Texas A&M College of Dentistry

Research and Innovations

Academy of Osseointegration honors for Gonzalez

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An idea with roots in oral and maxillofacial surgery has led to decreased patient time in the operating room and an award-winning case study. Teamwork made the recognition a reality.

Dr. Marianela Gonzalez doesn’t think inside the box.

When a patient came to her complaining of loose lower teeth, she found that many of the ones that remained were so mobile that extraction was required. Vertical bone loss was to blame. To prepare the patient to receive dental implants, Gonzalez needed to recreate ample bone in the patient’s mouth.

She was drawn to a product called Sonic Weld membrane. The material, made of poly-D-Lactic acid, can be reabsorbed into the tissue. It’s an enticing alternative to methods that use titanium mesh, which require bone grafts and secondary surgeries to remove the material.

Manufacturer instructions recommended placing the Sonic Weld membranes on the sides of the gums. But the assistant professor and director of the undergraduate oral surgery clinic had another idea.

“I thought, ‘I’m not going to gain enough bone and three-dimensional volume,’ so I went over the ridge and filled it up with Infuse Bone Graft, a protein that helps to create bone,” says Gonzalez. “We got excellent results, and we ultimately placed implants and crowns.”

That was in September 2011. Since then, Gonzalez has repeated the technique on several patients, now at varying stages of the implant process. In all cases, they found that within four to six months, the combination of the adaptable membrane and protein formed bone with more height and width, making it an even more suitable environment for implants.

“It is very difficult to create bone in the mouth,” says Gonzalez. “And in areas where we place implants, a lot of bone is needed. Not only does this technique give the patient new teeth, but we have a better cosmetic result because it results in extra soft tissue and extra bone.”

When the time came to submit posters for the Academy of Osseointegration Case Study Poster Competition, Gonzalez and several department faculty members decided the findings would make for a strong contender.

Dr. Regina Casian, a restorative sciences clinical faculty member, volunteered to travel to Seattle to present the poster during the academy’s annual meeting March 6-8 since Gonzalez was unable to attend. Casian’s husband, Dr. Francisco Curiel, implant fellow in the college’s Center for Maxillofacial Prosthodontics, already had plans to defend another oral surgery poster, so the two fielded questions from some of the 2,000 meeting attendees for several hours.

“At the beginning I wasn’t sure how things would go,” says Casian, a prosthodontist. “I studied the case, but I didn’t know what the questions would be. But as time passed, I began to feel really confident about it.”

The group effort paid off. The case study, titled “One stage three dimensional alveolar reconstruction with BMP-2 and Sonic Weld Membrane,” won first place among 225 submitted posters.

Back at Texas A&M University Baylor College of Dentistry, Gonzalez and department faculty continue to treat patients who will benefit from the procedure. One even begins treatment this week.

“It’s exciting because patients can finally have an alternative,” Gonzalez says. “Instead of going to the operating room and taking bone from the hip, we can recreate bone and be able to place implants, and patients can look natural and have complete function.”

—Jenny Fuentes