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Micro & Macro ratio​

Microporosity (pores <10µm) allows the diffusion of biological fluids, by the capillary action, into the three-dimensional matrix. Inside the fine pores of the matrix, biological fluids dissolve ß-TCP producing calcium phosphate ions that are released back into the biological fluids. This saturation of ions leads to precipitation of apatite crystal identical to that of the natural bone minerals. Shortly afterwards, this process creates a surface that promotes bone cell adhesion.

Macropores (300 to 600 µm) promote a deep invasion of osteogenic cells by osteoconduction. Through the same resorption and formation cycle as the natural bone remodeling process, new bone increases progressively at the expense of Eclipse.

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Micro & Macro ratio

Microporosity (pores <10μm) allows the diffusion of biological fluids, by the capillary action, into the three-dimensional matrix. Inside the fine pores of the matrix, biological fluids dissolve ß- TCP producing calcium phosphate ions that are released back into the biological fluids. This saturation of ions leads to precipitation of apatite crystal identical to that of the natural bone minerals. Shortly afterwards, this process creates a surface that promotes bone cell adhesion.

Macropores (300 to 600 μm) promote a deep invasion of osteogenic cells by osteoconduction. Through the same resorption and formation cycle as the natural bone remodeling process, new bone increases progressively at the expense of Eclipse.

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EpiGuide Case Reports

Cases by: Dr Frederic Hermann, AZZ Ambulantes Zahnmedizinisches Zentrum

Case #1: Periodontological Indication

     

  

The patient was 39 years old at baseline. Her general health was good. Extraoral examination did not reveal any pathological findings. The intraoral situation was characterized by soft and hard supragingival concrements. All teeth exhibited positive sensitivity. The gingival margin in all quadrants exhibited only moderate localized inflammatory changes. A swollen and reddened interdental papilla was found between teeth 15 and 16. Probing depths were between 2 and 4 mm, locally reaching 8 mm at 15 and 16. No pathological tooth mobility was present.

The radiological examination showed pronounced radical bone defect reaching the apical third (Figures 2 and 3, pre- and postoperative radiographs).

The microbiological examination of the subgingival plaque demonstrated the presence of Actinobacil lus actinomycetemcomitans and, in connection with the clinical findings, motivated a diagnosis of localized aggressive periodontitis.

Treatment

The surgical therapy was preceded by anti-infectious therapy, consisting of closed subgingival curettage accompanied by antibiotics (amoxicillin + metronidazole; Van Winkelhoff, 1989) and 0.12% chlorhexidine digluconate rinses. When the result of the treatment was assessed 10 weeks later, probing depths of 7 mm persisted at teeth 15 and 16. Subsequent surgical therapy provided for the regeneration of the intraosseous defect using the new resorbable Epi-Guide® barrier matrix (curasan AG, Kleinostheim, Germany) for guided tissue regeneration. Based on the morphology of the defect as uncovered intraoperatively (two-walled defect), additional support was consciously provided by applying a bone regeneration material (B-TCP/Cerasorb® M, 500–1,000 µm, curasan AG) to preserve the cavity. The surgical procedure is illustrated in Figures 4 to 11. The membrane and flap were additionally stabilized by an offset suture with resorbable suture material above the defect area. Vertical interrupted sutures were used to reposition the papilla.

Outcome

The wound healing process was free of complications. An attachment gain of 2.5 mm was subsequently measured. A slight papillary recession of 1 to 3 mm in the regeneration area is frequently seen and could not be predictably avoided even in this case despite the use of microsurgical methods and papilla preservation techniques. The patient should always be fully informed of this risk ahead of the operation, especially in the case of procedures in the esthetic zone. Probing depth decreased to 3 mm, which is a level that the patient can easily maintain, yielding a favorable long-term prognosis of freedom from inflammation if regular recalls are made.

Case #2: Implantological Indication

  

   

The patient was 67 years old at baseline. His general health was good. Extraoral examination did not reveal any pathological findings. The alveolar range between teeth 13 and 23 showed moderate vertical and pronounced horizontal atrophy. Following periodontological pretreatment, the existing maxillary telescopic restoration increasingly lost its retention, and it was decided to add abutments by implantological means. In addition, the patient requested a fixed restoration without a palatal bar.

Treatment

Following a minimally invasive incision along the top of the alveolar ridge (13–21) and mobilization of a mucoperiosteal flap, placement of a Revois® implant was accompanied by concurrent widening of the alveolar ridge using the bone-splitting technique. Following placement of the implant, the crestal aspect of the vestibular bony lamella fractured and developed a dehiscence, which was augmented with B-TCP (Cerasorb® M, 500–1,000 µm, curasan AG) and covered with a resorbable membrane (Epi-Guide®, curasan AG; see Figures 12 to18).

