Abstract

Today, large bony defects of the mandible and maxilla can be fully reconstructed without harvesting autogenous bone. This is accomplished in a straightforward manner by developing a graft in the operating room that completes the tissue engineering triangle of cells-signal-matrix. This uses a bone marrow aspirate as the source of cells as well as a contribution to the matrix, recombinant human bone morphogenetic protein-2 Acellular Collagen Sponge (rhBMP-2/ACS) as the signal, and cancellous allogeneic bone as the matrix. This graft system is referred to as in-situ tissue engineering. This graft consolidates sufficiently in six months to support dental implant placements and grows normally in a growing child. The advantages of this graft system, which essentially replaces autogenous bone, is a reduced time of surgery, reduced hospitalization, less pain for the patient, a faster return to the workplace and family, and less cost to the health care system. This graft system is also a predictable replacement for autogenous bone grafting in sinus augmentations, cystic defects, and
alveolar grafting.

Learning Objectives

• The attendees to learn the principles of in-situ tissue engineering.
• The attendees to learn how to harvest bone marrow stem cells in a safe and straightforward manner.
• The attendees to learn how to combine the cells-signal-and matrix in appropriate doses for the best outcome.
• The attendees to understand the timing of bone regeneration and bone maturation for effective dental implant placements.

Robert Marx, DDS

Robert E. Marx, DDS, is Professor of Surgery and Chief of the Division of Oral and Maxillofacial Surgery at the University of Miami Miller School of Medicine as well as Chief of Surgery at Jackson South Community Hospital in Miami, He is well known as an educator, researcher, and innovative surgeon. He has pioneered new concepts and treatments for pathologies of the oral and maxillofacial area as well as new techniques in reconstructive surgery including stem cell therapies. 

His many prestigious awards, including the Harry S. Archer Award, the William J. Giles Award, the Paul Bert Award, the Donald B. Osbon Award, and the Daniel Laskin Award, attest to his accomplishments and commitment to the field of oral and maxillofacial surgery. 

His textbook “Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment” has also won the American Medical Writers Associations Prestigious Book of the year Award and his other textbooks “Platelet Rich Plasma: Dental and Craniofacial Applications”, “Tissue Engineering”, “Oral and Intravenous Bisphosphonates Induced Osteonecrosis”, and an “Atlas of Bone Harvesting” have been best sellers. He is also a writer of fiction medical mystery novels. His first publication “Deadly Prescription” is currently a “Best Seller” on Amazon.

Abstract

Alveolar jaw reconstruction involves several factors to consider: the amount of volume needed, the nature of the reconstruction, the goals of the procedure, and the quality and quantity of available residual bone. Currently there’s a tendency to avoid major surgical
procedures considering its morbidity, increased trauma, and doubtful prognosis related to immediate results and stability. During the presentation these key points will be discussed in relation to the total edentulous jaws treatment.

Hugo Nary Filho, DDS, MS

Dr. Hugo Nary Filho graduated in Dentistry (Prosthodontic-Maxillofacial) from the University of Sao Paulo in 1989 and received his master’s degree in Dentistry from the Univsersidade Estadual Paulista Julio de Mesquita in 1994. He completed his PhD in Dentistry at the Univsersidade Estadual Paulista Julio de Mesquita in 1998. He is currently Professor of the specialized course in implantology associated with the Branemark Institute. He is an Assistant Professor and coordinator of the specialization
course in Implantology at the University of Sagrado Coracao. His emphasis in Oral Maxillofacial Surgery includes implants and implant-related jaw reconstruction as well as orthognathic surgery. He has given many invited lectures and completed research in a variety of areas including assessment of bone grafting techniques, including the use of various growth factors and autogenous, allogeneic, and xenogenic materials for reconstruction.