Abstract

Bone healing is a complex process, conditioned by the equilibrium between physical factors and the biological response. The use of bone grafts and substitutes in dentistry have markedly increased in recent years due to advancements in dental implantology and the growing need for repair of alveolar bone defects. These defects may arise from trauma, periodontal disease, surgical excision, infection or congenital malformations, and oral cancer. The most common observation of insufficient quantity of bone in dentistry is following tooth loss, where rapid resorption of alveolar bone occurs. This fact leads to special situations, characterized by different amounts of bone loss, and situations that require the use of bone grafts or substitutes, depending on different circumstances. The used bone grafts can be natural or synthetic, each one with their advantages and disadvantages and special indications as well. Bone substitutes are used to facilitate bone healing through osteoinductive, osteoconductive and osteogenic capacities. The various limitations of single bone grafts, as well as recent technological advances, have led to the presence on the market of various types of bone substitutes, with different chemical structures, mechanical and biological properties adapted to different types of bone defects. None of the products in the market currently possesses all the ideal properties for a bone substitute material including low patient morbidity, ease of handling, low immunogenicity, low cost and angiogenic potential. Composite bone substitute materials combine two or more materials, improving the mechanical properties of each component and their osteoinductive, osteoconductive or osteogenic  properties as well.

The last years have represented a period of uninterrupted progress in terms of solving different types of bone defects. Despite years of effort, the perfect bone regenerative material has not yet been developed.

Learning Objectives

• To discuss different types of alveolar bone defect
• To discuss characteristics different types of bone grafting materials
• To demostrate the indications for composite bone grafts in alvolar ridge regeneration
• To explain components of recent composite bone grafts used in clinical practice
• To discuss the clinical results after usage of different composite bone grafts