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Tunkel J, Hoffmann F, Schmelcher Y, Kloss-Brandstätter A, Kämmerer PW. Allogeneic versus autogenous shell technique augmentation procedures: a prospective-observational clinical trial comparing surgical time and complication rates. Int J Implant Dent 2023; 9:52. [PMID: 38117445 PMCID: PMC10733239 DOI: 10.1186/s40729-023-00505-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/04/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVES Autogenous and allogeneic blocks for shell augmentation of the jaw have shown comparable results. This observational clinical study aimed to compare both materials for shell augmentation concerning surgery time and intra- and postoperative complications. MATERIAL AND METHODS Bone augmentation with the shell technique using autogenous or allogenous bone was performed in 117 patients with segmental jaw atrophy. The primary study parameter was the surgical time, comparing both materials. Subsequently, intra- and postoperative complications were recorded. RESULTS Allogeneic (n = 60), autogenous (n = 52), or both materials (n = 5) were used. The use of allogeneic material led to a significantly shorter operation time (p < 0.001). A more experienced surgeon needed significantly less time than a less experienced surgeon (p < 0.001). An increasing number of bone shells (p < 0.001), an additional sinus floor elevation, and intraoperative complications also significantly increased the operation time (p = 0.001). Combining allogeneic and autogenous shells (p = 0.02) and simultaneous sinus floor elevation (p = 0.043) significantly impacted intraoperative complications. No correlations were found between the included variables for postoperative complications (all p > 0.05). In total, 229 implants were inserted after a healing time of 4-6 months, with a survival of 99.6% after a mean follow-up duration of 9 months. CONCLUSIONS Compared to the autogenous technique, allogeneic shell augmentation has a shorter surgical time and a similar rate of intra- and postoperative complications as autogenous bone. Together with its promising clinical results, this technique can be recommended.
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Affiliation(s)
- Jochen Tunkel
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Frederik Hoffmann
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Yannik Schmelcher
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Anita Kloss-Brandstätter
- Department of Engineering & IT, Carinthia University of Applied Sciences, Europastraße 4, 9524, Villach, Austria
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Kloss FR, Kämmerer PW, Kloss-Brandstätter A. Risk Factors for Complications Following Staged Alveolar Ridge Augmentation and Dental Implantation: A Retrospective Evaluation of 151 Cases with Allogeneic and 70 Cases with Autogenous Bone Blocks. J Clin Med 2022; 12:jcm12010006. [PMID: 36614811 PMCID: PMC9820942 DOI: 10.3390/jcm12010006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose: the aim of this study was to identify potential risk factors favoring complications by assessing the number and types of complications associated with allogeneic or autogenous bone blocks applied as onlay grafts for alveolar ridge augmentation prior to implantation. Methods: A retrospective chart review on the success of 151 allogeneic and 70 autogenous bone blocks in a cohort of 164 consecutive patients, who were treated over a period of 6 years by the same surgeon, was conducted. Statistical conclusions were based on ROC curves and multiple logistic regression models. Results: Complications were observed more frequently with autogenous bone blocks (14 out of 70 cases; 20%) compared to allogeneic bone blocks (12 out of 151 cases; 7.9%; p = 0.013). However, these complications were minor and did not impact the successful dental rehabilitation. In a multiple logistic regression model, the risk of a complication was increased by the use of an autogenous bone block (OR = 3.2; p = 0.027), smoking (OR = 4.8; p = 0.007), vertical augmentation above a threshold of 2.55 mm (OR = 5.0; p = 0.002), and over-contouring (OR = 15.3; p < 0.001). Conclusions: Overall, the complication rate of ridge augmentations carried out with autogenous or allogeneic bone blocks was low. Despite previous recommendations, over-contouring and a vertical augmentation above a threshold of 2.55 mm should be avoided.
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Affiliation(s)
- Frank R. Kloss
- Oral- and Maxillofacial Surgeon, Private Clinic for Oral- and Maxillofacial Surgery, Kärntnerstraße 62, 9900 Lienz, Austria
- Correspondence: ; Tel.: +43-4852-64643
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Centre Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Anita Kloss-Brandstätter
- Department of Engineering & IT, Carinthia University of Applied Sciences, Europastraße 4, 9524 Villach, Austria
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Suttiat K, Wattanutchariya W, Manaspon C. Preparation and Characterization of Porous Poly(Lactic Acid)/Poly(Butylene Adipate-Co-Terephthalate) (PLA/PBAT) Scaffold with Polydopamine-Assisted Biomineralization for Bone Regeneration. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7756. [PMID: 36363351 PMCID: PMC9658926 DOI: 10.3390/ma15217756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
The development of scaffolds that simultaneously provide porous architectures and osteogenic properties is the major challenge in tissue engineering. Herein, a scaffold with high porosity and well interconnected networks, namely poly(lactic acid)/poly(butylene adipate-co-terephthalate) (PLA/PBAT), was fabricated using the gas foaming/ammonium bicarbonate particulate leaching technique. Mussel-inspired polydopamine (PDA)-assisted biomineralization generated by two-step simple soaking in dopamine solution and 10× SBF-like solution was performed to improve the material's osteogenicity. Highly porous scaffolds available in less organized opened cell structures with diameters ranging from 10 µm to 100 µm and 200 µm to 500 µm were successfully prepared. The well interconnected porous architectures were observed through the whole thickness of the scaffold. The even deposition of the organic-inorganic bioactive mineralized layer composed of PDA and nano-scale hydroxyapatite (HA) crystals on the scaffold surface was evidenced by scanning electron microscopy (SEM), energy-dispersive X-ray analysis (EDX), Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). The developed scaffold exhibited high total porosity (84.17 ± 1.29%), a lower surface contact angle (θ = 45.7 ± 5.9°), lower material degradation rate (7.63 ± 2.56%), and a high level of material biocompatibility. The MTT assay and Alizarin Red S staining (ARS) confirmed its osteogenic enhancement property toward human osteoblast-like cells (MG-63). These results clarified that the developed porous PLA/PBAT scaffold with PDA-assisted biomineralization exhibited good potential for application as a biomaterial for bone tissue regeneration and hard tissue engineering.
