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Osteogenic Differentiation of Periodontal Ligament Stem Cells Seeded on Equine-Derived Xenograft in Osteogenic Growth Media. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111518. [PMID: 36363474 PMCID: PMC9693579 DOI: 10.3390/medicina58111518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/17/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
Background and Objectives: The duration of bone turnover is critical, and different time points help in identifying the optimal endpoint of treatment duration. However, investigating the combination of xenograft and stem cells to allow tissue regeneration within an ideal time duration remains an under-investigated topic. The current study aimed to assess the impact of equine-derived xenograft bone blocks in assisting the human periodontal ligament stem cells (PDLSCs) to demonstrate osteogenic differentiation (collagen type 1 expression and calcium deposition) within an osteogenic growth media. Materials and Methods: Human PDLSCs were acquired commercially and seeded onto xenograft bone blocks. After the 14th and 21st day of culture, enzyme-linked immunoassay (ELISA) was utilized for the detection and quantification of levels of collagen type I, while the mineralization assessment (deposition of calcium) was conducted by staining the PDLSCs with Alizarin Red S (ARS). The statistical comparison between the means and standard deviations of study groups were evaluated using analysis of variance (ANOVA). Results: ELISA assessment revealed an upsurge in the expression of collagen type I for PDLSCs cultured with xenograft after 14 and 21 days compared to the controls (intergroup comparisons significant at p < 0.05). Similar findings were obtained for mineralization assessment and on ARS staining. PDLSCs cultured with xenograft bone blocks presented an increased deposition of calcium compared to their control counterparts (intergroup comparisons significant at p < 0.05). Conclusions: PDLSCs embedded in xenograft bone blocks inside an osteogenic growth medium demonstrated greater osteogenic differentiation potential after 14 and 21 days. This superior osteogenic differentiation capability was evident by increased collagen type I expression and more significant calcium deposition at the 14th and 21st days after culture.
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Rehabilitation of the Completely Edentulous Mandible by All-on-Four Treatment Concept: A Retrospective Cohort Study with Up to 10 Years Follow-Up. MEDICINA (KAUNAS, LITHUANIA) 2021; 58:medicina58010010. [PMID: 35056317 PMCID: PMC8779431 DOI: 10.3390/medicina58010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/29/2021] [Accepted: 12/03/2021] [Indexed: 02/01/2023]
Abstract
(1) Background and Objectives. Currently, there are no definitive long-term data about clinically significant difference in the failure of prosthesis and implant or marginal bone loss related to the rehabilitation of the completely edentulous mandible by all-on-four treatment concept. The main aim of present investigation was to report the long-term outcomes (10-years follow-up) of complete-arch mandibular rehabilitations based on the all-on-four concept. (2) Materials and Methods. Patients in need of extractions of teeth due to the occurrence of caries and/or severe periodontal disease and patients presented with edentulous mandibles were enrolled to the study. A total of 96 participants (mean follow-up period after intervention of 3185.2 days) were enrolled in the study. Participants were evaluated at the first visit, 10 days after intervention and every year after the intervention. Implant and prosthesis survival, bone loss and both local biological and mechanical complications were evaluated during the follow-up period. (3) Results. An implants’ survival rate of 97.9% was observed at the end of the follow-up period. Biological complications were reported in 19.8% of patients, whereas mechanical complications were reported in 27.1% of cases. The average marginal bone level at baseline was −0.03 mm. A significant marginal bone loss was observed after 10-years follow-up (2.5 mm). Binary logistic regression analysis showed significant association between smoke and both marginal bone loss and local biological complications. Lastly, a significant association was observed between bruxism and mechanical complications. (4) Conclusions. The high implant and prosthesis survival rate and the moderate incidence of biological and mechanical complications observed in present investigation can be associated to several factors such as high implant primary stability, prosthetic design, and control of the occlusal forces.
