Surgitime Titanium. Surgitime Titanium. Benefits. Material. Safety. Handling Benefits. Surgitime Titânio. Indication and Purpose of Use

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1 (Titanium Mesh) It assists bone neoformation, acting as a barrier hindering the migration of epithelial cells and of the conjunctive tissue, thus avoiding competition with the bone graft. Material (Titanium mesh) is made of pure grade 1 Titanium according to Standard ASTM F 6 7. Safety Biocompatible made from pure medical grade titanium, with laser perforation for excellent oxygen permeability and free migration of immune defenses Benefits The titanium mesh provides excellent biocompatibility, and occlusive property, and it is permeable thus enabling the transmission of nutrients and easy utilization because it is highly malleable and can be cut for surgical site adaptations, having the capacity to ensure an unadulterated regenerative space and the possibility of graft vascularization on both sides (periosteum and endosseous). It has been designed to ensure a tridimensional reconstruction of alveolar bone defects and to facilitate bone replacement through the replacement material s adequate fixation. Handling Benefits Since it has memory, it can be premolded into the defect and fixed with graft bolts and Bionnovation fixation on the bone surface, however it is not necessary to use a bone graft screw for the titanium mesh to exercise its function, and its use varies according to the responsible professional s options. The titanium mesh conforms the tissue contours and also is rigid enough to keep a space on the bone defect and the overlapping tissue. It s important to use (titanium mesh) temporarily in order to promote an adequate environment, allowing the organism to utilize its natural cicatrization potential and regenerate the lost or missing tissue. The necessary stay for starting the osteoconduction is at least 21 days. Surgitime Titanium can be used both with autogenous bone material and in combination with bone regeneration materials. Surgitime Titânio Sizes 34 x 25 mm Thickness 0,04 mm / Hole 0,15 mm x 25 mm Thickness 0,04 mm / Hole 0,85 mm x 25 mm Thickness 0,08 mm / Hole 0,85 mm Indication and Purpose of Use (titanium mesh) is indicated for medical regenerative procedures (orthopedics and neurosurgery) and odontological (periodontics, oral and maxillofacial, implantodontics), especially for bone reconstructions. In odontological cases we recommend a second surgery for their removal, and since they are made of pure titanium, there may be osseointegration when used with autogenic bone graft, thus hindering their withdrawal. The titanium mesh s withdrawal varies according to the responsible professional s options. The titanium meshes, also known as mechanical barriers for GBR Guided Bone Regeneration, help in bone neoformation, acting as biological barriers to avoid cell migration from the epithelium, the conjunctive tissue and/or bacteria that might cause bone growth inhibition, promoting an adequate space for the formation of a natural fibrin understructure, precursor of the bone tissue. It is an easily manipulated membrane which function is to protect the clot from the invasion of the nonosteogenic structures and direct it, preventing its distortion by the pressure from adjoining tissues. Surgitime titanium is anyway a barrier even with the larger holes as mentioned in the report. is an excellent medium for maintaining the desired crest dimensions. Once exposed, (Titanium mesh) prevents a great loss of graft because an epithelial closure around the screen ends up occurring. It is supplied sterile, as long as kept under the ideal storage and conservation conditions and the packing integrity has not been compromised. It is sterilized by Gamma Radiation, and should not be used in case its validity time has expired.

2 Tips & Techniques Membrane exposure, how to proceed? The Seal is designed to be intentionally exposed in sealing alveolar post extraction procedures. It produces an environment for bone regeneration from the blood clot, protecting it from the invagination of soft tissue. In cases where they are used as coating slips, if exposure should be administered mouth rinse solution of chlorhexidine base 0.12% twice a day, or 0.20% chlorhexidine gel also twice daily. Maintain the exposed membrane in place until the graft acquires self-sustainability, which requires about 45 days. Bone screws, are indicated? The Bone screws are used to assist in the stabilization the Titanium Mesh on bone grafts. Necessarily they are used in regenerative procedures promoting immobilization, which is a harmful factor in maintaining the complex graft / clot. This also applies to. Yet Seal has primary indication for sealing socket. As it has great potential for exposure is not indicated for ROG procedures. How long can the membrane stay in place? It is recommended that the membrane stay in place for 21 days (This provides sufficient time for the initiation of osteoconductive) and 14 days if used to seal a fresh extraction socket. Membranes may also be used in conjunction with the Titanium Mesh. - Easy to handle to the surgical sites - Supple - No trauma on soft tissue - Proper containment of the bone graft - Protection for the graft site - Improve space for bone regeneration - Ultra thin (Thickness 0.04 and 0.08 mm) - Pore size 0.15 and 0.85 mm - Biocompatible - Grade 1 titanium - Membrane support - Tissue Support Exclusivity Code: - Thickness: 0,04 mm - Hole: 0,15 mm

