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Abdelmoneim D, Coates DE, Schmidlin P, Botter S, Li KC, Porter GC, Seo B, Duncan WJ. In vivo healing of low temperature deproteinized bovine bone xenograft in a rabbit cranial model. J Biomed Mater Res A 2024; 112:1436-1450. [PMID: 38466022 DOI: 10.1002/jbm.a.37693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 12/10/2023] [Accepted: 02/13/2024] [Indexed: 03/12/2024]
Abstract
The physicochemical properties of grafting materials affect the quality of the osteointegration, resorption rate, and the new bone (NB) formation. This study assessed the physicochemical properties and integration of a low temperature deproteinized bovine bone xenograft (BBX), referred to as optimized MoaBone® (OMB). This novel BBX was physiochemically characterized both pre and post chemical bleaching and sterilization by gamma irradiation. OMB was compared to two commercial BBX; Bio-Oss® (BO) and MoaBone® (MB) using a rabbit cranial model. Residual graft and NB were quantified using histology and micro-computed tomography. Results showed that chemical treatment and gamma irradiation had limited effect on the surface texture. A significant decrease in the collagen content was detected post chemical treatment and in the carbonate content post gamma irradiation. There was no evidence of inflammatory infiltrate, necrosis, or connective tissue encapsulation, and a significant increase of NB in all grafted sites as compared to untreated defects could be observed. However, there was no statistically significant difference between the grafted sites. We conclude that chemical treatment and terminal sterilization strongly impact the final graft's properties. OMB graft showed equivalence with BO for in vivo bone formation and potentially results in lower levels of graft retention.
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Affiliation(s)
- Dina Abdelmoneim
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Dawn Elizabeth Coates
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Patrick Schmidlin
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Sander Botter
- Swiss Center for Musculoskeletal Biobanking, Balgrist Campus AG, Zürich, Switzerland
| | - Kai Chun Li
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Gemma Claire Porter
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Benedict Seo
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Warwick John Duncan
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Mafra IJ, Bordin D, Siroma RS, Moraschini V, Faverani LP, Souza JG, Mourão CF, Shibli JA. Additive Manufacturing Titanium Dental Implants Placed in Sinuses Grafted with 70HA:30-TCP: A One-Year Retrospective Study for Evaluation of Survival Rate. Dent J (Basel) 2024; 12:181. [PMID: 38920882 PMCID: PMC11202463 DOI: 10.3390/dj12060181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/27/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
The present short-term retrospective study evaluated the implant survival rate and peri-implant bone loss around additive-manufactured titanium implants placed in sinuses grafted with Plenum Osshp (Plenum Bioengenharia, Jundia, SP, Brazil) (70HA:30β-TCP) material. A total of 39 implants were inserted after 23 sinus floor elevation procedures in 16 consecutive patients. Prosthetic rehabilitation included fixed partial prostheses (three units), single crowns (eleven units), and fixed full arches (three units). Clinical and radiographic parameters of implant-supported restorations were evaluated after at least one year of occlusal loading. The implant-crown success criteria included the absence of pain, suppuration, and clinical mobility, an average distance between the implant shoulder and the first visible bone contact (DIB) < 1.0 mm from the initial surgery, and the absence of prosthetic complications at the implant-abutment interface. The overall cumulative implant survival rate was 97.43%. No prosthetic complications at the implant-abutment interface were reported. After one year, the mean DIB was 0.23 mm ± 0.14. Within the limits of this retrospective study, it can be concluded that 70 HA:30 β-TCP allowed stable and reliable bone support to maintain healthy conditions around titanium dental implants produced by additive manufacturing.
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Affiliation(s)
- Ilton José Mafra
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (I.J.M.); (D.B.); (R.S.S.); (J.G.S.)
| | - Dimorvan Bordin
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (I.J.M.); (D.B.); (R.S.S.); (J.G.S.)
| | - Rafael S. Siroma
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (I.J.M.); (D.B.); (R.S.S.); (J.G.S.)
| | - Vittorio Moraschini
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rua Ibituruna, 108, Maracanã, Rio de Janeiro 20271-020, RJ, Brazil;
| | - Leonardo P. Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University (UNESP), R. José Bonifácio, 1193—V. Mendonca, Araçatuba 16015-050, SP, Brazil;
| | - João Gabriel Souza
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (I.J.M.); (D.B.); (R.S.S.); (J.G.S.)
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (I.J.M.); (D.B.); (R.S.S.); (J.G.S.)
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Wüster J, Neckel N, Sterzik F, Xiang-Tischhauser L, Barnewitz D, Genzel A, Koerdt S, Rendenbach C, Müller-Mai C, Heiland M, Nahles S, Knabe C. Effect of a synthetic hydroxyapatite-based bone grafting material compared to established bone substitute materials on regeneration of critical-size bone defects in the ovine scapula. Regen Biomater 2024; 11:rbae041. [PMID: 38903563 PMCID: PMC11187503 DOI: 10.1093/rb/rbae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/11/2024] [Accepted: 03/30/2024] [Indexed: 06/22/2024] Open
Abstract
Lately, the potential risk of disease transmission due to the use of bovine-derived bone substitutes has become obvious, demonstrating the urgent need for a synthetic grafting material with comparable bioactive behaviour and properties. Therefore, the effect of a synthetic hydroxyapatite (HA) (Osbone®) bone grafting material on bone regeneration was evaluated 2 weeks, 1 month, and 3, 6, 12 and 18 months after implantation in critical-size bone defects in the ovine scapula and compared to that of a bovine-derived HA (Bio-Oss®) and β-tricalcium phosphate (TCP) (Cerasorb® M). New bone formation and the biodegradability of the bone substitutes were assessed histomorphometrically. Hard tissue histology and immunohistochemical analysis were employed to characterize collagen type I, alkaline phosphatase, osteocalcin, as well as bone sialoprotein expression in the various cell and matrix components of the bone tissue to evaluate the bioactive properties of the bone grafting materials. No inflammatory tissue response was detected with any of the bone substitute materials studied. After 3 and 6 months, β-TCP (Cerasorb® M) showed superior bone formation when compared to both HA-based materials (3 months: β-TCP 55.65 ± 2.03% vs. SHA 49.05 ± 3.84% and BHA 47.59 ± 1.97%; p ≤ 0.03; 6 months: β-TCP 62.03 ± 1.58%; SHA: 55.83 ± 2.59%; BHA: 53.44 ± 0.78%; p ≤ 0.04). Further, after 12 and 18 months, a similar degree of bone formation and bone-particle contact was noted for all three bone substitute materials without any significant differences. The synthetic HA supported new bone formation, osteogenic marker expression, matrix mineralization and good bone-bonding behaviour to an equal and even slightly superior degree compared to the bovine-derived HA. As a result, synthetic HA can be regarded as a valuable alternative to the bovine-derived HA without the potential risk of disease transmission.
