Implant Seminars

Live Surgery

Dr. Arun Garg – June 26, 2009

Psychological Sedation

Garg uses an eye mask as eye pillow

PRP

BTI $5000 – Centrifuge $1000 and Packs $10-15

Harvest $6000 – Centrifuge $3000 and Packs $100

ACE $2000

CT Planning Software

Blue Sky Bio – Now available for no cost

Bone

Osteolife Biomedical: $80/bottle

50-250 microns – Best bone comes out of it

300-500 microns – Good

800-1200 microns

1000-2000 microns (1-2mm) Most difficult to condense and worst to heal, but easiest to handle

WANT MINERALIZED BONE

Dynablast is poorly demineralized

Osteoblast is half mineralized/half demineralized

Autogenous Bone in a Bottle

BMP – $850 per bottle

Wait 6-7 months

There will be a LOT of post-op swelling but no pain

Due to influx of millions of cells from BMP’s signals

1 week of swelling

BMP lasts 3 days

Maxillary Sinus Lift

Window

Superior line: 15mm

Inferior line: Ridge plus 3mm

Aseptico 1:1 Straight handpiece for Sinus Lift osteotomy

Piezo to finalize the window

Elevate sinus SLOWLY

Gauze soaked with 1:50,000 epi for hemostasis

Osteolife small particle mixed with salin

Use Cut off syringe to place bone

Use island of bone for coverage

Then cover Collatape with saline

Dental Health Products

Vicryl Type of suture

Made by LOOK

Close with horizontal mattress

½ carpule: Marcaine at the end for discomfort

Implant Placement

Midcrestal incisions

Primary closure with Vicryl

Note: Use sinus elevators as adjunct for reflection

Stage 2

Steal tissue from palate

Create papillae with palatal tissue

Papilla suture 5-0 needs to be fine

Vertical mattress suture

Flap sutures should be 3-0

Note: Use sinus elevators as adjunct for reflection

Sutures

Gut is good for vertical releases

Vicryl is good for crestal incisions

1 Wall Defect – Maxilla

Open flap, past muco-gingival jxn

Remove all soft tissue on the bone with Piezo

Mix water and BMP particulate

Impregnate collatape with BMP – 15 minutes

BMP binds to collagen

Then put BMP on bone

Place bone, pieces of BMP in collatape

Primary closure with horizontal mattress

Note: Use sinus elevators as adjunct for reflection

Heal time 8 months

Atraumatic Extraction& Socket Preservation

Raise a flap

Vertical releasing incisions

Make sure you pass the muco-gingival jxn

Release the flap so that you can get primary closure after ext and bone graft

Note: Use sinus elevators as adjunct for reflection

Piezo for creating PDL space on an ankylosed tooth

Atraumatic ext

Decorticate socket with Piezo and High speed #8 round diamond

Graft site with small particle with saline

Primary closure with 4-0 vicryl

Close the vertical releasing incisions with either the vicryl or gut

Heal time after bone graft

Molars: 16 weeks

Canines: 12 weeks

Premolars: 10 weeks

Upper centrals: 8 weeks

Lower Incisors & Upper laterals: 6 weeks

Implant Length

Length

Molar – 15mm

Canine – 13mm

Premolar – 11mm

Upper Central – 9 mm

Upper laterals and lower incisors – 7mm

Ridge Split

Raise a flap

Vertical releasing incisions

Make sure you pass the muco-gingival jxn

Release the flap so that you can get primary closure after ext and bone graft

Make it split thickness when it is apical to MGJ

Want to release muscle attachment

Note: Use sinus elevators as adjunct for reflection

Must use a Piezo for ridge split

NO OTHER OPTION

8mm vertical saw blade on Piezo

2 vertical cuts just through the cortical bone

Need at least a 3mm ridge to do this

Basically cutting bone on 3 walls, but maintaining bone at apex

Use ridge split kit to widen ridge

Place tapered implant

Posterior Mandible ridge thickening

Few options:

Ramus block

Chin block

J Block

Ridge split

BEST OPTION