Abstract
After tooth loss, bone resorption is irreversible, leaving the area without adequate bone volume for successful implant treatment. Bone grafting is the only solution to reverse dental bone loss and is a well-accepted procedure required in one in every four dental implants. Research and development in materials, design and fabrication technologies have expanded over the years to achieve successful and long-lasting dental implants for tooth substitution. This review will critically present the various dental bone graft and substitute materials that have been used to achieve a successful dental implant. The article also reviews the properties of dental bone grafts and various dental bone substitutes that have been studied or are currently available commercially. The various classifications of bone grafts and substitutes, including natural and synthetic materials, are critically presented, and available commercial products in each category are discussed. Different bone substitute materials, including metals, ceramics, polymers, or their combinations, and their chemical, physical, and biocompatibility properties are explored. Limitations of the available materials are presented, and areas which require further research and development are highlighted. Tissue engineering hybrid constructions with enhanced bone regeneration ability, such as cell-based or growth factor-based bone substitutes, are discussed as an emerging area of development.
Highlights
Studies have found that almost all current bone graft and substitute materials primarily serve as a structural framework for osteo-regenerative processes to occur, they only satisfy the osteoconductivity component of the ideal characteristics discussed previously [17,19,20]
Wong and Rabie found that when Gusuibu was integrated with a collagen carrier acting as a structural scaffold, new bone formation was increased by 24% all across the bony defect when compared with the grafted Guisuibu alone; and by 90% when compared with an absorbable collagen sponge routinely used as a carrier for growth factors (GFs) such as bone morphogenic protein (BMP) to induce bone regeneration [44]
These results show that the efficacy of Gusuibu in promoting new bone formation was comparable to that of the autograft material, suggesting that Gusuibu may present a promising viable bone substitute material when used with a collagen carrier
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. 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 craniofacial bony defects. As of 2018, the market value for dental bone substitutes has been estimated to be worth approximately US$493 million and is projected to grow to approximately US$931 million by 2025, at a combined annual growth rate of 9.5% [9] Despite this widespread use of bone graft and substitute materials globally, there are still limitations that remain associated with currently used materials. This review will provide an update on current bone graft and substitute materials used in dentistry, their relative efficacies and shortcomings and future directions for study
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