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Affiliation(s)
- Kullapop Suttiat
- Biomedical Engineering Institute, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wassanai Wattanutchariya
- Advanced Manufacturing and Management Technology Research Center, Department of Industrial Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chawan Manaspon
- Biomedical Engineering Institute, Chiang Mai University, Chiang Mai 50200, Thailand
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Tapered, Sand-Blasted, Large-Grit, and Acid-Etched Surfaced Internal Dental Implant in the Diverse Pathologic Jaw. J Craniofac Surg 2022; 33:2161-2168. [DOI: 10.1097/scs.0000000000008743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
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Fretwurst T, Tritschler I, Rothweiler R, Nahles S, Altmann B, Schilling O, Nelson K. Proteomic profiling of human bone from different anatomical sites - A pilot study. Proteomics Clin Appl 2022; 16:e2100049. [PMID: 35462455 DOI: 10.1002/prca.202100049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 04/11/2022] [Accepted: 04/20/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE The study aim is a comparative proteome-based analysis of different autologous bone entities (alveolar bone [AB], iliac cortical [IC] bone, and iliac spongiosa [IS]) used for alveolar onlay grafting. EXPERIMENTAL DESIGN Site-matched bone samples of AB, IC, and IS were harvested during alveolar onlay grafting. Proteins were extracted using a detergent-based (sodium dodecyl sulfate) strategy and trypsinized. Proteome analysis was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). MaxQuant was used for peptide-to-spectrum matching, peak detection, and quantitation. Linear models for microarray analysis (LIMMA) were used to detect differentially abundant peptides and proteins. RESULTS A total of 1730 different proteins were identified across the 15 samples at a false discovery rate of 1%. Partial least-squares discriminant analysis approved segregation of AB, IC, and IS protein profiles. LIMMA statistics highlighted 66 proteins that were more abundant in AB then in IC (vs. 92 proteins were enriched in IC over AB). Gene Ontology enrichment analysis revealed a matrisomal versus an immune-related proteome fingerprint in AB versus IC. CONCLUSION AND CLINICAL RELEVANCE This pilot study demonstrates an ECM protein-related proteome fingerprint in AB and an immune-related proteome fingerprint in IS and IC.
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Affiliation(s)
- Tobias Fretwurst
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | | | - René Rothweiler
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Brigitte Altmann
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,G.E.R.N Center for Tissue Replacement, Regeneration & Neogenesis, Department of Prosthetic Dentistry, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Oliver Schilling
- Institute of Surgical Pathology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Katja Nelson
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
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Wu B, Wu Y, Liu M, Liu J, Jiang D, Ma S, Yan B, Lu Y. Mechanical Behavior of Human Cancellous Bone in Alveolar Bone under Uniaxial Compression and Creep Tests. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15175912. [PMID: 36079293 PMCID: PMC9457185 DOI: 10.3390/ma15175912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 05/10/2023]
Abstract
In the process of orthodontic treatment, the remodeling of cancellous bone in alveolar bone (in this paper, cancellous bone in alveolar bone is abbreviated as CBAB) is key to promoting tooth movement. Studying the mechanical behavior of CBAB is helpful to predict the displacement of teeth and achieve the best effect of orthodontic treatment. Three CBAB samples were cut from alveolar bone around the root apex of human teeth. A uniaxial compression test was used to study the transient elastic properties of CBAB. A creep test was used to study the time-dependent viscoelastic properties of CBAB. Both tests were carried out at the loading rates of 0.02 mm/min, 0.1 mm/min and 0.5 mm/min. The results revealed that CBAB is a nonlinear viscoelastic and hyperelastic material. The stress−strain curve obtained from the uniaxial compression test could be divided into three stages: the collapse stage of the front section, the exponential stage of the middle section and the almost linear stage of the rear end. According to the strain−time curve obtained from the compression creep test, a trend of increasing strain over time was relatively obvious within the first 30 s. After 200 s, the curve gradually tended to plateau. Four hyperelastic models and three viscoelastic models were used to fit the test data. Finally, the fifth-order polynomial hyperelastic model (coefficient of determination “R2 > 0.999”) was used to describe the hyperelastic properties of CBAB, and the seven-parameter model of the generalized Kelvin modified model (“R2 > 0.98”) was used to describe the viscoelastic properties of CBAB.