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Sánchez-Labrador L, Molinero-Mourelle P, Pérez-González F, Saez-Alcaide LM, Brinkmann JCB, Martínez JLQ, Martínez-González JM. Clinical performance of alveolar ridge augmentation with xenogeneic bone block grafts versus autogenous bone block grafts. A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:293-302. [PMID: 33161168 DOI: 10.1016/j.jormas.2020.10.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/05/2020] [Accepted: 10/26/2020] [Indexed: 01/30/2023]
Abstract
INTRODUCTION This systematic literature review aimed to evaluate the feasibility of xenogeneic bone blocks for ridge augmentation compared with autogenous blocks by analyzing block survival rates, block resorption, subsequent implant survival rate, post-surgical complications, and histomorphometric findings. MATERIALS AND METHODS Electronic searches were conducted in the Medline (PubMed), Web of Science and Cochrane databases, complimented by a manual search in specialist journals, for relevant articles published up to March 2020. Inclusion criteria were human studies in which the outcomes of xenogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant survival rates. RESULTS Sixteen articles fulfilled the inclusion criteria and were analyzed. 333 patients were recruited with a total of 337 xenogeneic bone blocks and 82 autogenous bone blocks, showing block failure rates of 6.82% and 6.1%, respectively. Bone gain, in both height and width, was similar among xenogeneic and autogenous bone blocks, but autogenous bone blocks suffered greater resorption. Implant survival rates were slightly lower for xenogeneic bone blocks. Histological and histomorphometric analysis observed more bone formation and less residual bone substitute with autogenous bone blocks than xenogeneic bone blocks. CONCLUSIONS Atrophic alveolar crest reconstruction with xenogeneic bone block grafts would appear to offer a viable alternative to autogenous bone block grafts, obtaining similar block graft failure rate, fewer sensitive postoperative complications but a slightly lower implant survival rate. Further investigations generating long term data are needed to confirm the feasibility of xenogeneic bone blocks in different clinical scenarios.
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Affiliation(s)
- Luis Sánchez-Labrador
- Department of Dental Clinical Specialties Faculty of Dentistry, Complutense University of Madrid, Spain
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern., Switzerland
| | - Fabián Pérez-González
- Department of Dental Clinical Specialties Faculty of Dentistry, Complutense University of Madrid, Spain
| | - Luis Miguel Saez-Alcaide
- Department of Dental Clinical Specialties Faculty of Dentistry, Complutense University of Madrid, Spain
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Wide Anterior Maxillary Reconstruction with Equine Bone Xenograft: A Case Report of 24-Month Follow-Up. Case Rep Surg 2020; 2020:8890935. [PMID: 33145117 PMCID: PMC7596435 DOI: 10.1155/2020/8890935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 10/08/2020] [Accepted: 10/13/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction. Orofacial reconstruction plays an important role in the treatment of patients affected by oral and maxillofacial cancers. Improvements in technologies and studies of biomaterials have widely expanded surgical possibilities to achieve good functional and aesthetic outcomes. By the way, xenografting procedures gained great consensus in the last decades, because of their documented reliability and efficacy. We present a case of anterior maxillary chondrosarcoma (CHS) that has undergone surgical ablation followed by reconstruction with an equine-derived bone xenograft. Case Presentation. A 68-year-old woman affected by CHS of the premaxilla underwent surgical ablation involving the four incisors followed by reconstruction using an equine-derived bone substitute. Bony reconstruction was planned to achieve implant and dental prosthetic rehabilitation at a second surgical time. Primary surgery was carried out without complications. Good integration of the graft was confirmed by radiological examination. At 12-month follow-up, the patient refused the implant placement and spontaneously adopted a mobile prosthesis. One year later, plates and screws were removed, because of the exposure of a titanium plate. The graft was finally rejected within 3 weeks. Discussion. Nonantigenic equine-derived biomaterials have shown reliability and a good safety profile. In the presented case, implant insertion should have been performed 12 months after the primary surgery. During the follow-up, until dental mobile prosthesis was applied, clinical and instrumental examinations demonstrated a good integration of the graft. We suppose that a chronic inflammation of the mucosa led to the exposure of the plate, perhaps due to pressure, minimal movements, or imperfect fitting of the mobile prosthesis. Removal of fixation means was performed to prevent grafting failure, without success. On the other hand, missing load could induce the graft to act just like a prosthesis, without a real process of integration. Safety and reliability of equine-derived bone xenografts cannot be currently confirmed if not followed by implant insertion and dental rehabilitation.
