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Sepehr Zarrine: Immediate screw-retained CAD/CAM provisionalization with an integrated digital approach (Straumann® Guided Surgery)

  Successful immediate implant placement associated with immediate loading remains one of the biggest clinical challenges. In addition to the placement of an implant into a tooth socket concurrently with extraction, the creation of a screw-retained CAD/CAM provisional prosthetic restoration is critical for the esthetic outcome. Currently, the procedure can be achieved using a conventional approach resulting in a high number of patient appointments with time-consuming steps for the dentist. For the patient, the day of the immediate loading treatment remains a long and tiring experience from the surgery to the provisional restoration. Instead of exposing the patient to a “marathon” day, the treatment could be shortened considerably by fully involving the patient, the surgeon and the dental technician and by having a predictable treatment protocol for the tooth extraction and the prosthetic restoration design (including the individual emergence profiles prior to the surgery). This would also lead to a better patient experience and improved satisfaction. The goal of this clinical report is therefore to introduce an innovative one-step surgical approach for immediate screw-retained CAD/CAM provisionalization by using the latest technological improvements in prosthetic and surgical planning software and seamlessly integrating the dental technician into the development of the fully digital treatment planning and new prosthetics options. PRODUCT INFORMATION BY THE MANUFACTURER Straumann® Guided Surgery is a flexible, precise and simple solution for the access to a guided surgery procedure using the digital planning workflow. It enables you to deliver a cutting-edge solution to patients in all indications (single tooth to edentulous). The process involves the entire dental team from the very beginning and allows for a simple and efficient workflow. Predictability in advanced cases: comprehensive visualization and prosthetic- driven implant planning enable to achieve predictable results also in advanced surgical applications. Access to new protocols: guided surgery offers a reliable access to minimally invasive surgery, to immediate provisionalization protocols and is designed to reduce bone grafting procedures. Treatment efficiency: decreased time during the surgical procedure and enhanced communication within the treatment network helps improving efficiency. PICTURE DOCUMENTATION Fig. 1 zarrine01 Fig. 2 zarrine02 Fig. 3 zarrine03 Fig. 4 zarrine04 Fig. 5 zarrine05 Fig. 6 zarrine06 Fig. 7 zarrine07 Fig. 8 zarrine08 Fig. 9 zarrine09 Fig. 10 zarrine10 Fig. 11 zarrine11 Fig. 12 zarrine12 Fig. 13 zarrine13 Fig. 14 zarrine14 Fig. 15 zarrine15 Fig. 16 zarrine16 Fig. 17 zarrine17 Fig. 18 zarrine18 Fig. 19 zarrine19 Fig. 20 zarrine20 Fig. 21 zarrine21 Fig. 22 zarrine22 INITIAL SITUATION The patient was 65 years old, female, non-smoking, with a fragile health condition, and willing to get back an adequate chewing capability. The patient suffered from cachexia following a stomach ablation resulting in an obvious compromised diges­tion which is­ an aggravating factor in the dental condition (Fig. 1). The molars in sector 3 were missing, tooth 26 had to be restored and the occlusion curves adjusted. Teeth 13, 14 and 15 had a mobility classification of 3 according to Lindhe and Muehlmann. The roots were decayed and fractured, with the gum suffering from inflammation in 14 and 15 without abscess and sinusitis. Tooth 47 underwent an eruption, and bridge from 47 to 43 seems to follow this new curve of occlusion. This situation does not allow for sufficient inter-arch height in order to have number 16 as antagonist. To prevent an over-infection as well as for esthetic and comfort-related reasons, the urgency consisted in the treatment of sector 1. The overall health condition and drug treatment reinforced our decision to use a non-invasive surgical approach. The treatment plan was as follows: #47 and #43: recreating sector 4 with two individual ­implant-borne restorations (Straumann® Soft Tissue Level ­Implant RN, Roxolid® material, SLActive® surface) respecting the occlusion curves. #26: root treatment with a tooth-borne restoration in the ­occlusal plane. #35# 36, placing of two individual implant-borne restorations (Straumann® Soft Tissue Level Implant WN, Roxolid® material, SLActive® surface). From #13 to #16: implant-borne restoration after tooth ­extraction of 13, 14 and 15 (Straumann® Bone Level Implant RC, Roxolid® material, SLActive® surface) The patient will have a reduced arcade. However, the occlusion will be balanced and provide a good masticatory coefficient. The current situation forced us to compromise (Fig. 2) and to place three implants in place of three teeth: canine, premolar and molar. The aim was to extract atraumatically the three decayed teeth and to perform an immediate implant placement after extraction with flapless surgery in conjunction with immediate loading enabling restoration of the other sectors. In order to maximize accuracy and to reduce the number of steps, a fully digital approach using guided surgery was selected, allowing us to preoperatively produce a screw-retained CAD/CAM provisional restoration. PLANNING After detailed three-dimensional diagnostics, teeth 13, 14 and 15 were virtually extracted in the implant planning software (coDiagnostiX™, Dentalwings). The prosthetic design was created with Straumann® CARES® Visual (Fig. 3). The prosthetic project was shared with the implant planning software using the integrated online platform Synergy (Dentalwings). The three-dimensional radiographic DICOM data and the prosthetic design project STL file were matched in coDiagnostiX™. The integrated platform allows for real-time collaboration between the dentist and dental technician for finalizing the treatment planning from both implant placement and restorative design (Fig. 4). The surgical guide was designed with coDiagnostiX™ (Fig. 5) and produced using three-dimensional printing technology (Objet Eden260VS Dental Advantage (Stratasys, Minnesota, Fig. 6). The surgical guide was teeth- and mucosa-supported on the palate.