I had a funny dream the other day. I dreamed that someone had invented a material that mimicked the properties of natural bone, and could be formed, in the lab, to recreate the precise shape of a bony defect, enabling a much quicker, more accurate means of bone grafting. I woke up, to find, with that slight sag of the spirits that accompanies the replacement of a cherished dream with cold reality, that my world hadn’t changed. Not yet, at least; but we’ll come to that.
Some of my greatest challenges in implant dentistry arise from extensive bone loss. Regular readers won’t need reminding that when you lose teeth, the bone that supported them begins to disappear. Tooth loss itself is often caused by gum disease – another cause of bone loss.
We have a variety of grafting techniques to augment the remaining bone stock, sometimes using the patient’s own bone, harvested from some other part of the body, sometimes using biocompatible bone material prepared from human or bovine cadavers. The process has given many patients’ teeth a new lease of life, but it’s protracted and uncomfortable for the patient, and requires a great deal of skill to ensure that the resulting bone mass is the right size and shape to support the intended implant.
But it seems my dream might just be about to come true. Hala Zreiqat AM, Professor of Biomedical Engineering at Sydney University has come up with an entirely man-made material that seems to have much the same affinity for bone that the titanium we use in implants has. Better still, it can be 3D printed. It’s early days yet, but fingers crossed, I may yet be able to take a scan of my patient, use my computer-planning program to sculpt a scaffold made out of this lovely stuff in exactly the shape I want it, and send my plan to a lab to be printed. After placing the scaffold in the patient, there would, I expect, be a period of integration, while the patient’s bone grows into the scaffold, and before the implants can be placed. Overall, though, this promises a much simpler, more controllable means of restoring lost bone.
Isn’t the future a wonderful place?