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Perez A, Pierantozzi E, Di Felice R, Lombardi T. Clinical and Biological Validation of an Allogeneous Cancellous Bone Block for Alveolar Maxillary Ridge Reconstruction: A Case Series. Dent J (Basel) 2024; 12:42. [PMID: 38392246 PMCID: PMC10888231 DOI: 10.3390/dj12020042] [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: 01/29/2024] [Revised: 02/07/2024] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
This exploratory case series clinically and histologically investigated the performance of allogeneic cancellous freeze-dried bone allograft (FDBA) bone blocks (Maxgraft®) for the lateral augmentation of local alveolar defects in the posterior maxilla as part of two-staged implant therapy. Five patients receiving eight implants 5 months after block augmentation with a follow-up period of up to 3 years were documented and analyzed. Horizontal alveolar dimensions before and 5 months after block augmentation were quantified using CBCT. Radiographic marginal bone level changes were quantified at implant placement, loading, and 1 year post-placement. Graft integration and resorption were histologically qualitatively evaluated from core biopsies retrieved at implant placement. Block augmentations resulted in a pronounced horizontal median bone gain of 7.0 (5.5 to 7.8) mm. Marginal implant bone levels in block-augmented bone remained constant over the 1 year follow-up period. Block grafts appeared histologically well integrated. Histologic analysis also revealed signs of progressive resorption and new bone formation at the lateral aspects of the grafts. The results of this case series support using Maxgraft® cancellous FDBA blocks as suitable materials for the lateral augmentation of local alveolar defects.
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Affiliation(s)
- Alexandre Perez
- Unit of Oral Surgery and Implantology, Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Elena Pierantozzi
- Unit of Oral Surgery and Implantology, Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Roberto Di Felice
- Private Practice, Studio Roberto di Felice, Viale Buozzi 6, 63074 San Benedetto del Tronto, Italy
| | - Tommaso Lombardi
- Unit of Oral Medicine and Oral Maxillofacial Pathology, Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
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Galarraga-Vinueza ME, Barootchi S, Nevins ML, Nevins M, Miron RJ, Tavelli L. Twenty-five years of recombinant human growth factors rhPDGF-BB and rhBMP-2 in oral hard and soft tissue regeneration. Periodontol 2000 2024; 94:483-509. [PMID: 37681552 DOI: 10.1111/prd.12522] [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: 05/18/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
Contemporary oral tissue engineering strategies involve recombinant human growth factor approaches to stimulate diverse cellular processes including cell differentiation, migration, recruitment, and proliferation at grafted areas. Recombinant human growth factor applications in oral hard and soft tissue regeneration have been progressively researched over the last 25 years. Growth factor-mediated surgical approaches aim to accelerate healing, tissue reconstruction, and patient recovery. Thus, regenerative approaches involving growth factors such as recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and recombinant human bone morphogenetic proteins (rhBMPs) have shown certain advantages over invasive traditional surgical approaches in severe hard and soft tissue defects. Several clinical studies assessed the outcomes of rhBMP-2 in diverse clinical applications for implant site development and bone augmentation. Current evidence regarding the clinical benefits of rhBMP-2 compared to conventional therapies is inconclusive. Nevertheless, it seems that rhBMP-2 can promote faster wound healing processes and enhance de novo bone formation, which may be particularly favorable in patients with compromised bone healing capacity or limited donor sites. rhPDGF-BB has been extensively applied for periodontal regenerative procedures and for the treatment of gingival recessions, showing consistent and positive outcomes. Nevertheless, current evidence regarding its benefits at implant and edentulous sites is limited. The present review explores and depicts the current applications, outcomes, and evidence-based clinical recommendations of rhPDGF-BB and rhBMPs for oral tissue regeneration.
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Affiliation(s)
- Maria Elisa Galarraga-Vinueza
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- School of Dentistry, Universidad de las Américas (UDLA), Quito, Ecuador
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Marc L Nevins
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Myron Nevins
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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3
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Romito GA, Villar CC, Sapata VM, Soares HH, Fonseca MA, Conde M, Hammerle CHF, Schwartz F. Autogenous Bone Block versus Collagenated Xenogeneic Bone Block in the reconstruction of the atrophic alveolar ridge: a non-inferiority randomized clinical trial. J Clin Periodontol 2022; 49:1158-1168. [PMID: 35833539 DOI: 10.1111/jcpe.13701] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 06/13/2022] [Accepted: 07/10/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the efficacy of equine derived collagenated bone blocks (CXBB) and autogenous bone block (ABB) for lateral alveolar ridge augmentation and two-stage implant placement. MATERIALS AND METHODS Sixty-four patients with tooth gaps up to 4 teeth and atrophic alveolar ridges with ≤ 4 mm were randomly assigned to lateral augmentation using CXBB or ABB. Lateral bone thickness was measured 2 mm below the alveolar crest at augmentation surgery and 30 weeks later at implant placement. Implant related outcomes, adverse events, surgery duration, pain sensation, analgesic consumption and oral health-related quality of life were also assessed. Data was analyzed using Fisher's exact, Mann-Whitney, and Wilcoxon signed-rank tests. RESULTS At 30 weeks, the median change in lateral bone thickness amounted to 2.90 (CXBB) and 3.00 (ABB), respectively. Secondary endpoints demonstrated similar results for CXBB and ABB in terms of possibility to place an implant, need to perform a secondary bone augmentation at implant placement and rate of complications. Early implant failure was 20% for CXBB and 10% for ABB, with no difference between the groups. Pain scores and postoperative consumption of analgesics were significantly lower in the CXBB group than in the ABB group, especially during the first days post-surgery. CONCLUSION CXBB is non-inferior to ABB for horizontal alveolar ridge augmentation and two-stage implant placement. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Cristina Cunha Villar
