Regeneration Catalogue

Regeneration

Eureka R2 Special edition for Jeju Symposium, 2012

The future is already here.

Best choice of Bone Graft Material 01

02 Best selection for Sinus graft

18MICAkitTM

Crestal approach

Auto-MaxTM

Autogenous Bone Harvester

06

13Mega-Oss BovineTM

Xenograft

12Mega-OssTM

Allograft

14Mega-TCPTM

Synthetic

15Bone PlusTM

Synthetic

Ideal Ridge Reconstruction

24MILAkitTM

Lateral approach

0304

Best combination for narrow ridge

GBR membrane for ideal regeneration

29

51 i-GenTM

Thor& BonEx kitTM

Ideal Ridge Reconstructio

n

Best choice of Bone Graft M

aterial

01

Auto-MaxTM

Autogenous Bone Harvester

Mega-Oss BovineTM

Xenograft

Mega-OssTM

Allograft

A

A

Mega-TCPTM

Synthetic

Bone PlusTM

Synthetic

Auto-MaxTM

AutogeneousBone Harvester

Auto-MaxTM

6 | 7MEGAGEN Implant

Auto-MaxTM

Design Concept

Easy and Fast Insertion

1) Sufficient cutting force can be obtained even at low RPM. Autogenous bone can be harvested within 10 seconds!2) Amount of bone harvested may be equivalent to the size of Auto-Max! 3)Enables quick, easy bone harvesting in a single procedure! 4) It can be cleaned thoroughly as the Stopper is easily disconnectable!5) V shaped opening completely prevents bone chips from splattering during drilling!6) May be used in any type of bone with excellent durability!

Connection status when start.

Stopper- Material : Ti-6Al-4V(Titanium alloy)- Coating : TiN Coating

Wide opening to permit easy removal of harvested bone

Designed for easy connection & disconnection

Optimally designed so that bone does not escape.

4mm Stop

Unique sliding design for smooth lifting of Stop-per with appropriate resistance as drilling pro-gresses

Designed to connect the Stopper securely.A ledge to secure the position of Stopper at start

Center guide to prevent slippery during drilling

Equipped with optimal blade area, bone can be harvested with low RPM

Auto-Max Material : S42010

1. Connect an Auto-Max o the handpiece and position a stopper on the Auto-Max.

2. The Auto-Max should meet the bone surface perpen-dicularly. Press the handpiece to fix the sharp point on the bone and start drilling at about 500RPM with copious irrigation.

3. Do not pump during harvest. Pumping may scatter the harvested bone.

4. The Auto-Max will automatically stop advancing into the bone at a depth of 4mm.

5. Disconnect the stopper from Auto-Max and collect particulated autogenous bone at in a sterilized tray.

Ø5

How to use

[e.g.]

(O) (X) (X)

Ref. Code Diameter(Ø)

AM2535 Ø3.5

AM4050 Ø5.0

Ref. Code Diameter(Ø)

AM5060 Ø6.0

AM6070 Ø7.0

4mm

Ø3.5 Ø5.0 Ø6.0 Ø7.0

Products

Repeat steps 1~5 until the desired volume of bone is ob-tained.

6. Bone should be harvested from a new site each time avoiding overlap with other harvest sites.

Package


Auto-MaxTM

Clinical case 1

Clinical case 2

#34 was extracted and the socket was degranulated thoroughly.

Auto-Max was prepared for bone harvesting.

Autogenous bone was harvested from the ramus.

Severe periodontitis on # 34. # 35 was extracted 2 months before.

The prosthetics on mandibular right molar were broken with secondary caries.

Three implants were placed after extraction and degranulation of residual roots. All the implants showed bone defects.

Auto-Max harvested autogenous bone from edentulous area.

The autogenous bone was mixed with Mega-Oss bovine to increase volume of graft.

The defects were filled with the graft mixture and covered with a collagen membrane.

The panoramic radiograph taken immediately after surgery

Intraoral radiographs taken after delivery of customized abutments.

The defect was filled with shaved autogenous bone following implant placement.

Intraoral radiograph im-mediate after surgery.

Bone graft materials


Allograft Xenograft



We understand your CONCERNS about bone graft materialsand we have prepared All options for ideal regeneration.

We are proud of the world-class quality of our bone products and

are sure you will be happy with our competitive prices. We strictly control particle size of graft materials (400-750㎛),

and maintain higher interconnected porosity for angiogenesis.

