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
Dimension of the Facial Bone Plate - Literature Review Series

Description:
In this first of the series, Dr. Henry Salama will review a group of articles related to the dimensions of the facial bone plate. He will suggest what can be taken away from these articles as well as how they may influence clinical decisions in the treatment of extraction sites and immediate implant placement. Your participation in the form of comments, questions and suggestions are welcomed and will help invigorate what is hoped to be a type of online community study hall.

Date Added:
10/30/2014

Author(s):

Henry Salama, DMD Henry Salama, DMD
[read more]

Recognized Institutes







Online Videos / Surgery / Bone Grafting / Dimension of the Facial Bone Plate - Literature Review Series




Questions & Comments
Marcelo Nunes - (1/5/2015 8:04 PM)

excelent lecture and explanation. thank you!

Charles Schwimer - (11/8/2014 10:32 AM)

Howie and Henry excellent discussion! 2mm of vital bone will promote soft tissue stability, but what conditions need to be satisfied to to achieve and MAINTAIN 2mm of vital bone? What is the critical "jump distance" between bundle bone of the adjacent teeth and the remaining basal bone in the extraction site that will provide for bone stability over time? In addition, what role does soft tissue height and thickness play in a closed /submerged implant environment vs an open / functional implant environment? Any thoughts? Chuck

henry salama - (11/6/2014 12:38 PM)

Bashar, raising a full thickness flap traumatizes the periosteal blood supply and certainly will have a more negative effect on the labial plate than a "flapless" approach. However, when facing a labial plate of 1mm thickness or less, even a flapless approach in combination with atraumatic extraction will still result in significant ridge alteration unless other means such as bone and/or soft tissue grafting etc. are utilized. Therefore, as clinicians, we have to design our therapy in such a way as to minimize these ridge alterations. I hope I answered your question. Regards

Bashar imran - (11/6/2014 10:36 AM)

Thank you Dr.Henry for your presentation , my question is : does Atraumatic extraction without reflecting a flap would affect the 1mm thickness of labial plate of bone or not ?

saadou khalaf - (11/4/2014 11:03 PM)

great presentation and great discussion thank you very much

Howard Gluckman - (11/4/2014 2:02 PM)

Henry thanks for the feedback. I totally agree with all and I think the science confirms it to most degrees. The tissue issue I think has to do with the concavity of the abutment and the crown which is allowing thicker infill. Unfortunately it does not extrapolate into more stability in the short term and we are still seeing the same +/- 1mm recession on the buccal plate. We also did a number of other measurements which will share with you once I have it. Mostly they confirm what is known I believe.

henry salama - (11/4/2014 12:46 PM)

Howie, as to your second observation of thicker tissue 1 year post-op. Very interesting and definitely worth following up. My inquiry and interest would be related to asking what would have influenced that thickening: a) whether the sites were grafted?, b) whether placing the implants more palatally along with flatter or concave emergence profiles of the abutments/restoration creates more room for soft tissue to be thickened? and c) whether the tissue thickness should also be measured at 3 & 5mm apical to the gingival margin or a reference point on an adjacent tooth. Either way, I think you're collecting some very useful data to look at & correlate to clinical decision making. Well done Howie.

henry salama - (11/4/2014 12:35 PM)

Howie, great comments and observations. First, as to thickness of the labial plate. I agree, and as I mentioned in the review, I believe its more important to END with 2 mm than to BEGIN with a 2mm labial plate of bone. Its not unreasonable, however, to assume that Kan & Ferrer would be correct in their observations. I also believe that starting with a thicker labial plate would a) have a better chance of a greater percentage of the original labial plate surviving the extraction process, b) Therefore, protecting your grafted socket gap longer and better and c) support the attached component of the gingival tissue longer & better as well. That being said, the literature tells us that the chances of having an original pre-operative labial plate of 2mm is roughly only about 4-5% of potential extraction sites.