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vitor Marques Sapata
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Herbert Horiuti Soares
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Marina Conde
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Frank Schwartz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
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Ren S, Tang X, Liu L, Meng F, Yang X, Li N, Zhang Z, Aimaijiang M, Liu M, Liu X, Wang H, Huangfu H, Wang H, Zhang J, Li D, Zhou Y. Reinforced Blood-Derived Protein Hydrogels Enable Dual-Level Regulation of Bio-Physiochemical Microenvironments for Personalized Bone Regeneration with Remarkable Enhanced Efficacy. NANO LETTERS 2022; 22:3904-3913. [PMID: 35522592 DOI: 10.1021/acs.nanolett.2c00057] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Physiological microenvironment engineering has shown great promise in combating a variety of diseases. Herein, we present the rational design of reinforced and injectable blood-derived protein hydrogels (PDA@SiO2-PRF) composed of platelet-rich fibrin (PRF), polydopamine (PDA), and SiO2 nanofibers that can act as dual-level regulators to engineer the microenvironment for personalized bone regeneration with high efficacy. From the biophysical level, PDA@SiO2-PRF with high stiffness can withstand the external loading and maintaining the space for bone regeneration in bone defects. Particularly, the reinforced structure of PDA@SiO2-PRF provides bone extracellular matrix (ECM)-like functions to stimulate osteoblast differentiation via Yes-associated protein (YAP) signaling pathway. From the biochemical level, the PDA component in PDA@SiO2-PRF hinders the fast degradation of PRF to release autologous growth factors in a sustained manner, providing sustained osteogenesis capacity. Overall, the present study offers a dual-level strategy for personalized bone regeneration by engineering the biophysiochemical microenvironment to realize enhanced osteogenesis efficacy.
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Affiliation(s)
- Sicong Ren
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Xiaoduo Tang
- Joint Laboratory of Opto-Functional Theranostics in Medicine and Chemistry, The First Hospital of Jilin University, Changchun 130021, P.R. China
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, 2699 Qianjin Avenue, Changchun 130012, P.R. China
| | - Lijun Liu
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Fanrong Meng
- Department of Stomatology, The Aviation General Hospital, 3 Beiyuan Road, Beijing 100000, P.R. China
| | - Xudong Yang
- School of Chemical Engineering, Advanced Institute of Materials Science, Changchun University of Technology, 2055 Yan'an street, Changchun 130012, P.R. China
| | - Nuo Li
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Zhiying Zhang
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Maierhaba Aimaijiang
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Manxuan Liu
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Xinchen Liu
- Department of Endodontics, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Hanchi Wang
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Huimin Huangfu
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Huan Wang
- State Key Laboratory of Rare Earth Resources Utilization and Laboratory of Chemical Biology, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun 130022, P.R. China
| | - Junhu Zhang
- Joint Laboratory of Opto-Functional Theranostics in Medicine and Chemistry, The First Hospital of Jilin University, Changchun 130021, P.R. China
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, 2699 Qianjin Avenue, Changchun 130012, P.R. China
| | - Daowei Li
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
| | - Yanmin Zhou
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, 763 Heguang Road, Changchun 130021, P.R. China
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Pérez-González F, Sánchez-Labrador L, Molinero-Mourelle P, Sáez-Alcaide L, Cortés-Bretón-Brinkmann J, Torres García-Denche J, López-Quiles J, Martínez-González J. Dental implant placement through impacted teeth or residual roots as an alternative to invasive extraction surgeries: a systematic literature review. Br J Oral Maxillofac Surg 2021; 59:1120-1129. [DOI: 10.1016/j.bjoms.2020.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022]
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Windisch P, Orban K, Salvi GE, Sculean A, Molnar B. Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series. Clin Oral Investig 2020; 25:2969-2980. [PMID: 33040203 PMCID: PMC8060182 DOI: 10.1007/s00784-020-03617-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/01/2020] [Indexed: 12/01/2022]
Abstract
Objectives To evaluate the feasibility of a newly proposed minimally invasive split-thickness flap design without vertical-releasing incisions for vertical bone regeneration performed in either a simultaneous or staged approach and to analyze the prevalence of adverse events during postoperative healing. Materials and methods Following preparation of a split-thickness flap and bilaminar elevation of the mucosa and underlying periosteum, the alveolar bone was exposed over the defects, vertical GBR was performed by means of a titanium-reinforced high-density polytetrafluoroethylene membrane combined with particulated autogenous bone (AP) and bovine-derived xenograft (BDX) in 1:1 ratio. At 9 months after reconstructive surgery, vertical and horizontal hard tissue gain was evaluated based on clinical and radiographic examination. Results Twenty-four vertical alveolar ridge defects in 19 patients were treated with vertical GBR. In case of 6 surgical sites, implant placement was performed at the time of the GBR (simultaneous group); in the remaining 18 surgical, sites implant placement was performed 9 months after the ridge augmentation (staged group). After uneventful healing in 23 cases, hard tissue fill was detected in each site. Direct clinical measurements confirmed vertical and horizontal hard tissue gain averaging 3.2 ± 1.9 mm and 6.5 ± 0.5 mm respectively, in the simultaneous group and 4.5 ± 2.2 mm and 8.7 ± 2.3 mm respectively, in the staged group. Additional radiographic evaluation based on CBCT data sets in the staged group revealed mean vertical and horizontal hard tissue fill of 4.2 ± 2.0 mm and 8.5 ± 2.4 mm. Radiographic volume gain was 1.1 ± 0.4 cm3. Conclusion Vertical GBR consisting of a split-thickness flap and using titanium-reinforced non-resorbable membrane in conjunction with a 1:1 mixture of AP+BDX may lead to a predictable vertical and horizontal hard tissue reconstruction. Clinical relevance The used split-thickness flap design may represent a valuable approach to increase the success rate of vertical GBR, resulting in predicable hard tissue regeneration, and favorable wound healing with low rate of membrane exposure. Electronic supplementary material The online version of this article (10.1007/s00784-020-03617-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peter Windisch
