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Biology of Low-Substitution Bone Substitutes

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Surgical Research in Implant Dentistry

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Abstract

Over 40 years have now passed since bone grafting materials were utilized for the regeneration of missing bone around teeth and dental implants. Today an ever-increasing number of bone substitute materials are available, each with various properties and characteristics. While bone grafts are typically classified into autografts, allografts, xenografts, and synthetic alloplasts, more recent research has focused on the prominent role of non-resorbable versus resorbable biomaterials. While it was originally thought that all bone grafts should be slowly resorbed or degraded and replaced with native bone over time, accumulating evidence has in fact suggested that the non-resorbable alternative may in fact be favored for certain clinical indications in implant dentistry. This chapter highlights the current use of low-substitution bone substitutes for contour augmentation and discusses their biological behavior in contrast to resorbable/degradable materials. Assessment by cellular and molecular methods both in vitro and in vivo are discussed, including appropriate study designs describing why cells derived from the monocytic lineage vary their resorption properties on various bone substitute materials. Lastly, histological evidence from clinical studies is presented with long-term follow-up demonstrating how these bone grafts, surrounded by large multinucleated giant cells, remain stable years following implantation.

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Authors and Affiliations

  1. Department of Periodontology, University of Bern, Bern, Switzerland

    Richard J. Miron & Dieter D. Bosshardt

  2. Department of Oral Implantology, University of Wuhan, Wuhan, China

    Yufeng Zhang

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  1. Richard J. Miron
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Correspondence to Richard J. Miron .

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    Michel M. Dard

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Miron, R.J., Zhang, Y., Bosshardt, D.D. (2023). Biology of Low-Substitution Bone Substitutes. In: Dard, M.M. (eds) Surgical Research in Implant Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-031-37234-6_15

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