Bone and bone substitutes

Abstract

Bone replacement grafts will play a continuing role in periodontal and other regenerative therapy. Several choices are available to the clinician including autogenous, allogeneic, xenogeneic and a variety of alloplastic materials. Except for fresh autogenous bone, bone replacement graft(s) do not provide the cellular elements necessary for osteogenesis nor can they reliably be considered truly osteoinductive, but instead are mostly osteoconductive, providing a scaffold for bone deposition. Currently, significant decrease in clinical probing depth and gain of clinical attachment have been reported following use of bone replacement grafts when compared to flap debridement surgery alone for periodontal osseous defects. Reported differences among bone replacement grafts (autogenous, allogeneic, xenogeneic, and alloplastic) occur with respect to histological outcomes. Overall, probing depth reduction, attachment level gain and degree of defect fill are similar for all bone replacement grafts.

Bone repair process in calvarial defects using bioactive glass and calcium sulfate barrier

“…The joining of the materials to the bone was observed, even at the 7 th day of the post-operative period, which, in the case of BG, is well-documented 3,4,13,15,16,17,18,19,20,21 .…”

“…In contrast, there was a clear alteration, seen as of the 60 th day, in the morphology of the granules which appeared irregular on the surface and with reduced sizes in relation to the first group (after 7 days). These characteristics suggest the occurrence of the superficial dissolution of the material, described by a number of authors 3,5,12,17,20,22 , where a thick layer of silicon, covered with a thick layer of calcium and phosphate, is formed with a consequent collagenous attraction surrounding it.…”

“…The bone glass available in the market is composed of silicon dioxide (SiO 2 ), calcium oxide (CaO), sodium oxide (Na 2 O), and phosphate pentoxide (P 2 O 5 ); it possesses biocompatibility with body tissues, allows for bone migration and the colonization of osteogenic cells on its surface, in addition to presenting a greater capacity for linkage to the bone and soft tissues, when compared to other alloplastic materials 3,5 . The components of disassociation of the material support the formation of new bone, and its glass particles have the capacity of incorporating themselves within the new bone 7 .…”

“…Materials for implantation can be divided into four groups: autologous, homologous, heterologous, and alloplastic 3 .…”

Inorganic polyphosphate adsorbed onto hydroxyapatite for guided bone regeneration: An animal study

“…In addition, the amount of bone available for use is limited and may be inadequate in some clinical cases 7,27) . Bovine-derived anorganic bone matrix has been demonstrated to promote osteoconduction 28) , this product has not yet been approved for use implant therapy in Japan because of possible risks associated with bovine spongiform encephalopathies.…”