- Faculty of Dentistry, Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Kristof Orban
- Faculty of Dentistry, Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - Balint Molnar
- Faculty of Dentistry, Department of Periodontology, Semmelweis University, Budapest, Hungary
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Solak K, Yucel I, Karaduman ZO, Arda S, Orak MM, Midi A. Histological Comparison of Nanocomposite Multilayer Biomimetic Scaffold, A Chondral Scaffold, and Microfracture Technique to Repair Experimental Osteochondral Defects in Rats. Eurasian J Med 2020; 52:145-152. [PMID: 32612422 DOI: 10.5152/eurasianjmed.2019.19077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 08/22/2019] [Indexed: 11/22/2022] Open
Abstract
Objective We used biomimetic scaffolds, chondral scaffolds, and microfractures to repair experimentally created osteochondral defects in rat knees and then compared the results of each method. Materials and Methods We used a total of 56 female Wistar albino rats. The rats were grouped into 4 groups, with 14 rats each: biomimetic scaffold, chondral scaffold, microfracture, and control groups. Cylindrical full-thickness osteochondral defects 2.5 mm in diameter and 2 mm in depth were drilled into the right knees with the rats under general anesthesia. The knees of all rats were operated again after 4 weeks. Biomimetic and chondral scaffolds were classified into two groups. Microfractures 0.5 mm in diameter and 0.8 mm in depth were created in the rats of the microfracture group. The control group received no treatment. All the rats were observed for 6 weeks and then sacrificed, with samples subjected to macroscopic and histopathological examinations. Results The macroscopic and histopathological results in the biomimetic scaffold group differed significantly from those of the other treatment groups (p<0.05). When we compared the 3 treatment groups, the results of the chondral scaffold group were better than those of the microfracture group. The results of the microfracture group were somewhat better than those of the control group, but the result was not statistically significant (p>0.05). Conclusions Nanocomposite multilayer biomimetic scaffolds were better than chondral scaffolds and microfractures when used to treat osteochondral defects.
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Affiliation(s)
- Kazim Solak
- Department of Orthopedics and Traumatology, Duzce Atatürk State Hospital, Duzce, Turkey
| | - Istemi Yucel
- Department of Orthopedics and Traumatology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Z Okan Karaduman
- Department of Orthopedics and Traumatology, Duzce University School of Medicine, Duzce, Turkey
| | - Sena Arda
- Department of Medical Education, Istanbul Bahçeşehir University School of Medicine, Istanbul, Turkey
| | - M Mufit Orak
- Department of Orthopedics and Traumatology, Istanbul Bahcesehir University, Medical Park Hospital, Istanbul, Turkey
| | - Ahmet Midi
- Department of Pathology, Bahcesehir University School of Medicine, Istanbul, Turkey
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Pérez-González F, Molinero-Mourelle P, Sánchez-Labrador L, Sáez-Alcaide LM, Limones A, Cortés-Bretón Brinkmann J, López-Quiles J. Assessment of clinical outcomes and histomorphometric findings in alveolar ridge augmentation procedures with allogeneic bone block grafts: A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2020; 25:e291-e298. [PMID: 32040468 PMCID: PMC7103446 DOI: 10.4317/medoral.23353] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 12/09/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis. MATERIAL AND METHODS An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates. RESULTS Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts. CONCLUSIONS Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings.
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Affiliation(s)
- F Pérez-González
- Department of Conservative Dentistry and Orofacial Prosthodontics Faculty of Dentistry, Complutense University of Madrid, Spain Plaza Ramón y Cajal S/N, 28040, Madrid, Spain
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Malik R, Gupta A, Bansal P, Sharma R, Sharma S. Evaluation of Alveolar Ridge Height Gained by Vertical Ridge Augmentation Using Titanium Mesh and Novabone Putty in Posterior Mandible. J Maxillofac Oral Surg 2020; 19:32-39. [PMID: 31988560 DOI: 10.1007/s12663-019-01250-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 05/21/2019] [Indexed: 10/26/2022] Open
Abstract
Aim The purpose of this case series was to report the clinical and radiographical outcomes of vertical ridge augmentation in edentulous posterior mandible using a combination of titanium mesh with novabone putty. Material and Method Twenty patients were included, and grafting was done using alloplastic novabone putty supported by titanium mesh as the barrier for guided bone regeneration. Results Sixteen patients exhibited good soft tissue healing. Postoperative flap dehiscence occurred relatively early in the healing period in one patient followed by graft extrusion and delayed healing in other three patients. The mean vertical height of augmented bone was 4.825 ± 1.1387 mm. Conclusion This report demonstrates the remarkable efficacy of guided bone regeneration using a combination of titanium mesh and novabone putty for vertical ridge augmentation, thus expanding the indications for implant therapy and allowing recovery of the three-dimensional esthetic architecture in a severely resorbed alveolar ridge.
