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Video Details
Surgical Options and Solutions in Maxillary Ridge Augmentation: Advantages of Combined Therapy

Description:
This surgical video presentation will demonstrate the treatment of two advanced cases of maxillary deficiency. The emphasis of this presentation will be on combining several state-of-the-art surgical augmentation therapies to optimize dimensional increases in the deficient ridges in the maxilla in preparation of implant therapy. The two cases presented, of severe and moderate bone defects, in the Anterior Maxilla, the bone were reconstructed by using the anatomy (sub-nasal elevation), and several surgical techniques (bone augmentation, soft tissue manipulation and implant placement) in a systematic team oriented protocol (Surgeon, Restorative Dentist and Lab) to get the best esthetic results.

Date Added:
9/9/2013

Author(s):

Devorah Schwartz-Arad, DMD, PhD Devorah Schwartz-Arad, DMD, PhD

Devorah Schwartz-Arad, DMD, PhD

A specialist in Oral and Maxillofacial Surgery (OMS), Ph.D. degree in cancer research, anatomy and embryology...
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Online Videos / Surgery / Bone Grafting / Surgical Options and Solutions in Maxillary Ridge Augmentation: Advantages of Combined Therapy




Questions & Comments
Devorah Schwartz-Arad - (9/30/2013 5:47 AM)

Maurice
Sorry for the delay answer ,during the last decay I used the combination of p-PRP covered with p-PPP (platelets poor plasma) and my clinical experience with prp/ppp (yet not in vitro research), is very good and predictable. Nevertheless, in the search for the best "progenitor cells releaser" I've started lately to use concentrated Bone Marrow Aspirate (BMA) combined with PPP cover, with promising results. My clinical experience with BMP2 is limited (only few cases) but obviously, it does not imply excluding this option as part of the therapy.
Although there is evidence that the L-PRF membranes enable better sustained release of the growth factor and the matrix protein than the P-PRP gel membranes, the various platelets poor plasma (p-PRP and p-PPP) I am using, encompass very different biological characteristics. On top of that, an accurate definition and characterization of the different families of products is a key issue for a better understanding and comparison of the reported clinical effects of these surgical adjutants. (Dohan Ehrenfest DM, et al. Curr Pharm Biotechnol. 2012)
Dubi

Maurice Salama - (9/17/2013 9:56 AM)

Dr. Devorah Schwartz-Arad; Outstanding clinical presentation. Well described with CBCT and highlighted in your treatment options displayed. I have moved from PRP to PRGF/PRF in the last 12 years and have initiated my experience with BMP-2 in similar cases. Have you any experience with these biological agents? thanks Dr. Salama

Devorah Schwartz-Arad - (9/16/2013 1:30 PM)

Dear Alaa,
It is very important to improve the available bone and soft tissue -prior to implant placement, and only than fabricate the prosthesis, to rehabilitate the missing teeth and if still needed also the soft tissue. This allows better implant anchorage, better long-term success and easier oral-hygiene care. Yet, in cases when the available bone is suitable for implant placement, or in cases with high smile line, one might prefer the pink prosthetic border as superior as possible, for aesthetic outcome.

dinh bui - (9/14/2013 8:54 AM)

Thank you Dr. Shwartz for the great works. Just want to post few suggestions. PPP and PRP is an excellent way obtain regeneration result. However, we can use the much simpler BMPs technique with Infused Bone Graft from Metronics. That way we reduced the donor site healing and achieve similar or even better result. On the first case, We should restored with individual tooth. In the second case, connective tissue graft can be avoided with the lateral incisor cantilever with the cental incisor, contact point moved lower toward the bone crest, and canine restored by single crown. This will allow for the papilla to regenerate since the we lower the distance from interproximal contact to bone crest less than 6mm (according to Glickman). We have seen this so many times in the last 14 years of my practices. However, these are great cases with great result. Thank you for sharing with us.

Alaa YASSIN - (9/12/2013 11:57 PM)

Thank you Dr. Shwartz for these nice cases. About the first case, and as we get to the final point with a screw retained prosthesis with pink ceramic restoring the gingiva, was it a good alternative treatment plan to place implants at the available bone and then to fabricate a partial hybrid prosthesis, to rehabilitate the gingival missing tissue as well as the lip support? Thank you. Alaa

Dr. Janna Varfolomeyev - (9/12/2013 1:50 PM)

Greate work. .I saw this presentation in Puria hospital and today I enjoyed it twice

carlos cardenas - (9/12/2013 12:57 PM)

Excellent s case , and interesting procedure complexes cases.

Sam Busich - (9/12/2013 9:52 AM)

Great Presentation! Remarkable Technical Surgical Skill. Thanks Sam

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