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today Nobel Biocare Global Symposium June 25, 2016

Nobel Biocare Global Symposium 4 interview Excellent handling is only one aspect GBR expert considers benefits of creos xenoprotect by Nobel Biocare n Having lectured and co-authored papers and a textbook on the topic, Dr. Hadi Antoun from Paris, France, is an authority on guided bone regeneration (GBR) procedures. In this interview, Antoun shares his experiences with creos xenoprotect, a non-chemically cross-linked resorbable collagen membrane with outstanding handling properties and an extended barrier function for GBR and guided tissue regeneration procedures. The dense mesh of creos xenoprotect holds the bone graft material securely in place for undis- turbed healing. Nobel Biocare: What was your initial reaction when you first used the creos xenoprotect membrane? Dr. Hadi Antoun: That the membrane is easy to handle and, once moistened, does not stick to the site, so you can still change its position after placement. Why is it so important to have a membrane with easy handling? During surgery, we cannot afford to spend too much time adapting the membrane to the defect of each individual patient. We need a membrane that we can handle and cut easily, that does not stick to instruments and that can be adapted to the shape of the site after the biomaterial has been placed. Handling properties are important, but good handling alone is not enough. What then have you found to be the other main advantages of creos xenoprotect? Its elasticity and high biocompatibility. Biocompatibility is fundamental, while the elasticity means it can be sutured or fixated with pins and then tightened without tearing. It also resorbs slowly, allowing time for the ingrowth of bone cells to the site, remodeling and bone regeneration. In a case you have shared with our readers online (please see the link at the end of this interview), you used a combination of xenograft substitute and autogenous bone. What benefits does this combination offer? The cells that survive transplantation in the autogenous graft provide osteogenic potential and growth factors that are released gradually. This complements the bovine hy- droxyapatite, which is a biomaterial that re- sorbs very slowly. It acts as a scaffold for bone regeneration, providing the augmented bone with stability. You stated that, in this particular case, some remnants of the creos xenoprotect mem- brane could still be seen after six months. Were you surprised by this longevity? I was pleasantly surprised. Most resorb- able membranes resorb after a few weeks or three to four months at most. The core principles of GBR dictate that the longer we keep soft tissue and fibroblasts away from the bone area, the greater the opportunity for new bone to form. As such, a long degrada- tion time like this provides a greater chance of success. You chose to restore the case under discus- sion with a NobelProcera Titanium Abutment. Why did you opt for a NobelProcera individ- ualized restoration? An individualized abutment with a scal- loped contour in a biocompatible material like titanium is important for the attach- ment and adhesion of hemidesmosomes in the transmucosal part of the restoration. Bone preservation is very probably related to this barrier. Moreover, from an eco- nomical point of view, we do not have to deal with any additional costs related to a metal cast. Were you pleased with the results of this case? Re-entry at six months showed very sat- isfying results. Bone augmentation covered all exposed threads, and the most interesting observation was the bulky bone augmenta- tion right up to the