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1
Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
1
Confidence in your hands™
Confidential – Internal Use Only!
Who is Zimmer Dental?
Part # 7140, rev. 12/06
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
2
Confidence in your hands™
Confidential – Internal Use Only!
Zimmer Dental Regenerative Products
Biomend® / Biomend® Extend
Puros® Corticocancellous
Block
Puros® Dermis
CollaTM Products
Puros® Pericardium
Puros® Cortical Particles
Puros® Cancellous Particles
Availability: Puros ® – US, Canada, Latin America BioMend ® – Global (with some extensions)Colla™ – Everywhere but EU and AustraliaSocket Repair Membrane – US only (available on Jan. 31, 2007)
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Regenerative Products in Europe:
BioMend® Collagen Barrier Membranes:
CollaTape®CollaCoteTM CollaPlug®
BioMend®
BioMend® ExtendTM
Colla® Absorbable Collagen Wound Dressings*:
Zimmer® Socket Repair Membrane*:
*pending CE mark registration
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
4
Confidence in your hands™
Confidential – Internal Use Only!
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
BioMend Specifications
15mm X 20mm
20mm X 30mm
30mm X 40mm
• Packaged in a single blister pack, within a Tyvek envelope
• Two year shelf life
• No special storage requirements
Membrane size selection:
• 15 x 20mm, majority of defects• 20 x 30mm, distal or interproximal defects• 30 x 40mm, multiple defects on one patient
Competitive advantage: AlloDerm® requires refrigeration(Life Cell Corporation Branchburg, New Jersey)
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
BioMend® Features and Benefits
• Tear-resistant and pliable• Easy-to-handle even when hydrated• May be cut without fraying or fragmenting• Strong enough to be sutured• Adaptable to root surfaces
Excellent Handling
• Type I collagen helps stabilize and maintain clot in defect space
• Enhances healing and improved regeneration
Wound Stabilization
Competitive advantage: ePTFE (GORE) membranes are not hemostatic
Competitive advantage: Bio-Gide® and Alloderm® must be placed “right side up”
February 2006 Part# 6120 Rev. Date 01/06
Knees Confidence in your hands™Dental Confidence in your hands™
Confidential – Internal Use Only!
Absorbable Collagen Wound Dressings
CollaPlug®
CollaTape®
CollaCoteTM
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Colla Wound Dressings Features and Benefits
• Controls bleeding and stabilizes blood clots• Covers and protects the wound bed
• Provides matrix for tissue ingrowth• Accelerates healing process
• Fully absorbs within 14 days
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
CollaTape®
• Part Number 0100• 2.5 cm x 7.5 cm• 10 units per package
• Minor oral wounds:• Closure of osseous grafted
sites• Sinus - Repair of
Schneiderian Membranes (mucous membrane lining nasal chambers)
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
CollaCoteTM
• Part Number 0101• 2 cm x 4 cm• 10 per package
• Minor oral wounds:• Palatal donor sites• Mucosal flaps• Intraosseous defects• Around implants
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Case: Palatal donor site treated with CollaCoteTM
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
12
Confidence in your hands™
Confidential – Internal Use Only!
CollaPlug®
• Part Number 0102• 1 cm x 2 cm• 10 per package
• Extraction sites• Biopsy sites• Oral wounds
February 2006 Part# 6120 Rev. Date 01/06
Knees Confidence in your hands™Dental Confidence in your hands™
Confidential – Internal Use Only!
Zimmer® Socket Repair Membrane
Confidential
CONFIDENTIAL - Internal Use Only. Do Not Distribute.
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Case 1 Dennis Tarnow, DDS
New York, NY
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Case 1 – Dennis Tarnow, DDS
Periapical Radiograph
Dennis Tarnow, DDS
Dennis Tarnow, DDS
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Case 1 – Dennis Tarnow, DDS
Membrane Placed in Socket
Dennis Tarnow, DDS
Dennis Tarnow, DDS
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Case 1 – Dennis Tarnow, DDS
Puros Particulate Delivered into Socket
Dennis Tarnow, DDS
Dennis Tarnow, DDS
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Case 1 – Dennis Tarnow, DDS
Membrane Sutured in Place
Dennis Tarnow, DDS
Dennis Tarnow, DDS
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Case 1 – Dennis Tarnow, DDS
2 Weeks Post-Op
Dennis Tarnow, DDS
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Case 1 – Dennis Tarnow, DDS
2 Months Post-Op
Dennis Tarnow, DDS
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Case 1 – Dennis Tarnow, DDS
Final Esthetic Result
Dennis Tarnow, DDS
Richard Smith, DDS
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
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50,000 sq. ft. administration building
65,000 sq. ft. processing facility
• Tutogen Medical, Inc. founded 1971
• Regeneration Technologies, Inc. founded in
1998
• Merger in February 2008 to form RTI
Biologics, Inc.
