1
|
Pogacian-Maier AC, Mester A, Morariu RL, Campian RS, Tent A. The Use of Allograft Bone in the Lateral Approach of Sinus Floor Elevation: A Systematic Review of Clinical Studies. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:252. [PMID: 38399540 PMCID: PMC10890160 DOI: 10.3390/medicina60020252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: The aim of this systematic review was to assess the efficiency of using allografts for sinus lift. Materials and Methods: This systematic review was written under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recommendation of the Cochrane Handbook for Systematic Reviews of Interventions. Three electronic databases were screened until October 2023. The risk of bias was assessed according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. Statistical analysis was performed for median bone volume and implant survival rate. Results: From 321 articles retrieved, 7 articles were included in this review. A comparison between freeze-dried bone allograft (FDBA) and deproteinized bovine bone (DBB) for mean bone volume indicated a weighted mean difference (WMD) of -0.17 [-0.69, 0.36] (95% confidence interval (CI)), p = 0.53. For implant survival rate, a comparison was made between FDBA and autogenous bone indicating a risk ratio (RR) of 1.00 [0.96, 1.05] (95% CI), p = 1.00. Conclusions: The available evidence suggested that allograft bone can be used in sinus lift procedures. The results obtained are insufficient to compare with other types of bone graft, requiring a longer follow-up time. Future clinical trials are needed in order to evaluate the advantages of using allograft bone.
Collapse
Affiliation(s)
- Alexandra-Camelia Pogacian-Maier
- Department of Oral Health, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (A.-C.P.-M.); (R.-L.M.); (R.S.C.)
- Doctoral School, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400347 Cluj-Napoca, Romania
| | - Alexandru Mester
- Department of Oral Health, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (A.-C.P.-M.); (R.-L.M.); (R.S.C.)
| | - Rares-Luca Morariu
- Department of Oral Health, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (A.-C.P.-M.); (R.-L.M.); (R.S.C.)
| | - Radu Septimiu Campian
- Department of Oral Health, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (A.-C.P.-M.); (R.-L.M.); (R.S.C.)
| | - Andrei Tent
- Department of Oral and Maxillofacial Surgery, University of Oradea, 410087 Oradea, Romania;
| |
Collapse
|
2
|
Aurouer N, Guerin P, Cogniet A, Pedram M. The safe and effective use of supercritical CO 2-processed bone allografts for cervical and lumbar interbody fusion: A retrospective study. Front Surg 2023; 10:984028. [PMID: 36824495 PMCID: PMC9941326 DOI: 10.3389/fsurg.2023.984028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction The clinical efficacy and safety of supercritical CO2-processed bone allografts prepared from living donors has yet to be confirmed in spinal surgery. Here we report our clinical and surgical experience of using supercritical CO2-processed bone allografts for lumbar and cervical fusion. Methods Sixteen patients underwent one or two level anterior cervical discectomy and fusion and 37 patients underwent anterior retroperitoneal route lumbar fusion using bone allografts processed using supercritical CO2 extraction combined with chemical viral inactivation. Fusion success was assessed radiographically in the immediate postoperative period and at one month, six months, one year, and three years postoperatively. Function and pain were assessed using visual analog scales, Odom's criteria, the neck disability index (NDI), and the Oswestry disability index (ODI). Results At a mean of 43 and 47 months postoperatively, 95.3% and 90.5% of cervical and lumbar fusion patients had radiographic evidence of bone fusion, respectively. Over 80% of patients reported good to excellent outcomes according to Odom's criteria, the perception of pain significantly decreased, and the mean NDI and ODI scores significantly improved at the last follow-up compared with before the operations. There were no safety concerns. For the cervical group, the mean NDI score improved from 26.3 ± 6.01 preoperatively to 15.00 ± 8.03 and 17.60 ± 13.95 at immediate post-op (p = 0.02) and last follow-up visits (p = 0.037) respectively. For the lumbar cases, the mean ODI score improved from 28.31 ± 6.48 preoperatively to 14.68 ± 5.49 (p < 0.0001) and 12.54 ± 10.21 (p < 00001) at immediate post-op and last follow-up visits respectively. Conclusion Within the limitations of this study, the use of supercritical CO2-processed bone allografts resulted in satisfactory clinical outcomes and fusion rates with acceptable safety for both cervical and lumbar surgeries.
