9 months prognosis of autograft clinical and histologic .

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Posted on By Wahib Moussa In Implants

Hello all
A middle age patient presented for Restoring lower anterior teeth. Clinical and 3D examination, indicted mobility and marked bone
Loss, plan was to extract, autografting and implant insertion, Loading was done after 6 months.
A biopsy was obtained from grafted area and examined histologically to verify bone formed bone.
Thoughts and comments are welcomed ,,,
Wahib Moussa

4- biopsy 6 months after grafting
1-Pre-operative view for the patient & CBCT

2- boney defects & implants insertion .
3- auto graft

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Wow, a great case for conversation here....what are your thoughts on histological report? Some fibrous tissue invasion and osteoclastic activity, mild inflammation....it certainly looks and acts like bone. Thnx for sharing. Dr. Salama


Dr. Salama,, Very happy with your lovely comment. Thank you I fully agree that it is a topic for discussion and further investigation. I actually Consulted two clinical pathology specialists to write their reports, to be sure we are getting same conclusion, which is, the outcome of autograft certainly looks and acts like bone. Thanks a lot Dr. Salame. Best regards.Wahib


If there is contraindication for PET, dentin autograft for the site preservation became my first choice, too.
Have you utilized PRF membranes or have you left dentin autograft to interact with periosteum?
Great histology, explaining what we see and feel when reentering dentin grafted sites.
Thank you for sharing this case!
Best regards


Dr. Snjezana. Thank you very much for commenting on the post, I believe that presence of granuloma or apical infection and mobility are contra –indications for PET.I agree with your choice for auto graft as a favorite. I have not used membrane or PRF on auto graft, results are good but I feel that adding a barrier Can improve the prognosis ,and I will try in some cases and see the effect .Only in one case an enamel particle from auto graft penetrated the mucosa and I had to remove by a hemostat ,but case proceeded nicely. Thank you again for your positive comment. Best regards. Wahib


Hi Wahib, interesting case. IMHO a barrier like a collagen membrane would help achieving best bone volume. You can test with split mouth next and see the difference. On the other hand, I would like to follow the case. Congratulations. Keep us posted. Regards, Jorge


Hi, Dear Jorge, Thank you very much for your kind comment, I defiantly agree on using the barrier also on split mouth comparative study. It will be pleasure to post the prognosis of the case. Best regards .Wahib


Been using dentin (KometaBio) for over a year, first case I did a year ago was removal #36 and 46, grafted 36 with dentin from 36; 46 grafted with 50/50 out of a bottle, 3 months later for implants #36 looked like 100% native bone, and placed implant. #46 not mature enough to place implant, end up placing in area of 45.


Dr.Daniel .....Thank for your comment and for sharing your valuable info., and experience in using autogrft. graft findings are matching with ours. Best regards. Wahib


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