We encourage you to read and reach out to us regarding any of the following posts. We welcome your thoughts and look forward to discussing these topics with you. The better informed we are as a dental community, the better we can truly serve our patients.
This article will give you an understanding of bone formation at a tissue level. Examine the cells and the structures that those cells are creating so you can see in your mind what you are creating in your patients. Just as importantly, you will be able to direct the process of bone formation that you want for your patient by the materials you use.
With the understanding that infection associated with a tooth compromises the ability of the socket to heal, SteinerBio sought to find a way to improve socket healing after extractions when significant infection is present.
After the introduction of BioDensification for improving bone quality, a number of additional clinical uses have been developed, such as predictable implant integration for spinners, sinus augmentation without membrane exposure, and grafting immediate implants prior to implant placement.
Advantages of 3D printed bone regeneration by SteinerBio: the ability to predetermine the shape and contour of the regenerated bone, complete resorption of the graft material with proven normal bone regeneration, and predictable accurate bone regeneration.
It is not uncommon for an implant to lose bone at the apex within the sinus over time or for sinus augmentations to fail to regenerate sufficient bone to cover the apex of the implant. The following case is a method of regenerating the bone in the maxillary sinus for implant placement while at the same time covering the apex of a preexisting implant.
Decades of effort and surgical modifications have not improved the outcomes of lateral and vertical ridge augmentation. The failure of predictable ridge augmentation is not the failure of the surgeon. The search for predictable lateral ridge augmentation is a thing of the past at SteinerBio. This post will share with you the exciting progress we are making with our goal of predictable vertical ridge augmentation.
In regenerative medicine, there is always a reason for failure. When a bone graft fails and we do not understand why, we are destined to keep on failing. The only way to improve in the clinic is to study our failures until we find the cause. This case is an example of what we have been preaching for years:
Anything you do locally to kill bacteria will wipe out the regenerative cells.
Recently, we released our custom 3D-printed pure beta tricalcium phosphate bone grafts for lateral ridge augmentation. Through 10 years of R&D, we are finally at a point where lateral ridge augmentation is as predictable as a composite restoration. However, vertical ridge augmentation is completely different and leads to the question at the title of this article.
We’ve seen significant improvements in the Journal of Periodontology in the last year. Still, dubious research has continued to blemish the journal’s integrity. We have no interest in being dentistry’s policeman. However, when we see false information published in our journals, we have a responsibility to our profession and our patients to call it out.
An accurate diagnosis is required for a positive treatment outcome. In our last post, we discussed how periimplantitis is not possible in sites grafted with cadaver bone grafts. However actual periimplantitis is also common. For these two very different lesions we need very different treatment protocols.
Our profession is struggling with a continuing increase in implant loss. Virtually every case is diagnosed as periimplantitis. In this post, we will begin to identify the different reasons for implant loss, starting with when bone loss around a dental implant is not periimplantitis.
Prion infections are transmitted through cadaver tissue grafts and surgical instruments.
In this post, we will discuss what prions are, what human neurodegenerative diseases are caused by prions, and how the infections are transmitted.
In a previous article, “Sinus Augmentation Without Sinus Membrane Exposure”, we described a method of performing a sinus augmentation without contacting the sinus membrane. Here, we use the same technique that allows the graft material to flow through the bone and lift the sinus membrane, but with the ability to graft the sinus with any desired amount of graft material.
At age 2, ths patient suffered trauma to her lower jaw. At age 12, a significant lesion was found in her mandibular symphysis. The diagnosis was a traumatic bone cavity, previously called a traumatic bone cyst.
When talking to dentists about what bone graft material they use, we often hear that they use Puros because it has the most scientific support. We smile and do our best to maintain our composure. The last thing we want to do is to embarrass a fellow dentist by challenging his understanding of bone graft science. So, what did in this article is look at a few papers on Puros that are often quoted in support of this material.
