Alloderm For Dental Implant Applications?

Dr. G asks:

PurosI have been using Puros Allograft, from Zimmer Dental, for soft tissue augmentation. I’ve had mixed results and I would like to switch to Alloderm, from Lifecell, but I have not been able to find peer-reviewed articles establishing the efficacy of using Alloderm for dental implant placement. Do you have any experience with Alloderm with implant placement? How does it compare to Puros?

Editor’s Note:

About Puros:

“The Puros family of bone grafting products provides an effective and predictable clinical outcome for patients requiring bony enhancement of the mandible and maxilla in a timely manner. The patented Tutoplast┬« process gently removes unwanted material such as fats, cells, antigens, and inactivates pathogens, while preserving the valuable minerals and collagen matrix, leading to complete and rapid bone regeneration. Puros allografts are used in clinical situations where a human allograft is appropriate, such as dental bone grafting procedures, sinus grafting or in conjunction with dental implant procedures. ” More at ZimmerDental.com

About Alloderm:

“AlloDerm is an acellular dermal matrix derived from donated human skin tissue supplied by US AATB-compliant tissue banks… Since AlloDerm is regarded as minimally processed and not significantly changed in structure from the natural material, the FDA has classified it as banked human tissue. When AlloDerm is prepared, the human donor tissue undergoes a multi-step proprietary process that removes both the epidermis and the cells that can lead to tissue rejection and graft failure, without damaging the matrix…The processed tissue matrix is preserved with a patented freeze-drying process that prevents damaging ice crystals from forming. ” More at LifeCell.com

13 thoughts on “Alloderm For Dental Implant Applications?

  1. I have used both for a long time but are trying to compare apples and oranges….
    In short Puros is a bone filler and alloderm is a dermal substitute that works great to increase your gingiva when you have lack of it but there would be no way to switch from one to another as you hope to…

  2. Apparently the editor may have mislead the discussion. Zimmer Dental makes PUROS products. The PUROS branding only indicates that the product has undergone their Tutplast process to clean and sterilize their allograft materials. PUROS does not designate a hard or soft tissue branding. PUROS bone and PUROS dermis are available, both allografts.

    Dr. G is likely talking about the dermis allograft not the bone products, since soft tissue regeneration is the topic of his question. Most do not know about their dermis products since Alloderm has more market share.

    Their bone products work well, but I have little experience with allografts such as alloderm or puros dermis, and certainly not enough cases to compare the two. Obviously if you feel PUROS dermis is not what you expect, try Alloderm and see if it improves your restuls. I prefer to use autografts instead.

  3. I’ve used Alloderm for several years after taking Dr. Callan’s course and have been generally pleased with the results. As with any product, it has its shortcomings. If left exposed to the oral environment, it discolors and tends to taste bad as well as produce some degree of malodor. A few times, the overlying flap has sloughed, leaving most of the Alloderm exposed. This is a concern when it is used for root coverage, as with Dr. Pat Allen’s technique. It does produce a good dimension of thick connective tissue, though. I’ve not had it slough when used with implants, luckily. There is a thinner version of Alloderm, Alloderm GBR, which is easier to hide under a flap. Since I apparently am quite susceptible to the pitches of attractive product reps, we have purchased some of the Zimmer dermis to use, but I haven’t used it yet. What did you not like about it?

  4. To periodoc:

    I just got back from Dr. Callan’s course, and he is no longer using Alloderm…that is if he doesn’t have to. He is now use a pure resorbable collagen membrane from a company called Tissue Specialists.com

    They have a resorbable collagen membrane that is well priced and gets GREAT results! Call the number and ask for Chad. He is a great resource and the pwner of the company. He will let you know what is best for your specific situations.

    Also if you haven’t been to Dr. Callan’s course in awhile, then you might not know that he has improved his technique and using different materials. Again Chad at Tissue Specialists knows everything that Callan is using.

  5. I am hearing from Peers that the new bone level implant from Strauman is failing. Is this true? Any comments from Doctors only.

  6. I have a couple of comments about both the Zimmer Dermis material and the last post about Straumann Bone Level implants. First the Dermis. I did my Master’s thesis on Alloderm so i have used it extensively. For the past couple of years i have used exclusively Zimmer Dermis. The reasons are simple. There is a much better handling characteristic as well as thicker tissue and fewer post-operative problems.

    The alloderm product has more of an antigenic response than the dermis, so any small part that gets exposed, if that even happens, more rapidly covers and does not slough. It is much more stable tissue. I use it extensively around teeth as well as implants, or with bone augmentation procedures.

    The comment about Dr. Callan switching to a collagen membrane is just that collagen membranes are great for ridge augmentation type procedures. However, they typically don’t hold up as well to connective tissue type procedures where you want tissue to remain for decades, not months.

    The failure’s of Straumann Bone Level implants are the same as normal implants. There is no additional failure because of the design. I think there is more operator error with them because they are new and people are used to not doing bone level procedures with Straumann. Give it time and they’ll fix it. The surface of the implant is perfect.

  7. Hello
    Please i need to know if this company carries many compatible components for several dental implant lines .If not please help me to find another company.
    Please answer via email.
    sincerly

  8. Alloderm is very well researched and has been used extensively in medical surgery and plastic surgery applications for some 15 years. If you understand how to use Alloderm, as it has no cells or blood supply, you and thousands of other clinicians all over the world will have outstanding results for root coverage and several other tissue augmentation procedures.

    Puros Dermis has not a single study. One excerpt from a brazilian dog study that where a collagan membrane was used. Due to the processing and irradiation of the tissue it breaks down the collagen matrix just enough that it actually promotes scar like tissue often as opposed to the intrinsic healing process that you would like to see in tissue regeneration procedures.

    The superier Allograft is Alloderm

  9. I’ve been using Alloderm GBR for a while now to try to do free gingival grafts in the lower anterior and premolar areas. I read in the little pamphlet that comes with the LifeCell product that you want to create a “pouch” without vertical releasing incisions so as not to compromise blood supply. So I thought that inserting the membrane and then closing the (mostly) mucous gum tissue back over it would be a good way to protect it from the oral environment. I also put green occlusal wax with HistoAcryl and Barricade over the site.

    But, in 6 to 8 week follow ups, it sometimes looks like the membrane has been completely resorbed, with no trace of it ever having been there, and no keratinized tissue being generated. The patients report NO pain at all and rarely use the prescriptions I write.

    What to do in this instance? It seems that the tissue in this area is too thin to accomodate a full thickness AlloDerm membrane, especially if I want to cover it again.

    When I do root coverage via the sulcus, the results are more stable, ( The P. Allen type of approach) and the patients report more pain, which I interpret to mean that there is more tissue inflammatory response.

    Is it possible that in the covered free gingival porcedure, the tissue response is so low that it just doesn’t see a need to invade and colonize the membrane? Or am I not rehydrating the GBR enough ( five mins in first bath, at least ten in the second one)? Or perhaps, seeing as I am re-closing and suturing the area over the AlloDerm GBR, I should be orienting the membrane dermal side toward the gum tissue and the basement membrane towards the bone?

    TIA
    SP

  10. I have used AlloDerm and Puros and have to say that the far superior acellular dermis is neither.

    I have converted to a product called DermaMatrix, I get it from my local synthes cmf consultant. Handling, shelf life, rehydration is similar to Puros, but I have witnessed a much better biological response,overall better results, highly recommend

    Synthes Contact: 1-800-824-2020

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