Vertical augmentation with RPMTM

Re-inforced PTFE Mesh, RPMTM, can be easily trimmed, adapted, and fixed with pins. RPMTM offers a high stability and the secluded space can be augmented with a mixture of Geistlich Bio-Oss® and autologous bone. Geistlich Bio-Oss® provides long-term volume stability10, and autologous bone contain the required osteoinductive properties for vertical augmentation11. The autologous particulated bone graft can be harvested from the mandibular ramus using a bone scraper device9,11.

PTFE membranes have a long-standing history as barrier membranes and are highly biocompatible6. Collagen membranes, such as Geistlich Bio-Gide®, have been shown beneficial for uneventful soft tissue healing12,13 in guided bone regeneration (GBR) procedures resulting in low complication rates12. Thus, potential exposures can be anticipated by covering non-resorbable mesh with Geistlich Bio-Gide® to get a better soft tissue healing12,13. Moreover, both, Geistlich Bio-Gide® and RPMTM follow the concept of biofunctional membranes that allow early vascularization of the graft.

As for all augmentative procedures, soft tissue management is key9,14. This especially comprises:

  • Preparation of soft tissues before, during, or after treatment to increase mucogingival thickness and keratinized tissue width
  • Elevation of a full-thickness remote or papilla preservation flap
  • Periosteal release to advance flap to achieve tension-free closure
  • Primary soft tissue closure by horizontal mattress and single interrupted sutures

 

Bibliography:

  1. Urban IA, et al: Int J Oral Maxillofac Implants 2009, 24 (3), 502-10
  2. Schwarz F et al. Clin. Oral Implants Res. 2008;19(4): 402-415. (Pre-clinical study)
  3. Rothamel D et al. Clin. Oral Implants Res. 2005; 16(3): 369-378. (Pre-clinical study)
  4. Perelman-Karmon M et al. Int J Periodontics Restorative Dent. 2012 Aug;32(4):459-65. (Clinical study) 
  5. RPMTM is manufactured by Osteogenic Biomedical, Lubbock, Texas, USA
  6. Elgali I, et al: Eur J Oral Sci 2017; 125 (5), 315-337
  7. Urban IA, et al.: Int J Periodontics Restorative Dent 2013; 33(3): 299-307.
  8. Urban IA, et al.: Int J Oral Maxillofac Implants 2014; 29(1): 185-93
  9. Urban IA, et al.: J Periodontics Restorative Dent 2017; 37(5):639-645 (clinical study)
  10. Buser D et al., J Dent Res. 2013 Dec;92(12 Suppl):176S–82S (Clinical study).
  11. Urban IA et al., Int J Periodontics Restorative Dent 2015, 35(5):613-623 (clinical study)
  12. Becker J et al. Clin Oral Implants Res. 2009; 20(7):742-749. (Clinical study)
  13. Tal H et al. Clin Oral Implants Res. 2008; 19(3) : 295-302. (Clinical study)
  14. Urban IA, et al Int J Periodontics Restorative Dent 2016, 36(3):329-337 (clinical study)