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Filling nature’s void. Puros Allografts. Working together with nature.
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Proudlyoffering one of the mostcomprehensive dental implantproductlinesavailable, ZimmerDental isa marketleaderin the developmentof world-classimplantologyproducts, practice-building strategiesandeducational programsfocused on empowering cliniciansand improving patients’ lives.
Puros Allografts. Working together with nature.
Puros®
Allografts
1900 Aston AvenueCarlsbad, CA 92008-7308, USAIn the U.S. 800 854 7019
©20
06 Z
imm
er D
enta
lInc
. All
righ
tsre
serv
ed. 5
589,
Rev
. 2/0
6. T
utop
last
isa
regi
ster
ed tr
adem
ark
ofTu
toge
n M
edic
al, I
nc.
Bio
-Oss
isa
regi
ster
ed tr
adem
ark
ofG
eist
lich,
Woh
lhus
en, S
wit
zerla
nd; D
FDB
A is
a de
min
eral
ized
free
ze-d
ried
bon
e al
logr
aft.
For more information about our Products, Professional Programsand Continuing Education, contact us:
To fax an order 888 225 2483Outside the U.S. +1 760 929 4300Australia +61 (0)2 9950 5444Canada +1 905 567 2073 or 1 800 265 0968
France +33 (0)1 45 12 35 35Germany +49 (0)761 4584 722/723Israel +972 (0)3 6124242Spain +34 93 846 05 43
www.zimmerdental.com
To receive our eNews visit us at http://www.zimmerdental.com/news_eNewsLetterSignUp.aspx
Filling nature’s void.
Puros Family 9x12 Cover 2.qxp 3/8/06 11:19 AM Page 1
Collaborative Relationships Continuous Development Advancing Skills & Knowledge
Fast. Effective. Puros Allografts are the products
of choice for predictable and rapid bone
regeneration.Puros Allografts offer several unique qualities, including the ideal combination of pre-served natural collagen, mineral crystals, and structural bony architecture. These qualities are retained as a result of the proprietary Tutoplast ® Refinement Process,which gently removes unwanted materials while preserving the natural collagen matrix.Collagen is a crucial element in the formation of new bone and periodontal tissues. It is essential for blood clotting, promotes mineral deposition, and binds circulatingosteoinductive proteins to encourage bone formation.
The natural collagen and minerals found in Puros Allografts form a symbiosis to providenew bone with strength and rigidity, facilitating full bone remodeling. Puros Particulate Allografts can be tightly packed in either critical or noncritical-sized defects withoutfragmentation. This allows for the transmission of mechanical loads, a property essentialfor bone formation and remodeling, and enables predictable conversion to host bone.
In addition, while frozen and freeze-dried bone processing methods retain the collagenand minerals, marrow still present in the bone pores must first be absorbed before newbone ingrowth can occur. With Puros Allograft products, all bone marrow is removed, providing for healthy, immediate ingrowth by new bone.
The Puros family offers easy handling, quick rehydration, a five-year shelf life and room temperature storage. For rapid, predictable results, Puros products are the natural choice.
Puros Allografts.The natural choice for healthy bone growth.
Puros Allograft Family of ProductsA complete line of products to use togetheror separately for every bone grafting need.
Puros Cancellous Particles Puros Corticocancellous Block Puros Cortical Particles
Extraction sockets X X
Implant dehiscence defects X X
Severe localized ridge defects X
Moderate localized ridge defects X X
Sinus floor augmentation X X
Implant site development X X X
Coronal defects around immediate implants X X
Ridge volume preservation X X
Primary Indications of Puros Allografts
Histology courtesy of Gail G. Childers, DMD.
Puros HistologyRapid incorporation of Puros CancellousParticulate Allograft four months postsinus augmentation. (Donath technique, 48X)
Learn how to successfully place Puros Block Allograft at a limited attendance hands-on training course, including:
• Rationale for block bone grafting
• Receptor site preparation
• Block preparation – including hydration & block shaping
• Block placement
• Factors for creating long-term clinical success
• Limitations and complications
To register for the course, please contact your area representative. For more information on courses, visit our website at www.zimmerdental.com
Puros Allografts Patient Education Brochure
Find out more about Puros Allograft patienteducation materials.
