Abstract
In Guided Bone Regeneration (GBR) materials and techniques are essential to achieve the expected results. Thanks to their properties, blood clots induce bone healing, maturation, differentiation and organization. The preferred material to protect the clot in Guided Bone Regeneration is the titanium foil, as it can be shaped according to the bone defect. Furthermore, its exposition in the oral cavity does not impair the procedure. We report on five clinical cases in order to explain the management of blood clots in combination with titanium foil barriers in different clinical settings. Besides being the best choice to protect the clot, the titanium foil represents an excellent barrier that is useful in GBR due to its biocompatibility, handling, and mechanical strength properties. The clot alone is the best natural scaffold to obtain the ideal bone quality and avoid the persistence of not-resorbed granules of filler materials in the newly regenerated bone. Even though clot contraction still needs to be improved, as it impacts the volume of the regenerated bone, future studies in GBR should be inspired by the clot and its fundamental properties.
Highlights
In the last five years, scientific articles about bone regeneration have demonstrated how surgical techniques and materials have constantly been developing
The ideal regenerative materials should be applied in situ, avoiding pathological effects on the adjacent tissues and they should promote the enzymatic processes that lead to remodeling and substitution of the matrix as in physiological extracellular matrix (ECM) [10]
Starting from Murray’s intuition about the potential of clots as a natural scaffold in bone regeneration [21,22,23] and after the considerations based on his analysis, supporting evidence about the utilization of the blood clot in Guided Bone Regeneration (GBR) is required [24,25,26]
Summary
In the last five years, scientific articles about bone regeneration have demonstrated how surgical techniques and materials have constantly been developing. This aspect, associated with the evolution of dedicated biomaterials, offers multiple surgical approaches and opens new scenarios in patient selection and management [1,2,3,4,5,6,7,8,9]. The driving principle is to provide the right environment in order to steer cell differentiation with the desired phenotype at the right time and place [11]. To achieve these results, materials and methods are fundamental. Starting from Murray’s intuition about the potential of clots as a natural scaffold in bone regeneration [21,22,23] and after the considerations based on his analysis, supporting evidence about the utilization of the blood clot in Guided Bone Regeneration (GBR) is required [24,25,26]
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