microdent bone expansion · lateral bone condensation to improve density and quality of the bone....

29
MICRODENT BONE EXPANSION PRODUCT CATALOGUE

Upload: others

Post on 11-Mar-2020

4 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

(Spain)

Edition: August 2016

MICRODENTBONE EXPANSIONPRODUCT CATALOGUE

Page 2: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

2

MICRODENT FACILITIES (MANUFACTURING AND COMMERCIAL SITES)

MICRODENT CORPORATE

Page 3: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 3

Quality as objectiveIn order to completely and totally fulfil its customers’ requests, Microdent ensures that all products exceed the strictest regula-tory requirements set by international health authorities.

It is worth noticing that the raw material used in the manufacture of all Microdent products is of the highest quality and strength, like the titanium used for the manufacture of dental implants.

All production processes, assessed and validated by the inter-national certification body DNV-GL, include cytotoxicity tests to ensure the correct cleaning of the Microdent products, as well as validation studies of the implant sterilization process, microbiolo-gical quality assessments, endurance, torque and fatigue tests... and a large number of studies with several national and interna-tional universities on clinical outcomes of Microdent’s implants.

Technology, innovation, professionalism...When choosing Microdent implants, customers are placing their trust in a large company with a professional career achieved with much effort, full of successes and supported by many of the most renowned implantologists in the country.

Microdent facilities are equipped with cutting-edge technology where implants and implant components are manufactured under a targeted and rigorous unit quality control.

Continuing EducationMicrodent has shown a special interest in the area of education since its inception. Therefore, it often organizes and teaches continuing education clinical courses, seminars and hands-on workshops in order to provide practitioners with the appropri-ate knowledge and tools to achieve success in their work with patients. These courses take place in the company itself, where there is an auditorium and some practice rooms, but also in dif-ferent cities in Spain.

Human teamMicrodent has a team of highly-skilled, specialized technicians at the service of the professionals of implanlotlogy as well as a complete commercial network throughout the national territory which is complemented with an international distribution network in constant growth.

Page 4: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

4

ORTODONCIAMICRODENTMicroimplantes de Ortodoncia

Catálogo de productos

CORTICAL-FIXMICRODENTElevación de seno interna

Catálogo de productos

GENIUSMICRODENT

MANUAL DE PRODUCTO

Sistema implantológico

EKTOSMICRODENT

MANUAL DE PRODUCTO

Sistema implantológico

PRODUCT PRESENTATION

IMPLANT CATALOGUES

MANUALS

QUICK-GUIDES

OTHER CATALOGUES

DIGITAL INFORMATION

REGENERACIÓN ÓSEAMICRODENTInstrumental y casos clínicos

Catálogo de productos

GENIUSMICRODENT

GUÍA DE PRODUCTOS

Sistema implantológico

GENIUSImplantes de conexión interna

Sistema implantológicoSistema implantológico

EKTOSMICRODENT

GUÍA DE PRODUCTOS

Sistema implantológico

EKTOSImplantes de conexión interna

Sistema implantológico

CONEXIÓN EXTERNAMICRODENT

GUÍA DE PRODUCTOS

Sistemas implantológicos

SYSTEMImplantes de conexión externa

Sistema implantológico

UNIVERSALImplantes de conexión interna

Sistema implantológicoSistema implantológico

MICRODENTTRYLOGICGUÍA DE PRODUCTOS

Sistema implantológico

TRYLOGICImplantes de conexión interna

Sistema implantológico

MKpro & MKpro 4MICRODENT

GUÍA DE PRODUCTOS

Sistema implantológico

CIRUGÍA Y EXPANSIÓNGUIADA

MICRODENTCatálogo de productos

Page 5: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 5

nº1742465MICRODENT trademark registration.

nº9602250Patent for bone expanders in Spain.

nº6146138Patent for bone expanders in USA.

nº023801558Patent for bone expanders in Europe.

nº9800394Patent for prosthetic Micro-pik fixation system.

nº20002497Patent for transmucosal dental implant.

nº20002545Patent for overdenture flat-ball.

nº200102649Patent for surgery security device.

nº200102769Patent for impact fixation dental implant.

nº200102914Patent for bicortical provisional implant.

