Dr Mike Ainsworth, a UK-based practitioner, has worked with synthetic grafting materials for more than 15 years. Here, Dr Ainsworth shares some of his top tips and provides an insight into the benefits he has found through his work with EthOss®.
When it comes to synthetic grafting materials, I suspect I am something of an ‘early adopter’ – particularly from the perspective of the UK, which was dominated by xenografts before modern alloplasts such as EthOss emerged.
Why I switched to synthetics
I first started using synthetics in my daily practice in 2005, before switching exclusively to them in 2007 as, for me, synthetics tick every box when it comes to what we as practitioners want from a graft:
- Patient outcomes – the patient wants an excellent aesthetic, functional outcome
- Minimise trauma – ideally working with a single surgical site, with a minimal number of procedures and using biocompatible materials to reduce swelling and pain
- Minimise time – reduce the amount of time between different stages of the surgery. I find the protocol suggested by Dr Peter Fairbairn particularly useful as it compresses the treatment cycle whilst offering very high predictability.
- Minimise cost – this is particularly pertinent to materials like EthOss which have integrated membranes, removing the need for collagen membranes
- High margin of safety – completely removing the risk of cross-contamination from donor material
When you consider all of these desired outcomes, the logic and science behind synthetics just makes perfect sense – particularly materials which are fully resorbed and replaced by host-bone such as B-TCP.
There is a massive research base out there behind B-TCP. All you need to do is go and search for it on Pubmed. There are countless papers showing it to have high osteoinductive potential, along with osteoconductivity, an appropriate resorption timeframe relative to new bone formation and a host of other benefits.
This all led me to the path of trying Fortoss Vital back in 2005 – an early iteration of EthOss. I got on well with Vital and immediately saw the benefits of using graft with an integrated membrane, but I did share the frustrations others found with the occasional difficulties in handling.
I switched over to EthOss as soon as it was launched in the UK and I’ve never looked back. It seems to address these handling problems and more, offering a solution to practically any defect that you see.
Tricks of the trade
People often ask me if there are any tricks of using EthOss to get optimal results. However, for me, rather than using one specific trick, it’s more a case of having the right materials and techniques in place.
This includes having modern tools, such as EthOss and modern implants, as well as sharpening up your own skill set as a practitioner to get the best results.
It’s vital that you learn from others and modify your skills to suit the materials in hand. One of these techniques is the use of resorbable “tenting” sutures to increase graft stability. I first encountered this technique in the paper “Resorbable Dome Device and Guided Bone Regeneration: An Alternative Bony Defect Treatment Around Implants. A Case Series” from Parma-Benfenati (2014) and, upon reflection, thought it would work well in combination with EthOss.
The idea is simple – positioning short lengths of 2-0 PDS suture into a defect prior to grafting to create a “dome device”, providing tensile strength and increased stability against soft tissue pressure onto the site.
I’ve had a case published in the EDI journal showing this technique and it’s fantastic to see it being adopted by dentists all over the world on the EthOss Case Studies Facebook page.
Since switching to EthOss® I’ve never looked back. For both myself as a practitioner and my patients, it’s been a very worthwhile journey exploring new techniques to get the very best results.
My practice is based near Sheffield in the UK and I’m always happy to welcome visitors who want to learn more about these techniques and see them first-hand.
You can contact me through EthOss if you are interested in a Mentoring Session.