Dental Education
Online Dental Education Dental education lectures and videos Online dental ce Dental education articles Expert dental educators Dental products education Dental Community
 
Video Details
Autogenous Bone Graft - Part 4: Suturing and Tension Free Closure

Description:
In part 4 of this video instructional series of a cortical autogenous graft harvested from the ramus buccal shelf, Dr. Michael Pikos demonstrates the surgical techniques for suturing and tension free closure which are absolutely required for successful osseous augmentation procedures.

Date Added:
4/21/2009

Author(s):

Michael A Pikos, DDS Michael A Pikos, DDS
Dr. Michael A. Pikos Dr. Pikos is originally from Campbell, Ohio. He attended The Ohio State University where he graduated Summa Cum Laude and Phi Beta Kappa....
[read more]






Online Videos / Surgery / Bone Grafting / Autogenous Bone Graft - Part 4: Suturing and Tension Free Closure




Questions & Comments
edward shapiro - (8/26/2014 11:21 PM)

dr. pikos. very nice closure. do you prefer blunt dissection for release of flap in this area? what is the success rate of vertical growth and how much height was regenerated? thanks for the video.

yazad gandhi - (2/5/2010 9:34 PM)

Thanks Maurice,

Have taken a biopsy specimen lets see. Will keep you posted.
As regards the sterility breakdown that should not be the cause as it was done in the OT under strict asepsis.

Yazad Gandhi

Maurice Salama - (2/4/2010 6:25 AM)

Dr. Gandhi;
A very rare case failure. Very difficult to assess the reason. Did you take a culture or biopsy of the fibrous tissues and black bone? It would be needed to see what type of bacteria was present. Did the patient have a significant medical history or did the patient have any post surgerical illness? Without this information it would be a guess as to why this may have occured. Without flap breakdown or significant medical issues, I see no reason for the failure other than sterility breakdown. The resorption of the bone, especially the Bio-Oss is almost impossible at 4 1/2 months? Do a oral gingival culture and a blood test on this individual and have an ENT to evaluate the health of their Sinus before performing any other surgical procedures.

Dr. Salama

yazad gandhi - (2/4/2010 5:39 AM)

Dr.Pikos and Dr.Maurice,

Would like to know the reason for the failure of a case.
Did a Corticocancellous block graft fixation in the maxilla (iliac bone) in a case of Ectodermal Dysplasia. B/L sinus grafts were done using Autogenous & BIOSS 50:50 with biomend extend membrane. No perforations were there in the membrane which was tough n fibrous.
4 n 1/2 mths later the maxilla displayed fibrosis and upon reentry the graft had almost totally disappeared n left behind soft black bone as appears in aseptic necrosis. Almost all of the sinus graft has resorbed whichn has never happened with me till date and the membranes B/L are thinned out and perforated. All this despite there being no infective foci around.
Please comment on the possible causes.
Thanx

Maurice Salama - (8/11/2009 11:47 AM)

Leonardo;
Difficult situation. If there is exudate the block is probably not going to do well and should be removed, irrigated and sutured before coming back to regraft at a later date. Would prefer grafting soft tissue prior to 2nd surgery to make sure you have good quality tissue to cover the bone graft. If the block was secure with no exudate, I prefer to grind the exposed bone down until I see a bleeding surface and see if we get epithelialization over the top. Normally, we lose the exposed portion at the least.
Good luck
Dr. Salama

Leonardo Diaz - (8/10/2009 7:37 PM)

would like to know what colud I do with a patient with a deshicence in anterior maxilla after bone grafting.

I sutured tension free with dermis membrane alloderm the right site bone block is ok, but the left site is open with a little exudate after 15 days Post-op.

I take off partially the alloderm because a half was loose and the oter half fixed and sensitive pain.

i need to take a defenitive treatment, so could i do the flap again and a new alloderm leaving the bone block or taking this out.