Collapse
Affiliation(s)
- Nicolas Aurouer
- Centre Aquitain du dos, Clinique du Sport de Bordeaux, 2 rue Georges-Negrevergne, Mérignac, France
| | - Patrick Guerin
- Centre Aquitain du dos, Clinique du Sport de Bordeaux, 2 rue Georges-Negrevergne, Mérignac, France
| | - Arnaud Cogniet
- Centre Aquitain du dos, Clinique du Sport de Bordeaux, 2 rue Georges-Negrevergne, Mérignac, France
| | | |
Collapse
|
3
|
Fresh Frozen Allogeneic Bone Block in Maxillary Sinus Floor Elevation: Histomorphometric Analysis of a Bone Specimen Retrieved 15 Years after Grafting Procedure. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9061119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nowadays implant-prosthetic rehabilitations are one of the best solutions for rehabilitating our patients. These allow obtaining rehabilitations with optimal functional and aesthetic performances. Often patients, who undergo implant-prosthetic therapy, have the conditions of edentulias, single or multiple, that have been going on for some time. This, according to the literature, produces resorption of the alveolar bone, a process that is complicated in the posterior area of the upper arch by a pneumatization of the maxillary sinuses. The loss of vertical height, so that the implant fixtures can be inserted, requires a maneuver called maxillary sinus floor elevation. This procedure, now safely performed with piezoelectric instruments, allows increasing bone height through bone grafting. In this study, the tissue obtained from a patient, after 15 years from the intervention, was evaluated by histological and SEM analyses. The bone healing in the patient has led to a perfect integration between the patient’s bone and the fresh frozen allograft used, however still present and detectable after 15 years.
Collapse
|
4
|
Rizzo R, Checchi V, Marsili F, Zani A, Incerti-Parenti S, Checchi L. A New Transalveolar Sinus Lift Procedure for Single Implant Placement: The Ebanist Technique. A Technical Description and Case Series. Open Dent J 2017; 11:187-199. [PMID: 28567143 PMCID: PMC5418928 DOI: 10.2174/1874210601711010187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 02/24/2017] [Accepted: 03/09/2017] [Indexed: 11/23/2022] Open
Abstract
Background: Nowadays, there are many techniques to compensate bone atrophies of the posterior maxilla in order to obtain an implant-supported rehabilitation. Objective: This case series describes the Ebanist technique: a sinus lift procedure to be used in case of extremely resorbed bone crests (≤3 mm) allowing simultaneous implant placement. Methods: With a dedicated cylindrical trephine bur, it is possible to harvest a cylinder of bone from a fresh mineralized frozen homologous bone block graft and to simultaneously create a trapdoor on the recipient site. The trapdoor cortical bone is detached from the sinus membrane and removed. Dental implant is placed into the graft before the grafting procedure since the cylindrical block, once inserted in the recipient area, is not able to oppose sufficient resistance to the torque needed for implant placement. Results: Second-stage surgery and following prosthetic rehabilitation were performed after 5 months. In all cases, implant stability was manually checked and no pathological symptoms or signs were recovered at any follow-up visit. Conclusion: This technique can be considered a valid procedure for implant therapy on atrophic posterior upper maxillae, when the residual bone crest is extremely resorbed.
Collapse
Affiliation(s)
| | - Vittorio Checchi
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | | | | | | | - Luigi Checchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|
5
|
Long-Term Retrospective Evaluation of Dental Implants Placed in Resorbed Jaws Reconstructed With Appositional Fresh-Frozen Bone Allografts. IMPLANT DENT 2017; 25:400-8. [PMID: 27129000 DOI: 10.1097/id.0000000000000412] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the outcome of fresh-frozen bone allografts in preprosthetic surgery for implant placement purposes. MATERIALS AND METHODS The cohort comprised 45 patients treated with fresh-frozen bone block grafts and dental implants. Clinical and radiological evaluations were performed to evaluate the survival rate. The data were statistically analyzed with the Kaplan-Meier estimator to assess the influence of possible predictors of implant failure on survival. RESULTS Overall, 262 implants were retrospectively analyzed. The survival rate was 90.84% over a mean follow-up of 50 months. Comparing the donor site and the position of the implants, no statistically significant differences could be detected (P = 0.7194 and P = 0.2901, respectively), whereas sex resulted in a marginally statistically significant difference (P = 0.0581). When considering age categorized on the median value (≤55/>55 years), age resulted in a statistically significant difference (P = 0.0340), with higher failures found in older people. CONCLUSION Implant loss was strictly related to the lack of primary osseointegration. Female sex and old age were found to be risk factors, which could negatively influence implant survival.
