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Pabst A, Becker P, Götz W, Heimes D, Thiem DGE, Blatt S, Kämmerer PW. A comparative analysis of particulate bovine bone substitutes for oral regeneration: a narrative review. Int J Implant Dent 2024; 10:26. [PMID: 38801622 PMCID: PMC11130110 DOI: 10.1186/s40729-024-00544-z] [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: 04/15/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024] Open
Abstract
PURPOSE Particulate bovine bone substitutes (BS) are commonly used in oral regeneration. However, more literature is needed focusing on comparative analyses among various particulate bovine BS. This study evaluates pre-clinical and clinical data of different particulate bovine BS in oral regeneration. METHODS A narrative review was conducted by screening the PubMed database Included in the review were pre-clinical and clinical studies until 2024 comparing a minimum of two distinct particulate bovine BS. In addition to examining general data concerning manufacturing and treatment processes, biological safety, physical and chemical characteristics, and graft resorption, particular emphasis was placed on assessing pre-clinical and clinical data related to ridge preservation, sinus floor elevation, peri-implant defects, and various forms of alveolar ridge augmentation utilizing particulate bovine BS. RESULTS Various treatment temperatures ranging from 300 to 1,250 °C and the employment of chemical cleaning steps were identified for the manufacturing process of particulate bovine BS deemed to possess biosecurity. A notable heterogeneity was observed in the physical and chemical characteristics of particulate bovine BS, with minimal or negligible graft resorption. Variations were evident in particle and pore sizes and the porosity of particulate bovine BS. Pre-clinical assessments noted a marginal inclination towards favorable outcomes for particulate bovine BS subjected to higher treatment temperatures. However, clinical data are insufficient. No distinctions were observed regarding ridge preservation, while slight advantages were noted for high-temperature treated particulate bovine BS in sinus floor elevation. CONCLUSIONS Subtle variances in both pre-clinical and clinical outcomes were observed in across various particulate bovine BS. Due to inadequate data, numerous considerations related to diverse particulate bovine BS, including peri-implant defects, must be more conclusive. Additional clinical studies are imperative to address these knowledge gaps effectively.
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Affiliation(s)
- Andreas Pabst
- Department of Oral and Maxillofacial Surgery, German Armed Forces Central Hospital, Rübenacherstraße 170, 56072, Koblenz, Germany
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Philipp Becker
- Department of Oral and Maxillofacial Surgery, German Armed Forces Central Hospital, Rübenacherstraße 170, 56072, Koblenz, Germany
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Werner Götz
- Department of Orthodontics, University Hospital Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - Diana Heimes
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Daniel G E Thiem
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Sebastian Blatt
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Gan LM, Zhou QR, Zhang Y, Yu YC, Yu ZZ, Sun Y, Li RX, Wu XW, Yang F. Alveolar Bone Morphologic Predictors for Guided Bone Regeneration Outcome in Anterior Maxilla. Int Dent J 2024; 74:102-109. [PMID: 37714716 PMCID: PMC10829351 DOI: 10.1016/j.identj.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVES This study aimed to explore the influence of alveolar bone morphologic variables on the outcome of guided bone regeneration (GBR) in the anterior maxilla region. METHODS Twenty-eight patients who received single maxillary anterior tooth delayed implant placed simultaneously with GBR were recruited. Baseline data including age, gender, implant site, implant brand, and bone graft materials were recorded. The resorption rate of the grafted bone (RRGB), labial bone width at 0 mm, 2 mm, and 4 mm apical to the implant platform at Tn (LBW0Tn, LBW2Tn, LBW4Tn), implant angulation (IA), maximum bone graft thickness (MBGT), bone graft volume (BGV), and the initial bone morphologic variables bone concavity depth (BCD) and bone concavity angulation (BCA) were measured. The Pearson correlation analysis, analysis of variance (ANOVA), and optimal binning method were used to explore the potential predictors for GBR. RESULTS Among 28 patients, the labial bone width of implant and bone graft volume decreased significantly when measured 6 months after surgery. The mean percentage of RRGB was 49.78%. RRGB was not correlated with gender, age, bone graft material, IA, MBGT, bone graft volume at T1, implant site, and implant brand (P > .05). BCD and BCA were each moderately correlated with RRGB (r = -0.872 [P < .001] and r = 0.686 [P < .001], respectively). A BCD ≥1.03 mm and a BCA <155.30° resulted in a significantly lower percentage of RRGB (P < .001). CONCLUSIONS A significant grafted bone materials volume reduction was detected after GBR with collagen membrane and deproteinized bovine bone mineral (DBBM). The initial bone morphology can influence GBR outcome, and a bone concavity with a depth ≥1.03 mm and an angulation <155.30° led to a lower RRGB. BCD and BCA can be used as variables to predict the outcome of GBR.
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Affiliation(s)
- Luo-Man Gan
- Department of Stomatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, P. R. China
| | - Qian-Rong Zhou
- Department of Stomatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, P. R. China
| | - Yan Zhang
- Department of Stomatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, P. R. China
| | - You-Cheng Yu
- Department of Stomatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, P. R. China; Department of Stomatology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, P. R. China
| | - Zhen-Ze Yu
- Department of Stomatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, P. R. China
| | - Yang Sun
- Department of Stomatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, P. R. China
| | - Rui-Xue Li
- Department of Stomatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, P. R. China
| | - Xing-Wen Wu
- Department of Stomatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, P. R. China
| | - Fei Yang
- Department of Stomatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, P. R. China; Department of Stomatology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, P. R. China.
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Mu Y, Du Z, Gao W, Xiao L, Crawford R, Xiao Y. The effect of a bionic bone ionic environment on osteogenesis, osteoimmunology, and in situ bone tissue engineering. Biomaterials 2024; 304:122410. [PMID: 38043465 DOI: 10.1016/j.biomaterials.2023.122410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/15/2023] [Accepted: 11/24/2023] [Indexed: 12/05/2023]
Abstract
Bone, a mineralized tissue, continuously undergoes remodeling. It is a process that engages the mineralization and demineralization of the bone matrix, orchestrated by the interactions among cells and cell-secreted biomolecules under the bone ionic microenvironment (BIE). The osteoinductive properties of the demineralized organic bone matrix and many biological factors have been well-investigated. However, the impact of the bone ionic environment on cell differentiation and osteogenesis remains largely unknown. In this study, we extracted and isolated inorganic bone components (bone-derived monetite, BM) using a low-temperature method and, for the first time, investigated whether the BIE could actively affect cell differentiation and regulate osteoimmune reactions. It was evidenced that the BIE could foster the osteogenesis of human bone marrow stromal cells (hBMSCs) and promote hBMSCs mineralization without using osteogenic inductive agents. Interestingly, it was noted that BIE resulted in intracellular mineralization, evidenced by intracellular accumulation of carbonate hydroxyapatite similar to that oberved in osteoblasts cultured in osteoinductive media. Additionally, BIE was found to enhance osteogenesis by generating a favorable osteoimmune environment. In a rat calvarial bone defect model, the osteogenic capacity of BIE was evaluated using a collagen type I-impregnated BM (Col-BM) composite. It showed that Col-BM significantly promoted new bone formation in the critical-size bone defect areas. Taken together, this is the first study that investigated the influence of the BIE on osteogenesis, osteoimmunology, and in situ bone tissue engineering. The innate osteoinductive potential of inorganic bone components, both in vitro and in vivo, not only expands the understanding of the BIE on osteogenesis but also benefits future biomaterials engineering for bone tissue regeneration.
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Affiliation(s)
- Yuqing Mu
- School of Medicine and Dentistry, Griffith University (GU), Gold Coast, QLD, 4222, Australia; The Australia-China Centre for Tissue Engineering and Regenerative Medicine (ACCTERM), Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia; School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia
| | - Zhibin Du
- The Australia-China Centre for Tissue Engineering and Regenerative Medicine (ACCTERM), Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia; School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia
| | - Wendong Gao
- School of Medicine and Dentistry, Griffith University (GU), Gold Coast, QLD, 4222, Australia; The Australia-China Centre for Tissue Engineering and Regenerative Medicine (ACCTERM), Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia; School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia
| | - Lan Xiao
- School of Medicine and Dentistry, Griffith University (GU), Gold Coast, QLD, 4222, Australia; The Australia-China Centre for Tissue Engineering and Regenerative Medicine (ACCTERM), Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia; School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia
| | - Ross Crawford
- The Australia-China Centre for Tissue Engineering and Regenerative Medicine (ACCTERM), Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia; School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia
| | - Yin Xiao
- School of Medicine and Dentistry, Griffith University (GU), Gold Coast, QLD, 4222, Australia; The Australia-China Centre for Tissue Engineering and Regenerative Medicine (ACCTERM), Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia; School of Mechanical, Medical and Process Engineering, Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia.
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Sunarso S, Suryadi A, Indrani DJ, Pangesty AI. Compressive Strength of Newly Developed Nonsintered Hydroxyapatite Blocks for Bone Graft Applications. Eur J Dent 2023. [PMID: 37995731 DOI: 10.1055/s-0043-1774327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE This study aimed to fabricate and evaluate the phase purity and compressive strength of the nonsintered hydroxyapatite (HA) block obtained via phase transformation of set calcium sulfate dihydrate (CSD) block under hydrothermal conditions at different temperatures. MATERIALS AND METHODS Nonsintered HA block was prepared by immersion CSD block (4 mm in diameter and 8 mm in height) in a 1 mol/L sodium phosphate (Na3PO4) solution under hydrothermal conditions at 100°C, 140°C, and 180°C for 48 hours. X-ray diffraction was used to determine the crystalline phase of the obtained blocks. The mechanical strength of the blocks was measured using a compressive strength test. RESULTS The result shows that the CSD block could be fully transformed into a HA block at 180°C for 48 hours without changing its macroscopic shape. The compressive strength of the obtained blocks was lower compared with the CSD block. CONCLUSION The current method has successfully produced a nonsintered HA block at 180°C for 48 hours. The compressive strength of the HA block decreased compared with the gypsum block used as a precursor. However, the compressive strength of the HA block that was produced still falls within the range of cancellous bone.
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Affiliation(s)
- Sunarso Sunarso
- Departement of Dental Materials Science, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Abdi Suryadi
- Department of Dental Materials Science, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Decky Joesiana Indrani
- Departement of Dental Materials Science, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Azizah Intan Pangesty
- Department of Metallurgical and Materials Engineering, Faculty of Engineering, Universitas Indonesia, UI Campus, Depok, West Java, Indonesia
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Al Maruf DSA, Cheng K, Xin H, Cheung VKY, Foley M, Wise IK, Lewin W, Froggatt C, Wykes J, Parthasarathi K, Leinkram D, Howes D, Suchowerska N, McKenzie DR, Gupta R, Crook JM, Clark JR. A Comparison of In Vivo Bone Tissue Generation Using Calcium Phosphate Bone Substitutes in a Novel 3D Printed Four-Chamber Periosteal Bioreactor. Bioengineering (Basel) 2023; 10:1233. [PMID: 37892963 PMCID: PMC10604717 DOI: 10.3390/bioengineering10101233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Autologous bone replacement remains the preferred treatment for segmental defects of the mandible; however, it cannot replicate complex facial geometry and causes donor site morbidity. Bone tissue engineering has the potential to overcome these limitations. Various commercially available calcium phosphate-based bone substitutes (Novabone®, BioOss®, and Zengro®) are commonly used in dentistry for small bone defects around teeth and implants. However, their role in ectopic bone formation, which can later be applied as vascularized graft in a bone defect, is yet to be explored. Here, we compare the above-mentioned bone substitutes with autologous bone with the aim of selecting one for future studies of segmental mandibular repair. Six female sheep, aged 7-8 years, were implanted with 40 mm long four-chambered polyether ether ketone (PEEK) bioreactors prepared using additive manufacturing followed by plasma immersion ion implantation (PIII) to improve hydrophilicity and bioactivity. Each bioreactor was wrapped with vascularized scapular periosteum and the chambers were filled with autologous bone graft, Novabone®, BioOss®, and Zengro®, respectively. The bioreactors were implanted within a subscapular muscle pocket for either 8 weeks (two sheep), 10 weeks (two sheep), or 12 weeks (two sheep), after which they were removed and assessed by microCT and routine histology. Moderate bone formation was observed in autologous bone grafts, while low bone formation was observed in the BioOss® and Zengro® chambers. No bone formation was observed in the Novabone® chambers. Although the BioOss® and Zengro® chambers contained relatively small amounts of bone, endochondral ossification and retained hydroxyapatite suggest their potential in new bone formation in an ectopic site if a consistent supply of progenitor cells and/or growth factors can be ensured over a longer duration.
