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Video Details
New Technologies in Bone and Implant Reconstruction of the Posterior Mandible

Description:
This video series will highlight the extraction of a hopeless mandibular molar followed by autogenous bone grafting utilizing a new ACM (auto bone chipper) for easy harvesting of autogenous bone from the ramus. This bone is mixed with PRGF (Platelet Rich in Growth Factors) to reconstitute the deficient posterior mandible. 3 months later, Trabecular Metal Implants are inserted into the newly healed grafted site which will allow for early healing and the potential for earlier loading in lower quality bone areas. Trabecular Metal implants midsection are similar in structure to autogenous trabecular bone with high porosity which allows for early bone ingrowth.

Date Added:
11/10/2012

Author(s):

Maurice Salama, DMD Maurice Salama, DMD
Dr. Maurice A. Salama completed his undergraduate studies at the State University of New York at Binghamton in 1985, where he received his BS in Biology. Dr. Salama r...
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Questions & Comments
Charles Botbol - (11/17/2012 11:50 PM)

Hi Maurice I hope all is well and that was a beautiful surgical technique. Couple of questions regarding some of the instruments. As I am trying to keep my surgical kit small and simple, I'm curious as to which of the serrated curette sizes do you use most for the anterior and or posterior? I also noted that you used a serrated forcep.Either way which Models do you recommend for the anterior or posterior or upper or lower? Also I'm curious if you've ever created a list such as "top 10 surgical instruments I could not live without", Since you've been doing this for so long I'm sure there are some instruments that make life a lot easier.?

Maurice Salama - (11/17/2012 10:49 AM)

Terry; Thanks. No issues with Lingual Nerve injury if you keep your incision towards the crest and don't extend the incision down the lingual slope of the ridge. Excellent question and observation. Dr. S

terry abel - (11/16/2012 5:33 PM)

Beautiful surgery. Inspiring. Any concerns with lingual nerve injury and the pedicle flap closure?

Maurice Salama - (11/13/2012 12:52 PM)

Fernando; Yes, hello. The Best sizes are the 5mm, 6mm and 7mm Long shank 17mm drill length. Of course there are time where space is limited and a short 14mm drill may be supeior for access. Thanks for your interest and hope to see you in Vegas.
Dr. Salama

Fernando Lores - (11/13/2012 8:32 AM)

Hi Dr. Salama, remember me? I translated your excellent lecture when you came to Peru this year. Thanks for this great video. Could you tell us which sizes of ACM bone collectors are the most useful and for what areas? Thanks!

Maurice Salama - (11/11/2012 8:36 PM)

Ali; Thank you. It is the ACM Bone Collector from Neobiotech and you can Order it at the bottom LEFT of the screen if you are interested. Just click on the BUY button. good luck Dr. Salama

Ali Mandoub-Hashemi - (11/11/2012 8:07 PM)

Dr. Salama, Excellent video and technique. Can you please give me the name of the instrument you used to harvest the bone with plastic sleeve. Thanks.

Maurice Salama - (11/8/2012 9:55 PM)

Bassam; Thank you. Yes, if I were only replacing the 1st molar I could have utilized a wide or even a super wide implant as the bone regeneration was quite successful. I did utilize two 4.7mm diameter implants here for the 1st and 2nd molars which I feel are acceptable. As for Diode laser to perform minor gingival plasty, I would prefer a CO2 or NdYAG or even a radiosurgery. I will show the restorative portion of this case in the near future as no additional soft tissue work was needed. regards Dr. Salama

Bassam Algheryafi - (11/8/2012 6:40 PM)

Dr.Salama, thank you for sharing this interesting case and thanks to every one who contributed to the discussion. If you weren't attempting to restore tooth #18, why didn't you just use one big implant to replace #19? Also, do you still need to perform any sort of surgery, e.g., utilizing diode laser, to refine the emergence profile prior to restoring the implants?

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