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Affiliation(s)
- Bin Wu
- College of Mechanical and Electronic Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Yang Wu
- College of Mechanical and Electronic Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Mao Liu
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
| | - Jingjing Liu
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
| | - Di Jiang
- College of Mechanical and Electronic Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Songyun Ma
- Institute of General Mechanics, RWTH-Aachen University, 52062 Aachen, Germany
| | - Bin Yan
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
- Correspondence: (B.Y.); (Y.L.)
| | - Yi Lu
- College of Mechanical and Electronic Engineering, Nanjing Forestry University, Nanjing 210037, China
- Correspondence: (B.Y.); (Y.L.)
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Blume O, Donkiewicz P, Palkovics D, Götz W, Windisch P. Volumetric Changes of a Customized Allogeneic Bone Block Measured by Two Image Matching Tools: Introduction of a Novel Assessment Technique for Graft Resorption. Acta Stomatol Croat 2022; 55:406-417. [PMID: 35001936 PMCID: PMC8734454 DOI: 10.15644/asc55/4/8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/04/2021] [Indexed: 12/13/2022] Open
Abstract
Objective The purpose of this case report was to present a method for the assessment of volumetric changes of bone blocks during healing and demonstrate its practicability by analysing the resorption of a pre-shaped allogeneic bone block used for the reconstruction of a complex maxillary defect. Materials and methods CBCT-scans of a 19-year-old male treated with an allogeneic bone block were recorded pre-OP, post-OP, and following six months of healing. Graft shrinkage was assessed via two image matching tools, namely coDiagnostiX® and Slicer. A biopsy specimen was harvested along the implant canal at the time of implantation. Results The osseous defect was successfully restored and advanced graft remodelling was found upon re-entry as confirmed by the histomorphometric and histologic analysis. The initial volumes of the graft determined via coDiagnostiX® and Slicer were 0.373 mL and 0.370 mL., respectively, while graft resorption after six months of healing was 0.011 mL (3.00%) and 0.016 mL (4.33%). Conclusions The avoidance of bone harvesting and reduction of invasiveness display an important issue in dentoalveolar restorations. However, before grafting materials can be considered a safe alternative, understanding their clinical performance, especially resorption stability, is pivotal. The present case report demonstrates a limited resorption of the allogeneic bone block and further emphasizes the practicability of determining bone resorption by the here introduced method. As our investigation comprises solely one subject, the results should be considered with care and substantiated by further studies.
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Affiliation(s)
- Oliver Blume
- Private Practice 'Dres. Back & Blume', Tal 13, 80331 Munich, Germany
| | - Phil Donkiewicz
- Department of Oral Surgery and Dental Emergency Care, Faculty of Health, School of Dentistry, Witten / Herdecke University, North RhineWestphalia, Germany
| | - Daniel Palkovics
- Department of Periodontology, Semmelweis University, Szentkirályi u. 47, 1088 Budapest, Hungary
| | - Werner Götz
- Department of Orthodontics, Laboratory for Basic Research in Oral Biology, University of Bonn, Germany
| | - Péter Windisch
- Department of Periodontology, Semmelweis University, Szentkirályi u. 47, 1088 Budapest, Hungary
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Recombinant Proteins-Based Strategies in Bone Tissue Engineering. Biomolecules 2021; 12:biom12010003. [PMID: 35053152 PMCID: PMC8773742 DOI: 10.3390/biom12010003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022] Open
Abstract
The increase in fracture rates and/or problems associated with missing bones due to accidents or various pathologies generates socio-health problems with a very high impact. Tissue engineering aims to offer some kind of strategy to promote the repair of damaged tissue or its restoration as close as possible to the original tissue. Among the alternatives proposed by this specialty, the development of scaffolds obtained from recombinant proteins is of special importance. Furthermore, science and technology have advanced to obtain recombinant chimera’s proteins. This review aims to offer a synthetic description of the latest and most outstanding advances made with these types of scaffolds, particularly emphasizing the main recombinant proteins that can be used to construct scaffolds in their own right, i.e., not only to impregnate them, but also to make scaffolds from their complex structure, with the purpose of being considered in bone regenerative medicine in the near future.
