Vertical augmentation with RPM^TM

Reinforce, Revascularize, Regenerate

Have you ever wanted to take advantage of a form-stable barrier membrane that allows for better vascularization of the underlying bone graft, as like with collagen membranes?

Titanium-reinforced polytetrafluoroethylene (PTFE) membranes are a well-documented off-the-shelf solution for vertical alveolar ridge augmentation in oral and maxillofacial bone regeneration¹. They provide stability through the integrated titanium structure and provide a secluded space for undisturbed bone formation. However, classical PTFE membranes are occlusive membranes that do not allow vascularization from the periosteum. Early vascularization plays a central role in guided bone regeneration as angiogenesis is fundamental to new bone formation^2,3,4. The novel Reinforced PTFE Mesh⁵, RPM^TM, is characterized by perforations that allow vascularization from the periosteum.

• Circular perforations of 660 microns (0.66mm) -> allowing proper graft vascularization from periosteum to bone graft
• Titanium frame maintains space  -> essential for vertical bone augmentation⁶
• PTFE allows easy trimming and adaptation -> thickness of 250 microns, the most inert & stable polymer in the biological system⁶

RPM^TM combines the benefits of a stable scaffold and a PTFE barrier membrane, whilst allowing optimal supply of the bone graft through vascularisation from the periosteum to obtain vital bone. The concept and design of RPM^TM was co-developed with Prof. Istvan Urban, Hungary/USA and reflects the same principles as the Sausage Technique^{TM 7}, but for vertical alveolar ridge augmentation⁸.

RPM^TM has distinct configurations:

• Rectangular shapes
• With predefined fixation points distinctly outside the defect area
• For interproximal positioning

Selected shapes within the rectangular and interproximal portfolio are especially designed for the use in the mandible. The mandibular lingual side has mylohyoid muscle and vital anatomical landmarks⁹. Those shapes are characterized by a non-perforated area facing the lingual side and allow easy removal.

Bibliography:

1. Urban IA, et al: Int J Oral Maxillofac Implants 2009, 24 (3), 502-10
2. Schwarz F et al. Clin. Oral Implants Res. 2008;19(4): 402-415. (Pre-clinical study)
3. Rothamel D et al. Clin. Oral Implants Res. 2005; 16(3): 369-378. (Pre-clinical study)
4. Perelman-Karmon M et al. Int J Periodontics Restorative Dent. 2012 Aug;32(4):459-65. (Clinical study) 
5. RPMTM is manufactured by Osteogenic Biomedical, Lubbock, Texas, USA
6. Elgali I, et al: Eur J Oral Sci 2017; 125 (5), 315-337
7. Urban IA, et al.: Int J Periodontics Restorative Dent 2013; 33(3): 299-307.
8. Urban IA, et al.: Int J Oral Maxillofac Implants 2014; 29(1): 185-93
9. Urban IA, et al.: J Periodontics Restorative Dent 2017; 37(5):639-645 (clinical study) – review format of this reference
10. Buser D et al., J Dent Res. 2013 Dec;92(12 Suppl):176S–82S (Clinical study).
11. Urban IA et al., Int J Periodontics Restorative Dent 2015, 35(5):613-623 (clinical study) – review format of this reference
12. Becker J et al. Clin Oral Implants Res. 2009; 20(7):742-749. (Clinical study)
13. Tal H et al. Clin Oral Implants Res. 2008; 19(3) : 295-302. (Clinical study)
14. Urban IA, et al Int J Periodontics Restorative Dent 2016, 36(3):329-337 (clinical study) review format of this reference