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Affiliation(s)
- Jonas Wüster
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Norbert Neckel
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Florian Sterzik
- Department of Experimental Orofacial Medicine, Philipps University Marburg, Germany
| | - Li Xiang-Tischhauser
- Department of Experimental Orofacial Medicine, Philipps University Marburg, Germany
| | | | - Antje Genzel
- Veterinary Research Centre, Bad Langensalza, Germany
| | - Steffen Koerdt
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christian Müller-Mai
- Department of Orthopaedics and Traumatology, Hospital for Special Surgery, Lünen, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christine Knabe
- Department of Experimental Orofacial Medicine, Philipps University Marburg, Germany
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Zhou WH, Li YF. A bi-layered asymmetric membrane loaded with demineralized dentin matrix for guided bone regeneration. J Mech Behav Biomed Mater 2024; 149:106230. [PMID: 37976993 DOI: 10.1016/j.jmbbm.2023.106230] [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: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Guided bone regeneration (GBR) is a well-established method for repairing hard tissue deficiency in reconstructive dentistry. The aim of this study was to investigate the barrier function, osteogenic activity and immunomodulatory ability of a novel bi-layered asymmetric membrane loaded with demineralized dentin matrix (DDM). METHODS DDM particles were harvested from healthy, caries-free permanent teeth. Electrospinning technique was utilized to prepare bi-layered DDM-loaded poly(lactic-co-glycolic acid) (PLGA)/poly(lactic acid) (PLA) membranes (abbreviated as DPP bilayer membranes). We analyzed the membranes' surface properties, cytocompatibility and barrier function, and evaluated their osteogenic activity in vitro. In addition, its effects on the osteogenic immune microenvironment were also investigated. RESULTS Synthetic DPP bilayer membranes presented suitable surface characteristics and satisfactory cytocompatibility. Transwell assays showed significant fewer migrated cells by the DPP bilayer membranes compared with blank control, with or without in vitro degradation (all P < 0.001). In vitro experiments indicated that our product elevated messenger ribonucleic acid (mRNA) expression levels of osteogenic genes alkaline phosphatase (ALP), osteopontin (OPN), osteocalcin (OCN) and runt-related transcription factor 2 (Runx2). Among all groups, 20% DPP bilayer membrane displayed highest ALP activity (P < 0.001). Furthermore, DPP bilayer membranes enhanced the mRNA expression of M2 macrophage markers and increased the proportion of CD206+ M2 macrophages by 100% (20% DPP: P < 0.001; 30% DPP: P < 0.001; 40% DPP: P < 0.05), thus exerting an inflammation suppressive effect. CONCLUSIONS DPP bilayer membranes exhibited notable biological safety and osteogenic activity in vitro, and have potential as a prospective candidate for GBR approach in the future.
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Affiliation(s)
- Wan-Hang Zhou
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yan-Fei Li
- Department of Stomatology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China.
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Zenóbio EG, Resende DF, de Albuquerque VN, Mendes PA, de Abreu FAM, Côsso MG. How the use of xenogeneic grafts can impact the relationship with some social groups and blood donor patients. Clin Implant Dent Relat Res 2023; 25:787-788. [PMID: 37165465 DOI: 10.1111/cid.13215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Elton Gonçalves Zenóbio
- Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Dayane Ferreira Resende
- Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Polianne Alves Mendes
- Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Maurício Greco Côsso
- Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Fairbairn P, Kilner S, O'Hooley D, Fish A, Kurtzman GM. Sinus Augmentation for Implant Placement Utilizing a Novel Synthetic Graft Material with Delayed Immediate Socket Grafting: A 2-Year Case Study. J Clin Med 2023; 12:jcm12072485. [PMID: 37048568 PMCID: PMC10095567 DOI: 10.3390/jcm12072485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
Frequently, sinus augmentation is required when replacing failing or missing molars in the maxilla due to loss of alveolar bone related to periodontal disease, pneumatization of the sinus or a combination of the two factors. Various materials have been advocated and utilized; these fall into the categories of allograft, xenograft and synthetic materials. This article shall discuss a study of 10 cases with a 2-year follow-up utilizing a novel synthetic graft material used for sinus augmentation either simultaneously with implant placement or in preparation for sinus augmentation and implant placement in the posterior maxilla. The results of the 10 cases in the study found consistent results over the 2-year study period with maintenance of the alveolar height at the maxillary sinus. A lack of complications or failures in the study group demonstrates the technique has useful applications in increasing ridge height to permit implant placement inferior to the sinus floor.
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Affiliation(s)
- Peter Fairbairn
- Dental Clinic, School of Dentistry, University of Detroit Mercy, 2700 Martin Luther King Jr Blvd, Detroit, MI 48208, USA
- Private Practice, London, UK
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Suitability of R. pulmo Jellyfish-Collagen-Coated Well Plates for Cytocompatibility Analyses of Biomaterials. Int J Mol Sci 2023; 24:ijms24033007. [PMID: 36769326 PMCID: PMC9917789 DOI: 10.3390/ijms24033007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Cytocompatibility analyses of new implant materials or biomaterials are not only prescribed by the Medical Device Regulation (MDR), as defined in the DIN ISO Norm 10993-5 and -12, but are also increasingly replacing animal testing. In this context, jellyfish collagen has already been established as an alternative to mammalian collagen in different cell culture conditions, but a lack of knowledge exists about its applicability for cytocompatibility analyses of biomaterials. Thus, the present study was conducted to compare well plates coated with collagen type 0 derived from Rhizostoma pulmo with plates coated with bovine and porcine collagen. The coated well plates were analysed in vitro for their cytocompatibility, according to EN ISO 10993-5/-12, using both L929 fibroblasts and MC3T3 pre-osteoblasts. Thereby, the coated well plates were compared, using established materials as positive controls and a cytotoxic material, RM-A, as a negative control. L929 cells exhibited a significantly higher viability (#### p < 0.0001), proliferation (## p < 0.01), and a lower cytotoxicity (## p < 0.01 and # p < 0.05)) in the Jellagen® group compared to the bovine and porcine collagen groups. MC3T3 cells showed similar viability and acceptable proliferation and cytotoxicity in all collagen groups. The results of the present study revealed that the coating of well plates with collagen Type 0 derived from R. pulmo leads to comparable results to the case of well plates coated with mammalian collagens. Therefore, it is fully suitable for the in vitro analyses of the cytocompatibility of biomaterials or medical devices.
