Since Dr. Brånemark discovered integration of bone to titanium, the factors that guide successful implant integration have not changed. Good bone, good implant torque, and an optimized titanium surface are still the factors that are considered necessary for successful implant integration and long-term function. These factors have also been applied to delayed implant placement after tooth extraction. Delayed implant placement in extraction sites is based on the same criteria requiring mature mineralized bone that can provide adequate torque for successful implant integration. When left to heal on its own, bone heals slower and never normally. Gingiva, on the other hand, heals at a much faster rate. Gingiva and bone are intimately interconnected and require each other for optimum healing. There is crosstalk between all adjacent tissues, and for optimum regeneration, all tissues must heal synergistically.
There is new science developing regarding the tissue interactions during growth and repair. Bone and muscle provide molecular cross communications with each other during growth and repair that is required for optimal tissue formation and regeneration. If one tissue is deficient, it will compromise the healing of the adjacent tissue, resulting in an inferior clinical outcome.
Bone and gingiva are no different. If we can reestablish the synergy between gingival and alveolar healing with both tissues healing and maturing at the same rate, a paradigm shift in implant placement is possible. With the application of new bone graft technology, it is now possible to match the healing rate of gingiva and bone to bring back the synergy between the two tissues. SteinerBio bone graft technology reestablishes bone regeneration potential and marries the rate of bone growth to the remodeling rate of the gingiva, allowing for implant integration during gingiva/alveolar healing.
With no graft or with traditional graft materials during the first month, the gingiva is actively healing, yet no bone is formed during this period and the collaboration between gingiva and bone is lost. With no graft or with traditional graft materials, a blood clot must form followed by granulation tissue, then collagen plug, and ultimately bone begins to form after on month. However, due to SteinerBio osteogenic materials, this one-month lag in bone formation is skipped. After 4 weeks, the socket is filled with proliferating osteoblasts and mineralized bone, restoring the healing synergy between gingival and alveolar tissues.