ISRPD レポート Istcan Urban ソーセージテクニック
2019年06月9日
今をときめくUrban.講義も千人を飲み込むであろう会場が満席立ち見状態。あまりに混んでいたため、講義を一旦中止して会場内の整理を行うこともありました。すごい。
✅Caseもすごい。減張のレベルをはるかに超えたフラップマネジメント。下顎舌側は解剖学的リスクがあるので可及的に触らないで過ごしてきましたが、atrophicな臼歯部の造成にはあのレベルまで減張しなければいけないのでしょう。顎舌骨筋のマネジメント。オトガイ孔からの神経のマネジメント。あのスライドを見ただけで患者様 に試しては決していけないと思いますが、習得しておかなければいけないでしょう。
期間限定↓
https://www.dropbox.com/s/kgz6sb6g8x959xu/IMG_5445.MOV?dl=0
✅GBRの成功には自家骨の存在が重要。50パーセントの自家骨を入れなければしんせい骨の獲得は難しい。自家骨の十分にないソーセージは時間のムダで、やはり、相応の自家骨のボリュームが取れなければ意味がない。
That’s waste your time without at least 50 percent volume of autogenous bone.
” I use 60 percent,,,,,,,, well, 65persent volume of autogenous bone,,,,,,,”
✅舌側のフラップ伸展について
Effectiveness of Two Different Lingual Flap Advancing Techniques for Vertical Bone Augmentation in the Posterior Mandible: A Comparative, Split-Mouth Cadaver Study.
Abstract
Vertical ridge augmentation in the posterior mandible is a technique-sensitive procedure that requires adequate anatomical knowledge and precise surgical skills to minimize the risk of complications. One of the most important but also challenging aspects of the surgical technique is proper flap management to allow for passive flap closure and reduce the chances of postoperative complications affecting deep anatomical spaces. This article presents a detailed description of a novel lingual flap advancement technique and its validation via a split-mouth, comparative study using a cadaver model. A total of 12 fresh cadaver heads presenting bilateral posterior mandibular edentulism were selected. Sides were randomized to receive a classic lingual flap release technique (control) or the modified technique presented here, which involves the intentional preservation of the mylohyoid muscle attachment to the mandible. Vertical flap release was measured at three different zones using standard forces. The mean difference between the test and control group in zones I (retromolar pad area), II (middle area), and III (premolar area) was 8.273 ± 1.794 mm (standard error of the mean [SEM] = 0.5409 mm), 10.09 ± 2.948 mm (SEM = 0.8889 mm), and 10.273 ± 2.936 mm (SEM = 0.8851 mm), respectively, reaching very strong statistical significance (P < .0001) in all three zones.
✅今度はニューテクニック
Evaluation of the Combination of Strip Gingival Grafts and a Xenogeneic Collagen Matrix for the Treatment of Severe Mucogingival Defects: A Human Histologic Study.
Abstract
Predictable and effective surgical techniques that aim to increase the width of keratinized gingiva, relocate the mucogingival junction, and deepen the vestibule often involve soft tissue autografts; however, soft tissue autograft supply is limited and its harvesting is associated with patient morbidity. With a strip autograft and xenogeneic collagen matrix (XCM) technique combination, autograft harvest requirements and patient morbidity are reduced. In this histologic evaluation, 12 strip autograft/XCM biopsy samples were compared with 3 reference samples of palatal strip autografts. Tissue morphology, keratin, and collagen expression appear identical, indicating that the combined grafting technique provides desired and physiologically normal keratinized gingiva.
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