nº200200087Patent for internal connection implant.

nº200201614Patent for improved dental implant.

nºP200300602Patent for overdenture adjustable retention system.

nº200402082Patent for biomechanical connection system.

nº200800195CORTICAL FIX patent - conformation of the maxillary sinus cavity.

nº200203054Patent for use of melatonin for bone regeneration for human and veterinary use as active product.

nº200701563CAPITEL abutment patent - prosthetic angular correction.

nº200702213OSSCILIA patent - spherical oscillating retainer for overdenture fixation.

nºP200503064NOVATECH patent - angular fixation system.

nº200700408Patent for dental implant.

nº200701138MRT patent - dental implant with integral locking system.

nº200402082RODAS system patent - bio-mechanical connection system between implant and prosthesis.

nº200703251Patent for implant retention key.

nº200300041Patent for fixation system of dental prosthesis.

nº200500306Patent for orthodontics implant.

nº200801197MV implant patent - insertion without drilling.

nº200930627/aPatent for endosseus plataform for dental prosthesis implantation.

nº201031083/otPatent for bone expanders for guided dental surgery.

nº201030002/5Patent for disparallelism correction of dental implants.

Backed up by 30 patentsDriven by the constant desire to improve and continuous research, Microdent products are protected by several patents and utility models that back up and protect our approach to oral implantology.

Page 6: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

6

BONE EXPANSION CATALOGUE INDEX

EXPANSION TECHNIQUE DEVELOPMENT

DILATORS

ESBIPRO TECHNIQUE

BONE EXPANSION TECHNIQUE

PRACTICAL PROCEDURE

CLINICAL CASES

CLINICAL CASE Nº1

CLINICAL CASE Nº2

CLINICAL CASE Nº3

CLINICAL CASE Nº4

CLINICAL CASE Nº5

CLINICAL CASE Nº6

8

10

11

12

13

15

16

18

20

22

24

26

Page 7: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 7

BONE EXPANSION SYSTEMExpanders user’s manual

Page 8: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

8

EXPANSION TECHNIQUE DEVELOPMENT

Creators of the threaded bone expansion, non-traumatic technique in 1997

Expansion kit (PN-KEO3J)Content description:• Circular saw PN-F101• Expansion pilot drill PN-F1312• Crest opening drill PN-701• Long extender PN-ACL44• Manual key PN-644• Tightening handle PN-35• Expander nº1 (3 units) PN-1025• Expander nº2 (3 units) PN-1830• Expander nº3 (3 units) PN-2938• Expander nº4 (3 units) PN-3345• Expander nº5 PN-4452

• Sinus elevator PN-3535

Optional material (lower tray) not included• Ratchet spanner PN-LD1• Extra-oral key PN-LLEO

Microdent bone expanders have contributed to oral rehabilitation with very impor-tant innovative technology, becoming a worldwide reference product and a must for any implantology professional. This simple and functional bone expansion sys-tem prevents surgical trauma and enables an efficient, measured and progressive control of the expansion.

Two different configurations are available to clinicians:A basic expansion kit, with five expanders and an additional compactor.The new complete bone expansion kit, with all the necessary material andinstruments.

Main characteristics and features• Only a fissure drill or circular drill is needed to initiate procedure.

• Intermediate countersink and tapping drillings are removed from the drilling protocolof type D-2 bone.

• The excess of blood supply of type D-3 bone is used. Due to only one drill being used, theosteotomy cools down.

• Bone surpluses that are compacted in the neo-alveolus are used throughout the procedure.

• In type D-4 bone, which has a lower percentage of bone tissue, a tricortical anchor is pos-sible. By expanding the cortical crest from 1 to 2mm, broader implants can be used and5mm implants can be inserted.

• The expander nº6, of special design, enables non-traumatic sinus lift and prevents bone plate fracture.

Patent in Spain: 9602250Patent in USA: 6146138Patent in Europe: 023801558

NON-TRAUMATIC EXPANDERS

TYPE A BONEBone with:

· Width > 5 mm.· Height: 10 - 12 mm.· Length > 5 mm.· Angulation > 30%

TYPE B BONEBone with:

· Width: 2,5 - 5 mm.· Height: 10 - 12 mm.· Length > 15 mm.· Angulation > 20%

TYPE C BONEBone with:

· Unfavourable height and width, as well as length and angulation.

