Enzo Foti Education

€ 732,00 (Iva compresa) per portare a casa la F.I.R.S.T., la tecnica GBR che cambierà la vostra vita professionale.

Ho specificato subito il costo così c'é la selezione naturale di coloro che hanno la REALE VOLONTA' DI IMPARARE questa tecnica semplice, predicibile e alla portata di tutti.

Una full immersion clinica di 2 giorni con numerosi video chirurgici e una parte pratica dove potrete constatare con le vostre mani la potenza e l'efficacia della colla di fibrina.

Il prossimo sarà l'ottavo anno di corsi F.I.R.S.T. la tecnica che ho ideato nel 2016, oggetto di masters in Università Italiane.

I partecipanti riceveranno il PDF del protocollo di diluizione, modalità di erogazione e applicazione del farmaco. E soprattutto il PDF coi protocolli clinici step by step (Impianti Immediati-Preservazione Alveolare-Lamina Shield-GBR Orizzontale-One time Cortical Lamina-GBR Verticale) che guideranno la pianificazione e il trattamento dei vostri casi clinici dai più semplici ai più complessi.

Per ricevere il programma dettagliato scrivete a [email protected]

Dai prossimi corsi F.I.R.S.T. questo sarà il messaggio finale.

Solo aumentando la conoscenza é possibile comprendere gli errori commessi, migliorare le proprie skills e ottenere risultati predicibili a beneficio dei nostri pazienti.

Gli ultimi 4 posti disponibili per imparare la tecnica F.I.R.S.T. durante un corso teorico-pratico di 2 giorni che vi cambierà la vita professionale.

Da Settembre in poi e per gli anni futuri i partecipanti avranno a disposizione il pdf del protocollo clinico dettagliato che guiderà step by step le loro chirurgie rigenerative semplici e complesse.

Per informazioni scrivete a [email protected]

Tecnica F.I.R.S.T. - Evidence Based Medicine - Evidenza Clinica

La medicina basata sull'evidenza (EBM) é il fondamento alla base delle cure appropriate per le persone. Le prove scientifiche scaturiscono da studi prospettici randomizzati controllati (RCT), dalle Revisioni Sistematiche e dalle Metanalisi.
La tecnica F.I.R.S.T. (Fibrinogen-Induced Regeneration Sealing Technique) che ho ideato nel 2016 e pubblicato nel 2020 al momento non é validata da questo genere di studi, ma solo da 3 paper (due personali ed uno di un gruppo indipendente) dove sono stati presentati case report.

La Comunità Scientifica ritiene giustamente che la F.I.R.S.T. non ha le caratteristiche di una tecnica EBM, tuttavia è apprezzata da Professori Universitari e da Presidenti di Società Scientifiche italiane e straniere per la sua Evidenza Clinica. Infatti mi invitano a tenere relazioni e corsi di perfezionamento nelle loro sedi ufficiali. Sono persone competenti perché hanno capito che trattasi di una tecnica che merita di essere affiancata a quelle più blasonate e divulgata per la sua semplicità e predicibilità.

“Solo se si ha immaginazione e visione è possibile pianificare l’impossibile” Enzo Foti

Un caso apparentemente estremo con follow-up di 6 anni. La seconda foto é stata fatta al controllo di 2 giorni fa. Potrete vedere i dettagli chirurgici e protesici di una efficace semplificazione “out of the box”, che ha permesso un risultato ottenibile solitamente con tecniche più complesse e stadiate, in questo video pubblicato nel 2018
https://fb.watch/tqmwJ05-j3/

Peri-implant papilla with 12-year follow-up.
Immediate loading implant, collagenated porcine bone mixed with fibrin sealant.
Progressive papilla closure.
Maintenance of thickness and width of keratinized mucosa with "orange peel" appearance.

