Regenerative Biomaterials
View answers to our most asked questions about Regenerative Biomaterials
Bone Grafts
Composition of PentOS OI™ Flex. PentOS OI™ Flex is made of demineralized, osteoinductive 100% cortical bone.
The five elements of bone formation with PentOS OI™ Flex. Post sterilization in-vivo testing is performed on each batch, and each batch must demonstrate the presence of new bone, bone marrow, osteocytes, cartilage and chondrocytes within 28 days in an athymic rat model. If not, they do not call it PentOS OI™.
PentOS OI™ Max is made from 100% human allograft demineralized bone matrix and is cortical bone.
If primary closure is not possible, the use of a membrane is highly recommended. Normally, a dental membrane is used to prevent the epithelial cells from growing into the bone graft site, where new bone is forming. A Neomem® membrane also helps to keep the granules at the graft sight, preventing migration of the granules. A membrane is also used when primary closure is not possible. However, if the periosteum is still intact, it can be used to achieve primary closure. If the periosteum is damaged in any way, a membrane, such as Neomem® or Neomem® FlexPlus, should be used.
Many advantages of using the PentOS OI™ Max Mixed PentOS OI™ Max can be extruded through a syringe. It resists copious irrigation and has a five-year shelf life at ambient storage. Shown to form bone post-sterilization in-vivo. Demonstrates osteoconductivity. It can be used in patients with compromised immune systems, older patients and those who have more difficulty growing new bone. Up to 40x native BMP vs the BMP-2 control Each batch histologically demonstrates all five elements of bone formation pH balanced – non cytotoxic. Shown to form bone post-sterilization in-vivo
The features of PentOS OI™ There are many benefits to using PentOS OI™ Putty: Verified to be osteoinductive Osteoconductive Excellent handling characteristics Resists irrigation Sterilized using low-dose gamma irradiation Ready to use Stored at room temperature
You can use any grafting material at the site but you may wish to use a putty to help keep the graft material contained.
The PentOS OI™ Sponge can be trimmed with scissors, rongeurs or a scalpel, however you will want to hydrate the sponge before trimming. Hydrating the it allows you to trim the sponge to the exact size needed to avoid chipping off any areas of the sponge you may want to keep.
There are many applications for PentOS OI™ Putty: • Periodontal defects • Implant site development • Coronal defects around immediate implants • Extraction site repair • Implant dehiscence defects • Sinus lift procedures • Moderate localized ridge defects
Yes, PentOS OI™ Putty is sterilized using low-dose gamma irradiation
PentOS OI™ Putty is made from 100% human bone without any additional diluent or carriers to diminish its osteoinductive properties.
You can use PentOS OI™ Putty in an orbital floor defect, at the apex of the sinus. You have to remember that PentOS OI™Putty is demineralized and will have a tendency to resorb quickly, so you may want to add a mineralized component such as Raptos®. This would be at the 'ceiling' of the sinus cavity but, anatomically, the floor of the orbit below the eye and I assume it would be reached through the sinus cavity. Ideally, if they were using PentOS OI™ Putty, they would mix it with a mineralized component to add calcification and mechanical structure to the area. Healing time would be approximately six months.
In general, the use of a dental membrane is to prevent the soft tissue cell from entering the graft site before bone forms and to help contain granular grafting materials in place (if they are used). This is the natural role for periosteum—the separation of hard and soft tissue. As such, if there is primary closure of an intact periosteum, this is sufficient and there should be no need for a membrane when using PentOS OI™ Max. However, without primary closure, and if the periosteum is damaged, torn or cut for vertical release, it becomes less effective as a barrier and a membrane should be used.
PentOS OI™ Max is made from 100% human allograft demineralized bone matrix and is cortical bone.
You could use it by itself, layered over the defect, as long as there is adequate blood flow into it. It should be affixed with tacks or screws to prevent mobility, and covered with a resorbable membrane. It is osteoinductive so you should manage to grow some bone to the thickness of the PentOS OI™ Flex. Ideally we would backfill into the space with either autogenous or allograft bone such as Raptos® or PentOS OI™ Putty.
You could use it by itself, layered over the buccal plate defect, as long as there is adequate blood flow into it. It should be affixed with tacks or screws to prevent mobility, and covered with a resorbable membrane. It is osteoinductive so you should manage to grow some bone to the thickness of the Flex sheet. Ideally we would backfill into the space with either autogenous or allograft bone such as Raptos® or PentOS OI™ Putty.
PentOS OI™ Flex is somewhat malleable once it has been hydrated for at least 15 to 20 minutes. It is not as rigid as a bone block because it is demineralized and thinner, giving it more versatility than a bone block.
PentOS OI™ Flex can be used to regenerate bone around exposed implant threads. Essentially, PentOS OI™ Flex will remodel into a new buccal cortex to replace the deficient buccal wall. Depending on how shallow or deep the bone defect is, back-filling the space between the PentOS OI™ Flex veneer graft and the implant threads with putty or particulate bone graft may be indicated.
A bone putty such as PentOS OI™ Putty can be used when trying to repair bony defects, keeping granules at the graft site, for socket preservation or when trying to maintain the patient’s ridge height. Sometimes you will have cases that require more volume than you have available to you. One solution would be to add Raptos® particulates as well as a demineralized allograft mixture at the site to maximize regeneration and long-term retention.
Putties help keep granules on site when there is no proper pocket to contain them. The carrier allows the putty to be molded and transformed, giving surgeons the ability to manipulate the putty to the shape they want. The versatility of DBM putties such as PentOS OI™ Putty allows them to be used in different surgical procedures.
The versatility of putties such as PentOS OI™ Putty is that they can be used in a multitude of clinical cases and mixed with Raptos® particulates. They can also be used with antibiotics (as required).
PentOS OI™ Flex can be hydrated using the patient’s blood or with saline solution. To accelerate graft reconstitution, submerge PentOS OI™ Flex in saline for 10 to 30 minutes and manipulate periodically, especially for larger size grafts. A minimum of 15 minutes of hydration is necessary to start achieving the level of flexibility needed to prevent cracking the Flex veneer. Graft pliability may occur sooner than 10 to 30 minutes.
The doctor may wish to use a bone veneer such as PentOS OI™ Flex instead. They could affix it in place, carefully and 'lag' with screws to reduce pressure and cracking, and have it act as a 'dam'; fill in the resulting void with regular bone graft material such as Raptos®, cover with a Neomem® membrane would work as you have structure at both ends; wall at one end and PentOS OI™ Flex at the other). You would have to be conscious of adequate blood flow to the grafted site, passive flap and membrane coverage and absolutely NO micromovement of the graft or PentOS OI™ Flex. Average healing time is also six months or more using this procedure.
You can use PentOS OI™ Flex in the same way as you would use a titanium mesh. Hydrate the PentOS OI™ Flex and then fixate the veneer graft with titanium screws. The difference between titanium mesh and PentOS OI™ Flex , other than one being bone and the other titanium is that the PentOS OI™ Flex will be remodeled into a new orbital floor wall.
