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SMARTGRAFT


SMARTGRAFT
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Description:

Human-like native porcine graft

Smartgraft is a porcine xenograft supporting a vascularisation of the surgical site through its high porosity and large pores. The bone remodelling and volume stability are supported by the proprietary production process.

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Size of the Smartgraft:
Characteristic:
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Size of Smartgraft
0.50 cc / 0.25 – 1.00 mm
€65
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Files, documents

SMARTGRAFT booklet Booklet

Clinical cases

SFE with Smartgraft® + hyaDENT BG® and OSSIX® Plus
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Case provided By Prof. Dr. Anton Friedman (Chair and Head Department of Periodontology, School of Dentistry, Faculty of Health, University of Witten, Germany)

History of hopeless maxillary molars

Residual subantral bone ≈ 2 mm

Lateral window approach ≈ 6 months following tooth loss

History of hopeless maxillary molars
History of hopeless maxillary molars
History of hopeless maxillary molars

Sinus floor elevation and vertical application of biomaterials

Xenograft (Smartgraft®) hydrated with high weight hyaluronic acid (hyaDENT BG)

OSSIX®Plus membrane in place covers full extension of the grafted area

Separate membrane fixation unnecessary

Sinus floor elevation and vertical application of biomaterials
Sinus floor elevation and vertical application of biomaterials
Sinus floor elevation and vertical application of biomaterials

Coronally advanced flap (CAF) and suture

Coronal advancement of the buccal flap (CAF)

Complete tension free closure of the site with PTFE and monocryl sutures

Suture removal ≈ 12 days post-op

Coronally advanced flap (CAF) and suture
Coronally advanced flap (CAF) and suture
Coronally advanced flap (CAF) and suture

Stage 2 surgery - re-entry and tissue sampling 8 months after SFE

Periapical x-ray displays gain in mineralized tissue at the sinus and supracrestally (arrows)

Soft tissue and ridge dimension at stage 2

Macroscopically mature crestal bone across the ridge

Stage 2 surgery - re-entry and tissue sampling 8 months after SFE
Stage 2 surgery - re-entry and tissue sampling 8 months after SFE
Stage 2 surgery - re-entry and tissue sampling 8 months after SFE

Stage 2 - implant placement 8 months later

Ridge dimension achieved 8 months after SFE and lateral/vertical augmentation

WNI (Straumann SP/WN/10 mm length) in place

Gingiva former in place for transmucosal healing

Stage 2 - implant placement 8 months later
Stage 2 - implant placement 8 months later
Stage 2 - implant placement 8 months later

Histological observations in H.E. staining (courtesy Prof. Götz)

Decalcified serial sections reveal various stages of bone formation with appositional bone growth at the residual xenogenic particulate

Histological observations in H.E. staining (courtesy Prof. Götz)
Histological observations in H.E. staining (courtesy Prof. Götz)

Description

Balance high porosity with stable volume remodelling

Cell adhesion

Cell adhesion

The rough surface of human-like porcine particles facilitates the attachment of new cells.1, 2

Rough surface, large pores, and high porosity enhance bone ingrowth.

Cell migration/infiltration

Facilitates vascularization and bone ingrowth.

  • Smartgraft’s high porosity and large pores enhance vascularization, bone ingrowth and osteointegration of the implant after surgery.
  • Smartgraft’s macropores range from 0.1mm to 1.0mm.
  • Native porous carbonate apatite possesses the natural pore structure for cell conduction.
Cell migration/infiltration

Regeneration

Native porcine graft provides a human-like structure for balanced remodelling.9 The anorganic bone mineral matrix has interconnections that reduce the bulk density of the graft and allows for more void space for the growth of new bones.10

As a porcine-derived bone, Smartgraft accelerates alveolar bone healing as compared to Deproteinized Bovine Bone Mineral (DBBM).11, 12

The proprietary purifi cation process preserves carbonate apatite14, which has been shown to increase the bone forming activities of osteogenic cells and to enhance bioresorption of bone graft by osteoclasts.14-18

The biocompatibility is supported by the proprietary purifi cation process of the graft.19

IR Spectra for human and porcine bones

IR Spectra for human and porcine bones

Six reasons to add Hyadent BG to Smartgraft

  1. Sticky bone can be prepared with this out-of-the box gel and Smartgraft in 3 minutes.
  2. As hydrophilic agent, hyaluronic acid (HA) stabilizes blood clot and attracts growth factors to support and accelerate bone formation.20-23
  3. HA supports angiogenesis.24
  4. HA’s high molecular weight reduces swelling and discomfort while supporting scar-less healing.25
  5. HA has natural bacteriostatic properties.26
  6. HA’s special formulation remains present throughout the various phases of the healing process due to its slow degradation pattern (several weeks).22

Preparation of stable graft material:

Smartgraft step 1

Step 1

  • Place bone subtitute granules into a dish.
  • Hydrate using physiological solution or blood.
  • Remove any excess fluid.
Smartgraft step 2

Step 2

Add HYADENT BG to the hydrated bone substitution material.

