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

Over the past two decades, the Khoury plate technique has been widely utilized with much success to facilitate bone augmentation in critically deficient bone areas. Simply, the technique includes 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- to 6-month healing period, a flap is raised, screws may be removed, and implants are placed. With advancements made in tissue engineering, a novel mineral-organic resorbable bone adhesive (MORBA) formulated from underwater biomimetic marine proteins has recently been utilized for immediate bone-to-bone or bone-to-metal fixation. 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 immediately stabilize dental implants into host bone. The present article describes a novel modification of the Khoury plate technique that utilizes MORBA as a substitute for screws during bone plate fixation. A step-by-step protocol is described that utilizes this novel biomaterial, favoring a more biologic approach to this conventional technique. This novel modification is surgically easier to conduct and is a more biocompatible option that avoids screw fixation and removal.