Outcome

After tension-free primary wound closure, wound healing proceeded without complications, with no membrane exposure or inflammatory reactions. The vestibular contours of the alveolar ridge could be restored in their entirety.

1. Use of biodegradable polylactic acid barrier materials in the treatment of grade II periodontal furcation defects in humans–Part I: A multicenter investigative clinical study. Int J Periodontics Restorative Dent. 1998 Dec;18(6):572-85. Vernino AR et. al.

2. Guidor is a registered trademark of Sunstar Americas, Inc.

 

 

 

 

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The sterile, angled disposable bone scraper makes providing your patients with mineralized cortical bone easier than ever before.

Harvesting of osteogenic Autogenous bone grafting with the Osseous Glider allows harvesting vital bone in large or small amounts and from any surface.  

Autogenous bone is considered the gold standard and has several advantages over other augmentation techniques including short healing times, favorable bone quality, lower material costs, no risk of disease transmission or antigenicity, and predictability in the repair of larger defects or greater atrophy.  If you’ve never used an angled scraper, you won’t believe how much easier it is to use than a straight scraper. The secret is to hold the angled Glider at a 35-degree angle on the ridge.

FEATURES AND BENEFITS

• Sharp circular blade for 360° of harvesting
• Never a dull blade – expose a new cutting surface with 90° twist of any .050 hex driver
• Angled Osseous Glider is optimized for ergonomics  
• Harvest bone from the external oblique ridge ramus, mandibular symphysis, and tuberosity areas of the mouth.
• Single patient use. Individually packaged and delivered sterile
• Manually harvest autogenous bone while preserving cell vitality
• Easy slide bone trap for bone retrieval
• Easily handling of bone is collected with coagulated blood, it displays a high biological plasticity shortly after it is harvested. This makes the graft extremely easy to handle and mold.bone in an atraumatic manner
• Collect up to 2.5cc of graft material

Benefit vs other harvesting methods:

• The graft’s cellular vitality is maintained and no risk of potentially overheating bone
• Bone shavings harvested with the Osseous Glider have the porosity and low density to allow angiogenesis
• bone is collected with coagulated blood, it displays a high biological plasticity making the graft easy to handle and mold

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Raptos graft is a mixture of allograft mineralized cortical and cancellous chips in a convenient syringe with a filter cap. Curved syringe for better access to site. The cancellous and cortical blend forms an osteoconductive scaffold providing volume enhancement and effective site development for successful dental implant placement.

• Sourced from premier tissue bank in the US
  Strict processing procedures are taken by the tissue bank to ensure quality and safe tissue grafts for transplantation. Tissue bank complies with guidelines and regulations with the American Association of Tissue Banks (AATB), Food and Drug and Administration (FDA) and many other state health department regulations.

• Rigorous donor screening
  Extensive tests for infectious diseases such as AIDS, Hepatitis B&C and Syphilis are performed on all donors recovered by the tissue bank. Each donor is thoroughly evaluated using medical/social history questions, medical records, blood test and culture results, physical examinations and autopsy reports (when performed). The tissue bank’s medical director reviews all donor information, and if found acceptable the tissue is released for processing.

• Low dose gamma irradiation
  Musculoskeletal allografts are processed and sterilized using gamma irradiation following ISO 11137 methodology to provide a sterility assurance level of 10-6.

• Treated with patented cleaning treatment
  As part of a validated process, cleaning and disinfecting solutions such as alcohol, antibiotics and hydrogen peroxide, along with centrifuges, ultrasonic baths and pressure washes are used during a patented cleaning treatment, to remove viruses, bacteria and cellular material.

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• Easy to prepare & Use! Delivered in a dual-chamber, pre-filled syringe, containing the granulated powder and physiological saline.
• Self-setting cement, with an ability to attach to and set at the work site and to bond to granular bone substitutes, preventing them from moving.
• Membrane coverage is advisable but not essential
• Biocompatible
• Convenient to work with and shape significantly reduces treatment time and makes the clinician’s work easier.
• Exactly the same as MIS 4Matrix.

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The OsteoGen ® Plug combines bone graft with a collagen plug to yield the easiest and most affordable way to clinically deliver bone graft for socket preservation and ridge maintenance without the use of a membrane. Watch video below.

OsteoGen Plug, 5 per Pack: 10 mm diameter x 20 mm length

• Eliminate hassle of mixing particulate grafts. Eliminate graft wash out.
• Radiolucent on day of surgery – Radiopaque in 3-6 months
• Only $50 per piece. Sold in Packs of 5.
• Available in Large: 10mm in Diameter x 20mm in Length
• OsteoGen® proven safe, and clinically effective for use with implants for over 30 years

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