Dr Michael Tang webinar - Advanced Implantology with EthOss Synthetic Bone Graft Q&A

A big thank you to everyone who was part of the recent webinar with Dr Michael Tang discussing Advanced Implantology with EthOss Synthetic Bone Graft. It was wonderful to see so many clinicians with questions for Dr Tang both during and after the webinar.

We have brought together a summary of the questions for you below. If you have any additional questions to ask Dr Tang, please email us at marketing@w9.com.au

Can you please go through case selection and when and when not it is appropriate to use EthOss?

EthOss like conventional GBR techniques, only works predictably when the defect is within the bony envelope.  Key points are:

1. Correct preparation of the defect site

2. Correct mixing technique

3. Correct handling of EthOss - the graft needs to set correctly and remain stable therefore a 3 walled defect will always be more predictable.

Any provisional for 2nd case maxilla?

I used the patient's existing partial denture. This was modified to prevent pressure on the grafted site.

Is the gauze you apply to set Ethoss wet or dry?

Sterile gauze is applied dry for 3 mins.

Do we need a membrane for alveolar ridge preservation after extraction when using EthOss?

• For ridge preservation, make sure the socket is thoroughly cleaned with degranulation burs and sharp curette. Place the Ethoss and close the socket with membrane or collagen sponge.

• Alternatively, wait 2-4 weeks for soft tissue healing over the socket. Raise a flap over the socket, clean the socket, graft with EthOss , then close the flap without the need of membrane

Can Ethoss be used with Enamel Derived Matrix (EDM) in bone grafting procedures, and does it lead to improved outcomes? If so, do you mix the Ethoss with the EDM or PRP or are the gels applied first and Ethoss (saline mixed) then placed?

There is no value in mixing EthOss with anything other than saline.  Mixing EthOss with other materials gives very unpredictable results

Once you clean the bone do you make small holes in the bone before placing the EthOss?

No decortication is required. The key is to clean the defect site well and close the site tension-free.

How do you achieve flap closure if you graft and widen the ridge without causing tension on the flap?

First of all, make sure the flap is wide/big.  If required, one deep incision to release the periosteum. Avoid "destroying" the periosteum.

What temporary crown can we use other than the temporary abutment crown? Can we use a removable denture with loose contact to implant site or essix with tooth that can be removeable by patient?

You can use removable denture or essix to temporise, but with immediate implant placement you need a well contoured temporary implant crown to help maintain the gingival margin and papillae.

Can you mix EthOss with PRF instead of saline?

There is no value in mixing EthOss with PRF and is unpredictable.

You said EthOss has to be placed within the bony envelope for it to be successful. How about those with buccal bone defect? What happens to the gum to EthOss interfaces?

Like conventional GBR techniques, grafting is most predictable when the defect is within the bony envelope.  In buccal bone defects, the key is to have tension-free closure.