HARD TISSUE REGENERATION

EMPOWERING REGENERATION

At REGEDENT, we focus on leveraging hard tissue regeneration by getting artificial scaffold replaced by autogenous bone cells while providing a stable bone volume and minimizing the number of surgeries. Ultimately, patients benefit from better treatment predictability, combined with long-term outcome performance.

What is hard tissue regeneration?

Bone loss is a significant hallmark in dentistry. In periodontology, for example, pathogens, genetic factors, and environmental issues, such as tobacco, can lead to bone loss. It can result in tooth movement, dislocation, and eventually, tooth loss [1,2].

In implantology, the use of dental implants marks notable advantages for patients. However, it presents some risks caused by using inert materials in direct contact with bone and the absence of periodontal ligament (PDL). The PDL provides a buffer to distribute the mastication forces and, when absent, can lead to jawbone resorption [3,4].

Various techniques are used to enhance the osteogenesis process, such as bone grafting [5], scaffolds [6], stem cells [7], and growth factors. Bone grafting helps filling the physical gaps created by the missing or damaged bone, provides structural stability, and stimulates bone tissue growth [8]. Bone grafts are divided into four groups [9, 10]. First, autogenous bone is viewed as the “gold standard” for bone replacement [11], as it is used with minimal treatment and is the most efficient and fastest-healing bone substitute material [8]. Clinical applications showed that new bone and new periodontal connective tissue attachments are obtained [12].

Second, tissue banks provide different types of allogeneic bone grafts [13]. They are known to be not as effective as autografts due to the extensive chemical treatments required to prevent potential infectivity, disrupting the hierarchical structure of bone and removing a significant amount of the growth factors necessary for efficient bone regeneration [8].

Third, xenografts show distinct advantages. They are mass-produced at affordable processing costs. However, as they originate from other species’ bone tissues, their native osteological characteristics are different from those of human bone tissues. Yet, among xenografts, some, like porcine-originated substitutes, support bone regeneration due to their physicochemical characteristics and their structure like human bone [8, 14,15]. Besides, porcine bone has a relatively low risk of zoonosis [16].

Last, synthetic graft material, such as hydroxyapatite, are used for their osteoconduction, hardness, and acceptability by bone. Some synthetic bone grafts are made of calcium carbonate, which start to decrease in usage because it is completely resorbable in short time and makes breaking of the bone easier. This last category of graft material is increasingly being researched as it presents attractive advantages that xenograft material lack.

Ten signs of successful hard tissue regeneration

  1. User-friendly handling of grafting material and membrane for a cost-effective, predictable treatment protocol
  2. Use of biocompatible material
  3. Rapid blood clot stabilization
  4. Rapid angiogenesis
  5. Minimize inflammatory process (swelling, discomfort)
  6. Uneventful wound healing
  7. Predictable bone density
  8. Stable volume for predictable implant placement
  9. Resorbable material to avoid further surgeries and to be replaced by autogenous cells
  10. Patient and clinician satisfaction

Our solution for hard tissue regeneration

Hyadent BG, Smartbrane, and Smartgraft are designed to support hard tissue regeneration while being even more user-friendly together.

sticky bone with Smartgraft and Hyadent BG for hard tisue regeneration

Indeed, the gel combined with the porous bone makes a sticky putty in ~3 minutes, and the membrane’s tensile strength holds the augmented site well while adapting easily to the bone surface, yet without sticking. [20] Hyaluronic acid present in the augmented site appears to accelerate bone formation through its migratory and proliferative properties. [21-24]

Hyadent BG hyaluronic acid attracts blood and stabilize the blood clot

Regedent’s portfolio supports hard tissue regeneration. Hyadent BG and Smartbrane contribute to stabilizing the blood clot [25-26]. Hyaluronic acid attracts the growth factors naturally present in the blood and promotes vascularization with the support, for example, of porous porcine bone substitutes [27-29].

Bone cell adherence and proliferation are then facilitated with the porcine membrane and bone substitute’s rough surfaces [26, 28-31]. At the same time, the cross-linked high molecular weight hyaluronic acid enhances the overall cell proliferation [32-35]. Hyadent BG and Smartgraft contribute to accelerating bone healing while showing balanced bone volume remodeling [26, 36-41].

hyaluronic acid slows down collagen membrane resorption

During the bone healing process, the sticky bone made from Hyadent BG and Smartgraft benefits from its natural bacteriostatic shield [42]. The strong collagen membrane holds the grafted site together during the healing process. Its maintenance function is even prolonged through the slowed-down collagenase thanks to the membrane’s earlier coating with Hyadent BG [43].

By rebuilding not only the esthetic but also the functional structure around the tooth/implant, Hyadent BG is considered to regenerate rather than repair [44-47].

The wound healing properties of the Regedent portfolio are detailed in soft tissue regeneration.

Infrabony defect

Wide extended infrabony defects by Prof Andrea Pilloni with hard tissue regeneration

GBR prior to implant placement

Guided Bone Augmentation of distal mandibular edentulous ridge by Prof Darko Božić with hard tissue regeneration

Biofilm eraser against peri-implant / periodontal diseases

Dental regeneration for soft and hard tissues

Resorbable barrier membrane

Bone substitute for volume stable remodeling

CLEAN&SEAL banner

Effective treatment peri-implant / periodontal disease

Literature

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  2. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005 Nov 19;366(9499):1809-20. doi: 10.1016/S0140-6736(05)67728-8. PMID: 16298220.
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  5. Anushi, M.; Suresh, K. Periodontal bone regeneration in intrabony defects using osteoconductive bone graft versus combination of osteoconductive and osteostimulative bone graft: A comparative study. Dent. Res. J.  2015, 12, 25–30.
  6. Zhou, M.; Geng, Y.-M.; Li, S.-Y.; Yang, X.-B.; Che, Y.-J.; Pathak, J.L.; Wu, G. Nanocrystalline hydroxyapatite-based scaffold adsorbs and gives sustained release of osteoinductive growth factor and facilitates bone regeneration in mice ectopic model. J. Nanomater. 2019, 2019, 10.
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  20. Internal testing results, data on file.
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