1. OsteoBiol 2012

2. SEM image of an OsteoBiol Gen-Os granule,highlighting the porosity of the material.Magnification x30000Source: Courtesy of Dr Ulf Nannmark,University of Gteborg, Sweden 3. Welcome to the OsteoBiol world 2012INTRODUCTIONTissue regeneration technology: a difference that Focus on research and education: an evidence based Over recent years clinical research efforts have beenmatters.approach to biomaterials marketing.focussed on a better understanding of the preciseUsed in more than 200 000You may not immediately notice the xenogenic origin Our mission is simple and ambitious at the sameindications for various bone augmentationsurgeriesof the OsteoBiol biomaterials, and the collagentime: acquire a leading position in every majorprocedures and materials. Autogenous bone iscontent preserved in each granule by the Tecnoss market, corresponding to the outstanding quality ofgenerally considered the gold standard however it has to be harvested and patients may not always be Distributed in over 40 countriesinnovative biotechnology. OsteoBiol biomaterials. happy to donate their own bone since there is aYou may also not be aware of the excellentSince our start-up in 2004 already 33 scientific biological price to pay postoperative morbidity atbiocompatibility and total safety guaranteed by the papers regarding OsteoBiol grafting materials have Strong scientific background the donor site. The scientific literature tends to grosslyTecnoss certified manufacturing process. been published on international peer reviewedunderestimate the incidence of complications atNot until the very moment in which you will use anjournals, and several new studies are on-going and donor sites simply because complications are Extraordinary clinical resultsOsteoBiol grafting material in your first surgery: a will be published in the near future.underreported. Therefore, we do have a problem andunique handling sensation and clinical response fromEach research has required a great deal of effort andwe do need a solution. The solution is theoreticallyyour patient. patience, and we desire to thank all authors for their quite simple, to take bone from somewhere else.OsteoBiol is a complete and innovative biomaterial fantastic and passionate work. Bone could be taken from other humans, fromline: a family of products designed for each specific Each research has also contributed to understand the various mammals or it could be artificially produced.clinical indication.responses of cells in hard and soft tissues to the Each alternative has potential advantages andvarious OsteoBiol materials in each clinicaldisadvantages and personal beliefs and moralInnovation has always required to find the limits ofindication.aspects play important roles in the decision making. (1) ESPOSITO M, GRUSOVIN MG, FELICE P KARATZOPOULOS G, ,existing solutions, and to explore new ways to break If we are objective and examine the scientific WORTHINGTON HV, COULTHARD Psuch limits defining new quality standards. Perfect biocompatibility, abundant new bone INTERVENTIONS FOR REPLACING MISSING TEETH: evidence we can conclude that evidence isThis requires unconventional mentality and free formation, progressive resorption and graft volumeHORIZONTAL AND VERTICAL BONE AUGMENTATION accumulating that various animal derived bone grafts TECHNIQUES FOR DENTAL IMPLANT TREATMENTthinking: the essential attitudes of researchers. preservation are to be found in every OsteoBiol may be as good if not better than autogenous boneCOCHRANE DATABASE OF SYSTEMATIC REVIEWS 2009:product.CHICHESTER, UK: JOHN WILEY & SONSWhen Dr Giuseppe Oliva founded Tecnoss, he had (1,2). More evidence is still needed but there areonly one goal: develop and manufacture the best We offer a variety of solutions, designed for thenumerous ongoing trials which will providebiomaterials line for bone augmentation in dentistry. different clinical indications: each product has additional information in the near future. So we can (2) ESPOSITO M, GRUSOVIN MG, REES J, KARASOULOS D,specific advantages and handling properties to make FELICE P ALISSA R, ET AL, hazard to say that after the revolution ofHis philosophy has always been to achieve tissueyour augmentation surgery easier and safer in theINTERVENTIONS FOR REPLACING MISSING TEETH: osseointegrated implants in the seventies and eighties AUGMENTATION PROCEDURES OF THE MAXILLARY SINUSregeneration respecting biological principles and laws. recommended indication.we are now very much part of the bone substitute COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2010:These concepts, together with accurate design, pioneerCHICHESTER, UK: JOHN WILEY & SONSWe also want to share this knowledge with you: this is revolution.technologies and meticulous quality control, have why we believe and invest in professional educationSo what is the situation today? That xenografts offer abeen and will be the driving force of our company.and communication. reliable if not better alternative to autogenous bone inAt Tecnoss we dedicate all our energy and resourcesParticipating to one of the Symposiums or Live practically all indications when used in conjunctionto improve hard and soft tissue regeneration: this is Surgery courses organized by our company, or simplywith dental implants or in periodontal therapy. Thatour only activity and focus.browsing through our catalog or website will there is more evidence supporting the use ofOur unconditional passion for biomaterials reflects inintroduce you to the best approach in regeneration:xenografts than other types of bone substitutes. Thatevery single product we manufacture.the respect of biological principles and laws. the ideal bone substitute should be easy to handle and should not be resorbed too fast via anAnd every OsteoBiol product contains a biologicalThis is our marketing: evidence based scientific data inflammatory process or induce adverse reactions.added value that will create confidence in your enriched by the operatory experience of outstanding We now need to understand and identify the bestregenerative surgery and clinical success with your surgeons, ready to share it with you in a wide variety materials and techniques to reconstruct bone in thepatients. of educational programmes. most challenging situations such as the heavilyTecnoss biomaterials are different, a difference that Welcome to our regeneration network! resorbed maxilla.matters!Davide Oliva MD Marco Boarolo BEcMarco Esposito DDS, PhDManaging Director Managing DirectorDirector Postgraduate Dental SpecialtiesTecnoss s.r.l.Tecnoss Dental s.r.l.Manchester Academic Health Science CentreBiomaterials EngineeringInternational Sales & MarketingThe University of Manchester, UK 4. The most complete range of bone grafting materials 2012 INDEXINTRODUCTION PRODUCTS57A significant step ahead 7 BONE SUBSTITUTES 58Why xenografts?8Gen-Os60Collagen: a key factor for clinical success9mp3 64Collagen and bone regeneration10Putty 68From heterologous bone to biomaterial 12Gel 4072Characteristics of Tecnoss process 13 MEMBRANES AND BONE BARRIERS76Evolution 78Lamina82CLINICAL INDICATIONS15 SPECIFIC PRODUCTS86ALVEOLAR REGENERATION 18 Sp-Block 87Characteristics Dual-Block 88OsteoBiol products Apatos 89Case reports Tablet 90DEHISCENCES AND FENESTRATIONS 24 Duo-Teck 91 Characteristics Special92 OsteoBiol products Derma93 Case reports LIVE SURGERY COURSES94CRESTAL ACCESS SINUS LIFT 30 Brnemark Osseointegration Center95 Characteristics Marseille, France OsteoBiol products Lake Como Institute96 Case reports Como, ItalyLATERAL ACCESS SINUS LIFT 36 Venice Dental Center 97CharacteristicsVenice, ItalyOsteoBiol productsCase reports CERTIFICATIONS AND LITERATURE 99HORIZONTAL AND VERTICAL AUGMENTATION 42From nature to man100 Characteristics CE certificates 101 OsteoBiol products Case reportsBiocompatibility tests Gen-Os102PERIODONTAL REGENERATION50 Evolution 103Characteristics mp3 104OsteoBiol productsCase reports ISO 13485 105 Literature review 106 Scientific literature 108 5 5. SEM image of an OsteoBiol Gen-Os granule: osteoblasticcolonisation. Magnification x3000Source: Courtesy of Dr Ulf Nannmark, University of Gteborg, Sweden4 6. A significant step ahead INTRODUCTION INNOVATIONSEM images of an OsteoBiol Gen-Os granule colonised by osteoblasts from a cell-line (MG63)Source: Courtesy of Dr Ulf Nannmark, Gteborg University, SwedenResearch and development of biomaterialsThe first products developed through thesehave gone through many stages, buttechnologies have shown encouragingalways toward one goal: to heal boneclinical results, even if made of bonedeficit with newly-formed quality tissue in mineral matrix only.order to achieve functional recovery.The OsteoBiol new generation ofAll of this in the least time possible. biomaterials, thanks to a revolutionarytechnology, goes beyond the simple role ofThe examination of clinical results and theaiding natural bone regrowth bycommercial diffusion of various kinds ofstimulating and accelerating contactproducts developed by the biomedicalosteogenesis.industry show a clear superiority ofproducts of natural origin over those ofsynthetic derivation.The structure of animal bone ismorphologically more similar to humanbone than any synthesized product.Over the last twenty years severalprocesses have been developed to allowthe grafting of heterologous originproducts in the human body withoutadverse reaction. 7. Why xenografts?Xenografts offer a reliableXenografts are the most used biomaterials worldwide SEM image of OsteoBiol granulesif not better alternative toSource: Courtesy of Dr Ulf Nannmark, Gteborg University, SwedenThis is because:autogenous bone inpractically all indications >> tissues of origin are extremely safe and available in unlimited quantitieswhen used in conjunction>> xenogenic bone surface and porosity are extremely similar to autogenous bonewith dental implants or inperiodontal therapy. There>> there is no need to harvest autogenous bone in extraoral sites, with the relatedis moreevidence >> risk of morbidity and post-operatory complicationssupporting the use of>> sterile xenografts are completely biocompatible and safexenografts than other typesof bone substitutes>> no adverse reactions after grafting deriving from biomaterial degradation>> easy to handle, quick learning curveMarco Esposito DDS, PhDDirector Postgraduate Dental>> collagenated xenografts enhance osteoblasts and osteoclasts activitySpecialtiesManchester Academic Health>> wide scientific documentationScience Centre, The University ofManchester, UK>> excellent clinical performance>> storage can be done at room temperature>> long shelf life (5 years from production date)>> excellent price/quality ratio8 8. Collagen: a key factor for clinical success INTRODUCTIONTHE COLLAGEN FACTORTecnoss exclusive manufacturing process >> it stimulates the activation of theis able to neutralize the antigenicplatelets, osteoblasts and osteoclasts in thecomponents present in heterologous bonetissue healing process(achievement of biocompatibility) and to The presence of collagen inside eachpreserve the collagen matrix inside the granule makes OsteoBiol Gen-Osgranules of biomaterial. hydrophilic and facilitates further mixingMoreover, the molecular structure of with collagen gel (OsteoBiol Gel 0).natural hydroxyapatite is not significantly This technology has permitted thealtered thanks to the limited maximum development of three new versatile andprocess temperature(1). innovative products: OsteoBiol mp3,These characteristics of OsteoBiolOsteoBiol Putty and OsteoBiol Gel 40.products allow a consistent bone Their consistency allows an ideal filling ofneo-formation and a close contact bone defects and guarantees simplebetween mature neo-formed bone and handling and fast application.biomaterial granules. The OsteoBiol new generation ofCollagen has a key role in bone biomaterials, thanks to a revolutionaryregeneration process in that: technology, goes beyond the simple role of>> it acts as a valid substrate for platelet aiding natural bone regrowth byactivation and aggregation stimulating and accelerating this vital physiological process.