­ To avoid lateral movement, fixation screws were added (Straumann® Bone Block Fixation). An individualized two-piece splinted three-unit bridge was virtually designed (Fig. 7) and CAD/CAM-fabricated from a PMMA-based restoration ­material cemented to a pre-fabricated bonding base (Straumann® Variobase® for bar and bridges + Polycon ae, Straumann® CARES® X-Stream™, Fig. 8 – 10). The bridge design and the occlusion were checked on a printed jaw model (Dreve Dentamid, Germany, Fig. 11) and finally sealed then sent to the dental practice with the jaw model and the surgical guides. SURGERY On the day of surgery (Fig. 12, 13), the surgical protocol provided by the implant planning software guides the clinician through the surgical procedure and supports him in the use of the appropriate instruments from the guided surgery surgical kit (drill heights, drill handles, etc., Fig. 14, 15). To avoid deformation of soft tissues that could influence the stability of the surgical guide, we performed regional anesthesia: Vestibular: high tuberosity anesthesia for the alveolar nerve supra-posterior, and high canine anesthesia that reaches the supra-anterior alveolar branch of the maxillary nerve. Palatal: analgesia of the nasopalatal nerve in the retro-incisive area and the large palatal nerve in the area of the large palatal foramen. The crowns were removed; the root of 13 was cut and removed in fragments. The avulsions were created delicately; the ­alveoli­ were curetted and debrided under irrigation. Papillae were ­detached to allow for the regularization of the bone crest by ­removing bone that was too thin, anticipating the post-extraction resorption. The surgical guide was placed and the ­position was secured using 14mm fixation screws in the maxilla at sector 17 (Fig. 16). The drilling sequences were performed through the guide. To avoid bone overheating, high irrigation was performed using the up and down drilling technique. Tapping and profile drilling were essential despite the maxillary soft bone. This is critical in order to follow all the steps necessary for correct implant positioning according to the planning. In order to maximize the precision in the implant placement, we chose shorter implants than usual. This allowed us to achieve a quicker implant positioning through the surgical guide by using guiding transfer pieces that ensured the final positioning (depth and angle). The implants were stabilized with a torque of 50 N / cm (Fig. 17). After removal of the surgical guide, the bone chips harvested during the drilling sequences were used to shape the crest and to fill the gaps. Interdental papillae were repositioned buccally by rotation. A conjunctive tissue graft was partially dissected from the palate­ while remaining pedicle in order to recreate the interdental papillae. Sutures helped to stabilize the gingivoplasty (Fig. 18). The screw-retained two-piece CAD/CAM bridge was finalized before surgery and immediately placed and screwed onto the three implants (Fig. 19 – 20). Slight tension was detected during the screwing, but with no consequences for the implants since they were not yet osseointegrated and the mechanical stress was too low. The only change to the temporary bridge consisted in slightly adapting the under-occlusion. Additionally, the SLActive® surface stimulates the adsorption of blood proteins and enhances the fibrin network formation, which allows for the faster maturation of the bone. This is a major asset in immediate implant placement after tooth extraction and in immediate esthetics. Check-ups at 10 days post-op (Fig. 21) and at four weeks (Fig. 22) were used to verify correct gingival healing and implant integration. The postoperative courses were not painful and no edema or hematoma was observed. RESULTS Immediate implant placement associated with immediate loading is a predictable protocol with some variables. The digital tooth extraction was integrated with the production of a screw-retained CAD/CAM provisional restoration prior to the surgery and was successfully achieved and placed without any cementing steps in the dental practice. The entire treatment workflow was done fully digitally. Only a single surgical step was required to provide an entire individualized prosthetic rehabilitation. Sepehr Zarrine DDS Oral surgeon. Exclusive private implantology practice (Saint Dié, France). Speaker ITI France. European Master in Dental Implantology. Surgery, prosthetics, bone grafts (Frankfurt, Germany). University diploma in surgical maxillofacial rehabilitation (Medicine, Paris VII). The post Sepehr Zarrine: Immediate screw-retained CAD/CAM provisionalization with an integrated digital approach (Straumann® Guided Surgery) appeared first on STARGET COM.