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Survival Rates of Dental Implants in Autogenous and Allogeneic Bone Blocks: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121388. [PMID: 34946333 PMCID: PMC8705565 DOI: 10.3390/medicina57121388] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/11/2021] [Accepted: 12/14/2021] [Indexed: 12/17/2022]
Abstract
Background and Objectives: Preliminary studies emphasize the similar performance of autogenous bone blocks (AUBBs) and allogeneic bone blocks (ALBBs) in pre-implant surgery; however, most of these studies include limited subjects or hold a low level of evidence. The purpose of this review is to test the hypothesis of indifferent implant survival rates (ISRs) in AUBB and ALBB and determine the impact of various material-, surgery- and patient-related confounders and predictors. Materials and Methods: The national library of medicine (MEDLINE), Excerpta Medica database (EMBASE) and Cochrane Central Register of Controlled Trials (CENTRAL) were screened for studies reporting the ISRs of implants placed in AUBB and ALBB with ≥10 participants followed for ≥12 months from January 1995 to November 2021. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed via several scoring tools, dependent on the study design. Means of sub-entities were presented as violin plots. Results: An electronic data search resulted in the identification of 9233 articles, of which 100 were included in the quantitative analysis. No significant difference (p = 0.54) was found between the ISR of AUBB (96.23 ± 5.27%; range: 75% to 100%; 2195 subjects, 6861 implants) and that of ALBB (97.66 ± 2.68%; range: 90.1% to 100%; 1202 subjects, 3434 implants). The ISR in AUBB was increased in blocks from intraoral as compared to extraoral donor sites (p = 0.0003), partially edentulous as compared to totally edentulous (p = 0.0002), as well as in patients younger than 45 as compared to those older (p = 0.044), cortical as compared to cortico-cancellous blocks (p = 0.005) and in delayed implantations within three months as compared to immediate implantations (p = 0.018). The ISR of ALBB was significantly increased in processed as compared to fresh-frozen ALBB (p = 0.004), but also in horizontal as compared to vertical augmentations (p = 0.009). Conclusions: The present findings widely emphasize the feasibility of achieving similar ISRs with AUBB and ALBB applied for pre-implant bone grafting. ISRs were negatively affected in sub-entities linked to more extensive augmentation procedures such as bone donor site and dentition status. The inclusion and pooling of literature with a low level of evidence, the absence of randomized controlled clinical trials (RCTs) comparing AUBB and ALBB and the limited count of comparative studies with short follow-ups increases the risk of bias and complicates data interpretation. Consequently, further long-term comparative studies are needed.
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Martin-Piedra MA, Gironés-Camarasa B, España-López A, Fernández-Valadés Gámez R, Blanco-Elices C, Garzón I, Alaminos M, Fernández-Valadés R. Usefulness of a Nanostructured Fibrin-Agarose Bone Substitute in a Model of Severely Critical Mandible Bone Defect. Polymers (Basel) 2021; 13:3939. [PMID: 34833238 PMCID: PMC8618832 DOI: 10.3390/polym13223939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 11/17/2022] Open
Abstract
Critical defects of the mandibular bone are very difficult to manage with currently available materials and technology. In the present work, we generated acellular and cellular substitutes for human bone by tissue engineering using nanostructured fibrin-agarose biomaterials, with and without adipose-tissue-derived mesenchymal stem cells differentiated to the osteogenic lineage using inductive media. Then, these substitutes were evaluated in an immunodeficient animal model of severely critical mandibular bone damage in order to assess the potential of the bioartificial tissues to enable bone regeneration. The results showed that the use of a cellular bone substitute was associated with a morpho-functional improvement of maxillofacial structures as compared to negative controls. Analysis of the defect site showed that none of the study groups fully succeeded in generating dense bone tissue at the regeneration area. However, the use of a cellular substitute was able to improve the density of the regenerated tissue (as determined via CT radiodensity) and form isolated islands of bone and cartilage. Histologically, the regenerated bone islands were comparable to control bone for alizarin red and versican staining, and superior to control bone for toluidine blue and osteocalcin in animals grafted with the cellular substitute. Although these results are preliminary, cellular fibrin-agarose bone substitutes show preliminary signs of usefulness in this animal model of severely critical mandibular bone defect.
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Affiliation(s)
- Miguel-Angel Martin-Piedra
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, E18016 Granada, Spain; (M.-A.M.-P.); (C.B.-E.); (I.G.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, E18012 Granada, Spain
| | - Belén Gironés-Camarasa
- Division of Pediatric Surgery, University Hospital Virgen de las Nieves, E18014 Granada, Spain;
- Doctoral Program in Biomedicine, University of Granada, E18071 Granada, Spain
| | - Antonio España-López
- Craniofacial Malformations and Cleft Lip and Palate Management Unit, University Hospital Virgen de las Nieves, E18014 Granada, Spain;
| | | | - Cristina Blanco-Elices
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, E18016 Granada, Spain; (M.-A.M.-P.); (C.B.-E.); (I.G.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, E18012 Granada, Spain
| | - Ingrid Garzón
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, E18016 Granada, Spain; (M.-A.M.-P.); (C.B.-E.); (I.G.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, E18012 Granada, Spain
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, E18016 Granada, Spain; (M.-A.M.-P.); (C.B.-E.); (I.G.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, E18012 Granada, Spain
| | - Ricardo Fernández-Valadés
- Instituto de Investigación Biosanitaria ibs.GRANADA, E18012 Granada, Spain
- Division of Pediatric Surgery, University Hospital Virgen de las Nieves, E18014 Granada, Spain;
- Craniofacial Malformations and Cleft Lip and Palate Management Unit, University Hospital Virgen de las Nieves, E18014 Granada, Spain;
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Bitinas D, Bardijevskytė G. Short implants without bone augmentation vs. long implants with bone augmentation: systematic review and meta-analysis. Aust Dent J 2021; 66 Suppl 1:S71-S81. [PMID: 34037243 DOI: 10.1111/adj.12859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/19/2021] [Accepted: 05/13/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Anatomical limits such as the location of the lower alveolar nerve, the maxillary sinus in atrophied jaws might extend implant surgery treatment. The purpose of this systematic literature review is to review the literature and determine whether short implants can be an effective alternative to standard-length implants after bone augmentation. MATERIALS AND METHODS A systematic search was performed on PRISMA wizard. Searched for clinical trials 2010-2020 in the Medline database. The keywords chosen are "short versus long implants, augmented bone, clinical trial", and their various variations. RESULTS Meta-analyses of the studies of implant loss after 1, 3 and 5 years showed a statistically insignificant difference between groups. The number of complications after 1 year was statistically significantly higher in the control group. Meta-analyses with follow-up periods of 3 and 5 years showed a statistically insignificant difference; Meta-analyses of studies of marginal bone loss after 1, 3 and 5 years showed a statistically insignificant difference between the groups. CONCLUSIONS Short dental implants may be a suitable alternative to standard length dental implants after bone augmentation. The risk of their complications is possibly lower because of the lack of need for bone augmentation.