>> it serves to attract and differentiate themesenchymal stem cells present in the(1) FIGUEIREDO M, ET AL. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH PART B: APPLIED BIOMATERIALS (2010): 92B: 409419bone marrow(2) (2) SALASZNYK RM, ET AL. JOURNAL OF BIOMEDICINE AND>> it increases the proliferation rate of theBIOTECHNOLOGY (2004), 1: 24-34osteoblasts up to 2/3 times(3) (3) HSU FY, ET AL. BIOMATERIALS (1999), 20: 1931-1936 Composition of OsteoBiol Gen-OsSource: Courtesy of Nobil Bio Ricerche, Villafranca dAsti, ItalyOsteoBiol membrane collagenic structureMineral bone CollagenSource: University of Duisburg-Essen, Germany9 9. Collagen and bone regenerationAll OsteoBiolGuided bone regeneration (GBR) is necessary In fact, the primary post-haemorrhagic clotSampath and Reddi (1980) demonstratedcollagenated biomaterialsto treat bone deficits due to lesions orformationprocess throughplatelet crosslinked type I collagen to be the mostprovide the naturalbacterial infections. aggregation and lysis causes the release ofappropriatecarrierfor promotingsubstrate for correct bone both the coagulation cascade factors and osteoinductive signal activity. The bone defect recovery occurs through thetissue regeneration andgrowth factors, such as PDGF, IGF 1, IGF 2 general mechanisms of tissue healing, that is, The continuous progresses in comprehensionrepair, facilitating and and VEGF which are known for their by complex dynamic mechanisms directed of biological mechanisms regulating boneaccelerating the activating effect on osteoblasts and towards the repair of tissue function andtissue morphogenesis can be exploited alsophysiological regeneration osteoclasts, and TGF- (Bone Morphogenetic anatomic integrity.for elaboration of natural or artificial productsprocess and allowing Proteins belong to this superfamily) whichable to restore or maintain the function ofoptimal results within a The discovery of the events pathway leading starts bony callus formation.damaged tissues and organs (tissuereasonable period of time to tissue healing has helped to clearly identify >> the osteoblastic precursors derivingengineering)(1,2,3).Giuseppe Oliva MDthe main actors in bone healing process; the from bone marrow mesenchymal stem cellsR&D Director concomitant presence of the following threeInvitrostudiesdemonstratedthat are responsible, after cell differentiation inTecnoss s.r.l. components is necessary for the formation of heterologous collagen is able to induce osteoblasts, for the second phase of the de novo bone tissue: differentiationof mesenchymal healing process(enchondral and/orosteoprogenitor stem cells into osteoblasts(4), >> the platelets represent the principalintramembranous ossification) thanks to theand that association of collagen type I with a actors during the first phase of the healingsynthesis of collagen and other componentsscaffold of hydroxyapatite significantly process, when, subsequent to a lesion, an of the extracellular matrix.enhances osteoblasts proliferation rate(5). initial deposition of fibrin and the formation of >> an insoluble substrate, suitable carrier blood clot take place. This phase is This important scientific evidence provides the for osteoinductive signal and able to support characterized by significant activation of the rationale behind OsteoBiol product line: and guide new bone tissue formation. chemical signals mediated by cytokines and a complete series of biomaterials with growth factors.collagen base. 10 10. INTRODUCTION GUIDED BONE REGENERATIONCollagen, in addition to its well-known3. Angiogenesisstructural action carried on connectiveThe drawn monocytes/macrophages, in BIBLIOGRAPHYtissues, is endowed with the following their turn, stimulate both osteoblastic (1) GRIFFITH LG, NAUGHTON G, SCIENCE (2002); 295: 1009-14important properties, useful in tissue activity and angiogenesis process inSUBSTRATE(2) REDDI AH, TISSUE ENGINEERING (2000); 6: 351-59reparation processes:grafting site.Collagen(3) NAKASHIMA N, REDDI AH, NATURE BIOTECHNOLOGY1. Haemostasis 4. Osteoblastic activity(2003); 9: 1025-32Collagen is able to activate the receptors Collagen, binding to fibronectin, promotes(4) SALASZNYK RM, ET AL., JOURNAL OF BIOMEDICINE AND BIOTECHNOLOGY (2004), 1: 24-34present on cellular membranes of the anchorage of mesenchymal stem (5) HSU FY, ET AL., BIOMATERIALS (1999), 20: 1931-36platelets, responsible for their aggregation progenitors, on which it exerts itsand lysis process; moreover, during thechemotactic action,and induces OSTEOPROGENITORGROWTH FACTORSfirst week, it reinforces the action of fibrin differentiation into osteoblasts(4).CELLSTGF1 BMP: bloodin the formation of the primary clot, and Bone marrow 5. Receiving site remodelingthen, in the second week, it replaces the Exogenouscollagengrafting canfunction of fibrin. contribute in decreasing remodeling times2. Debridement of immature bone tissue.Collagen has a chemotactic action on 6. Osteoconduction and guidedmonocyte/macrophage cell lines, from regenerationwhich osteoclasts derive; these cells, Naturally integratedwith mineralthrough their action on mineral REGENERATION component, collagen is able to increasecomponent resorption of both bone tissueAlveolar bone osteoblasts proliferation rate(5), while as aand OsteoBiol biomaterials, can draw,periodontal ligament cementum resorbable membrane it is able to guideactivate and collaborate with osteoblasts in connective tissue regeneration.bone rearranging and remodeling. 11 11. From heterologous bone to biomaterialRESULTS OF INORGANIC CHEMICAL ANALYSES RESULTS OF ORGANIC CHEMICAL ANALYSESPERFORMED ON OSTEOBIOL GEN-OS PERFORMED ON OSTEOBIOL GEN-OS The separated proteins (one lane) were OsteoBiol Gen-Os fractionated in ten portions and analysed Chemical element (% in weight) with nano-LC-ESI MS/MS. In the fractions Ca25.7% Mineral 1-5 in the range from 20-200kDa we PO43- 35.2% component found ONLY COLLAGEN. In the fractions C 13.6%73.6%6-10 we identify NO PROTEIN H2.2% N2.9% O (not in PO4 ) 3- 20.4% TOTAL 100.0% Organic matrix22.4% Ca/P (n:n) 1.73Water 4.0%Inorganic chemical analyses resultsOrganic chemical analyses resultsSource: University of Duisburg-Essen, GermanySource: Proteome Factory, GermanyThe ideal bone substituteA biomaterial for the reconstruction of bone defects must beshould be easy to handlebiocompatible and have good handling and modeling properties; inand should not be resorbedspecific clinical situations, it must also provide sufficient resistance totoo fast via an inflammatoryloading.process or induce adverseTecnoss laboratories are specialized in processing heterologous bonyreactionsand collagenic tissues. OsteoBiol bone process, in particular, hasMarco Esposito DDS, PhD been developed to modify but maintain the original collagen matrix ofDirector Postgraduate DentalSpecialtiesheterologous tissue, in order to preserve its positive biologicalfunctions, obtaining at the same time complete biocompatibility(1,3).Manchester Academic HealthScience Centre, The University of Most biomaterials are inert products that do not interfere, or rather, doManchester, UKnot take part in the physiology of bone remodeling: since they havebeen developed according to the sole concept of biocompatibility, theirfunction is limited only to preservation of the graft volume (scaffold).The concept of biocompatibility by itself has an essential purpose in theimplant of permanent prosthetic elements inside the human body, butit is extremely restrictive in case of materials used for bonereconstruction.In the case of synthesized hydroxyapatite or natural bonehydroxyapatite derived from aggressive manufacturing processesosteoclastic cellular response is slow, causing extremely prolongedresorption time.12 12. Characteristics of Tecnoss processINTRODUCTION A UNIQUE PROCESSTecnoss has developed treatment BIBLIOGRAPHYmanufacturing processes of various (1) FIGUEIREDO M, ET AL. JOURNAL OF BIOMEDICAL MATERIALSanimal species connective tissues, allowingRESEARCH PART B: APPLIED BIOMATERIALS (2010): 92B: 409419to obtain the biocompatibility of these(2) TRUBIANI O, ET AL. JOURNAL OF IMMUNOPATHOLOGY ANDtissues, preserving at the same time their PHARMACOLOGY (2007); 20: 89-93collagen matrix(1).(3) NANNMARK U, SENNERBY L. CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH (2008) DEC; 10(4):264-70The protein components of animal tissues (4) CRESPI R, ET AL. INTERNATIONAL JOURNAL OF ORAL ANDare determinant to make every individual MAXILLOFACIAL IMPLANTS (2011) JUL-AUG; 26(4):866-72unique. They activate the cells of theimmune system of the receiving organismby interacting with receptors of the MajorHistocompatibility Complex (MHC).Their neutralization/denaturation allowsthe mineral bone and collagen matrix tobe transferred from animal to man withoutany dangerous adverse reaction outbreak.Successful Guided Bone Regeneration(GBR) depends both on stimulation oftissues involved in new bone formationand on the characteristics of graftedbiomaterials, which can determine thequality of bone/graft interface(2).The basic research for development of Image showing bone formation on collagenated porcine bone granules (OsteoBiol Gen-Os) 2 weeks after implantation in arabbit. In the lower left and right corners granules can be seen. These granules are covered by newly formed bone and a seamOsteoBiol product line has thus been of osteoblasts. Osteocytes in lacunae are visible in the newly formed bone. Close to the osteoblastic seam, both feedingmicrovessels and a venule can be seen. Staining hematoxyline-eosine. Original magnification x40driven by the ideal biomaterial concept: aSource: Courtesy of Drs Ulf Nannmark and Lars Sennerby, Gteborg University, Swedenmaterial with the highest affinity to the newendogenous bone.To pursue this aim, Tecnoss developed aThanks to this innovative technology, the OsteoBiol line has the following importantbiotechnology, able, by avoiding the high characteristics:temperature ceramization phase, to1. Absence of a foreign body response(4)preserve the structure of naturalhydroxyapatite and therefore allow an 2. Gradual resorption over timeosteoclastic-typeremodeling of3. Stimulation and acceleration of physiological tissue healing processbiomaterial, similar to physiological boneturnover time(3). 