Tisseos synthetic membrane in socket preservation after tooth extraction

Alveolar defects resulting from a tooth extraction can only be partially restored by bone neoformation and bone remodelling. While bone regrowth is observed at the base of the extraction socket, progressive, irreversible and cumulative bone loss occurs in the alveolar bone crest. Studies show horizontal bone loss of 29-63% and vertical bone loss of 11-22% 6 months following tooth extraction (Tan WL et al, 2012). The variation observed being due to different factors: general metabolism periodontal anatomy, functional constraints, reason for the extraction and the technique employed. A question arises – should one wait 6 months for full wound healing when most of the bone loss will have already occurred?  A simple technique of guided tissue regeneration would mean preserving the overall alveolar volume, particularly in light of a future implant placement to replace the extracted tooth. It has been shown that the best results in socket preservation are obtained using a bone substitute held in place by a resorbable membrane to prevent soft tissue ingrowth into the socket (Sanz et al, 2015). Biomedical Tissues developed Tisseos® A RESORBABLE SYNTHETIC MEMBRANE in order to offer clinicans a reliable and predictable solution. The barrier function of Tisseos® membrane remains intact for the first 4 weeks. Optimal bone and tissue regeneration are both guaranteed thanks to the slow, fully controlled resorption over 6 months, avoiding any need for second stage surgery for membrane removal.
Case n°1 : socket preservation on the day of extraction (Dr Hoornaert, Nantes). A 51 year old patient presented with a mobile bridge to replace the upper central incisors on a single support (tooth 11 – upper right 1).
Extraction T0
GTR at 6 weeks
GTR at 6 weeks (2)
Extraction at T0 : upper central incisor is extracted and a temporary prothesis is placed.
Guided Tissue Regeneration at 6 weeks: placement of the Tisseos® membrane between the flap and alveolar wall covering the bone subtitute.
Clinical situation at day 10
Implant placement at 6 months
Clinical situation at 14 months
Clinical situation at day 10: no sign of inflammation.
Implant placement at 6 months in positions 11 (upper right 1) and 21 ( upper left 1).
Clinical situation at 14 months with final restorations.

Using a membrane with slow, controlled resorption in socket preservation of the alveolar crest following tooth extraction protects against epithelial invagination and allows for predictable results.

References:
– Tan WL et al. “A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans” Clin Oral Impl Res 2012;23 Suppl 5:1–21
– Sanz M et al. “Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges” Dent Mater 2015;31:640–7
– Hoornaert A et al. “Biocompatibility, resorption and biofunctionality of a new synthetic biodegradable membrane for guided bone regeneration” Biomed Mater 2016;11:045012

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