Thank you for inviting me! I graduated in 2006 with a thesis in oral surgery and I have always dealt with surgical and implantological themes. Moreover, I’m also interested in digital dentistry.
The regeneration of hard and soft tissues is an aspect that must be faced up in most cases treated. I hardly imagine therapies that do not include this topic, indeed, if you lose a tooth, probably you have also lost bone and/or soft tissue. Rare are the cases that don’t need some kind of tissue augmentation in order to have an optimal result.
I discovered SmartBone® almost by chance, I think almost ten years ago. Giuseppe Perale (current Vice President of IBI SA) came to present the biomaterial. I was interested in the product and I started to use it in my private practice, alongside other biomaterials.
There is not yet a perfect biomaterial on the market but there are some very bad biomaterials.
SmartBone® has some peculiar characteristics that make it a biomaterial deeply different from others. Mainly the bone remodeling is very high, the biomaterial gets replaced by patient bone more quickly than many others bone substitute. This characteristic must be understood in depth because an important biological advantage succeeds: the bone that will surround the implants will be definitely vital. On the other hand is not an ideal biomaterial for crestal expansions with purely prosthetic purposes, in which it is not relevant how vital the newly formed bone is.
In summary, if the aim is to use a material very similar to autologous bone, SmartBone® is an excellent material; if the aim is just to modify the contours of a crest with a small amount of remodeling, I prefer other products.
Is important to underline that Smartbone® Blocks have a truly remarkable mechanical strength.
The packaging material of the vial has been changed from plastic to glass, and it has been a great improvement. In the previous version, electrostatic charges were formed and glued the granules to the vials, with the changeover to glass this problem no longer occurred.
The margins for improvement are those that have always been valid for all biomaterials: reducing more and more the gap with the autologous bone. The most important is osteoinductivity, the ability of a material to induce bone neoformation. The second is the integration time: for the autologous bone the time frame is three months.
I use SmartBone® mainly in granular form, for bone regeneration both with resorbable and non resorbable membranes. I often use collagen resorbable membranes supported by a variable number of osteosynthesis screws, then fixed with pins.
Most of the regenerative procedures I perform in daily practice are horizontal augmentations, of varying difficulty depending on the case. When the residual crest thickness is less than 3 mm, I prefer to choose synthetic means to give greater stability to the graft.
Thanks again for the invitation!