Simultaneous Bone Grafting with Implant Placement in Cases with Dehiscence?

On the contrary having done over 800 similtaneous placement and grafts the long term results are very encouraging as long as a fully bio-absorbable graft material has been used and thus "turned over" to form bone which we can monitor by radiograph . The idea of placement similtanoeusly worries some but there in fact may be less issues than placement into effectively a necrotic block which will re-model extensively or even sequestrate over time. The implant not only stabalizes the graft ( more stability better bone , Schenck and less fibrous tissue) but helps upregulate the host response by possessing a small negative surface charge which will attract host proteins ( Osteocalcin and Pontin as well CBF and Collagen Type 1 ). We feel better placing into something we can see but is that necessarily better in the long as far as we can see But early days , just a different spin on this issue Peter

couldnt agree more, specially in the recent years since using prgf. alex

With respect to Peter and Alejandro. I agree that the simultaneous grafting and placement of implants is successful and introducing factors that stimulate the osteoblasts and tissue healing enhances this process. I make an exception in the anterior region, and I do it being overly cautious. Here I prefer to do any grafting necessary (both osseous and connective tissue) prior to implant placement, and this allows me to feel safer, knowing where my tissue levels are and where they should stay. Grafting simultaneously in this area when there is a significant defect would be guessing where the tissue levels would end up. Again I emphasize that this depends on the extent of the defect.

The fun aspect of Dentistry is the variation in treament protocols ( and they all work for us else we would not be doing it for long). We feel that the aesthetic zone is the most important area to place early and at the time of grafting to preserve the all important ridge and buccal profile. It can be better regenerate bone than place in a site with necrotic grafted bone.