Implantology - site augmentation Flashcards
What is the rationale for performing site argumentation?
- To replace hard tissue deficit
- To replace soft tissue deficit
- To replace both HT and ST deficit
What is GBR?
Guided Bone Regeneration
- replaces hard tissue deficit
- uses a scaffold that allows for new bone growth, as well as a cell exclusion membrane
What is the point of having a cell exclusion membrane in GBR?
Cell exclusion membranes prevent unwanted cells from proliferating into that space and forming fibrous epithelial tissue. Allows for osteoblasts to grow.
List the function of a graft.
- Osseo-induction
- Osseo-conduction
- Osteogenic
What does an osteoconductive graft do?
Provide a scaffold only. Enables osteoblasts to start forming new bone and preserves space for the new bone to form.
What is the function of the scaffold?
- Porous structure allows for cell migration
- Allows for new BV to form
- Allows for osteoblasts to attach
E.g.: (Bio-oss = xeno, Bioceramic = allo)
What does an osteoinductive graft do?
Provides a scaffold AND induces new bone to form
How do the osteoinductive grafts induce new bone formation?
BMP’s (Bone Morphogenic Protein) stimulate the differentiation of mesenchymal cells into osteoblasts.
E.g.: DFDBA (allograft with human protein)
What does an osteogenic graft do?
Provide a scaffold AND generate new bone.
How does an osteogenic graft generate new bone?
From existing osteoblasts already contained within the graft.
E.g.: autogenous bone
Grafts can be b___ or p____.
blocks, particulates
What are particulate grafts?
Particles/small pieces of bone
Where can autogenous block grafts come from?
- The calvarium
- Mx tuberosity
- Md ramus (common, could be done adjacent to M3 surgery)
- Symphysis
How can you source autogenous particulate bone?
- During osteotomy
- Bone scrapers (anterior nasal spine)
- Bone mills
What are the types of augmentation?
- Peri-fixture placement
- Pre-fixture placement
When would simultaneous GBR be indicated?
If the ridge allows for optimal fixture position with good primary stability.
When would staged GBR be indicated?
When the ridge does NOT facilitate optimal fixture position with good primary stability.
What are the types of soft tissue augmentation?
- Connective tissue
- Free gingival
- Papilla generation
What are the two types of cell exclusion membranes?
Resorbable
Non-resorbable
What is a resorbable cell exclusion membrane?
Collagen is resorbable
What is a non-resorbable cell exclusion membrane?
PTFE is non-resorbable