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Affiliation(s)
- Donatas Bitinas
- Medical academy, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania
| | - Gailė Bardijevskytė
- Medical academy, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania
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12
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He Z, Liu Y, Liu X, Sun Y, Zhao Q, Liu L, Zhu Z, Luo E. Smart Porous Scaffold Promotes Peri-Implant Osteogenesis under the Periosteum. ACS Biomater Sci Eng 2020; 6:6321-6330. [PMID: 33449673 DOI: 10.1021/acsbiomaterials.0c00956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: Adequate peri-implant bone mass and bone quality are essential factors to ensure the initial stability of the implant and success of implant operation. In clinical settings, the lack of bone mass often restricts the implant operation. In this study, we fabricated a smart porous scaffold with a shape memory function and investigated whether it could promote peri-implant osteogenesis under the periosteum. Methods: A porous shape memory polymer (SMP) scaffold was fabricated and its shape memory function, mechanical properties, and degradation rate were tested in vitro. Moreover, the scaffold was implanted in the mandible of rabbits to evaluate its efficacy to promote peri-implant osteogenesis in the periosteum and enhance the initial stability of the implant. Histological, micro-CT, and biomechanical analyses were carried out for further verification. Results: The SMP scaffold has a good shape memory function and biocompatibility in vitro. In vivo experiments demonstrated that the SMP scaffold could recover to its original shape after implantation to create a small gap in the periosteum. After 12 weeks, the scaffold was gradually replaced by a newly formed bone, and the stability of the implant increased when it implanted with the scaffold. Conclusion: The present study indicates that the SMP scaffolds have a good shape memory function and could enhance peri-implant bone formation under the periosteum. The SMP scaffold provides a clinical potential candidate for bone tissue engineering under the periosteum.
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Affiliation(s)
- Ze He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Yao Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Xian Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Yue Sun
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Qiucheng Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Linan Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Zhaokun Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - En Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
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Angermair J, Bosshardt DD, Nelson K, Flügge TV, Stricker A, Fretwurst T. Horizontal bone grafting using equine-derived cancellous bone blocks is associated with severe complications: A prospective clinical and histological pilot study. Clin Oral Implants Res 2020; 31:1149-1158. [PMID: 32881075 DOI: 10.1111/clr.13661] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/30/2020] [Accepted: 08/21/2020] [Indexed: 12/20/2022]
Abstract
AIMS The aim of this prospective, clinical study was to evaluate the clinical performance and histological outcome of a new equine hydroxyapatite collagenated bone block (eHAC) for horizontal bone grafting prior to implant placement. MATERIALS AND METHODS Five patients (two male/three female) with a mean age of 51.6 years (range 22-66 years) and a reduced horizontal bone width of the alveolar ridge (mean 3.5 mm) underwent horizontal bone grafting using eHAC at 10 grafting sites. Reentry was performed 6.9 months after the horizontal grafting procedure. Clinical follow-up (mean 28.9 month) considered width gain of the alveolar ridge, soft tissue healing, and complications. To evaluate graft incorporation, four additional patients underwent histological assessment of equine blocks adjacent to autologous blocks 3 and 6 months after grafting. RESULTS The study was terminated after graft failure was observed in four of five patients. Mean horizontal bone width had increased by 3.6 ± 1.22 mm. Three out of nine implants placed had to be removed due to graft failure. Histological evaluation revealed large amounts of soft connective tissue within the grafts (mean 67.3 ± 9.5%). The proportion of new bone formation 3 months after the lateral grafting procedure revealed an average of 8.6%, compared to 11.4% after 6 to 7 months. CONCLUSION Lateral ridge grafting using eHAC achieved measurable horizontal width gain but revealed high rates of severe complications. CLINICAL IMPLICATIONS Within the limitations of this study, eHAC bone blocks cannot be recommended for horizontal bone grafting.