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Signorini L, Faustini F, Samarani R, Grandi T. Immediate fixed rehabilitation supported by pterygoid implants for participants with severe maxillary atrophy: 1-Year postloading results from a prospective cohort study. J Prosthet Dent 2020; 126:67-75. [PMID: 32631637 DOI: 10.1016/j.prosdent.2020.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Few investigations concerning the use of pterygoid implants have reported reproducible and consistent data, making survival data controversial. PURPOSE The purpose of this clinical study was to investigate the 1-year survival and success rates of pterygoid implants and prostheses in participants affected by severe atrophy of the posterior maxilla requiring a complete-arch immediate fixed prosthesis. MATERIAL AND METHODS Fifteen participants, either completely edentulous or with failing dentition in the maxillary arch and with severe atrophy of the posterior maxilla, were enrolled in the study. All participants underwent prosthodontic rehabilitation after implant placement in both the anterior maxilla areas and the pterygoid regions. The survival data of the implants were evaluated at the time of abutment connection by means of a mobility test for each implant. After placement of the prostheses, survival was assessed by means of marginal bone maintenance as assessed by panoramic radiographs and the absence of pain or symptoms of infection. The t test was used for evaluating the difference in age between men and women (α=.05). Correlations between categorical variables (Fisher exact test) were used to evaluate the possible association between the number of implants and both the age and presence of comorbidities (α=.05). RESULTS During the 1-year follow-up, high prosthesis stability and no implant loss were observed for all participants. In addition, participants did not report any pain or paresthesia. No peri-implant radiolucency was detected in the panoramic radiographs. Survival and success rates in the follow-up period were 100%. CONCLUSIONS The present study supports the conclusion that pterygoid implants have a high success rate with minimal or no complications.
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Affiliation(s)
- Luca Signorini
- Private practice, Rome, Italy; Professor, Saint Camillus University of Health Science, Rome, Italy.
| | - Fabio Faustini
- Private practice, Castelvetro Piacentino, Piacenza, Italy
| | - Rawad Samarani
- Professor, Department of Periodontology, Faculty of Dentistry, Université Saint Joseph, Beirut, Lebanon
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Piolanti N, Del Chiaro A, Matassi F, Nistri L, Graceffa A, Marcucci M. Bone integration in acetabular revision hip arthroplasty using equine-derived bone grafts: a retrospective study. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2019; 30:575-581. [PMID: 31858258 DOI: 10.1007/s00590-019-02613-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/13/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE During the last decade, total hip arthroplasty has become a common procedure performed in young patients, as well as elderly ones. This has led to an increase in total hip arthroplasty revisions. Loosening of primary components with associated bone loss represents the major cause of total hip arthroplasty revision. This study evaluates the safety and performance of an enzyme-deantigenic equine-derived bone graft material in acetabular defect reconstruction. METHODS Records of 55 patients who were treated for Paprosky type II or III acetabular bone defects with arthroplasty revisions using equine-derived bone and followed for an average of 34 months (range from 24 to 48 months) were analyzed. RESULTS Of the 55 revisions, 49 (89%) were regarded as successful, showing good osteointegration without signs of mobilization. Failures included six cases (11%) of mobilization: five cases of aseptic mobilization (9.1% of revisions, 83% of failures) and one case of septic mobilization (1.9% of revisions, 17% of failures). These results are consistent with those of studies having a similar follow-up period for allografts used in combination with trabecular metal components. CONCLUSIONS Results of the present study suggest that enzyme-treated equine-derived bone grafts may be a valid alternative to autogenous and homologous bone grafts in total hip arthroplasty revision.
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Affiliation(s)
- Nicola Piolanti
- Orthopaedic and Traumatology Division, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56124, Pisa, PI, Italy
| | - Andrea Del Chiaro
- Orthopaedic and Traumatology Division, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56124, Pisa, PI, Italy.
