Lamina and umbrella techniques in the highly atrophic jaw: The importance of osteoimmunology

In this webinar, Prof. Wainwright highlights the clinical application of lamina soft and lamina hard in cases of severe bone loss. When is it more favorable to use the soft lamina, and when the hard one? When is the Umbrella technique applicable in combination with the soft lamina? In addition, he will explain how to manage lamina exposure, as well as the necessity to precondition the patient to avoid failures.

The challenge of 3D bone grafting, especially including vertical dimensions, is defined as one of the most challenging surgical procedures in oral surgery. In this webinar, the author describes his decisions regarding when to use the soft lamina and when to use the hard lamina. Conditioning of the soft tissue is crucial for success in achieving tension-free primary closure of the defect. The author presents simple and less traumatic techniques to expand the periosteum prior to wound closure. The umbrella technique, used to maintain a stable gap while using the soft lamina, is also described in this webinar. Another topic of this webinar is the preconditioning of the patient prior to bone augmentative surgery. Not every patient is at the same immunological level, and the field of osteo-immunology has become more important in recent years, since RCTs have revealed a link between patient conditioning regarding vitamin and LDL status, which might have a great impact on the success or failure of bone grafting procedures. Based on studies and clinical application, the author describes what should be monitored and regulated to improve the patient’s condition, reduce oxidative stress, bone resorption, and fibrosis.