JIACD
The Journal of Implant & Advanced Clinical Dentistry
Growth factors from a bottle (infuse, gem21, EMD) vs PRP/PRGF/PRF from the patients; when do you use and what are your results?
Mon, 05/17/2010 - 22:52 — Barbegio
Growth factors are changing the way we operate and increasing the success of our surgery.
There are growth factors sold over the counter like infuse, gem21, emdogain or obtained from the patient in a blood draw like PRP/PRGF/PRF.
I am curious as to what Clinicians are using in terms of these growth factors? What results are you getting? When do you choose one over the other? Which is the best? and what is the most cost effective?
Thank you and I look forward to reading your opinions.
JIACD
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Comments
Emdogain for intrabony defects, PRGF for Implant related grafts
I tend to use emd for perio stuff, intrabony defects and soft tissue grafting.
I use PRGF for GBR and Sinus grafting.
PRGF is far superior platelet concentrate: Read Anitua articles
Dr. Anitua has many sound articles on PRGF. I spent a month with him in spain and his results are superior.
There is more literature to support PRGF then PRP or PRF.
It hase changed my practice.
Shaz
PRGF: Lots of literature to support it use.
I have been using PRGF for over 2 years and the results are outstanding. Soft tissue healing is great. I agree with Shaz it has helped my surgery technique and results.
Ted
Growth factor discussion: EMD or Gem 21 or PRP or PRF
I use EMD or Gem 21 for soft tissue procedures like recession.
I use PRP for bone regeneration for GBR or Sinus. I am interested in trying PRGF and PRF.
Emdogain for intrabony defects and PRGF for implant Surgery
Emdogain has plenty of hard research to demonstrate success in both hard and soft tissue perio defects. The work by anitua clearly demonstrates the success of PRGF in GBR.
PRGF PRP PRF and more
There is an ongoing debate here and elswhere regarding using autologous growth factors.I invite all of you to attend the 2nd Future Trends in implantology scheduled for november 11-13 in florence Italy.Both Dr Anitua and Dr Choukroun will be on the podium..
details can be found at www.ftidental.com
Growth Factors only do so much: They dont replace good surgery
Growth factors are important but they dont replace good surgical technique and judgement. Knowing when and where to use the growth factor is more important then the factor themselves.
Lets not forget the patient healing process. Sometimes no matter what you do the surgery fails. It is humbling but that is life.
Dr. 90201 couldnt agree more
I think people think the materials make all the diffence.
I dont think materials (while they do help) replace good surgical skill and the patients healing ability.
Barbs
Emdogain for soft tissue defects and I use PRP for Sinus grafts
I use emdogain for coronally position flaps as laid out by the Mcquire articles. I definitely see better root coverage.
I use PRP for Sinus grafts and I feel I get better soft tissue healing and better graft consolidation and handling.
I mix it with bio-oss.
Ted
"growth factors"
I use MANY growth factors/growth enhancers in my office.
Emdogain has been, since its' introduction, the backbone of my periodontal regenerative procedures, whether those are hard or soft tissue.
PRP in the literature has shown improved soft tissue healing. As far as "blood harvested factors" goes, there is more science and literature on PRF than the others (the primary author is Joseph Choukroun).
Infuse is a powerful osteoinductive agent that has worked well for me on large ridge augmentations when I know I need more than Regenaform alone.
There are many courses and other sources of information out there. Try to look for ones with scientific validation not just driven by the dollar/euro/pound.
The growth enhancer that I use most often, is one that I add to practically every bone graft I place. There are new formulations that allow the material to be used as both a graft and barrier and even mix other graft materials into it and still insert it into the recipient site with a syringe. This material - the white powder used for over 100 years - CALCIUM SULFATE. For EXTENSIVE literature on it - D Anson, J Ricci, J Sottosanti, G Pecora,.....
RAH What Calcium sulfate are you using?
What calcium sulfate are you using? Anything special on the new formulation?
Thanks
Tom
New Caso4 out now that is a
New Caso4 out now that is a significant move on (I have been working with and developing them for 7 years), from Israel and sold through MIS implants called Bond Bone.
Somehow they have made the material set even in the presence of blood which is technically very helpful.
Peter
Bone Bond what is the advantage of this CaSo4 over others?
Bone Bond what is the advantage of this CaSo4 over others?
Brooke
What is Bone Bond?
Isnt it just Calcium Sulfate? Whats the difference?
IT has very good handling
IT has very good handling charasteristics in that you can get it to "set" quickly even in the presence of blood. Other Caso4s I have used have been difficult in this area.
Bond Bone
bond Bone is calcium sulphate which has a unique cementable properties and has a capability to harden and maintain volume.In some instances no membrane is required.
PRF, CGF, PRGF any updates on what is best to use?
PRF, CGF, PRGF any updates on what is best to use? What types of clinical cases are you seeing the best results with them? Do they affect soft tissue only or is the bone healing better?
emdogain vs gem 21s
I want to know which is better in the treatment of gingival recessions
Thank you
Connective tissue graft is better
Treating gingival recession successfully depends on the etiology, biotype, tooth position, etc.
Best choice is always CTG.
I have a pal that adds Gem 21 to all of his CTG's, but he rarely uses Gem 21 alone with CPF. I have done many cases with EMD+CPF and have good success, but KG does not increase and neither does thickness. Not sure how this will last 5 years down the road compared to CTG.
CPF alone not the answer long term
I went to the Pikos and Salama Synergy course last year in Orlando and Dr. Salama showed many different methods for tissue grafting including Alloderm, Dermis, FGG, Semi-Lunar, CTG, CPF and all types of growth factors. The cases were impressive but he put certain restrictions and rules to their best utilization and what to expect with teeth, pontic sites and implants as they all respond differently.
CPF with Gem21 alone seems to not last well long term. Rather than Gem21, an autogenous CTG graft under the CPF would do much better.
By the way, I suggest the course with Pikos and Salama whenever they give it again. It was the best 3 1/2 days of dental ed I ever took.
Sam
Accell
There is a new bmp product called accell that has received awesome feedback. Keystone Dental carries the product along with the dynablast.