

Hi Will get to it just busy .... I never splint to other teeth and rarely/never splint Implants as function of implants makes bone better as long as the is no foreign matter in it we knew that 125 years ago with Woolfs Law .. Regards Peter

No Problem we have a video case or two here on this site with no palatal plate just graft prior to placement , no primary stability ( Not important ) no membrane ( a hinderance to healing ) and No Autogenous ( Dead stuff that the host needs to get rid of ) ..... can load in as little a 6 or 8 weeks but I am old fashioned so leave it to 10 and like to use Osstell Regards Peter

The videos referenced can be found via the links below: Bone Regeneration in the Anterior with Synthetic Graft Bone Regeneration in a Pre-Molar Case with Calcium Sulfate + B-TCP

Is this the same material that John Satossanti has been using since the 1970's?

No , but he is inspirational to us but remember these material and ideas have been used since 1890 in Medicine by Dressman ....... Nothing new .... just a re-think and material improvement .. Regards Peter

Thank you...I agree and furthermore, I feel that credit should be given him for his original landmark work with this material in periodontal regeneration, at least as an historical reference

Yes OMS and yes follow protocol that is published ( in Open Access as need free ability to Download ) ....... always removal 3 week healing the place and graft with no membrane ( have not used once in 3,500 grafts ) .... Vertical growth in the posterior mandible is case dependant .... and if extreme we have cad cam block of same material .......... place with a tunnel incision with particulate .... BUt the main issue is to return the host back to their previous state ......Healthy own bone .... like they would in Medicine. Regards Peter

Depends where you are and what is available ? it is hard for me to comment on mixing as there are a lot of variables . Peter

I Agree ..... as these cases are slam dunks relatively , daily routine cases , more complex cases some placed in one walled situations are published but , I prefer for Dentists to start on the easier cases . Closure is helpful but not critical and we have published on soft tissue healing by secondary intention over a stable graft material .... We have a case published where we used this material in a socket graft and photographed it every day for three months to shows this .. Regards Peter

Dr Fairbain, In more complex maxillary anterior cases where significant vertical and facial bone needs to be rebuilt to anchor implants, like in an auto accident where the wheel took out the maxillary central and laterals incisors (but some palatal and apical bone is still present but the palatal height is now reduced some), after flap reflection and de-granulation, can one use titanium tenting screws who's head is placed to the ideal vertical height and the facial is placed 2 mm lingual to the "ideal facial boney dimension" desired, then fill cs+tcp (ethoss) all around the titanium tenting screw, up to the head of the tenting screw, do you think it will it frequently grow bone to the height of the tenting pin head, and all around it? 3 months later removed the tenting pin and place the implants? (I know it is a little slower than the way you do it, but I have my reasons...). Would you still use small size b-tcp in the ethoss mix, in even large defects? How do I find "a video case or two here on this site with no palatal plate just graft prior to placement , no primary stability". No palatal plate? it it worked? I need help! Please help enlighten me,

To find a case, you can use the search feature, or go to our video section from the menu. Also, here are two prior videos which maybe what you are looking for: Bone Regeneration in the Anterior with Synthetic Graft Bone Regeneration in a Pre-Molar Case with Calcium Sulfate + B-TCP

edit it is an alloplast thanks

Yes I have used these materials for 14 years ...... and they are great with new research showing us why ( Medical research with Impact factor 12 !! ) .... Have used a fait bit of Easygraft and have nice cases .... Peter

Here is protocol ..http://www.hindawi.com/journals/ijd/2015/589135/ In Open access so can be downloaded for free Regards Peter.

I love these cases Peter. Many thanks and congratulations. What is the cost per site?

Can you use the protocol with transmucosal implants? Thanks Peter

I do not but others do and seems OK ...... but prefer sub -periosteal healing

About £ 75 or $ 105 ..... per case . but makes patients happier which is the key Regards Peter

Hi GB , yes there have been dramatic changes and understanding in these materials , this has been an orhtopeadic led over the years ......... but the past always lingers like a 70s Car compared to now . Unlike donor materials the changes can be dramatic ..... xenografts are the same as they were 20 years ago ............. progress through design and understanding has occurred .... I can post a real thought provoking video on here to really make the scale of this advance visible ............... host led regeneration with simple materials is a reality .... we just need to discover it in Dentistry.. Regards Peter

VD , sadly yes BTcP is very variable and is the important component .......not sure but maybe with allograft in the US as have had great results ... Peter

Agree theoretically would be ideal but these patients are the issue ...... always remove the crown put cover screw back on and let the gingiva heal over ..... then a month later flap and clean ( prophy jet ) and graft and allow to regenerate under the gingiva.... Safest way for result Peter

Hi John , yes still working on the blocks ..... and finalising FDA for EthOss .... it always takes longer with regulation ........ But yes can use a Medbone Block ...... and EthOss . We have been working on Tenting techniques using resorbable sutures with great results and will be publishing very soon .......I feel this is more exciting than blocks in many ways . But email me for the ideas with Sutures and update on blocks ... Regulatory issues are always out of your hands .. Regards Peter

I do believe that renting is more exciting than blocks... For the time being I am using osteosynthesis plates in the coronal part of bone in order to absorb pressure and tension from the flap and I do only horizontal incision in order to create a form of pouch. Do you have any cases with extended edentulism requiring 5mm of ridge augmentation either vertical or horizontal;

Great idea and yes vertical on an extended edentulous area is tough without a block or Ti Mesh ....... the CAD/CAM blocks will be great as highly porous and BTCP but will take longer than we thought.. Peter

So, if you have a case with an edentulous maxilla in which you have to gain 3-4 mm in height and 3-4 mm in width, that means you need a really 3d reconstruction what would you do? My option would be to place the implants, leave them exposed buccally and palatally and place osteosynthesis plates between the implants to help tenting and place ethoss. But I would like to know what would you do..