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  • 4500 140th Avenue North, Suite 112 Phone: 888-360-5550

    Clearwater, Florida 33762 Fax: 727-531-6005

    www.tatumsurgical.com tatumimplants@verizon.net

    March, 2011 Volume 4, Issue 1

    The Tatum Times

    Tatum RTA 2-4

    Tatum Institute Update 5

    Users of the Month 6

    Case Presentation information 6

    Upcoming Events 6

    INSIDE THIS ISSUE:

    Dr. Tatums appearance at the World Congress of Oral Implantology

    and the 1

    st AAID Global Conference.

    My question for you in 2011?

    Is Implantology heading in the right direction?

    Dr. Hilt Tatum gave his key note address on Is Implantol-ogy heading in the right direction? Dr. Tatum made some remarkable clinical observations that impacted upon producing predictable results and minimizing experimental procedures that compromises treatment out-comes. The conference was attended by over 800 dentists from over 20 countries. This was the first of its kind in South East Asia. Tatum Surgical was well represented and received by enthusiastic participants. The post-conference course included an advanced bone grafting program where over

    20 sinus lifts were performed utilizing the unique Tatum sinus lift instrumentation. Doctors Wadhwa, Wong, Iyer and Orton-Jones provided one on one instructions and demos. The course was held at the prestigious Maulana Azad Institute of Dental Sciences where Dr. Mahesh Verma - the director of the school along with Dr. Brij Sabherwal created an outstanding atmosphere for learning. Future courses are being planned as part of the Maxicourse-Asia. Tatum Surgical has established distribution centers in India to support dentists in South East Asia.

    At Tatum Surgical, we feel that there are several key components that must be considered before answering this question. First, we are building on our strengths and implementing positive changes.

    This year, we have introduced many new concepts using constructive suggestions from you...our friends and

    colleagues. These include indirect restorative techniques and screw retained bars. We will be addressing these products in our

    upcoming newsletters and look forward to your feedback.

    Article submitted by: Dr. Shankar Iyer Elizabeth, New Jersey, drsiyer@aol.com

  • Page 2

    The Tatum Times www.tatumsurgical.com

    RESTORATION OF AN ATROPHIC RIDGE USING A TATUM IMPLANT

    AND A ROCKY MOUNTAIN TISSUE BONE BLOCK

    Submitted by Dr. David Resnick 218-784-7119

    prairiedentalada@loretel.net www.prairiedentalcenters.com

    This case is an example of ridge

    restoration and a single tooth

    implant. Tooth #10 had been lost

    five years earlier due to trauma at

    age 13. Due to his bilateral

    diastemas, a bridge would not look

    right. Orthodontics was not an

    option to first close the diastemas.

    A single tooth implant and restora-

    tion, maintaining his natural

    diastemas, was chosen by the

    patient.

    Due to the significant ridge defect

    (figure 1) I discussed with him doing

    a bone graft procedure four to five

    months prior to the implant place-

    ment. Also, the crown would not be

    fabricated until the implant had been

    in the bone for three to four months.

    An I-Cat cone beam (figure 2)

    revealed a significant buccal defect,

    with less than 2.2 mm of bone width.

    I discussed with him either using an

    autologous graft (symphysis or

    ramus as a donor site) or using a

    human donor block graft. He chose

    the donor graft.

    The block was from the Rocky

    Mountain Tissue Bank (RMTB) and

    was an irradiated block graft of ver-

    tebral body in origin. Using the

    donor graft eliminates the morbidity

    and potential complications of an

    autograft. The cost of this donor

    block procedure in my office is less

    (the cost is $110.00 for a

    5mmX5mmX10mm block) than an

    autologous graft due to the

    significantly reduced surgical time.

    Also, for larger cases, an unlimited

    quantity of bone is available.

    Using an aseptic technique and

    local anesthetic (the patient opted

    not to have I.V. sedation) the block

    graft procedure was done. The full

    thickness flap was made using a

    sulcular incision from the mesial of

    #9 to the distal of #12 and a vertical

    release at the distal of #12. There

    was no mesial vertical release. A

    full thickness triangular flap was

    raised to reveal the bony defect

    (figure 3). This flap was designed to

    passively cover the bone graft and

    prevent the need for any cutting or

    scoring of the periosteum at the time

    of closure.

    The donor site was decorticated.

    The block graft, which had been

    soaking in clindamycin liquid, was

    shaped and secured with two bone

    screws (figure 4). Grouting, RMTB

    particulated irradiated cancellous

    bone was placed around the edges

    of the block. A pericardial

    membrane, soaked in clindamycin,

    from Community Tissue Services of

    Figure 4

    Figure 3

    Figure 2

    Figure 1

  • Page 3

    Volume 4, Issue 1 www.tatumsurgical.com

    Dayton, Ohio, was placed over the entire graft and pulled under the

    palatal flap using a suture.

    Healing was uneventful and five months later a new I-Cat was made

    verifying the 7mm width of the new ridge (figure 5). A flap was made

    revealing natural looking bone (figure 6). The bone screws were

    removed and a 2mm wide by 7mm deep bone biopsy trephine was done

    for a histological study. The Tatum Surgical implant, Tapered

    3.5mmX17mm was placed into the trephine hole after extending the hole

    with a 2mm drill to a depth of 17mm level with the gingival. It has been

    my experience in the maxillae that in a underprepared (in width)

    osteotomy site that the Tapered Tatum Implants will readily insert even

    with an under-preparation of as much as 1mm or 1.5mm. Occasionally, if

    the cortice of the crest is unusually hard, the crest only needs to be

    opened up to the diameter of the implant at its neck.

    An uneventful healing occurred over the next eight weeks. At that time a

    RHA was placed to start to develop a sulcus. Four weeks after place-

    ment of the RHA, the patient came in for abutment placement, crown

    prep and impression (figure 7 RHA on), (figure 8 RHA off). The

    abutment was cemented on and prepped. An impression was made and

    a temporary fabricated.

    Figure 5

    Figure 6

    Five weeks later the temporary was removed revealing a healed sulcus that will accommodate to the

    proper emergence profile of the crown (figure 9). The final crown was cemented in (figure 10). The end

    result was preserving his natural diastemas and restoring the ridge width (figure 11).

    Figure 7 Figure 8 Figure 9

    Figure 10 Figure 11

  • Page 4

    The Tatum Times www.tatumsurgical.com

    Figure 1: Two pieces of core bone biopsy stained with Touledene blue, 2.5 x 1.25 Original Mag. Figure 2:: 20 X 1.25 High Mag. Showing vital (lacunae with osteocyte) and graft bone (empty lacunae) Touledene blue staining Figure 3 & 4: 20 x 1.25 High Mag. Tetracycline Fluorescence images showing two

    lines of tetracycline labels indicative of new bone formation within the alogenic

    block.

    Total volume % Vital % Graft %

    100 77.76 22.24 Table 1: Shows the actual data

    Graph 1: Showing the % of

    Vital Vs.

    Graft bone

  • Page 5

    Volume 4, Issue 1 www.tatumsurgical.com

    T Talented clinicians seeking further education,

    Applied skills in a real world setting,

    True dedication to Implant Dentistry,

    Unique state - of - the - art facility,

    Mentorship?

    Where can you find...

    Tatum Institute International Introducing our new facility Atlanta is waiting for you!

    A

    T

    U

    M

  • The Tatum Times

    Page 6

    Users of the Month We are pleased to announce our

    Users of the Month

    for October, November, and December 2010. For this

    accomplishment, these clinicians will receive four

    complimentary implants of their choice.

    October Dr. Frank Sung

    Houston, TX

    November Dr.