Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-05-12, 09:42:21 | version 1.38.0
with time. After twelve months, bone re- generation material was still visible in five patients (12.2 %). Abnormalities were re- ported in four patients: in two cases, sero- mas were found at the three-month exam- ination. At the follow-up operation which was necessary, neither augmentation ma- terial nor newly-formed bone was found. Augmentation was therefore repeated. Af- ter six months, one patient did not have the necessary primary stability for the planned implant. After nine months, another patient showed radiolucency following placement of two implants at #35 and #37. It was found that, in the vast majority of cases, the treatment was complete after a little more than six months; the defects in the above-mentioned patients also healed somewhat later without problems. The dentist carrying out the treatment then gave a final summarising assessment of the success of the treatment and the tol- erability of the materials used. This assess- ment was made at the last observation point/last appointment of the patient at the dental practice in each case. If the “very good” and “good” judgements are added together, the results for effectiveness are almost 80 % and for tolerability are over 90 % (see Table 4, final evaluation of the de- fect filling/augmentation). Handling and healing were also judged to be very good or good in most cases. The rate of complications can be considered low and not abnormal; it decreased continually with time. Discussion In the first few years after the introduction of β-TCP CERASORB®, many users still tended to mix this bioceramic product with autologous bone before using it. This became progressively less common because of all the positive experience gained from us- ing the product on its own. As long ago as 2000, Szucs and colleagues reported that, in 52 patients with different dental or surgical indications, the implanted β-TCP had been completely transformed into bone within twelve months and that bone tissue stable enough to hold implants had formed within four to six months.1 They came to the conclu- sion that it is not necessary to use autolo- gous bone for a sinus lift or the filling of cysts because CERASORB® alone has shown itself to be a suitable material for these applica- tions. These results are supported by many publications including Hoch, Palti, Foitzik et al., Basa et al., Horch et al., Szabo et al. and Schermer.2–10 While the use of β-TCP to fill bone defects is now accepted, the need to use membranes in association with augmentation proce- dures is still controversial. In smaller proce- dures, where the mucous membranes are in good condition and the wound has been closed without tension, it may not be neces- sary to use a membrane. Appropriate mem- branes should be used if wound dehiscence occurs, or is to be expected, and whenever additional protection seems helpful for undisturbed bone regeneration. Both re- sorbable (e.g. Osgide®) and non-resorbable membranes (e.g. PTFE membrane) are avail- able depending on the indication and the aim of treatment. When choosing a membrane it is crucial that the indication and the technol- ogy are suitable for each other. Although the use of synthetic materials based on β-TCP can now be considered established, the "granular" form of the product was repeat- edly criticised; this led to the development of products that were easier to handle and more user-friendly. CERASORB® Paste—the sub- ject of this study—was developed to fill smaller defects. The main properties of this product can be summarised as follows. It is based on CERASORB® M Granules with their interconnecting pore system, which have been optimised in over 15 years of clinical use and serve as a mechanical framework for the formation of new bone. Parallely to the formation of new bone, the granular material is completely absorbed. Because of its entirely synthetic manufacture there is no risk of the immune reactions and infec- tions that can occur with donor material of human or animal origin. The paste can be completely and accu- rately applied directly from the sterile pre- filled syringe to fill small bone defects. The syringe also makes it possible to use the ma- terial effectively in sites that are hard to reach. After complete filling of the defect the paste maintains optimal contact with the surrounding healthy bone. The hydrogel does harden during and after application. This means that the paste keeps its long-term plasticity when in the defect and its volume remains stable; it can fill the defect com- pletely so that it is flush with the edge. After D A visio.lign® nics IMPLANTOLOGY MEETS BIONICS r d o Maté Sán c h e z d e V a l . P h D, M.Sc., D D S The one-time therapy a u r. José E d D . f o r P : e g a m I Train the bone – save the tissue with hybrid abutments made of titanium and BioHPP®. Immediate restoration without abutment change. • Perfect soft tissue • Natural colour • Increase profit Call (+49) 0 73 09 / 8 72-4 41 to get more information about the indications and the versa- tility of the SKY® fast & fixed therapy. attachment S I N C E 1 9 7 4 bredent medical GmbH & Co. KG | Weissenhorner Str. 2 | 89250 Senden | Germany