4500 140th Avenue North, Suite 112 Phone: 888-360-5550
Clearwater, Florida 33762 Fax: 727-531-6005
www.tatumsurgical.com [email protected]
March, 2011 Volume 4, Issue 1
The Tatum Times
Tatum RTA 2-4
Tatum Institute Update 5
Users of the Month 6
Case Presentation information 6
Upcoming Events 6
INSIDE THIS ISSUE:
Dr. Tatum’s appearance at the World Congress of Oral Implantology
and the 1
st AAID Global Conference.
My question for you in 2011?
Is Implantology heading in the right direction?
Dr. Hilt Tatum gave his key note address on ―Is Implantol-ogy heading in the right direction?‖ Dr. Tatum made some remarkable clinical observations that impacted upon producing predictable results and minimizing experimental procedures that compromises treatment out-comes. The conference was attended by over 800 dentists from over 20 countries. This was the first of it’s kind in South East Asia. Tatum Surgical was well represented and received by enthusiastic participants. The post-conference course included an advanced bone grafting program where over
20 sinus lifts were performed utilizing the unique Tatum sinus lift instrumentation. Doctor’s Wadhwa, Wong, Iyer and Orton-Jones provided one on one instructions and demos. The course was held at the prestigious Maulana Azad Institute of Dental Sciences where Dr. Mahesh Verma - the director of the school along with Dr. Brij Sabherwal created an outstanding atmosphere for learning. Future courses are being planned as part of the Maxicourse-Asia. Tatum Surgical has established distribution centers in India to support dentists in South East Asia.
At Tatum Surgical, we feel that there are several key components that must be considered before answering this question. First, we are building on our strengths and implementing positive changes.
This year, we have introduced many new concepts using constructive suggestions from you...our friends and
colleagues. These include indirect restorative techniques and screw retained bars. We will be addressing these products in our
upcoming newsletters and look forward to your feedback.
Article submitted by: Dr. Shankar Iyer Elizabeth, New Jersey, [email protected]
Page 2
The Tatum Times www.tatumsurgical.com
RESTORATION OF AN ATROPHIC RIDGE USING A TATUM IMPLANT
AND A ROCKY MOUNTAIN TISSUE BONE BLOCK
Submitted by Dr. David Resnick 218-784-7119
[email protected] www.prairiedentalcenters.com
This case is an example of ridge
restoration and a single tooth
implant. Tooth #10 had been lost
five years earlier due to trauma at
age 13. Due to his bilateral
diastemas, a bridge would not look
right. Orthodontics was not an
option to first close the diastemas.
A single tooth implant and restora-
tion, maintaining his natural
diastemas, was chosen by the
patient.
Due to the significant ridge defect
(figure 1) I discussed with him doing
a bone graft procedure four to five
months prior to the implant place-
ment. Also, the crown would not be
fabricated until the implant had been
in the bone for three to four months.
An I-Cat cone beam (figure 2)
revealed a significant buccal defect,
with less than 2.2 mm of bone width.
I discussed with him either using an
autologous graft (symphysis or
ramus as a donor site) or using a
human donor block graft. He chose
the donor graft.
The block was from the Rocky
Mountain Tissue Bank (RMTB) and
was an irradiated block graft of ver-
tebral body in origin. Using the
donor graft eliminates the morbidity
and potential complications of an
autograft. The cost of this donor
block procedure in my office is less
(the cost is $110.00 for a
5mmX5mmX10mm block) than an
autologous graft due to the
significantly reduced surgical time.
Also, for larger cases, an unlimited
quantity of bone is available.
Using an aseptic technique and
local anesthetic (the patient opted
not to have I.V. sedation) the block
graft procedure was done. The full
thickness flap was made using a
sulcular incision from the mesial of
#9 to the distal of #12 and a vertical
release at the distal of #12. There
was no mesial vertical release. A
full thickness triangular flap was
raised to reveal the bony defect
(figure 3). This flap was designed to
passively cover the bone graft and
prevent the need for any cutting or
scoring of the periosteum at the time
of closure.
The donor site was decorticated.
