One of the attractions of the EFP’s Perio Master Clinic 2020, which takes place in Dublin in March, will be the presentation by Hungarian periodontist Istvan Urban about the latest developments in vertical augmentation.
Speaking in the session on ridge augmentation (Saturday March 7, 9.45-11.30), Dr Urban will discuss the challenges of vertical augmentation and recent developments in this field.
Outlining his presentation, he says that there are two main challenges: “One is a technical challenge, because the soft tissue has to be advanced to provide a closed healing environment for the increased dimension of the healing bone graft – and this requires meticulous surgery.”
The second challenge is a biological one, “because regeneration and angiogenesis need to reach a certain distance from the existing bone.”
Turning to recent developments in vertical augmentation, he highlights the fact that we are now able to reduce invasiveness using certain graft material and “more gentle surgical techniques.”
Today, the main challenge is represented by “extreme vertical atrophy”, which is usually caused by untreated peri-implantitis.
GBR – less invasive and very reliable
In terms of the techniques used for vertical ridge augmentation, Urban notes that guided bone regeneration (GBR) is the most commonly used technique and is popular because “it is less invasive than traditional block applications and because it is very reliable.” Nonetheless, block applications are still being used successfully.
While the main advantage of guided bone regeneration is its reduced invasiveness compared to other techniques, it does have several disadvantages, which Dr Urban explains are “the multiple materials required, the extended healing time, and the expense of the treatment.”
He says that his personal practice in this field has evolved in three ways: “First, the surgical technique was developed to be much gentler. Second was the successful application of resorbable membranes in severe horizontal atrophies. The third involves the aftermath, which is the soft-tissue reconstruction after ridge augmentation – in particular, vestibular extension surgery using minimally invasive surgery.”
Looking at the whole programme for Perio Master Clinic 2020, which is devoted to the current and future challenges in soft- and hard-tissue reconstructions around teeth and implants, he says “it is a great programme and I am really looking forward to participating.”
Perio Master Clinic 2020 takes place on Friday, March 6 and Saturday, March 7 at the Royal Dublin Society. A series of related hands-on workshops takes place on Thursday, March 5.
Istvan Urban received his DMD degree and subsequently his MD degree from Semmelweis University School of Medicine and Dentistry (Budapest, Hungary) in 1991 and 1996. He completed a full-time programme in oral surgery at St. Istvan Hospital in Budapest (1992-1996) and completed his internship programme in periodontics at the University of California Los Angeles (USA). After graduating from the Fellowship Programme (1999-2000) in implant dentistry at Loma Linda University in Loma Linda, California, he was appointed assistant professor the following year. Dr. Urban teaches implant dentistry in the graduate programme at Loma Linda University, is licensed in the state of California, and has a private practice in Budapest.
Dr Urban received his PhD degree in periodontology in 2012 at the University of Szeged, Hungary and is an honorary professor at the University of Szeged. A board member of the Osteology Foundation, Dr Urban has published scientific articles and text-book chapters on bone regeneration and soft-tissue reconstructive surgery around dental implants. Recently, Dr. Urban has become an adjunct clinical associate professor at the Department of Periodontology and Oral Medicine at the University of Michigan (USA). He is the author of the textbook Vertical and Horizontal Augmentation, published by Quintessence.