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Affiliation(s)
- D. S. Abdullah Al Maruf
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Kai Cheng
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia;
| | - Hai Xin
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Veronica K. Y. Cheung
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; (V.K.Y.C.); (R.G.)
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Matthew Foley
- Sydney Microscopy & Microanalysis, The University of Sydney, Camperdown, NSW 2006, Australia;
| | - Innes K. Wise
- Laboratory Animal Services, The University of Sydney, Camperdown, NSW 2050, Australia;
| | - Will Lewin
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (W.L.); (D.R.M.); (J.M.C.)
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Catriona Froggatt
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
| | - James Wykes
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
| | - Krishnan Parthasarathi
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
| | - David Leinkram
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia;
| | - Dale Howes
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
| | - Natalka Suchowerska
- School of Physics, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia;
| | - David R. McKenzie
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (W.L.); (D.R.M.); (J.M.C.)
- School of Physics, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia;
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; (V.K.Y.C.); (R.G.)
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Jeremy M. Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (W.L.); (D.R.M.); (J.M.C.)
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Intelligent Polymer Research Institute, AIIM Facility, The University of Wollongong, Wollongong, NSW 2522, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Jonathan R. Clark
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia; (D.S.A.A.M.); (H.X.); (C.F.); (J.W.); (K.P.); (D.L.); (D.H.)
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia;
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de Almeida Malzoni CM, Pichotano EC, Freitas de Paula LG, de Souza RV, Okamoto R, Austin RS, Marcantonio E, de Molon RS, Zandim-Barcelos DL. Combination of leukocyte and platelet-rich fibrin and demineralized bovine bone graft enhanced bone formation and healing after maxillary sinus augmentation: a randomized clinical trial. Clin Oral Investig 2023; 27:5485-5498. [PMID: 37580431 DOI: 10.1007/s00784-023-05167-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/13/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND AND OBJECTIVE The resorption of alveolar ridge bone and maxillary sinus pneumatization are challenges to implant-supported prosthetic rehabilitation. Bone regeneration using bone substitutes and growth factors are alternatives for maxillary sinus augmentation (MSA). Therefore, we sought to evaluate the effects of the association between leukocyte and platelet-rich fibrin (L-PRF) and deproteinized bovine bone mineral (DBBM) in MSA procedures. MATERIALS AND METHODS Thirty-six maxillary sinuses from 24 individuals were included in this randomized clinical trial. The maxillary sinuses were randomly grafted with LPRF and DBBM (test group) or grafted only with DBBM (positive control). Dental implants were installed in the test group following two periods of evaluation: after 4 (DBBM+LPRF4) and 8 (DBBM+LPFR8) months of sinus graft healing, while the control group received implants only after 8 months. Cone beam computed tomography (CBCT) was taken 1 week after surgery (T1) and before implant placement (T2). Bone samples were collected during implant placement for histomorphometric and immunohistochemical (IHC) analysis. The primary implant stability was assessed by resonance frequency analysis. RESULTS CBCT analysis demonstrated a significant decrease in bone volume from T1 to T2 in all groups without differences among them. Histologically, the test group showed significantly increase in bone neoformation in both periods of evaluation (LPRF+DBBM4: 44.70±14.01%; LPRF+DBBM8: 46.56±12.25%) compared to the control group (32.34±9.49%). The control group showed the highest percentage of residual graft. IHC analysis showed increased staining intensity of osteocalcin (OCN), vascular endothelial growth factor (VEGF), and runt related transcription factor 2 (RUNX-2) in LPRF+DBBM4 group, and osteopontin (OPN) in the L-PRF+DBBM8. Primary implant stability was successfully achieved (above 60 in implant stability quotient) in all the evaluated groups. CONCLUSION Combination of L-PRF and DBBM increased and accelerated new bone formation allowing early implant placement probably due to the higher protein expression of RUNX2, VEGF, OCN, and OPN. These data suggest that the use of L-PRF might be an interesting alternative to use in combination with DBBM for augment the maxillary sinuses allowing the installation of appropriate length implants in shorter period of time. CLINICAL RELEVANCE This study showed improvement in bone neoformation and accelerated healing when associating L-PRF and DBBM for maxillary sinus augmentation procedures. TRIAL REGISTRATION This study was registered before participant recruitment in Brazilian Registry of Clinical Trials (ReBEC - RBR-95m73t).
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Affiliation(s)
- Carolina Mendonça de Almeida Malzoni
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Elton Carlos Pichotano
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Luiz Guilherme Freitas de Paula
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Ricardo Violante de Souza
- Private practice, School of Medicine of Ribeirão Preto, Sao Paulo University - USP, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, School of Dentistry at Araçatuba, São Paulo State University - UNESP, Araçatuba, SP, 16015-050, Brazil
| | - Rupert S Austin
- Tissue Engineering and Biophotonics, King's College London Dental Institute, Guy's Hospital, London, UK
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araçatuba, Sao Paulo State University - UNESP, Rua Jose Bonifacio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil.
| | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil.
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Pomini KT, Buchaim DV, Bighetti ACC, Andreo JC, Rosso MPDO, Escudero JSB, Della Coletta BB, Alcalde MP, Duarte MAH, Pitol DL, Issa JPM, Ervolino E, Moscatel MBM, Bellini MZ, de Souza AT, Soares WC, Buchaim RL. Use of Photobiomodulation Combined with Fibrin Sealant and Bone Substitute Improving the Bone Repair of Critical Defects. Polymers (Basel) 2022; 14:polym14194170. [PMID: 36236116 PMCID: PMC9572221 DOI: 10.3390/polym14194170] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
In this preclinical protocol, an adjunct method is used in an attempt to overcome the limitations of conventional therapeutic approaches applied to bone repair of large bone defects filled with scaffolds. Thus, we evaluate the effects of photobiomodulation therapy (PBMT) on the bone repair process on defects filled with demineralized bovine bone (B) and fibrin sealant (T). The groups were BC (blood clot), BT (B + T), BCP (BC + PBMT), and BTP (B + T + PBMT). Microtomographically, BC and BCP presented a hypodense cavity with hyperdense regions adjacent to the border of the wound, with a slight increase at 42 days. BT and BTP presented discrete hyperdensing areas at the border and around the B particles. Quantitatively, BCP and BTP (16.96 ± 4.38; 17.37 ± 4.38) showed higher mean bone density volume in relation to BC and BT (14.42 ± 3.66; 13.44 ± 3.88). Histologically, BC and BCP presented deposition of immature bone at the periphery and at 42 days new bone tissue became lamellar with organized total collagen fibers. BT and BTP showed inflammatory infiltrate along the particles, but at 42 days, it was resolved, mainly in BTP. In the birefringence analysis, BT and BTP, the percentage of red birefringence increased (9.14% to 20.98% and 7.21% to 27.57%, respectively), but green birefringence was similar in relation to 14 days (3.3% to 3.5% and 3.5% to 4.2%, respectively). The number of osteocytes in the neoformed bone matrix proportionally reduced in all evaluated groups. Immunostaining of bone morphogenetic protein (BMP—2/4), osteocalcin (OCN), and vascular endothelial growth factor (VEGF) were higher in BCP and BTP when compared to the BC and BT groups (p < 0.05). An increased number of TRAP positive cells (tartrate resistant acid phosphatase) was observed in BT and BTP. We conclude that PBMT positively influenced the repair of bone defects filled with B and T.
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Affiliation(s)
- Karina Torres Pomini
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Postgraduate Department, University of Marilia (UNIMAR), Marilia 17525-902, Brazil
| | - Daniela Vieira Buchaim
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Postgraduate Department, University of Marilia (UNIMAR), Marilia 17525-902, Brazil
- Teaching and Research Coordination of the Medical School, University Center of Adamantina (UNIFAI), Adamantina 17800-000, Brazil
| | - Ana Carolina Cestari Bighetti
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
| | - Jesus Carlos Andreo
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
| | | | - José Stalin Bayas Escudero
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
| | - Bruna Botteon Della Coletta
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
| | - Murilo Priori Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (FOB/USP), Bauru 17012-901, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (FOB/USP), Bauru 17012-901, Brazil
| | - Dimitrius Leonardo Pitol
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Ribeirão Preto 14040-904, Brazil
| | - João Paulo Mardegan Issa
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Ribeirão Preto 14040-904, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16066-840, Brazil
| | | | - Márcia Zilioli Bellini
- Pro-Rectory of Research and Graduate Studies, University Center of Adamantina (UNIFAI), Adamantina 17800-000, Brazil
| | | | - Wendel Cleber Soares
- Vice-Rector/President, University Center of Adamantina (UNIFAI), Adamantina 17800-000, Brazil
| | - Rogerio Leone Buchaim
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of São Paulo (FMVZ/USP), São Paulo 05508-270, Brazil
- Correspondence: ; Tel.: +55-14-3235-8220
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8
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Reich KM, Beck F, Heimel P, Lettner S, Redl H, Ulm C, Tangl S. Bone Graft Packing and Its Association with Bone Regeneration in Maxillary Sinus Floor Augmentations: Histomorphometric Analysis of Human Biopsies. BIOLOGY 2022; 11:biology11101431. [PMID: 36290335 PMCID: PMC9598793 DOI: 10.3390/biology11101431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022]
Abstract
Research in maxillary sinus floor augmentation (MSFA) focussed on the optimisation of microstructural parameters such as microporosity and particle size of bone substitute particles (BS). However, little is known about the impact of BS packing and the corresponding (void) interparticular space on bone regeneration. The aim of this study was to characterise the spatial distribution of BS and its association with BS integration 6 ± 1 months after MSFA. Histological thin-ground sections of 70 human sinus biopsies were histomorphometrically analysed: In serial zones of 100 µm proceeding from the sinus floor (SF) up to the apical end of the biopsy, we measured the distribution of BS particles within these zones in terms of volume (BSV/TV), number and size of BS particles, interparticle spacing (BS.Sp) and bone-to-BS contact. BS particles were not homogeneously distributed over the length of biopsies: The first 200 µm directly adjacent to the SF represented a zone poor in BS particles but with high osteogenic potential. Graft packing density increased from the SF towards the apical part of the AA. Integration of BS particles was inversely associated with the distance to the SF and the graft packing density. A high packing density through excessive compaction of BS particles should be avoided to optimise the macrostructural environment for bone regeneration.
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Affiliation(s)
- Karoline Maria Reich
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Correspondence:
| | - Florian Beck
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | - Stefan Lettner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
| | - Heinz Redl
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | - Christian Ulm
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
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9
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Evaluation of a New Porcine Bone Graft on the Repair of Surgically Created Critical Bone Defects in Rat Calvaria: Histomorphometric and Microtomographic Study. J Funct Biomater 2022; 13:jfb13030124. [PMID: 36135558 PMCID: PMC9504591 DOI: 10.3390/jfb13030124] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/08/2022] [Accepted: 08/19/2022] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the use of a new porcine bone graft in rat calvaria bone defects. Critical defects were surgically created in 24 rats that were divided into four experimental groups according to defect filling (n = 6): Control Group (CG)—blood clot; Porcine Bone Group (PG)—porcine-derived bone substitute; (BG): Bio-Oss Group (BG)−chemically and heat-treated bovine graft; Bonefill Group (BFG)—chemically treated bovine bone substitute. Euthanasia of the animals occurred 30 days after the surgery, and the area of the original surgical defect and the surrounding tissues were removed for micro-CT and histomorphometric analysis. In the micro-CT evaluation, the PG presented statistically significant differences (p < 0.05) in comparison to the CG, BG and BFG, for the parameters percentage of Bone Volume (BV/TV), Surface Bone Density (BS/TV), Number of Trabeculae (Tb.N) and Bone Connectivity (Conn), but not for Total Porosity (Po.tot) and Trabecular Thickness (Tb.Th). The histomorphometric analysis showed that the PG presented similar results to the BG regarding newly formed bone extension and to the BG and BFG regarding newly formed bone area. The porcine-derived graft presented superior microtomographic and histomorphometric results when compared to the two bovine bone substitutes.