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Mangano C, Luongo G, Luongo F, Lerner H, Margiani B, Admakin O, Mangano F. Custom-made computer-aided-design/ computer-assisted-manufacturing (CAD/CAM) synthetic bone grafts for alveolar ridge augmentation: A retrospective clinical study with 3 years of follow-up. J Dent 2022; 127:104323. [PMID: 36241044 DOI: 10.1016/j.jdent.2022.104323] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To report on the results obtained with computer-aided-design/ computer-assisted-manufacturing (CAD/CAM) custom-made synthetic hydroxyapatite/beta-tricalcium-phosphate (HA/beta-TCP) bone grafts in alveolar ridge augmentation for dental implant placement. METHODS The procedure included: (1) cone-beam computed tomography (CBCT) of the bone defect; (2) virtual design of the custom-made onlay bone grafts; (3) milling of grafts from a pre-formed block of synthetic HA/beta-TCP; and (4) bone reconstructive surgery. Implants were placed 8 months later. The patients were followed for 3 years. The study outcomes were: (1) intra- and immediate post-operative complications; (2) 8-month vertical and horizontal bone gain; (3) implant survival; (4) implant-crown success; and (5) peri-implant marginal bone loss (MBL). RESULTS Twenty-six patients underwent ridge augmentation with custom-made CAD/CAM HA/beta-TCP onlay grafts. Eight months later, these patients were rehabilitated with dental implants. During surgery, 25/26 (96.1%) of the grafts adapted well to the bone defect. Immediate post-operative complications were pain and swelling (2/26 patients: 7.6%), and bone graft exposure (3/26: 11.5%); one exposure led to infection, removal of the graft, and failure of the procedure. Excellent integration of the other grafts was observed 8 months after the regenerative procedure, with mean vertical and horizontal bone gains of 2.10 mm (± 0.35) and 2.96 mm (± 0.45), respectively. Twenty-five implants were placed and restored with single crowns. Three years later, all implants were in function. The 3-year implant crown success rate and peri-implant MBL were 92.0% and 0.7 mm (±0.19), respectively. CONCLUSIONS With custom-made CAD/CAM synthetic HA/beta-TCP onlay grafts reconstruction of small vertical and/or horizontal defects of the alveolar ridge was obtained; this enabled implant placement, with high implant-crown success rate after 3 years. Further studies are needed to validate this technique. STATEMENT OF CLINICAL RELEVANCE Custom-made CAD/CAM synthetic HA/beta-TCP onlay grafts may represent an option for regeneration of small bone defects prior to implant placement.
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Affiliation(s)
| | | | | | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe University, Frankfurt, Germany.
| | - Bidzina Margiani
- Department of Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
| | - Oleg Admakin
- Department of Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
| | - Francesco Mangano
- Department of Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
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Evaluation of a New Porcine Bone Graft on the Repair of Surgically Created Critical Bone Defects in Rat Calvaria: Histomorphometric and Microtomographic Study. J Funct Biomater 2022; 13:jfb13030124. [PMID: 36135558 PMCID: PMC9504591 DOI: 10.3390/jfb13030124] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/08/2022] [Accepted: 08/19/2022] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the use of a new porcine bone graft in rat calvaria bone defects. Critical defects were surgically created in 24 rats that were divided into four experimental groups according to defect filling (n = 6): Control Group (CG)—blood clot; Porcine Bone Group (PG)—porcine-derived bone substitute; (BG): Bio-Oss Group (BG)−chemically and heat-treated bovine graft; Bonefill Group (BFG)—chemically treated bovine bone substitute. Euthanasia of the animals occurred 30 days after the surgery, and the area of the original surgical defect and the surrounding tissues were removed for micro-CT and histomorphometric analysis. In the micro-CT evaluation, the PG presented statistically significant differences (p < 0.05) in comparison to the CG, BG and BFG, for the parameters percentage of Bone Volume (BV/TV), Surface Bone Density (BS/TV), Number of Trabeculae (Tb.N) and Bone Connectivity (Conn), but not for Total Porosity (Po.tot) and Trabecular Thickness (Tb.Th). The histomorphometric analysis showed that the PG presented similar results to the BG regarding newly formed bone extension and to the BG and BFG regarding newly formed bone area. The porcine-derived graft presented superior microtomographic and histomorphometric results when compared to the two bovine bone substitutes.
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10
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Porter GC, Abdelmoneim D, Li KC, Duncan WJ, Coates DE. The Effect of Low-Temperature Thermal Processing on Bovine Hydroxyapatite Bone Substitutes, toward Bone Cell Interaction and Differentiation. MATERIALS 2022; 15:ma15072504. [PMID: 35407837 PMCID: PMC8999525 DOI: 10.3390/ma15072504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/26/2022] [Accepted: 03/26/2022] [Indexed: 12/17/2022]
Abstract
Ideal bone grafting scaffolds are osteoinductive, osteoconductive, and encourage osteogenesis through the remodeling processes of bone resorption, new bone formation, and successful integration or replacement; however, achieving this trifecta remains challenging. Production methods of bone grafts, such as thermal processing, can have significant effects on the degree of cell-surface interactions via wide-scale changes in the material properties. Here, we investigated the effects of small incremental changes at low thermal processing temperatures on the degree of osteoclast and osteoblast attachment, proliferation, and differentiation. Bovine bone scaffolds were prepared at 100, 130, 160, 190, and 220 °C and compared with a commercial control, Bio-Oss®. Osteoclast attachment and activity were significantly higher on lower temperature processed bone and were not present ≥190 °C. The highest osteoblast proliferation and differentiation were obtained from treatments at 130 and 160 °C. Similarly, qRT2-PCR assays highlighted osteoblasts attached to bone processed at 130 and 160 °C as demonstrating the highest osteogenic gene expression. This study demonstrated the significant effects of small-scale processing changes on bone graft materials in vitro, which may translate to a tailored approach of cellular response in vivo.
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11
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Rodriguez A, Nowzari H, Teoh C. The migration of the bovine-derived xenograft particles: A case series. J Indian Soc Periodontol 2022; 26:178-185. [PMID: 35321292 PMCID: PMC8936023 DOI: 10.4103/jisp.jisp_494_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/11/2020] [Accepted: 12/19/2020] [Indexed: 11/29/2022] Open
Abstract
The long-term safety of xenografts and their potential association with disease are valid concerns. Bovine bone substitutes which are by far the most commonly used xenografts in dentistry are not biodegradable. The aim of the present report was to raise awareness on the long-term risks of the bovine-derived xenografts. Patients who experienced clinical complications after xenografting are reported. Patients’ demographic, significant medical, and dental findings are reported. Complications included migration/encapsulation/displacement of the graft material, chronic inflammation, and soft-tissue disturbances/fenestrations. Albeit some xenograft complications are not significant enough to compromise the initial outcomes achieved, the xenografted particles seemed to be left intact favoring conditions for migration. The authors observed the inability of the human host to biodegrade the xenograft particles. The intact/migrated bovine bone particles present a risk to patients and may contribute to long-term clinical complications in implant dentistry.
