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Video Details
A Clinical Update in Bone Regeneration: Autogenous Bone vs. BMP-2

Description:
For historical and biological reasons autogenous bone has long been considered the gold standard of bone graft materials. For bone augmentation procedures autogenous grafts provided predictable volume gains, favorable bone quality with short healing periods. However, the need to harvest the graft and associated morbidity are inherent disadvantages. The choice of a technique for bone augmentation is dependent on a number of factors including the use of bone substitutes. More recently recombinant human bone morphogenetic protein (rhBMP-2) has been shown to be effective in repairing buccal wall defects from extractions and in sinus bone grafting. The use of rhBMP-2 is currently under clinical investigation as a replacement for autograft in ridge augmentation process.

Date Added:
7/11/2014

Author(s):

Craig M Misch, DDS, MDS Craig M Misch, DDS, MDS
Dr. Craig M. Misch graduated from the University of Michigan School of Dentistry. He then received postgraduate certificates in prosthodontics and oral implantology as well a...
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Questions & Comments
robert d'orazio - (11/5/2014 10:36 PM)

Nice presentation. When using the "Lazarus" graft, do you tend to overbuild due to expected graft contraction?

parviz roshanzamir - (9/6/2013 3:19 PM)

Thank you so much for the great update on techniques and material . It's amazing to have an Implant figure like you on Dental xp.I hope we see more presentation from you explaining the techniques and material more in depth .

Sam Busich - (8/8/2013 8:34 AM)

Samuel Van Wyk; That's what you have to say after watching such a great lecture? By the way, the quality of the slides were excellent especially the text on my computer. Perhaps you should consider purchasing a new computer or checking you internet speed? Sam

SAMUEL VAN WYK - (8/8/2013 7:09 AM)

the quality of the slides is poor especially the written ones

Craig Misch - (8/4/2013 9:36 AM)

Thank you Mohannad. The tip of the screw can be smoothed with a diamond bur if there is concern it may cause irritation. Another worry is that a maxillary removable prosthesis could put pressure on the palatal aspect of the screw tip causing loosening. Eric has an excellent question about 3D scaffolds. Maurice pointed out that Botiss has develop Maxgraft. This is obviously the future of reconstructive surgery. At this time I believe the allograft scaffold is preferred over an alloplast or xenograft. I recommend "overbuilding" to account for remodeling/resorption as the graft is incorporated. Using growth factors with an allogeneic block may closer match the outcomes of autogenous bone. Cost is an obvious concern. You also still have to obtain a passive primary closure over the graft.

Mohannad Al Juhaini - (8/4/2013 8:35 AM)

Thank you for the nice presentation. a question about the fixation screw, i notice you leave their extension into the palatal/lingual aspect, do you grind them ? or just leave them ? would grinding them affect their stability after inserting them ? Thank you

Maurice Salama - (8/3/2013 11:51 AM)

Eric; It is already being done in Europe. Botiss is one such company already using this technique called MaxGraft. Maxgraft® bonebuilder provides clinical users a pre-fabricated allogenic bone implant which is individually designed for the patient’s bone defect. Harvesting of autologous bone and the manual adjustment of the obtained transplant is no longer required. Go to the following link for more information https://www.botiss-bonebuilder.com/en

Eric Kean - (8/3/2013 11:24 AM)

Do you see a use of 3D printing and allograft / xenograft material coming any time soon?

omid moghaddas - (8/2/2013 4:20 PM)

Craig that was great,enjoyed it as always. Dr Omid Moghaddas

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