Case: Next Paradigm in Bone regeneration

This simple case, presented by Dr. Peter Fairbairn shows the benefits of CaP synthetic materials. Loading at ten weeks ..and loaded 9 months. Any questions, please add your comments below.






48 Comments on Case: Next Paradigm in Bone regeneration

New comments are currently closed for this post.
CV
9/12/2016
Is this material available in the US yet? If not, when do you expect it to be?
Peter Fairbairn
9/13/2016
Hi CV , It is undergoing FDA approval at the moment , so will take a short while but DDSGadget sells some nice CS products which are FDA approved and follow the protocol that we have published ...... Regards Peter
Hal Wilson
9/13/2016
Where can I find the published protocol
Alex Zavyalov
9/13/2016
Why are you not posting any X-rays 9 months after the implant insertion? I wonder if it is joined with the patient’s own tooth and if it is cement or screw retained restoration.
Peter Fairbairn
9/13/2016
Can only post 5 pictures at a Time .... but can post rads ..... Regards Peter
osseonews
9/13/2016
To post more photos, simply post the case again with the additional photos and we'll add the new photos to the case. Please be sure to use the same email you used when you first posted the case so we can identify you.
Peter Fairbairn
9/15/2016
Hi Will get to it just busy .... I never splint to other teeth and rarely/never splint Implants as function of implants makes bone better as long as the is no foreign matter in it we knew that 125 years ago with Woolfs Law .. Regards Peter
CV
9/13/2016
Hi Peter In the case you show here, the palatal wall is still pretty good. If the palatal wall is also damaged like the facial wall, would the surgical protocol be still the same, ie simultaneous implant placement, NO membrane, loading at 10 wks?
Peter Fairbairn
9/13/2016
No Problem we have a video case or two here on this site with no palatal plate just graft prior to placement , no primary stability ( Not important ) no membrane ( a hinderance to healing ) and No Autogenous ( Dead stuff that the host needs to get rid of ) ..... can load in as little a 6 or 8 weeks but I am old fashioned so leave it to 10 and like to use Osstell Regards Peter
DRT
9/13/2016
no primary stability ( Not important ) How do you avoid floating drift?
CV
9/13/2016
What do you mean by "just graft prior to placement"? Don't you have to screw in the implant first (even by just a few threads) and then graft around it? Also, please post a link to the video that show a case where both facial and palatal walls are missing. Thanks very much.
osseonews
9/13/2016
The videos referenced can be found via the links below: Bone Regeneration in the Anterior with Synthetic Graft Bone Regeneration in a Pre-Molar Case with Calcium Sulfate + B-TCP
DrT
9/13/2016
Is this the same material that John Satossanti has been using since the 1970's?
Peter Fairbairn
9/14/2016
No , but he is inspirational to us but remember these material and ideas have been used since 1890 in Medicine by Dressman ....... Nothing new .... just a re-think and material improvement .. Regards Peter
Dr. T
9/19/2016
Thank you...I agree and furthermore, I feel that credit should be given him for his original landmark work with this material in periodontal regeneration, at least as an historical reference
oms
9/13/2016
Have you used successfully this material (as opposed to a block graft) for a large vertical ridge augmentation where 4mm or more of ridge height is to be regenerated and 2 or more implants in a row are to be placed? If yes, do you place the implants simultaneously and use any membrane?
Peter Fairbairn
9/14/2016
Yes OMS and yes follow protocol that is published ( in Open Access as need free ability to Download ) ....... always removal 3 week healing the place and graft with no membrane ( have not used once in 3,500 grafts ) .... Vertical growth in the posterior mandible is case dependant .... and if extreme we have cad cam block of same material .......... place with a tunnel incision with particulate .... BUt the main issue is to return the host back to their previous state ......Healthy own bone .... like they would in Medicine. Regards Peter
Omar Osman
9/14/2016
Dr fairbain what B tcp can we add to the CS to give it that mold ability right now .
Peter Fairbairn
9/15/2016
Depends where you are and what is available ? it is hard for me to comment on mixing as there are a lot of variables . Peter
