Study
https://pubmed.ncbi.nlm.nih.gov/38801622/
Pabst A, Becker P, Götz W, Heimes D, Thiem DGE, Blatt S, Kämmerer PW. Int J Implant Dent. 2024 May 27;10(1):26.
OBJECTIVES
Pre-clinical and clinical studies that compare a minimum of two different particulate bovine bone substitute materials for dental bone regeneration were analyzed with respect to production process, physicochemical characteristics, resorption properties, and performance of the bone substitutes by conducting a systematic search in PubMed database.
RESULTS
Bovine bone substitutes can be distinguished by their manufacturing processes.
Bovine bone substitutes can generally be separated into two groups based on their manufacturing processes. The bone raw material is either processed by applying elevated temperatures (> 1000°C; high temperature treated bovine bone substitute) or is treated at low temperatures including additional chemical cleaning (low temperature treated bovine bone substitute).
Low and high temperature treated bovine bone substitute materials have different properties.
The found data demonstrate differences between the bone substitutes concerning porosity, crystallinity, and calcium release rate, which can be correlated with their different production processes.
The analyzed pre-clinical and clinical studies have shown slight differences in the performance of the bone substitutes. A summary of the results of the found and evaluated data is provided in Table 1.
Table 1. Summary of the results of the found pre-clinical and clinical data:
| Low temperature treated bovine bone substitute (BS) | High temperature treated bovine bone substitute (BS) | |
| Physicochemical properties | ||
| Crystallinity (Crystal size compared to human bone) |
Increased by 200 – 300% |
Increased by 500 – 1000% |
| Calcium/phosphate ratio |
Both ranging from 1.74 to 1.33 |
|
| Calcium release |
12 mg/g |
4 mg/g |
| Resorption |
Both minimal to negligible |
|
| Pre-clinical data | ||
| In vitro | Slight evidence of minor advantages of high temperature treated BS, such as improved biocompatibility in cell cultures. | |
| In vivo | Subtle tendency towards variances in new bone formation between low and high temperature treated bovine BS across distinct healing intervals with potential slight benefits favoring high temperature treated bovine BS after 2–3 months. | |
| Clinical data | ||
| Ridge preservation |
|
|
| Sinus lift |
|
|
| Peri-implant bone defects |
|
|
| Lateral/vertical alveolar ridge augmentation | ||
CONCLUSIONS
Different manufacturing processes of particulate bovine bone substitute materials lead to different material properties.
Found and analyzed pre-clinical studies comparing at least two particulate bone substitute materials have demonstrated slight favorable outcomes for high temperature treated bovine bone substitutes.
No significant differences were noted for clinical outcomes based on the found comparative studies, except for sinus floor augmentation, which is that there is a trend towards small benefits with high temperature treated bovine bone substitute regarding volume loss, new bone formation and the amount of connective tissue.
However, data directly comparing particulate bovine bone substitutes are scarce, therefore additional clinical studies are required.
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