The porous granules in NovaBone Morsels have osteostimulative properties that help in the treatment of peri-implantitis defects.
Promising progress in the treatment of peri-implantitis defects
Inflammation around a dental implant that progresses to the peri-implantitis stage typically requires surgical intervention to decontaminate the implant surface and graft the site to regenerate bone for implant stability and pocket reduction. The materials and methods for the treatment of peri-implantitis vary.
Prominent researcher Dr. George Kotsakis — the Rolland E. Meffert Endowed Professor in Implant Dentistry and Director of ITI Implantology Program at the UT Health San Antonio — is leading ongoing human clinical trials and preclinical animal studies to identify the optimal parameters for peri-implant bone regeneration. Findings from these projects and his clinical experience have allowed Dr. Kotsakis to develop a promising evidence-based peri-implantitis treatment protocol.
Research shows that simple nonabrasive surface-cleaning strategies, such as the use of pressurized saline and polymer brushes, are most effective for cleaning the exposed implant surface. Metallic brushes or instrumentation can permanently damage the passivation layer on the implant surface, negatively impacting its cellular compatibility. This damage to the titanium surface leads to the release of titanium microparticles in the peri-implant tissue, which has pro-inflammatory and osteoclastic effects and negatively impacts regeneration. Dr. Kotsakis limits the use of therapeutic agents (threefold dilution of NaOCl is his preference) only to areas of the implant surface exposed to the gingival sulcus. Chlorhexidine is not preferred as it negatively impacts cell attachment to the titanium surface and may inhibit cell proliferation.
For bone grafts, Dr. Kotsakis uses NovaBone® Morsels (porous granules) for their osteostimulative properties. The graft will be contained/protected with a membrane per classic guided-bone regeneration procedures. This bone graft is a synthetic calcium phosphosilicate (CPS) material with bimodal particle distribution and interconnected porosity. His selection of this material is predicated on the following:
- NovaBone’s CPS material is a bioactive glass. Its formulation is osteostimulatory. As the material breaks down in vivo, elemental ions are released that attract osteoprogenitor cells. Most other synthetics and xenografts only serve as an osseoconductive scaffold and have no stimulatory mechanism of action.
- An in vitro study conducted by Dr. Kotsakis demonstrated that the NovaBone graft material showed an incremental chemotactic effect on osteoblasts and increased cell attachment and viability compared to the control and a test group incorporating beta-tricalcium phosphate. Viable attachment of osteoblasts to the treated titanium surface in the early phases of wound healing is critical to preventing the formation of long junctional epithelium on the implant surface.
- Research shows this class of bioactive glass has some antimicrobial effect, perhaps related to changes in the local pH during the material’s dissolution. If the titanium surface has any remaining biofilm contaminants, this antimicrobial effect may provide sufficient prophylaxis to allow for osteoblasts to attach and thrive on the implant surface.
- The NovaBone porous granules offer sufficient stability in the defect site. The material has been used clinically in extraction sockets, sinus augmentations, peri-implant defects, and localized ridge augmentations.
The NovaBone portfolio is distributed by Osteogenics Biomedical in the U.S./Canada and through a network of distributors internationally. To learn more, visit www.novabonedental.com.
This information was provided by NovaBone Products.
Besides NovaBone Morsels, read more about NovaBone products here: https://implantpracticeus.com/novabone-products/.
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