Video Details
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Flap Management and Site Preparation in Anterior Bone Augmentation - Part 2 of 2
Description:
In this detailed, technique oriented, surgical video, Dr. Howard Gluckman outlines his decision making on incision design and flap management in preparation for anterior osseous augmentation in conjunction with implant placement. Specifically, site preparation and implant placement along with emphasis on autogenous bone harvesting from the palate.
Date Added:
6/5/2012
Author(s):
Howard Gluckman, BDS, MChD, PhD
Dr Gluckman completed his dental training at the university of Witwatersrand in Johannesburg in 1990. After spending a number of years in a general practice he complete...
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Online Videos / Surgery / Bone Grafting / Flap Management and Site Preparation in Anterior Bone Augmentation - Part 2 of 2
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Questions & Comments
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Osama Abdel Qader - (11/24/2017 10:31 AM)
Excellent job Dr Glukman
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FİGEN ÖZÇELEBİ - (5/10/2016 10:07 AM)
Excellent video Dr Gluckman ,thank you
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Patrick Brain - (4/17/2016 7:43 PM)
Most excellent 2-part series! Would you consider grafting with autogenous particulate (either scraped or milled) placed against the titanium and in the gaps, followed by Bio-Oss, then a native membrane (Bio-Guide or Creoss), i.e., a standard GBR? If not, what are your indications for blocks over particulate? Lastly, I find the most challenging (and scary) part assuring tension free closure. You mentioned in part 2, having to release further. Did you simply deepen the incision/release in the same location, extend deep to the surface mucosa but laterally, etc? Again, fantastic case...amazing surgeon!
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PRISLY THOMAS - (4/13/2016 11:25 AM)
wow,Gluck,Really intresting to watch your surgery,quite impressive,learns a lot from tissue handling to advances..
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Howard Gluckman - (4/10/2016 11:24 PM)
Mo unfortunately they don't. Only because they are not financially viable in South Africa. I also have no experience with them so I am unable to compare or contrast between the different materials. But I still think that Autogenous remains Godl standard if I am correct over the growth factors please correct me if im wrong, if so I would always like to use the best if the patient is willing. Sometimes thy are not and sometimes the synthetics are definitely good enough.
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Christopher Whynott - (4/10/2016 3:36 PM)
Howard,
Fantastic. Great service to your patient and to us docs as well.
Part two even more interesting than part one so I felt compelled to comment.
Much thanks
chris
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Maurice Salama - (5/30/2014 8:33 AM)
Super video and surgical skill displayed here Howard. How do growth factors impact your decisions today? Thanks for sharing. Maurice
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Howard Gluckman - (11/20/2012 3:36 PM)
@ Jeremy. I dont understand as the osteotomy is done before the bone block is placed. THe block is only placed when the implant is in position. So I dont understand the question about better osseointegration. You are correct about the placement of bone from the bone collector as well as the xenograft in a sandwhich technique over the autogenous block. I have changed a little these days in that I only use autogenous bone and I dont use membranes at all any more I dont find it necessary and I get better flap closure this way. I dont understand the 3rd question can you eplain this one to me as well. With regards to question 4 I always try and use a provisional partial acrylic denture as I can easily control the pressure on the bone and the flap. One can easily remove it and check that the flap has closed well. thanks for the question
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Howard Gluckman - (11/20/2012 3:26 PM)
@Faez. THanks for the kind words. THis is not ideal for immediate placement as one would like to have the soft tissue close first. I usually wait 8 weeks which gives good soft tissue closure but very little bone remodelling. With regards to implant insertion torque you can definitely do as you say but I dont find it necessary unless the torque goes way too high. In this case one does not need the primary stanility as one is not going to immediate load or do single stage surgery it will get a cover screw and primary closure will take place. I hope this answers your question
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