Being between SIdP and IAO, the most important Italian Societies of Periodontology and Oral Surgery of which I’m member, testifies the success of F.I.R.S.T. mission 💪💪💪
SIdP 26.021 - EFE 14.050 - IAO 13.651

Double "Lamina Shield". Minimally invasive reconstruction by F.I.R.S.T. Three-year follow-up.
https://youtu.be/8EFwc4hE0ts

Double "Lamina Shield". Minimally Invasive Reconstruction by F.I.R.S.T. Three-year Follow-up.

Open Healing and Overgrafting

Open Healing, codified in the literature, is a healing by second intention after alveolar ridge preservation where a collagen membrane or a dermal matrix is sutured occlusally to protect the bone graft and to achieve good keratinized mucosa around implants.

Overgrafting is a personal concept, not validated from the literature, that I have been applying for several years where the overgraft represents the occlusal protection in place of a collagen barrier. No sutures.

Those who know me have seen numerous personal cases.
I show you the comparison between a healing at 8 weeks (image "E") taken from the paper:
Maiorana C, Deflorian M, Testori T, Mandelli M, Nagursky H, Vinci R. Alveolar socket preservation with demineralised bovine bone mineral and a collagen matrix. J Periodontal Implant Sci. 2017 Aug;47(4):194-210
and a 4-week healing of one of my clinical cases.
I would say that the healings are comparable.
I underline that Overgrafting can only be done if fibrin sealant is used, that has waterproofing and antibacterial action.

My friend Daniel Buser presented from Sergio Piano at “Open Consensus Conference on Treatment for the Post-Extraction Site”. Turin 2-3 February 2024
Great lecture! He use the fibrin glue 💪

Un grande evento fa non perdere dove saranno definite le linee guida sul trattamento del sito post-estrattivo.

OPEN CONSENSUS CONFERENCE "CONCEPTS OF TREATMENT FOR THE POST-EXTRACTION SITE"

Qualitative and volumetric outcome of hard and soft-tissue in patient with thick periodontal phenotype. Three-year follow-up.

In case like this, even more so, little or nothing needs to be done:

- Overgrafting with collagenated porcine bone mixed with fibrin sealant.
- Open Healing without occlusal membrane.
- Crestal sinus lift by Versah drills without biomaterial.
- Narrow Ti-base, 3 mm height.
- Adequate prosthetic design.

Then biology did the rest.

Inquadra il QR Code sul computer con la fotocamera del tuo smartphone per scaricare il programma dettagliato

Histologies after HORIZONTAL GBR with F.I.R.S.T technique.

Case 1 and 2: Positive osteoconductive action of collagenated heterologous biomaterial
Case 2: Collagenated heterologous cortical lamina osteointegrated after 4 years

In cases 1 and 2, the particles of residual biomaterial, undergoing osteoclastic resorption, are entirely surrounded by newly formed trabecular bone. When the newly formed bone surrounds the residual particles, it remains long term stable. When the biomaterial is external to the newly formed bone, the regenerative result is not predictable.

In case 2 the histology, performed 4 years after the GBR (for clinical reasons and not for research), shows cortical lamina in close contact with newly formed bone. This confirms long term reabsorbabilty of cortical lamina which can also osteointegrate.

Collagenated biomaterials are the osteoconductive gold standard.

Autologous bone (BONE CHIPS) is the osteoinductive gold standard, but it has poor osteoconductive action and reabsorbs if you wait longer than 4 months. In fact, other known techniques, although excellent, require regenerative relining with heterologous biomaterials and collagen membranes at the time of implant placement.
My histologies refer to horizontal GBR. In vertical GBR I use autologous bone and collagenated biomaterial 50/50, as well as fibrin sealant and heterologous cortical lamina.

Horizontal GBR by F.I.R.S.T. Checkup at five months.

Here you will not have to re-enter with the same flap of the first surgery to remove PTFE, titanium mesh, screws etc.

Here you will not have to remove anything, just restore the fornix and increase the keratinized mucosa.