Ron Leehacharoenkul: Esthetic tooth replacement (Straumann® Bone Level Implant)

  Self-Directed Learning (SDL), a process by which individuals take the initiative – with or without the assistance of others – in diagnosing their own learning needs and formulating learning goals, has been identified as an essential skill for clinicians. As dental clinicians, our busy patient schedules and time constraints prevent us from updating our knowledge with regular CE courses. SDL is therefore fundamental in meeting the challenges of today’s dental care environment, helping us to learn more and to learn better, as a “lifelong learning” process for acquiring both clinical skill and knowledge on our own. I would like to thank Straumann Thailand for organizing such an excellent campaign with the “Dental Implant Esthetic Competition”, the first ever regional dental implant competitive award for Thailand or Asia. It provided me with the opportunity to write up and evaluate my patient’s case report for the competition. Writing a case report is a good example of SDL since I have to organize the manuscripts systemically by reviewing the patient’s chart record, radiography and photos, and self-evaluation is part of the outcome. Not only was I updating my awareness of the literature and my knowledge in order to provide the optimal treatment plan, but processing the completed consent form correctly was an additional benefit for me when collecting the legal documentation prior to publication. SDL is an important expertise for all dental clinicians since its main purpose is to enhance individuals’ knowledge and clinical skill. Dental clinicians who pursue SDL are continually developing and, more importantly, constantly acquiring new knowledge and skills for the rest of their lives. As for me, the SDL clinician, I realize that the better I properly document my patient/case report and clinical photos, and the more new knowledge I acquire, the better clinician I become since I am able to learn from my mistakes and experiences and am willing to improve and learn more as a lifelong learning process. PRODUCT FEATURE Straumann® Bone Level Implant The Straumann® Bone Level Implant line was designed for a natural look and feel, providing flexibility and a balanced prosthetic portfolio for every indication. It enables for esthetically pleasing solutions, featuring important technical and biological concepts (Crossfit® connection, Consistent Emerging Profiles™, Bone Control Design™, Loxim™). It is available from Roxolid® and SLActive® and with the SLActive® or SLA® surfaces. By using the same surgical and prosthetic kit as the Straumann® Soft Tissue Level Implant line, the Bone Level Implant is the perfect addition to the Straumann® Dental Implant System, offering unmatched treatment flexibility and options. MORE? All the articles about the Straumann® Bone Level Implant at a glance. Click here PICTURE DOCUMENTATION Fig. 1 roongkit01 Fig. 2 roongkit02 Fig. 3 roongkit03 Fig. 4 roongkit04 Fig. 5 roongkit05 Fig. 6 roongkit06 Fig. 7 roongkit07 Fig. 8 roongkit08 Fig. 9 roongkit09 Fig. 10 roongkit10 Fig. 11 roongkit11 Fig. 12 roongkit12 Fig. 13 roongkit13 Fig. 14 roongkit14 Fig. 15 roongkit15 Fig. 16 roongkit16 Fig. 17 roongkit17 Fig. 18 roongkit18 Fig. 19 roongkit19 Fig. 20 roongkit20 Fig. 21 roongkit21 Fig. 22 roongkit22 Fig. 1 levine01 INITIAL SITUATION The following case report describes the management of replacing a maxillary lateral incisor with a hopeless prognosis with the Straumann® Bone Level Implant to achieve “a natural look and feel” for the patient. The replacement of a missing anterior tooth with an implant-supported prosthesis has become an accepted treatment modality. It counts as one of the greatest challenges in dentistry since it must meet functional requirements and satisfy patients’ high esthetic demands in this visible area. A 36-year old woman presented with the principal complaint that her front tooth was broken. The patient was aware that her tooth had a bad prognosis and desired a single-tooth implant replacement. She was very concerned about the final