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IPG-DET technique is a surgical procedure that interfaces with the upper posterior jaw to support dental implants and a future dental prosthesis.[1][2]
The basis of this innovative technique is a biological process called osseointegration where materials, such as titanium, form an intimate bond to bone. A variable amount of healing time between 4 to 8 months is required for osseointegration before the dental prosthetic is attached to the surface of a load artificial implant.[3] The surgeon can use this method in order to acquire the desired alveolar ridge dimensions so as to achieve implant stability and long-term aesthetic results where is a small amount of bone high in the upper jaw near the maxillary sinuses.
For vertical alveolar ridge deficiencies in the posterior areas of the maxilla, either extensive bone grafting techniques are used, or in most cases sinus floor elevation procedures are performed in order to create the bone height required for implant stability.[4]
With IPG-DET the surgeon can place immediately dental implants by using autologous CGF[5][6] growth factors, occasionally bone grafts materials as well as autologous stem cells or umbilical cord blood mesenchymal stem cells, in the same session, to increase the bone height in the sinus.[7][8]
Procedure
editIPG-DET technique is a surgical procedure that aims to increase the amount of bone in the maxillary sinus of the posterior maxilla (upper jaw bone), in the area of the premolar and molars and simultaneously insert dental implant in this area.[9]
When natural teeth in the maxilla are lost, the alveolar process begins to remodel and there is insufficient bone volume required for the placement of dental implants based on osseointegration.
The aim of IPG-DET is to introduce additional bone graft into the maxillary sinus at the same time as implant placement, so that more bone graft is available to achieve the initial stability of the dental implant.[10]
In IPG-DET,[11] additional bone is grafted into the maxillary sinus by intentional perforation the Schneiderian membrane (sinus membrane) and sealing the perforation with the pure autologus (from the same patient) biomaterial CGF-CD34+Matrix containing concentrated growth factors (CGF) and CD34-positive mesenchymal stem cells.[5][12]
The surgeon obtains the autologus CGF-CD34+Matrix biomaterial during the procedure by taking a small blood sample from the same patient. IPG-DET is a similar surgical procedure to maxillary sinus floor augmentation, but with three differences:
- the intentional perforation of the sinus membrane
- the use of a purely autologus biomaterial[13]
- the entire procedure (insertion of the biomaterial, the bone graftand the dental implant) is performed in a single-stage surgery.
References
edit- ^ I. P. Georgakopoulos et all 2014, Journal of Implant and Advanced Clinical Dentistry, Volume 6, No 1, 20-01-2014. A case-Study of Seven Implants Placed in the Maxillary Sinus With Intentional Schneiderian's Membrane Perforation.
- ^ Inchingolo, F., Dipalma, G., Paduanelli, G., De Oliveira, L. A., Inchingolo, A. M., Georgakopoulos, P. I., Inchingolo, A. D., Malcangi, G., Athanasiou, E., Fotopoulou, E., Tsantis, S., Georgakopoulos, I. P., Diem Kieu, N. C., Gargiulo Isacco, C., Ballini, A., Goker, F., Mortellaro, C., Greco Lucchina, A., & Del Fabbro, M. (2019). Computer-based quantification of an atraumatic sinus augmentation technique using CBCT. Journal of biological regulators and homeostatic agents, 33(6 Suppl. 2), .
- ^ I.P.Georgakopoulos et all. 2014, Clinical Cases in Mineral and Bone Metabolism 2014; 11(1): 59-66. The impact of Platelet Rich Plasma (PRP)in osseointegration of oral implants in dental anoramic radiography: texture based evaluation. "Potential adverse events of endosseous dental implants penetrating the maxillary sinus".
- ^ Dong-Seok Sohn et all. Implant Dent 2011;20:1–000. Fibrin-rich blocks with CGFs act as an alternative to bone grafting and can be a predictable procedure for sinus augmentation.
- ^ a b Luigi Fabrizio Rodella et all. Microscope Research and Technique 74:772-777 (2011). Growth Factors, CD34 Positive Stem Cells, and Fibrin Network Analysis in CGF (Concentrated Growth Factors) Fraction, University of Brescia, Italy Department of Biomedical Sciences and Biotechnologies, Division of Human Anatomy University of Milan, Italy Department of Biology.
- ^ Chen, H., Zhou, L., Wu, D., Zhang, J., Zheng, Y., & Chen, Y. (2022). Osteotome sinus floor elevation with concentrated growth factor and simultaneous implant placement with or without bone grafting: a retrospective study. International journal of oral and maxillofacial surgery, 51(8), 1078–1084. https://doi.org/10.1016/j.ijom.2021.10.010
- ^ Georgakopoulos, I.P., Ntontoulos, V., Georgakopoulos, P., Aggelos-Taxiarchis, Georgakopoulos, Tsantis, S., Xhanjanka, E., Kossyvakis, A., Dailiana, D., Dipalma, G., & Inchingolo, F. (2021). Minimally Invasive "IPG-Det Technique" with Autologous CGF and Human Umbilical Cord Blood Derived Mesenchymal Stem Cells towards Posterior Atrophic Maxilla Reconstruction-Case Report.
- ^ Michael Peleg et all Int. J Oral Maxillofac Implants 2006; 21:94-102. Predictability of Simultaneous Implant Placement in the Severely Atrophic Posterior Maxilla: A 9-Year Longitudinal Experience Study of 2,132 Implant Placed into 731 Human Sinus Grafts.
- ^ Georgakopoulos, Panagiotis & Inchingolo, Francesco & Dipalma, Gianna & Malcangi, Giuseppina & Batani, Tiziano & Georgakopoulos, Ioannis. (2019). IPG-DET Technique : Innovative Approach of Implant Placement and Grafting in the Sinus : A Reliable Alternative to Sinus Floor Elevation (SFE). Dental News. 26. 12-19. 10.12816/0055437.
- ^ Karabuda et all, J Periodontol. 2006 Dec; 77(12):1991-7.Effects of sinus membrane perforations on the success of dental implants placed in the augmented sinus.
- ^ Christos Simis., et al. "Rehabilitation of the Posterior Atrophic Maxilla by using the minimal invasive IPG-DET technique with CGF and CD34+ stem cells". Medicon Dental Sciences 1.4 (2022): 02-08.
- ^ Semaan Abi Najm et all. 2013 The Laryngoscope, 05/2013; DOI: 10.1002/lary.24189 Potential adverse events of endosseous dental implants penetrating the maxillary sinus.
- ^ Hirotsugu Honda et all. The Japanese Society for Artificial Organs, 1 May 2013, Concentrated growth factor (CGF) is an autologous leukocyte-rich and platelet-rich fibrin (L-PRF) biomaterial termed second-generation platelet concentrate.