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ePaper created 2016-11-23, 14:26:06 | version 1.38.0
| industry 30 implants 4 2016 Comparison of bone-graft substitutes Risks and benefits of synthetic and bovine derivate materials Author: Dr Robert J. Miller, MA, DDS, FACD, DABOI The topic bone graft substitutes or bone regenera- tion and the question whether to apply xenografts, allografts or synthetically created materials still causescontroversialdiscussionsinoralandmaxillofa- cial surgery. Yet, there are no doubts about the prog- ressandthegoodclinicalexperiencesmadewithbio- mimetic materials in the last two decades. The main discussioninthisproductgroupconcernsasubstitu- tionwithpersistingvolumeandnoorextremelyslow resorption versus a complete degradation of the in- sertedmaterialandtransformationtovitalbonewith the unavoidable attendant symptom of controlled loss of volume. The following article shows risks and benefits of established bone-graft materials and why the author prefers synthetic bone regeneration. Alloplasts and xenografts look the same both macroscopically and radiographically, and have al- mostidenticalhandlingcharacteristics.Butherethe similarities end. The measurement parameters for a successful grafting are the radiographic interpreta- tion and the maintenance of volume of the regener- ated ridge. More challenging is the interpretation of resorption rate, the percentage of vital bone and mineral density. Also important is the rate of com- plications and failures and if the material provides Fig. 2 Fig. 4 Fig. 1 Fig. 3 Figs. 1 & 2: In the radiographs of the first case we can see two materials compared after seven years. Figs. 3 & 4: Clinicaly the bone graft shows no vitalisation and no connection with the host bone. 42016