TYPE D BONECharacterised by:

· Severe atrophy· Basal bone loss· Flat upper jawbone· Pencil-thin mandible

Considerations aboutdifferent bone types:

Page 9: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 9

BASIC INSTRUMENTS

*Sinus compactor for 4.20mm diameter implants.

8 10 12 14 16

Depth marks: 8, 10, 12 and 16mm.

1025nº 1

1830nº 2

2938nº 3

3345nº 4

4452nº 5

3535nº 6 *

EXPANDERS

Main advantages• Practically non-traumatic use.

• It dilates the narrow ridges increasing thickness without bone loss.

• It compacts bone around the implant, which aids osseointegration.

• Perfect control of the insertion axis of the implant during surgery.

• Economic since, in some cases, replaces the use of drills preventing wear and tear.

• The progressive threaded insertion produces bleeding, favouring osseointegration.

• Minimal risk of lateral perforations in the labial area of the upper jaw compact bone due to excellent control of the expander either by hand or conveyor.

• Universal application for all implant systems.

Surgical Technique

Main indications• Thin crests regardless of the type of bone.

• Type II, III, IV bone.

• Type I bone in combination with the traditional drilling system.

• Non-traumatic sinus lift through the implant site.

• Manual key PN-644• Tightening handle PN-35• Expander nº1 PN-1025• Expander nº2 PN-830

• Expander nº3 PN-2938• Expander nº4 PN-3345• Expander nº5 PN-4452• Sinus compactor PN-3535

Basic expansion kit (PN-KBE)Content description:

EXPANDER nº1 EXPANDER nº2 EXPANDER nº3 EXPANDER nº4 EXPANDER nº5 EXPANDER nº6

INITIAL SHORT

Ø TIP 1.00mm to 2.30mm

INITIAL LONG

Ø TIP 1.50mm to 3.00mm

EXPANDER

Ø TIP 1.90mm to 3.80mm

EXPANDER

Ø TIP 2.50mm to 4.50mm

EXPANDER

Ø TIP 3.00mm to 5.10mm

SINUS

STRAIGHT

Ø 3.50mm

LONG. 10mm LONG. 16mm

8mm=Ø 2.75mm 10mm=Ø 3.00mm

12mm=Ø 3.25mm 14mm=Ø 3.50mm

YELOW COLOUR

RED COLOUR

LIGHT BLUE COLOUR

GREEN COLOUR

DARK BLUE COLOUR

8mm=Ø 3.40mm10mm=Ø 3.70mm12mm=Ø 4.00mm14mm=Ø 4.30mm

8mm=Ø 3.90mm10mm=Ø 4.20mm

FOR IMPLANTSØ 4mm

12mm=Ø 4.50mm14mm=Ø 4.80mm

Ø 4.20mm

ELEVATOR

Page 10: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

10

DILATORS

During the expansion process, Microdent dilators operate together and in combi-nation with bone expanders with higher active capacity, exerting far even greater control of the technique. Dilators’ main function is to keep the sequential widening of the bone table controlled until an implant is inserted in the mouth, which would act as “final retainer”, foregoing any other intermediate solution.

The complete bone expansion kit includes as optional material (to choose from 2 additional sets of expanders) a pair of dilators of each size, identified by the colour of each expander which they complement.

INSTRUMENTS FOR BONE EXPANSION

Pilot drillTo drill the crest to insert expander nº1 (PN-1025) later.

Extra-oral keyTo perform an expansion fromoutside the mouth.

Circular drillTo open the crest longitu-dinally.

701 drillTo open the crest longi-tudinally. Used with a turbine at high-speed.

Manual spannerIt provides a very sensitive control of the expansion.

Tightening handleTo tighten the manual key.

F1312 F101 701 644 35

1.20mm0.10mm

8mm

1mm

DH02 DH03 DH04 DH05

3.0mm

1.5mm

12mm

1.9mm

3.8mm

12mm

2.3mm

4.5mm

12mm

3.0mm

5.0mm

12mm

LLEO 7mm

DILATORS

Page 11: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 11

3D VIDEO OF THE ESBIPRO TECHNIQUE (Bioactive stimulation of osteogenic processes)

Microdent offers all its customers a 20-minute, 3D video which shows a summarised version of all steps involved in this technique.