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Affiliation(s)
- Rahul Malik
- 1Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India.,Gurgaon, India
| | - Ashish Gupta
- 1Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
| | - Pankaj Bansal
- 1Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
| | - Rahul Sharma
- 1Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
| | - Sneha Sharma
- 1Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
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Kheur MG, Kheur S, Lakha T, Jambhekar S, Le B, Jain V. Does Graft Particle Type and Size Affect Ridge Dimensional Changes After Alveolar Ridge Split Procedure? J Oral Maxillofac Surg 2018; 76:761-769. [DOI: 10.1016/j.joms.2017.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/26/2017] [Accepted: 11/04/2017] [Indexed: 02/08/2023]
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Elkholy S, Yahia S, Awad M, Elmessiery M. In vivo evaluation of β-CS/n-HA with different physical properties as a new bone graft material. Clin Implant Dent Relat Res 2018; 20:416-423. [DOI: 10.1111/cid.12599] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/29/2017] [Accepted: 02/01/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Sahar Elkholy
- Department of Removable Prosthodontics; Pharos University In Alexandria; Alexandria Egypt
| | - Sarah Yahia
- Center for Material Science (CMS), Zewail City for Science and Technology; Giza Egypt
| | - Manal Awad
- Department of engineering physics; Cairo university; Giza Egypt
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12
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Shahmohammadi R, Moeintaghavi A, Radvar M, Ghanbari H, Saghravanian N, Aghayan S, Sarvari S. Clinical and histological evaluation of increase in the residual ridge width using mineralized corticocancellous block allografts: A pilot study. J Dent Res Dent Clin Dent Prospects 2018; 11:229-235. [PMID: 29354249 PMCID: PMC5768955 DOI: 10.15171/joddd.2017.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 08/20/2017] [Indexed: 11/09/2022] Open
Abstract
Background. Lateral ridge augmentation is conventionally accomplished by means of autogenous bone grafts. However, due to its complications, the application of autogenous bone graft substitutes, e.g. mineralized corticocancellous allograft, is ecommended. Methods. In the present study, twelve patients were included, with insufficient alveolar ridge widths in the designated sites for dental implant placement. During the primary surgery, mineralized corticocancellous block allografts were fixed in deficient sites with titanium screws and resorbable collagen membranes were used to cover the blocks. After a period of six months, a flap was raised and variations in ridge width values was measured. Finally, a micro-biopsy was obtained from the sites for histologic investigation prior to preparing them for subsequent implant placement. Results. All the applied blocks were incorporated into the underlying bone except for one. A statistically significant difference was seen between the average ridge widths before placing the allografts compared with that of implant placement stage (2.62±1.02 mm vs. 7.75±1.63 mm, respectively). Vital bone tissue was detected in all the histological specimens obtained from the interface of blocks and the underlying bone. Conclusion. The results suggest that mineralized corticocancellous block allografts might be used as scaffolds for bone growth and ridge width augmentation.
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Affiliation(s)
- Reza Shahmohammadi
- Department of Endodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Moeintaghavi
- Dental Material Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrdad Radvar
- Dental Material Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Ghanbari
- Department of Periodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasrollah Saghravanian
- Oral and Maxillofacial Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shabnam Aghayan
- Department of Periodontics, Dental Branch, Islamic Azad University (Tehran), Tehran, Iran
| | - Sara Sarvari
- Mashhad University of Medical Sciences, Mashhad, Iran
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Khojasteh A, Kheiri L, Motamedian SR, Khoshkam V. Guided Bone Regeneration for the Reconstruction of Alveolar Bone Defects. Ann Maxillofac Surg 2017; 7:263-277. [PMID: 29264297 PMCID: PMC5717906 DOI: 10.4103/ams.ams_76_17] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Guided bone regeneration (GBR) is the most common technique for localized bone augmentation. PURPOSE The purpose of this review was to categorize and assess various GBR approaches for the reconstruction of human alveolar bone defects. MATERIALS AND METHODS Electronic search of four databases including PubMed/Medline, EMBASE, Web of Science, and Cochrane and hand searching were performed to identify human trials attempting GBR for the reconstruction of alveolar bony defects for at least 10 patients from January 2000 to August 2015. To meet the inclusion criteria, studies had to report preoperative defect dimensions in addition to outcomes of bone formation and/or resorption. RESULTS Twenty-five human clinical trials were included of which 17 used conventional technique that is the use of space maintaining membrane with bone grafting particles (GBR I). Application of block bone graft with overlying membrane and particulate fillers was reported in seven studies (GBR II), and utilizing cortical bone block tented over a defect preserving particulate fillers was reported by one study (GBR III). A wide range of initial defects' sizes and treatment results were reported. CONCLUSIONS This review introduces a therapeutically oriented classification system of GBR for treating alveolar bone defects. High heterogeneity among studies hindered drawing definite conclusions in regard to superiority of one to the other GBR technique.
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Affiliation(s)
- Arash Khojasteh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- University of Antwerp, Antwerpen, Belgium
| | - Lida Kheiri
- Gifted and Talented Dental Students Division, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Reza Motamedian
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Khoshkam
- Advanced Periodontology Program, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
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Sheikh Z, Hamdan N, Ikeda Y, Grynpas M, Ganss B, Glogauer M. Natural graft tissues and synthetic biomaterials for periodontal and alveolar bone reconstructive applications: a review. Biomater Res 2017; 21:9. [PMID: 28593053 PMCID: PMC5460509 DOI: 10.1186/s40824-017-0095-5] [Citation(s) in RCA: 195] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 05/16/2017] [Indexed: 12/11/2022] Open
Abstract
Periodontal disease is categorized by the destruction of periodontal tissues. Over the years, there have been several clinical techniques and material options that been investigated for periodontal defect repair/regeneration. The development of improved biomaterials for periodontal tissue engineering has significantly improved the available treatment options and their clinical results. Bone replacement graft materials, barrier membranes, various growth factors and combination of these have been used. The available bone tissue replacement materials commonly used include autografts, allografts, xenografts and alloplasts. These graft materials mostly function as osteogenic, osteoinductive and/or osteoconductive scaffolds. Polymers (natural and synthetic) are more widely used as a barrier material in guided tissue regeneration (GTR) and guided bone regeneration (GBR) applications. They work on the principle of epithelial cell exclusion to allow periodontal ligament and alveolar bone cells to repopulate the defect before the normally faster epithelial cells. However, in an attempt to overcome complications related to the epithelial down-growth and/or collapse of the non-rigid barrier membrane and to maintain space, clinicians commonly use a combination of membranes with hard tissue grafts. This article aims to review various available natural tissues and biomaterial based bone replacement graft and membrane options used in periodontal regeneration applications.
