Introduction
- To promote regeneration of bone loss due to periodontal disease or tooth extraction using synthetic material.
- Bioactive, particulate, ceramic materials have been shown to be very effective.
Uses
- To treat vertical infrabony osseous defects caused by periodontal disease
. - Filling endodontic-periodontic lesions .
- Filling traumatic periodontal defects.
- Filling intraosseous flaws related to pulpal floor or lateral root perforations.
- Filling tooth extraction site defects to maintain vertical height and width of the alveolar ridge.
- To produce supporting bone for loose teeth (combined with splint to solid tooth).
- Repairing fractures of the mandible when bone graft material is needed.
Advantages
- Rapidly bonds with living tissues (within 3 days) → security in defect site.
- Incorporates into the bone matrix without eliciting a foreign body response.
- Acts as a scaffold for bone production → rapid (from 7 days), extensive osteoproduction.
- Bending strength and stiffness comparable to normal bone within 3 months.
- Completely replaced by normal bone/soft tissue within 18 months .
- Promotes gingival reattachment and limits epithelial downgrowth → reduced periodontal pocket depth.
- Repairs and restores periodontium.
- Easy to use: easy to mix and manipulate, does not migrate from surgical site, adapts excellently to defect.
- No special site preparation required - material will bond even when not dry or blood-free.
- Bacteriostatic - allowing placement in areas of infection with good results.
- Hemostatic (mechanically).
- Radio-opaque allowing immediate and long-term observations.
Disadvantages
- Adequate post-operative home care is essential to the satisfactory outcome of the technique.
Requirements
Materials required
Minimum equipment
- A sufficient quantity of grafting material for defect to be filled.
- Small round or pear-shaped bur in handpiece
. - Cross-cut fissure bur in handpiece.
- No. 2 or 4 Periosteal elevator .
- Small bone rongeur.
- Mixing spatula (plastic/metal).
- Periodontal surgery pack.
Minimum consumables
- Sterile saline.
- Syringes for fluid transfer.
- No. 15c or 11 scalpel blade.
- 4-0 or 5-0 absorbable suture material.
Preparation
- Dependent upon site and extent of defect to be filled.
Sequelae
Complications
- Thermal necrosis from inadequate cooling while using burs.
- Gingival recession.
- Flap sloughing.
- Resorption or ankylosis of treated root.
- Infection.
- Pain.
- Abscess formation.
Prognosis
- Good - provided cases selected with care and good owner compliance with post-operative home care.
Reasons for treatment failure
- Inadequate home care → poor post-operative oral hygiene → advancement of plaque bacteria can → 'wash out' of the grafting material.
- Thermal necrosis → graft slough.
- Mobile teeth not stabilized.
- Endodontic/pulpal disease exists.
- Concurrent steroid treatment → bone destruction.
Sources
Publications
- DeForge D H (1997) Evaluation of Bioglass*R/PerioGlas *TM (Consil*TM) Synthetic Bone Graft Particulate in the Dog and Cat. J Vet Dent 14(4) 141-145.
