Fig.5 is a lingual view of the mandible (CT 3-D image). T: torus; *: #31 implant sticking into the submandibular fossa.
Dear Dr. Lynch: I have two questions about GEM® Synthetic Bone Graft Putty.
It is a calcium phosphate-based mineral with a carbonate apatite structure
similar to natural bone mineral combined with type I collagen derived from
bovine Achilles tendon. What is a carbonate apatite structure?
Can the putty be used as a collagen plug for socket preservation? How can it be
fixed in the socket? Thanks. The third question is about GEM bone graft,
apparently porcine xenograft. What is its additional value to allograft when
they are mixed? Increased resorption time?
Dear Dr. Lynch: Thanks for your knowledge.
I am pleased with the results of socket preservation with allograft if the
buccal plate is present. Does xenograft have additional benefit when the buccal
plate is defective? It appears that allograft shrinks a little too quick or I
cannot pack enough allograft. Does your porcine bone graft have capacity to be
packed in a similar fashion as amalgam or better than allograft?
I do not recommend the use of any currently available xenograft by itself in sockets, even with a defective buccal plate. You could mix some GEM xenograft into the FDBA if you feel like you need more structural stability to prevent graft shrinkage. I’d start with at least 2/3 FDBA, 1/3 GEM xenograft plus the rhPDGF of course. As mentioned previously you don’t hesitate to overpack the graft so that the buccal tissue is bulging a little bit so that if you get some shrinkage the new buccal plate will still end up where you want it. 5/28/2020
Return to
No Deviation
Xin Wei, DDS, PhD, MS 1st edition
03/23/2020, last revision
05/28/2020