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Affiliation(s)
- Johannes Angermair
- Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dieter D Bosshardt
- Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Katja Nelson
- Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tabea V Flügge
- Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andres Stricker
- Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center of Implantology, Periodontology and 3D Head-and-Neck Imaging Lake Constance, Konstanz, Germany
| | - Tobias Fretwurst
- Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany
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14
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Kim YK, Ku JK. Ridge augmentation in implant dentistry. J Korean Assoc Oral Maxillofac Surg 2020; 46:211-217. [PMID: 32606284 PMCID: PMC7338632 DOI: 10.5125/jkaoms.2020.46.3.211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022] Open
Abstract
In patients with insufficient bone height and width, the successful placement of dental implants is difficult with regards to maintaining an ideal pathway and avoiding important anatomical structures. Vertical and/or horizontal ridge augmentation may be necessary using various bone substitute materials and bone graft procedures. However, effective one-wall reconstruction has been challenging due to its poor blood supply and insufficient graft stability. In this paper, the authors summarize current evidence-based literature based on the author’s clinical experience. Regarding bone substitutes, it is advantageous for clinicians to select the types of bone substitutes including autogenous bone. The most important consideration is to minimize complications through principle-based ridge augmentation surgery. Ridge augmentation should be decided with complete consent of the patients due to the possible disadvantages of surgery, complications, and unpredictable prognosis.
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Affiliation(s)
- Young-Kyun Kim
- Editor-in-Chief of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea.,Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jeong-Kui Ku
- Editorial Board of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea.,Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Hospital, Armed Forces Medical Command, Seongnam, Korea
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15
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Singh R, Parihar AS, Vaibhav V, Kumar K, Singh R, Jerry JJ. A 10 years retrospective study of assessment of prevalence and risk factors of dental implants failures. J Family Med Prim Care 2020; 9:1617-1619. [PMID: 32509661 PMCID: PMC7266248 DOI: 10.4103/jfmpc.jfmpc_1171_19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/23/2020] [Accepted: 03/02/2020] [Indexed: 12/13/2022] Open
Abstract
Aim: The present study was conducted to determine the prevalence rate of dental implants failure and risk factors affecting dental implant outcome. Materials and Methods: The present retrospective study was conducted on 826 patients who received 1420 dental implants in both genders. Length of implant, diameter of implant, location of implant, and bone quality were recorded. Risk factors such as habit of smoking, history of diabetes, hypertension, etc., were recorded. Results: In 516 males, 832 dental implants and in 310 females, 588 dental implants were placed. Maximum dental implant failure was seen with length <10 mm (16%), with diameter <3.75 mm, and with type IV bone (20.6%). The difference found to be significant (P < 0.05). Maximum dental implant failures were seen with smoking (37%) followed by hypertension (20.8%), diabetes (20.3%), and CVDs (18.7%). Healthy patients had the lowest failure rate (4.37%). Conclusion: Dental implant failure was high in type IV bone, dental implant with <3.75 mm diameter, dental implant with length <10.0 mm, and among smokers.
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Affiliation(s)
- Rohit Singh
- Department of Prosthodontics, Crown Bridge and Implantology, Patna Dental College and Hospital, Patna, Bihar, India
| | | | - Vikas Vaibhav
- Department of Dentistry, Vardaman Institute of Medical Sciences, Pawapuri, India
| | - Kunal Kumar
- Department of Dentistry, Patna Medical College and Hospital, Patna, Bihar, India
| | - Revati Singh
- Department of Dentistry, Patna Medical College and Hospital, Patna, Bihar, India
| | - Jeethu John Jerry
- Department of Periodontics, Malabar Dental College and Research Centre, Malappuram, Kerala, India
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16
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Osseous ingrowth in allogeneic bone blocks applied for vertical bone augmentation: a preclinical randomised controlled study. Clin Oral Investig 2019; 24:2867-2879. [PMID: 31828520 DOI: 10.1007/s00784-019-03151-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 11/11/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of the present study was the qualitative and quantitative evaluation of osseous graft consolidation using allogeneic bone blocks for vertical bone augmentation in an animal model. MATERIAL AND METHODS Standardised allogeneic and autologous bone blocks were fixed on the frontal skull of 20 adult female pigs and covered with a resorbable collagen membrane. Animals were sacrificed after 2 and 6 months. Specimens were histologically and histomorphometrically analysed focusing on the amount of vital bone, residual bone substitute material and connective tissue. Furthermore, the amount of expression of bone matrix proteins (collagen type I and osteocalcin) and de novo vessel formation (von Willebrand factor) were quantified by immunohistochemistry. RESULTS Significantly more allogeneic bone blocks failed for both evaluation time points (p < 0.05). Allogeneic blocks showed significantly less vital bone with more connective tissue formation compared to autologous bone blocks. Increased vessel formation could be detected for both evaluation time points in the contact area of autologous bone with local bone. The expression of collagen type I and osteocalcin was significantly lower in the allogeneic bone graft. CONCLUSIONS Allogeneic cancellous bone blocks showed a significantly higher failure rate compared to autologous bone blocks. Allogeneic bone blocks seemed to negatively affect bone formation or negatively influence the host in the long term, and increased connective tissue formation and block loss should be anticipated. CLINICAL RELEVANCE In order to maintain patient safety and treatment success clinicians should be persuaded to make a conscious choice of the applied biomaterials with regard to their components and structure.
