ALVEOLAR PRESERVATION BY MODIFIED PERIOSTEAL INHIBITION

Volumetric restoration using an equine-derived Flex Cortical Sheet.

The clinical case concerns a 44-year-old patient who had a root remnant of element 46, which was not recoverable. The preoperative CBCT showed a sufficient amount of bone in the vertical direction but with a very thin vestibular cortical and a high risk of resorption. These conditions represented the correct clinical indication for the use of the Modified Periosteal Inhibition technique. To protect the vestibular cortical layer, a 0.5-mm vestibularly bagged Flex Cortical Sheet was inserted between the alveolar bone and periosteum after hydration for 5-6 seconds with sterile saline solution. The presence of the flexible cortical sheet prevents the passage of pre-osteoclasts from the periosteum to the vestibular cortical, thus preventing their differentiation into mature osteoclasts. CBCT performed 4 months after surgery showed perfect maintenance of the original bone volumes and good mineralisation of the alveolus. At 7 months the definitive prosthesis was delivered to the patient’s satisfaction with the excellent aesthetic result achieved.

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