Veterinary Dental Guided Bone Regeneration

Bone loss is a common occurrence in companion animals who have suffered from long term periodontal disease. In fact, periodontal disease is classified by the degree of degradation of the periodontal structures that support the tooth. It is also expected that up to 25% bone loss will occur post extraction. Thus the practice of bone regeneration should be treated as best practice for key teeth as well as a regenerative procedure for patients suffering from periodontal disease.

Use of Veterinary Dental Synthetic Bone Graft Material

Synergy™ is an advanced biosynthetic bone graft comprised of calcium phosphates that occur naturally in real bone. It is a biphasic combination of β-Tricalcium Phosphate (β -TCP) and Hydroxyapatite (HA).

The intelligent bioactive materials in Synergy ™ have the proven ability to stimulate bone formation.3 The β -TCP quickly releases calcium ions4 that cause clotting and release of platelet-derived growth factors. This cascade of mineral release and blood clotting provides the perfect environment for stimulation of bone healing. The cancellous-like porosity and surface structure encourage inward cell migration. As the β -TCP resorbs more space is created to support angiogenesis and bone formation1. The micro particles of HA provide a more long lasting osteoconductive structure.

Used for filling, bridging and/or reconstruction of non weight-bearing bony defects.

Exceptional performance for:

  • Void filling / Extraction sites
  • Periodontal pockets / Other bone loss / Furcation defects
  • Fracture repair
  • Cysts / Other osseous defects

Features & Benefits Advanced Formulation:  Biphasic Synergy™ is composed of biocompatible β-TCP and HA1 sintered together. The ratio is optimised for swift transformation into new bone throughout the graft.

  • 85% resorbable β -TCP
  • 15% structurally stable HA

Balanced Remodelling:Synergy™ works with the body in 2 integrated phases.

  • Phase 1: β-TCP simultaneously resorbs as new bone is formed, remodelling throughout the graft
  • Phase 2: HA microparticles slowly resorb, providing an osteoconductive scaffold

Cancellous-like, Osteoconductive Morphology : Synergy’s structure is the architectural equivalent of cancellous bone. Interconnected porous structure encourages stem cell migration, proliferation and differentiation into osteoblasts Provides for an adequate flow of nutrients to enhance new bone formation.

References:

  1. Farina et al., In vivo behaviour of two different biphasic ceramic implanted in mandibular bone of dogs. J Mater Sci: Mater Med 19:1565-1573, 2008
  2. Spivak JM, Hasharoni A. Use of hydroxyapatite in spine surgery. Eur Spine J. 10: S197-S204, 2001
  3. Habibovic P, de Groot K. Osteoinductive biomaterials – properties and relevance in bone repair. J Tissue Eng Regen Med. 1: 25-32, 2007
  4. Daculsi et al., Transformation of biphasic calcium phosphate ceramics in vivo: ultrastructural and physicochemical  characterization. J Bio Mat Res 23:883-94,1989

Use of Ossiflex™ Bone Membrane

Ossiflex™ Bone Membranes from Veterinary Transplant Services (VTS) are thin, flexible sheets made of natural demineraliSed cortical bone. These are thicker than the other membranes and, being made of cortical bone, provide a natural surface compatible with bony integration as well as epithelialiSation.

Guided Tissue Regeneration
Placing a membrane between the bone graft and soft tissue avoids premature soft tissue in-growth. 1-6
Oronasal Fistulas
While thin and flexible, Ossiflex™ Bone Membranes are strong enough to keep food particles from traveling through oronasal defects.
Cleft Palates and Cranio-Facial Defects
Ossiflex™ Bone Membranes are also ideal for treating cranio-maxillo-facial defects. For example, they can be used to support mucoperiosteal advancement flaps for closure of palatal defects.
Fracture Bridging
Ossiflex™ Bone Membranes can be wrapped around mandibular fractures to support healing.
Mandibular Canal Protection
Ossiflex™ Bone Membranes can be placed over open mandibular canals to keep growing tissue from impinging on the nerve.

