Excellent Bones Make Excellent Smiles
Using a digital workflow to fit the individual anatomy of each patient, Yxoss CBR has revolutionized the use of titanium mesh in complex bone augmentation procedures
Vince Lombardi famously said, “If we chase perfection, we can catch excellence.” In the pursuit of perfect smiles, Dr. Virgilio Gutierrez believes he is
catching dental excellence. Just ask him.
“When it comes to my practice and my patients, we don’t compromise. We strive to deliver excellence,” said Dr. Gutierrez, general practitioner and owner of The Smile Artisans in Cypress, TX. “Compromise is expensive; peace of mind is priceless.”
Coming from that point of view, it was natural to build an end-to-end digital dentistry workflow, he said. “Patients in our practice have always enjoyed a truly digital workflow that includes full-arch guided implant surgery, in-house ortho aligners via 3D printing and manufacturing, all the way to in-house CAD/CAM prosthetic and restorative solutions.”
So, when Geistlich Biomaterials introduced Yxoss CBR, a titanium mesh that could be custom 3D-printed to the specific needs of each patient for guided bone regeneration, Dr. Gutierrez was quick to adopt it into his practice.
“We wanted to facilitate our GBR surgical protocol to bring more predictability and streamline our procedures to keep our focus where it matters: consistent results and excellent patient care.”
- Dr. Virgilio Gutierrez
Titanium Scaffold to Guide Bone Regeneration
A ground-breaking product, Yxoss CBR—manufactured by ReOss—is a customized 3D-printed titanium scaffold that, when combined with bone regeneration materials such as Geistlich Bio-Oss and Geistlich Bio-Gide, can regenerate complex alveolar bone defects to support implant abutments.
Powered by CAD/CAM technology, Yxoss CBR can be customized to satisfy patient-specific requirements for a planned bone augmentation. A contoured, form-stable scaffold is 3D printed of pure titanium based on CT or CBCT images, allowing customized bone regeneration (CBR). Yxoss CBR has the potential to revolutionize oral bone augmentation by customizing the commonly used titanium mesh using a digital workflow to fit the individual anatomy of each patient.
The Yxoss CBR scaffold can also be used as a surgical guide for implant placement by ordering the prosthetic positioning with the 3D design. The digital proposal for the digital 3D design will have the opening integrated in the Yxoss CBR scaffold for future positioning of the implant pilot drill. After approving the design, the clinician receives the Yxoss CBR Backward scaffold for sterilization and implantation.
Staff Adoption Is Key to Success
“The idea of introducing this technology into our practice was simple,” said Dr. Gutierrez. “We wanted to facilitate our GBR surgical protocol to bring more predictability and streamline our procedures to keep our focus where it matters: consistent results and excellent patient care.”
And it was easy, too, because he already had an all-digital process. “Our team at Smile Artisans is well versed in high-tech dentistry. We have a phenomenal digital workflow that plays a huge part in our everyday dentistry, so it was quite easy for our team to integrate Yxoss to our practice.” There was not much to the learning curve, according to Dr. Gutierrez. “The Yxoss CBR platform lends itself to submit case files and instructions with ease. Communication between the planning center was great, and the planning/modifications were done in a very timely manner, usually by the next day. “
However, as with any new technology, the successful adoption of Yxoss hinged on whether it would be embraced by the entire team, he said. For other clinicians considering this technology, Dr. Gutierrez offered a few tips on encouraging staff adoption:
• Lead by example. “Spend time to explain to your staff how bringing Yxoss can be great for both the patient and your practice.”
• Lower the stress level. “Use of Yxoss minimizes some stress during GBR procedures, contributing to a more enjoyable work environment.”
• Bring value through clinical surgical excellence. “Technology like Yxoss that brings a higher sense of control in GBR surgery is, in my experience, worth every dollar.”
Minimizing Complications, Maximizing Success
Guided bone regeneration (GBR) always carries the risk of complications, Dr. Gutierrez acknowledged. “Good GBR surgical technique and principles together with a sterile environment and post-op care always help in minimizing complications,” he said.
“Complications can arise during and/or after procedures. Planning and designing the ideal 3D shape of the printed titanium Yxoss in order to adapt to most osseous defects helps bring forth a blueprint of the surgery, from flap design to the desired bone needed, as well as where the anchoring fixation devices will be placed. All these steps inevitably play a part in avoiding issues that can lead to complications.”
According to Geistlich, when planning an implant procedure, the implant should always be inserted at the prosthetically correct position. If a bone deficit or defect is in this location, Yxoss CBR can be used as a space holder during bone regeneration similar to a furring construct. This may be the case for immediate or delayed augmentation in extraction alveoli, for a larger reconstruction of the alveolar process, or generally to fill other maxillofacial defects.
Geistlich also notes that the titanium mesh cannot be reused, because it is individually produced for single use.
Unlike other titanium meshes that require chairside contouring real-time during surgery, Yxoss CBR is designed on screen and 3D printed to fit the patient. And like all non-resorbable scaffolding, Yxoss CBR is designed to be removed upon implant placement. Titanium mesh does not replace a resorbable membrane—it should be used in combination with a collagen membrane such as Geistlich Bio-Gide to hold the biomaterials in place during healing.
At the end of the day, Dr. Gutierrez said, it still comes down to excellence.
“To those looking to simplify their GBR protocol and minimize surgical time while offering results and ease of use, my advice is: adopt this technology,” he said. With a smile, of course.
To learn more about Geistlich and the Yxoss CBR, click here.
