Canis ISSN: 2398-2942

Periodontal bone grafting: synthetic material

Contributor(s): Norman Johnston

Introduction

  • To promote regeneration of bone loss due to periodontal disease or tooth extraction using synthetic material.
  • Bioactive, particulate, ceramic materials have been shown to be very effective.

Uses

  • To treat vertical infrabony osseous defects caused by periodontal disease Periodontal disease.
  • Filling endodontic-periodontic lesions Periodontal pockets.
  • Filling traumatic periodontal defects.
  • Filling intraosseous flaws related to pulpal floor or lateral root perforations.
  • Filling tooth extraction site defects to maintain vertical height and width of the alveolar ridge.
  • To produce supporting bone for loose teeth (combined with splint to solid tooth).
  • Repairing fractures of the mandible when bone graft material is needed.

Advantages

  • Rapidly bonds with living tissues (within 3 days) → security in defect site.
  • Incorporates into the bone matrix without eliciting a foreign body response.
  • Acts as a scaffold for bone production → rapid (from 7 days), extensive osteoproduction.
  • In vitrostudies have demonstrated that the material actively stimulates osteoblast proliferation and differentiation.
  • Bending strength and stiffness comparable to normal bone within 3 months.
  • Completely replaced by normal bone/soft tissue within 18 months.
  • Promotes gingival re-attachment and limits epithelial downgrowth → reduced periodontal pocket depth.
  • Repairs and restores periodontium.
  • Easy to use: easy to mix and manipulate, does not migrate from surgical site, adapts excellently to defect.
  • No special site preparation required - material will bond even when not dry or blood-free.
  • Bacteriostatic - allowing placement in areas of infection with good results.
  • Hemostatic (mechanically).
  • Radio-opaque allowing immediate and long-term observations.

Disadvantages

  • Adequate post-operative home care isessentialto the satisfactory outcome of the technique.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good - provided cases selected with care and good owner compliance with post-operative home care.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Ay A Y, Au R Y, Demko J L et al (2010) Consil (R) bioactive glass particles enhance osteoblast proliferation and selectively modulate cell signalling pathways in vitro. J Biomed Mater Res A 94 (2), 380-388 PubMed.
  • Au A Y, Au R Y, Al-Talib T K et al (2008) Consil (R) bioactive glass particles enhance osteoblast proliferation and maintain extracellular matrix production in vitro. J Biomed Mater Res A 86 (3), 678-684 PubMed.
  • Bosetti M, Cannas M (2005) The effect of bioactive glasses on bone marrow stromal cells differentiation. Biomaterials 26 (18), 3873-3879 PubMed.
  • Allan I, Newman H, Wilson M (2001) Antibacterial activity of particulate bioglass against supra-and subgingival bacteria. Biomaterials 22 (12), 1683-1687 PubMed.
  • Xynos I D, Hukkanen M V, Batten J J et al (2000) Bioglass 45S5 stimulates osteoblast turnover and enhances bone formation in bitro: implications and applications for bone tissue engineering. Calcif Tissue Int 67 (4), 321-329 PubMed.
  • Xynos I D, Edgar A J, Buttery L D et al (2000) Ionic products of bioactive glass dissolution increase proliferation of human osteoblasts and induce insulin-like growth factor II mRNA expression and protein synthesis. Biochem Biophys Res Commun 276 (2), 461-465 PubMed.
  • Stoor P, S√∂derling E, Salonen J I (1998) Antibacterial effects of a bioactive glass paste on oral microorganisms. Acta Odontol Scand 56 (3), 161-165 PubMed.
  • DeForge D H (1997) Evaluation of Bioglass*R/PerioGlas *TM (Consil*TM) synthetic bone graft particulate in the dog and cat. J Vet Dent 14 (4), 141-145 PubMed.
  • Oonishi H, Kushitani S, Yasukawa E et al (1997) Particulate bioglass compared with hydroxyapatite as a bone graft substitute. Clin Orthop Relat Res (334), 316-325 PubMed.
  • Vrouwenvelder W C, Groot C G, de Groot K (1993) Histological and biochemical evaluation of osteoblasts cultured on bioactive glass, hydroxylapatite, titanium alloy, and stainless steel. J Biomed Mater Res 27 (4), 465-475 PubMed.
  • Wilson J, Low S B (1992) Bioactive ceramics for periodontal treatment: comparative studies in the Patus monkey. J Appl Biomater (2), 123-129 PubMed.

Other sources of information

  • Nutramax Laboratories, Inc., 5024 Campbell Boulevard, Baltimore, Maryland 21236, USA.Consil *TM - Synthetic Bone Graft Particulate - Oral Surgical techniques.

Organisation(s)

  • Vetoquinol (UK) Ltd, Wedgewood Road, Bicester, Oxfordshire OX6 7UL, UK. Tel: +44 (0)1869 241287; Fax: +44 (0)1869 320145.


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