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Video Details
Surgical Protocols for Socket Type 2 in the Aesthetic Zone

Description:
The topic of this presentation is an implant surgical procedures for a socket type 2 (socket missing buccal bone) in an aesthetic area, with emphasis on modified IVAN* technique for socket preservation. IVAN* stands for inter-positional vascularised augmentation neogenesis. Author`s guidelines for selection of appropriate surgical protocols for sockets missing buccal bone wall, protocols that are proved to be most effective, are presented. Early implant placement with GBR, prosthetic socket preservation and socket augmentation with socket sealing are shortly presented as alternatives for some cases. From author modified IVAN technique is shown step by step.

Date Added:
9/3/2015

Author(s):

Snježana Pohl, MD, DMD Snježana Pohl, MD, DMD
Zagreb Faculty of medicine, Munich Faculty of Dental Medicine. Work experience at the General surgery and Orthopedics in Munich. Oral Surgery residency in Munich. Doctorate in...
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Online Videos / Surgery / Bone Grafting / Surgical Protocols for Socket Type 2 in the Aesthetic Zone




Questions & Comments
Tarek Assi - (10/27/2017 3:21 AM)

Thank you! Very nice presentation.

Vedran Šebečić - (6/27/2017 5:07 PM)

Very nice presentation and explanation of the procedure and cases. It was a joy to watch it. Thanks for sharing such a good technique. Good luck with the future work in oral surgery Snjezana. :)

snjezana pohl - (2/11/2016 8:30 AM)

I am delighted to discuss this subject. This is the best way to revisit and to learn. Buccal bone missing socket has four bone walls: palatal, medial, distal and apical. There is a buccal periosteum too. It is a great potential for regeneration, if handled properly. The socket inside I fill with autogenous bone gained with bone scraper. This autogenous material is not milled, it has a great bone regeneration potential too. There are few presented cases and a lot of discussion in dentalxp forum about Khoury technique for bone augmentation - autogenous bone gained with bone scraper plus cortical plates make this technique so predictably successful. Slow resorbable bone substitute granola (xenograft) has just about 1,5 mm thickness and it is in place to prevent autogenous bone resorption and to build a future cortical bone plate. Would I add BMP? If I had BMP I would. In Croatia we don`t have yet : BMP, allografts, Densah burs :)

Michael Corsello - (2/10/2016 7:07 PM)

With a barrier membrane containing the graft within the socket and the facial covered with the CT, what signals bone to grow on the facial? I would presume, in the end, the bulk (convexity) of the facial tissue is primarily CT and not bone. This is very good, but wouldn't you rather regenerate bone out there? Simply as a point for discussion, would you consider modifying this excellent procedure by placing additional autograft (or BMP or other osteoinductive material) on the facial side of the defect and complete the CT reposition over that for enhanced vascular closure. Of course you may have to do the frenectomy and loosen up additional tissue for a low tension closure. Thank you!

snjezana pohl - (2/10/2016 4:16 AM)

Thank you, Michael. If there is infection I would extract the tooth and perform prosthetic socket preservation. Three months after extraction implant placement with CTG. If the patient can not come for pontic shortening in 3 weeks intervalls I would perform an early implant placement with GBR and VIP CT. After taking out a tooth with a missing buccal bone wall there will be an advanced ridge collapse. In the most cases it is advisable to do a frenectomy at the same time as tooth extraction.

Michael Corsello - (2/9/2016 1:27 PM)

Excellent presentation!
Presuming there exists infection throughout the area from the diseased root. Would you proceed with this procedure or extract then delay for several weeks? What would you perceive to be a consequence of such a delay?

mia buljan - (11/24/2015 7:12 AM)

Such an inspirational lecture and a very clear explanation of the technique. I will for sure follow this protocol.

snjezana pohl - (10/10/2015 2:28 AM)

Thank you for your question. PCTG is kind of transposed, like a classical transposed flaps known in plastic surgery. Attention should be given not to rotate and strangulate it. And, very good observed, you are right, in animation you can`t see it clearly.

yosef kowalsky - (10/7/2015 2:29 AM)

Could you please explain "CTG is not rotated but overlaid. " In video it seemed it was rotated? Thank you . I really enjoyed the presentation.

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