A lecture by Daniel Rothamel
One of the most challenging procedures in dental implantology is the predictable and safe regeneration of bone and soft tissue defects. Although autogenous bone is still considered being the golden standard, different biomaterials such as bone substitutes and membranes have shown predictable results in augmentation procedures of the alveolar process. Whereas the regeneration of smaller defects inside the ridge contour may be supported by transmembraneous angioselectivity of the applied membranes, extended defects require volume-stable bone substitute materials and long-lasting barriers. Native porcine pericardium has shown favourable results, based on its multi-layered collagen structure. Moreover, available bone substitutes differ significantly in terms of biochemical aspects, influencing the volume stability, speed of bone formation, graft remodelling and patient´s acceptance. Also the quality of the recipient site, the osteogenicity of the graft and the selected healing time are affecting the predictability of the regeneration outcome.
In addition to bone augmentation biomaterials, specific collagen matrices have been established for soft tissue augmentation procedures, including gingiva thickening, vestibuloplasty and recession coverage. In contrast to the patient´s own soft tissue, the use of biomaterials is not accompanied by donor site morbidity.
This presentation will detail selection rules of different collagen matrices and different bone graft materials that fit to the indication, the defect´s shape and to the patient’s preconditions in order to achieve the best regeneration outcome. Based on clinical examples new treatment options of prevalent clinical indications like socket preservation that arise from the availability of novel collagen soft tissue grafts will be presented.