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10
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Coyac BR, Wolf BJ, Bahat DJ, Arioka M, Brunski JB, Helms JA. A WNT protein therapeutic accelerates consolidation of a bone graft substitute in a pre-clinical sinus augmentation model. J Clin Periodontol 2022; 49:782-798. [PMID: 35713219 DOI: 10.1111/jcpe.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/28/2022] [Accepted: 05/28/2022] [Indexed: 11/30/2022]
Abstract
AIM Autologous bone grafts consolidate faster than bone graft substitutes (BGSs) but resorb over time, which compromises implant support. We hypothesized that differences in consolidation rates affected the mechanical properties of grafts and implant stability, and tested whether a pro-osteogenic protein, liposomal WNT3A (L-WNT3A), could accelerate graft consolidation. MATERIALS AND METHODS A transgenic mouse model of sinus augmentation with immunohistochemistry, enzymatic assays, and histology were used to quantitatively evaluate the osteogenic properties of autografts and BGSs. Composite and finite element modelling compared changes in the mechanical properties of grafts during healing until consolidation, and secondary implant stability following remodelling activities. BGSs were combined with L-WNT3A and tested for its osteogenic potential. RESULTS Compared with autografts, BGSs were bioinert and lacked osteoprogenitor cells. While in autografted sinuses, new bone arose evenly from all living autograft particles, new bone around BGSs solely initiated at the sinus floor, from the internal maxillary periosteum. WNT treatment of BGSs resulted in significantly higher expression levels of pro-osteogenic proteins (Osterix, Collagen I, alkaline phosphatase) and lower levels of bone-resorbing activity (tartrate-resistant acid phosphatase activity); together, these features culminated in faster new bone formation, comparable to that of an autograft. CONCLUSIONS WNT-treated BGSs supported faster consolidation, and because BGSs typically resist resorption, their use may be superior to autografts for sinus augmentation.
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Affiliation(s)
- Benjamin R Coyac
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA.,Department of Periodontology and Implant Dentistry, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Benjamin J Wolf
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - Daniel J Bahat
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - Masaki Arioka
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - John B Brunski
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
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11
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Suehiro F, Komabashiri N, Masuzaki T, Ishii M, Yanagisawa T, Nishimura M. Efficacy of bone grafting materials in preserving the alveolar ridge in a canine model. Dent Mater J 2021; 41:302-308. [PMID: 34980766 DOI: 10.4012/dmj.2021-173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Preservation of the alveolar ridge after tooth extraction is an essential component for ideal implant positioning. Furthermore, preservation of bone around the implant after implant placement is an essential component for implant treatment. We aimed to evaluate the efficacy of bone grafting materials in preserving the alveolar ridge after implant placement. Implants were placed in regenerated bone without grafting material or with beta-tricalcium phosphate, bovine bone substitute, or carbonate apatite transplantation. In all groups, the bone healed and the implants were successfully placed within the bone. No significant differences in insertion torque and implant stability quotient values were found. The amount of bone around the implant 5 weeks after implant placement was significantly reduced in the bovine bone substitute group; however, implants placed in regenerated bone achieved sufficient initial fixation and osseointegration.
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Affiliation(s)
- Fumio Suehiro
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Naohiro Komabashiri
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Tomohiro Masuzaki
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Masakazu Ishii
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Takahiro Yanagisawa
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Masahiro Nishimura
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University
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12
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Raymond Y, Pastorino D, Ginebreda I, Maazouz Y, Ortiz M, Manzanares MC, Ginebra MP. Computed tomography and histological evaluation of xenogenic and biomimetic bone grafts in three-wall alveolar defects in minipigs. Clin Oral Investig 2021; 25:6695-6706. [PMID: 33931811 DOI: 10.1007/s00784-021-03956-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to compare the performance of a xenograft (XG) and a biomimetic synthetic graft (SG) in three-wall alveolar defects in minipigs by means of 3D computerised tomography and histology. MATERIALS AND METHODS Eight minipigs were used. A total of eight defects were created in the jaw of each animal, three of which were grafted with XGs, three with SGs, and two were left empty as a negative control. The allocation of the different grafts was randomised. Four animals were euthanised at 6 weeks and four at 12 weeks. The grafted volume was then measured by spiral computed tomography to assess volume preservation. Additionally, a histological analysis was performed in undecalcified samples by backscattered scanning electron microscopy and optical microscopy after Masson's trichrome staining. RESULTS A linear mixed-effects model was applied considering four fixed factors (bone graft type, regeneration time, anatomic position, and maxilla/mandible) and one random factor (animal). The SG exhibited significantly larger grafted volume (19%) than the XG. The anterior sites preserved better the grafted volume than the posterior ones. Finally, regeneration time had a positive effect on the grafted volume. Histological observations revealed excellent osseointegration and osteoconductive properties for both biomaterials. Some concavities found in the spheroidal morphologies of SGs were associated with osteoclastic resorption. CONCLUSIONS Both biomaterials met the requirements for bone grafting, i.e. biocompatibility, osseointegration, and osteoconduction. Granule morphology was identified as an important factor to ensure a good volume preservation. CLINICAL RELEVANCE Whereas both biomaterials showed excellent osteoconduction, SGs resulted in better volume preservation.
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Affiliation(s)
- Yago Raymond
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3F, 08025, Barcelona, Spain
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Av. Eduard Maristany, 10-14, 08019, Barcelona, Spain
| | - David Pastorino
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3F, 08025, Barcelona, Spain
| | - Ignacio Ginebreda
- Department of Restorative and Esthetic Dentistry, Universitat Internacional de Catalunya, Carrer de Josep Trueta, 08195 Sant Cugat del Vallès, Barcelona, Spain
| | - Yassine Maazouz
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3F, 08025, Barcelona, Spain
| | - Mònica Ortiz
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Av. Eduard Maristany, 10-14, 08019, Barcelona, Spain
| | - Maria-Cristina Manzanares
- Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, Universitat de Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Maria-Pau Ginebra
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3F, 08025, Barcelona, Spain.
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Av. Eduard Maristany, 10-14, 08019, Barcelona, Spain.
- Institute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology, C/ Baldiri Reixac 10-12, 08028, Barcelona, Spain.
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13
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Chen YW, Hsieh DJ, Periasamy S, Yen KC, Wang HC, Chien HH. Development of a decellularized porcine bone graft by supercritical carbon dioxide extraction technology for bone regeneration. J Tissue Eng Regen Med 2021; 15:401-414. [PMID: 33625772 DOI: 10.1002/term.3181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/04/2021] [Accepted: 02/14/2021] [Indexed: 11/09/2022]
Abstract
A series of novel decellularized porcine collagen bone graft (DPB) materials in a variety of shapes and sizes were developed by the supercritical carbon dioxide (SCCO2 ) extraction technique. The complete decellularization of DPB was confirmed by hematoxylin and eosin staining, 4,6-diamidino-2-phenylindole (DAPI) staining, and residual DNA analysis. The native intact collagen remained in the DPB after the SCCO2 process was confirmed by Masson trichrome staining. The physicochemical characteristics of DPB were investigated by scanning electron microscopy and x-ray diffraction. The cytotoxicity and biocompatibility tests according to ISO10993 and its efficacy for bone regeneration in osteochondral defects in rabbits were evaluated. The rabbit pyrogen test confirmed DPB was non-toxic. In vitro and in vivo biocompatibility tests of the DPB did not show any toxic or mutagenic effects. The bone regeneration potential of the DPB presented no significant histological differences compared to commercially available deproteinized bovine bone. In conclusion, DPB produced by SCCO2 exhibited similar chemical characteristics to human bone, no toxicity, good biocompatibility, and enhanced bone regeneration in rabbits comparable to that of deproteinized bovine bone. Results from this study could shed light on the potential application of the SCCO2 extraction technique to generate a native decellularized scaffold for bone tissue regeneration in human clinical trials.
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Affiliation(s)
- Yuan-Wu Chen
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei City, Taiwan.,School of Dentistry, National Defense Medical Center, Taipei City, Taiwan
| | - Dar-Jen Hsieh
- R&D Center, ACRO Biomedical Co., Ltd., Kaohsiung City, Taiwan
| | | | - Ko-Chung Yen
- R&D Center, ACRO Biomedical Co., Ltd., Kaohsiung City, Taiwan
| | - Hung-Chou Wang
- R&D Center, ACRO Biomedical Co., Ltd., Kaohsiung City, Taiwan
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, Ohio State University, Columbus, Ohio, USA
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14
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Narukawa M, Suzuki O, Mayahara M, Imamura E, Takagi Y, Funae T, Makino Y, Ohki R, Nakamura M. Resorption analysis of deproteinized cancellous bovine bone. Dent Mater J 2020; 39:760-765. [PMID: 32404567 DOI: 10.4012/dmj.2019-240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Commercially available deproteinized cancellous bovine bone (DPBB) has been indicated as non-absorbable bone filling materials. Stoichiometric hydroxyapatite (HA) was not resorbed by osteoclasts while calcium-deficient and carbonate-rich apatite converted from octacalcium (OCP hydrolysate) was resorbed by osteoclasts. We analyzed the chemical composition of DPBB and compared the tissue reactions around two materials after implanting into mouse bone marrow. X-ray diffraction analysis and Fourier transform infrared spectroscopy showed that DPBB was a carbonate-rich apatite. Micro-CT analysis indicated the massive bone formation on both materials at 2 weeks, then gradually resorbed. At 12 weeks, osteoclasts were directly attached to both materials. The ultrastructure of ruffled borders on DPBB was identical to osteoclasts resorbing normal bone while ruffled border on OCP hydrolysate showed irregular shape. These results indicated that DPBB was the absorbed material and that the structure of ruffled border of osteoclasts might be regulated by the size or orientation of HA.
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Affiliation(s)
- Masayuki Narukawa
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry
| | - Osamu Suzuki
- Division of Craniofacial Function Engineering, Tohoku University Graduate School of Dentistry
| | - Mitsuori Mayahara
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry
| | - Eisaku Imamura
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry.,Division of Oral Surgery, Yokohama General Hospital
| | - Yoshitoki Takagi
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry
| | - Takashi Funae
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry
| | - Yuusuke Makino
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry
| | - Retsu Ohki
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry
| | - Masanori Nakamura
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry
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15
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Aludden H, Mordenfeld A, Dahlin C, Hallman M, Starch‐Jensen T. Histological and histomorphometrical outcome after lateral guided bone regeneration augmentation of the mandible with different ratios of deproteinized bovine bone mineral and autogenous bone. A preclinical in vivo study. Clin Oral Implants Res 2020; 31:1025-1036. [DOI: 10.1111/clr.13649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 07/19/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Hanna Aludden
- Department of Oral and Maxillofacial Surgery Aalborg University Hospital Aalborg Denmark
| | - Arne Mordenfeld
- Plastic and Oral & Maxillofacial Surgery Department of Surgical Sciences Uppsala University Uppsala Sweden
| | - Christer Dahlin
- Department of Biomaterials BIOMATCELL VINN Excellence center Institute for Surgical Science The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Oral and Maxillofacial Surgery NU‐Hospital Organization Trollhättan Trollhättan Sweden
| | - Mats Hallman
- Department of Oral and Maxillofacial Surgery Gävle County Hospital Gävle Sweden
| | - Thomas Starch‐Jensen
- Department of Oral and Maxillofacial Surgery Aalborg University Hospital Aalborg Denmark
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16
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Pignaton TB, Spin-Neto R, Ferreira CEDA, Martinelli CB, de Oliveira GJPL, Marcantonio E. Remodelling of sinus bone grafts according to the distance from the native bone: A histomorphometric analysis. Clin Oral Implants Res 2020; 31:959-967. [PMID: 32716570 DOI: 10.1111/clr.13639] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate graft remodelling according to the distance from the native bone in maxillary sinuses grafted with anorganic bovine bone (ABB). MATERIAL AND METHODS Bilateral sinus grafting was performed in twenty patients with residual bone height <5 mm before implant placement. After 8 months, biopsy samples were harvested, and histomorphometric analysis was performed to examine bone formation according to the distance (in mm) from the native bone (sinus floor). In the grafted area, the percentages of new bone (NB), residual graft material (rABB), and soft tissue (ST) were evaluated. RESULTS A total of 103 biopsy samples were evaluated, and the percentages of NB, rABB, and ST were 31.62 ± 9.85%, 18.94 ± 7.88%, and 49.41 ± 9.52%, respectively, in the 1st mm; 27.15 ± 9.83%, 23.33 ± 9.45%, and 49.53 ± 11.73%, respectively, in the 2nd mm; 23.61 ± 13.02%, 21.35 ± 11.08%, and 55.03 ± 16.14%, respectively, in the 3rd mm; and 21.67 ± 12.29%, 19.67 ± 10.28%, and 58.66 ± 12.46%, respectively, in the 4th mm. The 1st millimetre of the grafted area (closer to the native bone) presented a larger amount of NB than the other portions of the grafted areas and a smaller amount of rABB than the 2nd mm of the grafted area (p < .05). The amount of ST was larger in the 3rd and 4th mm of the grafted area than in the first 2 millimetres (p < .05). CONCLUSION The distance from the native bone influences bone formation following maxillary sinus augmentation.
