CLINICAL
CASE
Dr Bernard Guillaume
6, rue de Rome, Paris 75008
doct.guillaume@wanadoo.fr
.
Maxillofacial Surgeon.
. President, Collège Français d’Implantologie.
. Accredited Expert, Paris and Versailles
Appellate Courts.
. Fellow, Lecturer, Unité INSERM
U 922 Biomaterials, Calcified Tissues, Dental Implantology
- 49045 Angers.
In the last 20 years, various synthetic and natural
biomaterials with highly variable osteogenic, osteoconducting
and osteoinducting properties have appeared on the market.
In maxillofacial and preimplantation surgery, bone replacement
to correct a bone defect is a major concern.
Resorting to autologous grafts to correct these defects
is an advantage in terms of osteogenic compatibility,
but the bone augmentation obtained is sometimes rather
limited (except with large bone samples presenting a
significant degree of morbidity).
In
view of frequently justified reluctance to harvest extra-oral
grafts and medico-legal constraints, synthetic substitutes
are becoming increasingly attractive. Most surgical
teams seek to develop a reliable bone matrix capable
of receiving implants by replacing all or part of the
bone graft with biomaterials.
ßTCPs,
which have proved to be reliable for several decades
in orthopedic surgery, are an obvious candidate for
maxillofacial and preimplantation surgery.
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ßTCP
characteristics
Kasios® ßTCP is a Tricalcium Phosphate
ß Ca3(POH4)2.
As it does not contain hydroxyapatite it is totally
biocompatible with surrounding body tissue and
resorbable in six to nine months, as evidenced
by animal and human histology studies.
Its
microporosity facilitates extracellular Ca and
P ion flows. The product's main feature is its
unique macroporosity representing almost 85% of
total mass. This constant ensures optimal osteoblastic
apposition and development of lamellar bone remodelling.
Its biocompatibility, resorption and receptor-bone
substitution capacity, together with its osteoconductive
properties, combine to produce a reliable and
particularly suitable material for filling alveoli
of various dimensions and for maxillofacial sinusal
reconstruction for preimplantation, regardless
of sinusal volume. There is a notable absence
of significant inflammatory reaction of the sinus
mucosa in direct contact with the biomaterial,
even in the first few weeks (verified with CT
scan). In six to eight months following biomaterial
placement, the density of graft biomaterial combined
with autologous bone becomes radiographically
visible and clinically evident when placing implants
in bone, density II-III.
In routine preimplantation maxillofacial surgery
practice, ßTCP ensures stable bone reconstruction
for the sinus lift. The bone volume facilitates
the placement of long and large-diameter implants,
in homothetic axis to the underlying implant prosthesis.
With these characteristics, the product is an
excellent choice for this kind of implant-supported
prosthetic rehabilitation.
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