Megagen’s suggestion for

Bone Graft MaterialAutogenous

Allograft

Xenograft

Synthetic

Auto-Max

Mega-Oss

Mega-Oss Bovine

Mega-TCP(β-TCP 100%)

Bone Plus(BCP, HA:β-TCP)

Synthetic Synthetic

Allograft

- 100% healthy US donor for US & world market, 100% healthy Korean donor for Korean market.- FDBA (Freeze Dried Bone Allograft)- Ideal Combination of Cancellous (60%) & Cortical (40%) bone.

- Selected particle size(400~710㎛)small particles( 250㎛) may provoke inflammatory response rather than osseous regeneration.

Does your current graft material consider this point?

Cancellous Powder (60%)Promotes cell adhesion, bone remodeling and re-formation of blood vessels.

Cortical Powder(40%)Cortical Bone has a slow infiltra-tion capacity, enabling the main-tenance of space in grafted areas.

volume of package

0.25cc

0.5cc

1.0cc

Selected particle size (400 ~ 710㎛)



Xenograft

volume of package

0.25cc

0.5cc

1.0cc

2.0cc

Superior porous structure

No crystallization with standard fusion temperature

Mega-Oss BovineTM is an inorganic natural bone material extracted from bovine bone from Australia which is recognized by BSE as safe and clean region. (Korea is not recognized by BSE as clean area.) The organic part of the bovine bone is effectively removed through various pro-cesses, no additives are added during processing, and it has no immunological rejection. All the products are produced in sterile processes from safe raw materials. Mega-Oss BovineTM is biocompatible bone graft material with porous structure similar to human cancellous bone and stimulates new bone formation and growth in grafted site. It has more and wider pores offering excellent hydrophilicity and angiogenesis.

The Low-Temperature deproteinizing process eliminates proteins effectively, but maintains the natural topography of cancellous bone with superior porosity.

The new gold standard for Xenograft

Mega-Oss BovineTM sincerely wants to be compared in quality with Bio-OssⓇ(Geistlich, switzerland), which has the biggest market share in the world.

proof of High multiporous structures

Synthetic

(100% β-TCP, Tri Calcium Phosphate)

volume of package

0.25g

0.5g

- Optimal porous structure similar to cancellous bone

㎛ in diameter) [Reference: B.S. Chang et al., Biomaterials, 2000. 21(12);1291-1298] (Korean Patent No. 10-0401941)

- Outstanding stability

Tricalcium Phosphate for Surgical Implantation), highly pure beta TCP is sintered at high tem-perature during production and gamma sterilized.

-

Research Institute)

- Biodegradable and resorbable materialTM is made of 100% biodegradable β-TCP, and has similar resorption speed with new

bone formation. Thus over time (6-18months) Mega-TCP will be completely replaced with new bone.

- Animal tests for the amount(%) of newly formed bone tissue(NB %) (Mouse, 4 and 8 week results) (compared with Bio-Oss, Geistlich, Switzerland)

New bone formation(%)

4 weeks 8 weeks

Mega TCP 11.92% 25.08%

Bio-Oss 11.24% 14.47%



- Histomorphometric results (4 weeks, mouse skull)

Amout of newly formed mineralized Bone tissue (NB%), 4weeks

Bone PlusTM

Group N Mean

Bone PlusTM 5 21.5±2.7

MBCP(BCP) 5 10.3±4.6

Osteon(BCP) 5 11.8±3.0

Bio-Oss(Bovine) 5 11.5±4.6

Cerasorb(β-TCP) 5 7.6±1.4Macropore of 400-500㎛ is ideal for angiogenesis and bone ingiowth.

Micropore, interconnected, of 10-50㎛ provide spaces for ion-exchange.

Bone PlusTM

[x60]Micro-pore

[x5000]

Trichrome stainSmall biopsy material was harvested from theridge between two fixtures to verify the qualityof regeneration with a trephine.

Synthetic

- Ideal combination of HA & β-TCP(60:40)-

tating to recipient tissue.

- Harmony of macro- and micro- pores.

volume of package

0.25g

0.5g

1.0g

2.0g

- A human biopsy to show excellent bone ingrowth into macro- and micro- pores.