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Affiliation(s)
- Tulio Bonna Pignaton
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP, Araraquara, Brazil
| | - Rubens Spin-Neto
- Section of Oral Radiology, School of Dentistry,, Aarhus University, Aarhus, Denmark
| | | | | | | | - Elcio Marcantonio
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP, Araraquara, Brazil
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17
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Trybek G, Jedliński M, Jaroń A, Preuss O, Mazur M, Grzywacz A. Impact of lactoferrin on bone regenerative processes and its possible implementation in oral surgery - a systematic review of novel studies with metanalysis and metaregression. BMC Oral Health 2020; 20:232. [PMID: 32843024 PMCID: PMC7448436 DOI: 10.1186/s12903-020-01211-6] [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: 02/01/2020] [Accepted: 08/09/2020] [Indexed: 12/17/2022] Open
Abstract
Background Lactoferrin is an iron – binding glycoprotein with anti-inflammatory and anabolic properties found in many internal fluids. It is worth looking at novel studies, because of their methodology and observations that may once be applicable in modern implantology. The aim of the study is to answer the question if lactoferrin is a promising factor for bone regenerative process in oral surgery. Method An electronic search was conducted on 14th October 2019 on the PubMed, Scopus and Web of Science databases. The keywords used in the search strategy were: lactoferrin AND bone regeneration AND oral surgery. The qualitative evaluation was conducted using the Jadad and Newcastle-Ottawa Quality Assessment Form. Then a metanalysis of a new bone growth and percentage of the resorbed graft were performed with the metaregression of lactoferrin dose to its outcome effects on bone regeneration. Results The search strategy identified potential articles: 133 from PubMed, 2 from Scopus, 4 from Web of science. After removal of duplicates, 136 articles were analyzed. Subsequently, 131 papers were excluded because they did not meet the inclusion criteria. The remaining 5 papers were included in the qualitative synthesis. The use of lactoferrin clearly increases the growth of a newly formed bone (2.58, CI:[0.79, 4.37]), as well as shortens the time of the graft resorption (− 1.70, Cl:[3.43, 0.03]) and replaces it with a species-specific bone. Heterogeneity is significant at p < 0.001 level. Metaregression indicates that one unit increase in the log (Treatment dose), i.e. a 2.78 times increase of the Treatment dose, results in an increase of the Effect size by 0.682. Conclusions The use of lactoferrin both systemically and locally promotes anabolic processes (new bone formation). There is a relationship between the increase in administered dose of lactoferrin and the intensity of new bone formation. However, it is not only necessary to continue experimental research, but also to extend it to the clinical studies on patients, due to the limitations of different animal model research and different methodology, to introduce lactoferrin as a standard procedure for the treatment of bone defects, because it is a promising product.
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Affiliation(s)
- Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72/18, 70-111, Szczecin, Poland
| | - Maciej Jedliński
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161, Rome, Italy.,Student Scientific Society at the Department of Oral Surgery, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72/18, 70-111, Szczecin, Poland
| | - Aleksandra Jaroń
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72/18, 70-111, Szczecin, Poland.
| | - Olga Preuss
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72/18, 70-111, Szczecin, Poland
| | - Marta Mazur
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161, Rome, Italy
| | - Anna Grzywacz
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, ul. Gen. Dezyderego Chłapowskiego 11, 70-103, Szczecin, Poland
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Lu DZ, Zhang YB, Dong W, Bi WJ, Feng XJ, Wen LM, Sun H, Chen H, Zang LY, Qi MC. Effectiveness of strontium-doped brushite, bovine-derived hydroxyapatite and synthetic hydroxyapatite in rabbit sinus augmentation with simultaneous implant installation. J Biomed Mater Res B Appl Biomater 2020; 108:3402-3412. [PMID: 32618100 DOI: 10.1002/jbm.b.34675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 11/09/2022]
Abstract
Various bone substitutes have been applied in sinus augmentation (SA) to overcome insufficient bone height at the posterior maxilla region caused by pneumatized sinus and severe alveolar bone resorption after teeth loss. However, their effectiveness in SA needs to be further elucidated. In this study, strontium-doped brushite (Sr-DCPD), a new bone substitute, together with bovine-derived hydroxyapatite (bHA) and synthetic hydroxyapatite (sHA) was used in rabbit maxillary SA with simultaneous implant installation. The sinus space-keeping capacity, resorption rate, osteoconductivity, and mechanical properties of regenerated bone, were evaluated by micro-computed tomography (CT), histological analysis, and mechanical testing. Sr-DCPD exhibited the best osteoconductivity and new bone formation (<4 weeks), but its final bone regeneration and removal torque of implants at week 12 were the lowest, mainly due to its poor space-keeping capacity and fast resorption. bHA exhibited the best space-keeping capacity and slowest resorption rate, but relative lower final bone volume and mechanical properties, while sHA showed good space-keeping capacity, slower resorption rate, and the best final bone formation and mechanical properties. sHA was most effective for SA and bHA was also an acceptable bone substitute; however, Sr-DCPD was least effective and not suitable in SA by itself.
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Affiliation(s)
- Da-Zhuang Lu
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, Hebei Province, China
| | - Yan-Bo Zhang
- Department of stomatology, Affiliated hospital of Chengde Medical College, Chengde City, Hebei Province, China
| | - Wei Dong
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, Hebei Province, China
| | - Wen-Juan Bi
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, Hebei Province, China
| | - Xiao-Jie Feng
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, Hebei Province, China
| | - Li-Ming Wen
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, Hebei Province, China
| | - Hong Sun
- Department of pathology, college of basic medicine, North China University of Science and Technology, Tangshan City, Hebei Province, China
| | - Hui Chen
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, Hebei Province, China
| | - Lu-Yang Zang
- Department of Endocrinology (Section 1), Tangshan Gongren Hospital, Tangshan City, Hebei Province, China
| | - Meng-Chun Qi
- Department of Oral & Maxillofacial Surgery, College of stomatology, North China University of Science and Technology, Tangshan City, Hebei Province, China
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Yaghobee S, Panjnoush M, Chokami Rafiei S, Amini Shakib P, Mahmoodi S, Rasouli-Ghahroudi AAR, Poursafar F. Effect of Simvastatin on Bone Regeneration: A Histologic and Histomorphometric Analysis. J Oral Maxillofac Surg 2020; 78:927-934. [PMID: 32084353 DOI: 10.1016/j.joms.2020.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE The purpose of the present study was to evaluate the efficacy of simvastatin administration as an osteoinductive agent combined with bovine bone material (BBM) for augmentation of human maxillary sinuses. MATERIALS AND METHODS In the present randomized clinical trial with a split-mouth design, 24 maxillary sinuses in 12 patients were augmented using BBM alone or BBM combined with simvastatin. Biopsy samples were taken 9 months after maxillary sinus floor augmentation for histologic and histomorphometric analyses. A total of 44 implants were placed in the augmented bone. RESULTS The results of the microscopic assessment of most samples revealed no inflammation or only mild chronic inflammation. Lamellation was detectable in old bone trabeculae under polarized light microscopy but was not observed in newly formed bone. Osteocytes were found with a lower frequency in the lacunae of newly formed bone compared with normal bone. No significant differences were found in the amount of newly formed bone and the amount of residual particles between the 2 groups. CONCLUSIONS Despite the greater mean percentage of newly formed bone in the test group, the histomorphometric analysis results did not show a significant positive effect for the use of simvastatin in maxillary sinus augmentation.
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Affiliation(s)
- Siamak Yaghobee
- Associate Professor, Department of Periodontology, Dental Implant Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Panjnoush
- Associate Professor, Department of Oral and Maxillofacial Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Chokami Rafiei
- Assistant Professor, Department of Periodontology, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Pouyan Amini Shakib
- Assistant Professor, Department of Oral Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Mahmoodi
- PhD in Pharmaceutics, Private Practitioner, Tehran, Iran
| | - Amir Ali Reza Rasouli-Ghahroudi
- Associate Professor, Department of Periodontology, Dental Implant Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Poursafar
- Resident, Department of Periodontology, Tehran University of Medical Sciences, Tehran, Iran.
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20
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Nakagawa T, Kudoh K, Fukuda N, Kasugai S, Tachikawa N, Koyano K, Matsushita Y, Sasaki M, Ishikawa K, Miyamoto Y. Application of low-crystalline carbonate apatite granules in 2-stage sinus floor augmentation: a prospective clinical trial and histomorphometric evaluation. J Periodontal Implant Sci 2019; 49:382-396. [PMID: 31886030 PMCID: PMC6920036 DOI: 10.5051/jpis.2019.49.6.382] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/22/2019] [Accepted: 08/28/2019] [Indexed: 11/08/2022] Open
Abstract
Purpose The purpose of this study was to elucidate the efficacy and safety of carbonate apatite (CO3Ap) granules in 2-stage sinus floor augmentation through the radiographic and histomorphometric assessment of bone biopsy specimens. Methods Two-stage sinus floor augmentation was performed on 13 patients with a total of 17 implants. Radiographic assessment using panoramic radiographs was performed immediately after augmentation and was also performed 2 additional times, at 7±2 months and 18±2 months post-augmentation, respectively. Bone biopsy specimens taken from planned implant placement sites underwent micro-computed tomography, after which histological sections were prepared. Results Postoperative healing of the sinus floor augmentation was uneventful in all cases. The mean preoperative residual bone height was 3.5±1.3 mm, and this was increased to 13.3±1.7 mm by augmentation with the CO3Ap granules. The mean height of the augmented site had decreased to 10.7±1.9 mm by 7±2 months after augmentation; however, implants with lengths in the range of 6.5 to 11.5 mm could still be placed. The mean height of the augmented site had decreased to 9.6±1.4 mm by 18±2 months post-augmentation. No implant failure or complications were observed. Few inflammatory cells or foreign body giant cells were observed in the bone biopsy specimens. Although there were individual differences in the amount of new bone detected, new bone was observed to be in direct contact with the CO3Ap granules in all cases, without an intermediate layer of fibrous tissue. The amounts of bone and residual CO3Ap were 33.8%±15.1% and 15.3%±11.9%, respectively. Conclusions In this first demonstration, low-crystalline CO3Ap granules showed excellent biocompatibility, and bone biopsy showed them to be replaced with bone in humans. CO3Ap granules are a useful and safe bone substitute for two-stage sinus floor augmentation.
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Affiliation(s)
- Takayuki Nakagawa
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Keiko Kudoh
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Naoyuki Fukuda
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shohei Kasugai
- Dental Implant Clinic, Dental Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Tachikawa
- Dental Implant Clinic, Dental Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiyoshi Koyano
- Regenerative Dentistry and Implant Center, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - Yasuyuki Matsushita
- Regenerative Dentistry and Implant Center, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - Masanori Sasaki
- Regenerative Dentistry and Implant Center, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - Kunio Ishikawa
- Department of Biomaterials, Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | - Youji Miyamoto
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Histological Evaluation of a New Beta-Tricalcium Phosphate/Hydroxyapatite/Poly (1-Lactide-Co-Caprolactone) Composite Biomaterial in the Inflammatory Process and Repair of Critical Bone Defects. Symmetry (Basel) 2019. [DOI: 10.3390/sym11111356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: The use of biomaterials is commonplace in dentistry for bone regeneration. The aim of this study was to evaluate the performance of a new alloplastic material for bone repair in critical defects and to evaluate the extent of the inflammatory process. Methods: Forty-five New Zealand rabbits were divided into five groups according to evaluation time (7, 14, 30, 60, 120 days), totaling 180 sites with six-millimeter diameter defects in their tibiae. The defects were filled with alloplastic material consisting of poly (lactide-co-caprolactone), beta-tricalcium phosphate, hydroxyapatite and nano-hydroxyapatite (BTPHP) in three different presentations: paste, block, and membrane. Comparisons were established with reference materials, such as Bio-ossTM, Bio-oss CollagenTM, and Bio-gideTM, respectively. The samples were HE-stained and evaluated for inflammatory infiltrate (scored for intensity from 0 to 3) and the presence of newly formed bone at the periphery of the defects. Results: Greater bone formation was observed for the alloplastic material and equivalent inflammatory intensity for both materials, regardless of evaluation time. At 30 days, part of the synthetic biomaterial, regardless of the presentation, was resorbed. Conclusions: We concluded that this novel alloplastic material showed osteoconductive potential, biocompatibility, low inflammatory response, and gradual resorption, thus an alternative strategy for guided bone regeneration.