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Affiliation(s)
- Zeeshan Sheikh
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Room 221, 150 College Street, Toronto, ON M5S 3E2 Canada
- Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, 25 Orde St, Toronto, ON M5T 3H7 Canada
| | - Nader Hamdan
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, 5981 University Avenue, PO Box 15000, Halifax, Nova Scotia B3H 4R2 Canada
| | - Yuichi Ikeda
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Room 221, 150 College Street, Toronto, ON M5S 3E2 Canada
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo, 113-5810 Japan
| | - Marc Grynpas
- Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, 25 Orde St, Toronto, ON M5T 3H7 Canada
| | - Bernhard Ganss
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Room 221, 150 College Street, Toronto, ON M5S 3E2 Canada
| | - Michael Glogauer
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Room 221, 150 College Street, Toronto, ON M5S 3E2 Canada
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Deluiz D, Santos Oliveira L, Ramôa Pires F, Reiner T, Armada L, Nunes MA, Muniz Barretto Tinoco E. Incorporation and Remodeling of Bone Block Allografts in the Maxillary Reconstruction: A Randomized Clinical Trial. Clin Implant Dent Relat Res 2016; 19:180-194. [DOI: 10.1111/cid.12441] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/30/2016] [Accepted: 07/11/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel Deluiz
- Postdoctoral researcher, Department of Periodontology; State University of Rio de Janeiro; RJ, Rio de Janeiro Brazil
| | - Luciano Santos Oliveira
- Professor, Department of Implantology; Pontifical Catholic University of Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - Fábio Ramôa Pires
- Professor, Department of Stomatology, Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - Teresita Reiner
- Investigator, Geriatric Research, Education and Clinical Center - Bruce W. Carter Veterans Affairs Medical Center; Miami FL USA
| | - Luciana Armada
- Professor, Department of Endodontics, Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - Marcus A. Nunes
- Professor, Department of Statistics, Federal University of Rio Grande do Norte; Natal RN Brazil
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Motamedian SR, Khojaste M, Khojasteh A. Success rate of implants placed in autogenous bone blocks versus allogenic bone blocks: A systematic literature review. Ann Maxillofac Surg 2016; 6:78-90. [PMID: 27563613 PMCID: PMC4979349 DOI: 10.4103/2231-0746.186143] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The aim of this study is to review and compare survival/success rate of dental implants inserted in autogenous and allogenic bone blocks (ALBs). A PubMed search was performed from January 1990 to June 2014 limited to English language and human studies. Studies that reported treatment outcome of implants inserted in augmented alveolar ridges with autogenous or ALBs were included. Primary search identified 470 studies. For autogenous bone block (ABB) 36 articles and for ALB 23 articles met the inclusion criteria. Evidence on implant survival/success rate of both techniques was limited to observational studies with relatively small sample sizes. Study design, treatment methods, follow-ups, defect location, and morphology varied among studies. The range of implant survival and success rates in ABB was from 73.8% to 100% and 72.8% to 100%, respectively. The corresponding numbers for ALB were 95.3-100% and 93.7-100%, respectively. A definite conclusion could not be reached. Future studies with long-term follow-ups are required to further elucidate this issue.
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Affiliation(s)
- Saeed Reza Motamedian
- Department of Orthodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Moein Khojaste
- Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Troeltzsch M, Troeltzsch M, Kauffmann P, Gruber R, Brockmeyer P, Moser N, Rau A, Schliephake H. Clinical efficacy of grafting materials in alveolar ridge augmentation: A systematic review. J Craniomaxillofac Surg 2016; 44:1618-1629. [PMID: 27622971 DOI: 10.1016/j.jcms.2016.07.028] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 06/22/2016] [Accepted: 07/29/2016] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To evaluate the efficacy of grafting materials in lateral and vertical ridge augmentations. MATERIALS AND METHODS A systematic review of the literature on the clinical use of grafting materials of the years 1995 to April 2015 was conducted using electronic search of PubMed and Cochrane libraries and hand search of eight print journals. A total of 184 papers were included, comprising 6182 patients. Parameters evaluated were observation period [months], bone formation [histologic area%], defect fill [%], horizontal and vertical gain [mm], loss of augmented volume [mm], complication rate [%], and implant survival rate [%]. Results are expressed as weighted means ± SD. RESULTS Results were obtained after a weighted mean observation period of 27.4 months (range 3-168 months). Bone formation in the augmented areas varied from 33.2 ± 14.9% for allogeneic grafts to 56.0 ± 25.6% for mixtures of autogenous and other grafting materials. Defect fill in dehiscence defects ranged from 51.0 ± 13.6% (synthetic) to 85.8 ± 13.4% (xenogeneic) for the different materials, with an overall weighted mean of 79.8 ± 18.7%. Weighted mean horizontal gain for all particulate grafting materials was 3.7 ± 1.2 mm, with variation between 2.2 ± 1.2 mm (synthetic) and 4.5 ± 1.0 mm (mixtures of autogenous bone with allogeneic/xenogeneic grafting material) without statistical significance. Weighted overall mean vertical gain was 3.7 ± 1.4 mm. Vertical gain was substantially higher when space-making barrier materials such as titanium meshes were used; however this was also associated with strong increase in complication rate. Block grafts achieved higher horizontal gain by approximately 1 mm. The use of block grafts achieved significantly increased vertical gain compared to particulate material only when autogenous block grafts from extraoral donor sites were used. CONCLUSION Horizontal and vertical gain by 3.7 mm on average can be achieved using particulate materials. This can be increased by using titanium meshes. Substantial vertical gains beyond this dimension require the use of extraoral bone block grafts.
