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The opinions within this web page are not ours. Authors have been credited for the individual posts and photographs where they are. - www.rxroots.com

2 month tissue check-Open sinus lift

From: Terry Pannkuk To: roots Sent: Wednesday, December 21, 2011 1:44 AM Subject: [roots] 2 month tissue check-Open sinus lift no graft I just decided to take a picture of my office managerís ridge after this discussion. Hereís the current status at 2 months post op. No symptoms or sinus issues. Soft tissues look well-healed. - Terry tissue check-Open sinus lift Terry, i'm interested in this technique as seems to be biologically based. However, could you guide me: what would be recommended reading if one is into "getting" the point? However, even in this case you can't totally avoid biomaterials - membrane :-) - Dmitri You are correct. I used a membrane. This issue isnít about whether you graft, use membranes, or not. Itís about how often and why you use graft and membranes. I get the distinct impression people just graft to graft without thinking about why and when they should and shouldnít - Terry I see grafting disasters quite frequently coming from other offices, like this one about 2 weeks ago. I didnít post it because my photography was about as bad as the graft result. Take home point: Grafting usually works out fine, when it doesnít itís a disaster and a mess. Itís an added complication with risk. The benefit better be worth the risk or there is no point in doing it - Terry grafting Thatís a problem with the operator, not with technique or materials. Name me a procedure we should embark upon where we should not have a specific goal in mind. Even if you and I decide to treat a case differently, perhaps graft and no graft, each one of us does so because our experience tells us we will attain a specific outcome. - Gary L. Henkel The problem is the whole enchilada, operator, materials, and the methodological approach. Cookie cutter dentistry is killing the profession of dentistry. The decision to always graft is as bad as the decision to never graft. The literature is riddled with inadequate studies, n=18, n=30, etc. having no control of site or operator ability. Small wonder they all tend to conclude everything is equal and good. i.e. no significant difference. Of course there is no significant difference because everything is out of control and equally out of control. We see horror stories coming into our practices every other day existing as presumed literature outliers. Should we feel better about all this bad dentistry just because it is evidence-based? Is it really? Hereís a graft I did last week filling out just the buccal defect: Presumptions: Native bone is better bone than grafted bone. Graft will provide soft tissue support (i.e. esthetics) Conclusion: it makes absolutely no sense to place graft in the apical socket, it makes some sense to support the soft tissues with underlying graft for esthetics. - Terry grafting
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