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23
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Hung CC, Fu E, Chiu HC, Liang HC. Bone formation following sinus grafting with an alloplastic biphasic calcium phosphate in Lanyu Taiwanese mini-pigs. J Periodontol 2019; 91:93-101. [PMID: 31350789 DOI: 10.1002/jper.17-0748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 06/03/2019] [Accepted: 06/11/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND To evaluate the new bone formation after grafting with a synthetic biphasic calcium phosphate in sinuses with minimal bone height, the alloplastic and xenograft materials were compared after grafting into Lanyu Taiwanese mini-pig sinuses via split-mouth design. METHODS In six mini-pigs, synthetic hydroxyapatite/tricalcium phosphate (HA/TCP) particles were inserted into one of the sinus cavities using the extra-oral approach, where deproteinized bovine bone mineral (DBBM) particles were placed contralaterally. Fluorescent bony labels of Alizarin and Calcein green were delivered at weeks 4 and 8, respectively. Animals were sacrificed at week 12 and the augmented tissues were evaluated by cone-beam computed tomography, microcomputed tomography, and histology. RESULTS By radiographic examination, the mean thicknesses of sinus cortexes for DBBM and HA/TCP groups were similar (0.35 versus 0.38 cm) and the mean volumes augmented were also indifferent (1.29 versus 1.64 cm3 ). The distributions of bones, residual particles, and non-mineralized tissues in augmented masses between groups were undistinguishable. Under microscopy, however, macroporosities of osteons were filled with HA/TCP residual particles, whereas the newly formed bones lay on top of DBBM particle surfaces. Although the mineral deposition rates between groups were indifferent, the mean labeled surface in the HA/TCP group was significantly greater than those in the DBBM group at week 4 (35.16% versus 14.00% for HA/TCP and DBBM, respectively) but less than that at week 8 (19.33% versus 39.16%, respectively). CONCLUSION Sinus augmentation with synthetic HA/TCP and DBBM exhibited similar effectiveness in new bone formation.
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Affiliation(s)
- Chao-Chien Hung
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan
| | - Earl Fu
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan.,Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Hsien-Chung Chiu
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan
| | - Huang-Chien Liang
- Department of Materials Engineering, Ming Chi University of Technology, New Taipei City, Taiwan
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24
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Pichotano EC, de Molon RS, de Souza RV, Austin RS, Marcantonio E, Zandim-Barcelos DL. Evaluation of L-PRF combined with deproteinized bovine bone mineral for early implant placement after maxillary sinus augmentation: A randomized clinical trial. Clin Implant Dent Relat Res 2019; 21:253-262. [PMID: 30690860 DOI: 10.1111/cid.12713] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 11/14/2018] [Accepted: 12/10/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To investigate the effectiveness of adding leukocyte and platelet-rich fibrin (L-PRF) to deproteinized bovine bone mineral (DBBM) for early implant placement after maxillary sinus augmentation. MATERIALS AND METHODS Twelve patients requiring two-stage bilateral maxillary sinus augmentation were enrolled to the study. The elevated sinus cavities were randomly grafted with DBBM + L-PRF (test) or DBBM alone (control) in a split-mouth design. Implants were placed in the augmented sites after 4 months in the test group and 8 months in the control group. Bone biopsies were collected during implant placement for histomorphometric evaluation. Resonance frequency analysis was performed immediately after implant placement and at implant loading in both groups. Cone-beam computed tomography was obtained preoperatively and postoperatively for evaluation of graft volume changes. RESULTS Both procedures were effective for maxillary sinus augmentation. Cone-beam computed tomography analysis did not reveal differences in graft volume between test and control group at any of the evaluated time points (P > .05). Histological evaluation demonstrated increased percentage of newly formed bone for the test group (44.58% ± 13.9%) compared to the control group (30.02% ± 8.42%; P = .0087). The amount of residual graft in the control group was significantly higher (13.75% ± 9.99%) than in the test group (3.59 ± 4.22; P = .0111). Implant stability quotient (ISQ) immediately after implant placement was significantly higher in the control group (75.13 ± 5.69) compared to the test group (60.9 ± 9.35; P = .0003). The ISQ values at loading did not differ between the groups (P = .8587). Implant survival rate was 100% for both groups. CONCLUSION The addition of L-PRF to the DBBM into the maxillary sinus allowed early implant placement (4 months) with increased new bone formation than DBBM alone after 8 months of healing.
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Affiliation(s)
- Elton Carlos Pichotano
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | | | - Rupert S Austin
- Tissue Engineering and Biophotonics, King's College London Dental Institute, Guy's Hospital, London, United Kingdom
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
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25
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Crestal Sinus Augmentation in the Presence of Severe Sinus Mucosal Thickening: A Report of 3 Cases. IMPLANT DENT 2018; 27:388-393. [PMID: 29570115 DOI: 10.1097/id.0000000000000754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE In the presence of severe sinus mucosal thickening, the ostium can be blocked when the sinus membrane is lifted, causing drainage disturbances and sinusitis. Here, we present 3 cases in which maxillary sinus floor elevation was performed using a crestal approach in the presence of severe sinus mucosal thickening (>10 mm). MATERIALS AND METHODS The effects of maxillary sinus floor elevation using the crestal approach technique on sinus mucosal thickening and bone formation in the sinus were evaluated using cone beam computed tomography. RESULTS None of the patients exhibited an increase in sinus membrane thickness. No complications were encountered during the follow-up periods, and bone formation was observed around the implants at the sinus floor. All implants were functioning successfully. CONCLUSIONS Maxillary sinus floor elevation using the crestal approach technique in the presence of severe sinus mucosal thickening allows for minimally invasive sinus grafting and simultaneous implant placement and does not increase sinus membrane thickness.
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26
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de Molon RS, Magalhaes-Tunes FS, Semedo CV, Furlan RG, de Souza LGL, de Souza Faloni AP, Marcantonio E, Faeda RS. A randomized clinical trial evaluating maxillary sinus augmentation with different particle sizes of demineralized bovine bone mineral: histological and immunohistochemical analysis. Int J Oral Maxillofac Surg 2018; 48:810-823. [PMID: 30442550 DOI: 10.1016/j.ijom.2018.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/19/2018] [Accepted: 09/10/2018] [Indexed: 02/02/2023]
Abstract
This study was performed to investigate sinus floor augmentation with two different particle sizes of demineralized bovine bone mineral (DBBM) by means of histological and immunohistochemical (IHC) analysis. A randomized clinical trial was conducted involving 10 individuals requiring two-stage bilateral maxillary sinus augmentation for implant installation. The patients were randomly divided into two groups following a split-mouth design: the maxillary sinus on one side was filled with small-sized particles (0.25-1mm) and on the contralateral side with large-sized particles (1-2mm). After a healing period of 8 months, 25 implants were placed. During implant site preparation, bone biopsies were obtained from each sinus, perpendicular to the long axis of the implant (buccal-palatal direction), for descriptive and histomorphometric analyses. IHC staining for protein expression of osteocalcin (OCN), vascular endothelial growth factor (VEGF), and tartrate-resistant acid phosphatase (TRAP) was also performed. Histomorphometric analysis revealed no statistically significant difference in the percentage of biomaterial (32.4±8.56% and 38.0±6.92%), newly formed bone (36.1±9.60% and 36.7±5.79%), or connective tissue (30.4±8.63% and 23.8±6.16%) between the small- and large-sized particle groups, respectively. IHC analysis did not reveal differences in the expression of OCN, VEGF, or TRAP. These findings suggest that both particle sizes of DBBM are effective for bone augmentation in the maxillary sinus.
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Affiliation(s)
- R S de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil.
| | - F S Magalhaes-Tunes
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - C V Semedo
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - R G Furlan
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - L G L de Souza
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - A P de Souza Faloni
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - E Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - R S Faeda
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
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27
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Histologic and Histomorphometric Analysis of Bone Regeneration with Bovine Grafting Material after 24 Months of Healing. A Case Report. J Funct Biomater 2018; 9:jfb9030048. [PMID: 30096773 PMCID: PMC6163257 DOI: 10.3390/jfb9030048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/29/2018] [Accepted: 07/31/2018] [Indexed: 12/21/2022] Open
Abstract
Anorganic bovine bone mineral matrix (ABBMM) has been reported to have osteoconductive properties and no inflammatory or adverse responses when used as grafting material in sinus augmentation procedures. However, controversy remains in regard to degradation rate of ABBMM. The aim of this study was to histologically and histomorphometrically evaluate the degradation of ABBMM in human bone samples obtained in one patient 24 months after sinus augmentation. Materials and Methods: The histologic and histomorphometric analysis was performed by means of light microscopy in three specimens harvested from the same patient, Results: After 24 months the tissue pattern appeared to be composed of residual particles, some in close contact with the newly formed bone, others separated by translucent areas and osteoid tissues. Newly-formed bone presented different levels of maturation and numerous osteocytes, with greater numbers in bone closer to the grafted particles (27.3% vs. 11.2%, p < 0.05). The histomorphometric analysis showed mean values of 40.84% newly-formed bone, 33.58% residual graft material, 23.84% marrow spaces, and 1.69% osteoid tissue, Conclusions: Even though ABBMM underwent considerable resorption, a great amount of residual grafting material was still present after two years of healing following sinus augmentation. This study confirms that the bovine grafts can be classified as long-term degradation materials.
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28
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Fujisawa K, Akita K, Fukuda N, Kamada K, Kudoh T, Ohe G, Mano T, Tsuru K, Ishikawa K, Miyamoto Y. Compositional and histological comparison of carbonate apatite fabricated by dissolution-precipitation reaction and Bio-Oss ®. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:121. [PMID: 30032409 DOI: 10.1007/s10856-018-6129-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 07/09/2018] [Indexed: 06/08/2023]
Abstract
Carbonate apatite (CO3Ap) is an inorganic component of bone. This study aimed to compare the composition and tissue response to of CO3Ap (CO3Ap-DP) fabricated by the dissolution-precipitation reaction using calcite as a precursor and Bio-Oss®, which is widely used in orthopedic and dental fields as a synthetic bone substitute. X-ray diffraction and Fourier transform infrared results showed that CO3Ap-DP and Bio-Oss® were both B-type carbonate apatite with low crystallinity. The average sizes of CO3Ap-DP and Bio-Oss® granules were 450 ± 58 and 667 ± 168μ m, respectively, and their carbonate contents were 12.1 ± 0.6 and 5.6 ± 0.1 wt%, respectively. CO3Ap-DP had a larger amount of CO3 than Bio-Oss® but higher crystallinity than Bio-Oss®. When a bone defect made at the femur of rabbits was reconstructed with CO3Ap-DP and Bio-Oss®, CO3Ap-DP granules were partially replaced with bone, whereas Bio-Oss® remained at 8 weeks after implantation. CO3Ap-DP granules elicited a significantly larger amount of new bone formation at the cortical bone portion than Bio-Oss® at 4 weeks after the implantation. The results obtained in the present study demonstrated that CO3Ap-DP and Bio-Oss® showed different behavior even though they were both classified as CO3Ap. The CO3 content in CO3Ap played a more important role than the crystallinity of CO3Ap for replacement to bone and high osteoconductivity.
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Affiliation(s)
- Kenji Fujisawa
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan.
- Department of Oral Health Sciences, Faculty of Health and Welfare, Tokushima Bunri University, Yamashirocho, Tokushima, 770-8514, Japan.
| | - Kazuya Akita
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Naoyuki Fukuda
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Kumiko Kamada
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Takaharu Kudoh
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Go Ohe
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Takamitsu Mano
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Kanji Tsuru
- Section of Bioengineering, Department of Dental Engineering, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Kunio Ishikawa
- Department of Biomaterials, Faculty of Dental Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Youji Miyamoto
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
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29
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Helder MN, van Esterik FAS, Kwehandjaja MD, Ten Bruggenkate CM, Klein-Nulend J, Schulten EAJM. Evaluation of a new biphasic calcium phosphate for maxillary sinus floor elevation: Micro-CT and histomorphometrical analyses. Clin Oral Implants Res 2018; 29:488-498. [PMID: 29638012 PMCID: PMC6001541 DOI: 10.1111/clr.13146] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 12/03/2022]
Abstract
Objectives Synthetic biphasic calcium phosphate (BCP) with a hydroxyapatite/ß‐tricalcium phosphate (HA/ß‐TCP) ratio of 60/40 (BCP60/40) is successfully used as alternative for autologous bone in patients undergoing maxillary sinus floor elevation (MSFE) for dental implant placement. A high percentage of HA in BCP60/40 may hamper efficient scaffold remodeling. Osteogenesis and neovascularization are pivotal in effective bone regeneration. We aimed to investigate whether differences exist in osteogenic and/or vasculogenic potential of BCP60/40 and BCP20/80 in patients undergoing MSFE. Materials and methods Twenty patients undergoing MSFE were treated with BCP60/40 (n = 10) or BCP20/80 (n = 10). Bone and graft volumes were determined by micro‐computed tomography and histomorphometrical analysis of biopsies of the augmented region. Osteoid volumes, number of osteoclasts, and blood vessels were determined by histomorphometrical analysis. The biopsies were taken 6.5 months (26 weeks) postoperatively prior to dental implant placement. Results Bone and osteoid volumes were 9.7% and 0.8% higher at the most cranial side of the BCP20/80 biopsies compared to the BCP60/40 biopsies. Graft volumes, number of osteoclasts, and blood vessels were similar in both groups. Conclusions BCP20/80 showed enhanced osteogenic potential in patients undergoing MSFE compared to BCP60/40, due to either a faster bone remodeling rate or an earlier start of bone formation in BCP20/80‐treated patients, suggesting that a higher TCP content positively contributes to the bone remodeling rate. Therefore, BCP20/80 might perform better, at least in the short term, as a scaffold for bone augmentation in the MSFE model than BCP60/40 as more bone is formed, and more osteoid is deposited at the cranial side in BCP20/80‐treated patients compared to BCP60/40‐treated patients. However, catch‐up of BCP60/40 in the long term cannot be ruled out.
