Graft That Solves a Lot
of Problems
toothache
We have
all seen this emergency scenario: A 45-year-old, new patient comes in with a toothache that kept him awake the night before with pain. The decay on tooth No. 2 is deep. Endodontic treatment or extraction are the two options presented. The patient reports limited finances, and after discussion, he elects to extract the tooth. Informed consent is obtained.
When possible, I like to avoid elevators for extractions like this, and within a few minutes, my 3-prong forceps have this tooth lifting out of the socket with little disturbance to the adjacent teeth. Examining the extracted tooth tells me that I will not be pursuing root tips near the sinus. I note a small sinus communication where the palatal root had been and some displacement of the buccal plate.
Socket Preparation and Grafting
The socket is irrigated with a slurry of sterile saline and the contents of a clindamycin capsule. After degranulation with a curette, irrigation is repeated. I
do not trust this socket to a collagen-plug-stabilized blood clot. I need a grafting material that will endure his 2-hour drive home and protect the socket from
contaminants such as saliva, food, and possibly emesis. Additionally, I want a grafting material that will obturate the sinus communication and stabilize
the buccal plate. I use ß-tricalcium phosphate (ß-TCP) granules in a quick-mix syringe polymer system. This alloplastic bone-grafting system, GUIDOR easy-graft
CLASSIC, is my “Swiss army knife” tool for
accomplishing these goals.
tooth.
Within 2 minutes of opening the pouch, the graft is placed, compacted, and solidified with minimal armamentarium. This site has no loose flaps of peripheral gingiva; the buccal and lingual bone is compressed
with finger pressure. Sutures are not required.
Protecting the Patient
Like many of these low-trauma/easy-grafted
cases, this patient reported minimal postoperative discomfort and did not require pain medication. GUIDOR easy-graft CLASSIC has become an important part of our goal to reduce the need for opioids.
I also prefer to use the product for patients on daily aspirin or anticoagulants, because the socket is almost completely filled with a “plug” of ß-TCP polymer that can reduce bleeding problems. Further, patients are not always compliant with my
postoperative instructions, so if they do not consistently bite on gauze to stop bleeding or if they eat too soon, rinse too vigorously, or cannot prevent a sneeze, GUIDOR easy-graft CLASSIC can help.
GUIDOR easy-graft CLASSIC
GUIDOR easy-graft CLASSIC is the first particulate bone-grafting material designed to be syringed directly into a bone defect, hardening into a stable, porous scaffold in approximately 1 minute, and
eliminating the need for a dental membrane in many cases. The product is 100% synthetic and fully resorbable. Each system is comprised of ß-TCP granules coated with a biodegradable polymer that is mixed with an NMP liquid activator called BioLinker to form a permeable, moldable material that
hardens to form the scaffold. The system is ideally suited for filling voids around immediate implant placements and ridge preservation after tooth extraction.
Dr. Cope received his DDS and a Bachelor of Science degree from the University of California at San Francisco and was a UC Regents Scholar. He has been in private practice in El Dorado Hills, CA, since 1987. Dr. Cope has published articles for the
Sacramento District Dental Society and has been an invited guest lecturer in the Sacramento area. He practices with his
son, Dr. Ben Cope, and wife, Kimberly Cope, RN.
