Misch C E, Dietsh F
University Oral Implantology Center, Department of Prosthodontics, University of Pittsburgh, School of Dental Medicine, PA 15261.
Implant Dent. 1993 Fall;2(3):158-67. doi: 10.1097/00008505-199309000-00003.
There are three classes of bone-grafting materials based upon the mode of action. Autogenous bone is an organic material and forms bone by osteogenesis, osteoinduction, and osteoconduction. Allografts such as demineralized freeze-dried bone are osteoinductive and osteoconductive and may be cortical and/or trabecular in nature. Alloplasts such as hydroxyapatite and tricalcium phosphate may be synthetic or natural, vary in size, and are only osteoconductive. They can be divided into three types based upon the porosity of the product and include dense, macroporous, and microporous materials. In addition, alloplastic materials may be crystalline or amorphous. These materials have different properties and therefore indications. The use of the three classes of materials in diverse combinations depends upon the size and topography of the bony defect. Small defects or defects with four walls of host bone can be repaired with alloplasts alone or allografts in combination with alloplasts. The loss of three or more bony walls mandates the addition of autogenous bone to the graft or the use of a small pore membrane. The larger the defect, the more autogenous bone is required. The different indications of bone substitutes are discussed as to their specific applications in implant dentistry.
根据作用方式，骨移植材料可分为三类。自体骨是一种有机材料，通过骨生成、骨诱导和骨传导形成骨组织。同种异体骨，如脱矿冻干骨，具有骨诱导性和骨传导性，其性质可能是皮质骨和/或小梁骨。异种骨，如羟基磷灰石和磷酸三钙，可能是合成的或天然的，大小各异，仅具有骨传导性。根据产品的孔隙率，它们可分为三种类型，包括致密材料、大孔材料和微孔材料。此外，异种骨材料可能是晶体或非晶体。这些材料具有不同的特性，因此有不同的适应症。这三类材料以不同组合使用取决于骨缺损的大小和形态。小的缺损或有宿主骨四壁的缺损可单独用异种骨或异种骨与同种异体骨联合修复。三壁或更多骨壁缺失则需要在移植物中添加自体骨或使用小孔膜。缺损越大，所需自体骨越多。本文将讨论骨替代物在种植牙科中的具体应用及不同适应症。