For pain control in dentistry, we deal with pain from periodontal therapy, endodontic therapy, and implant therapy. These surgeries deal with different tissues that are likely to respond differently to various pain medications. However, orthopedic surgeons and dental implantologists both work primarily with bone, and we can benefit from sharing information on the types of pain meds that best benefit our patients after skeletal surgery.
Sinus membrane perforation is the most common complication of sinus augmentation surgery. Dealing with the sinus membrane is also one of the most stressful parts of sinus augmentation surgery. This post describes a stress-free method of elevating the sinus membrane for predictable sinus augmentation.
Every day in the clinic we see dramatic post extraction ridge resorption. We accept this as normal because it happens for most patients. Because many patients delay implant placement, questions remain about the long term benefits of grafting. In the long term, does grafting prevent alveolar ridge resorption or do all ridges resorb irrespective if the site was grafted or not?
At SteinerBio, our posts are accompanied by cited literature to support our discussions. When we are discussing a subject that lacks solid published literature, we make an effort to be clear that we are only providing our opinion. In dentistry, a “bone cavitation” is a term often used to refer to areas of jawbone that is believed to be lacking mineralization or is very poorly mineralized, and filled with either chronically infected, necrotic (dead tissue), or otherwise pathologically affected tissue.
AlloOss Plus is sold to dentists by ACE Southern. It is the same product that killed 8 people two years ago due to tuberculosis infection. Recently, there has been one death and a number of systemic tuberculosis infections with the same product. The product claims to harvest regenerative cells from cadavers, but apparently they are also harvesting diseases that you are putting in your patients.
Even when Dr. Vanchit John, a prominent head of a graduate periodontal program, publishes confirmation that the bone produced by allografts is pathologic, don’t expect the profession to change. If new scientific findings are ignored in physics, it is only an intellectual debate. If new scientific findings are ignored in healthcare, it will have much more profound effects.
Dear Dr. Effie Ioannidou,
The future of periodontics is in your hands. Will your tenure as Editor-in-Chief at the Journal of Periodontology see no improvement in patient outcomes or will your tenure usher in a new and exciting time for our profession and the public we serve?
The one check on the publication of false information are letters to the editor, and unlike other journals, the Journal of Periodontology does not allow letters to the editor. Because of this, many thought leaders in the periodontal profession have protected themselves from scientific scrutiny. Debate is stifled because the false statements that are continually allowed to be published in Journal of Periodontology cannot be challenged.
In medicine, a “Gold standard” refers to the clinical model, method, procedure, intervention, or measurement of known validity and reliability, which is generally taken to be the best available. Objectively weighing information to determine its value as evidence is crucial to determining what may qualify as a Gold standard in medicine. Has implant dentistry become the exception?
A lack of a clear etiology of implant loss at any time frame has prevented our profession from changing what can be done differently to predictably reduce the incidence of implant loss. Determining what therapies have the best treatment outcomes and what variables contribute to the most failures is also a very big concern in medicine, where major heath institutions perform detailed data collection and analysis to identify what variables can be controlled to avoid failures. Fortunately for dentistry, this methodology has now been applied to dental implantology.
The study compared a modern beta tricalcium phosphate to mineralized freeze dried bone allograft and Bio-Oss, including an ungrafted control. The results are not surprising, but the authors’ understanding of the biology of the various bone grafts studied is what sets this article apart from all others. Most previous studies equate bone quality with the amount of new bone produced because the authors lack the ability to distinguish between normal healthy vital bone that has the ability to remodel and adapt, and bone that is pathologic and lacks the ability to remodel and adapt.
We aim to provide useful information and pass on knowledge that we believe will ultimately help provide the best for our patients. However, there are moments where we are bound to address an issue and present criticism when our profession lacks the ability to understand what they are saying. Today we will look at an in vitro bone regeneration study and assess the value of their findings.
Two recent studies confirm some of the points we have made about how to regenerate bone in an extraction socket: (A) Never pack graft material into a socket as it kills the regenerative cells and delays regeneration; (B) Bovine collagen is not biocompatible and causes significant inflammation; (C) Never remove the PDL or disturb the bone in the socket; and (D) Never place any chemicals that can modify the pH and kill regenerative cells.