4. Protection of the grafting site from infection (membranes)5. Capability of carrying medication to the surgical site13 13. CLINICALINDICATIONSALVEOLAR REGENERATIONDEHISCENCES AND FENESTRATIONS CRESTAL ACCESS SINUS LIFT Source: Courtesy of Dr Ulf Nannmark, Gteborg University, Sweden LATERAL ACCESS SINUS LIFT HORIZONTAL AND VERTICAL AUGMENTATIONPERIODONTAL REGENERATION15 14. Clinical indications for specific clinical indications Products specifically engineered ALVEOLARMAXILLARYPERI-IMPLANT HORIZONTAL REGENERATIONSINUS LIFT DEFECTS AUGMENTATIONSOCKETRIDGE LATERAL CRESTALDEHISCENCES AND2-WALL RIDGE PRESERVATION PRESERVATIONACCESSACCESS FENESTRATIONS, DEFECTS SPLITPERI-IMPLANT LESIONSONE OR TWO IF ONE OR TWO Gen-Os Collagenated heterologous cortico-cancellous bone mix | Granulometry 250-1000 m For information on OsteoBiol Gen-Os see page 60WALLS MISSING WALLS ARE MISSINGTO DYready to mp3 USE REAuse Pre-hydrated collagenated heterologous cortico-cancellous bone mix Granulometry 600-1000 m For information on OsteoBiol mp3 see page 64TO IF DEFECT WALLS DY Putty USE REA Pre-hydrated collagenated heterologous cortico-cancellous bone paste Granulometry up to 300 m For information on OsteoBiol Putty see page 68ARE PRESERVEDTO DY Gel 40 USE REA Pre-hydrated collagenated heterologous cortico-cancellous bone gel Granulometry up to 300 m For information on OsteoBiol Gel 40 see page 72 Sp-Block Collagenated heterologous cancellous block For information on OsteoBiol Sp-Block see page 88 Evolution Heterologous collagen membrane For information on OsteoBiol Evolution see page 78 STANDARD MODEL FINE MODEL Lamina Collagenated heterologous cortical bone For information on OsteoBiol Lamina see page 82 CURVED MODEL 16 15. VERTICAL PERIODONTALCLINICAL INDICATIONSAUGMENTATIONREGENERATIONINDICATION VS PRODUCT MATRIXINLAY2-WALL3-WALL GINGIVAL INTRABONY INTRABONY TECHNIQUE RECESSIONS DEFECTS DEFECTSOsteoBiol is the most complete range of biomaterials availableon the market today.Our products are specifically engineered to fulfill your needs in everyIN ASSOCIATIONsingle clinical indication. We believe that your valuable regenerativework should not be limited to one single product adapted to all clinicalindications but it should be given instead a solution thought anddesigned specifically for your different needs. WITH SP-BLOCKEach regeneration protocol is in fact different: this is why we work hardto deliver you the best solutions to help you improve your surgicalprocedures everyday.Your clinical success is our only missionKatia Gaetano BPharmProduction ManagerTecnoss s.r.l.DEEP/NARROWIN ASSOCIATION INTRABONY DEFECTS WITH MP3STANDARD MODEL FINE MODEL 16. Alveolar regenerationPost-extractive socket preservationRidge preservationPost-extractive alveolus grafted with OsteoBiol mp3Source: Courtesy of Dr Roberto Rossi, Genova, Italy 17. Characteristics CLINICAL INDICATIONSALVEOLAR REGENERATIONDEFECT ORIGIN AND DESCRIPTIONREGENERATION PROCEDURESBIBLIOGRAPHY | PAGES 19-21After the loss of dental elements alveolar Socket preservation technique(1) LEKOVIC V, CAMARGO PM, KLOKKEVOLD PR, ET ALbone starts resorbing due to the absence The goal is the preservation of the alveolar PRESERVATION OF ALVEOLAR BONE IN EXTRACTIONSOCKETS USING BIORESORBABLE MEMBRANESof mechanical solicitation transmitted byridge and extraction socket, in particular ifJOURNAL OF PERIODONTOLOGY (1998); 69: 1044-1049dental roots.patient will be rehabilitated with placement (2) LEKOVIC V, KENNEY EB, WEINLAENDER M, ET AL of endosseous implants.A BONE REGENERATIVE APPROACH TO ALVEOLAR RIDGEThis physiologic resorption subsequent to MAINTENANCE FOLLOWING TOOTH EXTRACTION.REPORT OF 10 CASEStooth loss or extraction is due to bothThe physiologic bone resorption of JOURNAL OF PERIODONTOLOGY (1997); 68: 563-570impossibility of regenerated bone to reach alveolar ridge after tooth extraction is (3) AMLER MH, JOHNSON PL, SALMAN Ithe pre-existing coronal level when theparticularly consistent in the anteriorHISTOLOGICAL AND HISTOCHEMICAL INVESTIGATION OFHUMAN ALVEOLAR SOCKET HEALING IN UNDISTURBEDbone is left healing in physiologicmaxilla, where the buccal plate often is EXTRACTION SOCKETSJOURNAL OF AMERICAN DENTAL ASSOCIATION (1960); 61:conditions (without any biomaterial graft) extremely thin and friable.32-44and the simultaneous cortical bone To minimize bone resorption the first(4) SCHROPP L, WENZEL A, KOSTOPOULOS L, KARRING Tremodelingprocess, both inBONE HEALING AND SOFT TISSUE CONTOUR CHANGES important step is the less traumatic FOLLOWING SINGLE-TOOTH EXTRACTION: A CLINICALcoronal-apical and vestibular-lingual AND RADIOGRAPHIC 12 MONTH PROSPECTIVE STUDY extraction technique for tooth removal.directions. JOURNAL OF PERIODONTICS AND RESTORATIVE DENTISTRY(2003); 23: 313-323 Often this procedure is associated withLekovic and coll.(1) demonstrated that the(5) OKAMOTO T, ONOFRE DA SILVA A socket augmentation using a variety of HISTOLOGICAL STUDY ON THE HEALING OF RAT DENTALpost-extraction bone loss is accelerated in SOCKETS AFTER PARTIAL REMOVAL OF THE BUCCAL BONY particulate bone graft materials with orthe first 6 months, followed by a gradual PLATE without membrane barriers. J NIHON UNIV SCH DENT (1983); 25: 202-213modeling (change in size or shape) and(6) SIMPSON HEturnover of the remaining bone, with asSeveralstudies(2-4) demonstrated EXPERIMENTAL INVESTIGATION INTO THE HEALING OF Source: Tecnoss Dental Media Library EXTRACTION WOUNDS IN MACACUS RHESUS MONKEYSmuch as 40% of the alveolar height and significantly reduced alveolar ridge JOURNAL OF ORAL SURGERY AND ANESTHETIC HOSPITAL60% of alveolar width lost in the first 6dimensional changes associated withDENTAL SERVICE (1960); 18: 391-399months.these preservation techniques. (7) NANNMARK U, SENNERBY LTHE BONE TISSUE RESPONSES TO PREHYDRATED ANDCOLLAGENATED CORTICO-CANCELLOUS PORCINE BONEThe result of this resorption often is a In case of a defect involving the original GRAFTS. A STUDY IN RABBIT MAXILLARY DEFECTSclinical problem able to compromisebuccal plate, multiple animal studiesCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, 2008,10: 264-270esthetic outcome and/or functional and showed that these defects do not heal(8) CARDAROPOLI D, CARDAROPOLI Gstructural aspects of restoration treatment. completely without use of grafting PRESERVATION OF THE POSTEXTRACTION ALVEOLAR techniques(5,6). RIDGE: A CLINICAL AND HISTOLOGIC STUDYTHE INTERNATIONAL JOURNAL OF PERIODONTICS ANDRESTORATIVE DENTISTRY, 2008, 28: 469-477 Thus, in the anterior maxilla, grafting for(9) ARCURI C, CECCHETTI F, GERMANO F, MOTTA A, space maintenance and ridge preservation SANTACROCE C may be beneficial. CLINICAL AND HISTOLOGICAL STUDY OF A XENOGENICSUBSTITUTE USED AS A FILLER IN POSTEXTRACTIVEALVEOLUS Moreover, for situations where the MINERVA STOMATOLOGICA, 2005, 54: 351-362 periapical bone or the socket walls are not(10) BARONE A, ALDINI NN, FINI M, GIARDINO R, intact, bone augmentation techniques may CALVO GUIRADO JL, COVANI UXENOGRAFT VERSUS EXTRACTION ALONE FOR RIDGE be used to restore the original anatomy, PRESERVATION AFTER TOOTH REMOVAL: A CLINICAL ANDHISTOMORPHOMETRIC STUDY with a particular attention to soft tissue JOURNAL OF PERIODONTOLOGY, 2008, 79: 1370-1377 perfect closure and graft containment, which are the main difficulties of this Alveolar preservation procedure.Source: Tecnoss Dental Media Library 19 18. Alveolar regeneration OsteoBiol product range PRODUCT CODES Gen-Os M1052FS | 1 Vial | 0.25 g | Porcine M1052FE | 1 Vial | 0.25 g | Equine M1005FS | 1 Vial | 0.5 g | Porcine M1005FE | 1 Vial | 0.5 g | Equine M1010FS | 1 Vial | 1.0 g | Porcine M1010FE | 1 Vial | 1.0 g | Equine M1020FS | 1 Vial | 2.0 g | Porcine M1020FE | 1 Vial | 2.0 g | Equine PuttyTissue of origin Collagenated heterologous cortico-cancellous Tissue of origin Pre-hydrated collagenated heterologousHPT09S | 1 Syringe | 0.5 cc | Porcinebone mixcortico-cancellous bone pasteHPT09E | 1 Syringe | 0.5 cc | EquineTissue collagen Preserved Tissue collagen Preserved + 20% additional collagen gelPhysical form Slightly radiopaque granulesPhysical form Plastic consistency composed of collagen gel HPT35S | 3 Syringe | 3x0.5 cc | PorcineComposition 100% granulated mix loaded with 80% micronized bone mixHPT35E | 3 Syringe | 3x0.5 cc | EquineGranulometry 250-1000 mComposition 80% granulated mix, 20% collagen gel HPT32S | 3 Syringe | 3x0.25 cc | PorcineRe-entry time 4/5 months, depending on grafting siteGranulometry Up to 300 m HPT32E | 3 Syringe | 3x0.25 cc | Equinecharacteristics Re-entry time About 4 monthsPackaging Vial: 0.25 g, 0.5 g, 1.0 g, 2.0 g Packaging Syringe: 0.5 cc, 3x0.5 cc, 3x0.25 cc mp3For more information on OsteoBiol Gen-Os see page 60 For more information on OsteoBiol Putty see page 68 A3005FS | 1 Syringe | 1.0 cc | Porcine A3005FE | 1 Syringe | 1.0 cc | Equine A3015FS | 3 Syringe | 3x0.5 cc | Porcine A3015FE | 3 Syringe | 3x0.5 cc | Equine A3030FS | 3 Syringe | 3x1.0 cc | Porcine A3030FE | 3 Syringe | 3x1.0 cc | Equine Evolution EV02LLE | 20x20 mm | Fine | Equine EV02HHE | 20x20 mm | Standard | Equine EV03LLE | 30x30 mm | Fine | Equine EV03HHE | 30x30 mm | Standard | Equine EVOLLE | 25x35 mm (oval) | Fine | Equine EVOHHE | 25x35 mm (oval) | Standard | Equine TabletTissue of origin Pre-hydrated collagenated heterologous Tissue of origin Heterologous collagen membraneBLE10S | 10x10x10 mm | 6 Blister | Porcinecortico-cancellous bone mix Tissue collagen PreservedBLE10E | 10x10x10 mm | 6 Blister | EquineTissue collagen Preserved + 10% additional collagen gel Physical form Dried membrane with one smooth side and oneFor more information on OsteoBiol Tablet see page 90Physical form Pre-hydrated granules and collagen gelmicro-rough sideComposition 90% granulated mix, 10% collagen gelComposition 100% pericardiumGranulometry 600-1000 mThickness Fine: 0.4 mm (0.1). Standard: 0.6 mm (0.1)Re-entry time About 5 monthsResorption time Fine: approx 3 months. Standard: approx 4Packaging Syringe: 1.0 cc, 3x0.5 cc, 3x1.0 cc monthsPackaging Fine: 20x20 mm, 30x30 mm, 25x35 mm (oval)For more information on OsteoBiol mp3 see page 64Standard: 20x20 mm, 30x30 mm, 25x35 mm (oval)For more information on OsteoBiol Evolution see page 7820 19. OsteoBiol products description CLINICAL INDICATIONSALVEOLAR REGENERATIONThe entire OsteoBiol line consists ofSCIENTIFIC LITERATURE ON ALVEOLAR REGENERATIONxenografts, i.e. biomaterials deriving from WITH OSTEOBIOL PRODUCTSheterologous bone.COVANI U, AMERI S, CRESPI R, BARONE APRESERVAZIONE DEL PROCESSO ALVEOLARE CONThe Tecnoss patented manufacturing OSSO ETEROLOGO. CONSIDERAZIONI ISTOLOGICHEITALIAN ORAL SURGERY, 2004, VOL 3, 1: 17-23process used to obtain these materials isARCURI C, CECCHETTI F, GERMANO F, MOTTA A,able to achieve biocompatibility preserving SANTACROCE CCLINICAL AND HISTOLOGICAL STUDY OF Apart of the collagen matrix of the animal XENOGENIC BONE SUBSTITUTE USED AS A FILLER INbone and avoiding at the same time high POSTEXTRACTIVE ALVEOLUSMINERVA STOMATOLOGICA, 2005 JUN;54(6):351-62temperaturesthatwouldcauseBARONE A, ALDINI NN, FINI M, GIARDINO R,ceramization of the granules: the result is a CALVO GUIRADO JL, COVANI Uunique particulate material, consisting ofXENOGRAFT VERSUS EXTRACTION ALONE FOR