Howard Gluckman - (11/3/2014 1:21 PM)

Mo I have some interesting data that may prove the complete opposite of what Chu and Tarnow are saying. I have 1 year follow up data on about 20 cases that I have not yet correlated the data. I have measured tissue thickness changes over the year after dimmed implant placement. I must check the data but if I remember correctly the tissue actually gets thicker. we measure 2mm below the gingival margin at placement and then 1 your follow up. may be some interesting stuff to write up when I look at all the data.

Related Videos
Biologic Strategies to Enhance Clinical and Aesthetic Success in Oral Implantology Premium Member Content

Biologic Strategies to Enhance Clinical and Aesthetic Success in Oral Implantology
This webinar will discuss clinical strategies for treatment of the complex implant site involving bone grafting and implant placement. Our understanding of cellular pathways, and our ability to control the wound response, expands our capacity to effect better aesthetic outcomes and compress treatment time. The reduction of the inflammatory phase of tissue regeneration speeds up osseointegration, prevents crestal bone loss, maintains papillary form, increases the density of peri-implant bone and increases tissue biotype. This enhanced tissue response allows us to predictably treat even the most complex surgical cases, compress time to final reconstruction, and to maintain these favorable tissue outcomes over an extended period of time. The use of dental implants with advanced biologic features and the incorporation autologous growth factors will be demonstrated.

Presented By:: Robert J. Miller, DDS, FACD, DABOI
Presentation Style: Video
Community Rating:
 
Watch Now>>
Bioengineering and Bone Grafting in Deficient Anterior Sites: A Case Presentation Premium Member Content

Bioengineering and Bone Grafting in Deficient Anterior Sites: A Case Presentation
Dr. Pikos shares a case presentation elucidating the need for bioengineering and osseous grafting to overcome severe deficiencies in anterior sites prior to implant placement. The case is that of a 19 year old caucasian female that presented with congenitally missing maxillary lateral incisors. Both sites were deficient in alveolar width. Subsequent treatment included a single ramus buccal shelf block bone graft that was utilized for bony augmentation along with mineralized allograft and PRGF with collagen membrane. This was followed 4 months later by two 3.8 mm diameter BioHorizons tapered internal Laser-Lok implants. Four year follow up is included.

Presented By:: Michael A Pikos, DDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
Creative Next Generation Surgical Tools and Solutions for the Implant Practice Premium Member Content

Creative Next Generation Surgical Tools and Solutions for the Implant Practice
This lecture will highlight specifically New Age Tools which offer creative and effective solutions for space maintenance, autologous bone harvesting, atraumatic implant removal, and screw fixation. Creative mini-titanium mesh shapes(CTI), autologous bone harvesting drills (ACM Auto Chip Maker), counter torque implant removal systems as well as tenting and fixation screw systems will be discussed and featured.

Presented By:: Maurice Salama, DMD
Presentation Style: Video
Community Rating:
 
Watch Now>>
Related Courses
Advanced Bone Grafting Techniques: Part 2 - Autogenous Bone Blocks in the Reconstruction of the Atrophic Maxillary Ridge Premium Member Content

Advanced Bone Grafting Techniques: Part 2 - Autogenous Bone Blocks in the Reconstruction of the Atrophic Maxillary Ridge
This lecture will describe the use of autologous onlay block bone grafting for reconstruction of moderate to severe atrophic maxillary alveolar ridge. This will include a discussion of the various options to this form of grafting, such as short implants, maxillary sinus augmentation, sub-nasal elevation procedure, connective tissue grafting and soft tissue manipulation, Le-Fort I down fracture/osteotomy and the use of progenitor cells: bone marrow aspirating concentrated. A description of surgical donor harvest sites in the mandible will also be performed as well as post-op healing of these sites. Additional time will be spent reviewing causes of failure with bone blocks and implants placed into these sites.

