Bone grafts and substitutes are increasingly used in dental implantology due to the growing need for replacing insufficient alveolar bone before implant placement. One of the primary reasons for bone deficiency is tooth loss due to periodontal disease, tooth fracture/trauma, periapical lesions, or other pathological conditions. After tooth extraction, dimensional changes affect the alveolar socket, leading to loss in alveolar bone height and width. Histological modifications also occur, with initial formation of a blood clot that is replaced with granulation tissue and subsequently with a provisional connective tissue matrix. Spontaneous healing ends with socket filling with woven bone, which is gradually replaced with lamellar bone and bone marrow. Adequate alveolar ridge dimensions and bone quality are required to assure optimal stability and osseointegration following dental implant placement. When a tooth is extracted, alveolar ridge preservation (ARP) procedures are an effective method to prevent collapse of the post-extraction socket. In addition to the autologous and homologous bone, heterologous bone is widely chosen by clinicians for ARP, and anorganic bone xenografts (ABXs) made bioinert by heat treatment represents the most used biomaterial in clinical applications. Collagen-preserving bone xenografts (CBXs) made of porcine or equine bone are fabricated by less invasive chemical or enzymatic treatments to remove xenogenic antigens, and these are also effective in preserving post-extraction sites. In the field of bone grafting, the biocompatibility of the graft material is of utmost importance. It is crucial for the material to not only interact safely with the bone tissues but also facilitate the growth and development of new bone cells. Research has indicated that sericin, owing to its proteinaceous nature and high biocompatibility, shows promise in promoting cellular adhesion and proliferation. This makes it an excellent candidate for bone graft applications. Additionally, sericin is biodegradable, which means that it can be gradually broken down and replaced by the patient's own cells. The long-term success of implant-supported restorations is based on the preservation of peri-implant bone levels, which relies on uneventful, successful osseointegration. Osseointegration is dependent on the implant being properly stabilized by the surrounding bone at placement (primary stability). Clinical differences between bone substitutes could clarify how processing protocols influence biomaterial behavior in alveolar ridge preservation and reconstruction.
Bone grafts and substitutes for alveolar ridge preservation / U. Garagiola. ((Intervento presentato al 25. convegno MAGYAR ARE-, ÀLTCSONT ÉS SZÉJSEBÉSZEII TÉRSASÉG : 14-16 november tenutosi a Szeged nel 2024.
Bone grafts and substitutes for alveolar ridge preservation
U. Garagiola
2024
Abstract
Bone grafts and substitutes are increasingly used in dental implantology due to the growing need for replacing insufficient alveolar bone before implant placement. One of the primary reasons for bone deficiency is tooth loss due to periodontal disease, tooth fracture/trauma, periapical lesions, or other pathological conditions. After tooth extraction, dimensional changes affect the alveolar socket, leading to loss in alveolar bone height and width. Histological modifications also occur, with initial formation of a blood clot that is replaced with granulation tissue and subsequently with a provisional connective tissue matrix. Spontaneous healing ends with socket filling with woven bone, which is gradually replaced with lamellar bone and bone marrow. Adequate alveolar ridge dimensions and bone quality are required to assure optimal stability and osseointegration following dental implant placement. When a tooth is extracted, alveolar ridge preservation (ARP) procedures are an effective method to prevent collapse of the post-extraction socket. In addition to the autologous and homologous bone, heterologous bone is widely chosen by clinicians for ARP, and anorganic bone xenografts (ABXs) made bioinert by heat treatment represents the most used biomaterial in clinical applications. Collagen-preserving bone xenografts (CBXs) made of porcine or equine bone are fabricated by less invasive chemical or enzymatic treatments to remove xenogenic antigens, and these are also effective in preserving post-extraction sites. In the field of bone grafting, the biocompatibility of the graft material is of utmost importance. It is crucial for the material to not only interact safely with the bone tissues but also facilitate the growth and development of new bone cells. Research has indicated that sericin, owing to its proteinaceous nature and high biocompatibility, shows promise in promoting cellular adhesion and proliferation. This makes it an excellent candidate for bone graft applications. Additionally, sericin is biodegradable, which means that it can be gradually broken down and replaced by the patient's own cells. The long-term success of implant-supported restorations is based on the preservation of peri-implant bone levels, which relies on uneventful, successful osseointegration. Osseointegration is dependent on the implant being properly stabilized by the surrounding bone at placement (primary stability). Clinical differences between bone substitutes could clarify how processing protocols influence biomaterial behavior in alveolar ridge preservation and reconstruction.File | Dimensione | Formato | |
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