4.03 JOMI Flashcards
Describe the first in-human pilot study using a “mineral-organic bone adhesive” for immediate implants
Norton et al JOMI
Used Tetranite (TN) , a bioadhesive, with immediate implant placement
* Tetranite is composed of Tetracalcium phosphate and O-phospho-L-serine
n=15 patients
Immediate implants that were placed required low primary stability (< 15 Ncm)
* ISQ recorded, then the implant was removed after low primary stability was confirmed
* The Tetranite was added into the socket, then the implant was placed again
* ISQ remeasured after 15 minutes (to allow the Tetranite to set)
* Temp crown added (immediate loading)
RESULTS:
4 of the 15 implants failed.
* Failures likely due to the researchers measuring ISQ at 1 week and 1 month, which required removal of the temp crown
* ISQ increased when comparing the implant placement before vs. after Tetranite placement (from ISQ of 62 to about 72)
What is the human rhPDGF-BB results in sinus elevation with collagen matrix and without a bone graft?
Ghassib et al
3 was extracted and a Caldwell-Luc was used to remove the root from the sinus
Case study
- Initial ridge height: 3mm
- Sinus wall fenestration present at the #2 area
Lateral sinus access was achieved, membrane elevated. A perforation occurred of the membrane, so 3 collagen tapes were soaked with rhPDGF-BB and placed in the sinus. The implant was then placed.
RESULTS:
6.02 mm of vertical bone height was achieved.
* Case study shows that “tenting” the sinus membrane using the implant may be a valid way to perform lateral sinus elevation.
Describe the study on the “expanded mesh free gingival graft”
De Greef et al JOMI
Case series
Created a “meshwork” free gingival graft via plastic-surgery-style incisions on the free gingival graft.
This allows “expansion” of the free gingival graft in a mesio-distal direction.
* Meshwork graft was expandable by about 50%, compared to the original FGG
NOTE: Dr. Wang says this technique is unnecessarily complicated
Describe how dental implants in 18 Scleroderma patients fare over 5 years.
Jackowski et al JOMI
Retrospective radiographic study
Examined implants placed in systemic scleroderma patients with limited mouth opening and limited manual dexterity.
n=18 patients
RESULTS:
* Overall marginal bone loss was 1.05 mm after surgery. (no comparison group; might be due to remodelling)
* Conclusion: Successful implant placement is possible in scleroderma patients
Describe the microsurgical approach for the management of the gingival cleft - case series
Reddy et al JOMI
Described how red and white clefts can be managed microsurgically
* Red cleft: A cleft is present in the tissue, but does not go all the way through the tissue.
* White cleft: A cleft penetrates the entire thickness of the tissue.
Treatment:
Used microscalpels to remove the epithelium of the cleft.
* Add CTG if it is a white cleft
* No CTG needed if it’s a red cleft
* Red clefts can spontaneously close on their own
Undermine the adjacent flaps to 3mm on each side of the cleft, then suture using 8.0 polyamide sutures.
Describe the vascular delay soft tissue technique in oral/maxillary bone grafting surgery.
Hernandez-Alfaro, JOMI
Oral surgeons commonly use the “vascular delay technique” to increase the survival of flaps via “neovascularization.”
This article decribes the technique:
* Perform the flap incisions and flap reflection, and then immediately suture.
* Reopen at 3 weeks and perform the GBR surgery.
The idea of the “vascular delay” technique is that opening the flap and then allowing early healing will increase the vascularization of the flaps, and therefore reduce the risk of flap necrosis at post-op.
- GBR used 3:2 autogenous to BioOss. Covered with TiMesh and BioGide
RESULTS:
* No surgical complications occurred.
* One patient had a small membrane exposure (<3 mm) without exudate, and was treated with topical chlorhexidine.
Conclusion: The vascular delay technique may reduce complicatiosn of GBR surgery.