Presented By:: Devorah Schwartz-Arad, DMD, PhD
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Is There One or More Reasons to Optimize the PRF & PRP Protocols? Future Trends in Dentistry, Orthopedics and Facial Aesthetics Premium Member Content

Is There One or More Reasons to Optimize the PRF & PRP Protocols? Future Trends in Dentistry, Orthopedics and Facial Aesthetics
The “Advanced” PRF (A-PRF) and “Injectable” PRF (I-PRF) protocols were designed with this new concept. Indications are numerous in all medical fields where we need regeneration: bone, cartilage, skin etc... However, the use of growth factors is not a guarantee of long term stability, as they are active only at the beginning of the process. Numerous rules of tissue engineering have to be applied to maintain the regenerated bone through an adequate blood supply: this lecture is an enlightenment on the biological and mechanical conditions for long term stability of the bone: “grafted bone” or “bone around implants”.

Presented By:: Joseph Choukroun, MD
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Negative Factors for Soft & Hard Tissue Maintenance Premium Member Content

Negative Factors for Soft & Hard Tissue Maintenance
Maintaining the bone is the most difficult challenge in implantology (bone grafted or native bone around implants). If a tissue want to live long, it has to follow 2 conditions: The first condition is to organize a full blood supply.. However, it’s not enough. The solution for the long term stability is to try to organize the stability of the blood supply.. by the respect of several biologic conditions. Almost of these conditions are explained in this lecture. We introduce here the new concept to avoid the reduction of blood supply by the periosteal incision: the soft brushing technique is the first technique which allows a very large increase of the flap without any incision: the flap closure without tension but without any incision.

Presented By:: Joseph Choukroun, MD
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Credit)
Watch Now>>
Related Articles
Screw "Tent-Pole" Grafting Technique for Reconstruction of Large Vertical Alveolar Ridge Defects Using Human Mineralized Allograft for Implant Site Preparation

Screw "Tent-Pole" Grafting Technique for Reconstruction of Large Vertical Alveolar Ridge Defects Using Human Mineralized Allograft for Implant Site Preparation
The purpose of this study was to evaluate the effectiveness of using titanium screws in combination with particulate human mineralized allograft, in a “tenting” fashion, to augment large vertical alveolar ridge defects for implant placement.

Author(s): Bach Le, DDS, MD, FICD;Michael D. Rohrer, DDS, MS; Hari S. Prassad, BS, MDT
View Article>>
Physical And Chemical Properties Of Commercially Available Mineralized Bone Allograft

Physical And Chemical Properties Of Commercially Available Mineralized Bone Allograft
Bone graft materials are critical to the success of dental implants when there is a need to increase the volume of bone in a defect. The surface properties of these graft materials will have a profound impact on the outcome of the graft procedure. The clinician has many choices of bone graft substitutes when augmenting bony deficits. Allograft bone is the most widely used class of bone graft substitutes. Within this class there are a number of different bone allografts, which are manufactured utilizing widely varying processing techniques. There also appears to be a wide range of results in the published literature across the spectrum of different bone allografts. This in-vitro study evaluated chemical and surface properties of five different commercially available mineralized bone allografts.

Author(s): David C. Greenspan, Ph.D.
View Article>>
A Fixed Whole-Mouth Rehabilitation Utilizing Natural Abutments and Implants: Treatment Concepts and Clinical Realization

A Fixed Whole-Mouth Rehabilitation Utilizing Natural Abutments and Implants: Treatment Concepts and Clinical Realization
A 45-year-old female patient presented to the clinic with a request to treat her deteriorating dentition that had been reconstructed 15 years ago with fixed restorations. Clinical examination revealed fixed partial dentures cemented to natural abutments in the maxilla, whereas telescopic restorations were cemented to natural abutments bilaterally in the mandible. The treatment plan included a whole-mouth rehabilitation utilizing natural teeth and implants. As the patient declined any surgical augmentation…

Author(s): Nitzan Bichacho, DMD;Rafi Lahav, MDT, Cobi J. Landsberg, DMD
View Article>>
Contact Us | Privacy Policy | Terms of Use
©2019

Preferred Language: English Flag
Contact Us · Login ·