Application of the Modified Periosteal Inhibition technique using a Flex Cortical Sheet of equine origin

Preserving bone volume and limiting post-extraction resorption are key objectives in the management of the post-extraction alveolar socket. Following tooth extraction, the alveolar ridge undergoes physiological changes in size. The use of graft biomaterials combined with barrier membranes, in accordance with the classic Alveolar Ridge Preservation (ARP) technique, can help to limit this resorption.

More recently, the Modified Periosteal Inhibition (MPI) technique has been developed, an alveolar preservation method that utilizes the properties of resorbable cortical lamina of equine origin to limit post-extraction resorption¹. This technique represents an evolution of the approach proposed in 2019 by Nguyen and colleagues, based on the placement of a PTFE membrane between the periosteum and the vestibular cortical bone of the alveolus².

The underlying biological principle involves hindering the migration of pre-osteoclasts from the periosteum towards the external bone surface, thereby limiting their differentiation into mature osteoclasts and the resulting resorption activity. Indeed, the literature reports that, following a tooth extraction, the recruitment of pre-osteoclasts from the deep periosteum towards the external bone surface promotes the formation of active osteoclasts responsible for bone resorption.

In this context, equine cortical lamina represents an advantageous alternative to PTFE membranes, as, by undergoing complete remodelling, it eliminates the need for a second surgical procedure to remove it, allows the formation of new bone tissue and effectively supports the soft tissues, maintaining volume.

PRODUCTS USED: Osteoxenon, Flex Cortical Sheet, OSP-OX09