A Novel Screwless Modification of the Khoury Plate Technique using an Innovative Bone Adhesive Formulated from Underwater Biomimetic Marine Proteins.

Abstract

The Khoury plate technique has been widely utilized with much success over the past 2 decades to facilitate bone augmentations in critically deficient bone areas. Simply, the technique encompasses harvesting autogenous bone plates and utilizing them with external screw fixation. The rigidity of the bone plates enclosing the bony defect on both the buccal and lingual surfaces allows for tension free bone remodeling to occur favoring an ideal bone forming environment. Following, a 4-6 month healing period, a flap is raised, screws may be removed and implant placement then follows. With advancements made in tissue engineering, recently a novel mineral-organic resorbable bone adhesive (MORBA) formulated from underwater biomimetic marine proteins has been utilized for immediate fixation of either bone-to-bone or bone-to-metal. MORBA is a synthetic, injectable, self-setting, and resorbable load-bearing adhesive biomaterial that exhibits over 300 pounds of fixation strength. The unique adhesive properties of MORBA enable it to provide immediate stabilization of dental implants into host bone. The present article describes a novel modification of the Khoury plate technique by utilizing MORBA as a substitute for screws during the fixation of bone plates. A step by step protocol is described where this novel biomaterial was utilized as a substitute to screws favoring a more biological approach to this conventional technique. This novel modification is both surgically easier to conduct, and favors a more biocompatible option that avoids screw fixation and removal.