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Video Details
Severe Atrophic Edentulous Maxilla – A Case Presentation - Part 2 of 2

Description:
Anterior maxillary alveolar bone deficiency, can prevent implant placement for fixed rehabilitation and jeopardize the esthetic outcome. Clinical case of severe atrophy of anterior maxilla, due to loss of implants, is described: A combination of sub-nasal procedure and intra-oral autologous onlay bone graft were used for ridge augmentation and dental implant placement in steps procedure, combined with Bio-Oss saturated in Platelets Rich Plasma (PRP) and covered with platelets-poor-plasma (PPP) as a "biological membrane".

Date Added:
9/18/2015

Author(s):

Devorah Schwartz-Arad, DMD, PhD Devorah Schwartz-Arad, DMD, PhD

Devorah Schwartz-Arad, DMD, PhD

A specialist in Oral and Maxillofacial Surgery (OMS), Ph.D. degree in cancer research, anatomy and embryology...
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Questions & Comments
Devorah Schwartz-Arad - (9/20/2015 2:41 AM)

2 . In the cases of onlay bone grafts in edentulous maxilla, the denture is not worn during the first 2-3 weeks till sutures removal.

Devorah Schwartz-Arad - (9/20/2015 2:38 AM)

Eli, Thanks for the compliments! SHANA TOVA!

Eli Raviv - (9/19/2015 10:53 PM)

Dear Dubi, Thank you so much for sharing with us your knowledge and experience. Outstanding diagnosis,planing and execution. KOL HAKAVOD!!! I am looking forward for an invitation to visit you and your facilities. Warmest regards, Eli

Devorah Schwartz-Arad - (9/19/2015 1:34 PM)

Thank you Meir for your kind words. Laurent Hi. Thank you for the compliment! To answer your questions: 1. The repair of the Schneiderian membrane rapture was performed with the PPP (Platelets Poor Plasma) and not with the PRP. The PPP has better qualities and a higher fibrin concentration as you can find in the results of our study that was published in J Periodontol. 2004 Apr;75(4):511-6. On the prevalence of surgical complications of the sinus graft procedure and their impact on implant survival, revealed that perforation of the Schneiderian membrane was the major intraoperative complication, (10%) suffered from postoperative complications. Membrane perforations were strongly associated with the appearance of postoperative complications (specific and non-specific to the procedure) (P < 0.001). However, no association was found between membrane perforations or postoperative complications and implant survival. 2 . In two cases of onlay bone grafts in edentulous maxilla, the denture is not worn during the first 2-3 weeks till sutures removal.

Meir Aviram - (9/19/2015 10:25 AM)

Very nice. You are always an inspiration for best quality treatment.

laurent oiknine - (9/18/2015 1:12 PM)


State of the art surgery!!
My questions are;
1_ after a tear in the Schneiderian membrane , do you feel that a layer of PRP will be strong enough in resisting mucus and bacteria from infecting the bone graft ? Wouldn`t it be better to just place the PRP with NO bone graft and let the implants act as tenting screws for autogenous new bone formation?
2_ Does the patient leave with a soft relined removable prosthesis after the firs surgery and does it in any way affect the stability of the bone graft
3_ Your feelings on screwing the final prosthesis directly to implants instead of to multi units if no change of angulation is deemed necessary.

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