Collapse
|
6
|
Maxillary sinus grafting with fresh frozen allograft versus bovine bone mineral: A tomographic and histological study. J Craniomaxillofac Surg 2016; 44:708-14. [PMID: 27107475 DOI: 10.1016/j.jcms.2016.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 02/22/2016] [Accepted: 03/14/2016] [Indexed: 01/10/2023] Open
Abstract
We evaluated histologically and tomographically the effects of fresh frozen bone allograft (FFB) or bovine bone mineral (BBM) in maxillary sinus floor augmentations. In total, 30 maxillary sinuses from 30 patients (mean age = 51.17 ± 10.86 years) underwent sinus augmentation. Patients were divided in two test groups (15 sinuses each). The first group was grafted with allograft bone, and the second group received bovine bone mineral. After 6 months, bone samples from each group were collected for histological examination. Implant survival rates were 97.78% (FFB group) and 100% (BBM group) 6 months after functional loading. Median volumetric reductions of 31.2% (11.33-40.56) and 12.22% (9.91-20.59) were observed in the FFB and BBM groups, respectively. Comparisons between the groups for differences in initial and final volumes of bone (p = 0.015) and the rate of resorption (p = 0.009) showed statistically significant differences. The FFB group showed osteoblastic cells in close contact with osteoid matrix, connected through bridges between allograft bone particles and new bone formation. The BBM group showed BBM particles in close contact with new bone, with visible osteoid matrix bridges and osteoblastic cells surrounding it. None showed signs of acute or chronic inflammatory infiltrate. Despite better results with BBM, both FFB and BBM in maxillary sinus augmentation resulted in high percentages of new bone formation, and allowed implant placement with a low rate of failure of osseointegration at a 6-month follow-up.
Collapse
|
7
|
Rodella LF, Cocchi MA, Rezzani R, Procacci P, Hirtler L, Nocini P, Albanese M. Fresh frozen bone in oral and maxillofacial surgery. J Dent Sci 2015. [DOI: 10.1016/j.jds.2014.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
|
8
|
Sehn FP, Dias RR, de Santana Santos T, Silva ER, Salata LA, Chaushu G, Xavier SP. Fresh-frozen allografts combined with bovine bone mineral enhance bone formation in sinus augmentation. J Biomater Appl 2014; 29:1003-13. [PMID: 25245781 DOI: 10.1177/0885328214552709] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated histologically, histomorphometrically, and tomographically the effects of the association of fresh-frozen bone allograft (FFB) with bovine bone mineral (BBM) in maxillary sinus floor augmentation. In total, 34 maxillary sinuses from 29 patients, with a mean age of 51.32 (±6.44) years, underwent sinus augmentation. Patients were divided into control and test groups (17 sinuses each). The controls were grafted with allograft bone, and the test group received a combination of FFB and BBM at a 2:1 ratio. After 6 months, bone samples were collected for histological and histomorphometric examinations. The implant survival rates were 93.02% (control group) and 100% (test group) at 6 months after functional loading. Median volumetric reductions of 28.32% (17.05-44.05) and 12.62% (5.65-16.87) were observed for the control and test groups, respectively. Statistically significant histomorphometric differences were found between the control and test groups regarding newly formed bone 12.54% (10.50-13.33) vs. 24.42% (17.62-35.92), p < 0.001, total bone 48.34% (39.03-54.42) vs. 61.32% (50.61-64.96), p = 0.007, and connective tissue 51.66% (45.57-60.97) vs. 39.30% (35.03-49.37), p = 0.007. The addition of BBM to allograft bone in maxillary sinus augmentation resulted in higher percentages of new bone formation and total bone, and permitted implant placement with a low rate of osseointegration failure at the 6-month follow-up.
Collapse
Affiliation(s)
- Felipe Perraro Sehn
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Rafael Rodrigues Dias
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Thiago de Santana Santos
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Erick Ricardo Silva
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Luiz Antonio Salata
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tel Aviv University, Israel
| | - Samuel Porfírio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
9
|
Fresh-Frozen Bone Blocks for Horizontal Ridge Augmentation in the Upper Maxilla: 6-Month Outcomes of a Randomized Controlled Trial. Clin Implant Dent Relat Res 2012; 16:116-23. [DOI: 10.1111/j.1708-8208.2012.00458.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|