Each situation and patient is individual – and so is the clinical user. Today, a multitude of different bonegrafting materials are available that offer attractive alternatives to patients’ autologous bone. In addition, there is widespread use of various membranes and other collagen-based materials that support bone and soft tissue regeneration. All of these materials demonstrate distinctive properties, based on their origin and the production process, that result in certain advantages or disadvantages, depending on the specific situation.
Dr. Christiane Marinc, Head of Product Management at botiss medical. Each patient is individual and the same applies to the clinical users. Consequently, the treatment plan and applied materials should be chosen with regard to the individual indication, defect configuration, the preferences of the patient, as well as the experience and skills of the surgeon. Hence, the many expectations with respect to the “ideal” bone graft or the “ideal” membrane cannot be met by one single product. This is the reason why botiss offers a broad portfolio of different biomaterials – the botiss regeneration system – enabling the clinical user to achieve optimal and predictable results in every situation.
(Click on the picture for a more detailed view)
SYNTHETIC BONE GRAFT SUBSTITUTE WITH CONTROLLED RESORPTION PROPERTIES
While many doctors are successful and satisfied with the application of bovine products, others prefer fully synthetic bone-grafting materials. Synthetic materials provide solutions for patients that oppose the use of xenogenic materials, and are also favorable in cases where the patient’s own regenerative capacity allows complete resorption of the biomaterial. The purely synthetic bone graft maxresorb® is completely resorbed and replaced by the body’s own bone within about two years. Due to its biphasic composition of 60 % HA and 40 % beta-TCP, the material is gradually degraded, providing space for new bone formation while ensuring mechanical stability over a longer time period. By mixing maxresorb® particles with a nano-HA gel, an injectable and non-hardening bone paste is obtained; the maxresorb® inject. The large surface area of the nano-HA particles facilitate interaction with bone cells, thus promoting rapid regeneration. On the other hand high cellular interaction increases the particles susceptibility to degradation, thus the material is not suited for the regeneration of larger or non-contained defects.
EXCELLENT HANDLING IN TERMS OF SHAPING AND SCREWING
If the focus is on an especially natural regeneration, fast and complete remodeling may be achieved with allogenic materials from human donors. Even complex, three-dimensional defect situations may be treated with allogenic bone blocks; this is made especially easy by using the sophisticated maxgraft® bonebuilder concept. The allogenic blocks and granules of the maxgraft® product line contain natural collagen that is preserved within the mineral phase of the bone during the production process. Collagen is a versatile protein that exerts chemotactic influence on osteoblasts and endothelial cells, thereby supporting the rapid incorporation and complete remodeling of the biomaterial. In addition, blocks of mineralized collagen offer excellent handling in terms of shaping and screwing, and have therefore become the current material of choice for block augmentation. The new maxgraft® solutions further demonstrate that botiss not only pursues established approaches, but also focuses on individual concepts and problem-oriented individual solutions. The maxgraft® bonebuilder technology is an important innovation in the field of block augmentation. Based on the three-dimensional radiological data of the defect/ridge, the allogenic bone transplant is designed and shaped into an individual construct. The exact fitting of the individualized bone block to the surface contours of the bone bed promotes optimized healing and improves the predictability of the augmentation. The shortened surgical time as compared to traditional block grafts (no intra-operative adaptation of the block) further adds to its advantages.
MAXGRAFT® BONE RING
SIMULTANEOUS AUGMENTATION AND IMPLANTATION IN A ONE-STAGE PROCEDURE
The maxgraft® bone ring is a prefabricated allogenic bone ring that enables simultaneous augmentation and implantation in a one-stage procedure. The so-called bone ring technique can be applied for many indications and is of particular benefit for vertical augmentations and one-stage sinus lifts with minimal maxillary bone height (between 1-4 mm).
A NATURAL MULTILAYER STRUCTURE FOR APROLONGED BARRIER FUNCTION
The botiss soft tissue portfolio also takes account of different treatment concepts. For instance, there is currently a general agreement that barrier membranes of collagen, which exhibit a long barrier function or support rapid vessel penetration, lead to especially successful GBR. Botiss has picked up on both ideas in its soft tissue product line. The Jason® membrane, which originates from porcine pericardium, offers a naturally long barrier function of 4 – 6 months due to its native multilayer structure. Accordingly, it guarantees an undisturbed bony regeneration, in particular for larger augmentative procedures. Due to its inherent architecture based on collagen type-1 and an increased content of collagen type-III, the Jason® membrane demonstrates excellent tear resistance and its low thickness supports excellent surface adaptation and aids in achieving tension-free wound closures.
FOR MEDIUM BARRIER FUNCTION WITH EXCELLENT ANGIOGENIC FEATURES
With the launch of the collprotect® membrane, botiss has extended its range of membranes to include a membrane with a medium barrier function of 2 – 3 months that displays excellent angiogenic features. The collprotect® membrane originates from porcine dermis. Its transmembraneous pore structure supports the rapid ingrowth of blood vessels into the defect area, while the dense collagen structure maintains a barrier against soft tissue ingrowth. It offers adequate protection for regeneration of most defetcs.
RESORBABLE COLLAGEN SPONGE FOR WOUND MANAGEMENT
In situations that do not require a particular barrier function, the Jason® fleece offers a cost-effective alternative, e.g. for protection of the Schneiderian membrane or covering extraction sockets. Du to the inherent hemostatic effect of the natural collagen and the highly porous structure, Jason® fleece helps to stabilize the blood coagulum and supports wound healing. It might be applied to cover minor oral wounds or biopsy harvesting sites. Furthermore, Jason® fleece offers a cost-effective alternative in situation that do not require a particular barrier function, e.g. for protection of the Schneiderian membrane or to cover extraction sockets.
A CONE-SHAPED COLLAGEN FLEECE TO FIT IN THE EXTRACTION SOCKET
Collacone® is a cone-shaped collagen fleece that was designed to fit in the extraction socket and specifically aimed at stabilization of the blood clot following tooth extraction.
A THREE DIMENSIONAL COLLAGEN MATRIX
Another innovative product from the botiss portfolio is mucoderm®, which is made from porcine dermis, developed for soft tissue augmentation. The complex collagen structure serves as a scaffold for ingrowing vessels and soft tissue cells, and is gradually remodeled into the patient’s own tissue. The application of mucoderm® circumvents the need for harvesting autologous gingival or subepithelial transplants during recessions coverage, regeneration of soft tissue defects and augmentation of attached gingiva. Accordingly, post-operative pain and risk of complications may be reduced, while the patient’s acceptance of the surgical intervention may increase.