Author: Dr. Bernardo Passoni
The bone remodeling standard after tooth extraction described by Araújo and Lindhe (2005) highlighted the need for materials to maintain and/or reconstruct the alveolar ridge. For decades, the topic of what the ideal material is for such procedures has been discussed. We’ve already passed the era when endogenous graft was the gold standard and now we’re experiencing the transition between xenogeneic and synthetic bone substitutes. The result obtained with xenogeneic materials is undeniable, however it would be somewhat naive to imagine that dentistry/implantology would not also evolve to synthetic materials. Therefore, the purpose of this article is to discuss the characteristics of synthetic substitutes, as well as the advantages of using this class of material.
Nanosynt, biphasic calcium from the FGM Dental Group, is a composition of 60% hydroxyapatite and 40% beta tri-calcium phosphate. As a clinician, do you know the purpose of this association? Hydroxyapatite is a slow remodeling bone substitute, in other words, it will take months, perhaps years, to be remodeled, maintaining the volume/framework necessary for bone neoformation. Meanwhile, B-tcp is a fast-remodeling material, that is, it will leave room for faster bone neoformation. Therefore, when comparing synthetic versus xenogeneic, there will always be greater bone formation in a shorter period of time in grafting synthetic material, since xenogeneic substitutes are 100% composed of animal hydroxyapatite. So, dear readers, here I present to you the first advantage of synthetic materials: Bone formation time, scientifically proven by Prof. P.G. Coelho (2014) from the University of NY, showing 20% more bone formation than xenogeneic competitors.
Besides biphasic composition, what other characteristics would provide these results? Nanosynt is a biomaterial with 80 to 90% of interconnected nanometric pores, providing better vascularity in the grafted area, in addition to facilitating cell migration and adhesion, and consequently bone matrix deposition. This characteristic also provides excellent hydrophilicity at the time of hydration and manipulation of this material. However, this hydration must be done gradually, using 5 to 8 drops for every 0.25g of material, creating conditions for the serum to permeate the nanopores.
In case you still don’t know Nanosynt, this biphasic calcium comes in 0.5g and 1g boxes. However, in both cases, packaging is divided into 0.25g ampoules. That is, you can open 0.25g at a time, without wasting material. From one clinician to another, how many times have you thrown more than half of the container away and thought about your money being thrown away too? So, in addition to the many benefits of the clinical results, Nanosynt will also make your practice more profitable
Finally, we must also emphasize that synthetic bone substitutes are 100% safe, that is, no risk of cross-contamination. In addition, since it’s synthetic and not of animal origin, it doesn’t present issues for blood donor patients, it isn’t rejected by vegan patients and so many other particularities that we find in our daily practice.
So dear readers, don’t be afraid of change. Good things go away so that better things can come (Author unknown). In short, no one condemns xenogeneic material, but both the present and future are about synthetics since this class of material is better, more practical, safer, more economical and most important of all: provides greater bone formation in less healing time.