Puros Allografts Training Course Brochure
Puros Block Allograft Training
Contact Zimmer Dental toll-free at 800 598 3029 today formore information.
Puros Family 9x12 Cover 2.qxp 3/8/06 11:19 AM Page 2
Puros Cortical Particulate Allograft.Stimulating solid results, naturally.
Case study
Figure ASeverely resorbed preoperative ridge.
Clinical photos courtesy of Sang-Hoon Park, DDS and Hom-Lay Wang, DDS, MSD, Department of Periodontics, University of Michigan. Individual results may vary.
Figure BImplant placed in periodontal defect.
Figure CPuros Cortical Particulate Allograft in place.
Figure DThree months postoperative: ridge widthrestored to natural contours (4mm increase).
Figure ERegenerated ridge six months postoperative.
Figure FRidge restored to natural contours.
The unique Tutoplast Process.Pure refinement. Proven results.
1. Delipidization with acetone inactivateslipid-enveloped viruses, such as HIV and HCV, and removes fat, enhancing the healingcharacteristics.
2. Osmotic Treatment kills bacteria, destroysand removes unwanted cells and most anti-genicity, and further reduces the viral load.
3. Oxidative Treatment destroys remainingproteins and minimizes the potential for graftrejection by removing proteins and inactivat-ing non-enveloped viruses.
4. Solvent Dehydration removes water fromtissue and acts as a disinfectant, removingbacteria, viruses, and inactivating prions.
5. Limited-Dose Gamma Irradiation guaranteessterility and preserves structural integrity.
Revascularization through the corticalparticles begin with initial osteoclasticenlargement of the existing Haversian andVolkmann’s canals, followed by blood vessel penetration. Osteoblasts in theblood flow deposit new bone to refill theenlarged canal spaces as the graft particu-late continues to resorb.
Puros Cortical Particulate Allograft is usedwhere space maintenance and volumeenhancement are desired, including sinuselevations, extraction sockets and ridgeaugmentations. Puros Cortical Particlescreate a dense lamellar structure thatmaintains graft volume and space, whileeffectively remodeling into natural bone.
Puros Cortical Particles offer superior structural strength, which help to maintainspace and volume during the remodelingprocess. Used alone or as a compositegraft, Puros Cortical Particles are an effec-tive alternative to intraoral graft harvestingand bovine-based products.
Cortical Allografts Cancellous Allografts
Volume enhancement
Space maintenance
Density
Osteoconductive function
Osteoinductive function**
*Fitch RB et. al. Compend Contin Education Pract Vet 1997; 19(5):558-578**Presence of Bone Morphogenic Protein (BMP) in tissue.
The Tutoplast Process, developed byTutogen Medical, Inc., is a proprietary,five-step treatment for preparing PurosAllograft materials from rigidly screeneddonor bone. In contrast to simple dehy-dration by conventional tissue processingmethods (e.g. freeze-drying, high-heat,etc.), the Tutoplast Process preserves the natural collagen architecture, while com-pletely removing all bone marrow, fat andnoncollagenous proteins. This providesan excellent bone matrix similar to naturalbone, making it easier to assimilate intothe body.
In contrast to conventional pathogen inactivation procedures such as irradiation,boiling, dry heat, and chemical treatment,which are ineffective in deactivating
prions (the infectious agents linked tospongiform encephalopathies), post-processing validation studies indicatethat the Tutoplast Solvent-DehydrationProcess effectively inactivates prions. The resulting Puros Allograft promotesrapid healing and complete bone remodeling.
The Tutoplast Process has been used forover 30 years in more than one millioncases without a single reported case ofdisease transmission.*
Facts• Allograft tissues are harvested and
processed according to pharmacologicalstandards that surpass those of the American Association of Tissue Banks(AATB).
• Voluntary tissue donors are rigorouslyscreened for health and lifestyle factors, medical history, and results of physicaland laboratory examinations.
