Introduction of the Botiss Maxgraft allograft portfolio by Straumann UK provides a balanced GBR portfolio
The following interview is a reproduction of one published in the USA with Dr Gregory Phillips, a dentist in private practice in Indiana, USA, in which he discusses his use of Straumann Allograft (produced by Lifenet Health for Straumann USA) and Straumann Boneceramic.
In the UK, Straumann supplies the Botiss Maxgraft allograft bone processed by the Cells and Tissue Bank Austria, mainly from living donor bone processed under pharmaceutical conditions. The article has been amended slightly to reflect the product range available to dentists in the UK.
Straumann: Straumann has an allograft portfolio for bone grafting in response to market needs. In your opinion what makes allografts such an attractive type of bone graft substitute in the United States?
Gregory Phillips: Allograft is a widely used bone graft in the United States because of its track record. For a surgeon, such as me, this means that there has been a considerable amount of published literature demonstrating successful and safe usage. Autografts are the gold standard of bone regeneration, but due to the morbidity associated with this treatment option, clinicians have tended to prefer ‘bottled bone’.
It’s easier to use, there is no second surgical site and frankly, more patients accept it. Allograft bone particles get recognised by the body, avoiding issues that might affect the treatment flow. Furthermore it has been shown in various literatures that bone allografts provide a high level of regeneration.
Based on market research it appears that allografts are more popular in the US than in Europe. What is the reason and why in your opinion?
Gregory Phillips: From my understanding, allograft hasn’t been as readily available in Europe as it has been in the United States. I believe this is due to the regulatory bodies that oversee the European markets, much like we have the FDA. In the US, many clinicians have used allografts during their training, which inevitably leads to increased usage as we are setting up our practices after training.
In your practice you also offer Straumann Boneceramic, our fully synthetic biphasic calcium phosphate. How does it help you having the choice between the two materials?
Gregory Phillips: Like many other clinicians in the US, allografts in general are my preferred option. I am confident in the results I can achieve with allograft.
I use Straumann Boneceramic whenever a patient may opt out of being treated by an allograft – from religious concerns to simple personal preference. In addition to that, Straumann Boneceramic is my choice when the necessity of using a bone graft material is unexpected. In fact I don’t believe I should use an allograft without providing the patient the choice upfront. It’s a great option that allows me the flexibility to make last-minute decisions when I am in surgery.
As just mentioned, I use Straumann Boneceramic for the development of the thickness of the facial plate during the placement of implants in the aesthetic zone because of its ability to maintain the volume.
Is there any indication/clinical situation where you would use only synthetic bone grafts?
Gregory Phillips: After seeing Professor Daniel Buser present information on Straumann Boneceramic at the Academy of Osseointegration 2009 meeting, I started using Straumann Boneceramic specifically for the development of the thickness of the facial plate because of its ability to maintain the volume. The main reason that I primarily use an allograft is in the relatively faster bone regeneration process, which in certain cases might compromise on volume maintenance.
Have you been able to identify in your patients a clear preference for allografts or synthetic materials?
Gregory Phillips: I have not identified such a preference specifically. If patients do not like being treated with an allograft, for one of the above mentioned reasons, I provide them with the option for a synthetic material, Straumann Boneceramic. I typically go into detail about the materials I recommend and rarely does a patient reject the allograft once they understand how safe it is.
Allograft products can come as cancellous or cortical bone. Is there any clinical situation where you would specifically use one or the other? Why?
Gregory Phillips: I opt for the cancellous bone particles when I need porosity and structure allowing for the ingrowth of blood vessels and bone in growth such as in ridge augmentations or sinus lifts. The cortical option offers more durability or rigidness because it’s a denser bone. I like this when I need more of this maintained structure.
In the USA, Straumann offers both a synthetic bone substitute and allografts. How do you feel about a company providing a differentiated portfolio for bone grafting?
Gregory Phillips: In my practice there’s definitely a place for both a synthetic bone graft material and an allograft. For anyone evaluating different types of graft materials, the important thing is to do your research and understand what works best in different situations.
I personally think that the addition of Straumann Allograft shows Straumann’s commitment to me and providing me with what I need. The addition of Straumann Allograft means a level of service that I can’t get anywhere else.
Obviously there are other implant companies that offer allograft bone graft materials, but across the board, Straumann provides me with what I feel are the best options – from an incredibly well-researched implant system, to predictable periodontal regeneration with Straumann Emdogain, to an allograft I know I can trust through the partnership with Lifenet Health (the human tissue provider for Straumann USA). For my staff, it means easier inventory management and only having to make one call to order products.
The Straumann botiss maxgraft range includes:
• Maxgraft cancellous granules (0.5-2.0mm)
• Maxgraft cortico-cancellous granules (0.5-2.0mm)
• Maxgraft cancellous blocks (10x10x10mm, 20x10x10mm)
• Maxgraft uni-cortical blocks (10x10x10mm, 20x10x10mm)
• Maxgraft bonerings
• Maxgraft bonebuilder (CADCAM-milled cancellous blocks).
Dr Gregory E Phillips, DDS, MSD runs a private practice in Columbus, Indiana, specialising in periodontics and implant dentistry. He holds a faculty position in the department of graduate periodontics at Indiana University School of Dentistry where he teaches periodontal surgery, implant dentistry and implant related procedures. Diplomate of the American Board of Periodontology, a member of Omicron Kappa Upsilon, fellowships in the American College of Dentists, International College of Dentists, International Team for Implantology and the Pierre Fauchard Academy.
FOR MORE INFORMATION on Straumann’s botiss maxgraft range contact Straumann on 01293 651230 or visit www.straumann.co.uk
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