DIO European Meeting 2013 - Rome by peter fairbairn

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Dr Peter Fairbairn's lecture on DIO SM and UF dental implants placed in reduced bone cases where synthetic graft material is used to ethically grow new bone in around 10 weeks.

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DIO European Meeting 2013 - Rome by peter fairbairn

  1. 1. The Use of Dio SM Implants in reduced Bone situations Dr Peter JM Fairbairn Visiting Professor , Department of Periodontology and Implant Dentistry, University of Detroit Mercy School of Dentistry,USA
  2. 2. My Faculty in Detroit , USA Dr Peter J M Fairbairn
  3. 3. Shift in Perceptions
  4. 4. “The Body wants to Heal , Lets work with it “ Dr Peter JM Fairbairn , Bone experts Forum , Zurich 2008
  5. 5. Bone the Key to Soft Tissue Success ! TRUE BONE RESTORATION THROUGH GBR IS VITAL FOR LONG TERM SOFT TISSUE AESTHETICS AS SEEN IN MANY ASPECTS OF DENTISTRY FROM RESTORATIVE , ORTHODONTIC AND PERIO-DONTIC TO IMPLANTOLOGY , GARBER SAID IT AND IT REMAINS SO TODAY Dr Peter J M Fairbairn
  6. 6. Balance of healthy tissues the key to AESTHETICS Dr Peter J M Fairbairn
  7. 7. Patient Physiology ? Dr Peter J M Fairbairn
  8. 8. But , what is the “gold Standard “ Graft Material ? The IMPLANT ? Prof Pinholt , Uni Copenhagen Synchtron study Dr Peter J M Fairbairn
  9. 9. Bone Modelling ! • “This Study indicates that concerning the optimal dimensions of the alveolar bone , it would be favourable to place the implant as soon as possible following tooth extraction.” • Schropp L , Wenzel A , et al “ Bone Healing and soft tissue contour changes following single tooth extraction ; A clinical and radiographic 12 month study” Int Journal Periodontics Dent 2003 ; 23, pgs 313-323 Dr Peter J M Fairbairn
  10. 10. My Routine 10 year old Protocol ! Atraumatic Extraction and leave for three weeks for soft tissue closure , then raise site specific flap place and graft. In rare cases where socket too big or Vital tissues ( IAN , Sinus ) an issue then Socket Graft and place at 3 Months Dr Peter J M Fairbairn
  11. 11. Guided Bone Regeneration Traditional particulates with a non- resorbable or bioresorbable membrane to stabalize (Schenk ) the graft and to exclude soft tissue in-growth may lengthen the healing period by excluding the Vital periosteal blood supply (Gutta) ! Dr Peter J M Fairbairn
  12. 12. Particulates and Traditional Membranes can have Difficulties Dr Peter J M Fairbairn
  13. 13. Membranes; A help OR a Hinderance ? BLOOD IS THE KEY TO BONE REGENERATION IN HEALING (Angiogenesis) 85-100% from Periosteum I now have not used a traditional collagen membrane for last 10 years by making the graft its own cell occlusive graft. Dr Peter J M Fairbairn
  14. 14. Benefits of BTcP , Membrane Free ! • Stromal cell derived factor 1 (SDF 1 ) is induced in the periosteum of injured bone and promotes bone healing by recruiting mesenchymal cells to the injured site . • Type 1 collagen is the predominant component of newly formed Osteoid and serves as the basis for the mineral scaffold . • Zhao J, Watanabe T et al , “Transcriptome analysis of BTcP implanted in dog mandible ,” Bone , Elsevier , pages 864-877 Dr Peter J M Fairbairn
  15. 15. Alloplasts ! No Autogenous ? Calcium Sulphate Beta Tri-Calcium Phosphate Hydroxy-Apetite Poly-Lactides Dr Peter J M Fairbairn