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12
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Santos A, Botelho J, Machado V, Borrecho G, Proença L, Mendes JJ, Mascarenhas P, Alcoforado G. Autogenous Mineralized Dentin versus Xenograft granules in Ridge Preservation for Delayed Implantation in Post-extraction Sites: A Randomized controlled clinical trial with an 18 months follow-up. Clin Oral Implants Res 2021; 32:905-915. [PMID: 33982320 DOI: 10.1111/clr.13765] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 04/24/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To test primary stability of delayed implants placed in post-extraction ridges preserved with autogenous mineralized dentin matrix (MDM) versus xenograft granules. Clinical, histological and pain experience outcomes were further assessed. MATERIAL AND METHODS From March 2018 to July 2020, patients requiring ridge preservation in preparation for delayed implant placement in post-extraction sites were included. Participants were randomly allocated to either the test (MDM) or control group (xenograft granules) prior to ridge preservation. Visual analogue scale and analgesic consumption were measured every day for a week. Six months after preservation, trephine cores were harvested for histomorphometry prior to implant placement. Implants were then placed, and implant stability was measured immediately as well as two months after placement. Marginal bone loss and presence of mucositis/peri-implantitis were registered up to 18 months after prosthetic loading. RESULTS Fifty-two patients (66 implants) completed the study. MDM and xenograft groups presented similar primary (77.1 ± 6.9 versus. 77.0 versus. 5.9) and secondary (81.8 ± 5.1 versus. 80.1 ± 3.8) implant stabilities. The percentage of newly formed bone in MDM (47.3%) was significantly higher than xenograft (34.9%) (p < .001), and the proportion of residual graft was significantly lower (12.2% in MDM and 22.1% in xenograft) (p < .001). No significant differences were found as far as clinical, radiographic and patient-related outcomes. CONCLUSIONS Implants placed in sites preserved with MDM had similar primary stability in comparison to xenograft granules. MDM showed a significantly higher quantity of newly formed bone and lower amount of residual graft in histomorphometry results and equal clinical and patient-related outcomes.
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Affiliation(s)
- Alexandre Santos
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Clinical Research Unit (CRU), CiiEM, IUEM, Caparica, Portugal
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Clinical Research Unit (CRU), CiiEM, IUEM, Caparica, Portugal
| | - Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Clinical Research Unit (CRU), CiiEM, IUEM, Caparica, Portugal
| | | | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, Caparica, Portugal
| | | | - Paulo Mascarenhas
- Oral and Biomedical Sciences Research Unit, Faculty of Dental Medicine, University of Lisbon, Lisbon, Portugal
| | - Gil Alcoforado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Clinical Research Unit (CRU), CiiEM, IUEM, Caparica, Portugal
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13
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Costa MM, Botticelli D, Moses O, Omori Y, Fujiwara S, Silva ER, Xavier SP. Maxillary Sinus Augmentation Using Ceramic Alloplastic Granules or Paste: An Experimental Study in Rabbits. Dent J (Basel) 2021; 9:65. [PMID: 34205201 PMCID: PMC8226577 DOI: 10.3390/dj9060065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Due to the lack of data comparing the biological behavior of two formulations, granules and paste, of alloplastic graft from microtomographic and histomorphometric points of view, the aim of the present experiment was to compare the histomorphometric and microtomographic healing of two formulations, i.e., granules (MR sites) or paste (MR-inject sites) of an alloplastic graft composed of a combination of beta-tricalcium phosphate and hydroxyapatite used for maxillary sinus lifting. METHODS A sinus lifting procedure was carried out bilaterally in 20 rabbits, and the elevated space was filled with either paste or granules of an alloplastic material. A collagen membrane was placed on the antrostomy and the animals were euthanized after 2 or 10 weeks, 10 animals each group. Microtomographic and histological analyses were performed. RESULTS Higher proportions of new bone formation were found at the MR, compared to the MR-inject sites both after 2 weeks (2.65 ± 2.89% vs. 0.08 ± 0.12%; p < 0.01) and 10 weeks of healing (34.20 ± 13.86 vs. 23.28 ± 10.35%; p = 0.022). CONCLUSIONS It was concluded that new bone formation was faster in the MR sites, compared to the MR-inject. However, a longer time of healing should be allowed to make final conclusions about the efficiency in bone formation of the paste formulation of the biomaterial used in the present study.
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Affiliation(s)
- Michael Medeiros Costa
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
| | | | - Ofer Moses
- Department of Periodontology and Dental Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Yuki Omori
- ARDEC Academy, 47923 Rimini, Italy; (D.B.); (Y.O.); (S.F.)
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan
| | | | - Erick Ricardo Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
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14
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Lu J, Wang Z, Zhang H, Xu W, Zhang C, Yang Y, Zheng X, Xu J. Bone Graft Materials for Alveolar Bone Defects in Orthodontic Tooth Movement. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:35-51. [PMID: 33307972 DOI: 10.1089/ten.teb.2020.0212] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Clinically, orthodontic tooth movement (OTM) across the narrow alveolar ridge area inevitably entails some adverse reactions such as limited movement and periodontal tissue damage. Hence, it is essential to reconstruct the morphology of the alveolar crest before the tooth movement. Unlike the routine reconstruction of alveolar ridge in the field of implant, the orthodontic practices are distinctive, which require dental movement across the constructed alveolar ridge with safety and stability. Herein, we addressed the pros and cons of reconstruction of the defected orthodontic alveolar ridge with different bone graft materials. Attention is also paid to other factors such as the postgraft initiation time of OTM that can substantially influence the bone reconstruction and tooth movement effect. Rather, considering the lack of a unified standard in orthodontic clinics related to bone reconstruction for OTM, we provide some recommendations and guidance for OTM through alveolar ridge defect area.
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Affiliation(s)
- Jiajia Lu
- Key Lab. of Oral Diseases Research of Anhui Province, Stomatological Hospital and College, Anhui Medical University, Hefei, China
| | - Zishuo Wang
- School of Stomatology, Tongji University, Shanghai, China
| | - Hongyan Zhang
- Key Lab. of Oral Diseases Research of Anhui Province, Stomatological Hospital and College, Anhui Medical University, Hefei, China
| | - Wenhua Xu
- Key Lab. of Oral Diseases Research of Anhui Province, Stomatological Hospital and College, Anhui Medical University, Hefei, China
| | - Chengfei Zhang
- Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Xianyu Zheng
- Key Lab. of Oral Diseases Research of Anhui Province, Stomatological Hospital and College, Anhui Medical University, Hefei, China
| | - Jianguang Xu
- Key Lab. of Oral Diseases Research of Anhui Province, Stomatological Hospital and College, Anhui Medical University, Hefei, China
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15
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de Oliveira Junior JM, Montagner PG, Carrijo RC, Martinez EF. Physical characterization of biphasic bioceramic materials with different granulation sizes and their influence on bone repair and inflammation in rat calvaria. Sci Rep 2021; 11:4484. [PMID: 33627770 PMCID: PMC7904940 DOI: 10.1038/s41598-021-84033-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/10/2021] [Indexed: 11/21/2022] Open
Abstract
Biphasic calcium phosphate bioceramics (BCP) consist of a mixture of hydroxyapatite (HA) and beta-tricalcium phosphate (β-TCP) within the same particle. Due to their osteoconductive properties, biocompatibility and resemblance to natural bone, these materials have become a promising and suitable alternative to autologous bone grafting. First, the topography characteristics, specific surface area, and total pore volume of BCP were evaluated using scanning electron microscopy and the BET and BJH methods. Next, this study aimed to evaluate the intensity of the inflammatory process and the bone neoformation capacity of various particle sizes of BCP in the repair of critical defects in the calvaria of rats. A xenogeneic biomaterial was used in the control group. After 30, 60, and 90 days, the animals were euthanized, followed by the processing of the samples to measure the intensity of inflammatory infiltrates and the areas of bone neoformation. Our results indicate that no considerable differences were observed in the inflammatory scores in sites treated with distinct BCP grain sizes. A greater area of bone neoformation was measured in the xenogeneic group at all analysis times, with no substantial differences in bone formation between the BCP particle size in the range of 250-500 µm and 500-1000 µm.