GENERAL GOALReversal of the bone loss process. Qualitative and quantitative parameters are redefined 3-dimensionally and the density is improved, both, through direct physiological functional stimuli applying a non-traumatic technique for maximum control and using Microdent threaded expanders.

SPECIFIC GOALSBone expansionTo gain bone width. Correct placement and axial inclination of implants.Sufficient bone volume.

Sinus liftTo gain bone height. Favourable inter-maxillary relation.Normalisation of intra-oral relations.

Lateral bone condensationTo improve density and quality of the bone.To increase sustentation surface. Greater resistance to loads.

TechniqueMinimally invasive, full thickness, large flaps without tissue release.Generous lateral corticotomy without lateral bone release or fractures of lateral release.Use of Microdent threaded expanders.

Simulations

Video realised in collaboration with Dr. Joaquín García Rodríguez, Dr. Elías Fornés Ortuño and Dr. Javier Martínez Osorio.

Digital supportESBIPRO TECHNIQUE

Page 12: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

12

Bone expansion techniqueILLUSTRATION OF THE SURGICAL TECHNIQUE

Crest with great bone resorption.

Osteotomy with 701 drill, made of tungsten, either with a disc drill or with piezoelectric surgery.

Insertion ofexpander nº3 for 3.80mm implants.

Shaping of the api-cal third of the im-plant bed with the appropriate drill for the implant that will be inserted.

Implant site ready for insertion.

Inserted implant.

Placing of the prosthesis.

Healing period.

Insertion ofexpander nº4 for 4.20mm implants.

Insertion ofexpander nº5 for 5.50mm implants.

Insertion ofexpander nº1.

Insertion ofexpander nº2.

Lifting of the flap, as small as pos-sible, and without release.

Progressivedeepening.

Only for type I bone.

Page 13: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 13

Bone expansion techniqueILLUSTRATION OF THE SURGICAL TECHNIQUE

Surgical technique PRACTICAL PROCEDURE

Preparation of the bone with small 1mm perforations.

Note the produced groove. It will relieve the stress suffered by the bone when the expansion is being performed.

The expansion always starts from the centre towards the sides. Note the initial expansion.

Continuation of the expansion sequence using red expanders (nº2). Starting of the expansion at the ends with yellow expan-ders (nº1).

Expansion at the ends with red expanders (nº2).

It is recommended to use an expander manual key in order to have dexterity and sensitivity during the dilation process.

Deepening and broadening of the insertion point with a small pilot drill for Ø 1.20 mm expanders.

Longitudinal cut with circular drill joining the perforations.

Deepening of the cut as much as the cir-cular drill or insert, in case of piezoelectric surgery, enables it.

Page 14: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

14

Moving of green expanders (nº4) to the sides. Observe how the desired expansion has been achieved.

Ending of procedure by inserting 4 internal connection, Ø4.20mm, Trylogic implants.

Removal of implant holders. Note the gained expansion. Placing of cover screws and finalisation of procedure.

If broad platform (Ø 5.00mm) implants are to be inserted, the expansion needs to continue with the dark blue expanders (nº5), followingthe same protocol as before (start at the centre and move towards the sides).

Deepening until the desired expansion has been achieved.

Shifting of light blue expanders (nº3) from the centre to the sides and placing of green expanders (nº4) in the centre, continuing this way with the expansion protocol.

It is advised, once the expander is fully inserted, to maintain it in position for a few seconds in order to cause microfractures and dilate the bone.

The tightening handle is used when the required tightening effort is great, without losing any dexterity or sensitivity compared to when the manual key is being used.

To keep a controlled broadening of the bone plate, dilators can also be used (see page 10). For an easier expansion, the manual key can be changed by the spanner key.

CLINICAL CASES

Page 15: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 15

CLINICAL CASES

Page 16: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

16

Expansion in non-extreme cases to gain transverse dimension

The expansion technique is a technique that seeks to increase the cross-section diameter of the bone, not only to be able to place implants but also to increase the cross volume and to give a better emergence to the prosthesis.

