ACM poster from Michigan University

1. A Novel Device for Collection of Autogenous Bone in the Mandible: A Technique Note
Jeff Y. Li, DMD; Jia Chang, DDS, PhD; Hom-Lay Wang, DDS, MSD, PhD; Hsun-Liang Chan, DDS, MS
Periodontics and Oral Medicine, University of Michigan School of Dentistry
During implant placement, areas of deficient bone
or implant dehiscence may require guided bone
regeneration (GBR) to prevent future bone
resorption and implant complications. Autogenous
bone is still considered the gold standard, but may
be limited in amount and difficult to harvest.
BACKGROUND
INTRODUCTION
CLINICAL CASE
DISCUSSION
POSTER #
This presentation will demonstrate the use of a
newly designed drill [NeoBiotech Auto Chip Maker
(ACM); NeoBiotech, Korea] for collecting
autogenous bone with ease and in substantial
amount, in the posterior mandible.
METHODS
• After stable implant placement has been
achieved according to standard protocol, the
area can be assessed for deficient bone (Fig. 10)
• ACM drill and stopper are attached to a
handpiece used for implant osteotomy (Fig. 13)
• Autogenous bone is collected over an
edentulous mandibular area such as the ramus
(Figs. 13 & 14)
• The drill is used at 70 RPM without irrigation,
and may drill to a depth of 4 mm
• The bone is collected into the drill and trapped
by the plastic stopper (Fig. 15)
• The collected autogenous bone is placed in the
defect area and covered with a resorbable
membrane or periosteum, and the implants are
buried in a staged procedure (Figs. 17-20)
• Normal post-operative procedures are followed,
and the amount of bone regeneration can be
assessed at a second stage procedure 3 to 4
months following implant placement (Fig. 26)
RESULTS
• Healing following the surgeries was uneventful
• Implant stability was adequate
• At the second stage procedure (3 months), a
significant amount of new bone had formed
around the implant and previously deficient site
• This new device is easy to use, and can collect
large amounts of autogenous bone quickly
• The collected bone has a coagulated and spongy
consistency, as it is well hydrated with the blood
that is collected simultaneously
• Advantages of this graft include its osteogenic,
osteoinductive and osteoconductive properties,
ease of handling and precision of placement
• Possible disadvantages include diminished
space maintenance and increased resorption.
• __ year old Caucasian female, in stable systemic and periodontal health, requiring single implant
restoration for missing tooth #30
• Clinical exam reveals possible horizontal bone deficiency with adequate vertical height
• Planned for Zimmer TSV 4.7x11.5mm implant with possible simultaneous guided bone regeneration
Figure 1. Pre-Op Bite
Figure 2. Pre-Op Buccal Figure 3. Pre-Op Occlusal
Figure 8. Final Drill Occlusal Figure 10. Implant OcclusalFigure 9. Final Drill BuccalFigure 7. Pilot PAFigure 6. Pilot DrillFigure 5. Flap ReflectionFigure 4. Crestal Incision
Figure 11. Implant Buccal Figure 12. Ramus Donor Figure 13. Collection Figure 14. Donor Site Figure 15. Bone in ACM Drill Figure 16. Collected Bone Figure 17. Recipient Site
Figure 24. 2 Week PO
Figure 23. Sutures BuccalFigure 22. Sutures OcclusalFigure 21. Final PAFigure 18. Intra-marrow
Penetrations
Figure 19. Grafted Bone Figure 20. Absorbable
Membrane
Figure 25. 3 Month PO Figure 26. 2nd Stage Figure 27. Abutment
Occlusal
Figure 28. Abutment Buccal
Figure 32. 2 Week PO Bite
Figure 30. 2 Week PO
OcclusalFigure 29. Abutment Bite
Figure 31. 2 Week PO
Occlusal
CONCLUSIONS
This newly designed instrument is a useful tool for
collecting autogenous bone, which can be used for
GBR around moderately deficient sites during
implant placement procedures.
Figure 10. Implant Occlusal
Figure 26. 2nd Stage
Figure 3. Pre-Op Occlusal Figure 25. 3 Month PO