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17
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Krisam J, Ott L, Schmitz S, Klotz AL, Seyidaliyeva A, Rammelsberg P, Zenthöfer A. Factors affecting the early failure of implants placed in a dental practice with a specialization in implantology - a retrospective study. BMC Oral Health 2019; 19:208. [PMID: 31488110 PMCID: PMC6727348 DOI: 10.1186/s12903-019-0900-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/26/2019] [Indexed: 12/14/2022] Open
Abstract
Background To evaluate early failure and possible risk factors for failure of dental implants placed under practice-based conditions. Methods To clarify the research question, anonymized data from 106 patients with 186 dental implants were analyzed. The presence of sucessful healing (yes/no) at the time of incorporation of the final prosthesis was assessed. Mixed models were compiled for each target variable to enable estimation of the effects of patient-related and implant-related conditions on the risk of early implant failure. Results Nine out of 186 implants (4.8%) placed in 106 participants failed before incorporation of the final prosthesis. The use of shorter implants (< 10 mm) and the need for augmentation procedures were associated with a greater risk of early implant failure. For shorter implants, the risk was 5.8 times greater than that for longer implants (p = 0.0230). Use of augmentation procedures increased the risk by a factor of 5.5 (p = 0.0174). Conclusions Implants placed in the dental practice with a specialization in implantology heal successfully. The use of augmentation procedures and of implants shorter than 10 mm seems to be associated with a greater risk of early implant failure.
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Affiliation(s)
- Johannes Krisam
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130, 69120, Heidelberg, Germany
| | - Larissa Ott
- Dental School, Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Stephanie Schmitz
- Praxis für Zahnmedizin Dr. Schmitz, Hauptstraße 13, 69434, Hirschhorn, Germany
| | - Anna-Luisa Klotz
- Dental School, Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Aida Seyidaliyeva
- Dental School, Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Peter Rammelsberg
- Dental School, Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Andreas Zenthöfer
- Dental School, Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
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18
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Arab S, Arab HR, Aghaloo M, Shiezadeh F, Tajik S, Moeintaghavi A. Periosteal Envelope Flap as a Technique for Horizontal Bone Augmentation: A Case Series Study. Open Dent J 2018. [DOI: 10.2174/1874210601812010995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:Following tooth extraction, the alveolar bone is typically subject to irrevocable and progressive changes that are collectively referred to as natural bone resorption. This process eventually results in a deficiency of the vertical and horizontal dimensions of the bone. Conventionally, various methods are used to repair alveolar defects resulting from tooth extraction, and to achieve vertical or horizontal bone regeneration. The aim of this study was to evaluate the influence of periosteal pocket flap on the enhancement of horizontal length in alveolar bone regeneration.Methods:Twenty-two patients (7 men, 15 women) aged 45–60 years were enrolled in this study. Periosteal envelope flaps and Cerabone were used to increase alveolar bone thickness. Ridge width was measured preoperatively and 4-6 months postoperatively using cone-beam computed tomography. The pre- and postoperative results were compared using the paired t-test.Results:An average of 2.53 mm (P< 0.001) horizontal enhancement of the alveolar ridge was achieved.Conclusion:The results of this study suggest that the use of a periosteal pocket flap with xenograft material is an excellent method which increase more than 2 mm alveolar bone width. As the study sample was small, further clinical investigations with larger samples are recommended.
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19
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Bernardi S, Gatto R, Severino M, Botticelli G, Caruso S, Rastelli C, Lupi E, Roias AQ, Iacomino E, Falisi G. Short Versus Longer Implants in Mandibular Alveolar Ridge Augmented Using Osteogenic Distraction: One-Year Follow-up of a Randomized Split-Mouth Trial. J ORAL IMPLANTOL 2018; 44:184-191. [DOI: 10.1563/aaid-joi-d-16-00216] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the reliability of 6-mm-long implants compared with normal-length implants placed in a vertical augmented atrophic posterior mandible, supporting cemented single crowns. Thirty-six patients with bilateral posterior edentulous mandible and presenting a bone availability height less than 9 mm from the mandibular canal were enrolled in this study. Patient hemiarches were randomized to receive both 6-mm-long and normal-length implants (10 mm). The technique used for the vertical bone augmentation was the “sandwich” technique, using a bone substitute block as graft. The data outcomes at 1 year postloading follow-up were the loss of implants and complications. Eighty-six 6-mm-long implants and 84 normal implants were inserted. Five short implants and 13 normal implants were lost. In 28 patients, complications occurred, and in 21 cases, the complication was present on the side of the ridge vertical augmentation. From the statistical analysis, the association between the side of the ridge augmentation and the side of occurrence of the complication was statistically significant (P < .05). The results from this trial suggest short implants can be preferred over vertical bone augmentation for the placement of longer implants in the rehabilitation of edentulous posterior mandibles. These initial results must be confirmed by larger and longer follow-ups of 5 years or more.