• Processing locations: Alachua, FL Neunkirchen, Germany
RTI Biologics Overview
For internal use only- Do not distribute
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
FAMILIA PUROS
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
The TUTOPLAST® Process
Tutoplast es el un proceso patentado de esterilización y preservación que consiste principalmente en una serie de baños químicos que aseguran la eficiencia y seguridad de los tejidos sometidos a este.
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Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Delipidización
Bañando los tejidos en
acetona y agitados con
ultrasonido.
La acetona es evaporada.
Elimina grasa para impedir su
interferencia con la
cicatrización.
Inactiva virus
Remueve bacteria
Proceso TUTOPLAST®
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
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Tratamiento Osmótica
Único del Tutoplast
Serie de baños ( altas y bajas
concentraciones de solución salina
y agua destilada)
Expone el material intracelular
permitiendo la eliminación de el
material bacteriano.
Mata bacterias
Destruye y elimina células
Elimina la mayoría de la
antigenicidad
Reduce el volumen viral
Proceso TUTOPLAST®
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
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Tratamiento Oxidativo
Baños con bajas
concentraciones de
peroxido de hidrogeno
Reacciona con las
proteínas
Remueve la antigenicidad
restante
Inactiva los virus
expuestos en el
tratamiento osmótica.
Proceso TUTOPLAST®
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Deshidratación con solvente
Baño con agua destilada.
7 baños de acetona.
Elimina el agua del tejido (lo que
permite almacenar el tejido por 5
años)
Inactiva los priones virales
remanentes.
Remueve bacteria
Conserva la estructura del tejido y
su firmeza
Proceso TUTOPLAST®
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
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Asegura la completa esterilidad y 5 años de almacenamiento
Se hace con el producto empacado
NO afecta las propiedades biomecánicas del tejido
Inactiva virus
Un máximo 2.5 mrad
Dosis limitadas de irradiación Gamma
Proceso TUTOPLAST®
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
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Cortical Bone
Dense, rigid bone tissue, cylindrical in shape and hard enough that surgeons must use a saw or drill to cut through it.
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
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Cortical Bone
Bone Structure
Forms the entire outside of the bone
Is very denseIs very strong
Highly resistant to compression and bending
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
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Cancellous Bone
La capa mas interna , también conocida como hueso trabecular o medular
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
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When is Puros fully matured ?What`s left after 6 months ?
(Puros after internal sinus lift, 8 months post op)
Following the recommended re-entry periods and the instructions for use,the following histological findings can be expected:• vital cancellous bone with lamellar structure • fat marrow with areas of collagen connective tissue• visible cement lines of layered bone remodeling and apposition of new bone• conclusive integration of a small amount of transplant residues
Traces of residual Puros are solidly integrated into newly formed, hard bleeding bone,complete turnover is depending on subsequent natural remodeling at the grafted site with respect to stress trajectories and general cellular activity.
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
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Aplicaciones del hueso
CORTICAL.
• RECONSTRUCCION DEL HUESO ALVEOLAR
• SOBRE IMPLANTES
• DEFECTOS PERIODONTALES
• ELEVACION DEL SENO MAXILLAR•
• EXTRACCION DE 3 MOLARES
ESPONJOSO.
• EXTRACCIONES ANTES DE IMPLANTES
• DEFECTOS PERIODONTALES
• ELEVACION DEL SENO MAXILLAR
February 2006 Part# 6120 Rev. Date 01/06
Knees Confidence in your hands™Dental Confidence in your hands™
Confidential – Internal Use Only!
Puros®
J-Block!