| | - Fabrizio Matassi
- Orthopaedic Clinic, Department of Surgery and Translational Medicine, University of Florence, C.T.O. Largo Palagi 1, 50139, Florence, Italy
| | - Lorenzo Nistri
- Articular Replacements Excellence Center (CESAT) - Fondazione Onlus "…In Cammino…", Fucecchio, Italy
| | - Angelo Graceffa
- Azienda Sanitaria Provinciale Di Enna, Via Armando Diaz 7/9, 94100, Enna, Italy
| | - Massimiliano Marcucci
- Orthopaedic Clinic, Department of Surgery and Translational Medicine, University of Florence, C.T.O. Largo Palagi 1, 50139, Florence, Italy
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Di Stefano DA, Greco G, Gherlone E. A Preshaped Titanium Mesh for Guided Bone Regeneration with an Equine-Derived Bone Graft in a Posterior Mandibular Bone Defect: A Case Report. Dent J (Basel) 2019; 7:dj7030077. [PMID: 31374857 PMCID: PMC6784736 DOI: 10.3390/dj7030077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/16/2019] [Accepted: 07/22/2019] [Indexed: 01/05/2023] Open
Abstract
One of the most often used bone augmentation techniques is the guided bone regeneration procedure. The authors report the case of a 75-year-old man with an atrophic right posterior mandible who underwent bone augmentation through guided bone regeneration with a preshaped titanium mesh adapted on a stereolithographic model of the patient’s jaw. The graft volume was simulated with a light-curing resin. The actual site was grafted with a mixture of autogenous and equine-derived bone. Five months later, the mesh was retrieved, three cylindrical implants were positioned, and a bone biopsy was collected for histomorphometric analysis. A provisional prosthesis was delivered three and a half months later. Definitive rehabilitation was accomplished after one additional month. The graft allowed for effective bone formation (newly formed bone, residual biomaterial, and medullar spaces were, respectively, 39%, 10%, and 51% of the core volume). The patient has functioned successfully throughout six and a half years of follow-up. Using the preshaped titanium mesh in association with the enzyme-treated equine bone substitute provided effective bone regeneration.
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Affiliation(s)
- Danilo Alessio Di Stefano
- Dental School, Vita e Salute University and IRCCS San Raffaele, 20132 Milan, Italy.
- Private Practice, 20148 Milan, Italy.
| | | | - Enrico Gherlone
- Dental School, Vita e Salute University and IRCCS San Raffaele, 20132 Milan, Italy
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Bone Density and Implant Primary Stability. A Study on Equine Bone Blocks. Dent J (Basel) 2019; 7:dj7030073. [PMID: 31266214 PMCID: PMC6784737 DOI: 10.3390/dj7030073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/16/2019] [Accepted: 06/25/2019] [Indexed: 11/17/2022] Open
Abstract
Previous results on synthetic blocks mimicking bone indicate that bone density can be measured by the friction encountered by a rotating probe while it descends into bone, and that primary implant stability may be measured through the integral (I) of the torque–depth curve at implant insertion. This study aims to repeat those tests on collagen-preserving equine bone blocks as they better reproduce the mechanical properties of natural bone. Fifteen cancellous equine blocks had their density measured using a measuring probe. This was compared to their known physical density through linear regression analysis. Implant placement was carried out into six cancellous equine blocks and primary stability was measured using (I), as well as the insertion torque (IT), the implant stability quotient (ISQ), and the reverse torque (RT). The relation between (I), (IT), (ISQ), and (RT) was investigated by correlation analysis. Bone density measured using the probe correlated significantly with actual density, both with (r = 0.764) and without irrigation (r = 0.977). (I) correlated significantly with IT and RT under all irrigation conditions, and with ISQ only without irrigation (r = 0.886). The results suggest that the probe provides actual bone density measurements. They also indicate that (I) measures primary implant stability and is more sensitive to density variations than IT, RT, and ISQ. Results are consistent with those obtained on synthetic blocks but suggest that equine bone blocks may better reproduce the mechanical properties of human cancellous alveolar bone. This should be the subject of additional studies.