3 Topographic Analysis Homogeneous roughness layer Homogeneous roughness layer Homogeneous roughness layer Surface: homogeneous regions can be delineated. Data on material s Physico-chemical properties Certificate AQ CCDM - DEMa/UFSCar Elements Titanium Plat ASTM F-67 Grade 1 Cód Lote: P Specifications Standard ASTM F Grade 1 Tolerance below the minimum or above the ceiling Standart ASTM F-67 % (m/m) % (m/m) % (m/m) % (m/m) Fe 0,04 0,20 máx. 0,10 C 0,030 0,08 máx. 0,02 O 0,115 0,18 máx. 0,02 N 0,015 0,03 máx. 0,03 H 0,0044 0,015 máx. 0,015 Note: The result is according to globally recognized standards: ASTM F67-06 Grade 1

4 Case Studies: Case Study: 1 Prof Dr Helder Valiens Ilhéus Bahia Brasil Case Study: 2 Prof Dr Fabio Mizutani, São Paulo SP Brasil Case Study: 3 Prof Dr Edgard Franco Bauru SP Brasil Case Study: 4 Prof Dr Rodrigo Neiva São Paulo SP Brasil Prof Alexandre Cabrera São Paulo SP Brasil Prof Alexandre TorresSão Paulo SP Brasil Case Study: 5 Prof Dr Rafael Manfro Florianópolis SC Brasil

5 Surgitime Titânio Case Studies: Case Study: 6 Prof Dr Helder Valiens Ilhéus Bahia Brasil Case Study: 7 Prof Dr Maiolino Thomaz, Uberlândia MG Brasil Case Study: 8 Prof Dr Darceny Zanetta Barbosa Uberlândia MG Brasil Prof Dr Maiolino Thomaz, Uberlândia MG Brasil

6 Case Studies: Case Study: 9 Prof Dr Danilo Maeda Reino Ribeirão Preto SP Brasil

7 Instruction for Use Using Cod The pictures below illustrate one of the techniques: How to use : 35 x 24 mm - Thickness 0.04 mm Hole 0.15 mm 1. Preoperative view. (Defect Analysis) 2. Template customization. 3. Template size s adequacy. 4. Checking the template dimensions. 5. Compare the template with the defect we have to handle x 25 mm Thick 0.04 Hole 0.15 mm Cód Shape the Titanium Seal with the scissors. 7. Verify that there are not sharp edges in the mesh to avoid irritations. 8. A surgical burr was used to decorticate the bone in prepara- tion for grafting 9. The decortications scheme is nonspecific as long as bleeding points are elicited from the recipient site. 10. Bone Screws selection. 11. Aggressive tip and thread design engages bone and allows for precise placement.

8 Surgitime Titânio Instruction for Use Using Cod The pictures below illustrate one of the techniques: How to use : 35 x 24 mm - Thickness 0.04 mm Hole 0.15 mm 12. Pick up bone screw on the Bionnovation Fixation Set (Code13118). 13. Cruciform head design makes screw pickup easy and safe. 14. Titanium Mesh placed. 15. TTitanium mesh secured using Bone Screws. 16. Titanium mesh fixed buccally by 2 fixation screws. 17. After fixed the Titanium Mesh, the defect is filled with the graft. 18. Bone graft preparation. 19. Place the bone graft into surgical site position. 20. Bone graft adaptation. 21. Defect filled with Bone Graft. 22. Place the into the defect to cover the bone graft. 23. Defect covered with a.

9 Instruction for Use Using Cod The pictures below illustrate one of the techniques: How to use : 35 x 24 mm - Thickness 0.04 mm Hole 0.15 mm 23a. Defect covered with a.