RIDGEPRESERVATION AFTER TOOTH REMOVAL: A CLINICALmineral component and organic matrix, OsteoBiol Putty | For more information see page 68OsteoBiol mp3 | For more information see page 64AND HISTOMORPHOMETRIC STUDYSource: Tecnoss Dental Media LibrarySource: Tecnoss Dental Media LibraryJOURNAL OF PERIODONTOLOGY, 2008 AUG;79(8):1370-7with a porous surface extremely similar toautogenous bone and able to resorbgranulometry packed in a sterile vial: due In case of insufficient soft tissue to cover CARDAROPOLI D, CARDAROPOLI GPRESERVATION OF THE POSTEXTRACTION ALVEOLARprogressively while new bone formationto its collagen content, once hydrated withand protect the graft, an OsteoBiol RIDGE: A CLINICAL AND HISTOLOGIC STUDYINTERNATIONAL JOURNAL OF PERIODONTICS ANDtakes place(7). saline, it allows an excellent graft stability Evolution membrane is recommended(8-10): RESTORATIVE DENTISTRY, 2008 OCT;28(5):469-77while its hydrophilia guarantees quick Evolution pericardiummembranes CRESPI R, CAPPAR P GHERLONE E ,These cortical and cancellous particlesblood absorption and therefore the guarantee an efficient barrier effect, DENTAL IMPLANTS PLACED IN EXTRACTION SITEShave been mixed in various proportionsGRAFTED WITH DIFFERENT BONE SUBSTITUTES:necessary graft vascularization. Its favour the correct soft tissue regrowth andRADIOGRAPHIC EVALUATION AT 24 MONTHSand granulometries with and without JOURNAL OF PERIODONTOLOGY, 2009 OCT;80(10):1616-1621cortico-cancellous composition allows awound closure and do not get infected incollagen gel, in order to develop variousprogressive resorption of osteoclastic type, case of exposure.ROSSI R, SANTOS MORALES R, FRASCARIA M, BENZI R,products aimed at different clinicalSQUADRITO Nwith in parallel a similar rate of new bone PLANNING IMPLANTS IN THE ESTHETIC ZONE USING Aindications: the OsteoBiol materialsOsteoBiol Putty is a collagen gel matrixNEW IMPLANT 3D NAVIGATION SYSTEMformation(7). These unique properties allow THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY, 2010indicated for alveolar regeneration areloaded for 80% of its volume witha very good graft volume preservation, aSUMMER;5(2):172-88OsteoBiol Gen-Os and OsteoBiol Putty.micronizedcortico-cancellous bonehealthy new bony tissue and ultimately, a CRESPI R, CAPPAR P ROMANOS GE, MARIANI E, BENASCIUTTI , particles (granulometry 300 m) packedE, GHERLONE EOsteoBiol Gen-Os is a cortico-cancellous successful implant rehabilitation(8). CORTICOCANCELLOUS PORCINE BONE IN THE HEALING in a sterile syringe.OF HUMAN EXTRACTION SOCKETS: COMBININGcollagenated bone mix with 250-1000 mHISTOMORPHOMETRY WITH OSTEOBLASTGENE The exclusive Tecnoss manufacturing EXPRESSION PROFILES IN VIVOINTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL process guarantees an exceptionalIMPLANTS, 2011 JUL-AUG; 26(4):866-72 malleability and plasticity(9): furthermore the syringe packaging gives Putty extraordinary handling properties making this product the ideal choice for incisors narrow sockets with intact walls. OsteoBiol mp3 has also been used successfully for alveolarridge preservation(10) while OsteoBiol Tablet is an anti-haemorrhagic biomaterial suitable toaccelerate bloodclottinginOsteoBiol Evolution | For more information see page 78 OsteoBiol Tablet | For more information see page 90 post-extractive sockets and to favourSource: Tecnoss Dental Media Library Source: Tecnoss Dental Media Libraryregeneration. 21 20. Case reportAlveolar ridge preservationSex: male | Age: 51Fig. 1 Initial x-rayFig. 2 Root separationFig. 3 Extracted toothFig. 4 Ridge preservation with OsteoBiol mp3Fig. 5 Grafting site protected with OsteoBiolEvolution collagen membraneFig. 1Fig. 2Fig. 3Fig. 6 Site before graftingFig. 7 Site after graftingFig. 8 Healing and bone regeneration at 12monthsFig. 9 Osteotomy for the insertion of the implantFig. 10 Thommen implant ( 5x12 mm)Fig. 11 Healing of peri-implant tissuesFig. 12 Final resultFig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9Documentation provided byDr Roberto RossiM.Sc.D. in Periodontology, Genova, Italye-mail: drrossi@mac.comBone substitute: OsteoBiol mp3For more information on OsteoBiol mp3 see page 64Membrane: OsteoBiol EvolutionFor more information on OsteoBiol Evolution see page 78Fig. 10 Fig. 11 Fig. 1222 21. Case report CLINICAL INDICATIONSALVEOLAR REGENERATIONTreatment of bone defects due to peri-implantitisSex: male | Age: 54Fig. 1 Initial intraoral image: it is possible toappreciate severe inflammation of the soft tissues.The prosthesis is subjected to considerable mobilityFig. 2 Endoral x-ray image: the diagnosis ofperi-implantitis in 3.5-3.6 zone was confirmedFig. 3 Intraoral image showing the residual bonedefects: in particular 3.5 site was defective of allbuccal coronal halfFig. 1Fig. 2 Fig. 3 Fig. 4 Defects were grafted with OsteoBiol Gen-OsFig. 5 The graft was stabilized and protected by aproperly shaped OsteoBiol Evolution membraneFig. 6 Soft tissues were repositioned and suturedFig. 7 Intraoral image of second surgical phase(re-entry after 8 months). It is possible to appreciatea complete regeneration of pre-existent bone defectsFig. 8 Placement of 3 implants on the base of amonophasic protocolFig. 9 Placement of titanium prosthesis abutmentsFig. 4Fig. 5 Fig. 6after 3 months from implant placement surgery: theverification of perfect implant osteointegration wasperformed with the resonance frequency analysis(ISQ>70)Fig. 10 Endoral x-ray image. It is possible toproceed with Platform SwitchingFig. 11 Final restoration with definitive prosthesiswas completed 3 months after surgery. Pictureshowing the situation 12 months after surgeryFig. 12 Control endoral x-ray image 12 monthsafter surgeryFig. 7Fig. 8 Fig. 9Documentation provided byDr Roberto CocchettoPrivate practitioner in Zevio, Italye-mail: rcocchetto@yahoo.itBone substitute: OsteoBiol Gen-OsFor more information on OsteoBiol Gen-Os see page 60Membrane: OsteoBiol EvolutionFor more information on OsteoBiol Evolution see page 78Fig. 10 Fig. 11Fig. 12 23 22. Dehiscences and fenestrationsPeri-implant lesions Fenestration. Cortical stimulation before grafting with OsteoBiol Gen-Os Source: Courtesy of Dr Claudio Stacchi, Gorizia, Italy 23. CharacteristicsCLINICAL INDICATIONS DEHISCENCES AND FENESTRATIONSDEFECT ORIGIN AND DESCRIPTIONREGENERATION PROCEDURES BIBLIOGRAPHY | PAGES 25-27After placement of implants, there are two The healing of these defects takes(1) CORRENTE G, ABUNDO R, CARDAROPOLI D, ET ALtypes of residual defects that can beadvantage to the principle of Guided Bone LONG-TERM EVALUATION OF OSSEOINTEGRATED IMPLANTS IN REGENERATED AND NON- REGENERATED BONEtreated with predictable regenerativeRegeneration (GBR) with the use of barrierINTERNATIONAL JOURNAL OF PERIODONTICS AND RESTORATIVE DENTISTRY (2000); 20: 390-397techniques, because these defects are able membranes that protect and isolate the (2) ZITZMANN NU, SCHARER P MARINELLO CP ,to self-maintain the space necessary for defect allowing the growth of neo-LONG-TERM RESULTS OF IMPLANTS TREATED WITH GUIDED BONE REGENERATION: A 5-YEAR PROSPECTIVE STUDYregeneration. In fact, positive results have regenerated bone in sites showing INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL IMPLANTS.been confirmed by long-term studies both insufficient bone volume. (2001); 16(3):355-366controlled(1-2) and non controlled(3-4), (3) BECKER W, DAHLIN C, LEKHOLM U, BERGSTROM C, In fact, significant more bone formationVAN STEENBERGHE D, HIGUCHI K, BECKER BEgrafting different kinds of biomaterials.FIVE-YEAR EVALUATION OF IMPLANTS PLACED AT EXTRACTION has been shown around defects protected AND WITH DEHISCENCES AND FENESTRATION DEFECTS AUGMENTED WITH EPTFE MEMBRANES: RESULTS FROM ADepending from their morphology, these with a barrier membrane compared with PROSPECTIVE MULTICENTER STUDY CLINICAL IMPLANT DENTISTRY RELATED RESEARCH (1999);1(1):27-32defects can be classified as follows,controls(7-9). (4) NEVINS M, MELLONIG JT, CLEM DS 3RD, REISER GM, BUSER DAaccording to Tinti and Parma-Benfenati Bio-absorbable collagen membranes are Fenestration grafted with OsteoBiol Gen-Os IMPLANTS IN REGENERATED BONE: LONG-TERM SURVIVALclinical classification(5):For more information see page 60INTERNATIONAL JOURNAL OF PERIODONTICS AND RESTORATIVE equally effective as non resorbable e-PTFESource: Courtesy of Dr Claudio Stacchi, Gorizia, Italy DENTISTRY (1998); 18(1):34-45Fenestration: it is a vestibular ormembranes, but reduce significantly the (5) TINTI C, PARMA-BENFENATI S CLINICAL CLASSIFICATION OF BONE DEFECTS CONCERNINGlinguo-palatal defect associated with arisk of complications in case of exposure THE PLACEMENT OF DENTAL IMPLANTS INTERNATIONAL JOURNAL OF PERIODONTICS AND RESTORATIVElack of bone thickness, creating a partial since they do not get infected. DENTISTRY (2003) ; 23:147-155exposure of an implant which is completely (6) CORRENTE G, ABUNDO R The use of pins to fix the membranes canIMMEDIATE POST-EXTRACTIVE IMPLANTSsurrounded by bone. limit significantly the risk of premature MAXILLARY SINUS LIFT WITH CRESTAL ACCESS. (2003) RC LIBRI (ITALY): 83-95Dehiscence: it is a vestibular orexposure. In association with cover (7) DAHLIN C, ANDERSSON L, LINDE Alinguo-palatal defect represented by a lackmembranes, several studies reported the BONE AUGMENTATION AT FENESTRATED IMPLANTS BY AN OSTEOPROMOTIVE MEMBRANE TECHNIQUE. A CONTROLLED> The implant is inserted and soft tissues (1) JENSEN OT, SHULMANN LB, BLOCK MS, IACONO VJbone starts resorbing due to the absence elevation is an effective bone restoration REPORT OF THE SINUS CONSENSUS CONFERENCEare suturedof mechanical solicitation transmitted byprocedure in the upper jaw, with highlyINTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIALIMPLANTS (1998); 13: 9-41dental roots. In the maxilla such bone predictable results(1).Through a little crestal breach and the (2) SUMMERS RBresorption process is complicated by theproper use of osteotomes and hammer,A NEW CONCEPT IN MAXILLARY IMPLANT SURGERY: The crestal access approach with THE OSTEOTOME TECHNIQUEmaxillary sinus, a cavity which undergoes the biomaterial can be pushed into the osteotomes for sinus floor elevation was COMPENDIUM OF CONTINUING EDUCATION IN DENTISTRYpneumatization expanding progressivelysinus cavity and, on the base of the(1994); 15: 152-158 first published in 1994 by Summers(2) andinto the space previously occupied by physical principle called Pascal Law, the (3) NANNMARK U, SENNERBY L can briefly described as follows:THE BONE TISSUE RESPONSES TO PREHYDRATED ANDalveolar bone.Schneider membrane can be elevated, due COLLAGENATED CORTICO-CANCELLOUS PORCINE >> Elevation of a total thickness flap into the increase of hydraulic pressure under BONE GRAFTS. A STUDY IN RABBIT MAXILLARYDEFECTSREGENERATION PROCEDURES order to expose the crestal bone; with the membrane itself.CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH,2008, 10: 264-270Athrophic maxillary alveolar bone needsproper osteotomes and burs the implantregeneration in order to restore the idealWith this technique it is possible to (4) NANNMARK U, AZARMEHR I site is prepared and the cortical plate isconditions for placement of endosseoussimultaneously insert implants, in presence COLLAGENATED CORTICO-CANCELLOUS PORCINE fracturedBONE GRAFTS. A STUDY IN RABBIT MAXILLARYimplants of proper diameter and height. of a residual bone height of 5-6 mm and a DEFECTSIN PRESS >> The biomaterial is introduced and sinus floor elevation of 4-5 mm.