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Affiliation(s)
- Sara Bernardi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Roberto Gatto
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Marco Severino
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Silvia Caruso
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudio Rastelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ettore Lupi
- Maxillofacial Division, San Salvatore Hospital, L'Aquila, Italy
| | | | - Enzo Iacomino
- ENT Division, San Salvatore Hospital, L'Aquila, Italy
| | - Giovanni Falisi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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20
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Cumulative Success Rate of Short and Ultrashort Implants Supporting Single Crowns in the Posterior Maxilla: A 3-Year Retrospective Study. Int J Dent 2017; 2017:8434281. [PMID: 28751913 PMCID: PMC5511658 DOI: 10.1155/2017/8434281] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/23/2017] [Indexed: 12/14/2022] Open
Abstract
AIM To determine cumulative success rate (CSR) of short and ultrashort implants in the posterior maxilla restored with single crowns. PATIENTS AND METHODS We performed a retrospective study in 65 patients with 139 implants. 46 were ultrashort and 93 short. Implants were placed with a staged approach and restored with single crowns. Success rate, clinical and radiographic outcomes, and crown-to-implant ratio (CIR) were assessed after three years. Statistical analysis was performed by descriptive and inferential statistics. A log-binomial regression model where the main outcome was implant success was achieved. Coefficients and 95% confidence intervals were reported. Analyses were performed with Stata 13.2 for Windows. RESULTS 61.54% of patients were female and mean overall age was 51.9 ± 11.08 years old. Overall CSR was 97.1% (95% CI: 92.4-98.9): 97.9 and 95.1% for short and ultrashort, respectively (P value: 0.33). Four implants failed. Covariates were not associated with CSR (P value > 0.05). Regression model showed coefficients correlated with implant success for ultrashort implants (0.87) and most of covariates but none were statistically significant (P values > 0.05). CONCLUSIONS Our results suggest that short and ultrashort implants may be successfully placed and restored with single crowns in the resorbed maxillary molar region.
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21
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Falisi G, Bernardi S, Rastelli C, Pietropaoli D, DE Angelis F, Frascaria M, DI Paolo C. "All on short" prosthetic-implant supported rehabilitations. ACTA ACUST UNITED AC 2017; 10:477-487. [PMID: 29682265 DOI: 10.11138/orl/2017.10.4.477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objectives Short implants are increasing their popularity among clinicians who want to fulfill the constant demanding of fixed prosthetic solutions in edentulous jaws. The aim of this report was to propose a new possibility to project and realize an occlusal guided implant cross-arch prosthesis supported by ultra-short implants, describing it presented an edentulous mandible case report. Methods A 61-year-old, Caucasian, female patient who attended the dental clinic of the University of L'Aquila presented with edentulous posterior inferior jaw and periodontitis and periimplantitis processes in the anterior mandible. The remaining tooth and the affected implant were removed. Six 4-mm-long implants were placed to support a cross-arch metal-resin prosthesis. Results At 1-year follow-up clinical and radiological assessment showed a good osseointegration of the fixtures and the patient was satisfied with the prosthesis solution. Conclusion The method, even if it requires further validation, seems to be a valid aid in solving lower edentulous clinical cases, and appears less complex and with more indications of other proposals presented in the current clinical literature. Our case report differs from the current technique All-on-Four, which uses four implants in the mandible to support over-denture prosthesis, assuring a very promising clinical result.
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Affiliation(s)
- G Falisi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - S Bernardi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - C Rastelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - D Pietropaoli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - F DE Angelis
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - M Frascaria
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - C DI Paolo
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
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Draenert FG, Gebhart F, Mitov G, Neff A. Biomaterial shell bending with 3D-printed templates in vertical and alveolar ridge augmentation: a technical note. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:651-660. [PMID: 28215503 DOI: 10.1016/j.oooo.2016.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 12/22/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Alveolar ridge and vertical augmentations are challenging procedures in dental implantology. Even material blocks with an interconnecting porous system are never completely resorbed. Shell techniques combined with autologous bone chips are therefore the gold standard. Using biopolymers for these techniques is well documented. We applied three-dimensional (3-D) techniques to create an individualized bending model for the adjustment of a plane biopolymer membrane made of polylactide. STUDY DESIGN Two cases with a vertical alveolar ridge defect in the maxilla were chosen. The cone beam computed tomography data were processed with a 3-D slicer and the Autodesk Meshmixer to generate data about the desired augmentation result. STL data were used to print a bending model. A 0.2-mm poly-D, L-lactic acid membrane (KLS Matin Inc., Tuttlingen, Germany) was bended accordingly and placed into the defect via a tunnel approach in both cases. A mesh graft of autologous bone chips and hydroxylapatite material was augmented beneath the shell, which was fixed with osteosynthesis screws. RESULTS The operative procedure was fast and without peri- or postoperative complications or complaints. The panoramic x-ray showed correct fitting of the material in the location. Bone quality at the time of implant placement was type II, resulting in good primary stability. CONCLUSIONS A custom-made 3-D model for bending confectioned biomaterial pieces is an appropriate method for individualized adjustment in shell techniques. The advantages over direct printing of the biomaterial shell and products on the market, such as the Xyoss shell (Reoss Inc., Germany), include cost-efficiency and avoidance of regulatory issues.
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Affiliation(s)
- Florian G Draenert
- D Implant Institute, Munich, Germany; Extraordinary Professor for Oral & Maxillofacial Surgery, University of Marburg, Germany.
| | | | - Gergo Mitov
- Department of Prosthodontics, DPU University, Vienna, Austria
| | - Andreas Neff
- Clinic for Oral & Maxillofacial Surgery, University of Marburg, Germany
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