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ePaper created 2017-12-06, 12:03:50 | version 1.38.0
Fig. 2a Fig. 2b Fig. 2c Fig. 3 Fig. 4 Fig. 5 Fig. 6 Interconnecting, spongy-open-celled pore struc- ture and continuous structuring with blood vessels Pores increase the surface and are vascularised in case of sufficient diameter. The pore diameter should at least be 100 µm for the ingrowth of vascularised, mineralised tissue. This enables a complete structur- ing. The pore size of the synthetic hydroxyapatite is mostly between 250 and 450 µm which supports vas- cularisation and osseointegration. Biocompatibility 28 days after the beginning of the cell cultivation, a very good cellular proliferation is clearly visible in the wide extension and clustering of the osteoblasts on Osbone®. The biocompatibility of the bone augmenta- tion material is already visible in vitro, due to good cell population properties. Due to its high similarity to a natural bone form, the hydroxyapatite could be con- firmed to have a very good biocompatibility. Compar- isons of in vitro studies with an osteoblast cell line show the reliable, very good cell population properties. Case studies—indications and usage Both of the two described products are qualified for the treatment and reconstruction of complex three-dimensional bone defects. However, after ex- tirpation of cysts, size, localisation, cyst-type and the age of the patient play a major role as well. The -TCP (CERASORB® M) is preferred because the goal is a complete regeneration from defect to the natural bone tissue (Figs. 2a–c). Filling of bone defects A 9-year-old patient came with an extensive fol- licular cyst in the region 23. Due to an extensive cyst growth, a massive bone resorption of the maxillary bone was noticed. The cyst growth completely de- composed the alveolar ridge bone up to the maxil- lary sinus (Fig. 3). After removal of the retained and extremely displaced tooth 23 (Fig. 4) as well as extirpation of the cyst and the surrounding tissue, a considerable bone defect remained (Fig. 5). The -TCP was mixed with blood from the defect and applied without pressure (Fig. 6). Additionally, the graft material was covered with a resorbable membrane. The postoperative radiograph after six months (Fig. 7) and after six years (Fig. 8) shows a perfect bone regeneration in the treated area. This creates a foundation for a good future for im- plantological treatment after the bone maturity is complete. industry | Figs. 2a–c:Structural comparison of CERASORB® M (a), natural bone spongiosa (b) and Osbone® (c). Fig. 3: Extensive follicular cyst region 23. Fig. 4: Removal of the retained and extremely displaced tooth 23. Fig. 5: Extensive bone defect. Fig. 6: Mixing -TCP with blood from the defect. implants 4 2017 39