(BCP, Biphasic Calcium Phosphate)

Best selection for Sinus graft02

MICAkitTM

Crestal approach MILAkitTM

Lateral approachCreessttaall aapppppprroacchh LLaateraal apppproachpppprrooaacchh

Surgical Method Classified by Sinus Conditionby Samuel Lee, DDS. MS

ClassⅠ: High and Wide H > 6mm, W > 12mm

ClassⅡ: Low and WideH < 6mm, W > 12mm

Short and Wide Implant (5 ~ 7mm)

ClassⅢ: High and NarrowH > 6mm, W < 12mm

ClassⅣ: Low and NarrowH < 6mm, W < 12mm

MICAKit MILAKit

ClassⅠ: High and Wide

MMIC

MICAKit

Crestal approach

MICAkitTM

(MegaGen Implant Crestal Approach Kit)

Drill safely with confidence!

mplant Crestal Approach Kit)

ly with confidence!fidence!

MICAkitTM [REV.04]

h confinfi


MICAkitTM

1. CleansibilityThe smooth surface makes cleaning easy and leaves no residues after cleaning.

3. Repeated useBone chips are easily removed without getting stuck, so continuous use is possible.

4. Cutting capabilityIts excellent bone cutting capability eliminates the need to use the pointed or ASBE trephine burs.

Diamond Drill Express Bur

Diamond Drill Express Bur

Diamond Drill Egg shell test Express Bur

· Innovation of Samuel Lee’s Internal Sinus Graft System REV.04

· Combined function of Diamond Drill and Reamer Drill

Express Bur

2. SafetyStopper provides safe drilling without damaging the membrane even when visibility is poor.

2 4 5 6 8

D

2

D

ASBE Trephine Bur | Scale 2:1

Diameter (D) Length (mm) Ref. C

Ø3.5/ Ø4.02/4/5/6/8Marking

ASBESS34

Ø4.0/ Ø5.0 ASBESS45

Ø5.0/ Ø6.0 ASBESS56

Point Trephine Bur | Scale 2:1

Diameter (D) Length (mm) Ref. C

Ø3.5/ Ø4.02

Marking

SPTB3540

Ø4.0/ Ø5.0 SPTB4050

Ø5.0/ Ø6.0 SPTB5060

Mushroom | Scale 2:1

Diameter (D) Length (mm) REF

Ø2.8/ Ø3.8 2/4/5/6/8/10Marking

SMR2838

Ø4.8/ Ø5.8 SMR4858

Hand Driver | Scale 2:1

Type Length (mm) Ref. C

1.2 Hex 10 TCMHDS1200


MICAkitTM

2 4 5 6 8 10

D

Cobra | Scale 1:1

Diameter Length (mm) Ref. C

Ø2.8/ Ø3.8 - SCB401

Spreader & Condenser | Scale 1:1


Ø2.8/ Ø3.82/4/5/6/8/10

MarkingSSC3828

Express Bur | Scale 2:1


Ø2.8

2/4/5/6/8/10Marking

EB28

Ø3.4 EB34

Ø4.2 EB42

Ø4.8 EB48

Ø5.8 EB58

Drill with a Point trephine bur : 2mm at a time until the laser marking is reached.

Adjust the position of the stopper to 1mm lon-ger than the remaining bone height and drill with a Express bur 0.7-1mm smaller in size than the diameter of the fixture.

Graft the harvested bone and alloplastic mate-rial using the Spreader.

Use the Mushroom to lift the membrane through the hole made.

Adjust the stopper of Condenser and press the bone up to desired depth.

Lift membrane using the Cobra.

Insert fixtures into the holes.

Drill with ASBE Trephine bur until 1-2mm of bone is left and break the bone by slightly tilting the bur. Remove the collected bone in the trephine by unscrewing the Mini Screw and rotating the shank.


MICAkitTM

Clinical case 1

Clinical case 2

ASBE Trephine Bur & Express Bur : expand the hole

Express Bur : expand the holeIntra-oral radiograph(Before) Point Trephine Bur : initial drill ASBE Trephine Bur : make a hole

Spreader & Condenser : bone graft

Spreader & Condenser : bone graft

Place a fixture

Place a fixture Intra-oral radiograph(After) Postoperative Panoramic View

Postoperative Intra-oral radiograph

Diagnosis with CT Before surgery Flap reflection

Graft any buccal defect and place a collagen membrane

Primary closure

MILAkitTM [REV.01]

Lateral approach

MILAkitTM

(MegaGen Implant Lateral Approach Kit)

Drill safely with confidence!

p pp )

safely with confidence!


MILAkitTM

Identify the position to drill accurately using Point Trephine bur.

Completely remove the remaining window wall with Express Bur.

Graft autogenous bone collected or alloplastic material.

Use Elevator 001 through the hole to perform the first membrane lift.

Choose Trephine depending on the thickness of the remaining bone and drill again over the hole made by Point Trephine bur.