(5) BARONE A, CORNELINI R, CIAGLIA R, COVANI UIMPLANT PLACEMENT IN FRESH EXTRACTION SOCKETSAND SIMULTANEOUS OSTEOTOME SINUS FLOORELEVATION: A CASE SERIESINTERNATIONAL JOURNAL OF PERIODONTICS ANDRESTORATIVE DENTISTRY, 2008, 28:283-289Source: Tecnoss Dental Media LibraryMaxillary Sinus grafted with OsteoBiol Gel 40 | For more information see page 72 Source: Tecnoss Dental Media Library31 30. Crestal access sinus lift OsteoBiol product range PRODUCT CODES Gel 40 05GEL40S | 1 Syringe | 0.5 cc | Porcine 05GEL40E | 1 Syringe | 0.5 cc | Equine 15GEL40S | 3 Syringe | 3x0.5 cc | Porcine 15GEL40E | 3 Syringe | 3x0.5 cc | Equine Gen-Os M1052FS | 1 Vial | 0.25 g | Porcine M1052FE | 1 Vial | 0.25 g | Equine M1005FS | 1 Vial | 0.5 g | Porcine M1005FE | 1 Vial | 0.5 g | EquineTissue of origin Pre-hydrated collagenated heterologousTissue of origin Collagenated heterologous cortico-cancellous M1010FS | 1 Vial | 1.0 g | Porcinecortico-cancellous bone gelbone mixM1010FE | 1 Vial | 1.0 g | EquineTissue collagen Preserved + 40% additional collagen gelTissue collagen Preserved M1020FS | 1 Vial | 2.0 g | PorcinePhysical form Collagen gel type I and III loaded with 60%Physical form Slightly radiopaque granules M1020FE | 1 Vial | 2.0 g | Equinecollagenated bone mixComposition 100% granulated mixComposition 60% granulated mix, 40% collagen gel Granulometry 250-1000 mGranulometry Up to 300 mRe-entry time 4/5 months, depending on grafting sitePuttyRe-entry time About 4 months characteristics HPT09S | 1 Syringe | 0.5 cc | PorcinePackaging Syringe: 0.5 cc, 3x0.5 ccPackaging Vial: 0.25 g, 0.5 g, 1.0 g, 2.0 g HPT09E | 1 Syringe | 0.5 cc | EquineFor more information on OsteoBiol Gel 40 see page 72For more information on OsteoBiol Gen-Os see page 60 HPT35S | 3 Syringe | 3x0.5 cc | Porcine HPT35E | 3 Syringe | 3x0.5 cc | Equine HPT32S | 3 Syringe | 3x0.25 cc | Porcine HPT32E | 3 Syringe | 3x0.25 cc | EquineTissue of origin Pre-hydrated collagenated heterologouscortico-cancellous bone pasteTissue collagen Preserved + 20% additional collagen gelPhysical form Plastic consistency composed of collagen gelloaded with 80% micronized bone mixComposition 80% granulated mix, 20% collagen gelGranulometry Up to 300 mRe-entry time About 4 monthsPackaging Syringe: 0.5 cc, 3x0.5 cc, 3x0.25 ccFor more information on OsteoBiol Putty see page 6832 31. OsteoBiol products descriptionCLINICAL INDICATIONS CRESTAL ACCESS SINUS LIFTThe entire OsteoBiol line consists ofThese unique properties allow a very goodThe soft consistency of Gel 40 is suitableSCIENTIFIC LITERATURE ON CRESTAL ACCESS SINUS LIFTxenografts, i.e. biomaterials deriving from graft volume preservation, a healthy new to lift the Schneider membrane using theWITH OSTEOBIOL PRODUCTSheterologous bone. The Tecnoss patentedbony tissue and ultimately, a successful syringe pressure, reducing laceration riskBARONE A, CORNELINI R, CIAGLIA R, COVANI Umanufacturing process used to obtainimplant rehabilitation. Gel 40 is a collagen to minimum and allowing a tight IMPLANT PLACEMENT IN FRESH EXTRACTION SOCKETS AND SIMULTANEOUS OSTEOTOME SINUS FLOORthese materials is able to achievegel matrix loaded for 60% of its volumepositioning of the biomaterial around the ELEVATION: A CASE SERIES INTERNATIONAL JOURNAL OF PERIODONTICS ANDbiocompatibility preserving part of the with micronized cortico-cancellous boneimplant threads.RESTORATIVE DENTISTRY, 2008 JUN;28(3):283-9collagen matrix of the animal bone andparticles (granulometry up to 300 m)CALVO GUIRADO JL, GOMEZ MORENO G, LOPEZ MARI L,avoiding at the same time highpacked in a sterile syringe. ORTIZ RUIZ AJ, GUARDIA J ATRAUMATIC MAXILLARY SINUS ELEVATION USINGtemperatures thatwouldcauseTHREADED BONE DILATORS FOR IMMEDIATEThe exclusive Tecnoss manufacturing IMPLANTS. A THREE-YEAR CLINICAL STUDYceramization of the granules: the result is aprocess guarantees an exceptionalMEDICINA ORAL, PATOLOGIA ORAL Y CIRUGIA BUCAL, 2010unique particulate material, consisting of MAR 1;15(2):E366-70malleability and plasticity: furthermore themineral component and organic matrix,syringe packaging gives Gel 40with a porous surface extremely similar toextraordinary handlingproperties(5)autogenous bone and able to resorbmaking this product the ideal choice forprogressively while new bone formationcrestal access sinus lift (squeezetakes place(3).technique).OsteoBiol Gel 40 | For more information see page 72These cortical and cancellous particlesSource: Tecnoss Dental Media Libraryhave been mixed in various proportionsand granulometries with collagen gel, inorder to develop various products aimedat different clinical indications: the specificmaterials for crestal access sinus lift areOsteoBiol Gen-Os (osteotome andhammer technique), OsteoBiol Gel 40(4)and OsteoBiol Putty.Gen-Os is a cortico-cancellouscollagenated bone mix with 250-1000 mgranulometry packed in a sterile vial: dueto its collagen content, once hydrated withsaline, it allows an excellent graft stabilitywhile its hydrophilia guarantees quickblood absorption and therefore thenecessary graft vascularization.Its cortico-cancellous composition allows aprogressive resorption of osteoclastic type,with in parallel a similar rate of new boneformation(3).Crestal access sinus lift grafted with OsteoBiol Putty | For more information see page 68Source: Courtesy of Dr Roberto Rossi, Genova, Italy33 32. Case reportCrestal access sinus liftSex: male | Age: 45Fig. 1 Pre-operative panoramic x-rayFig. 2 Initial situation, the three missing teeth willbe replaced by three single prothesisFig. 3 Flap opening and crest exposure, anhorizontal defect is also presentFig. 4 Osteotomy is performed on the three sitesFig. 5 Maxillary sinus lifted with OsteoBiolFig. 1Fig. 2Fig. 3Gel 40Fig. 6 Grafting has been completed and implantscan now be insertedFig. 7 Three implants placed into positionFig. 8 A mix of autologous bone and OsteoBiolGel 40 is preparedFig. 9 The bone/biomaterials mixture is graftedon the vestibular side of the defect to complete thehorizontal augmentationFig. 10 Flaps are repositioned and suturedFig. 4Fig. 5Fig. 6Fig. 11 Post-operative panoramic x-rayFig. 12 Final situationFig. 7Fig. 8Fig. 9Documentation provided byProf Dr Jose Luis Calvo GuiradoUniversity of Murcia, Spaine-mail: josecalvog@ono.comBone substitute: OsteoBiol Gel 40For more information on OsteoBiol Gel 40 see page 72Fig. 10 Fig. 11 Fig. 1234 33. Case reportCLINICAL INDICATIONS CRESTAL ACCESS SINUS LIFTCrestal access sinus lift, x-ray analysis Sex: female | Age: 43 Fig. 1 Initial x-ray Fig. 2 Control x-ray before osteotomy Fig. 3 Measuring before osteotomy Fig. 4 Maxillary sinus lifted with OsteoBiol Putty Fig. 5 Implant placed in the grafted site: final x-ray Fig. 6 Implant placed in the grafted site: final x-rayFig. 1 Fig. 2Fig. 3 Fig. 4 Documentation provided by Dr Roberto Rossi M.Sc.D in Periodontology, Genova, Italy e-mail: drrossi@mac.it Bone substitute: OsteoBiol Putty For more information on OsteoBiol Putty see page 68Fig. 5 Fig. 635 34. Maxillary sinus augmentationLateral access sinus lift Maxillary sinus grafted with OsteoBiol mp3 Source: Courtesy of Dr Antonio Barone, Lido di Camaiore, Italy 35. CharacteristicsCLINICAL INDICATIONS LATERAL ACCESS SINUS LIFTDEFECT ORIGIN AND DESCRIPTION REGENERATION PROCEDURES>> The sinus mucosa is carefullyBIBLIOGRAPHY | PAGES 37-39After the loss of dental elements alveolarAthrophic maxillary alveolar bone needsdissected and elevated. The bony wall is (1) JENSEN OT, SHULMANN LB, BLOCK MS, IACONO VJbone starts resorbing due to the absenceregeneration in order to restore the ideal gently pushed inside the sinus cavity toREPORT OF THE SINUS CONSENSUS CONFERENCEof mechanical solicitation transmitted by conditions for placement of endosseous form the roof of the graftINTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL IMPLANTS (1998); 13: 9-41dental roots. implants of proper diameter and height.>> Sinus cavity is grafted with (2) BOYNE PJ, JAMES RA GRAFTING OF THE MAXILLARY SINUS FLOOR WITHIn the maxilla such bone resorption In year 1996 the Consensus Conferencebiomaterial, a resorbable membrane is AUTOGENOUS MARROW AND BONEprocess is complicated by the maxillary came to the conclusion that sinus floorapplied to cover the bony window in order JOURNAL OF ORAL SURGERY (1980); 38: 613-616sinus, a cavity which undergoes elevation is an effective bone restoration to protect and stabilize the graft and then (3) NANNMARK U, PALACCI P MAXILLARY SINUS AUGMENTATION USINGpneumatization expanding progressivelyprocedure in the upper jaw, with highlysoft tissues are suturedCOLLAGENATED CORTICO-CANCELLOUS PORCINE BONE IN A ONE-STEP PROCEDURE. A CASE REPORTinto the space previously occupied by predictable results(1).Implants can be simultaneously placed LINFORMATION DENTAIRE, 2011 JUN, 23:19-23alveolar bone. during the sinus lift procedure(3) if at least(4) NANNMARK U, SENNERBY LThe lateral access approach for sinus floorTHE BONE TISSUE RESPONSES TO PREHYDRATED ANDelevation was first published in 1980 by 3-4 mm of residual crestal bone isCOLLAGENATED CORTICO-CANCELLOUS PORCINE BONE GRAFTS. A STUDY IN RABBIT MAXILLARYBoyne and James(2) and subsequentlyavailable, essential to guarantee a goodDEFECTSmodified by other clinicians.primary stability of implants.CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, 2008, 10: 264-270In brief, the operative phases of this In absence of this minimal bone height, (5) BARONE A, RICCI M, COVANI U, NANNMARK U, AZARMEHR I, CALVO GUIRADO JLtechnique are the following: implant placement has to be postponed a MAXILLARY SINUS AUGMENTATION USING few months after sinus lift procedure (5-7PREHYDRATED CORTICOCANCELLOUS PORCINE BONE:>> Elevation of a total thickness flap tomonths), when sufficient new regenerated HYSTOMORPHOMETRIC EVALUATION AFTER 6 MONTHS CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH,uncover the anterior wall of maxillary sinus bone will guarantee stability.2010 MAY 11 EPUBand consequent opening of a bony (6) BARONE A, MARCONCINI S, SANTINI S, COVANI U OSTEOTOMY AND MEMBRANE ELEVATION DURING THEwindow in this site to uncover Schneider MAXILLARY SINUS AUGMENTATION PROCEDURE.membrane A COMPARATIVE STUDY: PIEZOELECTRIC DEVICE VS. CONVENTIONAL ROTATIVE INSTRUMENTS CLINICAL ORAL IMPLANTS RESEARCH, 2008, 19: 511-515 (7) BARONE A, CRESPI R, ALDINI NN, FINI M, GIARDINO R, COVANI U MAXILLARY SINUS AUGMENTATION: HISTOLOGIC AND HISTOMORPHOMETRIC ANALYSIS INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL IMPLANTS, 2005 JUL-AUG;20(4):519-25Maxillary sinus grafted with OsteoBiol mp3 Maxillary sinus grafted with OsteoBiol Gen-Os Antrostomy covered with OsteoBiol EvolutionFor more informtation see page 64 For more informtation see page 60For more informtation see page 78Source: Tecnoss Dental Media Library Source: Tecnoss Dental Media LibrarySource: Tecnoss Dental Media Library37 36. Lateral access sinus lift OsteoBiol product rangePRODUCT CODESmp3A3005FS | 1 Syringe | 1.0 cc | PorcineA3005FE | 1 Syringe | 1.0 cc | EquineA3015FS | 3 Syringe | 3x0.5 cc | PorcineA3015FE | 3 Syringe | 3x0.5 cc | EquineA3030FS | 3 Syringe | 3x1.0 cc | PorcineA3030FE | 3 Syringe | 3x1.0 cc | EquineGen-OsM1052FS | 1 Vial | 0.25 g | PorcineM1052FE | 1 Vial | 0.25 g | EquineTissue of origin Pre-hydrated collagenated heterologous Tissue of origin Collagenated heterologous cortico-cancellous M1005FS | 1 Vial | 0.5 g | Porcinecortico-cancellous bone mix bone mixM1005FE | 1 Vial | 0.5 g | EquineTissue collagen Preserved + 10% additional collagen gel Tissue collagen Preserved M1010FS | 1 Vial | 1.0 g | PorcinePhysical form Pre-hydrated granules and collagen gelPhysical form Slightly radiopaque granulesM1010FE | 1 Vial | 1.0 g | EquineComposition 90% granulated mix, 10% collagen gelComposition 100% granulated mixGranulometry 600-1000 mGranulometry 250-1000 mM1020FS | 1 Vial | 2.0 g | PorcineRe-entry time About 5 monthsRe-entry time 4/5 months, depending on grafting siteM1020FE | 1 Vial | 2.0 g | EquinePackaging Syringe: 1.0 cc, 3x0.5 cc, 3x1.0 cc characteristicsPackaging Vial: 0.25 g, 0.5 g, 1.0 g, 2.0 gFor more information on OsteoBiol mp3 see page 64EvolutionFor more information on OsteoBiol Gen-Os see page 60 EV02LLE | 20x20 mm | Fine | EquineEV02HHE | 20x20 mm | Standard | EquineEV03LLE | 30x30 mm | Fine | EquineEV03HHE | 30x30 mm | Standard | EquineEVOLLE | 25x35mm (oval) | Fine | EquineEVOHHE | 25x35mm (oval) | Standard | EquineTissue of origin Heterologous collagen membraneTissue collagen PreservedPhysical form Dried membrane with one smooth side and onemicro-rough sideComposition 100% pericardiumThickness Fine: 0.4 mm (0.1). Standard: 0.6 mm (0.1)Resorption time Fine: approx 3 months. Standard: approx 4monthsPackaging Fine: 20x20 mm, 30x30 mm, 25x35 mm (oval)Standard: 20x20 mm, 30x30 mm, 25x35 mm (oval)For more information on OsteoBiol Evolution see page 7838 37. OsteoBiol products descriptionCLINICAL INDICATIONS LATERAL ACCESS SINUS LIFTThe entire OsteoBiol line consists ofmp3, a pre-hydrated cortico-cancellousThese unique properties allow a very goodSCIENTIFIC LITERATURE ON LATERAL ACCESS SINUS LIFTxenografts, i.e. biomaterials deriving from bone mix with 10% collagen gel is a readygraft volume preservation, a healthy new WITH OSTEOBIOL PRODUCTSheterologous bone.to use product packed in a sterile syringe:bony tissue and ultimately, a successful BARONE A, CRESPI R, ALDINI NN, FINI M, GIARDINO R,the mp3 syringe can be directly applied implant rehabilitation.COVANI UThe Tecnoss patented manufacturingMAXILLARY SINUS AUGMENTATION: HISTOLOGIC ANDinto the bony window without having to HISTOMORPHOMETRIC ANALYSISprocess used to obtain these materials is Another OsteoBiol material successfully INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIALmix mp3 granules with saline.IMPLANTS, 2005 JUL-AUG;20(4):519-25able to achieve biocompatibility preserving used in lateral access sinus lift is Gen-Os,part of the collagen matrix of the animal Due to its collagen gel content, mp3 allows a cortico-cancellous collagenated bone BARONE A, SANTINI S, SBORDONE L, CRESPI R, COVANI U A CLINICAL STUDY OF THE OUTCOMES ANDbone and avoiding at the same time high an excellent graft stability while itsmix with 250-1000 m granulometryCOMPLICATIONS ASSOCIATED WITH MAXILLARY SINUS AUGMENTATIONtemperaturesthatwouldcausehydrophilia guarantees quick bloodpacked in a sterile vial. Gen-Os can beINTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIALceramization of the granules: the result is a absorption and therefore the necessarygrafted alone or in combination with IMPLANTS, 2006 JAN-FEB;21(1):81-5unique particulate material, consisting ofgraft vascularization.autogenous bone(7).ORSINI G, SCARANO A, PIATTELLI M, PICCIRILLI M, CAPUTI S, PIATTELLI Amineral component and organic matrix,HISTOLOGIC AND ULTRASTRUCTURAL ANALYSIS OFIts cortico-cancellous composition allows aREGENERATED BONE IN MAXILLARY SINUSwith a porous surface extremely similar toprogressive resorption of osteoclastic type, AUGMENTATION USING A PORCINE BONE-DERIVEDautogenous bone and able to resorb BIOMATERIALwith in parallel a similar rate of new boneJOURNAL OF PERIODONTOLOGY, 2006 DEC;77(12):1984-90progressively while new bone formationformation(4).SCARANO A, PIATTELLI A, PERROTTI V, MANZON L, IEZZI Gtakes place(4).MAXILLARY SINUS AUGMENTATION IN HUMANS USING CORTICAL PORCINE BONE: A HISTOLOGICAL ANDThese cortical and cancellous particlesHISTOMORPHOMETRICAL EVALUATION AFTER 4 AND 6 MONTHShave been mixed in various proportions CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, 2009and granulometries with collagen gel, in BARONE A, RICCI M, COVANI U, NANNMARK U, AZARMEHR I,order to develops various products aimed CALVO GUIRADO JL MAXILLARY SINUS AUGMENTATION USING PREHYDRATEDat specific clinical indications: the specific CORTICOCANCELLOUS PORCINE BONE: HYSTOMORPHOMETRIC EVALUATION AFTER 6 MONTHSmaterial for lateral access sinus lift isCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, 2010OsteoBiol mp3(5,6), while OsteoBiolMAY 11 EPUBEvolution is the recommended resorbableSCARANO A, PIATTELLI A, ASSENZA B, QUARANTA A, PERROTTI V, PIATTELLI M, IEZZI Gmembrane to cover the bony window. PORCINE BONE USED IN SINUS AUGMENTATION PROCEDURES: A 5-YEAR RETROSPECTIVE CLINICAL EVALUATION JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 2010 AUG; 68(8):1869-73 PAGLIANI L, ANDERSSON P LANZA M, NAPPO A, VERROCCHI D,, VOLPE S, SENNERBY L A COLLAGENATED PORCINE BONE SUBSTITUTE FOR AUGMENTATION AT NEOSS IMPLANT SITES: A PROSPECTIVE 1-YEAR MULTICENTER CASE SERIES STUDY WITH HISTOLOGY CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, 2010 OCT 26, EPUB AHEAD OF PRINT BARONE A, ORLANDO B, TONELLI P COVANI U , SURVIVAL RATE FOR IMPLANTS PLACED IN THE POSTERIOR MAXILLA WITH AND WITHOUT SINUS AUGMENTATION: A COMPARATIVE COHORT STUDY JOURNAL OF PERIODONTOLOGY, 2011 FEB; 82(2):219-26 IEZZI G, DEGIDI M, PIATTELLI A, MANGANO C, SCARANO A, SHIBLI JA, PERROTTI V COMPARATIVE HISTOLOGICAL RESULTS OF DIFFERENT BIOMATERIALS USED IN SINUS AUGMENTATION PROCEDURES: A HUMAN STUDY AT 6 MONTHSOsteoBiol Evolution | For more information see page 78 OsteoBiol mp3 | For more information see page 642011 NOV 2, EPUB AHEAD OF PRINTSource: Tecnoss Dental Media Library Source: Tecnoss Dental Media Library 39 38. Case reportBilateral sinus lift with lateral accessSex: female | Age: 46Fig. 1 Preoperative panoramic x-ray imageshowing a severe maxillary atrophy in leftposterior regionFig. 2 Osteotomy to access the left maxillary sinusFig. 3 Autogenous bone chips collected with bonescraper from the tuberosity and anterior wall ofthe maxillaFig. 4 Intraoral image showing the left maxillaryFig. 1 Fig. 2Fig. 3sinus filled with OsteoBiol mp3: note also thegrafting over the bucal concavityFig. 5 Intraoral image showing the left maxillarysinus filled with OsteoBiol mp3Fig. 6 A properly trimmed OsteoBiol Specialmembrane was placed for left maxillary sinusantrostomy coveringFig. 7 Postoperative panoramic X-ray image after8 months of healingFig. 8 Implant placement and restorationFig. 4 Fig. 5Fig. 6Fig. 9 Restoration in placeFig. 7 Fig. 8Fig. 9Documentation provided byDr Bruno NegriAlicante, Spaine-mail: brunonegri2000@yahoo.comProf Dr Jos Luis Calvo GuiradoMurcia, Spaine-mail: josecalvog@ono.comBone substitute: OsteoBiol mp3For more information on OsteoBiol mp3 see page 64Membrane: OsteoBiol SpecialFor more information on OsteoBiol Special see page 9240 39. Case reportCLINICAL INDICATIONS LATERAL ACCESS SINUS LIFTLateral access sinus lift with simultaneous implant and horizontal augmentation Sex: female | Age: 42 Fig. 1 Initial x-ray showing a 3mm residual bone Fig. 2 Flap opening, a substantial vestibular bone resorption can be determined Fig. 3 Antrostomy performed with Piezo surgery technique Fig. 4 A OsteoBiol Evolution membrane is inserted through the antrostomy to protect the Schneider membrane from grafting materialFig. 1Fig. 2Fig. 3 Fig. 5 Maxillary sinus grafted with OsteoBiol mp3 Fig. 6 Immediate implant placement Fig. 7 A OsteoBiol Evolution membrane is stabilised with osteosynthesis screws above the antrostomy Fig. 8 Cortical bone stimulation Fig. 9 OsteoBiol mp3 is grafted on the vestibular side of the defect for horizontal augmentation Fig. 10 The OsteoBiol Evolution membrane isFig. 4Fig. 5Fig. 6 stabilised into position with a transpalatal suture Fig. 11 Final situation Fig. 12 Post-operative x-rayFig. 7Fig. 8Fig. 9 Documentation provided by Dr Rosario Sentineri Private practitioner in Genova, Italy e-mail: rosario.sentineri@gmail.com Bone substitute: OsteoBiol mp3 For more information on OsteoBiol mp3 see page 64 Membrane: OsteoBiol Evolution For more information on OsteoBiol Evolution see page 78Fig. 10 Fig. 11 Fig. 1241 40. Horizontal and verticalaugmentationTwo-wall defects|Ridge split technique|Inlay technique Horizontal augmentation beyond the skeletal envelope Source: Courtesy of Dr Luca Giovanni Maria Pagliani, Milano, Italy 41. Characteristics CLINICAL INDICATIONSHORIZONTAL AND VERTICALAUGMENTATIONDEFECT ORIGIN AND DESCRIPTIONREGENERATION PROCEDURESBIBLIOGRAPHY | PAGES 43-45Common sites for horizontal ridgeThe gold standard for rehabilitation of(1) VON ARX T, BUSER Daugmentation are the anterior (esthetic) horizontal and/or vertical ridge defects isHORIZONTAL RIDGE AUGMENTATION USINGAUTOGENOUS BLOCK GRAFTS AND THE GUIDED BONEzone in the maxilla and the posterior area considered autogenous block graft(3-4).REGENERATION TECHNIQUE WITH COLLAGENMEMBRANES: A CLINICAL STUDY WITH 42 PATIENTSin the mandible. These blocks can be harvested from CLINICAL ORAL IMPLANTS RESEARCH (2006); 17(4):359-66While traumatic tooth loss mostly affectsintra-oral or extra-oral sites and they can(2) CAWOOD JI, HOWELL RAA CLASSIFICATION OF THE EDENTULOUS JAWSadolescents and young adults, resulting in be inserted into the recipient site with two INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIALSURGERY (1988);17(4):232-6bone deficiencies in the anterior maxilla, different modalities: as onlay grafts or OsteoBiol Sp-Block OsteoBiol Gen-Osmandibular bone atrophy is often found ininlay grafts.(3) MARX RECLINICAL APPLICATION OF BONE BIOLOGY TOthe posterior segments in elderly peopleMANDIBULAR AND MAXILLARY RECONSTRUCTION Whatever is the applied technique, it is CLINICAL PLASTIC SURGERY (1994);21(3):377-92. REVIEWwho may have long-standing narrow recommended to fill the gaps of block with (4) PIKOS MAridges following premature tooth loss a biomaterial in granules(5) to achieve theBLOCK AUTOGRAFTS FOR LOCALIZED RIDGEbecause of endodontic or periodontalAUGMENTATION: PART I. THE POSTERIOR MAXILLA desired volume and contour for the IMPLANT DENTISTRY (1999);8(3):279-85problems. augmented recipient site.