Changing the understanding of the very nature of implant healing
Dr. Nelson Pinto presented “Guidelines for the Use of Autologous Platelet Concentrate Technologies in Tissue Regeneration: L-PRF Workshop” during the 2017 AAID meeting in San Francisco. Pinto is the founder and chairman of the Research Center for Tissue Engineering and Regenerative Medicine in Concepcion, Chile, where for the past 30 years, he has maintained an active private practice specializing in advanced oral implantology.
Pinto is a professor at the Universidad de Los Andes, Chile, Post-Graduate School of Periodontics and Implantology and a visiting professor at the Department of Oral Health Sciences and Periodontology, University Hospitals Catholic University, Belgium. He is a world leading expert in L-PRF, soft- and hard-tissue regeneration and wound healing.
In the past few months, he has spoken at various conferences around the world, including at the AO (United States), EAO (Sweden), SEPA (Spain), Gordon Conferences (New London) the ITI Annual Meeting (Valencia) and at events in Singapore, Taiwan, Italy, Switzerland, Belgium, Portugal, United Kingdom, Japan, Iran, Nepal, Costa Rica, Argentina and Chile.
Pinto sat down with Dental Tribune to discuss his thoughts on being a presenter at the AAID:
“I believe it’s been almost five years since I first addressed the academy and presented a workshop encompassing L-PRF. When I appeared before the body at that time, I was presenting not only our recent findings on the clinical and scientific significance of L-PRF but also on a subject I called ‘The Floating Implant.’
“This subject started with a clinical observation I made almost five years earlier. I had placed an implant into a large defect totally surrounded by L-PRF more as a space maintainer than anything else. Due to the size of the defect, I could not achieve initial stabilization of the implant in the bone. I fully expected that I would be removing the implant three weeks later at the patient’s next visit and simply adding additional L-PRF. To my surprise, the implant was stable when she returned. But how could this be?
“I knew my initial observations would be met with great skepticism. As a matter of fact, I was perhaps the greatest skeptic of all. This clinical experience was counter to everything I had been taught and everything, up to that point, that I had experienced. An implant must be stabilized in bone for any osseointegration to occur. This was established doctrine.
“I began reasoning that if a dental implant with an osteoinductive surface was surrounded by a blood supply containing L-PRF, bone should naturally grow not only from the defect wall but also from the implant surface. Such an implant may not necessarily need to be touching bone at the time of placement for healing to occur.
“I knew the remarkable results we were experiencing clinically with L-PRF, and I was aware of the scientific publications describing the implant’s surface as osteoinductive. I had been using Intra-Lock BLOSSOM implants with this surface in my practice for many years and observing first-hand remarkable bone healing starting from the first day of placement.
“This surface, called OSSEAN, was well-documented in the literature as displaying the potential to boost osteoblastic cell behavior by up-regulating the gene expression. Its nano-rough structure was ideal for fibrin attachment. It just stood to reason that if an OSSEAN surface implant was surrounded with L-PRF, even in a large defect with only L-PRF to stabilize it, I may have a functional implant ready for restoration within a relatively short healing period.
“The synergistic effect of these two healing catalysts should not be underestimated and well may explain my initial observations.
“Almost 10 years ago that clinical case started a path that changed my understanding of the very nature of implant healing.
“We now have well-documented scientific evidence and clinical experience that demonstrates, when utilized together, the synergy of L-PRF and OSSEAN provide a superior pathway for osteogenic cell migration not previously encountered in implant dentistry.
“Just before arriving at the AAID this year, I had been presenting these findings at venues throughout the world. I’m honored, as I was when at first presented at the AAID Annual Conference five years ago and each meeting since, to share this with the academy this year.”