DIO European Meeting 2013 - Rome by peter fairbairn

The Use of Dio SM Implants in reduced Bone situations

Dr Peter JM FairbairnVisiting Professor , Department of Periodontology and Implant Dentistry, University of Detroit Mercy School of Dentistry,USA

Dr Peter J M Fairbairn

My Faculty in Detroit , USA

Shift in Perceptions

“The Body wants to Heal , Lets work with it “

Dr Peter JM Fairbairn , Bone experts Forum , Zurich 2008


Bone the Key to Soft Tissue Success !

TRUE BONE RESTORATION THROUGH GBR IS VITAL FOR LONG TERM SOFT TISSUE AESTHETICS AS SEEN IN MANY ASPECTS OF DENTISTRY FROM RESTORATIVE , ORTHODONTIC AND PERIO-DONTIC TO IMPLANTOLOGY , GARBER SAID IT AND IT REMAINS SO TODAY


Balance of healthy tissues the key to AESTHETICS


Patient Physiology ?


But , what is the “gold Standard “ Graft Material ?

The IMPLANT ?

Prof Pinholt , Uni Copenhagen Synchtron

study


Bone Modelling !

• “This Study indicates that concerning the optimal dimensions of the alveolar bone , it would be favourable to place the implant as soon as possible following tooth extraction.”

• Schropp L , Wenzel A , et al “ Bone Healing and soft tissue contour changes following single tooth extraction ; A clinical and radiographic 12 month study” Int Journal Periodontics Dent 2003 ; 23, pgs 313-323


My Routine 10 year old Protocol !

Atraumatic Extraction and leave for three weeks for soft tissue closure , then raise site specific flap place and graft.

In rare cases where socket too big or Vital tissues ( IAN , Sinus ) an issue then Socket Graft and place at 3 Months


Traditional particulates with a non- resorbable or bio-resorbable membrane to stabalize (Schenk ) the graft and to exclude soft tissue in-growth may lengthen the healing period by excluding the Vital periosteal blood supply (Gutta) !

Guided Bone Regeneration


Particulates and Traditional Membranes can have Difficulties


Membranes; A help OR a Hinderance ?

BLOOD IS THE KEY TO BONE REGENERATION IN HEALING (Angiogenesis) 85-100% from Periosteum

I now have not used a traditional collagen membrane for last 10 years by making the graft its own cell occlusive graft.


Benefits of BTcP , Membrane Free !

• Stromal cell derived factor 1 (SDF 1 ) is induced in the periosteum of injured bone and promotes bone healing by recruiting mesenchymal cells to the injured site .

• Type 1 collagen is the predominant component of newly formed Osteoid and serves as the basis for the mineral scaffold .

• Zhao J, Watanabe T et al , “Transcriptome analysis of BTcP implanted in dog mandible ,” Bone , Elsevier , pages 864-877


Alloplasts ! No Autogenous ?

Beta Tri-Calcium Phosphate Hydroxy-Apetite

Poly-Lactides

Calcium Sulphate

Prof. Klaas de Groot

Emeritus Prof . Bio-materialsAuthor ; Bio-Ceramics of CaP


There are many types of Graft Particulates, WHY ALLOPLASTS ?

• “A major concern with the use of grafting materials is the presence of residual particles which might interfere with normal healing and bone - implant contact. As such bone quality could thus be as critical as quantity in determining the long term function and stability of Dental Implants and the peri-implant host tissues “

• “ Residual particles ( xenograft ) led to up to 23 % less bone in a site whereas alloplasts led to up to 22% increase of bone in a graft site , all materials led to reduced CT “

• Chan H-L , Wang H-L et al “ Alterations in Bone Quality after Socket Preservation with Grafting Materials: A Systemic Review “ JOMI ( Quintessence ) Vol 28 No 3 2013 , pgs 710 - 719

ResearchSocket grafting using β-tricalcium phosphate in a hydroxyl sulphate matrix.

Minas Leventis, DDS, MSc, PhD1, Orestis Vasiliadis, DDS1, Nadia Theologie-Lygidakis, DDS, MScM, MScD, PhD2, Peter Fairbairn, BDS3 and Ioannis Iatrou, MD, DDS, PhD4

1 Clinical Assistant, Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece2 Lecturer, Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece3 Private Practice, Kensington, London, UK4 Professor, Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece

NEWER RESEARCH !Experimental Study of the Biological Response to β-Tricalcium Phosphate/Calcium Sulfate Synthetic Graft Material.

