Human Resource Management - Its Impact on ... - Dental Asia

USERREPORTby Drs Steffen Kistler • Georg Bayer • Frank KistlerThe Beauty ofTutogen MembraneImplantWithout the use of membranes in bone tissue regenerationduring the last 20 years, the advance in oral implantologywould not have been possible. The introduction ofresorbable membranes has facilitated the surgical handlingand significantly reduced the risk of complication in suchprocedures.Figure 1 Case 1 – situation prior to implantation,with temporary crownThe Tutodent ® membrane, already used in orthopaedic surgery for a longtime, became available in the dental sector in the year 2000. Thismembrane, based on bovine pericardium, is manufactured by theTutoplast ® process, which differs in certain aspects from the othermanufacturing processes commonly used nowadays. This process maintains theextracellular matrix of the connective and supporting tissues, which alters theproperties of the membrane in comparison with other products, without affectingits safety with respect to pathogen transmission and antigenic reaction.The membrane has been used in our practice since 2000, in all areas of bone andsoft tissue regeneration; the main application is in bone augmentation before orduring implantation. For the user, the first feature that distinguishes the Tutodent ®membrane from other similar products is its availability in different sizes, includingmembranes with large surface areas, so that extensive defects can also besecurely covered with a single membrane.Figure 2 During operation, without temporarycrown, tissue defect easily recognisableThe surgical handling of the Tutodent ® membrane is not significantly different fromthe other collagen-based membranes on offer; it is resistant to tearing, has tensilestrength and is very adaptable when moist. In our practice, when used to coverbone reconstruction material, the membrane is usually fixed with nails asrecommended by the manufacturer. This brings a further advantage of themembrane into play: its somewhat coarse consistency also prevents too-rapidrestructuring of thematerial even whenit is in tension –something that isknown to reduceconsiderably thedegradation time ofa resorbablemembrane.Figure 3 Creation of the implant bedWe often use themembrane indouble thickness,taking advantage ofFigure 4 Insertion of a root-form implant48 Dental Asia • March / April 2008