Dental Education
Online Dental Education Dental education lectures and videos Online dental ce Dental education articles Expert dental educators Dental products education Dental Community
 
Video Details
Guided Bone Regeneration of a Compromised Extraction Site

Description:
In this surgical technique video, Dr. Michael Sonick shares a routine clinical challenge and demonstrates the extraction of a fractured premolar with simultaneous guided bone regeneration. His very detailed and concise demonstration focuses on the preparation of the extraction site as well as the utilization of growth factors and membranes.

Date Added:
9/24/2010

Author(s):

Michael Sonick, DMD Michael Sonick, DMD
Dr. Michael Sonick is a full time practicing periodontist and implant surgeon in Fairfield, Connecticut. He is also an active teacher, clinical researcher and author. ...
[read more]


Featured Products




Online Videos / Surgery / Bone Grafting / Guided Bone Regeneration of a Compromised Extraction Site




Questions & Comments
Joon Kim554 - (10/7/2017 9:33 AM)

Do you use surgical handpiece with the brassler bur 7408028? Is this a carbide bur that people often use for their composite?

Joon Kim554 - (10/7/2017 9:31 AM)

I wouldn't cover the top part of the socket with the membrane you used on covering the buccal. All resorbable membranes (even the long lasting ones), resorb too early when exposed to saliva enzyme. These membranes are supposed to be used for primary closure but we need secondary closure to achieve keratinized tissue. Ideal way to do it is do exactly what you did but also cover the top part with PTFE non resorbable membrane.

alireza torabi - (8/10/2013 9:06 PM)

Good job!

Mike Sonick - (4/20/2013 11:19 AM)

George. Thanks for your question. Please see my answer below to Benjamin. I agree with the publication by Artzi. That is why I use cancellous allograft with a growth factor. I obtain 50% vital bone in 6 months.

Mike Sonick - (4/20/2013 11:17 AM)

Benjamin There is not way to know if there is vital bone without a biopsy. In my experience the use of BioOss and Biogide results in 50% vital bone in approximately 6-9 months. The turnover is slow. I usually use Puros or some other bone allograft with Gem 21 and a collagen membrane. I have been able to obtain 50% vital bone in 4 months with this technique. For more information you may want to consult my text Implant Site Development published by Wiley Blackwell

Benjamin Saidel - (2/21/2013 8:36 PM)

Dr Sonick I am a quite new with these bone grafting techniques so your assistance will be greatly appreciated I grafted a socket following the extraction of a upper left first molar last year which had fractured post endo. (There was periapical pathology extending into the furcation with an associated buccal swelling.) Following extraction of the tooth it became obvious that the buccal plate had been lost so I raised a flap and grafted the socket using only Bio-OSS and a Bio-guide membrane. The socket healed uneventfully ( some granules had leaked out from under the membrane at 1 week review but did not seem to adversely affect healing) This was 6- 8 months ago. I have reviewed her a couple of times during this period and clinically the tissues have healed well. I have also taken peri apical X-rays which show the graft material  The patient is now ready to have the implant placed. I have taken a CBCT and in the area of the socket is a dense radiopacity which must be the graft material. My question to you is the following- Has bone formed in this area or is it only graft material? I am now concerned that when I raise a flap to place the implant all I will find is graft material with little or no new bone,which may even come away in the flap and I will be left with an open socket or partially healed socket Kind regards Benjamin Saidel London

George Kotsakis - (4/24/2011 11:19 AM)

Dr Sonick, you have been fastiduous in explaining us every step as always, thank you very much. I have only one question, you seem to have used some bovine graft as well. I have in my mind the publication by Artzi et al on bovine xenografts, where after 6 months the had minimal mature bone, mostly CT on the coronal aspect of the socket and almost 35% of xenograft all over the socket. Howcome u manage to get back in, as early as 5 months and get dense bone???

Mike Sonick - (12/12/2010 6:12 PM)

Jorge
The membrane was not exposed. It was placed underneath the tissue and a collagen plug placed coronally. altho the collagen plug is left exposed this does not seem to be a problem for it is completely epithelialized within two weeks. I used to use CTG for this procedure but have found them to take more time with no improvement in result.