Confidential
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February 2006 Part# 6120 Rev. Date 01/06
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Confidence in your hands™
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A = 18 mmB = 10, 15C = 8 mm
5 mm
A
C
2 mm B
Puros Block (J-Block): Uses/Indications
• Taken from Iliac crest – both cortical and cancellous• The J-Block Allograft is specifically designed for surgical ridge augmentation
of mandible or maxilla in patients where bone volume has been reduced due to atrophy in both vertical and lateral dimensions.
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
Puros® Pericardium Clinicals:Case 2- Horizontal and Vertical
Ridge Augmentation with Puros J-Block
By Paul PetrungaroDDS, MS, FICD, FACD, DICOI
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Pre-Operative View
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Confidence in your hands™
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Pre-Operative Defect
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Confidence in your hands™
Confidential – Internal Use Only!
Block Sizing
Puros Block Allograft
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Block Re-hydration – Saline First; PRP coating, if desired, afterward
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Confidence in your hands™
Confidential – Internal Use Only!
Puros Block Fixation
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Confidence in your hands™
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Rehydration of Puros Particulate & Pericardium Regenerative Complex
Puros Particulate Puros Pericardium
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Confidence in your hands™
Confidential – Internal Use Only!
Pericardium Membrane Placed
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Tension Free Closure
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6 Week Post Operative View
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Confidence in your hands™
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3 Month Post Operative Panorex
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3 Month Post Operative Clinical View
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Confidence in your hands™
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3 Month Re-Entry
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Confidence in your hands™
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Site Preparation Implant Placement
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Confidence in your hands™
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Re-Shaping RidgeOne Stage Implant Protocol
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Closure
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Confidence in your hands™
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6 Months Post J-Block-Loading
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February 2006 Part# 6120 Rev. Date 01/06
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Confidence in your hands™
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Definición del hueso Puros• Procesado con Tutoplast
• Mineralizado
• Esponjoso, cortical, bloque iliaco
• Alogenetico
• Osteoconductivo
• Conserva el colágeno con toda su pureza
• Estéril
1%
14%0.3%
50%
2%
33%
Cells
Type I Collagen
NoncollagenousproteinsHA
Other Minerals
WaterSTERILE R
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February 2006 Part# 6120 Rev. Date 01/06
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Manejo y consistencia
February 2006 Part# 6120 Rev. Date 01/06
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Puros® PericardiumResorbable Allograft Membrane
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Pricing
Product Description Price Puros Pericardium, 15X20mm $135 Puros Pericardium, 20X30mm $199 Puros Pericardium, 30X40mm $249
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February 2006 Part# 6120 Rev. Date 01/06
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Definición del Pericardio Puros
• Alogenetico
• Colágeno permanece intacto
• Procesado con Tutoplast
• Pericardio humano
• 5 años de almacenamiento
• Rígido con fibras multidireccionales.
• Se reabsorve entre 4 a 6 meses
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Pericardium
• Tejido conectivo denso que rodea el músculo del corazón
• El pericardium esta compuesto de colágeno tipo I.
• Funciones:
Proteger el corazón. Adhiere el corazón a las paredes
adyacentes. Previene el corazón de llenarse de
sangre. Limita los movimientos del corazón.
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February 2006 Part# 6120 Rev. Date 01/06
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Confidence in your hands™
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Definición del Pericardio Puros
• Alogenetico
• Colágeno permanece intacto
• Procesado con Tutoplast
• Pericardio humano
• 5 años de almacenamiento
• Rígido con fibras multidireccionales.
• Se reabsorve entre 4 a 6 meses
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February 2006 Part# 6120 Rev. Date 01/06
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Que hace al Pericardio Puros superior?
• Fácil de hidratar.