• Single-donor processing is performed to prevent cross-contamination from other samples.
• Sterility validation studies and adherenceto good manufacturing practices (GMP) help to ensure product safety.
• All allografts are fully traceable to their original donors and individual reference samples are stored for 15 years.
Comparison of Cortical vs. Cancellous Allograft Functional Qualities*
The process
*Data on file.
Puros Family Bro. 9x12 Interior.qxp 4/6/06 3:52 PM Page 1
Puros Block Allograft.Changing the concept of block grafting.
Puros Cancellous Particulate Allograft.A proven history of rapid regeneration.
Case study
Figure ANonrestorable central incisor.
Clinical photos courtesy of Scott D. Ganz, DMD. Individual results may vary.
Figure BTooth extraction socket.
Figure CPuros Cancellous Particulate Allograft in place.
Figure DRadiograph of grafted ridge.
Figure EDefinitive restoration eight months afterimmediate loading.
Figure FFinal result.
Case study
Figure ANarrow ridge, 2mm wide.
Clinical photos courtesy of J. Daulton Keith, Jr., DDS, FICD. Individual results may vary.
Figure BInlay site preparation.
Figure CPuros Block Allograft in place.
Figure DPuros Block Allograft well incorporated atfive months.
Figure EImplant placement in grafted ridge.
Figure FRadiograph showing final restoration.
As Puros Cancellous Particles have demon-strated, these “creeping substitution”processes have been sufficientlycompleted within four months, providingsolid, vascularized bone.
Puros Cancellous Particles have becomethe bone grafting material of choice due toits history of complete, rapid and effectiveresults.
The open trabecular structure of PurosCancellous Particles offers natural bonemineral structure and collagen matrix forcell attachment and bone remodeling, andprovides an ideal environment for rapidrevascularization and remodeling, leavingbehind healthy, natural bone.* Osteogenicprogenitor cells from the new bloodstreamdifferentiate into osteoblasts and deposita layer of new bone around the graft tra-beculae, while osteoclasts simultaneouslyresorb the entrapped particles until theyare completely replaced by new bone.
Puros Block Allograft delivers the rapidremodeling capabilities of cancellousbone with the strength advantages ofcortical bone. This corticocancellousrelationship is ideal for restoring bonevolume to severely resorbed ridge locations.
Puros Block Allograft eliminates the needfor a secondary surgical procedure to harvest autogenous bone block, therebysaving time, reducing pain and complica-tions, and shortening the patient’srehabilitation period. Studies demonstrateclinical results with the Puros BlockAllograft are comparable to those ofautogenous block grafting.
The graft's cancellous portion quicklyrevascularizes and regenerates in a manner similar to Puros CancellousParticles, while the cortical portion of thegraft provides a framework for strength,maintains volume and regenerates in asimilar manner to Puros Cortical Particles,enabling implant placement after healingwithin five to six months.
Comparisons of Puros Block Allografts with Autogenous Iliac Crest Autografts
Mean % of Block Graft Resorption at 12-13 months
Maxillary Implant Survival (%) in Grafts
Mandibular Implant Survival (%) in Grafts
Puros Block AllograftIliac Crest Autograft
*Data on file. **Curtis TA, Ware WR. J Prosthet Dent 1983;14(2):212-216.
***Williamson RA. Int J Oral Maxillofac Implants 1996;11(4):476-488.
*Data on file.
Histologic Comparison of Allografts after 10 Month in Human Sinuses*
Residual Graft Particles
Residual Graft Particles in Contact with Bone
Puros CancellousBio-Oss® with DFDBA (3:1)
From the repair of simple periodontaldefects to complex subantral augmenta-tion procedures, Puros CancellousParticulate Allograft is the next best thingto using a patient’s own bone. In dentalapplications, Puros Cancellous Particleshave proven to be clinically effective,allowing for successful implant placementin only four months.* Tutoplast-processedtissues have been successfully used forover 30 years in all medical disciplines.*
*Data on file.