Close the window wall

Use Elevator 002 to lift the membrane further.

Use Window Opener to fracture and remove the window wall.

Suture

Diameter Length (mm) REF

Ø7.5 0.5 TLSTBU6705

1. Point Trephine Bur | Scale 2:1


Ø7.5 1 TLSTBU6710

Ø7.5 1.5 TLSTBU6715

2. Lateral Trephine Bur | Scale 2:1


Ø7.5 1.7 TLSWO6710

3. Window Opener | Scale 2:1

1

D

7.5

1.7

1

D


MILAkitTM


Ø7.02/4/5/6/8/10

MarkingEB70

4. Express Bur | Scale 2:1


Ø7.0, 3 - TLSME001

2.8 - TLSME002

5. Membrane Elevator | Scale 1:1

1

D

Clinical case

Point Trephine Bur : Initial drillTrephine with 1mm external stopper

Elevator : Lift membrane. Graft : autogenous bone collected or alloplastic material

Window Opener : Remove the wall“Window Opener” to detach window wall

Completely remove the remaining window wall with Express Bur

Previously detached window wall is tapped into the position to prevent soft tissue migra-tion into the sinus bone grafting


MILAkitTM

BonEx kitTM

Thor

03 Best combination for thin ridge

Thor

< Simple >

< Strong >

1. Simple & Strong

Why Thor?

Measurements of vibration wave transmitted to the tips

End of saw

Vibrator

Smart Thor(dmetec Sample)BS01 Tip

PiezoSurgery(Mectron)OT6 Tip

Smart Thor(White)BS01 Tip

PiezonMaster(EMS)SL1 Tip

Smart Thor(Red)

BS01 Tip

PiezoSurgery(Mectron)BS01 Tip

Surgystar(dmetec Sample)BS01 Tip

Surgybone(Silfradent)SAW Tip

Piezotome(Acteon)BS1 Tip

350

300

250

200

150

100

50

0

Devices usedMeasurements of Tip End

Vibration Frequency

Thor 28.18 kHz

Dmetec 28.09 kHz

Mectron 27.14 kHz

EMS 27.94 kHz

Silfradent 28.33 kHz

Acteon 29.88 kHz

FootSwoch free Boost on ErrorFootSwoch Lock Boost off

Only Three buttons! : On & Off, Foot switch, Power Boost

Too many buttons & controllers

Measurement of vibration fre-quency at the end of saw


Thor & BonEx kitTM

6

8

10

4

2. Saw specially Designed Saw for Ridge Splitting

Calibrations to see the depth of cut!: 4, 6, 8 and 10 mm

Extremely Thin: 0.36 mm only!: allows sawing even in extremely thin bone

Saw compatability with other piezo machines

Brand Thickness

Thor 0.36mm

Mectron 0.79mm

EMS 0.56mm

Piezo tome 0.61mm

Company Product

Mectron PiezoSurgery

Silfradent Surgy Bone

ESACRO Surgy Sonic

DIT Sonic Surgeon300

3. Perfect match with AnyRidge Implants

4. Economical

Well tapered, Knife Threads, Narrow Platform make Ridge Splitting more effective!

Only ‘One’ Ridge Splitting Case can cover the cost of a Thor!

AnyRidge, Thinking Man’s Privilege

■Guarantee excelllent initial stability always!

■Less reduction and better preservation of cortical bone

■Wider implant possible than the cortical width

■Strong body and greater surface surface area

The powerful self tapping thread provides incredible initial stability with increased resistance to compressive force while minimizing the generation of shear force.

As the core is narrow & uniform, the implant can be placed into a horizontal bone incision during ridge splitting resulting in better initial stability and less stress to the bone.

AnyRidge macro shape helps maintain more buccal and lingual cortical bone than any other implant system in the market today. The unique shape of the implant with a narrow core and varying thread depths enables wider diameter implants to be placed into narrow ridges.

2 mm osteotomy guidesfixture placement

Sawing with Thor to the depth of implant length

2.3mm

Tapered body works as an Expander!

Narrow platform gives no stress to split cortical bone!

Knife Threads make insertion easier, but have excellent engagement into bone!

0.36mm

2mm


Thor & BonEx kitTM

BonEx kitTMPerfect for the exceptionally difficult cases

Useful in very narrow bone (<2mm)Try before lance drilling and expanders to avoid bone defects due to drillingCan be tapped on the end with a Mallet

Ref. C Diameter Length(mm) Marking line(mm)

TCMBE2813 Ø2.8

13 7 / 8.8 / 10 / 11.5

TCMBE3313 Ø3.3

TCMBE3813 Ø3.8

TCMBE4313 Ø4.3

TCMBE4813 Ø4.8

Handpiece connector

MM

HC2

50U

MM

HC2

50S

Expander

Chisel and Handle

Chisel (TCMSC403)Chisel (TCMSC403)

Ratchet ext.

