NQ Surgical Dentistry Attending the new Giestlich jaw reconstruction Course

Saturday 2 November 2019 was an opportunity for Colin to benefit from the visit to Australia of Professor Paolo Casentini, world-renowned implant surgeon and lecturer, from Milan, Italy.  Dr Casentini works in a multi-disciplinary surgical and reconstruction team in Milan offering reconstruction of jaw bone, associated soft tissues and replacement of lost teeth in patients with bone severe defects in the jaws.

Prof Casentini has been brought to Australia by Geistlich Australia, who provide high quality grafting materials that are used in the orthopaedic and facial reconstruction areas.  Although a Swiss family-owned company based in Wolhusen, Switzerland, Geistlich uses only cow bone harvested from a single herd of South Australia cows for the production of bone grafting materials.  The cows are certified free of infections such as Creutzfeldt-Jakob disease that has been found to affect cows in Europe and elsewhere.  This means such grafting materials are an Australian product and are used worldwide by surgeons.  Geistlich bone graft (Bio-Oss) is the only bone substitute that enables recipients to continue to be blood donors (International Red Cross regulations) after acceptance of a graft.

Geistlich Australia ran an intensive one-day post-graduate course in Sydney for experienced surgical clinicians involved in implant dentistry with a special interest in jawbone reconstruction in support of the rehabilitation of patients following severe jaw infections, bone destruction and loss of teeth.

Dr Colin Priestland has been involved in this field now for over 20 years and is a senior lecturer at the James Cook University Medical and Dental School providing the postgraduate Diploma in Clinical Dentistry in Dental Implants.

Professor, Dr Paolo Casentini from Milan, Italy, provided a full day of postgraduate education entitled “Prosthetically Guided Regeneration”.  The day was made up of lectures, superbly illustrated by high quality clinical photography and clinical videos of surgical procedures from multiple challenging clinical cases of severe hard and soft tissue deficiencies in both the jaws.

Case studies allowed for case discussions and assessment followed by comparison of all potential treatment options leading to a final treatment plan.  Full case reconstructive planning followed by production of laboratory manufactured removable radiopaque templates that are then used to assist in planning.  Templates are used for 3-dimensional imaging.  Such imaging is available here in NQ Surgical Dentistry and allows Dr Colin Priestland  to accurately pre-plan surgery to ensure a high degree of predictability and success when replacing lost bone and soft tissues in the jaws.

The course focused on the use of a variety of products from Geistlich including Bio-Oss bone grafting material, BioGide collagen membranes and other collagen-based grafting materials including Bio-Oss Collagen Block and Mucograft.  In particular, the new YXOSS Customised Bone Regeneration (CBR) Titanium mesh template, was thoroughly discussed and it’s use practiced on models.  This new technique is now available in Australia.  It offers surgeons an additional, reliable and accurate treatment option that adds to their armamentarium to regrow bone in severe bone defects that will ultimately support osseo-integrated dental Titanium implants that will support the new teeth as part of patient rehabilitation and reconstruction.

YXOSS CBR is a custom-made, patient-specific, titanium mesh, computer-designed and manufactured for use with a combination of the patient’s own bone chips (called autogenous bone) mixed with Bio-Oss graft material to reliably reconstruct the bone to a pre-planned size and contour.  The technique is minimally invasive and generally does not require additional surgery at a second site to harvest bone.

To obtain the YXOSS CBR custom device, the patient’s cone beam volumetric tomography scan data is transferred to the manufacturer to enable them to produce the device and this is then sent to Dr Colin Priestland.

Dr Colin Priestland has been using Geistlich Bio-Oss bone graft and Bio-Gide collagen membranes for many years along with newer products like Mucograft for the surgical enhancement of the soft tissues.  These products are the result of many years of research and development on bone and connective tissue regeneration technology that takes place in Wolhusen, Switzerland in their research and development laboratories.

Soft tissue surgical enhancement techniques were discussed extensively including the use of the patient’s own sub-epithelial connective tissue autograft that can be obtained from either the palate or the posterior zone of the upper jaw.  These autograft tissues remain the gold standard for the thickening of the soft tissues to allow surgeons to improve the soft tissue quality and quantity, increasing tissue thickness and resistance to inflammatory damage.   Being the patient’s own tissue, the quantity available for harvesting can be very limited and therefore synthetic alternatives have been developed to improve patient care and clinical outcomes.

It was an intensive day offering background science and hands-on practical training to enable those with extensive surgical experience in bone grafting surgery to offer this new, reliable and less invasive surgical protocol for the benefit of Australian patients.

This treatment is available here in Townsville.  It was a brilliant day and well worth the time taken to travel to Sydney for this training.  Thank you Geistlich Australia Team and thank you Professor Paolo Casentini.