esthetic result and her expectations were extremely high (Figs. 1-3). TREATMENT PLANNING Tooth #12 had a complicated crown-root fracture at sub-gingival level. The existing coronal structure was attached with gingival tissue. Intra-oral examination showed the tooth was discolored with 2 degrees of mobility. Minimal discomfort was reported. The gingival tissue presented with very thin biotype. Radiographic and CT examination revealed the root fracture at the cervical third and deficient labial plate thickness. The diagnosis was “crown root fracture with pulp involvement” (Figs. 4, 5). Several options were discussed with the patient regarding management of the tooth. Risks and benefits were explained. The patient agreed that the treatment of choice was extraction of the tooth followed by a dental implant. Type II implant placement was planned since the condition of the labial plate and the tissue biotype were compromised, however the palatal bone was thick enough to place the implant in a 3D position without any need for ridge preservation at the time of tooth extraction. The patient was informed of the compromised esthetic result due to the thin labial plate thickness and gingival tissue biotype. SURGICAL PROCEDURE Prior to extraction of tooth #12, an acrylic partial denture was fabricated as a temporary prosthesis. Atraumatic tooth extraction was performed but the labial plate was still lost about 8 mm from the gingival margin. The immediate denture was then delivered. The extraction socket had been left for 8 weeks to achieve soft and hard tissue healing (Figs. 6, 7). A Straumann® Bone Level Implant NC (Narrow Neck CrossFit®, Ø 3.3 mm, L 12 mm) was submerged in the site of #12 with a bone graft followed by surgical guide and CT evaluation (Figs. 8, 9), and a soft tissue graft was then performed to achieve the proper thickness (Fig. 10). The acrylic partial denture was adjusted so there was no undue load on the implant during the healing period. The patient was told to maintain good oral hygiene. After a twelve-week healing period (Fig. 12), a second soft tissue graft was performed to achieve optimal soft tissue thickness again (Figs. 11-14). The second-stage surgery was then completed for healing abutment delivery 8 weeks later (Figs. 15, 16). PROSTHETIC PROCEDURE About 5 months after implant placement, the implant was seen to be well osseointegrated with a satisfactory soft tissue profile and was ready for the implant prosthesis. An impression was taken at fixture level for the temporary abutment and crown. They were then delivered to create an optimal soft tissue emergence profile around the implant (Figs. 17, 18). The dental implant fixture and abutment used in this patient are the original Straumann components for ensuring consistent quality through high-precision manufacturing. FINAL RESULT “SELF-DIRECTED LEARNING IS FUNDAMENTAL IN MEETING THE CHALLENGES OF TODAY’S DENTAL CARE ENVIRONMENT, HELPING US TO LEARN MORE AND TO LEARN BETTER, AS A ‘LIFELONG LEARNING’ PROCESS FOR ACQUIRING BOTH CLINICAL SKILLS AND KNOWLEDGE ON OUR OWN.” Six weeks later, the surrounding soft tissue had acquired an esthetic and natural profile. The customized impression coping was then fabricated and taken at implant fixture level for the final prosthesis (Fig. 19). The zirconia abutment had been carefully selected and prepared and the ceramic crown of the implant (IPS e.max) was then delivered (Figs. 20, 21). The patient was extremely happy with the final result at the three-week follow-up (Figs. 22, 23). ACKNOWLEDGEMENTS Bangkok Hospital Dental Center: Atraumatic tooth extraction by Dr. Jarinda Thaisangsa-Nga. Implant and soft tissue surgery by Assistant Prof. Pintippa Bunyaratavej. Prosthetic work by In-House Dental Lab (Thailand): Mr. Uthai Mhudvongse Ron Leehacharoenkul DDS, MS DDS (Mahidol University, Thailand). Certificate in Operative Dentistry and MS (UNC at Chapel Hill, USA). Certificate in Prosthodontics (University of Iowa, USA) The post Ron Leehacharoenkul: Esthetic tooth replacement (Straumann® Bone Level Implant) appeared first on STARGET COM.

