As well as bone augmentation in preparation for dental implantology, bone substitute materials are also used in the surgical treatment of severe periodontal diseases that are accompanied by intrabony defects. The bone substitute material replaces the receded bone, thus keeping the tooth grounded within the tooth-supporting tissue. About 35% of all surgical periodontal treatments are currently carried out using various bone substitute materials.

Periodontal disease is caused by pathogenic microorganisms. It affects the gum and the entire tooth-supporting tissue, including the jaw bone. The disease is associated with severe inflammation and the formation of periodontal pockets around the affected tooth. The failure to appropriately treat periodontal disease results in progressive loss of tooth-supporting tissue, which finally leads to tooth loss. Severe untreated periodontal disease might also influence a patient's general health via a negative impact on the immune system and correlations to cardio-vascular disease have also been observed.

The effective treatment of the different stages of periodontal disease requires, in the first instance, products for the restoration of the periodontal ligament and gum and, in advanced cases, bone repair products.

Regenerative bone substitute materials

In the past, bone substitute materials only served as filling materials to mechanically strengthen the defect site. With the idea of natural tissue repair, regenerative bone substitute materials are gaining more and more interest. Regenerative bone substitute materials have the following advantages over purely synthetic alternatives:

• Osteoinductivity: the material has the ability to stimulate bone growth.
• Osteoconductivity: the material has the ability to provide a scaffold upon where new bone can form.
• Resorption: the material is completely replaced by natural bone.

These advantages lead not only to faster healing times but also to predictable clinical outcomes. From a material point of view, growth factor activated synthetic materials will become predominant for use as bone substitute materials, because only these offer the same efficacy as autologous bone without the disadvantages.

MD05, Scil Technology’s bone substitute material, is a synthetic, fully resorbable, compression resistant dental bone augmentation product combining osteoconductive and osteoinductive properties. While a clinical phase II study for sinuslift is ongoing, a further clinical trial for bone repair in severe periodontal disease is in preparation for start in 2006.

MD05 is a biomaterial with two components: a synthetic inorganic carrier ß-Tricalcium phosphate (ß-TCP) and a recombinant growth factor - rhGDF-5, a naturally occurring human protein that acts by promoting the growth of bone. ß-TCP provides a stable structural matrix for bone augmentation and rhGDF-5 promotes bone growth into the area of placement as the matrix is resorbed. In this way, MD05 encourages the re-growth of bone lost to severe periodontal disease.