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today ICOI World Congress XXXII Berlin 2015

business6 ICOI World Congress XXXII At this year’s ICOI World Con- gress, Dr Henrik-Christian Hollay will address the importance of sta- bility in guided bone regeneration therapy. In anticipation of his Sun- star pre-conference workshop on 15 October, Dental Tribune Interna- tional had the opportunity to ask him about promising new tech- nologies in regenerative practice and key factors for achieving the best possible clinical outcomes. Dental Tribune International: Dr Hollay, could you please ex- plain the importance of stabil- ity in guided bone regeneration therapy today? Dr Henrik-Christian Hollay: Stability is and always has been key to successful bone augmenta- tion and regeneration. In recent years,severalmethodsandmateri- als were developed to achieve this aim that are very complex and technique sensitive, such as tita- nium meshes, different types of membranes, which mostly have to befixedwithpins,andboneblocks thathavetobescrewedtothebone. Aside from the surgical challenge, the costs of these have driven the pursuit of materials that are cheaper and easy to handle and that facilitate the complete work- flow. Bone graft materials that harden shortly after being placed and membranes that remain in position have made substantial progress in achieving these goals. What techniques stand out in clinical practice? Guidedboneregenerationisthe keyword of the moment. There are many interesting techniques that are relevant in daily practice. A technique that has been much dis- cussed is socket or ridge preserva- tion. There are also a few very spe- cialnewtechniquesthathavebeen developed in the last few years, such as the tunnel augmentation technique and different shell tech- niques. All of them are minimally invasive,andtunnelaugmentation and socket or ridge preservation are even flapless. What are the main advantages of new technologies in the bone graft field compared to GBR with traditional particulate bone graft materials and mem- branes? Oneofthemostinterestingtech- nological developments is avail- ability of materials with in situ hardening and putty like mould- ability. These two feature allied to syringedeliveryallowcliniciansto consider minimally invasive (tis- sue sparing) techniques (such as the tunnel and soft shell tech- niquesdescribedabove).Forexam- ple, GUIDOR easy-graft from Sun- star is stable after 4 or 5 minutes forming an analogue of the defect site into which it is placed. Tradi- tional particulates (even those de- livered from a syringe) will remain mobileandoftendonotconformto the site morphology. The inherent mobility of a traditional particu- late often requires placement of a membrane to stabilise and contain the particles. Typically in such instances,themembranewillneed tooverlapthedefectonallsidesby 2 or 3mm necessitating a signifi- cantly larger access flap. Because of rapid enzymatic degradation, collagen membranes used in such instances must be covered by ten- sion free soft tissue closure. Tech- niques to achieve this may well re- quire elevation of the periosteum andmobilisationofafreeflap.This surgical cascade and the tissue trauma associated with it is tech- nique sensitive, painful and can delay healing as well as consume more time. Moreover, the micro- movements from a unstable site may well be associated with soft tissue invasion rather than the re- quired hard tissue regeneration. Compared with non-resorbable materials, what are the main advantages of alloplastic/syn- thetic matrices, such as the GUIDOR Bioresorbable Matrix Barrier? The most interesting and impor- tantpointaboutresorbablemateri- als is that a second operation to re- move the membrane is not neces- sary. Removal of a non-resorbable barrier requires the raising of a flap involving elevation of the pe- riosteum, which always results in bone resorption. The GUIDOR ma- trix barrier is a resorbable mate- rial, but the resorption process longer than that of collagen mem- branes, for example. It offers the long-term stability of a non-re- sorbablemembranewiththebene- fitofavoidingre-entrytoremoveit. What are the most important factors regarding favourable outcomes in regenerative prac- tice? Next to stability, in my opinion, the most important factor is blood. Without strong bleeding from the cancellous bone in the recipient bone area, bone regeneration and augmentation will not occur. The pluripotent mesenchymal cells that are carried to the augmenta- tion site via the blood do the real work for us, and it is important to bearthatinmind.Severaldifferent techniques and materials can lead to a good outcome in guided bone regeneration performed correctly, but why is that so? It is because the human body has enormous healing potential and only needs a little bit of guidance from sur- geons. After a long period of re- search on materials and tech- niques, our next mission will be to return to nature. Dr Henrik-Christian Hollay is pre- senting the Sunstar GUIDOR pre- conference workshop titled “Stabil- ityasakeyforsuccess:Anoverview of various augmentation tech- niques with in situ hardening bone graft substitutes” on 15 October, from 16.15 to 18.15. The Dental Tribune International C.E. 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CAD/CAM cone beam cosmetic dentistry* DT Study Club (France)*** gums* implants laser ortho prevention* roots I would like to subscribe to \ SUBSCRIBE NOW! fax: +49 341 48474 173 | e-mail: subscriptions@dental-tribune.com AD “Our next mission will be to return to nature” An interview with Dr Henrik-Christian Hollay,Germany “Stabilityisandalwayshasbeenkeyto successfulboneaugmentationandregeneration.” \ SUBSCRIBE NOW! fax: +4934148474173 | e-mail: subscriptions@dental-tribune.com

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