Bone grafts: which is the ideal biomaterial?

Abstract

Bovine xenograft materials, followed by synthetic biomaterials, which unfortunately still lack documented predictability and clinical performance, dominate the market for the cranio‐maxillofacial area. In Europe, new stringent regulations are expected to further limit the allograft market in the future. Aim Within this narrative review, we discuss possible future biomaterials for bone replacement. Scientific Rationale for Study Although the bone graft (BG) literature is overflooded, only a handful of new BG substitutes are clinically available. Laboratory studies tend to focus on advanced production methods and novel biomaterial features, which can be costly to produce. Practical Implications In this review, we ask why such a limited number of BGs are clinically available when compared to extensive laboratory studies. We also discuss what features are needed for an ideal BG. Results We have identified the key properties of current bone substitutes and have provided important information to guide clinical decision‐making and generate new perspectives on bone substitutes. Our results indicated that different mechanical and biological properties are needed despite each having a broad spectrum of variations. Conclusions We foresee bone replacement composite materials with higher levels of bioactivity, providing an appropriate balance between bioabsorption and volume maintenance for achieving ideal bone remodelling.

Management of the extraction socket and timing of implant placement: Consensus report and clinical recommendations of group 3 of the XV European Workshop in Periodontology

“…Based on strong pre‐clinical evidence (Haugen, Lyngstadaas, Rossi, & Perale, ; Donos, Dereka, & Calciolari, ; Omar, Elgali, Dahlin, & Thomsen, ), five different approaches that have been documented to a different degree in clinical studies are illustrated in Figure . The evidence pertains mostly to single tooth replacement, and thus, extrapolation to other scenarios may not apply.…”

Spontaneous progression of experimental peri‐implantitis in augmented and pristine bone: A pre‐clinical in vivo study

“…While a long‐term evaluation of implants placed in augmented bone indicated high implant survival rates (Buser et al, ), Galindo‐Moreno et al () in a long‐term retrospective clinical study reported that implants placed in deproteinized bovine bone mineral (DBBM)‐augmented bone in maxillary sinuses presented with larger amounts of crestal bone loss than implants placed in corresponding compartments of pristine bone. DBBM has a slow bio‐absorbability and presents with the most extensive documentation among biomaterials used in augmentation procedures in implant dentistry (Haugen, Lyngstadaas, Rossi, & Perale, ; Sanz et al, ). The question whether there are differences in the occurrence of peri‐implantitis or other biological complications around implants placed in augmented or pristine bone sites was addressed in a systematic review by Salvi, Monje, and Tomasi ().…”

Biomaterials and regenerative technologies used in bone regeneration in the craniomaxillofacial region: Consensus report of group 2 of the 15th European Workshop on Periodontology on Bone Regeneration

“…Biomaterials for craniomaxillofacial bone regeneration are usually available in the form of granules or blocks. Depending on the clinical needs, it is desirable to have a wide variability of sizes and forms, ranging from 0.1 to 2.0 mm in the particulate form (Haugen, Lyngstadaas, Rossi, & Perale, ). For certain indications an injectable mode of application would be desired to fill the defect volume through its plasticity. Manufacturing processes : The biomaterial should be provided with certification or documentation of the appropriate manufacturing and sterilization processes and assure long shelf time and reduced production costs.…”