Bone-inducing materials: their place in dentistry

Materials and techniques for use in the repair of periodontal defects, alveolar ridge augmentation, ridge maintenance and alveolar ridge recontouring are discussed. An increased sophistication in the use of freeze dried and frozen allogeneic bone banked materials is evident. The principal application in ridge augmentation is to provide a base for the construction of dentures or other appliances in the ageing patient. Recently developed ceramic materials, similar in composition to the normal tooth and/or bone, are being used today for both periodontal defect repair and to maintain or build-up the alveolar ridge. These materials are forms of hydroxylapatite or of beta tricalcium phosphate. Their role in causing bone growth, in providing a matrix for new bone growth and in providing a source of calcium and phosphate ions is discussed. Although the mechanism of action of the synthetic ceramics is not yet known, there is increasing evidence that some are safe and effective, especially in alveolar ridge augmentation. Effectiveness, however, depends very much on careful patient selection prior to surgery.