by Dr Fadi Dalati, Sublime Dental, Sydney, NSW
This system is used to tack membranes when doing bone grafts. Smaller grafts can have the membranes fixed with sutures or some soft tissue tension. This system works best with larger grafts where extra help is needed to hold the membranes in place. Pinning the membranes into the jaw with this system has a very high success rate.
What’s good about it
The system comes with three-millimetre titanium tacks, a tack holder and a small mallet. The tacks are hammered through the membrane and into the bone to hold the membrane in place. As the tacks are titanium, they can be left in place if the site is not going to be re-entered. In situations where you’re re-entering the surgical site, everything will be healed and integrated so the tacks can be removed and discarded.
This is a regular procedure in our practice. We used to utilise fixating sutures more frequently but we’ve found that by using the bone tacks, we are getting much better outcomes. The results are more predictable and there’s greater bone conversion without loss of biomaterial from movement of the membranes.
When using this system, you have to be comfortable in raising a slightly larger surgical field to fixate everything further away so it doesn’t interfere with the grafting. I’ve used this system dozens of times and it’s provided a huge improvement in the outcomes.
What’s not so good
Sometimes the pins can be dislodged and need to be retrieved which results in a second surgery. This system can also be quite finicky, particularly if you’re dealing with excessively soft bone.