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Affiliation(s)
- Markus Troeltzsch
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany.
| | - Matthias Troeltzsch
- Department of Maxillofacial Surgery, Ludwig - Maximilians - University of Munich, Germany
| | - Philipp Kauffmann
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
| | - Rudolph Gruber
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
| | - Phillipp Brockmeyer
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
| | - Norman Moser
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
| | - Anna Rau
- Department of Anesthesiology, University of Goettingen, Germany
| | - Henning Schliephake
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
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Draenert FG, Kämmerer PW, Berthold M, Neff A. Complications with allogeneic, cancellous bone blocks in vertical alveolar ridge augmentation: prospective clinical case study and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e31-43. [DOI: 10.1016/j.oooo.2016.02.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 02/25/2016] [Indexed: 12/31/2022]
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Clinical, Histological, and Histomorphometric Evaluation of Demineralized Freeze-Dried Cortical Block Allografts for Alveolar Ridge Augmentation. J Craniofac Surg 2016; 27:1181-6. [DOI: 10.1097/scs.0000000000002548] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Sfasciotti GL, Trapani CT, Powers RM. Mandibular Ridge Augmentation Using a Mineralized Ilium Block: A Case Letter. J ORAL IMPLANTOL 2016; 42:215-9. [DOI: 10.1563/aaid-joi-d-15-00023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Gian L. Sfasciotti
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Charles T. Trapani
- Department of Scientific & Clinical Affairs, LifeNet Health, Virginia Beach, Va
| | - Ralph M. Powers
- Department of Scientific & Clinical Affairs, LifeNet Health, Virginia Beach, Va
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Sheikh Z, Sima C, Glogauer M. Bone Replacement Materials and Techniques Used for Achieving Vertical Alveolar Bone Augmentation. MATERIALS 2015. [PMCID: PMC5455762 DOI: 10.3390/ma8062953] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Alveolar bone augmentation in vertical dimension remains the holy grail of periodontal tissue engineering. Successful dental implant placement for restoration of edentulous sites depends on the quality and quantity of alveolar bone available in all spatial dimensions. There are several surgical techniques used alone or in combination with natural or synthetic graft materials to achieve vertical alveolar bone augmentation. While continuously improving surgical techniques combined with the use of auto- or allografts provide the most predictable clinical outcomes, their success often depends on the status of recipient tissues. The morbidity associated with donor sites for auto-grafts makes these techniques less appealing to both patients and clinicians. New developments in material sciences offer a range of synthetic replacements for natural grafts to address the shortcoming of a second surgical site and relatively high resorption rates. This narrative review focuses on existing techniques, natural tissues and synthetic biomaterials commonly used to achieve vertical bone height gain in order to successfully restore edentulous ridges with implant-supported prostheses.
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Affiliation(s)
- Zeeshan Sheikh
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Room 221, Fitzgerald Building, 150 College Street, Toronto, ON M5S 3E2, Canada; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-514-224-7490
| | - Corneliu Sima
- Department of Applied Oral Sciences, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA; E-Mail:
| | - Michael Glogauer
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Room 221, Fitzgerald Building, 150 College Street, Toronto, ON M5S 3E2, Canada; E-Mail:
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Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater 2015; 31:640-7. [PMID: 25882277 DOI: 10.1016/j.dental.2015.03.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 03/14/2015] [Accepted: 03/16/2015] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To review the histological and clinical outcomes of the use of bone substitues in different oral bone regenerative procedures: socket preservation, immediate implant placement, lateral and vertical bone augmentation. METHODS Histological animal studies and clinical trials regarding the performances of bone substitutes, either allogenic, xenogeneic or alloplastic, have been evaluated. Different procedures examined separately and evidence-based results were provided. RESULTS The use of deproteinized bovine bone mineral (DBBM) seems to be effective most clinical indications, due to their osteoconductivity, space maintenance characteristics and slow resorption. The combination of Hydroxyapatite and Beta Tricalcium Phospate (HA/TCP) has also reported similar histological evidence and clinical outcomes. The use of autogenous block grafts is still the method of choice in clinical situations in need of vertical bone augmentation. CONCLUSIONS The use of bone substitutes is the standard of therapy in current modalities of lateral bone augmentation, mainly when used in conjunction with implant placement.
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Affiliation(s)
- Mariano Sanz
- Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, 28040 Madrid, Spain.
| | - Fabio Vignoletti
- Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, 28040 Madrid, Spain.