Minas D. Leventis, DDS, MS, PhD1), Peter Fairbairn, BDS2), Ismene Dontas, DVM, PhD3), Gregory Faratzis, MD, DDS, MS, PhD1), Lubna Khaldi, MD, PhD5), George Kostakis,

MD, DDS, MS, PhD1) and Efstathios Eleftheriadis, MD, DDS, PhD6)

1) Clinical Assistant, Department of Oral & Maxillofacial Surgery, Dental School, University of Athens, Greece

2) Visiting Professor in Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, USA

3) Professor of Experimental Surgical Research, School of Medicine, University of Athens, Greece

4) Registrar in Maxillofacial Surgery, Department of Maxillofacial Surgery, Greek Anticancer Institute, St Savvas Hospital, Athens, Greece.

Clinical, histological and micro-CT findings of sockets grafted with β-TCP in a calcium sulphate matrix or bovine bone mineral. A case report.

Minas Leventis, PhD1, Peter Fairbairn, BDS2, Les Coulton, PhD3 and Charles Mangham, PhD4

1 Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece

2 Visiting Professor in Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, USA

3 Department of Human Metabolism, Medical School, University of Sheffield, Sheffield, UK

4 Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK

Socket grafting using in situ hardening β-tricalcium phosphate: a case series.

Minas Leventis1, Peter Fairbairn2, Annette Lindner3 and Heiner Nagursky3

1 Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece2 Visiting Professor in Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, USA3 CTA - Cell Tissue Analysis, Department for Oral and Maxillofacial Surgery, University Clinic of Freiburg, Freiburg, Germany

Socket preservation in molar sites without primary wound closure. A clinical study.

Minas Leventis,1 Orestis Vasiliadis,1 Peter Fairbairn,2 Vasileios Margaritis,3 Demos Kalyvas1

1 Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece2 Department of Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, USA3 School of Health Sciences, Walden University, USA.

Study 1

Study 2

Study 3

Study 4.


ProTemPermanent or

temporary mini implants

NarrowFix Small osteotomy sites

SM Submerge

d

Root-form submerged implant

Extra Wide

Larger surface area

Biotite-H Bioactive SM implants

Implants for any Case and Any Bone !


Standard Protocol , ( Tarnow Type B)but always 3 week delay for

soft tissue


Radiographs

18 Months


Re-direction of path of Insertion


Ridge Expansion


The Solution:DIO Bone Expander


Expansion with SM Taper

Taper can be used to expand the bone !


Even NO Primary !!


Case Radiographs


Loaded

1 year 2 Years


Loaded 2 years


Loading at 3 Months


18 Months Loaded


So Is It Bone ??

The graft bio-absorbs fully , thus only host bone !


Micro Ct Cores


core From socket at 3 months , Fairbairn , Laventis et al 2012

H and E Staining


BIO-TITE H AND OSTELL


18 Months Loaded


Research on coated Implants with nano-particulate CaP


Where Next ?

3 months


Radiographs


Bone in 10 weeks !


Close to the IAN !

Dr Peter J M FairbairnCore Sample Site


2 Years Loaded


Sinus Augmentation with Low Primary Stability


Loading with Osstell readings ( 34 to 68 ) at 4 months.


Azure 2 and pararosaniline staining


UF , New From DIO


JUST YESTERDAY !


Ten weeks in Line with Healing !


So Lets Help the Body !!!

Bio-compatible , Bacterio-Static fully Bio-absorbed synthetic particulates , return the body to its healthy state.

No Foreign or Donor material ! your patients will appreciate it ! Happy Patient Happy Dentist


Thank You Jason and all at DIO Implants, South Korea, for

helping me to move ethical Implantology Forward

Dr Peter Fairbairn

Scarsdale Dental and Implant Centre

67 Earls Court Road

Kensington

London

W8 6EF

[email protected]

020 7937 2160


You Tube Case

Placed the lateral Implant and grafted similarly, can be

seen on “YOU TUBE” Fairbairn DIO .

DIO European Meeting 2013 - Rome by peter fairbairn

Health & Medicine

Transcript of DIO European Meeting 2013 - Rome by peter fairbairn