Guided Bone Regeneration

One important goal of modern periodontal therapy is the regeneration of lost periodontium including alveolar bone, periodontal ligament, and cementum. At present, the clinician can choose from biological grafting materials such as allografts from a tissue bank or autografts that use the patient's own bone. Synthetic grafting materials may be designed to fill space and permit the patient's own bone to grow into the defect.Lot of research is going in this feild and many new materials are expected to come in future. Amongest the most recent Advances in Dentistry Bone grafting is very important. Sucess of Periodontal Surgery and Dental Implants is largely attributed to Bone Grafting.Though many materials have been tested from time to time but researchers feel:

  1. An Ideal Synthetic Bone Substitute should be Biocompatible.
  2. Serve as a scaffold (framework) for new bone formation. Be resorbable in the long-term and have potential for replacement by host bone. v Be osteogenic, or at least facilitate new bone formation.
  3. Be radiopaque.
  4. Be easy to manipulate.
  5. Not support growth of oral pathogens. hydrophilic (to attract and hold the clot in a particular area). Be available in particulate and molded forms.
  6. Be microporous (for added strength to the regenerating host bone matrix and allow biological fixation).
  7. Be readily available. v Be nonallergenic.
  8. Have a surface that is amenable to grafting.
  9. Act as a matrix or vehicle for other materials (eg, bone protein inducers, autibiotics) Have high compressive strength.

    Bone Grafting is achieved by 3 different processes:
  • Osteogenesis
  • Osteoinduction, and
  • Osteoconduction.
An osteogenic graft is composed of organic material taken from or composed of living tissue involved in the growth or repair of bone. It encourages bone formation in soft tissues, or activate faster bone growth through factors present only in living bone. Bone regeneration may be facilitated and bone may extend or grow in places where it is not typically found. Osteoconductive graft materials are conducive to bone growth and allow bone apposition from existing bone. Osteoinduction graft materials induce bone formation when placed in soft tissue. These tissues are frequently inorganic and need existing bone Types of Graft Material.-Autogenous bone is considered the "cream" of grafting material because of its osteogenic properties that allow bone to form quickly . For other dental applications, allografts and alloplasts are appropriate.