Dong-Won Park
University College of Dentistry, Newyork, USA
Title: Rh-BMP2 enhanced open healing technique curriculum vitae pusan national
Biography
Biography: Dong-Won Park
Abstract
Horizontal ridge augmentation is very challenging procedure which requires primary closure to prevent early exposure of grafting material and membrane. To accomplish soft tissue closure, adjunct procedure such as releasing incisions, advancement of flaps, periosteal release, or scoring of the periosteum, are often required. These adjunctive procedures can compromise blood supply to the grafting site and eliminate keratinized tissue which is of great importance in implant survival. In this case series, a technique will be introduced which can achieve successful horizontal bone augmentation with simultaneous keratinized tissue widening by open membrane treatment modality. In this presentation, rh-BMP2 was used with non-porous teflon sheet to covering graft material with intentional open membrane technique. Basic surgical procedure is as follows: 1. Full thickness flap was elevated (split keratinized tissue if possible) 2. Decortication of recipient site was performed with round bur 3. Teflon sheet was trimmed to cover grafting material 4. Implant was placed based on prosthetically favorable position when primary stability can be achieved 5. Graft material is placed with gentle pressure (Autograft or Xenograft alone or mixed with allograft) 6. Short healing abutment (<2mm) is connected to implant to reserve space for soft tissue 7. PRF is placed and teflon sheet is covered. 8. 4-0 nylon suture is used without primary closure 9. Inject rh-BMP2 in augmented site 10. Suture was removed 1 week after surgery and Teflon sheet was removed 3 weeks after surgery 14 cases had successful result without any complication. 1 case failed due to heavy smoking. Autogenous bone harvested from chin or ramus showed more dense regeneration of cortical and cancellous bone according to cone beam CT evaluation than Xenograft and Allograft material. This case series suggested that the open membrane technique utilizing rh-BMP2 and teflon sheet can be used to recover horizontal bone defect with simultaneous keratinized tissue widening without primary closure.