maozsfjbvpaw midterm Flashcards
(36 cards)
Ideal Graft Material (5)
• Confirmed via biopsy
• Osteoinductive
o Turns on patients bone growing cells
o Ex. BMP (but v expensive)
• Osteoconductive
o Grows onto bone
o Ex. Cow bone
• Caution
o Infection or disease transmission
o Mad cow disease via prions
o Can use HIV bone because pt undergoes purifying process
• C-Graft
o Derived from calcified marine algae
o 15+ years of clinical success
o Successful bone regeneratin, porosity, absorption, resorption
When to Graft
When to Graft
• Thin labial plate
• Missing labial plate
• DO NOT graft if buccal plate is solid and 3 mm
Risk of chin bone graft
teeth because apex is
disturbed
BTP? brands?
Beta Tricalcium Phosphate
1) synthograft
2) cerasorb
3) graftek
what is Beta Tricalcium Phosphate?
o Completely resorbed without any residue
o Replaced by natural, vital bone
o Process takes about 3-24 months depending on type of bone
(desmal/chondral)
What is GEM 21S?
o Combo of bioactive protein (highly purified recombinant
human platelet derived growth factor) and biocompatible
osteoconductive matrix
o Has 1000x more growth factor than in platelet rich plasma
o Provides 3x more bone fill at 6 mo
o Provides a more predictable treatment option even in severe cases
Demineralized Freeze Dried Bone Allograft (DFDBA)
- Cadaver bone that has gone thru gamma radiation
- From accredited tissue banks
- Most popular at school
Vital Root Retention indication?
o NEVER OUR FIRST CHOICE
o Option for preserving alveolar bone for FMTE in young
patients
o Teeth must be vital with good perio health
Vital Root Retention Procedure
o Amputate tooth at crest
o Remove 2 mm more (sub-osseous)
o New bone grows over top of vital, asymptomatic root
o Can graft autogenous bone over tooth
**lasts 3-5 years
Coronectomy
- Indications -When roots of 3M are close to lingual nerve or IAN
- Results -Does not increase the risk of dry socket or infection
Immediate Implant Placement Following Extractions
1) requirments
2) sites
3) advatages
1) 3-4 mm SOLID bone at base of socket; No active infection
2) anterior teetha nd 1 PM
3) Success rates ~ normal; MAY reduce loss of labial plate; MAY improve esthetics; MAY save time
Platelet Rich Plasma Advantages
o Release growth factors that aid in hemostasis
o Increase rate of healing (mitogenesis, angiogenesis)
Platelet Rich Plasma DisAdvantages
o Cost
o Heals faster NOT better
o Invasive, borrow 45-90mL of blood
Indications for alveolar bone reconstruction?
When bone is taken from iliac crest or ribs (autogenous)
o Not enough bone for implant o Enough bone but suboptimal esthetics o Prevents pathologic fracture o Poor function/esthetics/retention of conventional removable prosthesis
what is the gold standard graft?
Autogenous Block Graft
Autogenous Block Graft Advantages
o Osteoinductive AND osteoconductive o No need for membranes o Holds form o Remodels into 100% high quality bone o No concerns about transmissible diseases
Autogenous Block Graft DisAdvantages
o Donor site morbidity
o Quantity is limited
o Lose 20-30% during healing
Membrane Advantages
o Contain particulate grafts
o Useful around teeth/exposed implant threads
Membrane DisAdvantages
o Add expense
o Infection risk
BMP (Bone morphogenetic proteins)
FDA approved types:
- BMP2 – spinal fusions
- BMP 7 – long bone defects
Decoronation
- In younger patients
- Remove crown of akylosed teeth and endo treat
- Kid wears flipper for many years
Distraction Osteogenesis used for?
Hemifacial microsomia and Pierre Roban Syndrome
Distraction Osteogenesis
• Generation of bone (and soft tissue) through “distraction” of
osseous callus
• Done by orthodontists via rapid palatal expansion
• The procedure was first proposed by Bernhard von Langenbeck in
1869, but the first publication of
NSAIDS Role
Inhibit COX activity and Reduce pain
