SMART SCIENCE™ - OSTEOSTIMULATION
Unlike other synthetic grafts that are bioinert, NB Putty belongs to the class of bioactive regenerative materials that not only acts as an osteoconductive scaffold but also interacts with the surrounding tissues and imparts an osteostimulatory effect. NB Putty is not osteoinductive but a number of in vivo studies have demonstrated an accelerated bone formation with CPS particles. Also, the viability and proliferation potential of osteoblasts has been shown to be exemplified in the presence of CPS particles. Studies also demonstrate increased osteocalcin and alkaline phosphatase levels in the presence of CPS particles providing a favorable site for bone formation.
Osteostimulation is an active process. NovaBone Dental Putty acts as a bone matrixand encourages differentiation of new bone cells at the site. This phenomenon results in faster bone regeneration than exhibited by osteoconduction alone while simultaneously increasing the resorption rate of the graft material.
BIOLOGIC INTERPRETATION
Immediately upon implantation, silicon and calcium ion release initiates a cascade of events that signals and recruits undifferentiated cells to the site
Several genes are regulated, resulting in proliferation and differentiation of undifferentiated cells into osteoblasts
The osteoblasts mature into osteocytes (mature bone cells) at the terminal stage
This process continues resulting in bone regeneration at a much faster pace than osteoconduction
CLINICAL INTERPRETATION
Upon implantation, the binder gets absorbed within 24-72 hrs, creating a 3-dimensional porous scaffold that facilitates active movement of blood and tissue fluids through the matrix
Smaller CPS particles interact with blood providing the initial burst of calcium and phosphate ions
This provides a favorable area for bone regeneration as it creates numerous calcium phosphate nodules that mature individually to form bone throughout the defect
Subsequently, the larger particles react and continue the process of bone regeneration
HISTOLOGIC INTERPRETATION
Rabbit Histology at 3 and 6 weeks helps visualize the osteostimulation phenomenon. At 3 weeks, cracks developing through individual particles can be noticed with bone growing through them. Pink areas of bone formation are also seen around the putty particles along with areas of cartilaginous cells & giant cells (purple).
3 weeks
6 weeks
B-Bone, P- Graft Particle, C- Cracks
Figure 2 – Histology demonstrating osteostimulation phenomenon at 3 & 6 weeks
At 6 weeks, abundant bone around each particle can be seen(pink areas). The cracks have progressed completely into the center of each particle, and an area of bone regeneration (pink) is seen within each individual particle. This is very unique to CPS products and results in the creation of multiple foci of bone regeneration resulting in enhanced bone regeneration and consequently faster material absorption!