MTR

D10

0E

MTR

D10

0L

Step- by-step ridge expander can be placed with a handpiece & a ratchet extension matching with the core shape of AnyRidge

Step by step Procedures of Ridge Split Technique

Step 1.Indications

Ridge Splitting techniques may be used in any cases presenting a narrow ridge. Single implant or limited space cases however, offer less room for explansion.

If the narrow ridge consists solely of cortical bone, with no intervening ancellous bone, it will be difficult to achieve a good ridge split.

Caution is also advised in the maxillary anterior as ridge splitting may cause the labial cortical bone to move too labially, resulting in severe angulation of the implant.

Step 2Incision

Incision line is recommended to be at the center of remaining keratinized tissue.

A longer horizontal incision is better to per-mit adequate sawing for ridge splitting. -- one tooth-size more, mesially and distally.

Step 3Flap reflection

Full thickness or Full-to-partial thickness flap is recommended.

If the ridge crest is less than 2 mm, it is advis-able to reduce the crestal bone until the width is at least 2mm.


Thor & BonEx kitTM

Step 5Drilling

Now drill the desired position and axis of implant.

In ridge expansion technique, lance and 2mm drilling is enough in most cases. It’s only to guide the implant path. If a flat-bottomed implant was planned, drilling should be extended to the diameter recommended by the manufacturer.

Step 4-1Chiseling (optional)

If the crest is less than 2 mm, it’s better to expand with a chisel first.

It is to avoid bone defects which can be made with drill-ing on the thin ridge.

Light tapping with a mallet will be enough.

Step 4Sawing

Sawing starts from the center of ridge.

The ridge should be cut at a slightly buccal angulation, because resorption oc-curs on buccal bone. If the lingual bone is too thin after sawing, splitting may occur to the lingual side, making implant position too far lingual.

Thin ridged bone should be cut to the depth of implant length. For example, if the intended implant length is 8.5mm, the incision should be cut to 8.5mm.

In most cases, vertical bone cutting is not necessary when you place AnyRidge implant. Only small offsets at the ends of horizontal bone cutting are enough to guide the direction of ridge expansion, if needed.

Try to maintain lingual bone thicker than buccal to expand thin ridge buccally

Slightly angulated cutting is recommended.

Step 5-1Expanding with BonEx kit (optional)

When the wider inside, slow expansion with BonEx kit is recom-mended.

The Expanders can be engaged easily with bone by a handpiece(50 Ncm). If it stops before the depth of osteotomy, use a hand wrench and a ratchet exten-sion. Same procedure can be repeated with wider diameter of BonEx Expander.

Step 7Bone graft & Membrane

The remaining bone defects can be filled with any kind of bone graft material. Resorbable membrane is recommendable for better bone filling.

Closing flap

One stage or two stage approach can be chosen according to the conditions, but it is recommended to finish several cases with successful result before trying one stage surgical approach.

Adequate periosteal releasing incision is need-ed if primary closure is planned.

Step 8Step 6Implant placement

When the ridge is expanded adequately or has enough flexibility, place the implants.

If you use BonEx Expanders, it’s better to leave an Ex-pander during placement of the first implant to keep the ridge expanded.

Torque force up to 60-70 Ncm will be fine to place an implant.


Thor & BonEx kitTM

Mandibular Posterior

Clinical case

A 79 year-old female patient visited with a chief complaint of chewing difficulty on the mandibular molar area. She had been using a denture for more than 30 years. The ridge stal bone, which needs ridge augmentation. She was physically healthy. Considering her age, the ridge split technic was decided to do.

The ridge width was about 3mm on the crest.

The ridge was splitted with a thin saw only horizontally to the depth of implant length (11.5, 10, 8.5 and 7mm from front to back, respectively), then 2mm lance drilling was done. Compare the drilling site with ridge width.

Preoperative panoramic radiograph

Fixtures were placed with a handpiece which was set on 40 Ncm torque force. Each fixture stopped at the level shown on the pic-ture. Then the fixtures were screwed down with a torque wrench, one full turn on each fixture sequentially.

All the fixtures were placed completely, 1 mm under the crest in con-sideration of bone remodeling. The crestal bone was split enough to make ideal width.