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On the feasibility of utilizing allogeneic bone blocks for atrophic maxillary augmentation. BIOMED RESEARCH INTERNATIONAL 2014; 2014:814578. [PMID: 25535616 PMCID: PMC4177739 DOI: 10.1155/2014/814578] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/02/2014] [Indexed: 01/11/2023]
Abstract
Purpose. This systematic review was aimed at assessing the feasibility by means of survival rate, histologic analysis, and causes of failure of allogeneic block grafts for augmenting the atrophic maxilla. Material and Methods. A literature search was conducted by one reviewer in several databases. Articles were included in this systematic review if they were human clinical trials in which outcomes of allogeneic bone block grafts were studied by means of survival rate. In addition other factors were extracted in order to assess their influence upon graft failure. Results. Fifteen articles fulfilled the inclusion criteria and subsequently were analyzed in this systematic review. A total of 361 block grafts could be followed 4 to 9 months after the surgery, of which 9 (2.4%) failed within 1 month to 2 months after the surgery. Additionally, a weighed mean 4.79 mm (95% CI: 4.51–5.08) horizontal bone gain was computed from 119 grafted sites in 5 studies. Regarding implant cumulative survival rate, the weighed mean was 96.9% (95% CI: 92.8–98.7%), computed from 228 implants over a mean follow-up period of 23.9 months. Histologic analysis showed that allogeneic block grafts behave differently in the early stages of healing when compared to autogenous block grafts. Conclusion. Atrophied maxillary reconstruction with allogeneic bone block grafts represents a reliable option as shown by low block graft failure rate, minimal resorption, and high implant survival rate.
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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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Block allograft for reconstruction of alveolar bone ridge in implantology: a systematic review. IMPLANT DENT 2014; 22:304-8. [PMID: 23680976 DOI: 10.1097/id.0b013e318289e311] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to evaluate the literature regarding clinical efficacy and predictability of block allograft for restoration of vertical and/or horizontal bone defects. MATERIALS AND METHODS A literature search was conducted in PubMed/MEDLINE and Cochrane databases about studies reporting the use of block allografts. The review included studies published in English from 1960 to 2011 and excluded single-case reports and articles that did not use block allograft stabilized by fixation screws. RESULTS The search revealed 567 articles, but only 14 were included, which were conducted in humans with a total of 194 patients treated with block allografts, totalizing 253 blocks. CONCLUSIONS Although a high success rate has been reported for the bone allograft survival, this systematic review demonstrated low level of scientific evidence articles with short follow-up time and diversified methodology with difficult possibilities to compare their results.
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Comparative biomechanical and microstructural analysis of native versus peracetic acid-ethanol treated cancellous bone graft. BIOMED RESEARCH INTERNATIONAL 2014; 2014:784702. [PMID: 24678514 PMCID: PMC3942278 DOI: 10.1155/2014/784702] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 12/10/2013] [Accepted: 12/23/2013] [Indexed: 01/29/2023]
Abstract
Bone transplantation is frequently used for the treatment of large osseous defects. The availability of autologous bone grafts as the current biological gold standard is limited and there is a risk of donor site morbidity. Allogenic bone grafts are an appealing alternative, but disinfection should be considered to reduce transmission of infection disorders. Peracetic acid-ethanol (PE) treatment has been proven reliable and effective for disinfection of human bone allografts. The purpose of this study was to evaluate the effects of PE treatment on the biomechanical properties and microstructure of cancellous bone grafts (CBG). Forty-eight human CBG cylinders were either treated by PE or frozen at −20°C and subjected to compression testing and histological and scanning electron microscopy (SEM) analysis. The levels of compressive strength, stiffness (Young's modulus), and fracture energy were significantly decreased upon PE treatment by 54%, 59%, and 36%, respectively. Furthermore, PE-treated CBG demonstrated a 42% increase in ultimate strain. SEM revealed a modified microstructure of CBG with an exposed collagen fiber network after PE treatment. We conclude that the observed reduced compressive strength and reduced stiffness may be beneficial during tissue remodeling thereby explaining the excellent clinical performance of PE-treated CBG.
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Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. Int J Oral Maxillofac Surg 2014; 43:606-25. [PMID: 24451333 DOI: 10.1016/j.ijom.2013.12.004] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 12/12/2013] [Accepted: 12/18/2013] [Indexed: 12/12/2022]
Abstract
Bone resorption following tooth loss often interferes with dental implant placement in a desired position, and requires additional bone augmentation procedures. Many techniques have been described to augment and reconstruct alveolar ridge width and height. The aim of this study was to systemically review whether there is evidence to provide indications for the various bone augmentation procedures based on defect dimension and type. An electronic search of the Medline database and Cochrane library, complemented by a manual search, was performed. Inclusion criteria for partial edentulism were: clinical trials on bone augmentation procedures in preparation or at the time of implant placement, reporting preoperative and postoperative dimensions of the ridge. For edentulous patients, studies were included when providing the data on ridge and defect description, or the amount of augmentation achieved. The search yielded 53 publications for partially edentulous patients and 15 publications for edentulous patients. The literature provides evidence that dehiscence and fenestrations can be treated successfully with guided bone regeneration (GBR) at the time of implant placement (mean implant survival rate (MISR) 92.2%, mean complication rate (MCR) 4.99%). In partially edentulous ridges, when a horizontal defect is present, procedures such as staged GBR (MISR 100%, MCR 11.9%), bone block grafts (MISR 98.4%, MCR 6.3%), and ridge expansion/splitting (MISR 97.4%, MCR 6.8%) have proved to be effective. Vertical defects can be treated with simultaneous and staged GBR (MISR 98.9%, MCR 13.1% and MISR 100%, MCR 6.95%, respectively), bone block grafts (MISR 96.3%, MCR 8.1%), and distraction osteogenesis (MISR 98.2%, MCR 22.4%). In edentulous patients, there is evidence that bone block grafts can be used (MISR 87.75%), and that Le Fort I osteotomies can be applied (MISR 87.9%), but associated with a high complication rate. The objective of extracting specific indications for each procedure could not be fully achieved due to the heterogeneity of the studies available. Further studies on bone augmentation procedures should report precise preoperative and postoperative measurements to enable a more exact analysis of the augmentation procedure, as well as to provide the clinician with the rationale for choosing the most indicated surgical approach.