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Di Stefano DA, Zaniol T, Cinci L, Pieri L. Chemical, Clinical and Histomorphometric Comparison between Equine Bone Manufactured through Enzymatic Antigen-Elimination and Bovine Bone Made Non-Antigenic Using a High-Temperature Process in Post-Extractive Socket Grafting. A Comparative Retrospective Clinical Study. Dent J (Basel) 2019; 7:dj7030070. [PMID: 31266159 PMCID: PMC6784468 DOI: 10.3390/dj7030070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 04/29/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022] Open
Abstract
Enzyme-deantigenic equine bone (EDEB) and anorganic bovine bone (ABB) are two xenografts made non-antigenic through different processing methods. This study aimed to characterize them for the presence of native bone collagen and other proteins and to compare their histomorphometric outcome when they were used to graft post-extractive sockets. The records of 46 patients treated with EDEB (n = 22) or ABB (n = 24) and followed-up for at least four months after delayed implant placement, were retrospectively collected. Samples of EDEB and ABB were analyzed using Attenuated Total Reflection Fourier Transform Infrared and Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis for the presence of collagen and other proteins. For histomorphometric analysis on bone specimens, newly formed bone and residual biomaterial percentages were calculated. Results of the present study show that EDEB contains type I bone collagen in its native conformation, while no proteins were detected in ABB. Grafting EDEB resulted in a significantly greater quantity of newly formed bone and less residual biomaterial. Our findings suggest that the manufacturing process can greatly affect the graft behavior and a process preserving collagen in its native form may favor bone tissue regeneration.
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Affiliation(s)
| | - Terry Zaniol
- Private Practice, Crocetta del Montello, 31035 Treviso, Italy
| | - Lorenzo Cinci
- Department of Neuroscience, Psychology, Drug Research and Child Health (Neurofarba), Pharmacology and Toxicology Section, University of Florence, Viale G. Pieraccini 6, 50139 Florence, Italy
| | - Laura Pieri
- Department of Health Sciences, Interdepartmental Forensic Medicine Section, University of Florence, Viale G. Pieraccini 6, 50139 Florence, Italy
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Comparative Investigation of Cutting Devices on Bone Blocks: An SEM Morphological Analysis. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9020351] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Bone regeneration is a reliable technique when the bone volume is insufficient to provide a functional and aesthetic outcome in surgery and implantoprosthesis procedures. When bone blocks are used but do not match the shape of the defect, the block must be adapted. The aim of our research was to evaluate, by Scanning Electron Microscopy (SEM) morphological observation, how different cutting devices modify the bone surface. Method: Four equine bone blocks were divided into 15 cubic shape samples with ultrasonic and sonic tips, as well as diamond, tungsten carbide, and Lindemann burs. The uncut surface of the obtained bone block was used as a control. Two observers independently analyzed the SEM observation recording, including cut precision, depth of incision, thermal damages, and presence of bone debris. For each group, sharpness, depth, carbonization, and bone debris were expressed as mean values. Results: The osteotomy performed with an ultrasonic tip shows the best results, preserving the bone morphology in both quantitative and qualitative analyses. The bone surface appeared sufficiently clean from debris and showed a reduced presence of carbonization. Conclusion: The shaping of the bone block as in vivo osteotomy respects the bone morphology and allows it to achieve the relevant biological and clinical outcome.
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Use of Bone Marrow Aspirate Concentrate (BMAC) Associated with Hyperbaric Oxygenation Therapy in Maxillary Appositional Bone Reconstruction. A Randomized Clinical Trial. Symmetry (Basel) 2018. [DOI: 10.3390/sym10100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Objectives: The objective of this study was to evaluate bone reconstruction using xenograft alone and associated with bone marrow aspirate concentrate (BMAC) and hyperbaric oxygen therapy. Material and Methods: Twenty-four maxillary edentulous patients were randomly assigned into three groups: Control group (CG)—xenograft bone alone (n = 8); Group 1 (G1)—xenogeneic bone block combined with BMAC (n = 8), and Group 2 (G2)—xenogeneic bone block combined with BMAC and hyperbaric oxygenation (n = 8). Bone biopsies were harvested 6 months after grafting. Vital Mineralized Tissue (VMT), Non-vital Mineralized Tissue (NVMT), and Non-Mineralized Tissue (NMT) were measured. Computed tomography was also performed on three occasions T0 (preoperative), T4 (4 months postoperative), and T8 (8 months postoperative). The difference between T4 and T8 values with respect to T0 was used to determine the thickness level gain after 4 and 8 months, respectively. Results: The tomographic evaluation did not show significant differences between the groups either at 4 or at the 8 months postoperatively. Regarding the histomorphometric analysis, CG had the lowest percentages of VMT (36.58 ± 9.56%), whereas G1 and G2 had similar results (55.64 ± 2.83% and 55.30 ± 1.41%, respectively). Concerning NMT and NVMT levels, the opposite was observed, with CG levels of 51.21 ± 11.54% and 11.16 ± 2.37%, G1 of 39.76 ± 11.48% and 3.65 ± 0.87%, and G2 of 40.3 ± 11.48% and 4.10 ± 0.87%, respectively. Conclusions: The use of bone block xenograft associated with BMAC resulted in a significant increase of bone neoformation when compared to the xenograft alone, though hyperbaric oxygenation did not enhance the results.