Immediate implants without a flap with this technique would be a probelm for the buccal plate would not be regenerated. It is all about eh buccal plate. If no buccal plate exists you must flap and regenerate independent of whether you are placing an implant or not.

Jorge Gutierrez - (11/29/2010 9:42 AM)

Dr Michael I would like to know in your video the membrane was exposed to the mouth that does not compromise the final result of their work, would not be better to cover with tissue graft?
What do you think of making an immediate implants with the technique without flap?

Related Videos
The Palatal Bone Block - An Innovative Autogenous Harvest Site Premium Member Content

The Palatal Bone Block - An Innovative Autogenous Harvest Site
This lecture will take you through the step by step technique of harvesting and fixing the bone blocks harvested from the palate.

Presented By:: Howard Gluckman, BDS, MChD
Presentation Style: Lecture
Community Rating:
 
Watch Now>>
Managing 3D Shape and Space in Bone Augmentation: Putty Assisted Regeneration. Premium Member Content

Managing 3D Shape and Space in Bone Augmentation: Putty Assisted Regeneration.
This presentation will demonstrate the utilization of Novabone in several different applications to include ridge preservation and sinus grafting and immediate implant placement.

Presented By:: Richard Martin, DDS
Presentation Style: Lecture
Community Rating:
 
Watch Now>>
Autogenous Bone Graft - Part 4: Suturing and Tension Free Closure Premium Member Content

Autogenous Bone Graft - Part 4: Suturing and Tension Free Closure
Suturing and tension free closure in bone augmentation.

Presented By:: Michael A Pikos, DDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
Related Courses
Modern Implant Dentistry: Rules of Engagement in the Esthetic Zone - Part 1 of 2 Premium Member Content

Modern Implant Dentistry: Rules of Engagement in the Esthetic Zone - Part 1 of 2
This presentation will focus on the interdisciplinary relationship of the restorative dentist, periodontist and orthodontist to reconstruct the soft tissue foundation for all of these restorative options in anterior tooth replacement. The diagnosis of deficiencies as well as the varied treatment options will be discussed in detail. This includes periodontal crown lengthening, esthetic periodontal plastic soft tissue grafting procedures as well as prescription adjunctive orthodontic tooth movement to manipulate the soft tissue foundation prior to or subsequent with the restorative options of implants, bridges, or pontic replacement.

Presented By:: Maurice Salama, DMD;David Garber, DMD
Presentation Style: Online Self-Study Course
CE Hours: 1 Continuing Education Unit (CEU)
Watch Now>>
Esthetic Tissue Reconstruction Around Implants - Part 1 of 2 Premium Member Content

Esthetic Tissue Reconstruction Around Implants - Part 1 of 2
Esthetics in implant-supported restorations is an important clinical objective in contemporary dentistry. Understanding the biological behavior of hard and soft tissues following tooth extraction is the first step to anticipate the physiological tissue remodeling and its consequences. Our objective in these 2 sequencial lectures was to provide straightforward decision trees related to several clinical scenarios observed in routine clinical practice. The 3 fundamental pillars for peri-implant excellence are: restorative-driven implant position, hard and soft tissue reconstruction using different biomaterials and grafts, and prosthetic management. Using this philosophical approach seems to provide esthetic and stable results over time irrespective of the initial clinical condition.

Presented By:: Robert Carvalho da Silva, DDS, PhD
Presentation Style: Online Self-Study Course
CE Hours: 1 Continuing Education Unit (CEU)
Watch Now>>
Esthetic Zone Reconstruction: Synergy of Hard and Soft Tissue Grafting Premium Member Content

Esthetic Zone Reconstruction: Synergy of Hard and Soft Tissue Grafting
The loss of alveolar ridge contour in the esthetic zone compromises both esthetics and function. This clinical presentation will focus on the application of both hard and soft tissue grafting in the esthetic zone implementing state of the art interactive CT diagnosis and treatment planning for optimal esthetic implant reconstruction. Emphasis will be on indications, graft and harvest site assessment, timing, and use of bioactive modifiers including BMP, PRGF and PDGF. The surgical protocol utilizing allogeneic and autogenous grafts in conjunction with connective tissue grafts, acellular dermis matrix, and related soft tissue procedures to avoid functional and esthetic pitfalls will be featured. Pre and post-grafting prosthetic workup, interactive CT graft assessment and perio prosthetic driven implant planning, stent driven implant placement, and computer milled abutment fabrication including guided surgery will be included.