The achieved volumes will make it possible to place anatomically guided implants in occlusal harmony with the opposing arch, as can be seen in the video of the CBCT performed after one month where I simulated what will be done with the help of a surgical guide.

Collagenated porcine bone, unlike biomaterials produced at high temperatures, is reabsorbed in the medium term by osteoclastic action and is replaced by newly formed trabecular bone.

This is an example of a 7 mm vertical GBR with the F.I.R.S.T. technique.

Autologous bone and collagenated porcine bone 50/50 mixed with fibrin sealant. Porcine cortical lamina glued with fibrin sealant.

Look at Rx comparison that clearly shows the difference between the graft and the new trabecular bone after 3 years.

The 4.4, with rhizolysis of the apex and mobility grade 2, was extracted and replaced by an immediate implant.

3d reconstruction by F.I.R.S.T. technique
Volumetric anatomy after surgery is the same after 10 months.
Simplicity, predictability, low morbidity.

To all women

Surgery of today. Achieved new three-dimensional anatomy by my simple F.I.R.S.T. An orthodontic implant was placed as tenting screw in area 12-11. In 8-10 months All-on-four. Patient will be without his removable full denture for 1 month. I will then modify it according to new anatomy and without crestal compression. It will have exclusive support on the palate with lots of adhesive paste.
Soon the surgical video step by step as my philosophy.

Updating of my challenging double "Lamina Shield" explained at the link.
10-month follow-up. NEVER INVOLVED PAPILLAE!
Do you know another minimally invasive approach for a similar case? Thanks for any feedback.
https://www.facebook.com/EnzoFotiEducation/posts/672360521180414?

3x4 mm dehiscence of the surgical wound found 9 days after my three-dimensional GBR by F.I.R.S.T.

Collagenated porcine bone mixed with fibrin sealant stabilized by means of collagenated porcine cortical lamina glued with fibrin sealant.

There is no exposure of the cortical lamina immediately protected by repair fibrin.

Today, 35 days have passed after the surgery performed in Chieti. The colleague (who sent me this documentation) informed me that dehiscence is perfectly re-epithelialized and the new clinical anatomy is superimposed on that highlighted in the pictures at 9 days.

I'm waiting to receive the updated documentation (including the surgical video) which I will publish together with the progressive follow-up.

Double "Lamina Shield" with 9-month follow-up.

Dear friends and colleagues, I show you this "challenge case" which I consider one of my best ever.

Challenge case, because we are in the aesthetic zone of a 27-year-old man with thin gingival biotype who was missing both the buccal and palatal bone walls on tooth 21, hopeless, and with infraosseous periodontal defect on tooth 22.

Due to external/internal coronal-root resorption, the colleague who sent the patient to me, performed orthodontic extrusion of tooth 21 to gain keratinized gingiva, then splinting it to the adjacent teeth.

Only two minimally invasive surgeries WITHOUT INVOLVING THE PAPILLAE, also performing a CTG (see the two videos), allowed this reconstructive, periodontal and aesthetic result.

My F.I.R.S.T. was decisive for the alveolar ridge preservation with two cortical laminae, inserted through buccal and palatal envelope, that made a single body with a collagenated porcine bone, thanks to the right use of the fibrin sealant for the stability of the lamina/graft complex.

After 8 months of healing, bone quality was excellent during guided surgery. Despite the torque of 50N, the implant did not enter in its coronal third, so I unscrewed it and finalized the site preparation with a normalizing drill whose diameter was equal to that of the implant.

6/0 resorbable suture in PGA was used during the second surgery to fix the CTG to the mini buccal flap after screwing the provisional crown.

I was very confident, but with my Team we went beyond our best expectations. Very happy patient.

In six months I will publish the final crown rehabilitation.

The link of first surgery https://www.facebook.com/EnzoFotiEducation/posts/672339404515859

The link of second surgery
https://www.facebook.com/EnzoFotiEducation/posts/672341241182342