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Affiliation(s)
| | - Pedro Giorgetti Montagner
- Division of Cell Biology and Oral Pathology, São Leopoldo Mandic Research Institute, Campinas, SP, 13045-755, Brazil
| | - Rafael Coutinho Carrijo
- Division of Oral Implantology, São Leopoldo Mandic Research Institute, Campinas, SP, 13045-755, Brazil
| | - Elizabeth Ferreira Martinez
- Division of Cell Biology and Oral Pathology, São Leopoldo Mandic Research Institute, Campinas, SP, 13045-755, Brazil
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16
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Research progress on applications of calcium derived from marine organisms. Sci Rep 2020; 10:18425. [PMID: 33116162 PMCID: PMC7595125 DOI: 10.1038/s41598-020-75575-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/12/2020] [Indexed: 11/08/2022] Open
Abstract
Calcium is an important mineral that plays an integral role in human health, especially bone health. Marine biological calcium is an abundant resource that is generally accepted and has a complex active structure. This review evaluates research progress on marine biological calcium with regards to its sources, use of calcium supplements, calcium bioavailability, and novel applications of marine calcium. The potential for future development and the use of products incorporating marine biological calcium in biomedical research and the pharmaceutical, health care, and food industries are also reviewed. The goal of this review is to provide a comprehensive documentation on resource utilization and product development from marine organisms.
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17
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Physical/Chemical Properties and Resorption Behavior of a Newly Developed Ca/P/S-Based Bone Substitute Material. MATERIALS 2020; 13:ma13163458. [PMID: 32764505 PMCID: PMC7475886 DOI: 10.3390/ma13163458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 12/11/2022]
Abstract
Properly regulating the resorption rate of a resorbable bone implant has long been a great challenge. This study investigates a series of physical/chemical properties, biocompatibility and the behavior of implant resorption and new bone formation of a newly developed Ca/P/S-based bone substitute material (Ezechbone® Granule CBS-400). Experimental results show that CBS-400 is comprised majorly of HA and CSD, with a Ca/P/S atomic ratio of 54.6/39.2/6.2. After immersion in Hank’s solution for 7 days, the overall morphology, shape and integrity of CBS-400 granules remain similar to that of non-immersed samples without showing apparent collapse or disintegration. With immersion time, the pH value continues to increase to 6.55 after 7 days, and 7.08 after 14 days. Cytotoxicity, intracutaneous reactivity and skin sensitization tests demonstrate the good biocompatibility features of CBS-400. Rabbit implantation/histological observations indicate that the implanted granules are intimately bonded to the surrounding new bone at all times. The implant is not merely a degradable bone substitute, but its resorption and the formation of new cancellous bone proceed at the substantially same pace. After implantation for 12 weeks, about 85% of the implant has been resorbed. The newly-formed cancellous bone ratio quickly increases to >40% at 4 weeks, followed by a bone remodeling process toward normal cancellous bone, wherein the new cancellous bone ratio gradually tapers down to about 30% after 12 weeks.
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18
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Mg-Based Metallic Glass-Polymer Composites: Investigation of Structure, Thermal Properties, and Biocompatibility. METALS 2020. [DOI: 10.3390/met10070867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In this work, the biomedical applicability and physical properties of magnesium-based metallic glass/polycaprolactone (PCL) composites are explored. The composites were fabricated via mechanical alloying and subsequent coextrusion. The coextrusion process was carried out at a temperature near to the supercooled liquid region of the metallic glass and the viscous region of the polymer. The structures, as well as thermal and mechanical properties of the obtained samples were characterized, and in vivo investigations were undertaken. The composite samples possess acceptable thermal and mechanical properties. Tensile tests indicate the ability of the composites to withstand more than 100% deformation. In vivo studies reveal that the composites are biologically compatible and could be promising for biomedical applications.
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19
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Hoornaert A, Maazouz Y, Pastorino D, Aparicio C, de Pinieux G, Fellah BH, Ginebra MP, Layrolle P. Vertical Bone Regeneration with Synthetic Biomimetic Calcium Phosphate onto the Calvaria of Rats. Tissue Eng Part C Methods 2019; 25:1-11. [PMID: 30501579 DOI: 10.1089/ten.tec.2018.0260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
IMPACT STATEMENT This work reports a new bone substitute made of precipitated apatite crystals that resemble in composition and crystallinity to the mineral phase of bone. The bone regeneration capacity of this synthetic biomimetic calcium phosphate (SBCP) was studied by using an original model of vertical bone regeneration with cups on the calvaria of rats. After 4 weeks, a significantly higher bone growth was found with SBCP compared with deproteinized bovine bone matrix and empty controls. This rapid vertical bone regeneration indicated that this new biomaterial is particularly interesting for filling bone defects in oral surgery.
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Affiliation(s)
- Alain Hoornaert
- 1 Inserm, UMR 1238, PHY-OS, Laboratory of Bone Sarcomas and Remodelling of Calcified Tissues, Faculty of Medicine, University of Nantes, Nantes, France.,2 Faculty of Dental Surgery, CHU Nantes, Nantes, France
| | | | | | | | - Gonzague de Pinieux
- 1 Inserm, UMR 1238, PHY-OS, Laboratory of Bone Sarcomas and Remodelling of Calcified Tissues, Faculty of Medicine, University of Nantes, Nantes, France.,4 Department of AnatomoPathology, CHU Tours, Tours, France
| | - Borhane H Fellah
- 5 Centre for Investigation on Pre-Clinical Research, Veterinary School of Nantes, ONIRIS, Nantes, France
| | - Maria-Pau Ginebra
- 6 Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgical Engineering, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Pierre Layrolle
- 1 Inserm, UMR 1238, PHY-OS, Laboratory of Bone Sarcomas and Remodelling of Calcified Tissues, Faculty of Medicine, University of Nantes, Nantes, France
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20
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Sánchez-Garcés MA, Jorba M, Ciurana J, Vinas M, Vinuesa MT. Is the re-use of sterilized implant abutments safe enough? (Implant abutment safety). Med Oral Patol Oral Cir Bucal 2019; 24:e583-e587. [PMID: 31433387 PMCID: PMC6764709 DOI: 10.4317/medoral.22967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/08/2019] [Indexed: 11/07/2022] Open
Abstract
Background: The reuse of implant healing abutments is common in dental practice. Effective elimination of bacteria and viruses is accomplished by conventional sterilization.