Puros Family Bro. 9x12 Interior.qxp 4/6/06 3:52 PM Page 2
Puros Block Allograft.Changing the concept of block grafting.
Puros Cancellous Particulate Allograft.A proven history of rapid regeneration.
Case study
Figure ANonrestorable central incisor.
Clinical photos courtesy of Scott D. Ganz, DMD. Individual results may vary.
Figure BTooth extraction socket.
Figure CPuros Cancellous Particulate Allograft in place.
Figure DRadiograph of grafted ridge.
Figure EDefinitive restoration eight months afterimmediate loading.
Figure FFinal result.
Case study
Figure ANarrow ridge, 2mm wide.
Clinical photos courtesy of J. Daulton Keith, Jr., DDS, FICD. Individual results may vary.
Figure BInlay site preparation.
Figure CPuros Block Allograft in place.
Figure DPuros Block Allograft well incorporated atfive months.
Figure EImplant placement in grafted ridge.
Figure FRadiograph showing final restoration.
As Puros Cancellous Particles have demon-strated, these “creeping substitution”processes have been sufficientlycompleted within four months, providingsolid, vascularized bone.
Puros Cancellous Particles have becomethe bone grafting material of choice due toits history of complete, rapid and effectiveresults.
The open trabecular structure of PurosCancellous Particles offers natural bonemineral structure and collagen matrix forcell attachment and bone remodeling, andprovides an ideal environment for rapidrevascularization and remodeling, leavingbehind healthy, natural bone.* Osteogenicprogenitor cells from the new bloodstreamdifferentiate into osteoblasts and deposita layer of new bone around the graft tra-beculae, while osteoclasts simultaneouslyresorb the entrapped particles until theyare completely replaced by new bone.
Puros Block Allograft delivers the rapidremodeling capabilities of cancellousbone with the strength advantages ofcortical bone. This corticocancellousrelationship is ideal for restoring bonevolume to severely resorbed ridge locations.
Puros Block Allograft eliminates the needfor a secondary surgical procedure to harvest autogenous bone block, therebysaving time, reducing pain and complica-tions, and shortening the patient’srehabilitation period. Studies demonstrateclinical results with the Puros BlockAllograft are comparable to those ofautogenous block grafting.
The graft's cancellous portion quicklyrevascularizes and regenerates in a manner similar to Puros CancellousParticles, while the cortical portion of thegraft provides a framework for strength,maintains volume and regenerates in asimilar manner to Puros Cortical Particles,enabling implant placement after healingwithin five to six months.
Comparisons of Puros Block Allografts with Autogenous Iliac Crest Autografts
Mean % of Block Graft Resorption at 12-13 months
Maxillary Implant Survival (%) in Grafts
Mandibular Implant Survival (%) in Grafts
Puros Block AllograftIliac Crest Autograft
*Data on file. **Curtis TA, Ware WR. J Prosthet Dent 1983;14(2):212-216.
***Williamson RA. Int J Oral Maxillofac Implants 1996;11(4):476-488.
*Data on file.
Histologic Comparison of Allografts after 10 Month in Human Sinuses*
Residual Graft Particles
Residual Graft Particles in Contact with Bone
Puros CancellousBio-Oss® with DFDBA (3:1)
From the repair of simple periodontaldefects to complex subantral augmenta-tion procedures, Puros CancellousParticulate Allograft is the next best thingto using a patient’s own bone. In dentalapplications, Puros Cancellous Particleshave proven to be clinically effective,allowing for successful implant placementin only four months.* Tutoplast-processedtissues have been successfully used forover 30 years in all medical disciplines.*
*Data on file.
Puros Family Bro. 9x12 Interior.qxp 4/6/06 3:52 PM Page 2
Puros Cortical Particulate Allograft.Stimulating solid results, naturally.
Case study
Figure ASeverely resorbed preoperative ridge.
Clinical photos courtesy of Sang-Hoon Park, DDS and Hom-Lay Wang, DDS, MSD, Department of Periodontics, University of Michigan. Individual results may vary.
Figure BImplant placed in periodontal defect.
Figure CPuros Cortical Particulate Allograft in place.