Smartgraft step 3

Step 3

  • Mix using a spatula.
  • Repeat steps 2 & 3: Add additional HYADENT BG until the desired consistency is reached (ca. 2/3 Vol% graft material, 1/3 Vol% HYADENT BG).
Smartgraft step 4

Step 4

Keeping the putty at room temperature for 3-5 minutes may improve the consistency of the putty and make it slightly harder.

Smartgraft step 5

Step 5

Apply putty on to the defect.

Four reasons to use Smartbrane with Smartgraft

  1. Smartbrane ensures adequate tensile strength to safely maintain bone graft stability and structure.27
  2. Smartbrane is adaptable to bony surfaces without sticking to the graft or the instrument.31
  3. Smartbrane has a resorption time of 8-12 weeks that can even be extended with Hyadent BG by several weeks.28,29
  4. Smartbrane supports blood clotting and cell attachment.1,3,30
SMARTBRANE rehydrated

SMARTBRANE rehydrated: excellent adaptation to surfaces without sticking to graft or instrument.

Your regenerative options for your indications

INDICATIONS SMARTGRAFT SMARTBRANE HYADENT BG
Root coverage with CTG 1 x 1.2 ml
Intraosseous defect (1-3 walls) Furcation 0.25 – 1.0 mm granules 15 x 20 mm 1 x 1,2 ml
Fenestration defect 0.5 cc or 1 cc of fine particles 20 x 30 mm 1 x 1.2 ml
Implant dehiscence 0.5 cc or 1 cc of fine particles 15 x 20 mm 1 x 1,2 ml
Extraction socket 1.0 cc of fine particles 10 x 10 mm or 15 x 20 mm 1 x 1.2 ml
Vertical / horizontal augmentation 2.0 cc of large particles 20 x 30 mm or 30 x 40mm 1 x 1,2 ml
Ridge preservation 2.0 cc of large particles 30 x 40mm 1 x 1,2 ml
Sinus floor elevation 2.0 cc of large particles 15 x 20mm / 20 x 30 mm 1 x 1,2 ml
Protection Schneiderian membrane 15 x 20 mm or 20 x 30 mm 1 x 1,2 ml

