Journal of Oral Implantology April 2013 - (Page 234)
LETTER TO THE EDITOR
Dear Editor,
I would like to highlight a few key aspects of Ohno
and colleagues1 excellent paper published in this
issue of Journal of Oral Implantology (JOI) and thank
the authors from Kanagawa Dental College for their
collaboration and outstanding work. The article
focuses on using OsteoGen crystals coated with a
biomimetic nano-crystalline fluorapatite surface
technology to promote osteoblast cell differentiation, migration, and proliferation, which are expected to accelerate bone growth; a finding supported
by our own and a related researcher’s histologic
findings.2 The paper established increased physiologic bioactivity for bone mineralization due to the
unique fluorapatite nano-crystalline surface coating.
Increased levels of the osteogenic differentiation
marker, alkaline phosphatase (ALP), demonstrated
this physiologic bioactivity.
Osteoblast cell recruitment is also true, but to a
lesser degree, with the original nonfluoridated
OsteoGen crystals and clusters.3–5 Ohno and colleagues’1 paper (Figure 2a, the control noncoated
crystals) confirms that OsteoGen is chemotactic with
;6 to 7 osteoblast cells in the field of microscopic
view. This control is compared to the experiment
(Ohno et al1, Figure 2b) having fluorapatite coated
crystals showing ;18 to 21 osteoblast cells, or an
improvement of 300% to accelerate osteoblast cell
recruitment and proliferation for the purpose of
laying down new bone formation.
I would like to thank JOI for the opportunity to
clarify some misconceptions regarding the differences between nonresorbing dense filler granules
classified as ceramics (eg, hydroxylapatite [HA], tricalcium phosphate [TCP], bovine, coralline, glass,
and plastics) and nonceramic synthetic bioactive
resorbable HA crystals. Physicochemically ceramic
grafts are distinctively different from OsteoGen
grafts.
OsteoGen nonceramic crystals are not sintered like
ceramics. By avoiding high temperatures associated
with ceramics, the material does not lose its natural
state [Ca5(PO4)3(OH)] and retains physicochemical
properties similar to human trabecular bone.3,4,6
DOI: 10.1563/AAID-JOI-D-Letter.3902
234
Vol. XXXIX /No. Two / 2013
Similarities exist between nonceramic OsteoGen
crystals and human bone mineral as the two have
the same formulation and crystallographic structure
for HA, as defined by the International Center for
Diffraction Data. Ceramic granules [CA 1 0 (PO4)6(OH)2], including bovine ceramics, dehydroxylate under high heat sintering and convert to
oxyapatite [Ca10(PO4)6O2], losing their hydroxyl and
calcium carbonate groups.7,8 Ceramic HA is not truly
an HA and these ceramic granules are dissimilar to
OsteoGen crystals or biological bone, as evidenced
by infrared spectroscopy and X-ray diffraction.4
Nonresorbable dense and monolithic particulates
are mostly removed by macrophages and giant cells
through fragmentation. This could result in passage
of these particles to the regional lymph nodes,
lungs, and spleen for further processing, and
therefore, interfering with the normal function of
these organs and possibly compromise the immune
system.9,10
Artzi and colleagues’ clinical study9 reports that
‘‘OsteoGen is physiochemically and crystallographically equivalent to human bone,’’ and the ‘‘threedimensional configuration of OsteoGen (crystal
clusters) provides more space between particles
when compared to ceramics. These spaces facilitate
cellular and tissue proliferation into the grafted
material, thus enhancing osseointegration.’’ Reference is made to the Sinus Consensus Conference11
where Artzi et al5 clarifies that ‘‘what is important is
the implant success rate over time (3 to 5 years).’’
Fifteen papers have reported on the safety,
effectiveness, and over 5 year cumulative 98%
success rate of OsteoGen.12
In conclusion, as Ohno et al1 have demonstrated:
nonceramic OsteoGen crystals coated with a
biomimetic nano-crystalline fluorapatite surface
technology promote osteoblast cell differentiation,
migration, and proliferation, which is expected to
accelerate bone formation. This reaffirms the work
of previous investigators.2 Beyond these benefits,
the microfine nano-crystalline fluorapatite coating,
both loosely and firmly bound on the nonceramic
OsteoGen crystal surface provides a time-release
mechanism of having a bioactive barrier resulting in
the creation of a bacteriostatic state. This bacterio-
Table of Contents for the Digital Edition of Journal of Oral Implantology April 2013
Evidence-Based Practice or Practice-Based Evidence?
Evaluation of Optimal Taper of Immediately Loaded Wide-Diameter Implants: A Finite Element Analysis
A Prospective, Randomized Controlled Preclinical Trial to Evaluate Different Formulations of Biphasic Calcium Phosphate in Combination With a Hydroxyapatite Collagen Membrane to Reconstruct Deficient Alveolar Ridges
Retention of Implant-Supported Overdenture With Bar/Clip and Stud Attachment Designs
The Clinical and Histologic Outcome of Dental Implant in Large Ridge Defect Regenerated With Alloplast: A Randomized Controlled Preclinical Trial
Fluoride-Treated Bio-Resorbable Synthetic Hydroxyapatite Promotes Proliferation and Differentiation of Human Osteoblastic MG-63 Cells
Resonance Frequency Analysis of 208 Straumann Dental Implants During the Healing Period
A Simplified Technique for Solving the Transfer Problem of Implant-Supported Fixed Partial Dentures for Patients With Microstomia
Esthetic Evaluation of Single-Tooth Morse Taper Connection Implants Placed in Fresh Extraction Sockets or Healed Sites
A Technique for Improving the Retention of Dentures Retained by Ramus Frame Implants
Treatment of Congenitally Missing Maxillary Lateral Incisors: An Interdisciplinary Approach
Use of Titanium Mesh in Lieu of a Fixation Screw to Stabilize an Autogenous Block Graft: A Case Report
A Novel Approach to Preserve the Buccal Wall in Immediate Implant Cases: A Clinical Report
Implant Failure Associated With Actinomycosis in a Medically Compromised Patient
Replacement of Mandibular Posterior Teeth With Implants in a Postmandibular Resection Case: A Case Report
Zygomatic Implants/Fixture: A Systematic Review
An Overview of Immediate Root Analogue Zirconia Implants
Letter to the Editor
Reviews of Current Literature
Journal of Oral Implantology April 2013
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