Saturday, August 5, 2017

Guided Bone Regeneration in Animal Dentistry- Donald H. DeForge, VMD-Fellow of the Academy of Veterinary Dentistry-The New England and NY Animal Dental Health Services-Centers for Oral Care

Donald H. DeForge, VMD
Fellow of the Academy of Veterinary Dentistry
Silver Sands Veterinary-Milford Veterinary Hospital
The New England and New York Animal Dental Health Services
Centers for Oral Care
No. 25

Guided Bone Regeneration in Animal Dentistry
Celebrating Twenty Years of Removing Oral Pain and Restoring Quality of Life with Bone Alloplast- ConsilⓇ
Donald H. DeForge, VMD
Fellow of the Academy of Veterinary Dentistry

In The Journal of Veterinary Dentistry-[JVD, Vol. 14, No.4, Dec 1997], I evaluated Bioglass/PerioGlas now under the veterinary label of ConsilⓇ/Nutramax Labs.  That clinical journey has led to hundreds of animals being helped throughout the United States and in countries around the world.  A bone alloplast fills voids in extraction cases; oral mass removal sites; and in periodontal surgery.  New bone occurs as osteoblasts infiltrate and proliferate on the surface of the material.  Bone growth occurs uniformly throughout the defect.

My mentor and friend, Dr. Robert Wiggs who was lost at too young and age, wrote the following in 1997: "As advances in veterinary dentistry occur, new techniques and materials are being utilized to offer treatment for teeth with advancing periodontal lesions that previously would have been extracted."  If he were alive today, he would be delighted to know that general practitioners, veterinary dentists, and veterinary orthopedic surgeons have incorporated bone alloplast into their treatment programs contributing to patient well being; re-establishment of a quality of life; and accelerated healing.

With the use of any Guided Tissue Regeneration and Bone Grafting material, comes a responsibility to take pre- and post oral x-rays of the site.  Patients must be followed with regular rechecks with oral x-ray appointments under general inhalation anesthesia.

The veterinarian must realize that the primary therapy of all periodontal disease management is the control of the periodontal pathogens that cause the patient to suffer.
Technicians must be trained in all aspects of root planing and periodontal piezoelectric mechanical equipment for perfect removement of plaque.  These technicians must be given the foundation of digital oral radiology diagnostic training to allow the doctor visualization of pathology.

In many instances, the veterinarian can with Informed Consent perform basic periodontal surgery and or exodontia with usage of synthetic bone graft particulate. [i.e. ConsilⓇ]

In other cases, the small animal practitioner may want to make use of the expertise of an animal dentist.  

The important fact is to believe what Dr. Wiggs taught me a quarter of a century ago. He stated, "one of the biggest challenges in animal dentistry is incorporating technology with insight into education!"  He wanted individuals to move forward and to improve the oral care of companion animals but only with a complete understanding of each and every technique they introduce into their general practice...... oral care programs.

I encourage all veterinarians to study and utilize Guided Tissue/Bone Regeneration in their practices. ConsilⓇ has been tested and proven to be an exceptional bone alloplast.  I never remove any tooth without restoring alveolar ridge height with ConsilⓇ.  I have been the advocate of the general practitioner for more than two decades.  With national, regional, and local lectures and wet labs, I have brought the techniques and the educational tools that Dr. Bob Wiggs taught me in my early years of training.

I continue to write, lecture, and be active in oral clinical practice through The New England and New York Animal Dental Health Services.  Take the information supplied in this brief web log and consider re-educating yourself in the techniques utilized in periodontal and oral surgery.

In the second edition of An Atlas of Veterinary Dental a tribute and dedication to Robert B. Wiggs, DVM-and Diplomate of the AVDC I write:

"Success is to be measured not so much by the position one has reached in life but by the obstacles one has overcome while trying to succeed."
Booker T. Washington

Please find below important information about ConsilⓇ from Nutramax Labs. Questions can be addressed directly to Nutramax Labs.

What is Consil®?
Consil synthetic bone graft material is a bioactive ceramic containing salts of calcium, sodium, silica, and phosphorus. It undergoes a time dependent surface reaction when implanted at the dental or orthopedic repair site. The surface reaction results in the formation of a calcium phosphate layer that is substantially equivalent to the hydroxyapatite layer found in bone material. Osteoblasts infiltrate and proliferate on the surface of the material, and bone growth occurs uniformly throughout the defect.
Consil material accelerates the healing process and research has shown that Consil’s mechanisms of action include enhancing cell signaling and cell division necessary for facilitating bone regeneration and repair of bony defects. 1,2

  • Restore bone, contributing to patient comfort and well being
  • Conform readily to the defect site
  • Composed of materials naturally present in the body
  • Begin to repair bony defects through new bone production within 4 weeks3
  • Develop a bending strength and stiffness very similar to normal bone in 3 months
  • Can be used in contaminated sites because of the physiological pH maintained which inhibits bacterial growth,4,5 though site should be flushed well to remove debris
  • Minimize bleeding at the site and will not migrate due to hemostatic properties3,6
  • Multiple year shelf life

Dental Applications:
  • Infrabony pockets caused by periodontal disease
  • Tooth extraction sites
  • Endodontic-periodontic lesions
  • Traumatic defects or intraosseous flaws related to pulpal floor or lateral root perforations

Orthopedic Applications:
  • Long bone multiple or comminuted fracture repair
  • Osteotomy sites
  • Delayed unions/nonunions
  • Arthrodesis

  • \om cysts, tumors or screw removal
  • Or anywhere a bone graft material is needed

  • The same bone graft particulate as Consil Dental and Orthopedic pre-mixed with a synthetic, absorbable binder for improved handling and adaptability
  • Ready to use (no mixing or other prep needed) – just apply to surgical site
  • Non-hardening putty consistency makes graft material very easy to handle and mold to surgical site
  • Available in two sizes: 2.5 cc and 10 cc tray packaged with a dual sterile barrier
  1. Au AY, Au RY, Al-Talib TK, et al. Consil bioactive glass particles enhance osteoblast proliferation and maintain extracellular matrix production in vitroJ Biomed Mater Res Part A 2008; 86(3):678-684.
  2. Au AY, Au RY, Demko JL, et al. Consil® bioactive glass particles enhance osteoblast proliferation and selectively modulate cell signaling pathways in vitro. J Biomed Mater Res Part A 2010;94(2):380-388.
  3. Oonishi H, Kushitani S, Yasukawa E, et al. Particulate bioglass compared with hydroxyapatite as a bone graft substitute. ClinOrthop 1997: (334)16-325.
  4. Allan I, Newman H, Wilson M. Antibacterial activity of particulate bioglass against supra- and subgingival bacteria. Biomaterials 2001;22:1683-1687.
  5. Stoor P, Soderling E, Salonen JI. Antibacterial effects of a bioactive glass paste on oral microorganisms. Acta Odontol Scand 1998;56:161-165.
  6. DeForge DH. Evaluation of Bioglass/PerioGlas (Consil) synthetic bone graft particulate in the dog and cat. J Vet Dent 1997;14:141-145.


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