Abstract

When teeth are missing, the surrounding bone and soft tissue is challenged as a result of the natural resorptive process or from traumatic destruction subsequent to extraction. The diminished structural foundation for prosthetic reconstruction with or without implants can therefore be compromised. Recent technological innovations in computer hardware and software have given clinicians the tools to determine 3-dimensional anatomy, quality, and density of bone, which can aid in the diagnosis and treatment planning for reparative or augmentative grafting procedures. Advanced synthetic bioactive resorbable bone graft (SBRG) materials and innovative surgical techniques have made it possible to predictably alter the defective site to create favorable osseous conditions for implant placement. The synthetically derived, resorbable, cluster-like, hydrophilic, particulate, bone-grafting material, having similar mechanical and chemical properties as the host bone, can provide the means to modify existing bone topography by aggressively overpacking the material for ridge preservation, ridge augmentation, or to enhance the bony site and subsequent prosthetic rehabilitation. Since bone does not bridge in empty spaces, the aggressive overfill, commonly referred to as force mineralization, controls excessive bleeding and eliminates voids. Part 1 of this 2-part series presented evidence of safety and effectiveness of the SBRG materials, crystal morphology, chemical properties, and characterization through animal and clinical studies. The osteoconductive cluster particulate assists in the bridging of lost bone anatomy by chemotactic response and resorption concurrent with regeneration of new bone formations. Part 2 demonstrates specific clinical handling characteristics and use of this material to facilitate implant placement and/or prosthetic reconstruction through clinical case applications. Additionally, in a unique clinical presentation, a composite graft mixture consisting of the SBRG and dense, ceramic, bovine-derived HA (sintered at 1150°C) was compared using electron microscopy.

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