I want to give you some tips and tricks for Predictable Regeneration but first we need to understand the biology behind the tissues to predict the result.
The hard and soft tissues have the ability to regenerate and in order to achieve that we must put together as many factors as possible that promote the regeneration without disturbance.
1-. The type of defect.
That means the regenerative potential of the hosting bone. The more blood supply, the more walls or hosting tissue that surrounds the graft, the better regenerative potential. This is what feeds up the graft we use.
So analyze first and then make the decision.
2-. Type of biomaterial:
Never use a biomaterial for how cheap it is. Companies nowadays are fighting on a pricing system that does not help the clinicians to make correct decisions so apply the biology and never gamble with the biomaterials. It is important to understand that xenografts, allografts, synthetics and autogenous bone grafts have different properties and each one works for different purposes and even some times might work mixed to get the best out of both. So understand what’s behind each one of them.
3-. Membrane type:
Today you have collagen membranes, pericardium, gore-Tex membranes, Ti Mesh that you will have to chose depending on the amount of bone you need to regenerate. The most severe defects will require a more rigid and stable membrane to avoid 2 important issues: micro-movement and encapsulation.
4-. Membrane fixation:
Membrane stability is the key to avoid the 2 mentioned issues.
You can screw or tack depending on the membrane and the hosting bone.
You can even suture the membrane to the periosteum with resorbable sutures to avoid second surgery to remove racks or screws.
5-. Use of PRGF or growth factor therapy to achieve:
– Graft stability.
– Bacteriostatic effect.
– Improve soft tissue healing.
6-. Patient management:
Your patient needs to be a candidate to receive this type of surgery.
If he or she is not, try to turn them into candidates but always avoid heavy smokers and non controlled diabetic patients.
Periodontally compromised patients without control should not be part of this treatments unless they change the oral hygiene habits.
Visit the Masterclass Trailer to understand the biological rationale.