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Affiliation(s)
- Marco N Helder
- Department of Oral and Maxillofacial Surgery, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Department of Orthopedic Surgery, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Fransisca A S van Esterik
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Mardi D Kwehandjaja
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Christiaan M Ten Bruggenkate
- Department of Oral and Maxillofacial Surgery, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Jenneke Klein-Nulend
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Engelbert A J M Schulten
- Department of Oral and Maxillofacial Surgery, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Ge J, Yang C, Wang Y, Zheng J, Hua H, Zhu J. Comparison of different grafting materials for treatment of bone defect distal to the molar in canine. Clin Implant Dent Relat Res 2018; 20:444-454. [DOI: 10.1111/cid.12603] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 02/10/2018] [Accepted: 02/13/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Jing Ge
- Department of Oral Surgery; Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology; Shanghai People's Republic of China
| | - Chi Yang
- Department of Oral Surgery; Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology; Shanghai People's Republic of China
| | - Yong Wang
- Department of Oral Surgery; Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology; Shanghai People's Republic of China
| | - Jiawei Zheng
- Department of Oral-maxillofacial Head and Neck Surgery; Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology; Shanghai People's Republic of China
| | - Hongfei Hua
- Department of Oral Surgery; Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology; Shanghai People's Republic of China
| | - Jun Zhu
- National Engineering Research Center for Nanotechnology; Shanghai People's Republic of China
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Pichotano EC, de Molon RS, Freitas de Paula LG, de Souza RV, Marcantonio E, Zandim-Barcelos DL. Early Placement of Dental Implants in Maxillary Sinus Grafted With Leukocyte and Platelet-Rich Fibrin and Deproteinized Bovine Bone Mineral. J ORAL IMPLANTOL 2018; 44:199-206. [PMID: 29457934 DOI: 10.1563/aaid-joi-d-17-00220] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This case report aimed to describe the effects of leukocyte and platelet-rich fibrin (L-PRF) associated with demineralized bovine bone mineral (DBBM) and absorbable collagen membrane (CM) on bone regeneration in maxillary sinus augmentation. A 59-year-old male patient was referred to the Department of Periodontology for implant rehabilitation of his edentulous upper jaw. The treatment plan involved maxillary sinus augmentation followed by implant installations. A split-mouth design was employed in which the right maxillary sinus was filled using L-PRF, DBBM, and CM; the left side was filled with DBBM and CM. After 4 and 8 months postoperatively, 2 dental implants were installed in each of the right and left maxillary sinuses. Cone-beam computerized tomography (CBCT) was taken before and after sinus augmentation for evaluation of tridimensional bone volume alterations. Bone biopsies were harvested from the implant sites for histomorphometric evaluation. Resonance frequency analysis was employed immediately after implant placement and before prosthetic rehabilitation for evaluation of implant stability. Implants were loaded 10 months after sinus augmentation. CBCT analysis showed a higher resorption rate in the right side of the maxillary sinus (L-PRF + DBBM) compared to the left side (22.25% and 8.95%, respectively). Implant stability quotients were above 68 in all time-points for both groups. Histomorphometric analysis showed a high amount of newly formed bone when L-PRF was used compared with DBBM alone (2 118 102 and 975 535 mm3, respectively). Taken together, both techniques were effective for maxillary sinus augmentation, however the addition of L-PRF to the graft allowed early implant placement and accelerated bone healing in the conditions studied.
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Affiliation(s)
- Elton Carlos Pichotano
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Rafael Scaf de Molon
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
| | | | | | - Elcio Marcantonio
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Daniela Leal Zandim-Barcelos
- 1 Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, SP, Brazil
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Silva Gomes Ferreira PH, De Oliveira D, Duailibe De Deus CB, Okamoto R. Evaluation of the Different Biomaterials Used in Alveolar Cleft Defects in Children. Ann Maxillofac Surg 2018; 8:315-319. [PMID: 30693253 PMCID: PMC6327813 DOI: 10.4103/ams.ams_140_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to use a literature review to evaluate and compare the different biomaterials used in surgeries for the closure of the palatal and alveolar clefts as alternatives to isolated autografting. For the search strategy, the PubMed and Medline databases were used with the indexing terms "'cleft palate' (Mesh), 'biocompatible materials' (Mesh), and 'dentistry' (Mesh)." There was no restriction on language or publication time. After the research, 26 articles were found, and then, only the filter for clinical trials was selected. With this methodology, five articles were selected. The full texts have been carefully evaluated. The main issue among the five selected articles was the closure of a cleft palate and/or alveolar bone with the use of different types of biomaterials (e.g. autogenous bone from the iliac crest and chin, deproteinized bovine bone (DBB), β-tricalcium phosphate (β-TCP), synthetic resorption based on calcium sulfate, and the engineering of bone tissue); they evaluated preoperative and postoperative clinically and through imaging tests. The autogenous bone associated with DBB or β-TCP significantly reduces the amount of autogenous bone harvested from the iliac crest, morbidity, and the hospitalization of the patient, and the isolated use of bovine hydroxyapatite resulted in lower bone density compared to that from autogenous bone.
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Affiliation(s)
| | - Danila De Oliveira
- Department of Basic Sciences, Araçatuba Dental School, University Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Ciro Borges Duailibe De Deus
- Department of Surgery and Integrated Clinic, Araçatuba Dental School, University Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, Araçatuba Dental School, University Estadual Paulista, Araçatuba, São Paulo, Brazil
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Aludden H, Dahlin A, Starch-Jensen T, Dahlin C, Mordenfeld A. Histomorphometric analyses of area fraction of different ratios of Bio-Oss ® and bone prior to grafting procedures - An in vitro study to demonstrate a baseline. Clin Oral Implants Res 2017; 29:185-191. [PMID: 29080268 DOI: 10.1111/clr.13079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The objective of this study was to estimate the area fraction of different ratios of Bio-Oss® and bone, prior to grafting in an in vitro model to demonstrate a histomorphometric baseline. METHODS Bio-Oss® particles were mixed with autogenous bone from pig jaw in three different ratios (50:50, 80:20 and 100:0) and packed in rice paper in a standardized procedure. Histomorphometric analyses were performed in 25 specimens and 74 regions of interest. The area percentage of Bio-Oss® , bone, and non-mineralized tissue (NMT) were calculated. Results were reported as mean values and 95% confidence interval (CI). RESULTS The mean area fraction of Bio-Oss® was 20.6% (CI: 18.2-23) in the 50:50 mixture, 33.6% (CI: 29.7-37.6) in the 80:20 mixture, and 43.4% (CI: 40.5-46.3) in the 100:0 mixture. The mean area fraction of NMT was 60.5% (CI: 57.9-63.1) in the 50:50 mixture, 59.6% (CI: 56.4-62.7) in the 80:20 mixture, and 56.6% (CI: 53.7-59.5) in the 100:0 mixture. The mean area fraction of bone was 18.9% (CI: 16.9-20.9) in the 50:50 mixture and 6.8% (CI: 5-8.6) in the 80:20 mixture. CONCLUSION There is a great difference in the clinically estimated percentage and the histomorphometrically evaluated percentage of Bio-Oss® at baseline, prior to grafting. The area fraction of different tissues presented in this study may be beneficial as guidance for histomorphometrical baseline calculations when different mixtures of Bio-Oss® and autogenous bone are used as grafting materials.
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Affiliation(s)
- Hanna Aludden
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Anna Dahlin
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Christer Dahlin
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Oral and Maxillofacial Surgery, NU-Hospital, Organization Trollhättan, Sweden
| | - Arne Mordenfeld
- Department of Oral & Maxillofacial Surgery, Public Health Service, Gävle, Sweden.,Centre for Research and Development, Uppsala University/Gävleborg County Council, Gävleborg, Sweden.,Plastic and Oral & Maxillofacial Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Nizam N, Eren G, Akcalı A, Donos N. Maxillary sinus augmentation with leukocyte and platelet-rich fibrin and deproteinized bovine bone mineral: A split-mouth histological and histomorphometric study. Clin Oral Implants Res 2017; 29:67-75. [PMID: 28786494 DOI: 10.1111/clr.13044] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the effect of leukocyte and platelet-rich fibrin (L-PRF) in combination with deproteinized bovine bone mineral (DBBM) on bone regeneration in maxillary sinus augmentation. MATERIAL AND METHODS Thirteen patients (nine males and four females, mean age ± SD; 49.92 ± 10.37) were enrolled to the study. 26 maxillary sinus augmentation procedures were randomly performed using DBBM and L-PRF mixture (test) or DBBM alone (control) in a split-mouth design. The same surgical procedures were performed in both groups, and bone biopsies were harvested from the implant sites 6 months postoperatively for histological and histomorphometric evaluations as the primary outcome of the study. Implants were placed and then loaded in the augmented sites after 6 months. The secondary outcomes included clinical and radiographic data and were obtained pre- and postoperatively. RESULTS There was no qualitative difference in histological analyses among the groups. In all samples, a newly formed bone was in direct contact with the residual material. The percentages of newly formed bone (test; 21.38 ± 8.78% and control; 21.25 ± 5.59%), residual bone graft (test; 25.95 ± 9.54% and control; 32.79 ± 5.89%), bone graft in contact with the newly formed bone (test; 47.33 ± 12.33% and control; 54.04 ± 8.36%), and soft tissue (test; 52.67 ± 12.53% and control; 45.96 ± 8.36%) were similar among the groups (p < .05). Similar radiographic bone height in the augmented area was observed, and implant survival rate was 100% for both groups. CONCLUSIONS Both techniques were effective for maxillary sinus augmentation, and after 6 months of healing, the addition of L-PRF in DBBM did not improve the amount of regenerated bone or the amount of the graft integrated into the newly formed bone under histological and histomorphometric evaluation.
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Affiliation(s)
- Nejat Nizam
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Gülnihal Eren
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Aliye Akcalı
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.,Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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Kolerman R, Nissan J, Rahmanov M, Vered H, Cohen O, Tal H. Comparison between mineralized cancellous bone allograft and an alloplast material for sinus augmentation: A split mouth histomorphometric study. Clin Implant Dent Relat Res 2017; 19:812-820. [PMID: 28752693 DOI: 10.1111/cid.12518] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 06/06/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Several grafting materials have been used in sinus augmentation procedures including autogenous bone, demineralized freeze-dried bone, hydroxyapatite, β-tricalcium phosphate, anorganic deproteinized bovine bone, and combination of these and others. Yet, the issue of the optimal graft material for sinus floor augmentation is controversial. PURPOSE This prospective, randomized split-mouth study was undertaken to histomorphometrically compare a biphasic calcium phosphate (BCP) alloplastic bone substitute and a human bone mineral allograft (freeze-dried bone allograft, FDBA) in patients undergoing bilateral maxillary lateral sinus floor augmentation. MATERIAL AND METHODS Apico-coronal core biopsies were harvested at 9 months from 26 bilateral sites in 13 treated patients. Specimens were processed for histological and histomorphometrical analyses. RESULTS Newly formed bone (NB) was evident in all specimens with values of 27.5% and 24.0% at the FDBA and BCP sites, respectively (P = .331). The residual graft particle values were 12.5% and 25.4% (P = .001), and the connective tissue values were 60.0% and 50.6%, respectively. The osteoconductive value was 52.6% for the FDBA and 26.7% for the alloplast (P = .001). The values for the measured residual graft particles, connective tissue, and osteoconductivity, but not for NB, showed highly significant differences between the two groups. All sections in the alloplast material showed evidence of a light chronic inflammatory infiltrate, mainly comprising lymphocytes and multinucleated giant cells. CONCLUSIONS Both graft materials are suitable for sinus floor augmentation, with the allograft material being more osteoconductive.