(5) BARONE A, COVANI UMAXILLARY ALVEOLAR RIDGE RECONSTRUCTION WITHHorizontal ridge augmentation of a In order to minimize block graft resorption, NONVASCULARIZED AUTOGENOUS BLOCK BONE:deficient alveolar bone site is performed CLINICAL RESULTS several studies suggested to protect blocksJOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 2007,eithersimultaneouslywith implant65: 2039-2046 with resorbable barrier membranes(1,4).placement, or with a staged approachOsteoBiol mp3OsteoBiol Curved Lamina(6) NANNMARK U, SENNERBY Lprior to implant insertion.Ridge splitting is an alternative techniqueHorizontal defect grafted respectively withOsteoBiol Sp-Block, OsteoBiol Gen-Os, OsteoBiol mp3THE BONE TISSUE RESPONSES TO PREHYDRATED ANDCOLLAGENATED CORTICO-CANCELLOUS PORCINE for horizontal ridge augmentation. The and OsteoBiol Curved LaminaBONE GRAFTS. A STUDY IN RABBIT MAXILLARYThe main criteria to consider whenSource: Tecnoss Dental Media Library DEFECTS surgical technique can be schematized as CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH,choosing the procedure are the residual the alveolar widening with properThe major benefit of crestal widening is2008, 10: 264-270bone volume needed to allow correct osteotomes and chisels which produces athat the thin alveolar bone can be utilized (7) CALVO GUIRADO JL, PARDO ZAMORA G,implant positioning, the bone density SAEZ YUGUERO MR greenstick fracture leaving the remainingfor implantation and the implants placedRIDGE SPLITTING TECHNIQUE IN ATROPHIC ANTERIORneeded to achieve primary implant MAXILLA WITH IMMEDIATE IMPLANTS, BONE periosteum attached to the bone. Thissimultaneously with the bone expansionstability, and the defect morphology of the REGENERATION AND IMMEDIATE TEMPORISATION: A periosteally pedicled buccal cortex is procedure.CASE REPORTperi-implant bone defect. In the esthetic JOURNAL OF THE IRISH DENTAL ASSOCIATION, 2007, 53: repositioned and a new implant bed is187-190zone, additional factors must be taken into Ongoing studies are investigating the created.account, such as the gingival biotype and efficacy of augmenting alveolar ridge withthe level of the lip line(1).The direction of forces by chisels should be significant horizontal and vertical aimed palatally to decrease the damage resorption, due to non-treated extraction,The classification of Cawood & Howell(2) is exerted on the fragile buccal plate. The with particulate xenogenic biomaterialscurrently the most comprehensive way of bone can be flexed to some extent due to covered and stabilized by heterologousclassifying edentulous jaws.This its elasticity.cortical bone foils properly fixed withclassification is considered the mostosteosynthesis screws.comprehensive system at present and it isAfter this preparation of receiving site andinternationallyrecommended for after placing the implants, the resultingstandardization in reports of pre-prosthetic gap can be covered by resorbablesurgery. membrane and filled with particulate biomaterial. 43 42. Horizontal and verticalaugmentationOsteoBiol product rangePRODUCT CODESmp3A3005FS | 1 Syringe | 1.0 cc | PorcineA3005FE | 1 Syringe | 1.0 cc | EquineA3015FS | 3 Syringe | 3 x 0.5 cc | PorcineA3015FE | 3 Syringe | 3 x 0.5 cc | EquineA3030FS | 3 Syringe | 3 x 1.0 cc | PorcineA3030FE | 3 Syringe | 3 x 1.0 cc | EquinePuttyHPT09S | 1 Syringe | 0.5 cc | PorcineHPT09E | 1 Syringe | 0.5 cc | EquineHPT61S | 1 Syringe | 1.0 cc | PorcineTissue of origin Pre-hydrated collagenated heterologous Tissue of origin Pre-hydrated collagenated heterologous HPT61E | 1 Syringe | 1.0 cc | Equinecortico-cancellous bone mix cortico-cancellous bone paste HPT35S | 3 Syringe | 3 x 0.5 cc | PorcineTissue collagen Preserved + 10% additional collagen gel Tissue collagen Preserved + 20% additional collagen gel HPT35E | 3 Syringe | 3 x 0.5 cc | EquinePhysical form Pre-hydrated granules and collagen gelPhysical form Plastic consistency composed of collagen gelComposition 90% granulated mix, 10% collagen gelloaded with 80% micronized bone mix HPT32S | 3 Syringe | 3 x 0.25 cc | PorcineGranulometry 600-1000 mComposition 80% granulated mix, 20% collagen gelHPT32E | 3 Syringe | 3 x 0.25 cc | EquineRe-entry time About 5 monthsGranulometry Up to 300 m Sp-BlockPackaging Syringe: 1.0 cc, 3x0.5 cc, 3x1.0 cc Re-entry time About 4 monthsBN0E |10x10x10 mm | EquinePackaging Syringe: 0.5 cc, 1.0 cc, 3x0.5 cc, 3x0.25 ccFor more information on OsteoBiol mp3 see page 64BN1E |10x10x20 mm | EquineFor more information on OsteoBiol Putty see page 68BN2E |10x20x20 mm | EquineBN8E | 35x10x5 mm | EquineDual-BlockSTS7S | 20x15x5 mm | Porcine curvedSTN4B | 20x15x5 mm | BovineSTN5B | 20x10x5 mm | Bovine curvedSTN6B | 20x20x5 mm | Bovine curvedLaminaLS03SS | 30x30x(2.0-4.0) mm | Standard | PorcineLS03SE | 30x30x(2.0-4.0) mm | Standard | EquineLS10HS | 35x35x(0.8-1.0) mm | Medium Curved | PorcineLS10HE | 35x35x(0.8-1.0) mm | Medium Curved | EquineLS25FS | 25x25x(0.4-0.6) mm | Fine | PorcineLS25FE | 25x25x(0.4-0.6) mm | Fine | EquineLS24FS | 20x40x(0.4-0.6) mm | Fine | PorcineLS24FE | 20x40x(0.4-0.6) mm | Fine | EquineLS23FS | 25x35x(0.4-0.6) mm (oval) | Fine | PorcineTissue of origin Sp-Block: cancellous boneTissue of origin Heterologous cortical bone LS23FE | 25x35x(0.4-0.6) mm (oval) | Fine | EquineDual-Block: cortico-cancellous bone Tissue collagen PreservedTissue collagen Preserved Physical form Rigid dried lamina, flexible after re-hydrationEvolutionPhysical form Rigid dried block Thickness Standard (2.0-4.0 mm).EV02LLE | 20x20 mm | Fine | EquineRe-entry time About 8 monthsMedium Curved (0.8-1.0 mm). Fine (0.4-0.6 mm) EV02HHE | 20x20 mm | Standard | EquinePackaging Sterile blister Resorption time Standard: about 8 months. EV03LLE | 30x30 mm | Fine | Equine(for dimension references see column on the right)Medium Curved and Fine: about 6 monthsEV03HHE | 30x30 mm | Standard | EquinePackaging Standard: 30x30 mm, Medium Curved: 35x35 mm,For more information on OsteoBiol Sp-Block see page 87 EVOLLE | 25x35 mm (oval) | Fine | EquineFine: 25x25 mm, 20x40 mm, 25x35 mm (oval)For more information on OsteoBiol Dual-Block see page 88EVOHHE | 25x35 mm (oval) | Standard | EquineFor more information on OsteoBiol Lamina see page 82For more information on OsteoBiol Evolution see page 7844 43. OsteoBiol products descriptionCLINICAL INDICATIONS HORIZONTAL AND VERTICAL AUGMENTATIONThe entire OsteoBiol line consists of SCIENTIFIC LITERATURE ON HORIZONTALxenografts, i.e. biomaterials deriving fromAUGMENTATION WITH OSTEOBIOL PRODUCTSheterologous bone. The Tecnoss patented CASSETTA M, CALASSO S, VOZZA I, DELLAQUILA D REHABILITATION OF ATROPHIC ALVEOLAR CRESTS WITHmanufacturing process used to obtain CYLINDRICAL SANDBLASTED AND ACID ETCHEDthese materials is able to achieve IMPLANTS: A PILOT STUDY EUROPEAN JOURNAL OF IMPLANT PROSTHODONTICS, 2005;biocompatibility preserving part of the(3)1:133-144collagen matrix of the animal bone and BARONE A, COVANI Uavoiding at the same time high MAXILLARY ALVEOLAR RIDGE RECONSTRUCTION WITH NONVASCULARIZED AUTOGENOUS BLOCK BONE:temperatures thatwouldcauseCLINICAL RESULTS JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 2007ceramization of the granules: the result is aOCT; 65(10):2039-46unique particulate material, consisting ofOsteoBiol Soft Lamina stabilised with titanium post Split ridge to be grafted with OsteoBiol Putty CALVO GUIRADO JL, PARDO ZAMORA G, SAEZ YUGUERO MRmineral component and organic matrix, Source: Courtesy of Dr Giuseppe Presti, ItalySource: Courtesy of Prof Dr Jose Louis Calvo Guirado, Murcia, Spain RIDGE SPLITTING TECHNIQUE IN ATROPHIC ANTERIOR MAXILLA WITH IMMEDIATE IMPLANTS, BONEwith a porous surface extremely similar topacked in a sterile syringe: the mp3 An OsteoBiol Evolution membrane is REGENERATION AND IMMEDIATE TEMPORISATION: A CASE REPORTautogenous bone and able to resorbsyringe can be directly applied into the recommended to cover implants and JOURNAL OF IRISH DENTAL ASSOCIATION, 2007 WINTER;progressively while new bone formationdefect without having to mix the mp3 grafted biomaterial: Evolution pericardium53(4):187-90takes place(6). granules with saline. Due to its collagenmembranes guarantee an efficient barrierSANTAGATA M, GUARINIELLO L, TARTARO G A MODIFIED EDENTULOUS EXPANSION (MERE)gel content, mp3 allows an excellent graft effect, favour the correct soft tissueTECHNIQUE FOR IMMEDIATE PLACEMENT OF IMPLANTS.These cortical and cancellous particlesstability while its hydrophilia guarantees regrowth and wound closure and do not A CASE REPORThave been mixed in various proportions JOURNAL OF ORAL IMPLANTOLOGY, 2010 JUN 16quick blood absorption and therefore the get infected in case of exposure.and granulometries with collagen gel, in SCARANO A, CARINCI F, ASSENZA B, PIATTELLI M, MURMURAnecessary graft vascularization. G, PIATTELLI Aorder to develop various products aimedVERTICAL RIDGE AUGMENTATION OF ATROPHICat different clinical indications: theIts cortico-cancellous composition allows aPOSTERIOR MANDIBLE USING AN INLAY TECHNIQUE WITH A XENOGRAFT WITHOUT MINISCREWS ANDOsteoBiol materials indicated forprogressive resorption of osteoclastic type, MINIPLATES: CASE SERIES CLINICAL ORAL IMPLANTS RESEARCH, 2011 OCT;horizontal augmentation are OsteoBiolwith in parallel a similar rate of new bone22(10):1125-30mp3, OsteoBiol Lamina and OsteoBiol formation. Used in combination withPutty.OsteoBiol Lamina, mp3 allows a verygood graft volume preservation and aOsteoBiol mp3, a pre-hydratedhealthy new bony tissue.cortico-cancellous bone mix with 10%collagen gel is a ready to use productOsteoBiol Putty is a collagen gel matrixOsteoBiol Putty | For more information see page 68loaded for 80% of its volume withSource: Tecnoss Dental Media Librarymicronized cortico-cancellous boneparticles (granulometry up to 300 m)packed in a sterile syringe.The exclusive Tecnoss manufacturingprocess guarantees an exceptionalmalleability and plasticity: furthermore thesyringepackaginggives Puttyextraordinary handling properties makingthis product the ideal choice for filling theOsteoBiol Curved Lamina and Soft Laminagaps between implants in ridge splittingFor more information see page 82 OsteoBiol mp3 | For more information see page 64Source: Tecnoss Dental Media Library procedures(7). Source: Tecnoss Dental Media Library45 44. Case reportHorizontal defect grafted with OsteoBiol Lamina and mp3Sex: female | Age: 45Fig. 1 The preoperative cone beam scanFig. 2 Alveolar ridge presenting an inadequatewidth for implant placementFig. 3 Intraoperative view demonstrating thealveolar defect. Due to the limited vertical andhorziontal dimension the elevation of the sinushas been performedFig. 4 Fixation of Osteobiol cortical Lamina withFig. 1 Fig. 2 Fig. 3titanium pins performed prior to ridgeaugmentation.Fig. 5 Reconstruction of the alveolar ridge withbone substitute (OsteoBiol mp3, Tecnoss).Fig. 6 Covering the augmented area withOsteobiol LaminaFig. 7 Primary flap closure was achievedFig. 8 Digital volumetomograph six month afteraugmentation procedure demonstrates theamount of new boneFig. 4 Fig. 5 Fig. 6Fig. 9 Intraoperative view of the augmented areasix months after augmentation procedureFig. 10 Placement of two implantsFig. 11 Postoperative radiographFig. 12 Final prosthetic reconstructionFig. 