Thor & BonEx kitTM

The gap defect was filled with Mega-Oss allograft and covered with a collagen membrane. Then primary closure was made.

Postoperative panoramic radiograph. The other side was done with same procedure of ridge splitting.

Intraoral radiographs taken at the following procedures. The crestal bone was well maintained with excellent bone regeneration following the ridge split technique.

The healing was uneventful, and the second stage surgery was done with simple incision in 3 months.

6 wks

4.5 mns

4 mns

final restoration

Mandibular PosteriorA 74 year-old female patient visited with chief complaints of denture discomfort and chewing difficulty on the mandible. On the intraoral and radiographic examinations, she showed problems on many teeth, but she wanted to treat edentulous area first. Both mandibular molar area showed thin ridges which needed to be augmented for implant placement.

Preoperative panoramic radiograph and intraoral views.

When the flap was reflected on the right side, the ridge width was less than 3mm. The ridge was saw with a Thor horizontally to the depth of 10 mm.

Only a lance drilling (2mm in diameter) was made on the anterior two implant sites, and 2.9mm drilling was done on the second molar area. Then 4.5 x 10 mm AnyRidge implant were placed for the two molars. The 50Ncm-set handpiece stopped at the level shown at the center picture. Compare the ridge width and the size of AnyRidge fixtures on the right.


Thor & BonEx kitTM

Only a lance drilling (2mm in diameter) was made on the anterior two implant sites, and 2.9mm drilling was done on the second molar area. Then 4.5 x 10 mm AnyRidge implant were placed for the two molars. The 50Ncm-set handpiece stopped at the level shown at the center picture. Compare the ridge width and the size of AnyRidge fixtures on the right.

Small amount of Mega-Oss allograft and collagen membrane were placed to enhance regeneration, and primary closure was made.

Postoperative panoramic radiograph.

The first molar implant was placed. Due to the special structure ofthe AnyRidge Implant system, the cortical bone on the top showed green-stick fracture during placement, but when the implant was placed completely under the crest, the fractured bone came back to the original position.

3 months after the ridge split and implant placement, the second stage surgery was made with simple incision and flap, just by splitting the remaining keratinized tissue into two, despite its being limited. The bone was regenerated excellently.

4mm diameter healing abutments

were connected. Smaller diameter healing abutments are recommend-ed in the case of limited keratinized tissue in order to help preserve the tissue.Final restorations were delivered following routine procedure. All implant prosthetics were made as

single crowns.

At the first follow-up visit after 3 months from final restoration de-livery, the gingival condition had

improved. The patient was very sat-isfied with the result, and wanted to have more implants for other teeth.


Thor & BonEx kitTM

Intraoral radiographs with clinical procedures and follow-up. All the implants were restored as a single crown. The crestal bone showed excellent response at all implants.

1 mn postop

Provisional restorations

6 months after final restorations

4 mns postop- before second stage surgery

Final restorations

Maxillary premolar

A 53 year-old female patient visited with chief complaints of discomfort during chewing on the maxillary left posterior. On the clinical and radiographic examination, the first premolar which was an abutment of three unit bridge revealed subgingival decay under the crown. So it was decided to extract it and place two implants on the premolars.

Upon extraction and flap reflection, the ridge on the second premolar showed thin ridge.

Two 3.5mm implants were placed with excellent stability. During placement, green stick fracture was made on the second premolar area.

Thin ridge was splitted with a Thor, and drillings up to 2.9mm were made.


Thor & BonEx kitTM

Postoperative panoramic radiograph.

Intraoral radiographs showing excellent bone response after ridge split procedure.

Mega-Oss (Allograft) and Bone Plus (Synthetic, BCP) were mixed and grafted around the bone defect, and a collagen membrane was placed following healing abutment connection. Simple interrupted suture was made for close adaptation of flaps.

1 month after surgery

Final restoration

3 months after surgery

1.5 yr after final restoration

Extremely thin mandibular posterior

11.5

10

8.8

7

This patient showed extremely thin ridge on the mandibular posterior. The ridge width was less than one mm on the crest. In a case like this, the alveolar process is mainly composed with cortical bone without cancellous bone inside. It needs careful splitting to prevent total fracture of the cortical plate.

A specially designed Thor’s saw can start splitting even on this narrow ridge without reduction of the sharp edge. The horizontal cut went down to the depth of implant fixture, but no vertical incisions were done.

After 2 mm drilling to guide the path of bone expanders, three expanders from 2.4 to 3.3 were used. The first implant was placed while an expander was in position to keep the expanded ridge.