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Steam Sterilization of Equine Bone Block: Morphological and Collagen Analysis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9853765. [PMID: 30186873 PMCID: PMC6109994 DOI: 10.1155/2018/9853765] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/01/2018] [Indexed: 11/18/2022]
Abstract
Introduction The use of equine bone blocks is widely reported for bone augmentation techniques. The block must be shaped according to the form of the defect that should be regenerated. The shaping could be performed by hand before or during the surgery, in a sterile ambient, or using a CNC milling machine that could not be sterile. The aim of our study was to evaluate if a steam sterilization could provide a medical grade sterilization of the blocks and to evaluate if bone microstructure and collagen structures change after different steam sterilization protocols provided by mainstream autoclave. Materials and Method Two blocks of equine bone were divided into 16 samples. 1 sample was used as control and not submitted to any treatment. 15 samples were infected with a Streptococcus faecalis bacterial culture. The samples were singularly packed, randomly divided into 3 groups, and submitted to autoclave sterilization on the same device. The groups were submitted to a sterilization cycle (Gr. A: 121°C, 1,16 bar for 20'; Gr. B:134°C, 2,16 bar for 4'; Gr. C: 134°C, 2,16 bar for 3.30 min.). 2 samples for each group were evaluated for the sterility. 3 samples for each group were observed at SEM to notice the macro- and microstructure modification and to confocal microscope to observe the collagen. Results All samples were sterile. The SEM evaluation showed, in all groups, a preserved morphological structure. Confocal microscope evaluation shows that the collagen structure appears to be more uniform and preserved in group C. Conclusion Data show that autoclave steam sterilization could be reliable to obtain sterilization of equine bone blocks.
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Mattioli B, Iacoviello P, Aldiano C, Verrina G. Subcranial Le Fort III Advancement with Equine-Derived Bone Grafts to Correct Syndromic Midfacial Hypoplasia: A Case Report. J Maxillofac Oral Surg 2017; 17:296-300. [PMID: 30034147 DOI: 10.1007/s12663-017-1058-z] [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: 05/26/2016] [Accepted: 11/20/2017] [Indexed: 02/07/2023] Open
Abstract
Patients with hypoplasia of the midface normally present a flattening of their facial profile due to insufficient development of the nose and maxilla. Treatment aimed to restore function and an aesthetic appearance calls for a Le Fort III osteotomy and the advancement of the midfacial segment either through distraction or interposition of autogenous bone blocks. However, drawbacks in using autogenous bone suggest that use of alternative graft material may be advisable. The present report describes a Le Fort III advancement using two enzyme-treated equine cancellous bone blocks to correct syndromic midfacial hypoplasia in a 22-year-old patient. A 12-mm surgical advancement was achieved, improving the patient's facial profile. At the 28-month follow-up, the midface advanced position was stable. Equine bone blocks could be a valid alternative to autogenous bone in Le Fort III midface advancement.