  16. 16. Prof. Klaas de Groot Emeritus Prof . Bio-materials Author ; Bio-Ceramics of CaP
  17. 17. There are many types of Graft Particulates, WHY ALLOPLASTS ? • “A major concern with the use of grafting materials is the presence of residual particles which might interfere with normal healing and bone implant contact. As such bone quality could thus be as critical as quantity in determining the long term function and stability of Dental Implants and the peri-implant host tissues “ • “ Residual particles ( xenograft ) led to up to 23 % less bone in a site whereas alloplasts led to up to 22% increase of bone in a graft site , all materials led to reduced CT “ • Chan H-L , Wang H-L et al “ Alterations in Bone Quality after Socket Preservation with Grafting Materials: A Systemic Review “ JOMI ( Quintessence ) Vol 28 No 3 2013 , pgs 710 - 719 Dr Peter J M Fairbairn
  18. 18. Research Socket grafting using β -tricalcium phosphate in a hydroxyl sulphate matrix . Minas Leventis, DDS, MSc, PhD1, Orestis Vasiliadis, DDS1, Nadia Theologie-Lygidakis, DDS, MScM, MScD, PhD2, Peter Fairbairn, BDS3 and Ioannis Iatrou, MD, DDS, PhD4 Clinical Assistant, Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece 2 Lecturer, Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece 3 Private Practice, Kensington, London, UK 4 Professor, Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece 1
  19. 19. NEWER RESEARCH ! Study 1 Experimental Study of the Biological Response to β - Tricalcium Phosphate/Calcium Sulfate Synthetic Graft Material. Minas D. Leventis, DDS, MS, PhD1), Peter Fairbairn, BDS2), Ismene Dontas, DVM, PhD3), Gregory Faratzis, MD, DDS, MS, PhD1), Lubna Khaldi, MD, PhD5), George Kostakis, MD, DDS, MS, PhD1) and Efstathios Eleftheriadis, MD, DDS, PhD6) 1) Clinical Assistant, Department of Oral & Maxillofacial Surgery, Dental School, University of Athens, Greece 2) Visiting Professor in Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, USA 3) Professor of Experimental Surgical Research, School of Medicine, University of Athens, Greece 4) Registrar in Maxillofacial Surgery, Department of Maxillofacial Surgery, Greek Anticancer Institute, St Savvas Hospital, Athens, Greece. Study 2 Clinical, histological and micro-CT findings of sockets grafted with β-TCP in a calcium sulphate matrix or bovine bone mineral. A case report. Minas Leventis, PhD1, Peter Fairbairn, BDS2, Les Coulton, PhD3 and Charles Mangham, PhD4 1 Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece 2 Visiting Professor in Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, USA 3 Department of Human Metabolism, Medical School, University of Sheffield, Sheffield, UK 4 Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK Study 3 Socket grafting using in situ hardening β-tricalcium phosphate: a case series. Minas Leventis1, Peter Fairbairn2, Annette Lindner3 and Heiner Nagursky3 Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece Visiting Professor in Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, USA 3 CTA - Cell Tissue Analysis, Department for Oral and Maxillofacial Surgery, University Clinic of Freiburg, Freiburg, Germany 1 2 Study 4. Socket preservation in molar sites without primary wound closure. A clinical study. Minas Leventis,1 Orestis Vasiliadis,1 Peter Fairbairn,2 Vasileios Margaritis,3 Demos Kalyvas1 Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece Department of Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, USA 3 School of Health Sciences, Walden University, USA. 1 2
