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Next Generation Biomaterials for Bone and Periodontal Regeneration

 

The use of biomaterials in dental medicine has become so widespread over the past few decades that an entire textbook was needed to address their use during bone and periodontal regeneration. As little as 40 years ago, the practice of dentistry did not embrace the various bone grafts, barrier membranes, or growth factors currently available in today’s market. Over the years, exponential growth of each of these classes of biomaterials has delivered many new regenerative modalities and protocols for the improvement of patient care. As the number of new and innovative biomaterials continues to rise, many of them remain entirely foreign to practicing clinicians, and this book was designed to address this gap of knowledge by summarizing some of the groundbreaking research performed to date on this topic. Over 70 international authors have contributed to this textbook, each with different surgical backgrounds and expertise utilizing the various regenerative biomaterials presented throughout this book. The first 10 chapters focus on the biologic background and applications of bone grafting materials utilized in dentistry. For each of these classes of biomaterials—including autografts, allografts, xenografts, and alloplasts—the pros and cons are discussed extensively with their appropriate clinical indications. In addition, next-generation biomaterials—including the recently developed osteoinductive synthetic bone grafts, 3D-printed bone grafts, and novel bone adhesives used to facilitate bone-to-bone and bone-to-implant adhesion—are presented as future grafting options.

 

In chapter 11, the principles of guided tissue and bone regeneration are covered in detail with many recent advancements in barrier membrane technologies presented, including their uses and indications. Furthermore, a more natural approach utilizing platelet-rich fibrin is emphasized in chapter 12. Chapters 13 through 22 cover the increasing use of growth factors utilized in dentistry for bone regeneration, including the currently available FDA-approved bone morphogenetic protein 2 (BMP-2, Infuse Bone [Medtronic]), as well as those utilized for periodontal regeneration, including enamel matrix derivative (EMD, Emdogain [Straumann]) and platelet-derived growth factor (GEM21, Osteohealth). While the use of such growth factors in daily dental practice remains in its infancy, it is generally accepted that they provide a prominent future avenue for regenerative medicine as the field continues to move toward more minimally invasive surgery. As such, the use of growth factors has been the focus of many research laboratories around the world investigating the impact of single or combined bioactive molecules for the regeneration of either soft or hard tissues. These include a liquid delivery system for EMD (Osteogain, Straumann), recombinant human BMP-9, recombinant human fibroblast growth factor 2, adenovirus delivery of growth factors (gene therapy), as well as the incorporation of various trace elements that induce bone/periodontal regeneration, including strontium (Sr), boron (Br), and magnesium (Mg), into biomaterials.

 

The final chapter of this textbook is perhaps the most important. It covers the selection criteria and decision-making process for clinicians and is designed to help select appropriate biomaterials for each specific regenerative protocol. These include important topics such as which bone graft to utilize for guided bone regeneration, sinus augmentation, as well as around dental implants under various clinical settings and loading protocols. Furthermore, the regenerative potentials of each growth factor are compared with clinical cases presented discussing their specific use in dentistry. Much like one implant diameter, size, and length cannot be utilized for each placed implant, neither can one bone grafting material or barrier membrane be utilized for all bone augmentation procedures. Similarly, it should neither be expected that one growth factor can fulfill the task of maximizing the regenerative outcomes in all clinical situations. This textbook aims to better address these issues and limitations in a simple and understandable manner to maximize the clinician’s ability to utilize biomaterials in an appropriate, predictable, and evidence-based manner.

 

I am very proud and honored to bring together this work from internationally recognized experts in this first edition of Next-Generation Biomaterials for Bone & Periodontal Regeneration. I sincerely hope you enjoy the read!

 

Authors of the book

Richard J Miron, Yufeng Zhang, Anton Sculean, Michael A Pikos, Hom-Lay Wang, David L Cochran, Giovanni Zucchelli, Stuart Froum, Maurizio Tonetti, Pierpaolo Cortellini, Homah Zadeh, Guilio Rasperini, Carlos Nemcovsky, Andreas Stavropoulos, Leonardo Trombelli, Joseph Choukroun, Shahram Ghanaati, Nikos Donos, Søren Jepsen, Reinhard Gruber, Staale Petter Lyngstadaas, Alberto Monje, Howard Gluckman, Patrick R Schmidlin, Michel Dard, Dieter D Bosshardt, Alan Pollack, James Deschner, Paul Fugazzotto, Adrian Kasaj, Yoshinori Shirakata, Toshiaki Nakamura, Gregori Kurtzman, Masako Fujioka-Kobayashi, Nikola Saulacic, Dimitris Nikolidakis, Nicole B. Arweiler, Ferenc Dori, Tobias Fretswurst, Ismael Khouly, Kathia Nelson, Jonathan Du Toit, Itzhak Binderman, Jordi Caballe Serrano, Yulan Wang, Alexandre Amir Aalam, Alina Amir Aalam, Alain Simonpieri, Ferdinando D’Avenia, Angel Insua, Mark Bishara, Sarah Al-Maawi, Mustafa Abd El Raouf, Andrea Grassi, Alberto Barassa, Joost de Bruijn, Huipin Yuan, Marius Duda, Gideon Hallel, Robert Horowitz, George Kay, Michael Brown, Bruce R Donoff, Vincent Guillemette, Fatiha Chandad, Liwei Zheng, Ye Ling, Kazuyuki Noguchi, Benjamin Pippenger, Meizi Eliezer, Xioshi Jia, Hudi Xu