Journal of Oral Implantology February 2013 - (Page 69)
CLINICAL
The Bis-Acryl Stent
Dennis Flanagan, DDS*
When placing dental implants, there may be a surgical flap to reposition. The flap can be sutured or held in
place with a stent that protects the flap and maintains its position and immobility. Use of a bis-acryl stent may
be preferable to sutures or other materials in many cases. Bis-acryl is easily applied from an auto-mixing gun.
Stents may be preferable to sutures in that there is no ‘‘wicking effect,’’ where bacteria colonize the suture
beneath the healing surgical wound. Additionally, many times there is no submucosa to suture to, and the sides
of the wound may not allow appropriate flap positioning and immobility with sutures. In these situations an
acryl stent may be placed for easy and proper flap positioning and healing.
Key Words: tissue immobility, surgical flap, apically positioned flap, dental implant, healing
INTRODUCTION
A
dental implant surgical flap may need
to be repositioned appropriately and
fixed into place to cover a surgical site
or augment the zone of attached
gingiva. This can be done with sutures,
a stent, or both. Stents were first used in oral
surgery by a 19th-century London dentist, Charles T.
Stent (1807–1885).1 He used a custom-made
‘‘improved’’ gutta-percha molded material dressing
to guide oral surgical wound healing. The eponymous term ‘‘stent’’ was then used by plastic
surgeons in the 20th century. The term has been
used to describe a device that guides, supports, or
maintains healing tissue.2,3 Recently, the term has
been used to describe a device that maintains
patency of an artery or ureter or other anatomical
conveyer. Contemporary stents are made from a
multitude of materials. A stent is not a surgical
template or guide.
Stents can be made of several different kinds of
materials and are produced by different manufacturers (Barricaid, Dentsply, Milford, Del; Coe-Pak,
Coe Pak GC America, Alsip, Ill). Periodontal pack
dressing can be a stent. A stent protects and
immobilizes the postsurgical site and enhances
keratinized tissue formation. The increased zone of
keratinized tissue makes for a functional implant
Private practice, Willimantic, Conn.
* Corresponding author, e-mail: dffdds@comcast.net
DOI: 10.1563/AAID-JOI-D-11-00129
outcome. A bis-acryl stent can be made immediately and easily to fixate a surgical flap as described
herein.
MATERIALS
AND
METHODS
A fast and easy technique to create a stent is to
use an auto-mix gun to prepare a fast-set
provisional bis-acryl that sets in 2 minutes (Figure
1). First, the end of the mixing tip is cut off with
crown and bridge scissors at the point where the
mixing-spiral terminates, about 10 mm from the
tip end (Figure 2). The cut tip is then compressed
by the scissors or with a needle holder, creating a
slot opening that causes the bis-acryl to be
expressed as a thick ribbon. The bis-acryl is
automatically combined in the auto-mix gun and
expressed as a heavy, very soft, very viscous
material that sets in 2 minutes.
Before the acryl is placed, the wound flap is
positioned appropriately for proper healing to
maximize the creation of the most keratinized
tissue or provide optimum site coverage (Figures
3 and 4). The surgical flap may need to be
compressed against the submucosa or bone with
a surgical sponge for 1–5 minutes to ensure its
immobility and proper position during the placement of the stent.
The cut mixing tip is directed at the distal-most
area of the surgical site. The gun handle is squeezed
to express the automatically mixed bis-acryl to the
tip. The bis-acryl is expressed from the tip and
Journal of Oral Implantology
69
Table of Contents for the Digital Edition of Journal of Oral Implantology February 2013
Could the Fountain of Youth Be All in Your Bones?
Vertical Bone Augmentation With Simultaneous Implant Placement Using Particulate
Evaluation of the Bone Healing Process Utilizing Platelet-Rich Plasma Activated by Thrombin
Effect of Model Parameters on Finite Element Analysis of Micromotions in Implant Dentistry
Peri-Implant Defect Augmentation With Autogenous Bone: A Study in Beagle Dogs
Would Nitric Oxide be an Effective Marker for Earlier Stages of Peri-Implant Disease? An
The Effect of Different Surface Treatments on Cement-Retained Implant-Supported
Effect of Rotating Osteotomes on Primary Implant Stability—An In Vitro Investigation
Horizontal Augmentation Through the Ridge-Split Procedure: A Predictable Surgical
The Bis-Acryl Stent
Clinical, Histological, and Histomorphometrical Analysis of Maxillary Sinus Augmentation
A Technique to Salvage a Single Implant-Supported Fixed Dental Prosthesis Having a
Ridge Expansion and Immediate Placement With Piezosurgery and Screw Expanders in
Pterygoid Implants for Maxillofacial Rehabilitation of a Patient With a Bilateral Maxillectomy
Technology in Maxillary Premolar Region: A New Strategy for Soft Tissue Management
Fracture of Anterior Iliac Crest Following Bone Graft Harvest in an Anorexic Patient: Case
A Technique for Constructing a New Maxillary Overdenture to a Nonretrievable Implant
Edentulous Maxillary Arch Fixed Implant Rehabilitation Using a Hybrid Prosthesis Made of
Journal of Oral Implantology February 2013
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