7 Fig. 8 Fig. 9Documentation provided byProf Dr Hannes WachtelDr Tobias ThalmairPrivate Institute for Periodontology andImplantology, Munich, GermanyEmail: hannes@wachtel.bizBone substitute: OsteoBiol mp3For more information on OsteoBiol mp3 see page 64Membrane: OsteoBiol LaminaFor more information on OsteoBiol Evolution see page 82Fig. 10Fig. 11Fig. 1246 45. Case reportCLINICAL INDICATIONS HORIZONTAL AND VERTICALTreatment of a failing implant caseAUGMENTATION Sex: female | Age: 56 Fig. 1 Clinical situation. Implant supported restoration upper left. Teeth supported restoration upper right. Fig. 2 Full thickness flap elevated showing implants placed partly outside the alveolar ridge Fig. 3 Implants are removed. Major bone loss defects can be seen Fig. 4 Ridge reconstructed with OsteoBiol mp3Fig. 1Fig. 2Fig. 3 carefully compacted against the plate of bone Fig. 5 A collagen sponge is placed above the MP3 giving more stability to the material and adding volume to the soft tissues Fig. 6 Four months later a flap is elevated Fig. 7 The lateral incisor is extracted and the recreated ridge can be seen Fig. 8-9 The implants are placed into a very dense boneFig. 4Fig. 5Fig. 6 Fig. 10-11 Four months later a flap is elevated and abutments placed into a very stable bone (ISQ Osstell between 72 and 78) Fig. 12 Prosthetic restorations in place. Upper left and rightFig. 7Fig. 8Fig. 9 Documentation provided by Dr Patrick Palacci Brnemark Osseointegration Center Marseille, France e-mail: patrick@palacci.com Bone substitute: OsteoBiol mp3 For more information on OsteoBiol mp3 see page 64Fig. 10 Fig. 11 Fig. 1247 46. Case reportRehabilitation of a total superior edentulism with ridge split technique Sex: female | Age: 58 Fig. 1 Initial endoral image, showing a total superior edentulism Fig. 2 Pre-operative TC image showing the crestal defect width Fig. 3 Edentulous crest expansion with ridge-split technique: insertion of depth markers Fig. 4 Placement of 6 implantsFig. 1 Fig. 2Fig. 3Fig. 5 Bone deficits grafted with OsteoBiol Putty Fig. 6 2 OsteoBiol Special membranes placed as a protection of the graft Fig. 7 Intraoral image after 8 months from implant placement Fig. 8 Intraoral image at second surgical phase: it is possible to appreciate the regeneration of pre-existing bone defects Fig. 9 TC control image after 12 months from surgery: it is possible to appreciate a good preservation of crestal boneFig. 4 Fig. 5Fig. 6 Fig. 10 Placement of a connection bar between implants Fig. 11 Detail of prosthesis: lingual view Fig. 12 Final image showing a good prosthetic rehabilitationFig. 7 Fig. 8Fig. 9 Documentation provided by Dr Fabrizio Nanni Private practitioner in Pontedera, Italy and Contract Professor at Universit di Siena e-mail: fabrizio.nanni7@tin.it Bone substitute: OsteoBiol Putty For more information on OsteoBiol Putty see page 68 Membrane: OsteoBiol Special For more information on OsteoBiol Special see page 92Fig. 10Fig. 11 Fig. 1248 47. Case report CLINICAL INDICATIONSHORIZONTAL AND VERTICALVertical regeneration with inlay techniqueAUGMENTATIONSex: female | Age: 60Fig. 1 Pre-operatory x-rayFig. 2 After one horizontal and two verticalosteotomies, the bone fragment is moved towardsthe coronal directionFig. 3 Space obtained after moving the bonefragmentFig. 4 Positioning of OsteoBiol Sp-BlockFig. 1Fig. 2 Fig. 3 Fig. 5 Rx post-surgeryFig. 6 Clinical appearance of the graft duringre-opening, after 3 monthsFig. 7 Preparation of implant sitesFig. 8 Positioning of the implantsFig. 9 Positioning of the implantsFig. 10 Histology after 3 months*Fig. 11 Histology detail*Fig. 12 Histology detail*Fig. 4Fig. 5 Fig. 6Fig. 7Fig. 8 Fig. 9Documentation provided byDr Pietro FeliceUniversity of Bologna, ItalyE-mail: pietro.felice@unibo.it*Prof Ulf NannmarkGteborg University, SwedenBone substitute: OsteoBiol Sp-BlockFor more information on OsteoBiol Sp-Block see page 87Fig. 10 Fig. 11Fig. 12 49 48. Periodontal regenerationIntrabony defects Gingival recessions Intrabony defect grafted with OsteoBiol Gen-Os Source: Courtesy of Dr Roberto Abundo and Dr Giuseppe Corrente, Torino, Italy 49. Characteristics CLINICAL INDICATIONSPERIODONTAL REGENERATIONDEFECT ORIGIN AND DESCRIPTION With regard to intrabony defects, two typesAfter having coronally advanced the flap BIBLIOGRAPHY | PAGES 49-51According the glossary of terms of theof defects can be recognized: intrabonyand suture, a periodontal dressing is(1) WAERHAUG JAmerican Academy of Periodontology, andefects and craters. Intrabony defects are generally placed to protect and favor theTHE ANGULAR BONE DEFECT AND ITS RELATIONSHIP TOintrabony defect is defined as abony defects whose intrabony component flap healing. Healing can be expectedTRAUMA FROM OCCLUSION AND DOWNGROWTH OFSUBGINGIVAL PLAQUEperiodontal defect within the bone affects primarily one tooth, while in cratersafter 3-4 months from surgery. JOURNAL OF CLINICAL PERIODONTOLOGY (1979): 6: 6182surrounded by one, two or three bonythe defect affects two adjacent root(2) WAERHAUG J In case of deep intrabony defects or whenTHE INFRABONY POCKET AND ITS RELATIONSHIP TOwalls or combination thereof.surfaces to a similar extent. TRAUMA FROM OCCLUSION AND SUBGINGIVAL PLAQUE bony walls are missing, healing can be JOURNAL OF PERIODONTOLOGY (1979); 50: 355365Irrespective of the number and nature ofIntrabony defects have been classified expected after 5-6 months from surgery.(3) GOLDMAN HM, COHEN WDthe contributing factors involved, theaccording to their morphology in terms of THE INTRABONY POCKET: CLASSIFICATION ANDTREATMENTformation of an osseous periodontal lesionresidual bony walls, width of the defect (orJOURNAL OF PERIODONTOLOGY (1958); 29: 272is considered to be the result of an apical radiographic angle), and in terms of their(4) GARRETT Sdowngrowth of subgingival plaque with a topographic extension around the tooth. PERIODONTAL REGENERATION AROUND NATURAL TEETHANNALS OF PERIODONTOLOGY (1996); 1: 621-666concomitant resorption of bone within a Three-wall, two-wall and one-wall defects(5) BRUNSVOLD MA, MELLONIG JT2mm radius from the root surface(1-2).have been defined on the basis of the BONE GRAFTS AND PERIODONTAL REGENERATIONnumber of residual alveolar bone walls. PERIODONTOLOGY 2000 (2000); 1: 80-91The more remotely located bone structures This represents the primary classification(6) LAURELL L, GOTTLOW J, ZYBUTZ M, PERSSON Rand the root surface retain their integrity system.TREATMENT OF INTRABONY DEFECTS BY DIFFERENTSURGICAL PROCEDURES. A LITERATURE REVIEWand form the anatomical boundaries of JOURNAL OF PERIODONTOLOGY (1998); 69: 303-313the osseous lesion. REGENERATION PROCEDURES(7) NANNMARK U, SENNERBY LBone replacement grafts remain amongTHE BONE TISSUE RESPONSES TO PREHYDRATED ANDThe classification of these periodontal COLLAGENATED CORTICO-CANCELLOUS PORCINE BONEthe most widely used therapeutic strategies GRAFTS. A STUDY IN RABBIT MAXILLARY DEFECTSdefects according to Goldman andCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, 2008,for the correction of periodontal osseous 10: 264-270Cohen(3) isbasedon specificintrabony defects.morphological criteria and differentiatesPeriodontal probingbetween suprabony, intrabony andObservational and controlled studies Source: Tecnoss Dental Media Libraryfurcation defects.generally document improvements inclinical parameters following placement ofIntrabony defects are defined by the apicalgraft materials(4-6).location of the base of the pocket withrespect to the residual alveolar crest. The surgical technique for treatment of notdeep intrabony defects includes elevationof a full-thickness flap, with particular carein preserving the integrity of the distalmargin, in order to guarantee properblood bedewing to the receiving site.Then, after adequate cleaning of rootsurface, particulate biomaterial can easilybe grafted and covered with a collagenresorbable membrane, which assuresprotection and exclusion of epitheliumPeriodontal defect grafted with OsteoBiol Gen-Os tissue from the attachment apparatus to be Periodontal defect grafted with OsteoBiol Gel 40For more information see page 60 For more information see page 72Source: Tecnoss Dental Media Library regenerated. Source: Tecnoss Dental Media Library 51 50. Periodontal regeneration OsteoBiol product range PRODUCT CODES Gen-Os M1052FS | 1 Vial | 0.25 g | Porcine M1052FE | 1 Vial | 0.25 g | Equine M1005FS | 1 Vial | 0.5 g | Porcine M1005FE | 1 Vial | 0.5 g | Equine M1010FS | 1 Vial | 1.0 g | Porcine M1010FE | 1 Vial | 1.0 g | Equine M1020FS | 1 Vial | 2.0 g | Porcine M1020FE | 1 Vial | 2.0 g | Equine Gel 40 Tissue of origin Collagenated heterologous cortico-cancellous Tissue of origin Pre-hydrated collagenated heterologous 05GEL40S | 1 Syringe | 0.5 cc | Porcine bone mixcortico-cancellous bone gel 05GEL40E | 1 Syringe | 0.5 cc | Equine Tissue collagen Preserved Tissue collagen Preserved + 40% additional collagen gel 15GEL40S | 3 Syringe | 3x0.5 cc | Porcine Physical form Slightly radiopaque granulesPhysical form Collagen gel type I and III loaded with 60% 15GEL40E | 3 Syringe | 3x0.5 cc | Equine Composition 100% granulated mix collagenated bone mix Granulometry 250-1000 mComposition 60% granulated mix, 40% collagen gel Re-entry time 4/5 months, depending on grafting siteGranulometry Up to 300 m Evolution characteristics Re-entry time About 4 monthsEV02LLE | 20x20 mm | Fine | Equine Packaging Vial: 0.25 g, 0.5 g, 1.0 g, 2.0 g Packaging Syringe: 0.5 cc, 3x0.5 cc EV02HHE | 20x20 mm | Standard | Equine For more information on OsteoBiol Gen-Os see page 60 For more information on OsteoBiol Gel 40 see page 72 EV03LLE | 30x30 mm | Fine | Equine EV03HHE | 30x30 mm | Standard | Equine EVOLLE | 25x35 mm (oval) | Fine | Equine EVOHHE | 25x35 mm (oval) | Standard | Equine Tissue of origin Heterologous collagen membrane Tissue collagen Preserved Physical form Dried membrane with one smooth side and one micro-rough side Composition 100% pericardium Thickness Fine: 0.4 mm (0.1). Standard: 0.6 mm (0.1) Resorption time Fine: approx 3 months. Standard: approx 4 months Packaging Fine: 20x20 mm, 30x30 mm, 25x35 mm (oval) Standard: 20x20 mm, 30x30 mm, 25x35 mm (oval) For more information on OsteoBiol Evolution see page 78 52 51. OsteoBiol products description CLINICAL INDICATIONSPERIODONTAL REGENERATIONThe entire OsteoBiol line consists ofSCIENTIFIC LITERATURE ON PERIODONTALxenografts, i.e. biomaterials deriving from REGENERATION WITH OSTEOBIOL PRODUCTSheterologous bone.DEL CORSO MSOFT TISSUE RESPONSE TO PLATELET RICH FIBRIN:The Tecnoss patented manufacturing CLINIC EVIDENCESCOSMETIC DENTISTRY, 2008, 3: 16-20process used to obtain these materials isCARDAROPOLI D, CARDAROPOLI Gable to achieve biocompatibility preserving HEALING OF GINGIVAL RECESSIONS USING ACOLLAGEN MEMBRANE WITH A HEMINERALIZEDpart of the collagen matrix of the animal XENOGRAFT: A RANDOMIZED CONTROLLED CLINICALbone and avoiding at the same time high TRIALINTERNATIONAL JOURNAL OF PERIODONTICS ANDtemperaturesthatwouldcauseRESTORATIVE DENTISTRY, 2009 FEB;29(1):59-67ceramization of the granules: the result is aunique particulate material, consisting of Gingival recession grafted with OsteoBiol Gel 40 Source: Courtesy of Dr Daniele Cardaropoli, Torino, Italy Intrabony defect Source: Courtesy of Dr Roberto Rossi, Genova, Italymineral component and organic matrix,with a porous surface extremely similar to These unique properties allow a very goodautogenous bone and able to resorb graft volume preservation, a healthy newprogressively while new bone formation bony tissue and ultimately, a successfultake