The Ridge Expander kit was used to expand the thin ridge slowly.


Thor & BonEx kitTM

Four implants were placed completely with excellent initial stability. A green stick fracture was made on the mesial of first premolar.

Mega-Oss allograft was grafted into the bone defects between implants.

Three months after ridge split and implant placement, a simple second stage surgery was made. The alveolar bone around implant was regenerated fabu-lously with enough width. Compare with the initial photo.

Maxillary lateral incisor case

A 52 year-old gentleman wanted to exchange his old PFM bridge on the maxillary anteriors. During treatment, he wanted to place an implant on the missing area of lateral incisor to make single crowns on each teeth.

The ridge was thin due to resorption with a big undercut on the labial plate.

The thin ridge was splitted with a Thor. In this case, due to limited space, a vertical bony cut was made on the mesiolabial margin of canine. The vertical cut was oblique in the bone not to make damage on the root of canine.

A 2mm diameter of drill was used to guide the path of an implant.


Thor & BonEx kitTM

A 3.5x15mm AnyRidge implant was partially inserted into the socket, and the 40Ncm set handpiece stopped the fixture at the level on the right photo.

The implant was completely placed with a hand wrench. During placement, a small green stick fracture was made on the mesial side.

Mega-Oss allograft and a collagen membrane was placed to cover the defect.

Primary closure was made and the healing was uneventful.

Intraoral radiographs taken at 1month after surgery, during impression taking, after final restoration.

Second stage surgery was made with simple 3 corner flap. And final restoration was delivered following routine procedures.

110105 110525 110722

50

Thor & BonEx kitTM

i-GenTM

04 GBR membrane for ideal regeneration

Design Concept

Design Concept

Various height of Healing abutment and Cover screw

should be prepared to allow one or two stage surgical approach according to situation.

>2.5mm horizontal extensionneeded to make >2mm labial bone after remodeling

Lingual Extension should be considered for a large defect

Need to have at least 1mm space above the platform of a fixture

: tempting to make this space with a pre-existing abutment, eg, Flat abutment...

>100°blunt anglewith bevel should be made to avoid soft tissue irritation.

shrinkage will occur after removal of membrane!

should be adapted to the bone.

0.5~1.0mm

Apical skirt

Ideal regeneration line


i-GenTM

How to use

Ideal + Regeneration membrane ⇨ i-Gen membrane

1. Place an implant into the recipient site.

3. selection of i-Gen and placement. According to the size and shape of bone defect, an i-Gen can be chosen from 12 different i-Gens. Match the hole of i-Gen with the screw hole of flat abutment.

2. Connect a flat abutment to the implant and bone grafting. Usually 1 mm cuff height is good enough for vertical space, but 2 or 3 mm cuff height of flat abutment can be chosen according to situation. The amount of graft material should be enough to fill the space between i-Gen and the fixture.

4. Fixate i-Gen with a healing abutment. Choose a healing abutment or cover screw to fix i-Gen membrane depend on the need of one or two stage surgery. And tight adaptation of soft tissue flap is recommended.

maxilla

mandible

Typei-GEN membrane Dimension

CodeSmall Regular Wide PL

(Proximal Length)BW

(Buccal width)BL

(Buccal Length)BD

(Buccal Distance)

Single

A type4 9 11 4.5 IG1W45094 10 11 5.5 IG1W55104 11 11 6.5 IG1W6511

B type5 9 11 4.5 IG2W0918

6.5 11 11 5.5 IG2W11209 13 11 6.5 IG2W1323

C type5 9 11 4.5 IG3W0921

6.5 11 11 5.5 IG3W11259 13 11 6.5 IG3W1328

Multiple D type13 15 15 4 IGM152215 17 16 5 IGM172520 22 17.5 6.5 IGM2229

i-Gen membrane has 12 different size and shapes.

As seen on the figure left, alveolar bone has different widths according to locations. It can be divided into three categories; Anterior(Pink dots), Premolar(Blue dots) and Molar(Green dots). For Anteriors, ‘narrow’ mem-branes can be used, which has 4.5mm buccal horizontal extension from the center of fixture. For Premolars, ‘Regular’ membranes which has 5.5mm buc-cal extension, can be selected. The molar area usually needs wide membrane (6.5mm from fixture center), especially at the immediate placement case with wall defects.

