Tissue Regeneration | Bone Grafting

Whether used to replace autogenous bone entirely or expand autogenous grafts, bone substitute materials (BSM) or synthetic bone graft material must be effective for time-delayed procedures before dental implant insertion and for recipient site optimization at the time of implant placement (simultaneous procedures). Fixation devices such as guided bone regeneration membranes, collagen membranes, titanium mesh, and bone screws may be used to counteract mechanical stresses on the graft during healing.

The most commonly used alloplastic graft materials are calcium phosphate-based ceramics such as hydroxyapatite (incompletely resorbed) and tricalcium phosphates (completely resorbed). Bioactive glass is more reactive than these materials, and promotes bone and dental tissue regeneration by releasing silica ions. Over time, it is fully absorbed and, when mixed with autogenous bone graft material, bioactive glass doubles natural bone regeneration. One newer alloplastic material is made to be syringed directly into the defect and, in many cases, eliminates the need for a matrix.

Different types of BSMs can be combined and even hybridized, allowing for a wide range of resorption rates in formulations such as powders, granules, pastes, blocks, and custom manufactured grafts.

Resorbable and nonresorabable barrier membranes (natural biomaterials, collagen, synthetic polymers) exclude undesirable cell types while creating and maintaining space, providing clot stabilization, and allowing tissue integration.