In cases like this, the placement of implants should not be difficult, but more tissue is needed on the vestibular for a good emer-gence.

Gaining a few millimetres transversely guarantees the prosthesis emergence.

Administration of crestal anaesthetics. Note the loss of cross-bone. The prosthesis emergence will improve due to the expansion being performed.

Crestal-lingual incision to mantain kerati-nized tissue on the vestibular.

A longitudinal corticotomy is made with piezoelectric surgery.

Start of expansion protocol with yellow ex-panders in the centre of the corticotomy.

37-year-old patient who goes to the clinic to replace four missing teeth, 4.4- 4.5- 4.6- 4.7.It is decided to place 3 implants due to reduction of space by mesialisation of 4.8.

Note the loss of transverse space at crestal level and the lack of loss at apical third level.

Bone expansion techniqueCLINICAL CASE Nº1

Page 17: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 17

Continuation of protocol. Removal of yellow expander from the centre and replacement by red expander.

Continuation of protocol. Replacement of yellow expanders by red expanders, always from the centre to the sides.

From yellow expanders to red expanders in distal.

Red expanders in mesial. Continuation of the same sequence and placement of blue expanders (nº3).

Removal of blue expanders from the centre and insertion of Microdent 4.20 x12mm expansive implant.

Repetition of the same process in distal. Note the expansion gained.

Filling up with biomaterials (Apatos hete-rologous bone).

Stitching with silk sutures, thus avoiding injuries on the tongue by being in contact with the monofilament.

Page 18: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

18

Expansion and delayed regeneration55-year-old patient with 4.2- 4.2 teeth extracted, with apical cysts and bags exceeding 9mm and with recurrent abscesses. Clinical examination shows loss of keratinized tissue and cross-section defect.It is decided to perform an FGG (free gingival graft) technique to obtain good tissue and, thus, protect the graft.

Observe the loss of transverse bone tissue and lower jaw contour on the orthopanto-mography.

Performance, first, of an FGG to guarantee the protection of the graft.

Note the 2mm crest and 4mm defect.

In the axial cuts, it could be possible to insert two slightly embedded implants loosing 3mm in the vertical, finding bigger crowns. However, it must be remembered that there has been loss of mandibular contour in that sector and, therefore, the implants will be very close together and with oversized crowns.

A corticotomy is made with piezoelectric surgery. Start of the expansion with Micro-dent expanders.

Removal of yellow expanders (nº1) and replacement by red expanders (nº2)deepening until a depth of 14 mm is reached.

Observe the slightly vertical loss on the orthopantomography.

Bone expansion techniqueCLINICAL CASE Nº2

Page 19: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 19

Continuation of the protocol by changing red expanders by blue expanders and reaching a depth of 14mm.

Part of the osteosynthesis screw remains outside to perform a regeneration using the tent-pole technique.

Protection of the graft with a Derma mem-brane fixed with osteosynthesis screws.

Stitching with simple monofilament sutures and retention silk sutures.

Removal of the other expander and place-ment of another osteosynthesis screw to avoid the collapse of the plate. Note the transverse improvement.

Filling of the defect and regeneration by tent-pole technique using biomaterials (Apatos heterologous bone).

Note that the mesial fracture does not involve neighbouring teeth.

Removal of expander and placement of an osteosynthesis screw.

Page 20: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

20

36-year-old patient with quadrant-3 teeth extracted 16 years ago. 2mm crest visible with irregular bone tissue. It is decided to create a hybrid prosthesis with 6 implants, doing first an expansion with implant placement during the same surgery in the dental arches.

Bone expansion in extreme cases to gain transverse dimension. Complication

A longitudinal corticotomy is made. Note the vertical fracture at level of tooth 34. Place-ment of a yellow expander in the centre of the corticotomy.

Placement of a fourth yellow expander mesial to the fracture.

Placement of the next expander kit, the red expander set, following the same sequence as did for the yellow expanders, first in the centre and then at the edges.

Continuation of the expansion protocol with the blue expander set, following the same sequence as with the other coloured kits.

