THE USE OF A NEW NON-RESORBABLE CELL OCCLUSIVE MEMBRANE TO IMPROVE BONE PRESERVATION AND AUGMENTATION
PRESERVATION OF SOFT AND HARD TISSUE AROUND IMPLANTS IN AESTHETIC AREAS
The author presents his experience in the field of regenerative surgery in order to obtain good and stable results in particular in the aesthetic zones.
The presence or absence of soft and hard tissue between adjacent implants and between implant and teeth is of great concern in implant dentistry. In the last years the use of dental implants with new microstructure and macrostructure design seems to improve tissues’ stability around implant.
On the other side a lot of different surgical techniques has been proposed to ricreate good quality and quantity of soft and hard tissue.
The author presents his experience in the field of regenerative surgery in order to obtain good and stable results in particular in the aesthetic zones. The use of different barriers and different biomaterials will be explicated in correlation with the different surgical technique.
THE USE OF ACELLULAR DERMAL MATRICES IN THE SOFT TISSUES MANAGEMENT AROUND TEETH AND IMPLANTS
The treatment of gingival recessions has become an important therapeutic issue due to the increasing number of cosmetic requests from patients.
The goal of mucogingival procedures is to obtain complete root coverage, up to the cementoenamel junction, along with an increase of soft tissue thickness to maintain the result in the long term, reducing the risk of recession recurrence. The use of a coronally advanced flap in conjunction with a collagen matrix avoids the need for autograft harvesting, thus reducing patient morbidity and discomfort. The collagen matrix will support blood clot stabilization by serving as a scaffold for ingrowing blood vessels and fibroblasts; within a few months, the matrix will be completely degraded and the blood clot will be gradually transformed into new connective tissue, which will be responsible for the increase in soft tissue thickness. This represents a key aspect of the long-term success of root coverage.
The use of a promising porcine acellular dermal matrix for peri-implant soft tissues thickness increase as well as its long-term clinical outcome will also be described.
THE USE OF MUCODERM® IN PERI-IMPLANT SOFT TISSUE AUGMENTATION PROCEDURES AND ALVEOLAR RIDGE RECONSTRUCTION IN THE AESTHETIC ZONE
In this webinar, the use of mucoderm® in peri-implant augmentation will be discussed, highlighting its properties and advantages in the aesthetic zone.
Dimensional and structural alterations of the alveolar process are well-documented consequences of tooth extraction in the aesthetic zone, with several factors influencing bone modelling, such as flapless extractions, ridge preservation techniques and immediate implant placement.
Over the years, several authors have investigated bone resorption pattern in maxillary incisors and premolars, concluding that a facial bone wall thickness of 1 mm or less was the main factor affecting the degree of bone alterations.
Furthermore, soft tissue alterations may follow tooth extraction, in particular loss of keratinized mucosa width (KMW), with a significant impact on the aesthetic and functional outcomes of future implant-supported restorations. The optimal timing for implant placement and the necessity of alveolar ridge preservation procedures are still debated in literature. A simultaneous or subsequent connective tissue graft (CTG) may be needed in order to prevent/treat mucosal recession.
Over the years, several bone substitutes have been utilized for GBR procedures and, recently, a porcine derived acellular dermal matrix (mucoderm®) has been proposed as autogenous graft substitute in order to avoid palatal harvesting and obtain comparable results to CTGs, with excellent dimensional stability and aesthetic results.
OFF THE SHELF BONE BLOCK GRAFTING. THE WHY AND HOW OF EFFECTIVE ALLOGRAFT BLOCK GRAFTING
This webinar will present indications, clinical applications and differences in technique between maxgraft cancellous blocks vs. maxgraft unicortical cancellous blocks.
Placing a dental implant in the correct four dimensional position and within the future prosthetic envelop is considered as one of the crucial aspects of long term peri-implant bone and soft tissue stability in implant dentistry. It is unacceptable anymore to place an implant tilted buccally with the apex directed too palatally in order to achieve primary stability in cases with deficient bone volume as this will lead to a compromised and oversized clinical crown, minimal peri-implant labial bone thickness and gum recession.
Therefore, in cases with considerable bone defects such as one wall defects, no wall defects or even two wall defects with extensive mesio-distal gap, a pre-implant augmentation surgery is a vital prerequisite to allow correct implant placement in order to achieve satisfactory aesthetic and functional short and long term results. A variety of bone-grafting materials have been used, but autogenous bone blocks harvested from either extraoral or intraoral sites have been traditionally claimed to be the gold standard . However, allograft blocks are nowadays considered by a wide group of clinicians as a valid and well documented alternative which offers comparative results at a fraction of trauma, morbidity and risk to our patients.
In this webinar, Dr Maghaireh will present the clinical workflow of various types of allograft bone blocks used at his practice in Leeds- UK with more than 5 years follow up. He will also present bone grafting clinical tips and recommendations in addition to detailing advantages and potential drawbacks and discuss indications and contraindications of various types of allograft blocks