The following is our Early Implant Protocol for improved esthetics, reduced post operative pain, and shorter time from extraction to restoration. This time period of implant placement also allows for no flap implant placement, which reduces the time of surgery and post-operative discomfort to the patient because there are no incisions, flaps, or sutures.
Bone cells live in the most protected environment in the body. Bone cells are encased in thick cortical bone that is never exposed to the surrounding environment. If this protected environment is breached, the regenerative cells that we work with are easily killed. Today we will discuss how dentists routinely compromise the health of bone and how to avoid killing regeneration.
SteinerBio bone grafts were developed to boost implant success rates.. The goal was to stimulate mineralization, not just allow it to happen. The unique qualities built into our grafts have given us a pathway to achieving significant clinical advancements. Therefore, it is important to understand the do’s and don’ts of our bone graft products in order to achieve successful bone regeneration.
In tissue engineering and regeneration, most everything of interest happens in the first 4 weeks. This post will discuss the clinical application of 3D-printed bone grafts for ridge augmentation and evaluate what is happening in the graft as it is converted into vital bone. We will discuss the surgical application of 3D-printed beta tricalcium phosphate ridges and assess what is happening in the graft material from day of surgery through 4 weeks…
This is the continuation of a previous article, “Alveolar Bone as the Surgical Guide for Early Implant Placement“. In that post, we demonstrated the case of doing an osteotomy at the time of extraction to facilitate early implant placement. Click the link below to see the rest of the case…
A recent study published in the Journal of Periodontology compared the gingival response to sockets grafted with cadaver bone grafts and non-grafted sites. While the gingiva over cadaver bone grafts was found to be ischemic and inflamed, the gingiva over non-grafted sites resulted in the gingiva returning to normal pre-treatment physiology…
Early implant placement with regenerative grafting materials that stimulate osteoblast formation and proliferation provides us with many advances over delayed implant placement. In our experience, early implant placement provides a superior level of osseointegration and implant stability. The following case demonstrates early implant placement…
The accepted dogma of the day is that pluripotent stem cells that can make many different tissues can be induced to form bone. This process is called osteoinduction. As the dogma goes, mesenchymal stem cells (MSCs) that have the ability to form bone, muscle, fat, etc. can be directed by molecules such as BMP-2 to form bone. However, mesenchymal stem cells are not stem cells, they are not pluripotent, and they do not form any type of tissue…
Sinus augmentation is a complex but predictable surgery. When implant placement is added, they can become very interesting procedures with multiple moving parts. With science-based regenerative bone graft materials, areas with minimal bone and lost membranes can be successfully treated…
Calcium phosphate in its elemental state is known to stimulate bone formation and Socket Graft is the only bone graft on the market that contains calcium phosphate in elemental form which contributes to the bone formation shown in the series of radiographs shown in this article…
There have been a number of well done, head to head studies that have compared beta TCP to various types of harvested bone grafts and we are unaware of any published human clinical study where autografts, allografts, or xenografts have outperformed beta TCP. The studies listed found that beta TCP was equal to or better than autografts, allografts or xenografts…
Increasing the odds that your patients accept a bone graft is the first step to increasing the odds your patient returns to place an implant. When a patient invests in a bone graft, they have made the decision to have the best possible therapy and are determined to follow through with the implant. Why is it that when some patients are presented with a treatment plan that includes an extraction, bone graft, and implant, they never follow through or simply disappear?
In your practice, you would never place a filling material in a tooth that has not been cleared by the FDA as safe and effective. You would never prescribe a drug that has not been found to be safe and effective. Still, many are putting materials in patients that have no scientific justification, unlike every other material you use in your dental office…
MEMBER:
American Society for Bone and Mineral Research (ASBMR)
Tissue Engineering and Regenerative Medicine International Society (TERMIS)
American Academy of Implant Dentistry (AAID)