Placement of a second yellow expander next to the first, as close as possible but with enough space to work comfortably.

Magnification of the fracture when a third yellow expander is placed.

Observe the injury with lack of bone continuity at the level of tooth 34, which later will frac-ture the plate, on the left sector of the radiography.

The crest on the left side measures trans-versely 2 mm.

Bone expansion techniqueCLINICAL CASE Nº3

Page 21: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 21

Note the important gap in the regeneration and the double fractures due to the irregular remaing bone.

Note the movement of the vestibule plate. Placement of implants using the vestibule plate as a barrier.

Placement of a third implant. Note the plate fracture and how the implant has placed the plate at the same level.

Placement of biomaterials (Apatos heter-ologous bone) hydrated in patient’s own blood.

Cut through the periosteum to enable tissue displacement and stitching.

8 days after the surgery.

Placement of implants submerged 1mm and insertion of an osteosynthesis screw to stabilize the vestibular plate while keeping the distance to facilitate the regeneration.

Fixing of a collagen membrane at the bot-tom of the vestibule.

Page 22: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

22

Extreme expansion for second intention implant placement55-year-old patient with teeth extracted 25 years ago and using a mismatched complete prosthesis. It is decided to place a hybrid prosthesis with 6 implants, doing first an expansion and implant placement in a second session due to bone thickness and height.

Note the good-quality keratinized tissue that will facilitate the subsequent surgery.

Crest. Crest with a thickness of 1mm and a height lower than 12mm.

Placement, first, of yellow expanders, and, next, of red expanders following the protocol.

Placement of blue expanders. Note how the expansion becomes apparent.

Removal of expanders and filling with bio-materials (Apatos heterologous bone).

A corticotomy is made as long and deep as possible.

Observe the 12mm distance from the bone to the Schneiderian membrane on the orthopan-tomography. It is decided to do a CT scan before performing surgery, but patient refuses to have one. Patient signs the consent papers and decides to undergo surgery.

Bone expansion techniqueCLINICAL CASE Nº4

Page 23: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 23

Filling of the bone corticotomy, thus in-creasing its thickness by more than 5 mm.

Placement, fixing and stitching of a collagen membrane.

4 months after the first surgery, a second surgery is performed.

Observe that only 3mm had been gained out of the 5mm that were available. This is due to not having used osteosynthesis screws to keep the bone plates open.

The expansion is continued by using red expanders, 6 sets are used for a more stable expansion.

Placing of 6 green expanders. Insertion of 4 MV 4.20 x12 mm expansive implants. The quantity of expanders is not related to the number of placed implants.

Regeneration with bone and membrane to increase cross volume.

Note the good healing 3 days after surgery. Hybrid prosthesis.

Due to the previous expansion, implants can be placed with good bone plates to avoid reabsorption at crestal level. Note the presence of a less corticalised bone.

A crestal incision is made.

Page 24: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

24

Extreme lateral expansion to the inferior alveolar nerve

Start of a corticotomy after using supra-crestal and supra-periosteal anaesthetics and a single barrel to keep the area awake.

Observe the atrophic bone with a height of 5mm and a thickness of 3mm on the CT scan slices.

Observe on the control radiography how the procedure is being performed behind the mental foramen.

Use of only two expander kits due to the short corticotomy.

Observe on the control radiography of the red expanders how they have been placed behind the inferior alveolar nerve.

A crestal-lingual incision is made. The corticotomy is performed with piezo-electric surgery.

47-year-old patient who wants to “rehabilitate the gap left by missing teeth from the lower left sector”. It is decided to place the teeth 4.4- 4.5- 4.6 inserting two implants. First, an expansion is done, followed by the placement of implants, behind the mental foramen and in front of the inferior alveolar nerve.

Distance of 5mm to the inferior alveolar nerve and of 4mm to the mental nerve.

Bone expansion techniqueCLINICAL CASE Nº5

Page 25: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 25

Extreme lateral expansion to the inferior alveolar nerve

Blue expanders at 13mm deep. Placement of Microdent 4.20 x12mm ex-pansive implants.

A control radiography shows how the implants are placed behind the inferior alveolar nerve and mental nerve.

Final aesthetics.