Figure DThree months postoperative: ridge widthrestored to natural contours (4mm increase).
Figure ERegenerated ridge six months postoperative.
Figure FRidge restored to natural contours.
The unique Tutoplast Process.Pure refinement. Proven results.
1. Delipidization with acetone inactivateslipid-enveloped viruses, such as HIV and HCV, and removes fat, enhancing the healingcharacteristics.
2. Osmotic Treatment kills bacteria, destroysand removes unwanted cells and most anti-genicity, and further reduces the viral load.
3. Oxidative Treatment destroys remainingproteins and minimizes the potential for graftrejection by removing proteins and inactivat-ing non-enveloped viruses.
4. Solvent Dehydration removes water fromtissue and acts as a disinfectant, removingbacteria, viruses, and inactivating prions.
5. Limited-Dose Gamma Irradiation guaranteessterility and preserves structural integrity.
Revascularization through the corticalparticles begin with initial osteoclasticenlargement of the existing Haversian andVolkmann’s canals, followed by blood vessel penetration. Osteoblasts in theblood flow deposit new bone to refill theenlarged canal spaces as the graft particu-late continues to resorb.
Puros Cortical Particulate Allograft is usedwhere space maintenance and volumeenhancement are desired, including sinuselevations, extraction sockets and ridgeaugmentations. Puros Cortical Particlescreate a dense lamellar structure thatmaintains graft volume and space, whileeffectively remodeling into natural bone.
Puros Cortical Particles offer superior structural strength, which help to maintainspace and volume during the remodelingprocess. Used alone or as a compositegraft, Puros Cortical Particles are an effec-tive alternative to intraoral graft harvestingand bovine-based products.
Cortical Allografts Cancellous Allografts
Volume enhancement
Space maintenance
Density
Osteoconductive function
Osteoinductive function**
*Fitch RB et. al. Compend Contin Education Pract Vet 1997; 19(5):558-578**Presence of Bone Morphogenic Protein (BMP) in tissue.
The Tutoplast Process, developed byTutogen Medical, Inc., is a proprietary,five-step treatment for preparing PurosAllograft materials from rigidly screeneddonor bone. In contrast to simple dehy-dration by conventional tissue processingmethods (e.g. freeze-drying, high-heat,etc.), the Tutoplast Process preserves the natural collagen architecture, while com-pletely removing all bone marrow, fat andnoncollagenous proteins. This providesan excellent bone matrix similar to naturalbone, making it easier to assimilate intothe body.
In contrast to conventional pathogen inactivation procedures such as irradiation,boiling, dry heat, and chemical treatment,which are ineffective in deactivating
prions (the infectious agents linked tospongiform encephalopathies), post-processing validation studies indicatethat the Tutoplast Solvent-DehydrationProcess effectively inactivates prions. The resulting Puros Allograft promotesrapid healing and complete bone remodeling.
The Tutoplast Process has been used forover 30 years in more than one millioncases without a single reported case ofdisease transmission.*
Facts• Allograft tissues are harvested and
processed according to pharmacologicalstandards that surpass those of the American Association of Tissue Banks(AATB).
• Voluntary tissue donors are rigorouslyscreened for health and lifestyle factors, medical history, and results of physicaland laboratory examinations.
• Single-donor processing is performed to prevent cross-contamination from other samples.
• Sterility validation studies and adherenceto good manufacturing practices (GMP) help to ensure product safety.
• All allografts are fully traceable to their original donors and individual reference samples are stored for 15 years.
Comparison of Cortical vs. Cancellous Allograft Functional Qualities*
The process
*Data on file.
Puros Family Bro. 9x12 Interior.qxp 4/6/06 3:52 PM Page 1
Collaborative Relationships Continuous Development Advancing Skills & Knowledge
Fast. Effective. Puros Allografts are the products
of choice for predictable and rapid bone
regeneration.Puros Allografts offer several unique qualities, including the ideal combination of pre-served natural collagen, mineral crystals, and structural bony architecture. These qualities are retained as a result of the proprietary Tutoplast ® Refinement Process,which gently removes unwanted materials while preserving the natural collagen matrix.Collagen is a crucial element in the formation of new bone and periodontal tissues. It is essential for blood clotting, promotes mineral deposition, and binds circulatingosteoinductive proteins to encourage bone formation.