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Affiliation(s)
- Roni Kolerman
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Joseph Nissan
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Marina Rahmanov
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Hana Vered
- Department of Oral Pathology, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Omer Cohen
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Haim Tal
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Yilmaz S, Ozden B, Bas B, Altun G, Altunkaynak BZ. Could Calcified Triglyceride Bone Cement Be an Alternative Graft Material in Maxillary Sinus Augmentation? J Craniofac Surg 2017; 28:97-103. [PMID: 27977491 DOI: 10.1097/scs.0000000000003236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The ideal graft material for maxillary sinus augmentation is still a matter of controversy and the search for a more appropriate bone substitute for use continues. The aim of this study was to evaluate bone formation as a sign of the regeneration following maxillary sinus augmentation in rabbits using 3 different biomaterials, one of which is a newly developed graft material; calcified triglyceride bone cement (CTBC).Twenty-one New Zealand rabbits were used and randomly divided into 3 groups. Bilateral maxillary sinus augmentation was carried out and autogenous bone (AB), bovine hydroxyapatite (BHA), and CTBC were administered. Maxillary sinuses were dissected after fourth and eighth weeks of the operation. The bone formation was evaluated by stereological and histopathological analysis and the data were analyzed statistically.When the volume of primary bone is compared, statistically significant differences were found among all groups at both of the fourth and eighth weeks. The highest value was obtained from AB applied group. In BHA and CTBC applied groups, active bone formation, osseointegration of graft materials were observed at both fourth and eighth weeks. In CTBC applied group, primary bone formation was only seen as linked to the continuation of parent sinus bony wall.The efficiency of primary bone formation of CTBC was found less than AB and BHA. Of the 3 graft materials tested, BHA is the strongest alternative to AB graft for maxillary sinus augmentation.
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Affiliation(s)
- Seda Yilmaz
- *Department of Oral and Maxillofacial Surgery, Private Dental Clinic, Istanbul †Department of Oral and Maxillofacial Surgery, Faculty of Dentistry ‡Department of Histology and Embryology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Additional Effects of Platelet-Rich Fibrin on Bone Regeneration in Sinus Augmentation With Deproteinized Bovine Bone Mineral: Preliminary Results. IMPLANT DENT 2017. [PMID: 26204169 DOI: 10.1097/id.0000000000000306] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE Platelet-rich fibrin (PRF) has been reported to contribute to bone regeneration; however, little is known about details with deproteinized bovine bone mineral (DBBM). This study aims to evaluate additional effects of PRF on bone regeneration in sinus augmentation with DBBM. MATERIALS AND METHODS Sinus augmentations were made with DBBM/PRF mixture as lateral approach for 4 sinuses from 4 patients. Bone biopsies were obtained from posterior maxilla at the implant placements 7 or 10 months after sinus augmentations. Histological observations and histomorphometric analyses from augmented areas were performed. RESULTS The new bone formation was found around the DBBMs with very good contact while surfaces of DBBMs were partly resorbed. Osteoclasts recognized the DBBMs for remodeling, followed by new bone running. The histomorphometric analyses revealed that mean percentages of newly formed bone were 31.7 ± 1.2%, 21.0 ± 1.0%, 38.0 ± 0.6%, and 47.0 ± 0.6%, respectively (mean 34.5 ± 5.7%). CONCLUSIONS Additional effects of PRF could be found because of higher percentages of newly bone formation by DBBM/PRF mixture than those by DBBM individual in previous reports.
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Moon JW, Sohn DS, Heo JU, Kim JS. Comparison of two kinds of bovine bone in maxillary sinus augmentation: a histomorphometric study. IMPLANT DENT 2016; 24:19-24. [PMID: 25621547 DOI: 10.1097/id.0000000000000187] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to compare the histomorphometric from sinus augmentation with calcium-phosphate nanocrystal-coated bovine bone (Biocera) and anorganic bovine bone matrix (Bio-Oss). MATERIALS AND METHODS Bilateral maxillary sinus augmentations were performed on 5 patients with delayed placement of implants. The lateral bony window was created using a piezoelectric saw, and the sinus membrane was elevated to make a new compartment. Bio-Oss was grafted in one sinus as the control group and Biocera was grafted in the opposite sinus as the test group. The bony window was repositioned over the bone graft. In all cases, samples were taken for biopsy at the time of implant placement, 6 to 8 months after the grafting procedure. Independent t tests were used to examine between-group differences. RESULTS None of the 5 patients had complications during healing period. Histomorphometrically, the Bio-Oss group showed 28.46% (±5.28%) of newly formed bone. Biocera group showed 29.94% (±8.72%) of newly formed bone. Newly formed bone along inner surface of repositioned bony window area showed more mature and dense bone structure than new bone formed along bone graft. CONCLUSIONS This study revealed that both bovine bone grafts were considered as suitable bone graft materials for maxillary sinus augmentation.
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Affiliation(s)
- Jee-Won Moon
- *Assistant Professor, Department of Dentistry and Oral and Maxillofacial Surgery, Catholic University Hospital of Daegu, Daegu, Korea. †Professor, Department of Dentistry and Oral and Maxillofacial Surgery, Catholic University Hospital of Daegu, Daegu, Korea. ‡Private Practice, Busan, Korea. §Private Practice, Jeonju, Korea
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D'Alessandro D, Perale G, Milazzo M, Moscato S, Stefanini C, Pertici G, Danti S. Bovine bone matrix/poly(l-lactic-co-ε-caprolactone)/gelatin hybrid scaffold (SmartBone ®) for maxillary sinus augmentation: A histologic study on bone regeneration. Int J Pharm 2016; 523:534-544. [PMID: 27769886 DOI: 10.1016/j.ijpharm.2016.10.036] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/12/2016] [Accepted: 10/17/2016] [Indexed: 11/27/2022]
Abstract
The ideal scaffold for bone regeneration is required to be highly porous, non-immunogenic, biostable until the new tissue formation, bioresorbable and osteoconductive. This study aimed at investigating the process of new bone formation in patients treated with granular SmartBone® for sinus augmentation, providing an extensive histologic analysis. Five biopsies were collected at 4-9 months post SmartBone® implantation and processed for histochemistry and immunohistochemistry. Histomorphometric analysis was performed. Bone-particle conductivity index (BPCi) was used to assess SmartBone® osteoconductivity. At 4 months, SmartBone® (12%) and new bone (43.9%) were both present and surrounded by vascularized connective tissue (37.2%). New bone was grown on SmartBone® (BPCi=0.22). At 6 months, SmartBone® was almost completely resorbed (0.5%) and new bone was massively present (80.8%). At 7 and 9 months, new bone accounted for a large volume fraction (79.3% and 67.4%, respectively) and SmartBone® was resorbed (0.5% and 0%, respectively). Well-oriented lamellae and bone scars, typical of mature bone, were observed. In all the biopsies, bone matrix biomolecules and active osteoblasts were visible. The absence of inflammatory cells confirmed SmartBone® biocompatibility and non-immunogenicity. These data indicate that SmartBone® is osteoconductive, promotes fast bone regeneration, leading to mature bone formation in about 7 months.
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Affiliation(s)
- Delfo D'Alessandro
- Department of Surgical, Medical, Molecular Pathology and Emergency Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Giuseppe Perale
- Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Via Cantonale 2C, 6928 Manno, Switzerland; Industrie Biomediche Insubri S/A (IBI), Via Cantonale 67, CH6805 Mezzovico-Vira, Switzerland
| | - Mario Milazzo
- Creative Engineering Design Area, The Biorobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio 34, 56025 Pontedera (PI), Italy
| | - Stefania Moscato
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Cesare Stefanini
- Creative Engineering Design Area, The Biorobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio 34, 56025 Pontedera (PI), Italy; Department of Biomedical Engineering and Robotics Institute, Khalifa University of Science Technology and Research, P.O. Box 127788, Abu Dhabi, United Arab Emirates
| | - Gianni Pertici
- Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Via Cantonale 2C, 6928 Manno, Switzerland; Industrie Biomediche Insubri S/A (IBI), Via Cantonale 67, CH6805 Mezzovico-Vira, Switzerland
| | - Serena Danti
- Department of Surgical, Medical, Molecular Pathology and Emergency Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy; Creative Engineering Design Area, The Biorobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio 34, 56025 Pontedera (PI), Italy; Department of Civil and Industrial Engineering, University of Pisa, Largo L. Lazzarino 2, 56122 Pisa, Italy.
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de Assis Gonzaga F, de Miranda TT, Magalhães LMD, Dutra WO, Gollob KJ, Souza PEA, Horta MCR. Effects of Bio-Oss ® and Cerasorb ® dental M on the expression of bone-remodeling mediators in human monocytes. J Biomed Mater Res B Appl Biomater 2016; 105:2066-2073. [PMID: 27401453 DOI: 10.1002/jbm.b.33747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/23/2016] [Accepted: 06/27/2016] [Indexed: 02/04/2023]
Abstract
In contribution to diverse techniques of bone reconstruction involving biomaterials in contemporary dentistry, this study aimed to evaluate the effect of the bone-grafting materials Bio-Oss® and Cerasorb® Dental M on the expression of cytokines associated with bone remodeling by human monocytes in vitro. Bio-Oss® and Cerasorb® Dental M were incubated in separate culture media, and their supernatants were added to mononuclear cells of human peripheral blood, some of which had been stimulated with Porphyromonas gingivalis. The frequency of total monocytes and CD14+ monocytes producing cytokines interleukin 6 (IL-6), IL-8, IL-10, IL-12, and tumor necrosis factor alpha (TNF-α) were determined by flow cytometry. One-way analysis of variance with repeated measures, followed by Tukey's post hoc test, revealed that stimulation with P. gingivalis increased the expression of IL-6 and IL-8 and reduced the expression of TNF-α compared to effects demonstrated in the control group (p < 0.05). Adding biomaterial supernatants did not significantly affect the expression of any cytokine evaluated, however, either in the absence or in the presence of bacterial stimulation. Our data suggest that Bio-Oss® and Cerasorb® Dental M neither stimulate cytokine production in human monocytes nor interfere with mechanisms of cell communication mediated by cytokines evaluated during stimulation with P. gingivalis. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2066-2073, 2017.
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Affiliation(s)
- Filipe de Assis Gonzaga
- Graduate Program in Dentistry, Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - Tatiana Teixeira de Miranda
- Graduate Program in Dentistry, Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - Luisa Mourão Dias Magalhães
- Department of Morphology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Walderez Ornelas Dutra
- Department of Morphology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Instituto Nacional de Ciência e Tecnologia, Doenças Tropicais, Belo Horizonte, Minas Gerais, Brazil
| | - Kenneth John Gollob
- Instituto Nacional de Ciência e Tecnologia, Doenças Tropicais, Belo Horizonte, Minas Gerais, Brazil.,Núcleo de Ensino e Pesquisa do Instituto Mário Penna, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Eduardo Alencar Souza
- Graduate Program in Dentistry, Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - Martinho Campolina Rebello Horta
- Graduate Program in Dentistry, Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
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Caneva M, Lang NP, Garcia Rangel IJ, Ferreira S, Caneva M, De Santis E, Botticelli D. Sinus mucosa elevation using Bio-Oss ® or Gingistat ® collagen sponge: an experimental study in rabbits. Clin Oral Implants Res 2016; 28:e21-e30. [PMID: 27080163 DOI: 10.1111/clr.12850] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2016] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To describe the sequential healing in augmented sinus cavities with deproteinized bovine bone mineral (DBBM) granules or collagen sponges. MATERIAL AND METHODS Twenty albino New Zealand rabbits were included in the study. An incision was performed along the midline of the nasal dorsum, and the nasal bone was exposed. Circular bony windows with a diameter of 5 mm were prepared bilaterally. After elevation of the mucosa, the two sites were randomly filled with either DBBM or a collagen sponge. Five animals each were randomly sacrificed after 7, 14, 21 and 40 days, respectively. RESULTS At both sides, new bone was found forming from the resident pristine bone. During the first stage of healing, DBBM granules were surrounded by a denser connective tissue that was attached to the biomaterial surface and that was progressively mineralized. At the collagen sponge side, the biomaterial was almost completely resorbed and the space was reduced by to two-thirds already after 21 days. At both sides, after 40 days, mineralized bone and marrow spaces were occupying large areas of the elevated space. CONCLUSIONS New bone was found forming from the pristine bony walls of the sinus and extending toward the most peripheral regions in both sites. While DBBM particles yielded osteoconductivity and were able to preserve over time the space within the elevated mucosa, the collagen sponge failed the goal of maintaining the space.
