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Hydrocolloids were the first elastic materials to be used in the dental field. Elastic impression materials include reversible (agar-agar), irreversible (alginate) hydrocolloids and synthetic elastomers (polysulfides, polyethers, silicones). They reproduce an imprint faithfully, providing details of a high definition despite the presence of undercuts. With the removal of the impression, being particularly rich in water, the imprints can deform but later adapt to the original shape due to the elastic properties they possess. The advantages of using alginate include the low cost, a better tolerability on the part of the patient, the ease of manipulation, the short time needed for execution, the instrumentation and the very simple execution technique and possibility of detecting a detailed impression (even in the presence of undercuts) in a single step. A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed database. Authors conducted a search of articles in written in English published from 2008 to 2018. All the relevant studies were included in the search with respect to the characteristics and evolution of new marine derived materials. Much progress has been made in the search for new marine derived materials. Conventional impression materials are different, and especially with the advent of digital technology, they have been suffering from a decline in research attention over the last few years. However, this type of impression material, alginates (derived from marine algae), have the advantage of being among the most used in the dental medical field.

Giant cell tumor (GCT) is a relatively common skeletal tumor. Mandibular localization of this tumor is usually treated with resection of the tumor area. Several autogenous bone-grafting techniques are available for the restoration of large continuity defects of the mandible. However, these procedures are associated with limitations involving postoperative morbidity, difficulty in ambulation (hip graft), and pain. The development of a technique of surgical reconstruction not involving autogenous bone would offer new opportunities for facial bone reconstruction, particularly of the mandible. This study aims to underline the effect of recombinant human bone morphogenetic protein type 2 (rhBMP-2) in a collagen carrier with concomitant bone grafting material in the restoration of continuity critical-size defects after GCT resection in the mandible. The rhBMP-2 was used with absorbable collagen sponge. A total dose of 4 to 8 mg of rhBMP-2 was delivered to the surgical site in concentrations of 1.5 mg/mL. The patient was followed up over a period from 6 to 18 months. Occlusal function was initially restored with conventional prosthesis. Bone formation in the surgical area could be palpated at the end of 3 to 4 months and identified radiographically at the end of 5 to 6 months. The results clearly indicated that the use of rhBMP-2 without concomitant bone grafting materials in large critical-size mandibular defects secondary to GCT produced excellent regeneration of the area, establishing the basis for the return of prosthodontic function.

The goal of this study was to demonstrate the technique and effectiveness of incorporating recombinant human bone morphogenetic protein-2 (rhBMP-2) to the established sandwich osteotomy technique. Although the success of the sandwich osteotomy procedure has been well documented, we hope to show that the addition of rhBMP-2 will enhance bone formation.We performed a sandwich osteotomy technique in patients who had been treated initially by grafting with suboptimal results. Only defects involving the anterior maxilla (3 patients) or the anterior mandible (1 patient) were included. There were 4 patients, 2 men and 2 women, with an age range of 19 to 62 years. The causes of the ridge deficiencies ranged from pathology to trauma. The height (distance) of distracted transport bone segment was measured. The amount of relapse was measured 6 months after the surgery.All patients exhibited a significant increase in bone height. The amount distracted was 6.75 mm (range, 5-11 mm). The amount of relapse was 8.5% (range, 0%-18%). Dental implants were placed in the reconstructed ridges in all patients. There were no instances of permanent paresthesia. Two patients had exposure of a portion of the hardware, which healed uneventfully.The sandwich osteotomy technique has proven to be an effective method for augmenting deficient alveolar ridges. The addition of rhBMP-2 may aid in its success rate by promoting osteogenesis at the osteotomy site, especially in multiple-operated patients where other traditional techniques have failed to gain the desired ridge height.

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Bisphosphonates are a class of agents used for treating osteoporosis and malignant bone metastases treatment. Osteonecrosis of the jaws is the main complication in a subset of patients receiving these drugs. Based on a growing number of case reports and institutional reviews, bisphosphonate therapy can cause exposed and necrotic bone that is isolated to the jaw. This clinical investigation is aimed at analyzing the clinical effect of recombinant human bone morphogenetic protein type 2 (rhBMP-2) application in patients affected by bisphosphonates-related osteonecrosis of the jaws undergoing surgery for necrotic bone removal.A case review was made of 20 patients. The rhBMP-2 in all the cases reported here was used alone with the collagen carrier without concomitant bone materials. The cases involved osteonecrotic lesions of the upper and lower jaws. A total dose of 4 to 8 mg of rhBMP-2 was delivered to the surgical site in concentrations of 1.5 mg/mL (depending on the size of lesion). Patients were followed up over a period ranging 6 to 12 months.Patients had successful healing of the necrotic area. New bone formation in the surgical area could be clinically evaluated by palpation at the end of 3 to 4 months and confirmed by radiographic examination at the end of 12 months.This study indicated that the use of rhBMP-2 without concomitant bone grafting materials was useful in promoting healing of bisphosphonates-related osteonecrosis of the jaws. The use of growth factors, particularly rhBMP-2, should be considered a therapeutic choice in patients affected by osteonecrosis of the jaws related to bisphosphonate therapy.

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