Measure the depth and width of the socket for plug quantity selection. Hold the OsteoGen® Bone Gra�ing Plug with sterile tweezers, taper plug apically and del iver into tooth root dry. Compact the plug aggressively. The Plug should be large enough, with excess of 4.0 to 5.0 mm above occlusal plane, so that it can be compressed into and fill the en�re socket, up to the so� �ssue level. Do not place plug to the crestal bone height!

Following anesthesia, extract tooth using standard atrauma�c flapless protocol. A�er tooth removal, thoroughly cure�e socket to remove all so� �ssue debris with a serrated cure�e, round bur, fissure bur or Lindemann bur. ¹⁻³

With Plug in place, passively suture using crisscross technique. No membrane is required. Crestal soft tissue should bridge across in 9-14 days. The non-ceramic OsteoGen® is low-density graft. Extraction site will be radiolucent on the day of placement. On average, resorption time of Plug is 4-5 months depending on patient's age, metabolism and root size. Gradually the OsteoGen® Plug progressively resorbs and is replaced by host bone. The site will become radiopaque and ready for implant installation.

ALVEOLAR RIDGE PRESERVATION USING THE BIOACTIVE OSTEOGEN® BONE GRAFTING PLUG WITHOUT A MEMBRANE

IMPLADENT LTD 800-526-9343 www.impladentltd.com 86-90 188TH ST, JAMAICA, NY, 11423

A�er debridement, remove the Periodontal Ligament in its entirety, flush socket with sterile water. Make holes and remove the Lamina Dura (Palatally) where trabecular bone is available to procure medullary blood from the Alveolar Process containing oteoclast cells and to trigger the Regional Acceleratory Phenomenon (Rap).4 Profuse bleeding will be absorbed by the OsteoGen® Plug and will help prevent dry socket. Do not hydrate the Plug prior to delivery. 5,6

Plug compression is achieved by using a Pluggersm Instrument to align and compact the bone grafting crystals closer together creating a bioactive membrane barrier which controls migration of connective tissue.7-9 Use more than one Plug if necessary for multiple roots. Fill and unite roots superiorly from the root trunk to the level of the soft tissue crest. Leave the top of the Plug intact so that it can be compressed into the socket.

SURGICAL PROTOCOL For Doctors Immediate A�en�on:

Doctors: Please ask your patients if they are allergic to collagen. Advise the patient not to drink alcohol, use mouthwash or chlorhexidine for 2 weeks, as it is toxic to fiberblast an may retard healing and crestal bridging of soft tissue.

Please read Product Insert.

Fig. 1 Extrac�on & Debridement:

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Surgery:

Making a Membrane:

Radiolucent to Radiopaque:

Requiring Excess Plug 3-5.0mm Above Occlusion:

BIBLIOGRAPHY

1. Schlesinger C: Extraction with immediate placement and immediate temporization: the ultimate in patientsatisfaction. Implant Practice 2015; 8(6):20-24

2. Kosinski T: Simple and predictable socket preservation techniques all dentists can implement regardless ofextraction or grafting experience. The Profitable Dentist Summer 2016:46-50

3. Kosinski T: A Simple and cost-effective socket preservation technique. Dentistry Today 2016;35(4)

4. Frost HM: The Regional Acceleratory Phenomenon: a Review. Henry Ford Hosp Med J 1983; 31(1):3-9

5. Schlesinger C: Using OsteoGen® Strips to graft the gap around an implant: a case study. Implant Practice2017; 10(3):25-30

6. Schlesinger C: A Novel approach grafting around implants. Dentistry Today 2017;36(12):50-54

7. Spivak JM, Ricci JL, Blumenthal NC and Alexander H: A new canine model to evaluate the biological responseof intramedullary bone to implant materials and surfaces. J Biomed. Mater Research, 24:1121-1149, 1990.

8. Ricci JL, Blumenthal NC, Spivak JM and Alexander H: Evaluation of a low-temperature calcium phosphateparticulate implant material: Physical-chemical properties and in vivo bone response. J Oral MaxillofacialSurgery 50:969-978, 1992.

9. Valen M and Ganz SD: Part I: A Synthetic Bioactive Resorbable Graft (SBRG) for predictable implantreconstruction. J Oral Implantol, 28(4):167-177, 2002.