References

Fugazzotto PA. The use of demineralized laminar bone sheets in guided bone regeneration procedures: report of three cases. Int J Oral Maxillofac Implants. 11: 239-244, 1995.
Rosenquist B, Ahmed M. The immediate replacement of teeth by dental implants using homologous bone membranes to seal the sockets: clinical and radiographic findings. Clin Oral Impl Res. 11: 572–582, 2000.
Scott TA, Towle HJ, Assad DA, Nicoll BK. Comparison of bioabsorbable laminar bone membrane and non-resorbable ePTFE membrane in mandibular furcations. J Periodontal. 68: 679-686, 1997.
Rankow, Henry J, Krasner, Paul R. Endodontic applications of guided tissue regeneration in endodontic surgery. Oral Health. 86(12): 33, 1996.
Mundell RD, Mooney MP, Siegel MI, Losken A. Osseous guided tissue regeneration using a collagen barrier membrane. J Oral Maxillofac Surg. 51: 1004-1012, 1993.
Majzoub Z, Cordioli G, Aramouni PK, Vigolo P, Piattelli A. Guided bone regeneration using demineralized laminar bone sheets versus GTAM membranes in the treatment of implant-associated defects. A clinical and histological study. Clin Oral Implants Res. 10:406-414, 1999.
Cox CL, Hunt GB, Cadier MM. Repair of oronasal fistulae using auricular cartilage grafts in five cats. Veterinary Surgery 36: 164-169, 2007.
Soukup JW, Synder CJ, Gengler WR. Free auricular cartilage autograft for repair of an oronasal fistula in a dog. J Vet Dent. 26(2): 86-95, 2009.
Duskova M, Leamerova E, Sosna B, Gojis O. Guided tissue regeneration, barrier membranes and reconstruction of the cleft maxillary alveolus. J Craniofac Surg. 17(6):1153-1160, 2006.
Scott JK, Webb RM, Flood TR. Premaxillary osteotomy and guided tissue regeneration in secondary bone grafting in children with bilateral cleft lip and palate. Cleft Palate Craniofac J. 44(5): 469-475, 2007.
Le BT, Woo I. Alveolar cleft repair in adults using guided bone regeneration with mineralized allograft for dental implant site development: a report of 2 cases. J Oral Maxillofac Surg. 67: 1716-1722, 2009.
Retzepi M, Donos N. Guided bone regeneration: biological principle and therapeutic applications. Clin Oral Impl Res. 21: 567-576, 2009.
Reiser GM, Manwaring JD, Damoulis PD. Clinical significance of the structural integrity of the superior aspect of the mandibular canal. J Periodontal. 75(2): 322-326, 2004.

Use of Fascia Collagen Membrane

Fascia is processed and freeze-dried fascia lata allografts. Fascia is a natural collagen scaffold that allows integration with the host tissues and cellular ingrowth organises along the native fibres inherent in fascia. During the integration phase it provides a barrier for GTR procedures. It is thinner and somewhat more flexible than the Ossiflex Bone Membranes.

Guided Tissue Regeneration
Placing a membrane between bone graft and soft tissue avoids premature soft tissue in-growth. 1-6

Oronasal Fistulas
While thin and flexible, Fascia is strong enough to keep food particles from traveling through oronasal defects.

Cleft Palates and Cranio-Facial Defects
Fascia is also ideal for treating cranio-maxillo-facial defects. For example, it can be used to support mucoperiosteal advancement flaps for closure of palatal defects.

References
Rankow, Henry J, Krasner, Paul R. Endodontic applications of guided tissue regeneration in endodontic surgery. Oral Health. 86(12): 33, 1996.
Cox CL, Hunt GB, Cadier MM. Repair of oronasal fistulae using auricular cartilage grafts in five cats. Veterinary Surgery 36: 164-169, 2007.
Soukup JW, Synder CJ, Gengler WR. Free auricular cartilage autograft for repair of an oronasal fistula in a dog. J Vet Dent. 26(2): 86-95, 2009.
Duskova M, Leamerova E, Sosna B, Gojis O. Guided tissue regeneration, barrier membranes and reconstruction of the cleft maxillary alveolus. J Craniofac Surg. 17(6):1153-1160, 2006.
Retzepi M, Donos N. Guided bone regeneration: biological principle and therapeutic applications. Clin Oral Impl Res. 21: 567-576, 2009.