Yxoss CBR® is a customized titanium grid structure designed for the regeneration of bone defects – based on a patient’s CBCT or CT data. It stabilizes the graft in the optimal position and can be easily removed later.
Dr. Marcus Seiler | Germany
The 66-year-old patient presented with periodontal problems, and she requested a restoration of the posterior region of the lower mandible. After extraction of teeth 35, 37, 45 and 47, which were not worth retaining, the bone proved to have a horizontal and vertical volume deficit in both posterior regions.
The bone was augmented using a 1:1 mixture of autologous bone chips (retromolar removal) and Geistlich Bio-Oss®, as well as a titanium scaffold produced specifically for the patient (Yxoss CBR®). A Geistlich Bio-Gide® collagen membrane shielded the graft from the soft tissue. A dual-sided split-flap permitted a tension-free wound closure and allowed a sufficiently wide keratinized mucosa to form later in the implant area.
After six months, the soft tissue conditions were clinically stable and free of any dehiscences. A ridge incision from position 5 to 7 was selected for the removal of the grid structure. After loosening the fixing screw, the grid structure could be separated carefully into two parts by applying small extrusion movements to the target breakpoint with a periostal elevator and be removed. The implants (Camlog, Screw Line®) were then inserted into the regions 35, 36, 37 and 45, 46, 47.
Transversal contour deficit in the initial clinical situation.
Clear transversal deficit in the regions 35–37 and 44–47 in the pre-operative DVT.
The surgical area.
Geistlich Bio-Oss® and autologous bone in a 1:1 ratio are introduced into the Yxoss CBR® titanium grid.
The titanium grid with a fixing screw and the slightly compressed graft material in situ.
A Geistlich Bio-Gide® membrane covers the graft.
The augmented volume in a transversal CBCT angle.
After removal of Yxoss CBR® by applying small extrusion movements to the target breakpoint (Easy Removal®), well-vascularized bone can be seen.
Parallel placement of the implants (Camlog® Screw Line, regions 35 and 45 (diameter 3,8 mm / length 11 mm) as well as regions 36, 37 and 46, 47 (respectively diameter 4,3 mm/ length 11 mm).
Correct position of implants in the post-operative X-ray.
After introduction of the abutment connection.
Final situation with the individually separated crowns.
Why has this particular treatment been chosen?
In such a complication it is crucial to wait until the tissue has completely healed. The waiting period prior to the second augmentation was three months. In the event of major bone defects the bone shield technique described by Prof.Khoury produces predictable results for 3D alveolar ridge regeneration and, compared to cortical block augmentation, vital regeneration.
Dr. Marcus Seiler | Germany
Clinica Dr. Seiler e associati
Filderstadt e Kirchheim u.T.
ReOss GmbH
Filderstadt
Dr. Marcus Seiler is the proprietor and CEO of ReOss GmbH, which has developed the product Yxoss CBR®. Products including ReOss technology are marketed by Geistlich Biomaterials in Germany. These products are not yet available in all countries.
Illustration Header: Alessandro Holler / Quaint
Comments
Dr Mandar Bhosekar wrote:
"Are there any comparative histologic studies with reinforced titanium mesh or cytoplast titanium reinforce membrane by osteogenics. As regarding the healing and amount "
Answer