Combined Palatal Bone Harvest and Khoury Plate

516 Rating(s).


Posted on By Maurice Salama In Bone Grafting

Following a failed bone graft in the maxillary anterior region by another office, we utilized a combination of "PBB" Palatal Bone Block Harvest and Khoury Plate for reconstruction of the damaged ridge. Thoughts and comments welcomed. Dr. Salama

CBCT 3D view preop
Defect Site

Palatal Bone Block Harvest
Harvest with Chisel


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35 Comments

Bone graft added to site with membrane.

Added Auto bone chips
Non-cross linked collagen membrane


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8 weeks healing

8 weeks healing
8 weeks healing


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PA pre and post

PA preop
PA post op


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CBCT pre and post

preop CBCT
post op CBCT


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5 months CBCT

5 months
5 months


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It just doesn’t get any better. This is phenomenal work Mo in every way. What I love about you most is your ability to continue to morph and grow. You have it all and yet that doesn’t stop you from doing other stuff. You are an inspiration my friend to every one of us.


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Howie, you have been a vital part of my growth as a surgeon. IF we stop learning we die. I first saw you present this concept on Dentalxp platform and I just loved it. Since then it has become a very critical part of my autogenous harvest selection. Also, the autologous plate concept that you modified from Khoury has been an additional step up in my Regen offerings...Thanks buddy Mo


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Hey Maurice, fantastic surgery. As a younger clinician, how to do you manage bleeding from the nasopalatine foramen? Is it a significant or frequent occurrence? Thanks in advance.


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Not frequent but when it occurs we use electrocautery or hemostatice bandage and pressure. All of this is based upon careful CBCT 3D evaluation of the anatomic structures to avoid complications of nasal floor perforation or nasopalatine infringement. regards Dr. Salama


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Mo, I do agree with you. This is the best option imho! Besides, excelent management, my friend! All steps are quality made. Thanks for sharing. Jorge


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Jorge; Thanks my friend, yes sound surgical management is MORE critical I believe than any singular technique or biologic material. Flap management, graft stability, and tension free closure!! Thanks Mo


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You guys are all an inspiration for everyone on the forum. Just keep sharing your skills and wisdom! Beautiful case Maurice, the more cases like this you do, and specially seeing the results, it's difficult to choose another technique, isn't it? Regards


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Yes sir...


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Spectacular!
Thank you for sharing
Snjezana


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Thnx Snjezana


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Spectacular; what was your protocol for the mesial/buccal root surface of tooth number 7?


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Most difficult aspect is bone loss on root surface of adjacent teeth....no real surgical solution that works IMHO...only ortho extrusion. Regards Dr. S


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Article in PBBH

Article


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Most difficult aspect is bone loss on root surface of adjacent teeth....no real surgical solution that works IMHO...only ortho extrusion. Regards Dr. S


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5 months re-entry

5 months healing
5 months CBCT


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5 months implant placement with Ritter Spiral

implant dedicated drill
Ritter Sprial


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Before & After Regen

Before
After


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Amazing result, big applause! Can't wait to see final result Regards


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Thnx my friend.... Will update this post after healing...


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Just perfect, as always , as Howie said, you understand more than anyboby the importance of evolution to become a better clinician.


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Thanks my friend...we hope to start seeing you at XP events in the future.


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Beautiful bone! Go for the Orthodontic extrusion. It’s the only way achieve perfection and only takes 4 months


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Thanks Chuck, you may be right, no doubt if we can not get it thru surgery and tissue molding then ortho is always there waiting!!! regards Mo


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Thank You Dr Salama.
Great results !
Why did you cover with a membrane ?
Thank you!


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Because I added particulate bone to the border of the plate....so I add Collagen drapeable barrier non-cross linked.


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Thank you! I was sure there was a reason for that !


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This is amazing, thanks for inspiring Dr. Salama!


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Thank you...all about sharing


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amazing case couldn't have been done better


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Many thanks...


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Hu-Friedy