Presented By:: Michael A Pikos, DDS
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Related Articles
Post-Traumatic Treatment of Maxillary Incisors by Immediate Dentoalveolar Restoration with Long-Term Follow-Up

Post-Traumatic Treatment of Maxillary Incisors by Immediate Dentoalveolar Restoration with Long-Term Follow-Up
Replacing both missing maxillary interior teeth is particularly challenging, especially in compromised sockets. The case report describes the management of an 18-year-old female patient, who suffered avulsion of both maxillary central incisors at 7 years of age. The multidisciplinary implant technique, called Immediate Dentoalveolar Restoration (IDR), included extraction of the injured teeth and a single procedure for immediate implant placement and restoration of the compromised sockets after root fracture and peri-apical lesion development were detected during orthodontic treatment. Successful esthetic and functional outcomes and reestablishment of the alveolar process after bone reconstruction were observed during the 3-year follow-up period. The predictable esthetic outcomes and soft and hard tissue stability that can be achieved following IDR are demonstrated.

Author(s): José Carlos Martins da Rosa, DDS, MS;Ariadene Cristina Pertile de Oliveira Rosa, DDS, MSc; Carlos Eduardo Francishone, DDS, MSc, PhD; Mauricio de Almeida Cardoso, DDS, MSc, PhD; Ana Carolina Alonso, DDS; Leopoldino Capelozza Filho, DDS, MSc, PhD
View Article>>
Long Term Follow-Up of Dental Implants Placed in Autologous Onlay Bone Graft

Long Term Follow-Up of Dental Implants Placed in Autologous Onlay Bone Graft
The aim of this study was to evaluate the efficacy of autologous intraoral onlay bone grafting (OBG) in correlation with long-term survival rates of dental implants placed in the augmented bone. A retrospective study was conducted on 214 patients who received a total of 633 dental implants placed in 224 autologous intraoral block OBG augmentations, combined with Bio-Oss – mixed with platelet-rich plasma (PRP) and covered by platelet-poor plasma (PPP) – as scaffold, with a follow-up time up to 137 months. We suggest that augmentation of severely atrophied jaw bone through the placement of horizontal and/or vertical intraoral OBGs in combination with Bio-Oss saturated with PRP and covered by PPP should be considered a reliable, safe, and very effective surgical technique for obtaining high bone graft survival rate and high long-term implant survival rate.

Author(s): Devorah Schwartz-Arad, DMD, PhD;Ronen Ofec, DMD, MSc; Galit Eliyahu, PhD; Angela Ruban, PhD; Nir Sterer, DMD, PhD
View Article>>
Subclassification and Clinical Management of Extraction Sockets with Labial Dentoalveolar Dehiscence Defects

Subclassification and Clinical Management of Extraction Sockets with Labial Dentoalveolar Dehiscence Defects
Immediate implant therapy involving implants placed into intact Type 1 extraction sockets has become a consistent clinical technique. The classification of Type 2 extraction sockets, where the mucosal tissues are present but there is a midfacial osseous dehiscence defect, has been described according to the extent of the buccal bone plate absence. The literature has offered different techniques in the treatment of Type 2 sockets; however, the extent of the defect has never been defined or delineated.

Author(s): Stephen J. Chu, DMD, MSD, CDT;Dennis P. Tarnow, DDS;Guido O. Sarnachiaro, DDS; Mark N. Hochman, DDS
View Article>>
Contact Us | Privacy Policy | Terms of Use
©2019

Preferred Language: English Flag
Contact Us · Login · Register