The aim of this work was to explore the eventual survival of microorganisms on sterilized healing abutments and to rule out the presence of transmissible organic material after standard procedures.
Material and Methods: A total of 55 healing abutments previously used in patients will be washed and sterilized in a steam autoclave at 121ºC for 15 min. Each healing abutment will be cultured in Brain Heart Infusion broth (BHI) under strict aseptic conditions. Besides, two control groups will be included: one of 3 unused healing abutments, and the other of just medium. After 10 days at 37°C under a 5% CO2 100 µl of the broth will be plated on solid media (Brain Infusion Agar, BHIA) and Columbia Blood agar to test for sterility. The remaining volume will be centrifuged, the sediment fixed, and a Gram stain performed to discard the presence of non-cultivable microorganisms. Moreover, to determine the presence of remaining organic material after the cleaning and sterilizing treatments, the bioburden will be determined by measuring total organic carbon (TOC) in another 10 previously used healing abutments, cleaned and sterilized, that will be submerged in Milli-Q water and sonicated.
Results: No bacterial growth was detected on any of the 58 cultured abutments, indicating that the sterilization was completely satisfactory in terms of removal of live bacteria or spores. Nevertheless, significant amounts of organic carbon may still be recovered (up to 125,31 µg/abutment) after they have been sterilized.
Conclusions: Significant amounts of the bioburden remained adhered to the surfaces in spite of the cleaning and sterilization procedures. Taking into account our results and data from other authors, the presence of infectious particles on the reused healing abutments such as prions cannot be ruled out.
Key words:Healing abutment, abutment surface, peri-implantitis, mucositis, sterilization.
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Affiliation(s)
- M-A Sánchez-Garcés
- Department of Pathology and Experimental Therapeutics, Feixa Llarga s/n. Pavelló de Govern, 5 planta, 08907 L'Hospitalet de Llobregat, Barcelona, Spain,
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21
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Loin J, Kün-Darbois JD, Guillaume B, Badja S, Libouban H, Chappard D. Maxillary sinus floor elevation using Beta-Tricalcium-Phosphate (beta-TCP) or natural bone: same inflammatory response. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:97. [PMID: 31440845 DOI: 10.1007/s10856-019-6299-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
Sinus elevation is a common procedure to increase bone volume in the atrophic maxilla to allow placement of dental implants. Autogenous bone is the gold standard but is limited in quantity and causes morbidity at the donor site. β-TCP is a synthetic biomaterial commonly used in that purpose. It appears to induce a poor inflammatory response. This study aimed to evaluate the degree of edema of the sinus mucosa after sinus lift surgery according to the type of biomaterial. Forty sinuses (20 patients) were included retrospectively and divided into 2 groups according to the biomaterial that was used: synthetic biomaterial (BTCP group), natural bone (BONE group). A control group (CTRL group) was constituted by the non-grafted maxillary sinuses. Twelve measurements per sinus were realized on pre- and post-operative computed tomography and averaged to provide the sinus membrane thickness value (SM.Th). SM.Th was thicker post-operatively in the BTCP and BONE groups in comparison with the CTRL group and in comparison with pre-operative measurements. No difference was found post operatively between the BTCP and BONE groups. We found that a synthetic biomaterial (β-TCP) induced the same degree of edema, and thus of inflammation, as natural bone. It constitutes therefore an interesting alternative to autogenous bone for maxillary sinus lifts.
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Affiliation(s)
- Justine Loin
- Service de Chirurgie Maxillo-faciale et stomatologie, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France
| | - Jean-Daniel Kün-Darbois
- Service de Chirurgie Maxillo-faciale et stomatologie, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France.
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France.
| | - Bernard Guillaume
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
- Centre Français d'Implantologie CFI, 6 rue de Rome, 75008, Paris, France
| | - Smail Badja
- Service de Chirurgie Maxillo-faciale et stomatologie, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France
| | - Hélène Libouban
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
| | - Daniel Chappard
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
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22
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Abdullah N, Al-Marzooq F, Mohamad S, Abd Rahman N, Chi Ngo H, Perera Samaranayake L. Intraoral appliances for in situ oral biofilm growth: a systematic review. J Oral Microbiol 2019; 11:1647757. [PMID: 31489127 PMCID: PMC6713217 DOI: 10.1080/20002297.2019.1647757] [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: 05/12/2019] [Revised: 07/15/2019] [Accepted: 07/22/2019] [Indexed: 10/29/2022] Open
Abstract
Background: Oral biofilms are the root cause of major oral diseases. As in vitro biofilms are not representative of the intraoral milieu, various devices have been manufactured over the years to develop Appliance Grown Oral Biofilm (AGOB). Objective: To review various intraoral appliances used to develop AGOB for microbiological analysis, and to judge the optimal means for such analyses. Design: Four databases (PubMed, Science Direct, Scopus and Medline) were searched by two independent reviewers, and articles featuring the key words 'device' OR 'splint' OR 'appliance'; 'Oral biofilm' OR 'dental plaque'; 'in vivo' OR 'in situ'; 'Microbiology' OR 'Bacteria' OR 'microbiome'; were included. The standard Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were adopted for data gathering. Results: Of the 517 articles which met the initial inclusion criteria, 24 were deemed eligible for review. The age of the AGOB, sampled at various intervals, ranged from 30 min to 28 days. The most commonly used microbiome analytical methods were fluorescence microscopy, total cell count using conventional, and molecular tools including Next Generation Sequencing (NGS) platforms. Conclusions: No uniformly superior method for collecting AGOB could be discerned. NGS platforms are preferable for AGOB analyses.
