Predictable Strategies in Alveolar Bone Augmentation: Management of Minor & Major Bone Defects

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Homa H. Zadeh, DDS, PhD

Course Description

Patients with atrophic alveolar bone have a variety of different presentations, including vertical versus horizontal atrophy, anatomic features such as flat vs. sloped defect walls or concavities, and various bone density (ex: cortical vs. cancellous bone). Each of these features can affect the efficacy of bone augmentation, either in a favorable or unfavorable manner. The oral location (posterior vs. anterior maxilla, post vs. anterior mandible) requires special considerations. Therefore, the approach utilized needs to thoroughly analyze and classify the site and patient characteristics in order to select an appropriate technique, material and protocol. Another consideration is the potential of complications for the selected protocol and a risk assessment to determine the likelihood of encountering negative outcomes based on patient features. Modular bone augmentation (MBA) refers to an approach, which is based on the convergence of several components required for successful bone regeneration. MBA will employ different components based on requirements of the individual patient and site. The components of MBA include 1) scaffold, 2) osteogenic cells, 3) osteogenic signals, 4) blood supply and 5) wound stabilization. Many controversies remain, including whether membrane are really necessary and primary closure or open healing concept. The application of MBA for the regeneration of alveolar bone and mucosa will increase the likelihood of successful outcomes and reduce the potential for complications.
 

Educational Objectives

Diagnosis

  • Classification of alveolar ridge deficiencies

 

Risk Assessment: 

  • Patient and site characteristics
  • Management of patient/site risks

 

Material Selection:

  • Autogenous: Methods and location of harvesting
  • Xenograft: Effects of sintering temperature
  • Allograft: DFDBA, FDBA, cortical, cancellous
  • Alloplastic: HA, TCP, biphasic HA/TCP
  • Platelet Rich Fibrin (PRF):
    • Biology
    • Protocol
    • Applications
    • Forms: Liquid PRF, solid matrix PRF
  • Membrane selection:
    • Resorbable vs. non-resorbable
    • Cross-linked vs. native collagen

 

Evidence-Based Therapy

  • Evidence on efficacy of GBR and other techniques

 

Biology

  • Biology of wound healing
  • Integration of various bone graft material

 

Flap Design

  • Flap design in posterior maxilla
  • Flap design in posterior mandible
  • Flap design in anterior maxilla
  • Flap design in anterior mandible
  • Achieving tension-free flap
  • Management of failed sites with scarred periosteum
  • VISTA: vestibular access for bone augmentation

 

Suture Material & techniques

  • Resorbable vs. non-resorbable suture
  • Suture techniques for effective flap adaptation
  • Prevention of graft exposure

 

Graft & Membrane Stabilization

  • Fixation system:
  • MODfix/UNIfix
  • Tenting screws
  • Membrane fixation

 

Decortication
 

Soft Tissue Management

  • Material:
    • Native xenogenic collagen (Mucograft)
    • Form-stable xenogenic collagen (FibroGide)
    • Connective tissue graft
    • Free gingival graft
  • Vestibuloplasty
    • FIVE (Fibrin Immobilization Vestibular Extension)

 

Complications

  • Prevention and management

 

Pre- & Post-Operative Care

  • Antibiotics and antiseptics
  • Analgesics
  • Anti-inflammatory agents
  • Nutritional and herbal supplements

 

Hands-on Workshop Simulated Exercises

  • Flap design in GBR in posterior maxilla
  • Flap design for lateral window antrostomy
  • Flap design for crestal osteotomy
  • Piezosurgery
  • Platelet Rich Fibrin (PRF):
    • Preparation
    • Liquid PRF, solid matrix PRF
  • Membrane fixation
  • Fixation system:
    • MODfix/UNIfix
    • Tenting screws
    • Membrane fixation
  • Suture techniques: to prevent graft exposure
  • Graft and membrane stabilization
  • Decortication
  • Soft tissue management
  • Vestibuloplasty

 

Live Surgery Demo

  • GBR
  • Platelet Rich Fibrin (PRF):
    • Preparation
    • Liquid PRF
    • Solid matrix PRF

 

Educational Format

This course offers flexible educational format to accommodate all clinicians’ needs and interests. Participation may take place:

  • In-person or remotely (held over Zoom)
  • Live or on-demand
  • Lecture only or lecture plus hands-on workshops

Regardless of mode of participation, online resources are available to supplement live lecture material. This information is accessible on an on-demand basis.
 

Tuition

  • $1995 Live in-Person: Lecture + Workshop
  • $1495 Remote Learning: Lecture + Workshop
  • $995 Remote Learning: Lectures Only

Tuition for remote workshops includes two-way shipment of all supplies to allow participants to complete the workshops in their own facility.
 

Continuing Education

  • 16 hours of live lecture + hands-on workshop and live surgery demonstration
  • 4 hours of on-demand online education

 

Schedule for Live event

Sat July 10, 2021
7:00 AM to 8:00 AM ……Registration & Breakfast (Served outside)
8:00 AM to 10:00 AM ……Homa Zadeh Lecture
10:00 AM to 10:30 AM ……Break
10:30 AM to 12:30 PM ……Homa Zadeh Lecture
12:30 PM to 1:30 PM …… Lunch
1:30 PM to 2:45 PM ……Homa Zadeh Lecture
3:15 PM to 5:00 PM ……Hands-on workshop

Sun July 11, 2021
7:00 AM to 8:00 AM ……Breakfast
8:00 AM to 10:00 AM ……Homa Zadeh Lecture
10:00 AM to 10:30 AM ……Break
10:30 AM to 12:30 PM ……Homa Zadeh Lecture
12:30 PM to 1:30 PM …… Lunch
1:30 PM to 2:30 PM ……Hands-on workshop
3:00 PM to 5:00 PM ……Live Surgery

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