The natural collagen and minerals found in Puros Allografts form a symbiosis to providenew bone with strength and rigidity, facilitating full bone remodeling. Puros Particulate Allografts can be tightly packed in either critical or noncritical-sized defects withoutfragmentation. This allows for the transmission of mechanical loads, a property essentialfor bone formation and remodeling, and enables predictable conversion to host bone.
In addition, while frozen and freeze-dried bone processing methods retain the collagenand minerals, marrow still present in the bone pores must first be absorbed before newbone ingrowth can occur. With Puros Allograft products, all bone marrow is removed, providing for healthy, immediate ingrowth by new bone.
The Puros family offers easy handling, quick rehydration, a five-year shelf life and room temperature storage. For rapid, predictable results, Puros products are the natural choice.
Puros Allografts.The natural choice for healthy bone growth.
Puros Allograft Family of ProductsA complete line of products to use togetheror separately for every bone grafting need.
Puros Cancellous Particles Puros Corticocancellous Block Puros Cortical Particles
Extraction sockets X X
Implant dehiscence defects X X
Severe localized ridge defects X
Moderate localized ridge defects X X
Sinus floor augmentation X X
Implant site development X X X
Coronal defects around immediate implants X X
Ridge volume preservation X X
Primary Indications of Puros Allografts
Histology courtesy of Gail G. Childers, DMD.
Puros HistologyRapid incorporation of Puros CancellousParticulate Allograft four months postsinus augmentation. (Donath technique, 48X)
Learn how to successfully place Puros Block Allograft at a limited attendance hands-on training course, including:
• Rationale for block bone grafting
• Receptor site preparation
• Block preparation – including hydration & block shaping
• Block placement
• Factors for creating long-term clinical success
• Limitations and complications
To register for the course, please contact your area representative. For more information on courses, visit our website at www.zimmerdental.com
Puros Allografts Patient Education Brochure
Find out more about Puros Allograft patienteducation materials.
Puros Allografts Training Course Brochure
Puros Block Allograft Training
Contact Zimmer Dental toll-free at 800 598 3029 today formore information.
Puros Family 9x12 Cover 2.qxp 3/8/06 11:19 AM Page 2
Proudlyoffering one of the mostcomprehensive dental implantproductlinesavailable, ZimmerDental isa marketleaderin the developmentof world-classimplantologyproducts, practice-building strategiesandeducational programsfocused on empowering cliniciansand improving patients’ lives.
Puros Allografts. Working together with nature.
Puros®
Allografts
1900 Aston AvenueCarlsbad, CA 92008-7308, USAIn the U.S. 800 854 7019
©20
06 Z
imm
er D
enta
lInc
. All
righ
tsre
serv
ed. 5
589,
Rev
. 2/0
6. T
utop
last
isa
regi
ster
ed tr
adem
ark
ofTu
toge
n M
edic
al, I
nc.
Bio
-Oss
isa
regi
ster
ed tr
adem
ark
ofG
eist
lich,
Woh
lhus
en, S
wit
zerla
nd; D
FDB
A is
a de
min
eral
ized
free
ze-d
ried
bon
e al
logr
aft.
For more information about our Products, Professional Programsand Continuing Education, contact us:
To fax an order 888 225 2483Outside the U.S. +1 760 929 4300Australia +61 (0)2 9950 5444Canada +1 905 567 2073 or 1 800 265 0968
France +33 (0)1 45 12 35 35Germany +49 (0)761 4584 722/723Israel +972 (0)3 6124242Spain +34 93 846 05 43
www.zimmerdental.com
To receive our eNews visit us at http://www.zimmerdental.com/news_eNewsLetterSignUp.aspx
Filling nature’s void.
Puros Family 9x12 Cover 2.qxp 3/8/06 11:19 AM Page 1