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Affiliation(s)
- Nizam Abdullah
- College of Dental Medicine, University of Sharjah, Sharjah, UAE.,School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Malaysia
| | - Farah Al-Marzooq
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - Suharni Mohamad
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Malaysia
| | - Normastura Abd Rahman
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Malaysia
| | - Hien Chi Ngo
- College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Lakshman Perera Samaranayake
- College of Dental Medicine, University of Sharjah, Sharjah, UAE.,Faculty of Dentistry, University of Hong Kong, Hong Kong
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23
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Granel H, Bossard C, Nucke L, Wauquier F, Rochefort GY, Guicheux J, Jallot E, Lao J, Wittrant Y. Optimized Bioactive Glass: the Quest for the Bony Graft. Adv Healthc Mater 2019; 8:e1801542. [PMID: 30941912 DOI: 10.1002/adhm.201801542] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/25/2019] [Indexed: 12/21/2022]
Abstract
Technological advances have provided surgeons with a wide range of biomaterials. Yet improvements are still to be made, especially for large bone defect treatment. Biomaterial scaffolds represent a promising alternative to autologous bone grafts but in spite of the numerous studies carried out on this subject, no biomaterial scaffold is yet completely satisfying. Bioactive glass (BAG) presents many qualifying characteristics but they are brittle and their combination with a plastic polymer appears essential to overcome this drawback. Recent advances have allowed the synthesis of organic-inorganic hybrid scaffolds combining the osteogenic properties of BAG and the plastic characteristics of polymers. Such biomaterials can now be obtained at room temperature allowing organic doping of the glass/polymer network for a homogeneous delivery of the doping agent. Despite these new avenues, further studies are required to highlight the biological properties of these materials and particularly their behavior once implanted in vivo. This review focuses on BAG with a particular interest in their combination with polymers to form organic-inorganic hybrids for the design of innovative graft strategies.
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Affiliation(s)
- Henri Granel
- INRA, UMR 1019, UNH, CRNH Auvergne F‐63009 Clermont‐Ferrand France
- Université d'Auvergne, Unité de Nutrition HumaineClermont Université BP 10448 F‐63000 Clermont‐Ferrand France
| | - Cédric Bossard
- CNRS/IN2P3, Laboratoire de Physique de ClermontUniversité Clermont Auvergne BP 10448 F‐63000 Clermont‐Ferrand France
| | - Lisa Nucke
- Helmholtz‐Zentrum Dresden‐RossendorfInstitute of Ressource Ecology‐Bautzner Landstraße 400 01328 Dresden Germany
| | - Fabien Wauquier
- INRA, UMR 1019, UNH, CRNH Auvergne F‐63009 Clermont‐Ferrand France
- Université d'Auvergne, Unité de Nutrition HumaineClermont Université BP 10448 F‐63000 Clermont‐Ferrand France
| | - Gael Y. Rochefort
- Faculté de Chirurgie Dentaire, Paris Descartes, EA2496, Laboratoires PathologiesImagerie et Biothérapies orofaciales 1 rue Maurice Arnoux 92120 Montrouge France
| | - Jérôme Guicheux
- Inserm, UMR 1229, RMeSRegenerative Medicine and SkeletonUniversité de Nantes, Oniris Nantes, F‐44042 France
- UFR OdontologieUniversité de Nantes Nantes, F‐44042, France
- CHU Nantes, PHU4 OTONNNantes, F‐44093, France
| | - Edouard Jallot
- CNRS/IN2P3, Laboratoire de Physique de ClermontUniversité Clermont Auvergne BP 10448 F‐63000 Clermont‐Ferrand France
| | - Jonathan Lao
- CNRS/IN2P3, Laboratoire de Physique de ClermontUniversité Clermont Auvergne BP 10448 F‐63000 Clermont‐Ferrand France
| | - Yohann Wittrant
- INRA, UMR 1019, UNH, CRNH Auvergne F‐63009 Clermont‐Ferrand France
- Université d'Auvergne, Unité de Nutrition HumaineClermont Université BP 10448 F‐63000 Clermont‐Ferrand France
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24
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Rodriguez AE, Nowzari H. The long-term risks and complications of bovine-derived xenografts: A case series. J Indian Soc Periodontol 2019; 23:487-492. [PMID: 31543624 PMCID: PMC6737859 DOI: 10.4103/jisp.jisp_656_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The frequency of dental implant related surgeries that involve soft tissue and bone augmentation procedures has increased significantly. Bovine-derived substitutes have been by far the most commonly used xenografts in dentistry. Albeit literature is replete with clinical studies in favor of bovine-derived graft materials, bibliographical data reporting on risks and clinical complications is scarce. Clinical impression and concern for patient safety led to the report we have provided. The aim of the present case series was to raise awareness on the long-term risks and late clinical complications of bovine-derived graft materials. Patients were referred to a private practice due to bone augmentation complications. Demographics, significant medical and dental findings are reported. Complications included sinus and maxillary bone pathoses, displacement of the graft materials, oroantral communications, implant failure, foreign body reactions, encapsulation, chronic inflammation, soft tissue fenestrations and associated cysts. Bovine-derived graft materials were not biodegradable. Resolution of the associated lesions and symptoms was achieved after the removal of the bone graft materials. The surgical removal of the xenograft materials may require advanced clinical skills because of the different configurations clinicians might encounter of the non-resorbed and migrated particles. The authors’ concern is that patient morbidity may not be reduced with xenografts, due to the inherent risks and associated complications. Clinicians seeking to provide functional and esthetic outcomes should be aware of the complications of the bovine-derived graft materials. The long-term safety of xenografts and their potential association with disease are valid concerns.
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Bone Healing in Rabbit Calvaria Defects Using a Synthetic Bone Substitute: A Histological and Micro-CT Comparative Study. MATERIALS 2018; 11:ma11102004. [PMID: 30336544 PMCID: PMC6213059 DOI: 10.3390/ma11102004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 09/14/2018] [Accepted: 10/15/2018] [Indexed: 01/13/2023]
Abstract
Bioactive alloplastic materials, like beta-tricalcium phosphate (β-TCP) and calcium sulfate (CS), have been extensively researched and are currently used in orthopedic and dental bone regenerative procedures. The purpose of this study was to compare the performance of EthOss versus a bovine xenograft and spontaneous healing. The grafting materials were implanted in standardized 8 mm circular bicortical bone defects in rabbit calvariae. A third similar defect in each animal was left empty for natural healing. Six male rabbits were used. After eight weeks of healing, the animals were euthanized and the bone tissue was analyzed using histology and micro-computed tomography (micro-CT). Defects treated with β-TCP/CS showed the greatest bone regeneration and graft resorption, although differences between groups were not statistically significant. At sites that healed spontaneously, the trabecular number was lower (p < 0.05) and trabecular separation was higher (p < 0.05), compared to sites treated with β-TCP/CS or xenograft. Trabecular thickness was higher at sites treated with the bovine xenograft (p < 0.05) compared to sites filled with β-TCP/CS or sites that healed spontaneously. In conclusion, the novel β-TCP/CS grafting material performed well as a bioactive and biomimetic alloplastic bone substitute when used in cranial defects in this animal model.