Adrian Kasaj: Treatment of multiple recessions with a modified coronally advanced flap (botiss mucoderm®)

  A 29-year-old female patient presented at our clinic with the desire for an esthetic improvement of her teeth. Teeth 1.2 to 1.4 showed multiple Miller class I recessions with a particularly deep recession of >6mm at tooth 1.3 (Fig. 1). The patient was healthy with good oral hygiene. She raised concerns against the harvesting of a connective tissue graft from the palate; therefore, we decided to treat the recessions with botiss mucoderm®, an acellular dermal collagen matrix which is derived from the dermis of pigs through a multi-stage wet-chemical cleaning process. It can be applied instead of an autologous tissue graft in various situations, including the augmentation of attached gingiva and covering of gingival recessions. PICTURE DOCUMENTATION Fig. 1 kasaj1 Fig. 2 kasaj2 Fig. 3 kasaj3 Fig. 4 kasaj4 Fig. 5 kasaj5 Fig. 6 kasaj6 PROCEDURE The exposed tooth roots were prepared with an air scaler and then treated with 24 % EDTA for 2 minutes. The flap was performed according to Zucchelli with two angular incisions, avoiding the need for vertical incisions (Fig. 2). The anatomical papillae were de-epithelialized. The mucoderm® was rehydrated for 7 minutes in sterile saline solution to enable sufficient flexibility for the adaptation of the matrix to the tooth roots. The matrix was then fixed to the periosteum with cross sutures (Fig. 3). Subsequently, the flap was coronally repositioned and fixed with polypropylene 6-0 sutures (Premilene by B. Braun Melsungen AG). The surgically created papillae were sutured over the de-epithelialized anatomical papillae. Particular attention was paid to complete coverage of the collagen matrix (Fig. 4).  Post-operative care included rinsing with 0.12 % CHX solution twice a day and 600 mg ibuprofen if needed. Furthermore, the patient was briefed to avoid tooth brushing in the affected region for 14 days. Sutures were removed 10 days post-operative. The healing time was uneventful. The control at 3 months post-op demonstrated almost complete coverage of the previously exposed tooth roots as well as clear thickening of the marginal gingiva (Fig. 5). In region 1.3 to 1.4, an area of dense connective tissue was visible with a cleft marking the area were the mucoderm® matrix was sutured. Eighteen months post-op, this irregularity has disappeared, without the need for gingival plastic surgery. The gingiva were homogenous and bright (Fig. 6). The patient was very satisfied with the esthetic result. DISCUSSION In the last two years, we have treated more than 50 patients with the mucoderm® membrane. Due to very good and predictable results, we prefer applying the matrix using either the tunnel technique or the Zucchelli approach. In any case, good flap mobilization is very important to allow for complete coverage of the matrix and a tension-free closure, both of which are essential for a successful and esthetic outcome. mucoderm® is an acellular matrix which needs to be revitalized. As revitalization from the underlying tooth roots is not possible, an ingrowth of vessels from the covering flap should be ensured. Insufficient mobilization with tensions on the flap could lead to early exposure of the matrix and hence its degradation. An interesting observation that we made in many cases was an improvement in the esthetic outcome progressing for several months after the surgical treatment. A kind of creeping substitution as well as the leveling of irregularities in the thickness of the gingiva without any plastic surgery intervention can be observed. Adrian Kasaj p_kasaj Adrian Kasaj Dr. med. dent/PhD Specialist in periodontology (European Dental Association). Associate Professor at the Department of Operative Dentistry and Periodontology, University of Mainz, Germany. Vice Chairman of the “Neue Arbeitsgruppe Parodontologie e.V” (NagP). Author and co-author of more than 80 scientific publications within the field of periodontology. Numerous national and international courses and lectures in the fields of regenerative periodontal therapy and plastic periodontal surgery. The post Adrian Kasaj: Treatment of multiple recessions with a modified coronally advanced flap (botiss mucoderm®) appeared first on STARGET COM.

