- To understand the importance of bone as the foundation for successful implant restorations
- To be aware of the various types of bone grafting materials and the modern techniques available for alveolar ridge preservation and augmentation in everyday clinical practice
- To understand the make-up of new synthetic graft materials
- To discuss the key role of bone quality on the long-term stability and function of dental implants
- To examine the importance of Histology and Histo-morphometry in the true evaluation of bone quality
In modern Dental Implantology, like in Orthopedics and Regenerative Medicine, our aim is to restore the form and function of the lost bone, so that we can give back to our patients exactly the same tissue, a healthy bone tissue which can remodel and adapt to the transmitting occlusal forces. Only the host can regenerate bone so especially in the aesthetic zone we need to work with and up-regulate this host healing for optimal long-term outcomes
A new generation of novel alloplastic materials may elicit a controlled action and reaction to the host tissue environment, whilst exhibiting controlled chemical breakdown and resorption with an ultimate replacement by new bone. As surgeons, if bone regenerationis the aim of our treatment, a fully resorbable material should be used so that the newly formed bone will be in identical to the lost host bone and no residual graft should be present in the long term. Long-term incorporation of non-resorbable graft particles in the augmented bone leads to incomplete regeneration, so in these cases repairor bone augmentationare more appropriate terms.
Novel synthetic biomaterials are designed to be not only osteoconductive but also osteoinductive, i.e. to stimulate the differentiation of multipotent cells towards osteoblasts capable of depositing bone matrix, and there are currently numerous medical research papers showing this. All this medical research can teach us how to engineer functional bone in Dentistry and Implantology, we can learn and understand the role of periosteum, the importance of angiogenesis and biomechanics, so that we translate this knowledge into clinical applications for the benefit of our patients.
The aim of this lecture is to discuss these concepts and developments, and to present new minimally invasive protocols in order to optimize the host regeneration.