Video

References

Literature
  1. Deligianni DD, Katsala ND, Koutsoukos PG, Missirlis YF, Effect of Surface Roughness of Hydroxyapatite on Human Bone Marrow Cell Adhesion, Proliferation, Differentiation and Detachment Strength. Elsevier Biomaterials 22 (2001) 87–96
  2. Shu-Thung L et al. (2014) Isolation and Characterization of a Porous Carbonate Apatite From Porcine Cancellous Bone. Science, Technology, Innovation, Aug: 1-13 (data on file)
  3. Frank M. Klenke, Yuelian Liu, Huipin Yuan, Ernst B. Hunziker, Klaus A. Siebenrock, Willy Hofstetter. Impact of Pore Size on the Vascularization and Osseointegration of Ceramic Bone Substitutes in vivo. Journal of Biomedical Materials Research Part A, 2007, 777-786
  4. Hannink G1, Arts JJ. Bioresorbability, porosity and mechanical strength of bone substitutes: what is optimal for bone regeneration? Injury. 2011 Sep;42 Suppl 2:S22-5
  5. Saghiri MA, Asatourian A, Garcia-Godoy F, Sheibani N. The role of angiogenesis in implant dentistry part II: The effect of bone-grafting and barrier membrane materials on angiogenesis. Med Oral Patol Oral Cir Bucal. 2016 Jul 1;21(4):e526-37. doi: 10.4317/medoral.21200. PMID: 27031074; PMCID: PMC4920468.
  6. Data on file
  7. Data on file
  8. Shu-Thung L et al. (2014) Isolation and Characterization of a Porous Carbonate Apatite From Porcine Cancellous Bone. Science, Technology, Innovation, Aug: 1-13 (data on file)
  9. Bracey DN, Seyler TM, Jinnah AH, Lively MO, Willey JS, Smith TL, et al. A decellularized porcine xenograft-derived bone scaffold for clinical use as a bone graft substitute: a critical evaluation of processing and structure. J Funct Biomater. 2018;9(3):45.https://doi.org/10.3390/jfb9030045.
  10. Lai VJ, Michalek JE, Liu Q, Mealey BL. Ridge preservation following tooth extraction using bovine xenograft compared with porcine xenograft: A randomized controlled clinical trial. J Periodontol. 2020 Mar;91(3):361-368. doi: 10.1002/JPER.19-0211. Epub 2019 Aug 23. PMID: 31380563.
  11. Renzo et al.: Tissue Dimensional Changes Following Alveolar Ridge Preservation with Different Xenografts Associated with a Collagen Membrane. Results at the 4-Month Re-Entry Surgery. Int Arch Oral Maxillofac Surg, 2017, 1:003
  12. Guarnieri R, Di Nardo D, Di Giorgio G, Miccoli G, Testarelli L. Effectiveness of Xenograft and Porcine-Derived Resorbable Membrane in Augmentation of Posterior Extraction Sockets with a Severe Wall Defect. A Radiographic/Tomographic Evaluation. J Oral Maxillofac Res. 2019 Mar 31;10(1):e3. doi: 10.5037/jomr.2019.10103. PMID: 31086644; PMCID: PMC6498814.
  13. Method of Preparing Porous Carbonate Apatite from Natural Bone. United States Patent US 8,980,328
  14. F Landi E., Celotti G., Logroscino G., Tampieri A. 2003. Carbonated Hydroxyapatite as Bone Substitute. Journal of the European Ceramic Society 23: 2931–2937.
  15. Spense G., Patel N., Brooks R., Rushton N. 2009. Carbonate Substituted Hydroxyapatite: Resorption by Osteoclasts Modifi es the Osteoblastic Response. Journal of Biomedical Materials Research Part A 217-224.
  16. Doi Y, Shibutani T, Moriwaki Y, Kajimoto T, Iwayama Y. Sintered carbonate apatites as bioresorbable bone substitutes. J Biomed Mater Res 1998;39:603–610
  17. Hasegawa M, Doi Y, Uchida A. Cell-mediated bioresorption of sintered carbonate apatite in rabbits. J Bone Joint Surg [Br] 2003;85:142–147.
  18. Spense G., Patel N., Brooks R., Rushton N. 2009. Carbonate Substituted Hydroxyapatite: Resorption by Osteoclasts Modifi es the Osteoblastic Response. Journal of Biomedical Materials Research Part A 217-224.
  19. Method of Preparing Porous Carbonate Apatite from Natural Bone. United States Patent US 8,980,328.
  20. Muzaffer A et al. ‘The Effect of Hyaluronic Acid-supplemented Bone Graft in Bone Healing: Experimental Study in Rabbits.’J Biomater Appl 2006 20:209
  21. Sasaki T, Watanabe C. ‘Stimulation of osteoinduction in bone wound healing by high-molecular hyaluronic acid.’ Bone. Vol. 16. No.1 January 1995:9-15
  22. Stiller M et al. ‘Performance of β-tricalcium phosphate granules and putty, bone grafting materials after bilateral sinus floor augmentation in humans.’ Biomaterials 2014;35(10):3154-3163.
  23. Mendes RM et al. ‘Sodium hyaluronate accelerates the healing process in tooth sockets of rat.’ Arch Oral Biol 2008; 53:1155–1162
  24. King, S.R., Hickerson, W.L. and Proctor, K.G. (1991) Benefi cial Actions of Exogenous Hyaluronic Acid on Wound Healing. Surgery, 109, 76-86.
  25. Asparuhova M, Kiryak D, Eliezer M, Mihov D, Sculean A. ‘Activity of two hyaluronan preparations on primary human oral fi broblasts’. J Periodontal Res 2018 Sep 27. Epub 2018 Sep 27
  26. Pirnazar P et al. ’Bacteriostatic effects of hyaluronic acid.’ Journal of Periodontology 1999;70:370-374
  27. Internal testing results, data on file.
  28. Internal testing results, data on file.
  29. Eliezer M, Sculean A, Miron RJ, et al. ‘Hyaluronic acid slows down collagen membrane degradation in uncontrolled diabetic rats.’ J Periodontal Res. 2019;00:1–9. https://doi.org/10.1111/jre.12665
  30. Brett D. A Review of Collagen and Collagen-based Wound Dressings. Wounds 2008;20(12).
  31. Data on file
Note: Smartgraft is a registered brand of Regedent AG and manufactured by Collagen Matrix Inc. HYADENT BG is a registered brand and manufactured by BioScience GmbH. Smartbrane is a registered brand and manufactured by Regedent AG

Other
Size of Smartgraft 0.50 cc / 0.25 – 1.00 mm
€65
Buy in 1 clickBuy in 1 click
Terms of delivery Delivery Is free of charge within 24 hours after funds are credited to your Bank account
Calculate deliveryCalculate delivery
Out of stockOut of stock
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