  20. 20. Implants for any Case and Any Bone ! ProTem Permanent or temporary mini implants NarrowFix Small osteotomy sites SM Submerged Root-form submerged implant Extra Wide Larger surface area Biotite-H Bioactive SM implants Dr Peter J M Fairbairn
  21. 21. Standard Protocol , ( Tarnow Type B)but always 3 week delay for soft tissue Dr Peter J M Fairbairn
  22. 22. Radiographs 18 Months Dr Peter J M Fairbairn
  23. 23. Re-direction of path of Insertion Dr Peter J M Fairbairn
  24. 24. Ridge Expansion Dr Peter J M Fairbairn
  25. 25. The Solution: DIO Bone Expander Dr Peter J M Fairbairn
  26. 26. Expansion with SM Taper Taper can be used to expand the bone ! Dr Peter J M Fairbairn
  27. 27. Even NO Primary !! Dr Peter J M Fairbairn
  28. 28. Case Radiographs Dr Peter J M Fairbairn
  29. 29. Loaded 1 year 2 Years Dr Peter J M Fairbairn
  30. 30. Loaded 2 years Dr Peter J M Fairbairn
  31. 31. Dr Peter J M Fairbairn
  32. 32. Loading at 3 Months Dr Peter J M Fairbairn
  33. 33. 18 Months Loaded Dr Peter J M Fairbairn
  34. 34. Dr Peter J M Fairbairn
  35. 35. So Is It Bone ?? The graft bio-absorbs fully , thus only host bone ! Dr Peter J M Fairbairn
  36. 36. Micro Ct Cores Dr Peter J M Fairbairn
  37. 37. H and E Staining core From socket at 3 months , Fairbairn , Laventis et al 2012 Dr Peter J M Fairbairn
  38. 38. BIO-TITE H AND OSTELL Dr Peter J M Fairbairn
  39. 39. 18 Months Loaded Dr Peter J M Fairbairn
  40. 40. Dr Peter J M Fairbairn
  41. 41. Research on coated Implants with nano-particulate CaP Dr Peter J M Fairbairn
  42. 42. Where Next ? 3 months Dr Peter J M Fairbairn
  43. 43. Radiographs Dr Peter J M Fairbairn
  44. 44. Dr Peter J M Fairbairn
  45. 45. Dr Peter J M Fairbairn
  46. 46. Bone in 10 weeks ! Dr Peter J M Fairbairn
  47. 47. Dr Peter J M Fairbairn
  48. 48. Close to the IAN ! Dr Peter J M Fairbairn
  49. 49. Core Sample Site Dr Peter J M Fairbairn
  50. 50. Dr Peter J M Fairbairn
  51. 51. 2 Years Loaded Dr Peter J M Fairbairn
  52. 52. Dr Peter J M Fairbairn
  53. 53. Sinus Augmentation with Low Primary Stability Dr Peter J M Fairbairn
  54. 54. Loading with Osstell readings ( 34 to 68 ) at 4 months. Dr Peter J M Fairbairn
  55. 55. Dr Peter J M Fairbairn
  56. 56. Azure 2 and pararosaniline staining Dr Peter J M Fairbairn
  57. 57. Dr Peter J M Fairbairn
  58. 58. Dr Peter J M Fairbairn
  59. 59. UF , New From DIO Dr Peter J M Fairbairn
  60. 60. JUST YESTERDAY ! Dr Peter J M Fairbairn
  61. 61. Ten weeks in Line with Healing ! Dr Peter J M Fairbairn
  62. 62. So Lets Help the Body !!! Bio-compatible , Bacterio-Static fully Bio-absorbed synthetic particulates , return the body to its healthy state. No Foreign or Donor material ! your patients will appreciate it ! Happy Patient Happy Dentist Dr Peter J M Fairbairn
  63. 63. Thank You Jason and all at DIO Implants, South Korea, for helping me to move ethical Implantology Forward Dr Peter Fairbairn Scarsdale Dental and Implant Centre 67 Earls Court Road Kensington reception@scarsdaledental.co.uk 020 7937 2160 London W8 6EF Dr Peter J M Fairbairn
  64. 64. Dr Peter J M Fairbairn
  65. 65. You Tube Case Placed the lateral Implant and grafted similarly, can be seen on “YOU TUBE” Fairbairn DIO . Dr Peter J M Fairbairn

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