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Affiliation(s)
- Beniamino Mattioli
- 1Maxillo-Facial Surgery Department, E.O. Ospedali Galliera, Via Mura delle Cappuccine 14, 16128 Genoa, Italy
| | - Paolo Iacoviello
- 1Maxillo-Facial Surgery Department, E.O. Ospedali Galliera, Via Mura delle Cappuccine 14, 16128 Genoa, Italy
- Via Belvedere 3 A, 16011 Arenzano, Genoa, Italy
| | - Carola Aldiano
- Private Practitioner, Corso A. Podestà 6/4, 16128 Genoa, Italy
| | - Giuseppe Verrina
- 1Maxillo-Facial Surgery Department, E.O. Ospedali Galliera, Via Mura delle Cappuccine 14, 16128 Genoa, Italy
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14
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Effectiveness of hydrogen peroxide and electron-beam irradiation treatment for removal and inactivation of viruses in equine-derived xenografts. J Virol Methods 2016; 232:39-46. [DOI: 10.1016/j.jviromet.2016.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 03/04/2016] [Accepted: 03/04/2016] [Indexed: 12/26/2022]
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Di Stefano DA, Greco GB, Riboli F. Guided Bone Regeneration of an Atrophic Mandible with a Heterologous Bone Block. Craniomaxillofac Trauma Reconstr 2015; 9:88-93. [PMID: 26889354 DOI: 10.1055/s-0035-1551544] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/12/2015] [Indexed: 10/23/2022] Open
Abstract
The aim of this work was to test the effectiveness of using enzymatically deantigenated equine bone block as a scaffold for guided bone regeneration (GBR) during a horizontal augmentation of the lower jaw. A partially edentulous atrophic mandible was augmented using an equine-derived block with an expanded polytetrafluoroethylene membrane. After 8.5 months, two bone core samples were collected at the augmentation site, and implants were placed. A definitive prosthesis delivered 6 months after implant placement provided excellent functional and aesthetic rehabilitation throughout the follow-up period. Histological and histomorphometrical analysis of the biopsies showed newly formed bone to be present and the residual biomaterial was still undergoing remodeling. Comparison of cone beam computed tomography scans taken before augmentation and 26 months later showed maintenance of ridge width and possible corticalization of the vestibular augmented ridge side. The equine-derived bone block placed in accordance with GBR principles provided a successful clinical, radiographic, and histological outcome.
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Affiliation(s)
- Danilo Alessio Di Stefano
- Department of Dentistry, Vita e Salute San Raffaele University, Milan, Italy; Dentalnarco Odontoiatric Center, Trezzano Sul Naviglio, Italy
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Di Stefano DA, Greco GB, Cinci L, Pieri L. Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft. J Contemp Dent Pract 2015; 16:154-62. [PMID: 25906808 DOI: 10.5005/jp-journals-10024-1653] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AIM The present work describes a horizontal ridge augmentation in which a titanium mesh was preshaped by adapting it to a stereolithographic model of the patient's jaw that was fabricated from CT scans. BACKGROUND Guided bone regeneration (GBR) involves covering the augmentation site with a long-lasting barrier to protect it from the invasion of surrounding soft tissues. Among barriers, titanium meshes may provide a successful outcome, but the intraoperatory time needed to shape them is a disadvantage. CASE DESCRIPTION The 54-year-old patient, missing the right mandibular second bicuspid, first molar, and second molar, had her atrophic ridge augmented with a 30:70 mixture of autogenous bone and equine, enzyme-deantigenic collagen-preserved bone substitute. Two conical implants were inserted concomitantly in the second bicuspid and first molar positions, and the site was protected with the preshaped mesh. Four months later, the titanium mesh was retrieved, a bone sample was collected, and histological and histomorphometric analyses were performed. Provisional and definitive prostheses were then delivered, and follow-up controls were performed for up to 24 months. CONCLUSION Preshaping the mesh on a model of the patient's mandible shortened the surgical time and enabled faster mesh placement. Two years after surgery, the implants were perfectly functional, and the bone width was stable over time as shown by radiographic controls. Histological analysis of the bone sample showed the heterologous biomaterial to be biocompatible and undergoing advanced remodeling and replacement with newly formed bone. CLINICAL SIGNIFICANCE Preshaping a titanium mesh over a stereolithographic model of the patient's jaw allowed for a significant reduction of the intraoperative time and may be therefore, advisable in routine practice.
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Affiliation(s)
- Danilo Alessio Di Stefano
- Professor, Department of Dentistry, Vita e Salute San Raffaele University, Milan, Italy, Phone: 390248705703, e-mail:
| | | | - Lorenzo Cinci
- Department of Neuroscience, Psychology, Drug Research and Child Health (Neurofarba), Pharmacology and Toxicology Section, University of Florence, Florence, Italy
| | - Laura Pieri
- Department of Health Sciences, Interdepartmental Forensic Medicine Section, University of Florence, Florence, Italy
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