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Affiliation(s)
- Marco Caneva
- ARDEC Academy, Ariminum Odontologica, Rimini, Italy
| | - Niklaus P Lang
- Center for Dental Medicine, University of Zurich, Zurich, Switzerland.,University of Bern, Bern, Switzerland
| | | | - Sabrina Ferreira
- UNESP - Faculdade de Odontologia de Araçatuba, UNESP - Universidade Estadual Paulista, São Paulo, Brazil
| | | | | | - Daniele Botticelli
- ARDEC Academy, Ariminum Odontologica, Rimini, Italy.,UNESP - Faculdade de Odontologia de Araçatuba, UNESP - Universidade Estadual Paulista, São Paulo, Brazil.,POI - Programa Odontológico Internacional, Cartagena de Indias, Colombia
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Scala A, Lang NP, Velez JU, Favero R, Bengazi F, Botticelli D. Effects of a collagen membrane positioned between augmentation material and the sinus mucosa in the elevation of the maxillary sinus floor. An experimental study in sheep. Clin Oral Implants Res 2016; 27:1454-1461. [PMID: 26754150 DOI: 10.1111/clr.12762] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the influence of a collagen membrane placed subjacent to a pristine sinus mucosa on the healing outcome of a sinus floor elevation procedure. MATERIALS AND METHODS Eight Pelibuey sheep (Cubano rojo) underwent sinus floor elevation on both sides of the maxilla. At a randomly selected side (test), a collagen membrane was placed subjacent to the sinus mucosa, while the contralateral side (control) was left without the placement of a membrane. Deproteinized bovine bone mineral (DBBM) was used to fill the space created. A collagen membrane was placed bilaterally to cover the access osteotomy. After 4 months, biopsies were harvested and ground sections prepared. Morphometric analysis was performed in four different regions, three within the elevated area and one at the site of the osteotomy. RESULTS The total percentages of mineralized new bone within the elevated area were 29.4 ± 16.2% and 30.9 ± 9.2% and of marrow spaces 44.0 ± 23.0% and 45.6 ± 14.1%, at the Non-membrane and at the Membrane sites, respectively. A low content of connective tissue within the elevated area was noticed. A higher content of connective tissue was found in the osteotomy region, however. Remnants of DBBM granules were found at a percentage of 17-19%. No statistically significant differences were observed between test and control sites. CONCLUSION The application of a collagen membrane subjacent to the Schneiderian mucosa in a sinus floor elevation procedure did not influence the healing outcomes at all.
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Affiliation(s)
| | - Niklaus P Lang
- Center for Dental Medicine, University of Zurich, Zurich, Switzerland.,University of Bern, Bern, Switzerland
| | | | | | - Franco Bengazi
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | - Daniele Botticelli
- ARDEC, Ariminum Odontologica, Rimini, Italy. .,Faculty of Dentistry, University of Medical Science, La Habana, Cuba.
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43
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Mendoza-Azpur G, Olaechea A, Pinazo M, Gomez C, Salinas E, de la rosa M, Khouly I. Histomorphometric Evaluation of Ridge Preservation With and Without Connective Tissue Graft Over Buccal Plate Using Different Types of Bone Substitute. IMPLANT DENT 2015. [DOI: 10.1097/id.0000000000000307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Seifeldin SA. Is alveolar cleft reconstruction still controversial? (Review of literature). Saudi Dent J 2015; 28:3-11. [PMID: 26792963 PMCID: PMC4688438 DOI: 10.1016/j.sdentj.2015.01.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/15/2014] [Accepted: 01/27/2015] [Indexed: 11/18/2022] Open
Abstract
Cleft lip and palate (CL/P) is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material.
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Affiliation(s)
- Sameh A. Seifeldin
- Corresponding author at: 11545, Riyadh- B.O. 60169, Riyadh, Saudi Arabia. Tel.: +966 506944359; fax: +966 14678548.
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45
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Bone regeneration of macropore octacalcium phosphate-coated deproteinized bovine bone materials in sinus augmentation: a prospective pilot study. IMPLANT DENT 2015; 24:275-80. [PMID: 25886841 DOI: 10.1097/id.0000000000000249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the osteogenic potential of macropore octacalcium phosphate (OCP)-coated deproteinized bovine bone materials (DBBMs) in sinus augmentation. STUDY DESIGN Macropore OCP-coated DBBM was manufactured from bovine bone by thermal and chemical processing. Sinus grafts of a lateral window approach with experimental bone were conducted in 10 patients. At 6 months after surgery, a total of 10 specimens were obtained from 10 patients. But, 4 of them were excluded because the amount of specimens was not enough for evaluation. Morphological investigation under scanning electron microscopy and histological evaluation were performed. RESULTS OCP was evenly attached to the surface of the experimental graft and showed a relatively large pore size (300-400 μm) compared with Bio-Oss (100-200 μm). New bone comprised 23.49% (± 0.10), and residual graft material comprised 15.39% (± 0.06) in bone specimens. CONCLUSION A macropore-sized design and OCP coating could present a favorable environment for new bone formation in maxillary sinus grafts.
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Milani S, Dal Pozzo L, Rasperini G, Sforza C, Dellavia C. Deproteinized bovine bone remodeling pattern in alveolar socket: a clinical immunohistological evaluation. Clin Oral Implants Res 2014; 27:295-302. [DOI: 10.1111/clr.12535] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Stefano Milani
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
| | - Laura Dal Pozzo
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- Foundation IRCCS Ca' Granda Polyclinic; Milan Italy
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health; Università degli Studi di Milano; Milan Italy
| | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
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Ardeshirylajimi A, Mossahebi-Mohammadi M, Vakilian S, Langroudi L, Seyedjafari E, Atashi A, Soleimani M. Comparison of osteogenic differentiation potential of human adult stem cells loaded on bioceramic-coated electrospun poly (L-lactide) nanofibres. Cell Prolif 2014; 48:47-58. [PMID: 25495212 DOI: 10.1111/cpr.12156] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 08/31/2014] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To compare potential of four types of stem cell in tissue engineering and regenerative medicine applications, osteogenic capacity of newly introduced mesenchymal stem cells (MSCs) derived from buccal fat pads (BFP) (an adipose-encapsulated mass of the oral cavity), was compared to those isolated from bone marrow (BM-MSCs), adipose tissue (AT-MSCs) and unrestricted somatic stem cells (USSCs). Cells were cultured on poly (L-lactide) (PLLA) nanofibres, Bio-Oss(®)-coated PLLA (PLLA-Bio), and culture plates (TCPS) as control. MATERIALS AND METHODS Capacity of proliferation and osteogenic differentiation of the stem cells was investigated by MTT assay and common osteogenic markers, alkaline phosphatase activity, calcium mineral deposition and bone-related genes. RESULTS Highest proliferation level was observed in cells cultured on PLLA-Bio, but with no significant difference between proliferation levels of the four types of stem cell. Over the period of study, BM-MSCs cultured on PLLA-Bio scaffolds exhibited greatest alkaline phosphatase (ALP) activity and mineralization with BFP-MSCs having the next closest results. However, AT-MSC had the lowest capacity for ALP activity and mineralization during osteogenic differentiation. Gene expression evaluation revealed that highest expression of three important bone-related genes was observed in stem cells cultured on bioceramic-coated nanofibrous scaffolds. CONCLUSIONS Results indicated Bio-Oss-coated PLLA to compose most appropriate substrates to support proliferation and osteogenic differentiation of stem cells in vitro. BFP-MSCs demonstrated the same osteogenic differentiation capacity as other stem cells tested and thus hold very promising potential for applications in bone tissue engineering and regenerative medicine.
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Affiliation(s)
- A Ardeshirylajimi
- Department of Stem Cell Biology, Stem Cell Technology Research Center, 1997775555, Tehran, Iran
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Comparison of histological and three-dimensional characteristics of porous titanium granules and deproteinized bovine particulate grafts used for sinus floor augmentation in humans: a pilot study. IMPLANT DENT 2014; 22:339-43. [PMID: 23736312 DOI: 10.1097/id.0b013e3182938d03] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Slow-resorbing deproteinized bovine bone grafts have presented high success rates when used for sinus augmentation. However, histologic evaluation shows that this material is eventually excreted as a result of a foreign body reaction. The purpose of this study was to compare and to evaluate the performance of a recently introduced particulate porous graft material, consisting of pure titanium granule (PTG) to the deproteinized bovine bone grafts, when used as a sinus augmentation material. MATERIALS AND METHODS To understand the histological aspects of PTG, deproteinized bovine particulates (Bio-Oss) and PTG were placed contralaterally as sinus grafting materials in 2 patients. After 9 months, biopsies were performed for histologic and 3-dimensional analysis. RESULTS Both materials were in contact with newly formed bone. The Bio-Oss showed signs of foreign body reaction. In contrast, bone filled the space between the single PTG particulates, and no foreign body reaction was observed. CONCLUSIONS From a bone formation perspective, PTG grafts were comparable with the commonly used Bio-Oss grafts and may be regarded as a possible alternative for permanent grafting in sinus augmentation.
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Wen SC, Lin YH, Yang YC, Wang HL. The influence of sinus membrane thickness upon membrane perforation during transcrestal sinus lift procedure. Clin Oral Implants Res 2014; 26:1158-64. [PMID: 24891094 DOI: 10.1111/clr.12429] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Schneiderian membrane perforation is one of the main complications during sinus augmentation. The reasons may be associated with surgical technique, septum, inadequate ridge height, and membrane thickness. However, reports that used cone-beam computed tomography (CBCT) to quantify the thickness of sinus membrane were limited. The aims of this retrospective study were: to study the correlation between membrane thickness and perforation rate during transcrestal sinus lift and to propose a classification system of sinus membrane thickness based upon CBCT data. MATERIAL AND METHODS One hundred and twenty-two subjects who received dental implant restorations over posterior maxilla with a total of 185 transcrestal sinus lift procedures between years 2010 to 2013 were selected consequently. Each patient selected had to have taken CBCT in the initial examination and immediately after surgery. The membrane thickness, perforation rate, residual bone height, and elevated bone height were recorded and processed for statistical analysis. RESULTS The mean thickness of the Schneiderian membrane was 1.78 ± 1.99 mm. There was a significant correlation between membrane thickness and perforation rate (P < 0.05), and the perforation rate was higher in thicker (≥3 mm) and thinner membrane (≤0.5 mm). Among the thickness group, Class B (between ≥1 and <2 mm) had the lowest perforation rate. No significant difference was between the perforation and the membrane morphology. A negative relationship between residual bone height and membrane thickness was found. Trend showed that in the thicker and the thinner residual bone height, the higher the perforation rate would be. CONCLUSIONS There was a significant correlation between membrane thickness and perforation rate. The perforation rate was lowest when the thickness was 1.5-2 mm.
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Affiliation(s)
| | - Yen-Hua Lin
- Department of Dentistry, Cathay General Hospital, Taipei City, Taiwan, China
| | - Yeuh-Chao Yang
- Department of Dentistry, Cathay General Hospital, Taipei City, Taiwan, China
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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50
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Scala A, Lang NP, de Carvalho Cardoso L, Pantani F, Schweikert M, Botticelli D. Sequential healing of the elevated sinus floor after applying autologous bone grafting: an experimental study in minipigs. Clin Oral Implants Res 2014; 26:419-425. [PMID: 24712345 DOI: 10.1111/clr.12378] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 01/21/2023]
Abstract
AIM To describe the sequential healing after elevation of the maxillary sinus mucosa applying the lateral access technique with the use of autogenous bone grafting without membrane to occlude the osteotomy access. MATERIAL AND METHODS Immediately after the elevation of the maxillary sinus Schneiderian membrane, applying the lateral access technique in 10 minipigs, autologous bone was harvested from the lateral aspect of the mandibular molar region and ground into particles with a bone mill. The space under the Schneiderian membrane was filled with this graft. No membranes were placed onto the access osteotomy. The healing was evaluated after 15, 30, 90 and 180 days. Paraffin sections were prepared and analyzed histologically. RESULTS After 15 days of healing, the elevated area was mainly filled with provisional matrix, newly formed bone and some remnants of bone chips, and appeared reduced in volume compared with that at the time of surgery. After 30 days of healing, further shrinkage of the height of the elevated space was found, with similar percentages of the different tissue components. After 90 and 180 days, the area underneath the Schneiderian membrane appeared reduced in volume and condensed toward the base of the sinus. The bone tissues appeared to be more mature, both for the mineralized and the non-mineralized portions, while connective tissue occupied 20% of the space, most likely related to the lack of the use of a membrane occluding the access at the time of surgery. CONCLUSIONS Suboptimal healing outcomes with respect to augmentation of the space under the sinus floor membrane were documented when autologous bone chips were used as a filler and no membrane was applied to cover the access.
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Affiliation(s)
| | | | | | | | | | - Daniele Botticelli
- ARDEC, Ariminum Odontologica, Rimini, Italia.,Faculty of Dentistry, University of Medical Science, La Habana, Cuba.,UNESP - Faculdade de Odontologia de Araçatuba, UNESP - Universidade Estadual Paulista, São Paulo, Brasil
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