• Alta adaptabilidad a los tejidos
• Fácil de manipular
• Predecible absorción.(4 a 6 meses)
• Acepta todo tipo de dispositivos de fijación
• Resistente
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February 2006 Part# 6120 Rev. Date 01/06
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Aplicaciones de el Pericardium
• Sobre injertos de bloques
• Sobre injertos de reconstrucción alveolar
• Sobre extracciones
• Sobre defectos periodontales
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Puros® Pericardium Clinicals:Case 1- Ridge Preservation
By Paul PetrungaroDDS, MS, FICD, FACD, DICOI
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Pre-Operative View
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Regenerative Barrier
Puros PericardiumPuros Pericardium
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Treatment of the Osseous Defects
Puros Particulate
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PRP Enhanced Graft Complex and Membrane
Pericardium Membrane
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3 Month Re-entry and Placement of Implants
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3 Month Re-Entry3 Month Re-Entry
Pre-Op DefectPre-Op Defect
CoreCore
3 Month Re-Entry3 Month Re-Entry
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February 2006 Part# 6120 Rev. Date 01/06
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Puros® Dermis Allograft Tissue Matrix
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Dermis
• Skin is the largest organ in the body. It contains 3 layers: Epidermis Dermis Subcutaneous
• Functions: Protection Provides strength Thermoregulation Supports vascular and nerve network Sensation Delivers nutrients
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Caracteristicas
• De facil uso Segundos para hidratarla (no
necesita de antibioticos) No necesita de segunda cirugia Excelente respuesta de los tejidos Esteril
• Fuerte , con fibras multidireccionales• No requiere de refrigeracion• 5 años se puede guardar • Biocompatible• Compuesta de Collageno tipo 1• Se reabsorve entre 4 a 6 meses
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Hydration using PRP
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Puros Dermis in Place and Sutured
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Product Positioning - Dermis
Providing an easy-to-use, sterile solution, Puros® Dermis is a natural alternative to autogenous soft tissue grafts.
It can be used for both horizontal and vertical soft tissue augmentation, increasing volume and leading to a highly cosmetic clinical result.
Puros Dermis offers superb soft tissue response and maturation, ideal for aesthetic case requirements.
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Congelado-Desecado Vs Tutoplast
Congelado-Desecado (liofilizado)
(Largas vesículas debido a los cristales de hielo áreas densas no uniformes)
Tutoplast processed(Apariencia uniforme)
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Mineralizado Vs Desmineralizado
• Mineralizado
― Mejor matriz para el hueso remodelar― Soporte ― Estructura― Arquitectura
• Desmineralizado
― Se remodela mas rápido que el hueso del paciente, así perdiendo volumen
― Osteoinduccion??????
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Proj. T15b
• RTI Overview
• DBM Basics
• What Is It?
• How It’s Made
• Puros DBM Putty Product Description
• Competitive DBM Products
RTI & Zimmer
For internal use only- Do not distribute
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What Is It?
• 100% processed allograftActive DBM*
Carrier DBM
Water
• Open bore dispensers
*DBM induced bone formation when implanted in an athymic rat assay. Findings from an animal model are not necessarily predictive of human clinical results.
For internal use only- Do not distribute
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+ +Carrier DBM
=
For internal use only- Do not distribute
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Zimmer® Sinus Lift Balloon
Zimmer Dental has signed an Exclusive Distribution Agreement with Osseous Technologies of America (OTA) for a product line of Sinus Lift Balloons
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©2009 Zimmer Dental Inc. All rights reserved. 1289, Rev. 8/09.
Zimmer® Sinus Lift Balloon
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FAQsWhat is the Sinus Lift Balloon?Zimmer® Sinus Lift Balloon is a unique device to assist clinicians in performing atraumatic sinus membrane elevation.
What is the price of a Sinus Lift Balloon?$129 each (no discounting)
What are the part numbers?14002 – Straight14003 – Angled14004 – Micro-Mini
Availability?US – October 2009Canada – 2Q10EU/ROW – 1Q10 (APR countries vary based on product registry)
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February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
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Confidence in your hands™
Confidential – Internal Use Only!
How to use a Sinus Lift Balloon*
Clinical photos ©2009 Dr. Ronald Cardoso. All rights reserved. Individual results may vary.
Step 5 Step 6 Step 7
S5) Insert deflated balloon into osteotomyS6) Slowly and evenly inflate balloon with saline to lift sinus membraneS7) Deflate balloon and remove from osteotomy, inspect sinus membrane. Site is now ready to receive graft material
*Refer to the IFU for further information and detailed steps.
S1) Determine which balloon you need for the indicationS2) Inflate the balloon with air, pump multiple times to expand balloonS3) Create an osteotomy S4) Fill the syringe with saline
94
Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
94
Confidence in your hands™
Confidential – Internal Use Only!
LITERATURE
95
Knees
February 2006 Part# 6120 Rev. Date 01/06
Confidence in your hands™Dental
95
Confidence in your hands™
Confidential – Internal Use Only!
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