CASE PRESENTATION
A ‘Swiss-Made’ Alloplastic
Graft That Solves a Lot
of Problems
Figure 1—Preop panoramic x-ray of patient presenting with
toothache
When possible, I like to avoid elevators for extractions like this, and within a few minutes, my 3-prong forceps have this tooth lifting out of the socket with little disturbance to the adjacent teeth. Examining the extracted tooth tells me that I will not be pursuing root tips near the sinus. I note a small sinus communication where the palatal root had been and some displacement of the buccal plate.
Socket Preparation and Grafting
The socket is irrigated with a slurry of sterile saline and the contents of a clindamycin capsule. After degranulation with a curette, irrigation is repeated. I do not trust this socket to a collagen-plug-stabilized blood clot. I need a grafting material that will endure his 2-hour drive home and protect the socket from contaminants such as saliva, food, and possibly emesis. Additionally, I want a grafting material that will obturate the sinus communication and stabilize the buccal plate. I use ß-tricalcium phosphate (ß-TCP) granules in a quick-mix syringe polymer system. This alloplastic bone-grafting system, GUIDOR easy-graft CLASSIC, is my “Swiss army knife” tool for accomplishing these goals.
Figure 2—The decay on tooth No. 2 is deep.
Figure 3—Preop occlusal view
Figure 4—A 3-prong forceps is used to extract the
tooth.
Figure 5—Examination of the extracted tooth
Figure 6—The extraction site shows a small sinus communication where the palatal root was, and some displacement of the buccal plate.
Figure 7—The soft ß-TCP granules will harden when placed in the site.
Protecting the Patient
Like many of these low-trauma/easy-grafted cases, this patient reported minimal postoperative discomfort and did not require pain medication. GUIDOR easy-graft CLASSIC has become an important part of our goal to reduce the need for opioids.
Figure 8—A graft packer is used upon placement.
Figure 9—The graft has been placed, compacted, and solidified with minimal armamentarium.
Figure 10—As seen in the postop x-ray, the socket is almost completely filled with a “plug” of ß-TCP polymer.
GO-TO PRODUCT USED IN THIS CASE
GUIDOR easy-graft CLASSIC is the first particulate bone-grafting material designed to be syringed directly into a bone defect, hardening into a stable, porous scaffold in approximately 1 minute, and eliminating the need for a dental membrane in many cases. The product is 100% synthetic and fully resorbable. Each system is comprised of ß-TCP granules coated with a biodegradable polymer that is mixed with an NMP liquid activator called BioLinker to form a permeable, moldable material that hardens to form the scaffold. The system is ideally suited for filling voids around immediate implant placements and ridge preservation after tooth extraction.
JAMES C. COPE, DDS
Dr. Cope received his DDS and a Bachelor of Science degree from the University of California at San Francisco and was a UC Regents Scholar. He has been in private practice in El Dorado Hills, CA, since 1987. Dr. Cope has published articles for the Sacramento District Dental Society and has been an invited guest lecturer in the Sacramento area. He practices with his son, Dr. Ben Cope, and wife, Kimberly Cope, RN.
Dr. Cope received his DDS and a Bachelor of Science degree from the University of California at San Francisco and was a UC Regents Scholar. He has been in private practice in El Dorado Hills, CA, since 1987. Dr. Cope has published articles for the Sacramento District Dental Society and has been an invited guest lecturer in the Sacramento area. He practices with his son, Dr. Ben Cope, and wife, Kimberly Cope, RN.
