Month: August, 2010

Case of the Week Infuse

all on 4 dental implantsLast week was interesting. Most of my days are consumed doing the traditional all on 4 procedure where I extract the remaining teeth, place implants, and build a complete set of new teeth all in the same day. Sometimes as this morning it is just one arch, upper or lower, other times both arches. Last week was unusual in that we only did two all on four cases. The rest of the week was consumed doing bone grafts in preparation for future implant placement. I have mentioned previously that there are a couple of new products on the market to facilitate bone regeneration; Osteocell, a stem cell product, and Infuse, a bone morphogenic product. About 6 months ago I reported on a case where a young man had a bicycle accident that caused severe damage to the front of his mouth. Three teeth were lost and the damage to the supporting bone was extreme. We placed a temporary non-removable bridge and grafted with Infuse contained with a titanium mesh membrane. Last week I uncovered the surgical site to remove the membrane. After removing the temp I noticed that under one of the bridge pontics {replacement tooth for a missing tooth} the mesh was exposed. I had not noticed that previously or I would probably have removed the mesh at 4 months. After reflecting the tissue I found extremely hard, dense dental bone except under the exposed area. There was plenty of bone there as well but less mature. After removing the mesh I harvested some soft tissue from the palate {roof of the mouth} and achieved excellent coverage and enough plumping of the tissue to form a little “tissue anatomy” with the pontics. I had hoped to place implants but decided to let the tissues mature for 2 months as it will help ensure a cosmetically pleasing result. All things considered I have never seen a graft deliver such a high quality and quantity of bone. This is consistent with previous cases I have treated with Infuse. I uncovered an Osteocell graft with a membrane about to expose and did two extensive grafting procedures, one with Infuse, the other with Osteocell last week as well. I’m leaving for Hamburg on Friday to attend an ICOI meeting and study with some exceptional dental implant specialist. If I get a break I’ll report on those other cases before I leave and hopefully I’ll have something new and exciting to report about dental implants when I return.