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Zielak JC, Neto DG, Cazella Zielak MA, Savaris LB, Esteban Florez FL, Deliberador TM. In vivo regeneration functionalities of experimental organo-biomaterials containing water-soluble nacre extract. Heliyon 2018; 4:e00776. [PMID: 30229137 PMCID: PMC6141258 DOI: 10.1016/j.heliyon.2018.e00776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 02/08/2018] [Accepted: 09/05/2018] [Indexed: 12/01/2022] Open
Abstract
Background Novel multifunctional biomaterials were recently designed to allow for an optimized tissue regeneration process. Purpose To comprehensively assess (photographic, radiographic and histological) the in vivo functionality of demineralized bovine bone matrix (DBM) associated with an experimental marine organic extract (MOE) from nacre in a sheep ectopic grafting model. Materials and methods Synthesis of MOE was based on mixing powdered nacre (0.05 g, particles average size <0.1 mm) with acetic acid (5 mL, pH 7) under constant stirring for 72 hours (25 °C). Polyethylene tubes (3/animal, n = 4, diameter: 5.0 mm × length: 10.0 mm) from the control (empty) or experimental groups (DBM or DBM + MOE) were then intramuscularly implanted into the lumbar regions of sheep (n = 8, 2-years old, ≈45 kg). Animals were euthanized at 3 and 6 months to allow for the collection of tissue samples. Tissue samples were fixed in formalin 10% (buffered, 7 days) in preparation for photographic, radiographic and histological assessments. Acquired images were then analyzed using digital image analysis software to quantify the amount of neoformed tissues, whereas radiographic and histological analyses were performed to determine radiopacity and classification of tissues deposited inside of the tubes. Results Photographic and radiographic analyses have shown that both pure (unaltered) and MOE-modified DBM were capable of depositing neoformed tissues (at 3 and 6 months), where higher levels of deposition and radiopacity were observed on groups treated with experimental materials. Histological results, however, demonstrated that tissues formed from both unaltered and MOE-modified DBM were only fibrous connective in origin. Conclusions As an ectopic grafting in sheep, the experimental organo-biomaterial association applied did not reveal any osteoinductive property but led to a fibrous tissue repair only.
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Affiliation(s)
- João César Zielak
- Graduate Program in Dentistry, Universidade Positivo, Rua Professor Pedro Viriato Parigot de Souza, 5300, Curitiba, Paraná, 81280-330, Brazil
| | - David Gulin Neto
- Graduate Program in Dentistry, Universidade Positivo, Rua Professor Pedro Viriato Parigot de Souza, 5300, Curitiba, Paraná, 81280-330, Brazil
| | - Makeli Aparecida Cazella Zielak
- Graduate Program in Dentistry, Universidade Positivo, Rua Professor Pedro Viriato Parigot de Souza, 5300, Curitiba, Paraná, 81280-330, Brazil
| | - Leonardo Brunet Savaris
- Graduate Program in Dentistry, Universidade Positivo, Rua Professor Pedro Viriato Parigot de Souza, 5300, Curitiba, Paraná, 81280-330, Brazil
| | - Fernando Luis Esteban Florez
- Department of Restorative Sciences, Division of Dental Biomaterials, The University of Oklahoma Health Sciences Center, 1201 N. Stonewall Ave., Oklahoma City, OK, 73117, USA
| | - Tatiana Miranda Deliberador
- Graduate Program in Dentistry, Universidade Positivo, Rua Professor Pedro Viriato Parigot de Souza, 5300, Curitiba, Paraná, 81280-330, Brazil
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Alveolar Ridge Preservation Using a Novel Synthetic Grafting Material: A Case with Two-Year Follow-Up. Case Rep Dent 2018; 2018:6412806. [PMID: 29487751 PMCID: PMC5816876 DOI: 10.1155/2018/6412806] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/13/2017] [Indexed: 11/25/2022] Open
Abstract
This case report highlights the use of a novel in situ hardening synthetic (alloplastic), resorbable, bone grafting material composed of beta tricalcium phosphate and calcium sulfate, for alveolar ridge preservation. A 35-year-old female patient was referred by her general dentist for extraction of the mandibular right first molar and rehabilitation of the site with a dental implant. The nonrestorable tooth was “atraumatically” extracted without raising a flap, and the socket was immediately grafted with the synthetic biomaterial and covered with a hemostatic fleece. No membrane was used, and the site was left uncovered without obtaining primary closure, in order to heal by secondary intention. After 12 weeks, the architecture of the ridge was preserved, and clinical observation revealed excellent soft tissue healing without loss of attached gingiva. At reentry for placement of the implant, a bone core biopsy was obtained, and primary implant stability was measured by final seating torque and resonance frequency analysis. Histological analysis revealed pronounced bone regeneration while high levels of primary implant stability were recorded. The implant was successfully loaded 12 weeks after placement. Clinical and radiological follow-up examination at two years revealed stable and successful results regarding biological, functional, and esthetic parameters.
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Luongo F, Mangano FG, Macchi A, Luongo G, Mangano C. Custom-Made Synthetic Scaffolds for Bone Reconstruction: A Retrospective, Multicenter Clinical Study on 15 Patients. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5862586. [PMID: 28070512 PMCID: PMC5192311 DOI: 10.1155/2016/5862586] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/23/2016] [Indexed: 02/07/2023]
Abstract
Purpose. To present a computer-assisted-design/computer-assisted-manufacturing (CAD/CAM) technique for the design, fabrication, and clinical application of custom-made synthetic scaffolds, for alveolar ridge augmentation. Methods. The CAD/CAM procedure consisted of (1) virtual planning/design of the custom-made scaffold; (2) milling of the scaffold into the exact size/shape from a preformed synthetic bone block; (3) reconstructive surgery. The main clinical/radiographic outcomes were vertical/horizontal bone gain, any biological complication, and implant survival. Results. Fifteen patients were selected who had been treated with a custom-made synthetic scaffold for ridge augmentation. The scaffolds closely matched the shape of the defects: this reduced the operation time and contributed to good healing. A few patients experienced biological complications, such as pain/swelling (2/15: 13.3%) and exposure of the scaffold (3/15: 20.0%); one of these had infection and complete graft loss. In all other patients, 8 months after reconstruction, a well-integrated newly formed bone was clinically available, and the radiographic evaluation revealed a mean vertical and horizontal bone gain of 2.1 ± 0.9 mm and 3.0 ± 1.0 mm, respectively. Fourteen implants were placed and restored with single crowns. The implant survival rate was 100%. Conclusions. Although positive outcomes have been found with custom-made synthetic scaffolds in alveolar ridge augmentation, further studies are needed to validate this technique.
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Affiliation(s)
| | - Francesco Guido Mangano
- Department of Surgical and Morphological Science, Dental School, Insubria University, 21100 Varese, Italy
| | - Aldo Macchi
- Department of Surgical and Morphological Science, Dental School, Insubria University, 21100 Varese, Italy
| | - Giuseppe Luongo
- Department of Oral and Maxillofacial Surgery, Federico II University, 80131 Naples, Italy
| | - Carlo Mangano
- Department of Dental Sciences, Vita Salute San Raffaele University, 20132 Milan, Italy
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