implant neck. There was more than 2 mm of newly formed bone on the buccal side. What would you say to a clinician consider- ing trying creos xenoprotect for the first time? I would recommend trying the mem- brane. The results are very encouraging and, provided that the basic principles of GBR are followed, complications seem very rare. For me, the combination of autogenous and xenogeneic biomaterials with the mem- brane has worked well. The final trimming of the membrane can be done after augmenta- tion by stretching the membrane before fixat- ing it. Tension-free soft-tissue coverage is a key factor for successful bone augmentation. 7  According to Dr. Hadi Antoun, creos xenoprotect pro- vides numerous advantages, including good handling and slow resorption. More to explore! Further information about creos xenoprotect can be found at xenoprotect. The case referred to in this article is avail- able at Visit Science First creos™ xenoprotect – the superior membrane 9.2% area % Bio-Gide® 20.0% area % p<0.050 creos xenoprotect creos xenoprotect Bio-Gide® 9 weeks 20 weeks 4 weeks 1 week after implant placement 200 300 400 500 600 700 Membrane thickness (µm) 22–32% 39–64% Chemically cross-linked collagen membranes Non-chemically cross-linked collagen membranes 12% creos xenoprotect &CJNKP%&CJNKP#'OCPWGNUUQP.)CUUGT#1OCT16KUUWGF[PCOKEUQHPCVKXGEQNNCIGPOGODTCPGUHQTIWKFGFDQPGTGIGPGTCVKQP,&GPV4GU| (Spec Iss A):Abstract 1141, 2016 ( 2 Bozkurt A, Apel C, Sellhaus B, van Neerven S, Wessing B, Hilgers RD, Pallua N. Differences in degradation behavior of two non- ETQUUNKPMGFEQNNCIGPDCTTKGTOGODTCPGUCPKPXKVTQCPFKPXKXQUVWF[%NKP1TCN+ORNCPVU4GU&GE 9GUUKPI$'OOGTKEJ/$Q\MWTV#*QTK\QPVCNTKFIGCWIOGPVCVKQPYKVJCPQXGNTGUQTDCDNGEQNNCIGPOGODTCPGs#TGVTQURGEVKXGCPCN[UKUQH EQPUGEWVKXGRCVKGPVU+PV,2GTKQFQPVKEU4GUVQTCVKXG&GPV Slower degradation Greater bone formation 5KIPKƂECPVN[ITGCVGTDQPGHQTOCVKQP in the center portion of the defect at FC[|YKVJETGQUZGPQRTQVGEVKPXKXQ1 5KIPKƂECPVN[UNQYGT membrane degradation YKVJETGQUZGPQRTQVGEVKP XKXQsHQTNQPIGTRTQVGEVKQP of the graft material.2 5KIPKƂECPVN[NQYGTFGJKUEGPEGTCVG YKVJETGQUZGPQRTQVGEVEQORCTGFYKVJ chemically cross-linked as well as other non-chemically cross-linked membranes KP|RCVKGPVU Lower dehiscence rate Bio-Gide® is a trademark of Ed. Geistlich Söhne AG. Science First creos™ xenoprotect – the strong membrane Visit Highest force at break Highest stress at break Highest suture retention Gasser A, Wessing B, Eummelen L, Bühren A, Leemhuis H. Mechanical stability of collagen membranes: an in vitro study. ,&GPV4GU 5RGE|+UU|##DUVTCEV| creos xenoprotect is a very strong membrane when hydrated, OCMKPIKVGCUKGTVQUVTGVEJUWVWTGCPFƂZCVGYKVJRKPU 5VCVKUVKECNN[UKIPKƂECPVFKHHGTGPEGEQORCTGFYKVJETGQUZGPQRTQVGEV 20 10 5 15 0 CX CO JS BG BE ML OP BM CY OF * * * * * * * (N/mm²) (N) 25 20 30 10 5 15 0 CX CO JS BG BE ML OP BM CY OF * * * * * * (N) 5 4 6 7 8 2 1 3 0 CX CO JS BG BE ML OP BM CY OF * * * * * * * * * Non-cross-linked collagen membranes CX: creos™ xenoprotect CO: CopiOs® JS: Jason® OF: Osseoguard Flex™ BG: Bio-Gide® Cross-linked collagen membranes BE: BioMend® Extend™ ML: Mem-Lok® OP: Ossix® Plus BM: BioMend® CY: Cytoplast™ RTM Bio-Gide® is a trademark of Ed. Geistlich Söhne AG, BioMend®, BioMend® Extend™ and CopiOs® of Zimmer Group, Cytoplast™ RTM of Osteogenics Biomedical, Jason® of botiss dental GmbH, Mem-Lok® of BioHorizons Group, 1UUGQIWCTF(NGZvQH$KQOGVK+PECPF1UUKZŠ2NWUQH,QJPUQP,QJPUQP)TQWR GMT 46507_Science First_creos xenoprotect mechanical superiority_Qs.indd 1 2016-05-30 10:24 GMT 46507_Science First_creos xenoprotect mechanical superiority_Qs.indd 12016-05-3010:24

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