At agenesis sites with predominantly horizontal bone atrophy, the question is not only implant yes or no, but how to rebuild the bone thickness. The two routes, conventional graft and MTM approach, start from different biological premises. Here we compare them transparently, recalling that MTM is an elective procedure, indicated only after a clinical, radiological and instrumental assessment, and not applicable in all cases.
What the MTM approach is
Developed in Rome by Dr. Gaetano Calesini, Morphogenic Tissue Management induces bone and muco-periosteal regeneration without grafts, membranes or heterologous materials, directing the biological signals present at the site during implant placement.
The differences, point by point
Operative. Conventional graft: a possible second surgical site (harvest) or the use of biomaterials and membranes. MTM approach: no harvest, no biomaterial or membrane, the work is done at the site itself.
Biological. Conventional graft: integration of exogenous material and response to heterologous materials. MTM approach: regeneration guided by the signals of the site, without foreign materials.
Time. Conventional graft: often a multi-stage sequence, with waiting for the graft to mature. MTM approach: in selected cases it simplifies the sequence.
Economic. Conventional graft: costs linked to biomaterials, membranes and a possible second procedure. MTM approach: it avoids those specific costs. No price is stated: every plan is individual.
Morbidity. Conventional graft: possible discomfort at the donor site. MTM approach: no donor site.
Prognostic. Conventional graft: documented and reliable outcomes. MTM approach: outcomes documented over multi-year follow-up; it depends on case selection.
When it is not indicated
MTM does not replace the graft in every situation. In case of severe atrophy, significant vertical deficit, uncontrolled systemic disease or reduced vascular supply, regeneration without materials may not be sufficient, and the graft remains the correct choice. The distinction is made only after the instrumental assessment, not a priori.
Why it matters in agenesis cases
The agenesis site typically presents exactly that horizontal atrophy in which the approach is relevant: where biological conditions allow, it makes it possible to address the deficit while avoiding harvests and biomaterials.
Related reading
- MTM in implant dentistry, Rome
- Implant on an agenesis site
- Tooth agenesis: what it is and how it is treated
- Second opinion
References: ERE technique and edentulous site regeneration PMID 7751111, 10635173, 18991003, 19244882. Informational disclaimer. Author: Dr. Gaetano Calesini, physician and surgeon, specialist, Clinical Director of Studio Calesini srl.