Page 26: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

26

Bone expansion techniqueCLINICAL CASE Nº6

42-year-old patient with teeth lost more than 25 years ago. Patient with narrow crest, type C bone and a distance between the crest and the inferior alveolar nerve lower than 10 mm. It is decided to place MV 3.80 x 12mm implants in 44, 45 and 46 with the ESBIPRO technique, a technique for the bioactive stimulation of osteogenic processes.

Expansion and placement of implants laterally to the nerve

A long corticotomy is performed lingual of the crest.

Continuation of the expander sequence. Progressive expansion. Expansion is only up to the blue expander to insert 3.80mm implants.

The corticotomy is done with piezoelectric surgery.

Start of the expansion with yellow expan-ders.

Inferior alveolar nerve and mental foramen loop.

Narrow alveolar crest. Narrow alveolar crest type C.

Page 27: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

ww

w.m

icro

dent

syst

em.c

om

Bone expansion catalogue 27

MV implants act as expanders, therefore, the process must always start in the centre.

Expansion of the bone crest.

Placement of implants laterally of the nerve.

The patient did not have any type of para-esthesia.

Placement of 3 implants and their cover screws.

Note the large expansion achieved.

Progressive insertion of implants. Placement of MV implants.

Clinical cases by: Dr. Holmes Ortega Mejía

• Degree in Dentistry from the Universidad Santo Tomás de Aquino (Bucaramanga, Colombia).• International Master’s degree in Implantology and Periodontics from the Paris Descartes University (Paris, France – Madrid, Spain).• Specialist in Oral Implantology from the Universidad de Veracruz (México).• Orthodontics at GNATUS Foundation (Madrid, Spain).• International Master’s degree in Advanced Surgery from the Paris Descartes University.• Founder and general director of the Canal de Cirugía Bucal.• Director of the Advanced Surgery intensive course, for professional training in Lisbon (Portugal).• Director of the Advanced Implantology clinical course (Camarena, Toledo, Spain).• Director of the Advanced Surgery for Experts clinical course (Alexandria, Egypt).• Director of the clinical course in Advanced Surgery aimed at Professional Training (Barcelona, Spain).• Lecturer at many national and international courses and congresses.• Member of Microdent’s scientific committee.

Page 28: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

General conditions

Customer serviceTel. 0034 - 93 844 76 50 from Monday – Thursday: 9h-18h and Friday: 8h-15h.

Purchase order• Tel. 0034 - 93 844 76 50, extension 1.• Fax: 0034 - 93 844 76 93.• E-mail: [email protected].• Webpage: www.microdentsystem.com.

Delivery timesPeninsula: Orders placed before 14h will be delivered on the next business day. Canary Islands: Orders placed before 14h will be delivered on the next 24-48h. Province of Barcelona: consult about same day deliveries.

* For deliveries outside Spain, please contact us.

Shipping policyThe following shipment methods are available for orders placed before 14h:• Service 8.30• Priority: delivery between 8.30h and 10h.• Express: delivery between 10h and 13h.• Service 19h: delivery before 19h.• Urgent: delivery time out of the established timetable (in the evening) has an extra charge.

* Available for the Peninsula (for Canary Islands, please contact us).* For deliveries outside Spain, please contact us.

Product return policyAll returns must be accompanied by the return form, duly completed, and a copy of the delivery note.Any returns or refunds of items that have been opened, tampered with or not in their original condition will not be accepted.

Billing and payment methodsAsk our customer service or your local representative about different payment plan options.

* Microdent reserves the right to improve, modify or discontinue products and equipment at any time without incurring any obligation or without prior notice. * For commercial schedules and deliveries outside Spain, please ask about conditions by country.

ImportantThe use of foreign-brand surgical instruments may compromise the stability and fixation of the prosthesis, as well as cause situations of loosening or fracture. Moreover, it also voids the product warranty.

D

esig

n &

layo

ut:

2016

Page 29: MICRODENT BONE EXPANSION · Lateral bone condensation To improve density and quality of the bone. To increase sustentation surface. Greater resistance to loads. Technique Minimally

(Spain)

Edition: August 2016

MICRODENTBONE EXPANSIONPRODUCT CATALOGUE