The growing importance of biomaterials (botiss regeneration system)

  Each situation and patient is individual – and so is the clinical user. Today, a multitude of different bonegrafting materials are available that offer attractive alternatives to patients’ autologous bone. In addition, there is widespread use of various membranes and other collagen-based materials that support bone and soft tissue regeneration. All of these materials demonstrate distinctive properties, based on their origin and the production process, that result in certain advantages or disadvantages, depending on the specific situation. Dr. Christiane Marinc, Head of Product Management at botiss medical. Each patient is individual and the same applies to the clinical users. Consequently, the treatment plan and applied materials should be chosen with regard to the individual indication, defect configuration, the preferences of the patient, as well as the experience and skills of the surgeon. Hence, the many expectations with respect to the “ideal” bone graft or the “ideal” membrane cannot be met by one single product. This is the reason why botiss offers a broad portfolio of different biomaterials – the botiss regeneration system – enabling the clinical user to achieve optimal and predictable results in every situation. (Click on the picture for a more detailed view) CERABONE® RELATED ARTICLES PREDICTABLE LONG-TERM VOLUME STABILITY WITHOUT THE RISK OF RECURRING RESORPTION Among bone graft materials, bovine bone has a very long tradition and well-documented use. The bovine bone graft cerabone® is produced from the femoral heads of cattle destined for the food industry. The unique high-temperature treatment during the production process lays the basis for its maximum safety, turning the bovine bone into a pure hydroxyapatite ceramic of such high crystallinity that it is insusceptible to complete degradation by the body’s own processes. The cerabone® particles become completely integrated into the newly formed bone matrix, offering the advantage of predictable long-term volume stability without the risk of recurring resorption. This feature is of importance in several indications, e.g. augmentations of the buccal wall in the anterior ridge where the bony support of the soft tissue is critical for a long-term aesthetic result. cerabone® is especially useful in maintaining the contours of the ridge when no implantation is planned, and hence no functional loading will take place after augmentation. MAXRESORB® RELATED ARTICLES SYNTHETIC BONE GRAFT SUBSTITUTE WITH CONTROLLED RESORPTION PROPERTIES While many doctors are successful and satisfied with the application of bovine products, others prefer fully synthetic bone-grafting materials. Synthetic materials provide solutions for patients that oppose the use of xenogenic materials, and are also favorable in cases where the patient’s own regenerative capacity allows complete resorption of the biomaterial. The purely synthetic bone graft maxresorb® is completely resorbed and replaced by the body’s own bone within about two years. Due to its biphasic composition of 60 % HA and 40 % beta-TCP, the material is gradually degraded, providing space for new bone formation while ensuring mechanical stability over a longer time period. By mixing maxresorb® particles with a nano-HA gel, an injectable and non-hardening bone paste is obtained; the maxresorb® inject. The large surface area of the nano-HA particles facilitate interaction with bone cells, thus promoting rapid regeneration. On the other hand high cellular interaction increases the particles susceptibility to degradation, thus the material is not suited for the regeneration of larger or non-contained defects. MAXGRAFT® RELATED ARTICLES EXCELLENT HANDLING IN TERMS OF SHAPING AND SCREWING If the focus is on an especially natural regeneration, fast and complete remodeling may be achieved with allogenic materials from human donors. Even complex, three-dimensional defect situations may be treated with allogenic bone blocks; this is made especially easy by using the sophisticated maxgraft® bonebuilder concept. The allogenic blocks and granules of the maxgraft® product line contain natural collagen that is preserved within the mineral phase of the bone during the production process. Collagen is a versatile protein that exerts chemotactic influence on osteoblasts and endothelial cells, thereby supporting the rapid incorporation and complete remodeling of the biomaterial. In addition, blocks of mineralized collagen offer excellent handling in terms of shaping and screwing, and have therefore become the current material of choice for block augmentation. The new maxgraft® solutions further demonstrate that botiss not only pursues established approaches, but also focuses on individual concepts and problem-oriented individual solutions. The maxgraft® bonebuilder technology is an important innovation in the field of block augmentation. Based on the three-dimensional radiological data of the defect/ridge, the allogenic bone transplant is designed and shaped into an individual construct. The exact fitting of the individualized bone block to the surface contours of the bone bed promotes optimized healing and improves the predictability of the augmentation. The shortened surgical time as compared to traditional block grafts (no intra-operative