Our doctor, Srdjan Cvejanović, has attended an international implantology and oral surgery congress hosted by dr Istvan Urban with the central theme of “sausage technique”.
Our region is becoming one of Europe’s centres in the field of innovative implantology techniques, the one most deserving of credit being Dr Istvan Urban, whose sausage technique has emerged as the most effective solution for jaw bone regeneration in this decade. On 27th and 28th October 2018, a team gathered around this renowned Hungarian expert organized the 1st Urban International Hard and Soft Tissue Regeneration Symposium to discuss the hard and soft tissue regeneration and to showcase the most recent accomplishments in the field of bone and soft tissue regeneration.
The symposium participants were by and large oral surgeons and implantologists who wished to start using the sausage technique, and Cvejanović Clinic is among the first in Europe to utilize it, as early as 2013 (the technique was in its experimental stage until 2012). Aside from Dr Urban, other well-known implant experts working on the technique also attended – Craig Mitch, Michael A. Pikos, Giovanni Zucchelli, Hom-Lay Wang and José Carlos Martins da Rosa, who have shared their recent experiences and organized workshops and demonstrations.
What is the “sausage technique”?
Many patients, especially the elderly ones, do not possess enough volume and quality of bone tissue to be able to render a placed implant immobile. In the last couple of years, the use of remote bone grafting technique, using for example the patient’s hip or rib bone tissue for jaw bone grafting, has been in decline. What has become more prevalent instead is the use of mesh material composed of artificial bone graft and the patient’s bone graft, resulting in a completely bio-compatible substrate. What’s more important, this mesh is finely granulated, which facilitates the permeation of blood vessels as opposed to using graft blocks. It has been indicated that a good permeation of blood vessels in the wound is very important for new bone formation and its buildup, since all the cells are carried by blood.
Sausage technique differs from other techniques in the way it applies bone tissue on the jaw and the way it forms the composite of artificial bone graft and the patient’s bone graft. The membrane, which is semi-permeable and does not allow the soft tissue to pass through, but allows the interaction with the patient’s native bone and artificial bone through blood, forms a kind of sausage and is fastened by mini-tacks to the jaw bone. We do not use the bone tissue from thigh or arm, but from the oral cavity, since only a little quantity is needed to form the mesh. The artificial bone graft is obtained from granules, which turned out to be a much better approach than to use graft blocks. In this way, not only the width, but also the height of the bone is increased, which contributes to a more successful implant placement.
Importance of soft tissue
One interesting detail regarding recent implantology practice is how important the soft tissue around the implant is. It was formerly considered that the only important thing is to have at least 2mm of bone around the implant. However, now we know that to have complete success, alongside the bone, we need at least 3mm thick soft tissue as well, which is why we set to work on soft tissue regeneration during or after the artificial bone placement, and which is exactly why it is incorporated in the name of this Budapest held symposium. In this way, in addition to a better quality bone graft, the implant is firmly immobilized, which guarantees long-term stability of the implant and a better quality of life for the patient.
At Cvejanović Clinic, we perform sausage technique bone grafting, which is the specialty of Dr Srdjan Cvejanović, a leading expert in the field of sausage technique. The procedure is fast and painless, unlike other artificial bone grafting treatments, which are quite invasive, and the grafting itself is done under local anesthetics.