Interview with Dr. Francisco Marchesani – Expansion, sinus lift and implant placement

February 17, 2022by Osseotouch0

Osseotouch had the pleasure of interviewing Dr. Francisco Marchesani, expert in Oral Maxillofacial Implantology, in relation to the interesting clinical case of expansion, sinus lift and implant placement performed with the Magnetic Mallet in the following video.

 

Osseotouch: Can you describe the case and why did you choose to use the Magnetic Dynamic Technology?

Dr. Francisco Marchesani: It is a severe case of horizontal atrophy. On the right maxillary side there is a recent extraction. On the left maxillary side, massive horizontal atrophy in the area of ​​the first premolar and in ​​the molar is found, in addition to the horizontal loss pneumatization of the maxillary sinus. The proposed treatment is then horizontal GBR on both sides plus elevation of the sinus floor on the left side. Bone condensation in extreme situations is a way to achieve implant stabilization. There have been osteodilation/osseodensification techniques using mechanical hammers and dilators with various designs, but they are extremely invasive in the local situation and for the comfort of the patient. They are also associated with the vertiginous syndrome. At the same time, there are osseocondensing rotary instruments that I have used but that require several steps and eventually do not work in extreme situations such as this clinical case. The simultaneous installation of the implants is evaluated, and it is decided to handle the osteotomies with rotary instruments only as a guide and to take advantage of the expansion capacity of the Magnetic Mallet technology. Its biological basis in the sense of being minimally invasive, osteocondensing, controllable and saving as much as possible the little remaining bone makes it possible to install the implants in the same surgical time.

 

Osseotouch: What was the initial bone quality and how did the use of Magnetic Dynamic improve the condition?

Dr. Francisco Marchesani: The initial bone from the point of view of its quantity is extremely compromised horizontally and very poor in quality. This situation would normally prevent the placement of the implants in the same surgical time that the reconstruction is performed. For this reason, it is necessary to improve the quality and quantity of bone. With the magneto-dynamic technology that the Magnetic Mallet has, it is possible to work the bone, taking advantage of its dilatation capacity to the maximum. High energy transmitted in a very short period but at the same time the high control makes this instrument a perfect tool for this type of situation. It then manages not only to stabilize the implant for osseointegration but also its ideal prosthetic location by working the bone towards the ideal area.

 

Osseotouch: Was the directionality of the osteotomy axis facilitated using the Magnetic Dynamic osteotomes?

Dr. Francisco Marchesani: One of the major advantages of the Magnetic Mallet when compared to the use of drills is the directionality that can be given to the preparation using the axis of the osteotome as a guide to the prosthetically guided location of the implant. It is very easy to guide the preparation following the direction of the neighboring teeth as a guide or even through a conventional prosthetic guide. The use of straight and / or angled osteotomes facilitates the correct placement of the implants.

 

Osseotouch: How do you evaluate the biological response in terms of new bone formation?

Dr. Francisco Marchesani: From an entirely biological point of view beyond the stability achieved, the technology offered by the Magnetic Mallet supports maximum bone viability. On one hand, no heat is generated, as a rotary instrument does; on the other hand, it avoids bone loss generated by rotation in most drill systems. This suggests that local biological conditions are better than those offered by traditional rotating systems. In situations in which expansion is indicated, what is essentially done is to create a four-sided biological cage that has a great osteo-forming capacity and that also provides stability for the graft to be used. One of the characteristics that is remarkable when starting to use this instrument, is the vascularization that is achieved in the surgical bed. There is abundant bleeding from the bone, which is a situation that many times is not possible to achieve when using rotary instruments. In summary, the use of the Magnetic Mallet provides an ideal biological bed for new bone formation.

 

Do you have any questions for Dr. Francisco Marchesani? Leave a comment below the post. Do you want to see other clinical cases? Go to clinical cases with the Magnetic Mallet.

 

Download the curriculum vitae of Dr. Francisco Marchesani


Curriculum Vitae - Dr. Francisco Marchesani

Dr. Francisco Marchesani completed his undergraduate studies at the University of Concepción, Chile in 1986, where he received his bachelor's degree in dentistry and a degree in dentistry. In 1987 he joined the Department of Oral Surgery at the Faculty of Dentistry of the University of Concepcion as an instructor teacher. In 1990 he began his studies in the area of Dento Alveolar Reconstructive Surgery at the Department of Maxillofacial Surgery of the Ohio State University under Prof. Dr. Larry Peterson.

In 1993 he studied at the Albert Ludwig University in Freiburg, Germany. Having as a tutor in the area of implantology and maxillofacial reconstructive surgery, Prof. Dr. Gisbert Krekeler.

In 1993 he made contact with the Dexeus Center in Barcelona, Spain and carried out implantology studies supervised by Prof. Dr. Joan Pi Urgell, director disciple of Prof. Branemark.

Back at the University of Concepción, he takes charge of the Implantology Unit of which he was director and organizes the implantology program for undergraduate students. In 2005 he organized with the University of Ghent, Belgium and Nijmegen, Netherland, an exchange program at the undergraduate, graduate and teaching levels, being its coordinator for more than 10 years.

Former Associate Professor at the University of Concepción and former professor at the Department of Pathology and Diagnosis. He was in charge of the Surgical Area of deferents post graduate educational programs: Prosthodontic, Periodontology and Implantology, Implantology for Maxillofacial Surgery and of the Specialization Program in Implantology with a mention in reconstruction and aesthetics.

He is an active member of the Chilean Implantology Society, a member of the American Academy of Osseointegration and of the European Osseointegration Association.

In October 2011 he visited the Face Surgery center in Parma, Italy and together with Dr. Andrea Menoni, inventor of the BoxTechnique, they introduced this technique in Latin America and Europe.

He was appointed International Box Technique tutor in October 2012. Lecturer as international tutor of BoxTechnique at the Paris V University, in the years 2012 and 2013 and the ICLO Arezzo Center, Italy. In 2014, he organized the ongoing training program on fresh cadaver in collaboration with the Pontificia Universidad Católica de Chile.

In 2016, the Marchesani Clinic and Marchesani Education project, of which he is its cynical director, took shape. He is currently Director of the Advanced Implantology Improvement Program (PIA) and the Clinical Residences Program at Clínica Marchesani.

Director of Ossix Community and Best Practice whose objective is the good use and management of reconstruction biomaterials.

Key Clinician for various implant and biomaterial companies at international level. His characteristic being independence and the absence of conflict of interest in his work as a clinician, professor and lecturer.

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