The block graft, which had been
soaking in clindamycin liquid, was
shaped and secured with two bone
screws (figure 4). Grouting, RMTB
particulated irradiated cancellous
bone was placed around the edges
of the block. A pericardial
membrane, soaked in clindamycin,
from Community Tissue Services of
Figure 4
Figure 3
Figure 2
Figure 1
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Volume 4, Issue 1 www.tatumsurgical.com
Dayton, Ohio, was placed over the entire graft and pulled under the
palatal flap using a suture.
Healing was uneventful and five months later a new I-Cat was made
verifying the 7mm width of the new ridge (figure 5). A flap was made
revealing natural looking bone (figure 6). The bone screws were
removed and a 2mm wide by 7mm deep bone biopsy trephine was done
for a histological study. The Tatum Surgical implant, Tapered
3.5mmX17mm was placed into the trephine hole after extending the hole
with a 2mm drill to a depth of 17mm level with the gingival. It has been
my experience in the maxillae that in a underprepared (in width)
osteotomy site that the Tapered Tatum Implants will readily insert even
with an under-preparation of as much as 1mm or 1.5mm. Occasionally, if
the cortice of the crest is unusually hard, the crest only needs to be
―opened up‖ to the diameter of the implant at its neck.
An uneventful healing occurred over the next eight weeks. At that time a
RHA was placed to start to develop a sulcus. Four weeks after place-
ment of the RHA, the patient came in for abutment placement, crown
prep and impression (figure 7 – RHA on), (figure 8 – RHA off). The
abutment was cemented on and prepped. An impression was made and
a temporary fabricated.
Figure 5
Figure 6
Five weeks later the temporary was removed revealing a healed sulcus that will accommodate to the
proper emergence profile of the crown (figure 9). The final crown was cemented in (figure 10). The end
result was preserving his natural diastemas and restoring the ridge width (figure 11).
Figure 7 Figure 8 Figure 9
Figure 10 Figure 11
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The Tatum Times www.tatumsurgical.com
Figure 1: Two pieces of core bone biopsy stained with Touledene blue, 2.5 x 1.25 Original Mag. Figure 2:: 20 X 1.25 High Mag. Showing vital (lacunae with osteocyte) and graft bone (empty lacunae) Touledene blue staining Figure 3 & 4: 20 x 1.25 High Mag. Tetracycline Fluorescence images showing two
lines of tetracycline labels indicative of new bone formation within the alogenic
block.
Total volume % Vital % Graft %
100 77.76 22.24 Table 1: Shows the actual data
Graph 1: Showing the % of
Vital Vs.
Graft bone
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Volume 4, Issue 1 www.tatumsurgical.com
T Talented clinicians seeking further education,
Applied skills in a real world setting,
True dedication to Implant Dentistry,
Unique state - of - the - art facility,
Mentorship?
Where can you find...
Tatum Institute International Introducing our new facility — Atlanta is waiting for you!
A
T
U
M
The Tatum Times
Page 6
Users of the Month We are pleased to announce our
Users of the Month
for October, November, and December 2010. For this
accomplishment, these clinicians will receive four
complimentary implants of their choice.
October Dr. Frank Sung
Houston, TX
November Dr. Timothy Hacker
Bartlett, TN
December Dr. Vincent Liang
Milpitas, CA
Visit us at:
www.tatumsurgical.com
Did you know that
you will receive a
free dental
implant for a
good suggestion
that is used at
Tatum Surgical?
Did you know?
Did you know that
Tatum Surgical now
offers a screw
retained bar option
of treatment?
Upcoming Events
Tatum Surgical would like to express sincere appreciation to our Mentor’s for their commitment and dedication to Dr. Tatum. We are developing a case presentation section for our website. Please feel free to submit interesting cases that we can post. Included with this submission should be a current picture
attached to current CV.
Dr. Tatum
is inviting you to the
8th or 9th
"Journey to Remember"
trips in
Normandy, France.
May 22—28, 2011 July 31—Aug 8, 2011
Registration: 888-360-5550
Tatum Institute, International
Atlanta, Georgia Module III
May 13 —14, 2011 Day 1:
Bone Grafting Day 2:
Nerve Repositioning and Segmental Osteotomy
Registration: 727-459-4910
2011 AAID Northeast District Meeting
Rescue of the Ailing Implant
June 10 - 11, 2011 Baltimore, Maryland
Come visit us to learn about our:
low cost treatment options using one piece implants,
screw retained bar system,
steps for easier restorations,
and much more!