Sean Peng - (4/30/2009 1:04 AM)

Nice and smooth surgery.
I’m looking forward to see some videos about complication management during surgery, such as soft tissue bleeding, intra bony bleeding and sinus membrane perforation. I know it’s hard to collect that kind of video, but it makes Dentalxp different from other similar website. I think we should be able to manage complications comfortably before becoming a good surgeon.

Related Videos
Autogenous Bone Graft - Part 1: Flap Management Premium Member Content

Autogenous Bone Graft - Part 1: Flap Management
Detailed treatment planning and flap management.

Presented By:: Michael A Pikos, DDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
Autogenous Bone Graft - Part 2: Site Preparation Premium Member Content

Autogenous Bone Graft - Part 2: Site Preparation
Demonstration of site preparation for autogenous bone harvesting.

Presented By:: Michael A Pikos, DDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
Autogenous Bone Graft - Part 3: Contouring & Fixation Premium Member Content

Autogenous Bone Graft - Part 3: Contouring & Fixation
Contouring and fixation of a cortical autogenous graft.

Presented By:: Michael A Pikos, DDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
Autogenous Bone Graft - Part 5: Case Review Premium Member Content

Autogenous Bone Graft - Part 5: Case Review
Detailed Case Review of a ridge augmentation case utilizing autogeneous bone harvested from the ramus buccal shelf.

Presented By:: Michael A Pikos, DDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
New Age Esthetics: Integration of Tissue Reconstruction, Tooth Replacement and Ceramics Premium Member Content

New Age Esthetics: Integration of Tissue Reconstruction, Tooth Replacement and Ceramics
Dr. Miguel Stanley exhibits detailed clinical cases that represent his "No Half Smiles" philosophy integrating site development, tooth replacement and esthetic composition.

Presented By:: Miguel Stanley, DDS
Presentation Style: Lecture
Community Rating:
 
Watch Now>>
Autologous Bone vs. Bioactive Modifiers/BMP-2: A Clinical Update in Bone Regeneration - Part 2 of 2 Premium Member Content

Autologous Bone vs. Bioactive Modifiers/BMP-2: A Clinical Update in Bone Regeneration - Part 2 of 2
There are several techniques and materials available for implant site development. The choice may depend on a number of factors including size of the defect, osseous morphology, costs and surgeon or patient preferences. Autogenous bone has long been considered the gold standard of graft materials. The trend today is to reduce patient morbidity but still provide predictable outcomes. This lecture will discuss the use of autogenous bone versus using bioactive modifiers such as platelet concentrates, rhPDGF and rhBMP-2 as replacement for the need to harvest bone.

Presented By:: Craig M Misch, DDS, MDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
The Next Challenge in Implant Dentistry: The Rise in Peri-implantitis and What Can We do About It? Premium Member Content

The Next Challenge in Implant Dentistry: The Rise in Peri-implantitis and What Can We do About It?
In this presentation, Dr. H. Ryan Kazemi will discuss etiologies for implant failure due to peri-implantitis, its preventive measures, and what treatment modalities work best. He will also describe a new classification to help clinicians choose the optimal treatment approach.

Presented By:: H. Ryan Kazemi, DMD
Presentation Style: Video
Community Rating:
 
Watch Now>>
Related Courses
Autologous Bone vs. Bioactive Modifiers/BMP-2: A Clinical Update in Bone Regeneration - Part 1 of 2 Premium Member Content

Autologous Bone vs. Bioactive Modifiers/BMP-2: A Clinical Update in Bone Regeneration - Part 1 of 2
There are several techniques and materials available for implant site development. The choice may depend on a number of factors including size of the defect, osseous morphology, costs and surgeon or patient preferences. Autogenous bone has long been considered the gold standard of graft materials. The trend today is to reduce patient morbidity but still provide predictable outcomes. This lecture will discuss the use of autogenous bone versus using bioactive modifiers such as platelet concentrates, rhPDGF and rhBMP-2 as replacement for the need to harvest bone.

