Bone Substitute Materials in Implant Dentistry

Abstract

Although bone autografts have been routinely used as "gold standard" for reconstruction/ replacement bone defects, because they have osteogenic, osteoinductive, osteoconductive properties, they have a high number of viable cells and are rich in growth factors. However, the use of autograft is limited by several factors, being one of them the insufficient amount of donor tissue. Therefore, bone substitute materials have been extensively studied in order to develop an ideal material for substitution of bone grafts, due to some disadvantages presented by autografts, allografts and xenografts, such as poor bone quality, an inadequate amount of bone and possible immunogenicity for allografts and xenografts, which limit the use of these grafts in specific surgical protocols. These disadvantages have led tissue engineering and biotechnology to develop new materials and promising methods for tissue repair, especially for bone tissue. Thus, bone substitutes, synthetic and/or biotechnologically processed have become potential materials for clinical applications in different areas of health. An ideal bone substitute (BS) material should provide a variety of shapes and sizes with suitable mechanical properties to be used in sites where there are impact loading; moreover, these materials should be biocompatible, osteoconductive, preferably being resorbable and replaced by new bone formation. In general, resorbable BS materials are preferred, since these materials are expected to preserve the increased bone volume during the reconstruction and simultaneously are gradually replaced by newly formed bone. Synthetic materials, denominated as alloplastics, may act as scaffolds for bone cells providing tissue growth inside the respective material.

Effect of bone sialoprotein coated three‐dimensional printed calcium phosphate scaffolds on primary human osteoblasts

“…Delayed cell proliferation was further observed on similar scaffolds during the first days by others . Superficial resorption processes and an accelerated dissolution as a result of CDHAs high surface area of about 50 m 2 /g can lead to a reduced rate of cell proliferation . BSP coating might compensate for the material surface effects via its integrin‐binding arginylglycylaspartic acid (RGD) sequence.…”

“…39,40 Superficial resorption processes and an accelerated dissolution as a result of CDHAs high surface area of about 50 m 2 /g can lead to a reduced rate of cell proliferation. [41][42][43][44] BSP coating might compensate for the material surface effects via its integrin-binding arginylglycylaspartic acid (RGD) sequence. Several studies demonstrated enhanced cell attachment via the RGD-domain of BSP.…”

Surface modification of porous alpha-tricalcium phosphate granules with heparin enhanced their early osteogenic capability in a rat calvarial defect model

“…Recently, numerous studies have reported that biodegradable calcium phosphates, such as alpha tricalcium phosphate (α-TCP, α-Ca 3(PO4)2), β-TCP, carbonate apatite, and octacalcium phosphate (OCP), can be substituted by the bone tissue over time through the bone remodeling processes [1][2][3][4] . Some biodegradable calcium phosphates have been extensively investigated and applied for treating the site of bone defects to stabilize dental implants 5,6) .…”

BONEFILL ® block as alternative for bone substitute: a toxicological evaluation

“…In addition, allografts and xenografts have been used as alternatives for bone repair, although they may promote rejection, and diseases can be transmitted when not properly chemically processed (Suchanek, Yoshimura, 1998). For these reasons, alternative bone substitutes auto, allo and xenografts to replace auto, allo, and xeno bone grafts (Saska et al, 2015) which contain materials with similar characteristics to bone tissue, such as osteoconductive, osteoinductive and osteogenic properties for decreasing immunogenic and compatibility problems (Saska et al, 2015).…”

“…One of those, poly(lactic-co-glycolic acid) (PLGA) is a biodegradable aliphatic polyester polymer obtained from hydroxyl acids (De Lima et al, 2011); it is used in several biomedical applications, such as tissue and genetic engineering and drug delivery (Cieślik et al, 2009). This polymer has the capacity to modulate the mechanical properties of others compounds and provide versatility in their structure (Saska et al, 2015), and it can be used as supporting or stabilizing elements by creating composites based on them (Cieślik et al, 2009). The association with other compounds provides biocompatibility, bioactivity, satisfactory mechanical properties, and osteoconduction, which makes them potential materials in regenerative medicine therapies (Saska et al, 2015).…”