“What do you need to change in your surgical procedures in order to avoid the oxidative stress? Almost everything!”
The oxidative stress is a cell aggression generated by an accumulation of free radicals also named oxidants. The biological reaction of cells is to produce antioxidants in order to neutralize these oxidants.
The main factors of high oxidation level are : ischemia, inflammation and biologic situations where the body is unable to produce enough antioxidants as smoking, diabetes, hypercholesterolemia, deficiency in vitamin D, etc..
The healing of oral rehabilitation by implants and bone grafts depends on the quality of the new vascularization.
However, the long term stability requires the maintenance of the blood supply and a good biologic behaviour in the reconstructed area during the whole life.
This lecture will present all the factors of chronic oxidation and the solutions to avoid the oxidative stress and to maintain the blood supply:
- Biological factors as vit. D and cholesterol have to be checked before the surgery, in order to reduce the oxidation and to increase the antioxidants production.
- The choice of biomaterials: the compatibility is not the same for all biomaterials. The ranking is very clear and scientifically established.
- The management of the flaps is one the main factor of the tissues maintenance. Too much tension creates excessive oxidation : the soft brushing technique is a new technique to increase the flap laxity without periosteal incision nor bleeding. A specific protocol of sutures will also avoid the tension coming from the vestibule in the margins.
- The implant placement has to be done with an adapted insertion torque, according the bone density, specially after bone grafting.
- The sticky bone (A-PRF) and the use of stem cells from the blood (i-PRF) injected before the surgery are a new solution to reduce the ischemia of the flaps and to improve angiogenesis in the bone graft after the surgery
- The reduction of the pressure applied by the flaps during procedures of bone augmentation is a key factor of success in bone augmentation.
All these procedures will allow the surgeons to achieve the long term stability of the bone grafts and implants.
CV Joseph Choukroun
Date of Birth: 5 Novembre 1952,
Diploma: Medicine 1979. University of Montpellier, France
Anestesiology 1981. University de Montpellier, France)
Study of Management of Pain 1986. University of Strasbourg, France
Chief of Staff: Private Pain Therapy Center. 49 Rue Gioffredo, 06000, Nice, FRANCE
Inventor of the PRF® technique. “Platelet Rich Fibrin” (autologus platelet growths factors) 2000
President of the Syfac congress : International Symposium on Growth Factors www.syfac.com