OJV
9/15/2016
Very interesting technique. I see that in most of the cases the implant is still within the boney envelope as the teeth were recently extracted. Can a variation of this technique be used for situations where there has been horizontal bone loss, for ridge augmentation or during placement of an implant when there may be some threads exposed coronally? Also, is primary closure critical and what happens if surgical site becomes exposed?
Peter Fairbairn
9/15/2016
I Agree ..... as these cases are slam dunks relatively , daily routine cases , more complex cases some placed in one walled situations are published but , I prefer for Dentists to start on the easier cases . Closure is helpful but not critical and we have published on soft tissue healing by secondary intention over a stable graft material .... We have a case published where we used this material in a socket graft and photographed it every day for three months to shows this .. Regards Peter
Gary
9/28/2016
Dr Fairbain, In more complex maxillary anterior cases where significant vertical and facial bone needs to be rebuilt to anchor implants, like in an auto accident where the wheel took out the maxillary central and laterals incisors (but some palatal and apical bone is still present but the palatal height is now reduced some), after flap reflection and de-granulation, can one use titanium tenting screws who's head is placed to the ideal vertical height and the facial is placed 2 mm lingual to the "ideal facial boney dimension" desired, then fill cs+tcp (ethoss) all around the titanium tenting screw, up to the head of the tenting screw, do you think it will it frequently grow bone to the height of the tenting pin head, and all around it? 3 months later removed the tenting pin and place the implants? (I know it is a little slower than the way you do it, but I have my reasons...). Would you still use small size b-tcp in the ethoss mix, in even large defects? How do I find "a video case or two here on this site with no palatal plate just graft prior to placement , no primary stability". No palatal plate? it it worked? I need help! Please help enlighten me,
osseonews
9/29/2016
To find a case, you can use the search feature, or go to our video section from the menu. Also, here are two prior videos which maybe what you are looking for: Bone Regeneration in the Anterior with Synthetic Graft Bone Regeneration in a Pre-Molar Case with Calcium Sulfate + B-TCP
ew
9/16/2016
any thoughts on easygraft guidor. it is a btcp allograft thanks
ew
9/16/2016
edit it is an alloplast thanks
Peter Fairbairn
9/20/2016
Yes I have used these materials for 14 years ...... and they are great with new research showing us why ( Medical research with Impact factor 12 !! ) .... Have used a fait bit of Easygraft and have nice cases .... Peter
guy
9/17/2016
can we get the link to the published articles? Need protocols
Peter Fairbairn
9/20/2016
Here is protocol ..http://www.hindawi.com/journals/ijd/2015/589135/ In Open access so can be downloaded for free Regards Peter.
Philip Christie
9/21/2016
I love these cases Peter. Many thanks and congratulations. What is the cost per site?
Philip Christie
9/21/2016
Can you use the protocol with transmucosal implants? Thanks Peter
peter Fairbairn
9/21/2016
I do not but others do and seems OK ...... but prefer sub -periosteal healing
peter Fairbairn
9/21/2016
About £ 75 or $ 105 ..... per case . but makes patients happier which is the key Regards Peter
Cyrus
9/24/2016
Hi Peter Thank you for video What implant make did you use ? Regard Cyrus
Peter Fairbairn
9/25/2016
I use a number of Implants as when lecturing on grafting , I like to show the use the sponsors implants in my talks .... But here using a DIO SM which I like and have been using Paltop as well , really like them as well ....
careforsmiles@yahoo.com
9/27/2016
Hello Peter. Can the protocol be done at time of extraction?
GB
9/28/2016
There seems to be something different here. It just looks like the old TCB. I've used Tricalcium Phosphate before and was not that impressed compared to the use of even demineralize human bone for onlay grafts (I generally use mineralized with a membrane for onlay particulate grafts, because without the membrane most everything is enveloped by the connective tissue and mineralized sticks around longer). Usually TCP seems to be even less substantive than demineralized human bone... Is the "CS" an additive like recombinant BMP? Thanks, GB
