Dr. O. asks:
I read an article in a peer reviewed dental journal describing a new technique for achieving more predictable results in bone grafting implants where the threads have been exposed. The technique involved placing cancellous bone graft material or autograft directly over the exposed threads. The next layer grafted over this is a cortical bone graft. The graft is then covered with a resorbable collagen membrane. Have you tried this technique and how were the results? Are there any other indications for this technique?
Sandwich Bone Graft Technique: How are the Results?
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hi
if one or two thread is exposed ,just remove the thread with a air roter with copious irrigation and then polish the area so that htere is gingival attachment
interesting talking about removing the thread of the top of the implant
Had a multiple unit case with the patients complaint when pushing on the edge of the crown and bridge he had pain. Flap showed some thread exposure in the posterior and so polished off the thread, healed just fine, complaint went away also.
The implants were 15 mm long, so loosing some top threads will not be a problem
It does point out, thickness of bone, critical
To answer the question, have done the sandwich but the key is getting the implant surface clean, some you can and some you can not
I have had nothing but excellent results with the “Sandwich Graft” and using “Osteogen” as a particulate graft material.
There is nothing new about the ‘Sandwich Technique’. Dr Hom Lay Wang coined the term and has been writing/talking about it for several years now. But if you have threads exposed to the oral cavity and want to cover them with hard/soft tissue you have to comprehensively clean the surface of all debris/contaminants prior to any type of graft procedure.
LOL. It’s nothing more than a GBR procedure. I love how all these guys are coining terms like it’s some original idea.
Lot of clinicians have used a mix of allograft and calcium sulfate or a mix of autograft and calcium sulfate (e.g. DentoGen) and it really works well. it forms a nice putty and heals the site great.
I have had nothing but success with a sandwich graft (it’s a five wall defect). ANY TIME YOU GET PAST A 4 WALL DEFECT ie. 3 , 2,1 WALL YOUR CHANCES OF FAILURE GO UP GREATLY. Yes, again I use Osteogen. The price is right, safe and it’s predictable.