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| industry 32 implants 4 2016 tion, as it is shown by the studies of Bernhard A. et al. in 2010 (Figs. 5a–c).1 Animportantreasonfortheuseofahighlyresorb- ablealloplastisthebiologiceffectoftheresorptionof calcium phosphate materials (Fig. 6). During the re- sorptive phase, there is a contribution of the release offreeionicCa2+ .Severalstudies2–4 certifytheimpor- tance of calcium for proliferation of osteoclasts and osteoinduction which is important for bone forma- tion.6 Furtherparametersfortheevaluationofabone regeneration material or a bone substitute are: Primary particle size Toavoidcellulardegradation,aprimaryparticlesize of 10 µm is required. It provides mechanical stability of the framework and also interconnecting micropo- rosity.Grainslowerthan10 µmstimulatephagocyto- sisfrommacrophages8 andleadtoanunintendedan- ticipatedlossofthebonegraftmaterialinthedefect. As a result, a complete biological bone regeneration remains undone. Stability of the framework An early break-up in micro particles provokes the activity of phagocytosing macrophages and giant cells.Thisinitiatesanunspecificimmunologicalreac- tionwhichderangestheregenerationandleads,inthe worst case, to an excessively inflammatory reaction. Open cell and spongious, interconnecting structure Thesepropertiesprovideacontinuousmigrationof blood vessels and osseointegration. Biocompatibility The biocompatibility of a bone-graft material is al- ready demonstrated in vitro by an accelerated settle- mentwithvitalcells.7 Materialswithastructuresimilar to cancellous bone have an advantage in this regard. Indications and examples Filling and reconstruction of multi-wall bony de- fects, e.g. cysts, ridge- and socket preservation or si- nusflooraugmentationaretypicalindicationsforthe use of Cerasorb®M. Alveolar ridge augmentation with dental implants Theimageshowshealthysofttissueconditionsand solid incorporated dental (Fig. 7). Final results After one year we can see an inflammation-free soft tissue and a complete bone regeneration in the augmented area (Figs. 8 & 9). Summary Today we have different bone graft materials for preservationandreconstruction ofthealveolarbone that allow a vast range of therapeutic approaches. Aftermorethan20yearsofexperiencewithsynthetic bone grafts and the excellent results achieved with Cerasorb®Mnodisadvantagecanbeseeninmaterials ofbiologicalorigin.Theobviousdisadvantagesofbo- vinematerialsarealowpercentageofvitalbonewith a lower stress bearing modulus. They do not release free ionic calcium, are not resorbable and their only function is that of a filler. The main disadvantage is that they may experience foreign body-reaction and require an intensive patient information. Cerasorb®M is highly resorbable and replaced by autogenous bone at a rapid rate. It releases free ionic calcium(osteoinductive)andleadstoahighpercent- ageofvitalbone.Alsoitprovidesahigherstressbear- ing modulus from an increased density. Last but not least, there is no foreign-body reaction and now risk of transmitting prions—it is safe._ Fig. 7 Fig. 8 Fig. 9 contact Dr Robert J. Miller, MA, DDS, FACD, DABOI The Center For Advanced Aesthetic & Implant Dentistry 16244 South Military Trail, Suite 260 Delray Beach, FL 33484, USA Tel.: +1 561 499-5665 dentalimplantsdelraybeach.com Fig. 7: The image shows healthy soft tissue conditions and solid incorporated dental implants. Figs. 8 & 9: After one year we can see an inflammation-free soft tissue and a complete bone regeneration in the augmented area. Literature Author details 42016 Tel.: +1561499-5665