Type A and B membranes are only to cover single wall defects. Type C has a lingual extension to cover lingual wall defect. Type C has a lingual extension to cover lingual wall defect. Type D has no hole for a Flat abutment, so it can be used for ridge augmentation of multiple teeth, Due to the need to fixate the membrane with tags, Type D has 4 small holes at each corner.

Which i-Gen?


i-GenTM

Clinical case

. Mandibular premolar

This 65 year-old male patient visited with a chief complaint of discomfort on #24 during chewing. On the pan-oramic view, large bone defect was observed.

The tooth was extracted and socket was degranulated thoroughly. A 4.5 mm AnyRidge fixture was placed at the center of socket with excellent initial stability.

The combined image of i-Gen, a flat abut-ment and a healing abutment.

A flat abutment, 1 mm cuff height, was connected with the fixture. A 1.6mm hex driver is needed to place a flat abutment, which is included in the kit. Mega-Oss allograft was grafted into the defect.

A healing abutment was connected on the Flat abutment to fix the i-Gen for one stage surgical approach. Watch the horizontal extension of i-Gen.

Simple suture was made to adapt the buccal flap against the healing abutment.

3 months after surgery. Gingival healing was excellent and intraoral radiograph showed considerable increase in radiopacity.

Usually flap opening is not necessary to remove i-Gen, but in this case the flap was elevated to check the bone regeneration. The i-Gen was maintained very stable in the tissue, and it was easily removed with a hemostat.

The defect was filled with healthy regener-ated bone. From the occlusal view, the buc-cal bone has more than 3mm width at the level of implant platform.

Flap was closed with simple suture.

Postoperative panoramic and intraoral radiograph.


i-GenTM

. Maxillary premolar

The first premolar was extracted due to severe periodontitis. Due to the inflam-mation around that tooth, the implant surgery was delayed almost a month.

When the flaps were elevated, there found two dif-ferent bone defects: The first premolar showed large extraction socket defect due to periodontitis, and the second premolar showed quite big undercut on the buccal bone.

Ostetotomy sockets were made. A big fenestration de-fect on twas made he second premolar due to bony undercut.

Two 4 x 13 AnyRidge Xpeed fixtures were placed at thwith excellent initial fixation. Look e defects around both implants.

Flaps were closed with simple interrupted sutures, and panoramic and intraoral radiographs were taken after surgery.

Healing was uneventful for a month. Intraoral radiograph was taken one month later from surgery.

Two regular size i-Gen (Type A) was fixated with healing abutments.

The defects were grafted with the mixture of Mega-Oss(allograft) and Bone Plus (synthetic, BCP)

Two Flat abutmentscuff height, were, 2mm connected due to the irregularity on the crestal bone.


i-GenTM

. Mandibular incisor area

The first premolar was extracted due to severe periodontitis. Due to the inflam-mation around that tooth, the implant surgery was delayed almost a month.

Two fixtures were placed on into both lateral incisors. Due to the ver-tical defect, fixture platforms were positioned about 3 mm above the crest. And again 3mm cuff height Flat abutments were connected to the fix-tures to make more space under the membrane.

Mega-Oss bovine was grafted on the horizontal and vertical defects.

Two narrow Type C i-Gen membranes were positioned and fixated with cover screws. Then a collagen mem-brane was placed at the center of the defect.

Intraoral radiographs taken 1 month after surgery. Find the position of fixture platform, a Flat abutment and i-Gen membrane.

A panoramic radiograph taken immediate after surgery.

Primary closure was made with the periosteal releasing.

Starting package

※ Individual items can be ordered separately to fill up the package.※ Different connections of Flat abutment for Different implant system are available upon special orden. Ask to your sales reps.

Due to the difficulty to recognize the size and shape of bone defects before surgery, it is not easy to order an i-Gen membrane and components on each patient whenever needed.So a starting package which includes everything for i-Gen, should be set at surgery room. And it is strongly recommended to fill up the empty space immediately after surgery for the next case.

22 i-Gen membranes15 Flat abutments (1mm, 2mm, 3mm cuff x 5 each)5 Cover screws10 Healing abutments (2.5 & 3.5 mm height)

i-Gen starting package includes


i-GenTM

Auto-MaxTM

Mega-OssTM

Mega-Oss BovineTM

Mega-TCPTM

Bone PlusTM

MICAkitTM

MILAkitTM

Thor & BonEx kitTM

i-GenTM

Regeneration

Head Office 377-2 Kyochon-Ri, Jain-Myun, Gyeongsan, Gyeongbuk, Korea, 712-852T. +82-53-857-5770 F. +82-53-857-5432 www.imegagen.com

Documents

Regeneration Catalogue