Peter Fairbairn
9/28/2016
Hi GB , yes there have been dramatic changes and understanding in these materials , this has been an orhtopeadic led over the years ......... but the past always lingers like a 70s Car compared to now . Unlike donor materials the changes can be dramatic ..... xenografts are the same as they were 20 years ago ............. progress through design and understanding has occurred .... I can post a real thought provoking video on here to really make the scale of this advance visible ............... host led regeneration with simple materials is a reality .... we just need to discover it in Dentistry.. Regards Peter
GB
9/28/2016
EDIT: TCP not "TCB"...sorry
VD
9/29/2016
Hi Peter, Since this material is not yet available in US, I'm considering two options: mixing CS with an allograft OR mixing CS with a b-TCP (such as OsseoConduct, Cerasorb, Synthograft....). Which option do you think will produce better result? If CS+b-TCP is better, does it matter which b-TCP to be used?
peter Fairbairn
9/30/2016
VD , sadly yes BTcP is very variable and is the important component .......not sure but maybe with allograft in the US as have had great results ... Peter
OJV
9/30/2016
Hi Peter- Have you used this material to treat peri-implantitis cases? It seems like it would be ideal.
peter Fairbairn
9/30/2016
Agree theoretically would be ideal but these patients are the issue ...... always remove the crown put cover screw back on and let the gingiva heal over ..... then a month later flap and clean ( prophy jet ) and graft and allow to regenerate under the gingiva.... Safest way for result Peter
Richard
10/1/2016
Peter, could you please elaborate further on the role of the b-TCP component in your composite graft material? How is it different from other b-TCP such as Cerasorb or Osseoconduct...?
John Avgeris
4/17/2017
No dr Fairbairn, I am a user of ethoss since last year, you said earlier about cad cam blocks of same material like ethoss. How can we get access to them; Alternatively can we use a block of b-TCP from medbone and ethoss particles to fill the spaces and give the shape of the ridge; 2) in large cases can we use osteosynthesis plates to relieve the pressure and tension from the flap? Because from what I conclude in gbr the tesnsion and pressure from the flap is as important as the graft material ..
Peter Fairbairn
4/18/2017
Hi John , yes still working on the blocks ..... and finalising FDA for EthOss .... it always takes longer with regulation ........ But yes can use a Medbone Block ...... and EthOss . We have been working on Tenting techniques using resorbable sutures with great results and will be publishing very soon .......I feel this is more exciting than blocks in many ways . But email me for the ideas with Sutures and update on blocks ... Regulatory issues are always out of your hands .. Regards Peter
John Avgeris
4/18/2017
I do believe that renting is more exciting than blocks... For the time being I am using osteosynthesis plates in the coronal part of bone in order to absorb pressure and tension from the flap and I do only horizontal incision in order to create a form of pouch. Do you have any cases with extended edentulism requiring 5mm of ridge augmentation either vertical or horizontal;
Peter Fairbairn
4/18/2017
Great idea and yes vertical on an extended edentulous area is tough without a block or Ti Mesh ....... the CAD/CAM blocks will be great as highly porous and BTCP but will take longer than we thought.. Peter
John Avgeris
4/18/2017
So, if you have a case with an edentulous maxilla in which you have to gain 3-4 mm in height and 3-4 mm in width, that means you need a really 3d reconstruction what would you do? My option would be to place the implants, leave them exposed buccally and palatally and place osteosynthesis plates between the implants to help tenting and place ethoss. But I would like to know what would you do..

Featured Products

OsteoGen Bone Grafting Plug
Combines bone graft with a collagen plug to yield the easiest and most affordable way to clinically deliver bone graft for socket preservation.
CevOss Bovine Bone Graft
Make the switch to a better xenograft! High volume of interconnected pores promotes new bone. Substantially equivalent to BioOss and NuOss.