adaptation of the block) further adds to its advantages. MAXGRAFT® BONE RING RELATED ARTICLES SIMULTANEOUS AUGMENTATION AND IMPLANTATION IN A ONE-STAGE PROCEDURE The maxgraft® bone ring is a prefabricated allogenic bone ring that enables simultaneous augmentation and implantation in a one-stage procedure. The so-called bone ring technique can be applied for many indications and is of particular benefit for vertical augmentations and one-stage sinus lifts with minimal maxillary bone height (between 1-4 mm). JASON® MEMBRANE RELATED ARTICLES A NATURAL MULTILAYER STRUCTURE FOR APROLONGED BARRIER FUNCTION The botiss soft tissue portfolio also takes account of different treatment concepts. For instance, there is currently a general agreement that barrier membranes of collagen, which exhibit a long barrier function or support rapid vessel penetration, lead to especially successful GBR. Botiss has picked up on both ideas in its soft tissue product line. The Jason® membrane, which originates from porcine pericardium, offers a naturally long barrier function of 4 – 6 months due to its native multilayer structure. Accordingly, it guarantees an undisturbed bony regeneration, in particular for larger augmentative procedures. Due to its inherent architecture based on collagen type-1 and an increased content of collagen type-III, the Jason® membrane demonstrates excellent tear resistance and its low thickness supports excellent surface adaptation and aids in achieving tension-free wound closures. COLLPROTECT® MEMBRANE RELATED ARTICLES FOR MEDIUM BARRIER FUNCTION WITH EXCELLENT ANGIOGENIC FEATURES With the launch of the collprotect® membrane, botiss has extended its range of membranes to include a membrane with a medium barrier function of 2 – 3 months that displays excellent angiogenic features. The collprotect® membrane originates from porcine dermis. Its transmembraneous pore structure supports the rapid ingrowth of blood vessels into the defect area, while the dense collagen structure maintains a barrier against soft tissue ingrowth. It offers adequate protection for regeneration of most defetcs.   JASON® FLEECE RELATED ARTICLES RESORBABLE COLLAGEN SPONGE FOR WOUND MANAGEMENT In situations that do not require a particular barrier function, the Jason® fleece offers a cost-effective alternative, e.g. for protection of the Schneiderian membrane or covering extraction sockets. Du to the inherent hemostatic effect of the natural collagen and the highly porous structure, Jason® fleece helps to stabilize the blood coagulum and supports wound healing. It might be applied to cover minor oral wounds or biopsy harvesting sites. Furthermore, Jason® fleece offers a cost-effective alternative in situation that do not require a particular barrier function, e.g. for protection of the Schneiderian membrane or to cover extraction sockets. COLLACONE® RELATED ARTICLES A CONE-SHAPED COLLAGEN FLEECE TO FIT IN THE EXTRACTION SOCKET Collacone® is a cone-shaped collagen fleece that was designed to fit in the extraction socket and specifically aimed at stabilization of the blood clot following tooth extraction. MUCODERM® RELATED ARTICLES A THREE DIMENSIONAL COLLAGEN MATRIX Another innovative product from the botiss portfolio is mucoderm®, which is made from porcine dermis, developed for soft tissue augmentation. The complex collagen structure serves as a scaffold for ingrowing vessels and soft tissue cells, and is gradually remodeled into the patient’s own tissue. The application of mucoderm® circumvents the need for harvesting autologous gingival or subepithelial transplants during recessions coverage, regeneration of soft tissue defects and augmentation of attached gingiva. Accordingly, post-operative pain and risk of complications may be reduced, while the patient’s acceptance of the surgical intervention may increase. INNOVATION AND EDUCATION In the future, we will continue to work on the development of new and innovative products and concepts. A composite material made of biphasic calcium phosphate and porcine collagen has been registered and the market entry is under preparation. Furthermore, allogenic plates of cortical bone will be available soon for application of the shell technique. A non-resorbable synthetic membrane made of dPTFE is currently going through the approval process. It is the broad product portfolio and the ongoing development of new innovative biomaterials that makes the botiss regeneration system stand out. The clinical users may select their own individual portfolios based on different aspects, knowing that in case of need there are always other prominent alternatives within the system they can rely on. Moreover, a broad product portfolio requires a complex system of ongoing education. botiss continuously recruits experts to give lectures and courses at different levels and to discuss their clinical and scientific results. THE BOTISS PORTFOLIO All articles related to the botiss biomaterials portfolio. Click here BROCHURE All about the Straumann® Biomaterials offering: “When one option is not enough”. Click here SUBSCRIBE Subscribe to our monthly STARGET newsletter to receive the latest news about implant dentistry. Click here The post The growing importance of biomaterials (botiss regeneration system) appeared first on STARGET COM.


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