Robert Odegard - (1/31/2010 8:49 PM)

Is it recommended to remove the membranes with the sutures in two weeks? I have been leaving mine in for 4-6 weeks. I have been getting great results.

Robert Odegard - (1/31/2010 8:49 PM)

Is it recommended to remove the membranes with the sutures in two weeks? I have been leaving mine in for 4-6 weeks. I have been getting great results.

Barry Bartee, DDS, MD - (2/24/2009 1:47 PM)

Here are links to images of the case reports mentioned in my response.

http://dentalxp.com/xperts/76/ti250_flapless.pdf

http://dentalxp.com/xperts/76/Cytoplast_Technique_Single_Page_09.pdf

http://dentalxp.com/xperts/76/dual_layer_cytoplast.pdf

Paresh Dodhiwala - (2/22/2009 2:57 AM)

excellent presentation

Barry Bartee, DDS, MD - (2/18/2009 6:23 PM)

Thank you for the question Dr. Haq. If there is a bony dehiscence of the buccal wall, my choice of protocols and materials will differ depending on the morphology of the defect and esthetic demands of the patient, i.e. smile/lip line, and gingival biotype. In esthetically demanding cases, assuming a moderate or thick biotype, I will use a layered approach using mineralized bone, bovine collagen membrane (Cytoplast RTM) and then the PTFE membrane over that (Cytoplast TXT 200). If more than 1/2 of the socket width is missing, then I will not place an immediate implant, but rather graft and place the implant later in a staged approach. The titanium reinforced version of the dPTFE membrane (Cytoplast Ti250 AN) can be used as well, and this can even be used with a tunneling approach, avoiding incision and reflection of the interdental papilla. I will post a link to that case report and the dual layer case report. As far as using alloplastic materials, that would be appropriate if you have a patient that does not want to use allograft, but the time to achieve bone regeneration is typically longer, greater than 6 months in my experience, and as a result there will be some additional volume loss compared to using the faster resorbing alloplasts. I have had sucecss with beta tricalcium phosphate in this application.

Wleed Haq - (2/10/2009 4:25 AM)

Dear Barry,
What protocol and which materials would you use if you had a dehisence of the buccal wall during extraction of an upper incisor? Could this be achieved using alloplastic materials? Many thanks.

Timothy Williams - (11/19/2008 12:57 PM)

Since taking Dr. Bartee's socket preservation courses many years ago I have experienced nothing short of success. Since using the Cytoplast TXT-200 membrane and Cytoplast PTFE suture combination, I have seen the predictability of excellent tissue response sky-rocket. Patient's have been extremely complimentary of the healing period and lack of post-operative complications. As stated by Dr. Rabinowitz, I likewise have seen excellent bone quality and quantity upon implant placement. Thank you Dr. Bartee for this very clear and informative video on Extraction Site Grafting.

Jeffrey Rabinowitz - (11/9/2008 7:16 AM)

Very nice presentation. I have been successfully utilizing Dr Bartee's extraction site preservation technique for several years. I use it routinely in single tooth extraction cases where five essentially intact socket walls remain. I have only occassionally used it for multiple extraction site cases or in cases of compromised buccal and/or lingual wall integrity - instances in which I typically utilize collagen membranes. In five walled single extraction cases, I have consistently seen excellent bone quality and quantity for subsequent successful implant placement or as pontic receptor sites. I have always used Puros as the graft material along with the Cytoplast TXT-200 membrane with great results. Even lacking primary closure, which is typically the case, the post-op course is calm and comfortable. For anyone who has not tried this technique, I highly recommend it as being precictable and successful. Dr Bartee's one day course on socket preservation and this particular technique is also quite worthwhile. As an aside, the technique is very cost effective, due to the reasonable pricing of the membranes, but as they are so good and the procedure is so predictable and successful, I would likely utlize them regardless of cost.

Michael Weinberg - (11/1/2008 9:18 PM)

Barry, Well done! I've gone back to using the Cytoplast TXT-200 instead of collagen membranes. I am getting much better results.