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Bone-Forming Capabilities of a Newly Developed NanoHA Composite Alloplast Infused with Collagen: A Pilot Study in the Sheep Mandible. Int J Dent 2013; 2013:296391. [PMID: 24285956 PMCID: PMC3826298 DOI: 10.1155/2013/296391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 09/01/2013] [Indexed: 01/02/2023] Open
Abstract
Lateral or vertical bone augmentation has always been a challenge, since the site is exposed to constant pressure from the soft tissue, and blood supply only exists from the donor site. Although, for such clinical cases, onlay grafting with autogenous bone is commonly selected, the invasiveness of the secondary surgical site and the relatively fast resorption rate have been reported as a drawback, which motivated the investigation of alternative approaches. This study evaluated the bone-forming capability of a novel nanoHA alloplast infused with collagen graft material made from biodegradable polylactic acid/polyglycolic acid versus a control graft material with the same synthesized alloplast without the nanoHA component and collagen infiltration. The status of newly formed bone and the resorption of the graft material were evaluated at 6 weeks in vivo histologically and three dimensionally by means of 3D microcomputed tomography. The histologic observation showed that newly formed bone ingrowth and internal resorption of the block were observed for the experimental blocks, whereas for the control blocks less bone ingrowth occurred along with lower resorption rate of the block material. The three-dimensional observation indicated that the experimental block maintained the external geometry, but at the same time successfully altered the graft material into bone. It is suggested that the combination of numerous factors contributed to the bone ingrowth and the novel development could be an alternative bone grafting choice.
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Effect of Crown to Implant Ratio and Implant Dimensions on Periimplant Stress of Splinted Implant-Supported Crowns. IMPLANT DENT 2013; 22:406-13. [DOI: 10.1097/id.0b013e31829c224d] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Calvo-Guirado JL, Gómez-Moreno G, Guardia J, Ortiz-Ruiz A, Piatelli A, Barone A, Martínez-González JM, Meseguer-Olmo L, López-Marí L, Dorado CB. Biological response to porcine xenograft implants: an experimental study in rabbits. IMPLANT DENT 2012; 21:112-7. [PMID: 22440978 DOI: 10.1097/id.0b013e3182425991] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effect of a new porcine biomaterial and collagen paste in 20 New Zealand rabbits. MATERIALS AND METHODS Forty implants using a porcine xenograft made up of 80% corticocancellous collagenated bone particles of ≤300 μm in size were placed in the proximal metaphyseal area of both tibiae. Four periods of time were formed: 1h, 5, 8, and 15 months. After implantation, an anteroposterior and lateral radiological study was carried out. Samples were sectioned at 5 μm and stained using hematoxylin-eosin, Masson's trichromic, and Gordon-Switt reticulin stains. RESULTS These results confirmed the biocompatibility of this porcine biomaterial-collagen paste; only a few, occasional macrophages and scattered lymphocytes were observed. No fibrosis was observed between the implants and the bone. Moreover, the material was osteoconductive acting as a "scaffold" for bone cells, and there was a progressive increase in bone growth in and around the implants. CONCLUSION This new porcine biomaterial-collagen paste seemed to be biocompatible, bioresorbable, and osteoconductive.
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Abstract
The use of autogenous cortical cancellous block grafts to augment the premaxilla is a safe and effective technique to provide adequate bone height and width when reconstructing patients with atrophic premaxilla ridge when endosteal implants are planned. Intraoral bone graft harvests have the advantages of proximity of the donor site to the graft site, convenient surgical access, minimal operative time, and ease of performance in an office setting. The major limitation of these donor sites is the smaller quantity of graft obtainable compared with iliac crest bone harvest sites.
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Valiati R, Paes JV, de Moraes AN, Gava A, Agostini M, Masiero AV, de Oliveira MG, Pagnoncelli RM. Effect of low-level laser therapy on incorporation of block allografts. Int J Med Sci 2012; 9:853-61. [PMID: 23155359 PMCID: PMC3498750 DOI: 10.7150/ijms.4440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 10/30/2012] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the effect of low-level laser therapy (LLLT) on the incorporation of deep-frozen block allografts in a rabbit model. BACKGROUND DATA Studies have shown that LLLT has beneficial effects on tissue repair and new bone formation. METHODS Bone tissue was harvested from two rabbits, processed by deep-freezing and grafted into the calvaria of 12 animals, which were then randomly allocated into two groups: experimental (L) and control (C). Rabbits in group L were irradiated with an aluminum gallium arsenide diode laser (AlGaAs; wavelength 830 nm, 4 J/cm(2)), applied to four sites on the calvaria, for a total dose of 16 J/cm(2) per session. The total treatment dose after eight sessions was 128 J/cm(2). Animals were euthanized at 35 (n = 6) or 70 days (n = 6) postoperatively. RESULTS Deep-freeze-processed block allografts followed by LLLT showed incorporation at the graft-host interface, moderate bone remodeling, partial filling of osteocyte lacunae, less inflammatory infiltrate in the early postoperative period, and higher collagen deposition than the control group. CONCLUSION Optical microscopy and scanning electron microscopy showed that allograft bone processed by deep-freezing plus LLLT is suitable as an alternative for the treatment of bone defects. Use of the deep-freezing method for processing of bone grafts preserves the structural and osteoconductive characteristics of bone tissue.
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Affiliation(s)
- Renato Valiati
- School of Dentistry, Universidade do Planalto Catarinense, Lages, Brazil.
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