Procedures

Ridge Augmentation
Using Grafton® DBM Flex and Putty

Don Callan, D.D.S.
Assistant Professor
 Baylor College of Medicine, Houston, TX

The patient is a 60-year-old female with a severely atrophic edentulous region of the right posterior mandible and possible residual socket defects who desires treatment with endosseous dental implants. The site requires onlay grafting to build the ridge width and bony support for the implants to achieve appropriate bone support and a cosmetic result.

Radiograph of the area to be treated.
An incision is made at the crest of the ridge and a full mucoperiosteal flap is reflected buccally and lingually.

Grafton® DBM Flex is cut to match the
length of the area to be grafted.
Grafton® DBM Flex is placed
to contour the grafted area.
Additional Grafton® Putty is placed to fill
any voids.
 Primary closure is obtained if avoiding compaction of the graft is possible.
"By using Grafton® DBM Putty and Flex to gain ridge width and height, I restore the normal occlusal spaces to ensure implant success."

Don Callan, D.D.S.
General Remarks
Dr. Callan used Grafton® DBM Flex and Grafton® DBM Putty processed by Osteotech, Inc. The following is Dr. Callan's technique for onlay grafting of the atrophic edentulous alveolar ridge with Grafton® DBM Flex and Grafton® DBM Putty for the placement of endosseous dental implants.

Detailed Description
  • A full-thickness mucogingival flap with releasing incision is made at the crest of the alveolar ridge and is reflected buccally and lingually.

  • The Grafton® DBM Flex is rehydrated prior to placement. The Grafton® DBM Flex is trimmed to accommodate the geometry of the graft site.

  • Grafton® DBM Flex is placed along the buccal side of the ridge to build the ridge width. Additional Grafton® DBM Putty is gently packed into discontinuities and to fill out any residual socket defects. Care is taken to avoid excessive compaction of the graft material.

  • The incision is first re-approximated at the coronal portion of the releasing incision. The site is then closed with 4-0 gut and 4-0 Vicryl (Ethicon) suture. If primary closure cannot be achieved, a barrier membrane should be used to protect the graft site from bacterial contamination and epithelial cell migration.

  • If a temporary prosthesis is being utilized, it must be modified to accommodate the grafted width of the alveolar ridge. If necessary, a periodontal dressing is used to avoid trauma to the graft site.

  • After a healing period of approximately four months, a dental implant will be placed. Prosthetic restoration will then be completed after an additional four-month healing period.

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