Loaded question here. I to would like more info on Mesh and infuse. Any info shared would be appreciated.

Smoking decreases success of implants long term and short term. I try my best to get them to quit. If they dont its on them and I am happy to charge them again when the implant fails

Instead of criticizing, let's make sure some basic principles are covered. You need to look at the case in particular and decide what type of membrane is most appropriate; and whether or not additonal tissue grafting will be required. If you deem it necessary to place a Ti-mesh, then you must make sure that you obtain complete primary closure of the wound with no exposed edges of the membrane and that the flap is tension-free. Most cases with exposed membranes result from inadequate closure, or flap design/closure resulting in a non-union healing of the gingiva with subsequent epithelial migration into the graft. As has been stated previously, the techniques you are working with and materials are exteremly technique sensitive and are difficult even in experienced hands. Having said that, it would behoove anyone interested to read-up on what the current techniques are, watch live surgeries, etc before attempting it on your own.

As for smoking the data is pretty clear. The interesting thing is that most of the research is done in Europe and the number of people who don't smoke there one can count on one hand. When I am talking to smokers, I try to focus on the whole cancer and death thing, not their teeth; which doesn't work either :(

Will I learn enough at these course to take this to my practice? Is there a hands on?

I have used ti mesh several times. Ace surgical sells it in two different thicknesses. I like the thinner of the two. It can be bent to conform to the shape that you want.

The first time I used it gave me the very best grafting results I had ever obtained. Since that time I have used it under various circumstances with success and failures.

Problems:
1. You must cut the mesh to fit the site. That leaves sharp edges which can cause exposure. Extend the mesh like a membrane.

Solution: Use orthodontic instruments to make the sharp areas curve towards bone instead of the soft tissues. Place a barrier over the mesh (my preference is collagen soaked in prp). Lastly tack the mesh occlusally and apicallty so that it will not move.

2. Exposure. My only advice is that if it does get exposed, to remove it asap and cover the grafted area with collagen or alloderm.

3. Removal. Some times it works so well that bone grows through, not just under the mesh. Also, it can become imbedded in soft tissue.

Solution: Just allow more time for removal.

When placing ti mesh, always extend the flap at least one tooth mesial and distal to the graft site. Score the flap to obtain primary closure.

An additional use for ti mesh is during implant placement. If at implant placement you know from x-ray studies that part of the coronal area of the implant will be supra-crestal, you can cut a piece of titanium mesh to extent around the exposed area, place autogenous bone from the osteotomy site over the exposed area and fixate the titanium mesh with the cover screw. For good measure I usually place a collagen barrier over the mesh.

Give ti mesh a try. It is versatile. Often the hardest part is the fixation step. Placing screws or tacks in every area of the mouth can be a challenge.

Good luck!

Xavier

apply tetracycline on ti-mesh and cover it with periodontal dressing.
follow up him for 3 weeks and change your dressing each 7days.
it is biocompatible ...dont worry a bout ti-mesh exposure
Do not use tetracycline she is pregnant