Presented By:: Craig M Misch, DDS, MDS
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Managing the Extraction Site - Optimal Preservation and Enhancement Techniques Premium Member Content

Managing the Extraction Site - Optimal Preservation and Enhancement Techniques
The importance of piezosurgery, atraumatic surgical technique, the use of bone grafts, resorbable membranes and growth factors will be elucidated along with soft tissue enhancement.

Presented By:: Michael Sonick, DMD
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Ridge Expansion, GBR & Meshes: Decision Making in Clinical Practice Premium Member Content

Ridge Expansion, GBR & Meshes: Decision Making in Clinical Practice
A variety of bone augmentation procedures are currently available at use to the clinician. Techniques of variable complexity can essentially yield favorable results. The choice of technique to utilize however, is often based on defect site presentation and operator comfort level. This presentation will focus on the use of ridge expansion, guided bone regeneration (GBR), and titanium mesh. Merits and indications of each technique will be discussed, and clinical cases will be presented that showcase the decision making process involved in treatment planning.

Presented By:: Ehab Moussa, DDS
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Related Articles
Histologic Effect of Pure-Phase Beta-Tricalcium Phosphate on Bone Regeneration in Human Artificial Jawbone Defects

Histologic Effect of Pure-Phase Beta-Tricalcium Phosphate on Bone Regeneration in Human Artificial Jawbone Defects
The effect of the pure-phase beta-tricalcium phosphate (beta-TCP) Cerasorb on bone regeneration was evaluated in hollow titanium cylinders implanted in the posterior jaws of five volunteers.

Author(s): Paolo Trisi, DDS, PhD;Walter Rao, MD, DDS; Alberto Rebaudi, MD, DDS; Peter Fiore, MD, DDS
View Article>>
Manejo Integral de Maloclusion Clase III en Adulto, con Requerimientos Periodontales y Protesicos; Reporte de un caso clinico

Manejo Integral de Maloclusion Clase III en Adulto, con Requerimientos Periodontales y Protesicos; Reporte de un caso clinico
En nuestra clinica observamos un aumento de pacientes adultos con problemas esqueletales, compromiso periodontal y necesidades protesicas. Debemos recurrir a la interconsulta con el periodoncista, protesista y cirujano maxilofacial, para la correccion del caso, prestando especial atencion al componente dentario, esqueletal y los tejidos blandos faciales del paciente. La cirugia ortognatica, que generalmente la realizamos luego de una preparacion ortodoncica, permite corregir discrepancias en el adulto y restaurar la funcion y estetica en los tres planos del espacio. Realizada la correccion oclusal, procedemos a sustituir dientes ausentes, mediante implantes y protesis fijas. El Periodoncista, mantiene un control constante de la salud de los tejidos de soporte, durante todas las fases de la terapia multidisciplinaria.

Author(s): Miguel Hirschhaut, DDS;Jorge Ravelo, DDS
View Article>>
Reconstruction of Damaged Fresh Sockets by Connective-Bone Sliver Graft From the Maxillary Tuberosity, to Enable Immediate Dentoalveolar Restoration - A Clinical Case

Reconstruction of Damaged Fresh Sockets by Connective-Bone Sliver Graft From the Maxillary Tuberosity, to Enable Immediate Dentoalveolar Restoration - A Clinical Case
This paper describes a procedure for immediate loading of an implant following tooth extraction, in a socket presenting severe damage to the vestibular bone plate and gingival recession in the region of the upper central incisors. The procedures of extraction of the tooth, immediate insertion of the implant, connective- bone graft from the maxillary tuberosity and immediate restoration were shown to be a predictable treatment alternative. These procedures led to restoration of the tooth, bone and gingival structures in a single surgical stage and to maintenance of the favorable esthetic and functional result 24 months afterwards.

Author(s): José Carlos Martins da Rosa, DDS, MS;Darcymar Martins da Rosa; Carla Mônica Zardo; Ariádene Cristina Pértile de Oliveira Rosa; Luigi Canullo
View Article>>
Contact Us | Privacy Policy | Terms of Use
©2020

Preferred Language: English Flag
Contact Us · Login ·