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Luo Q, Luo Y, Liu J, Yang X. The influence of bone block graft position on bone dimensional changes in staged onlay horizontal ridge augmentation: A 6-month retrospective cohort study. Clin Oral Implants Res 2024. [PMID: 38794847 DOI: 10.1111/clr.14299] [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: 04/25/2023] [Revised: 04/28/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVES To analyze changes in bone dimensions and their modulating factor in bone dimensions 6 months after horizontal ridge augmentation using autogenous bone grafts. MATERIALS AND METHODS Thirty-eight patients with horizontally atrophic alveolar ridges of a single edentulous tooth at the maxillary anterior site were divided into two groups based on the fixation position of the bone block during ridge augmentation surgery (H0, vertical distance from the upper edge of the bone block to the alveolar crest). Patients were classified into a crestal level (CL) group if H0 ≤ 1 mm and a sub-crestal level (SCL) group if H0 > 1 mm. The width and height of the alveolar ridge were recorded using CBCT both before and 6 months after the augmentation procedure. RESULTS The CL group comprised 20 patients with 23 implants, whereas the SCL group comprised 18 patients with 22 implants. All the augmentation sites exhibited vertical bone resorption. Vertical bone resorption in the SCL group (1.94 ± 2.11 mm) was significantly higher than that of the CL group (0.61 ± 0.64 mm). The SCL group showed significantly lower horizontal bone gain than the CL group (SCL: 1.02 ± 2.30 mm; CL: 3.19 ± 3.17 mm) at the cervical level. Peri-implant marginal bone loss increased significantly in the SCL group (1.00 ± 2.71 mm) compared to the CL group (0.64 ± 0.40 mm). CONCLUSION The bone height decreased after horizontal ridge augmentation using autogenous onlay grafting. The fixation position of the bone block was a modulating factor. The SCL group showed more vertical bone loss, less horizontal bone gain 6 months after surgery, and more marginal bone loss after restoration.
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Affiliation(s)
- Qiyue Luo
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yilin Luo
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jingjing Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xingmei Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Wang S, Duan S, Chen R, Wang Z, Tang Y. Immediate loading in partially edentulous patients with fixed implant-supported restorations cases report. FRONTIERS IN ORAL HEALTH 2024; 5:1369494. [PMID: 38774040 PMCID: PMC11106488 DOI: 10.3389/froh.2024.1369494] [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: 01/12/2024] [Accepted: 04/24/2024] [Indexed: 05/24/2024] Open
Abstract
Objectives This article reports on four rare cases involving multiple trauma-induced adjacent missing anterior teeth in the maxillary or mandibular region. These cases were successfully treated using a 4-axial implant-based alternative insert and an immediate loading protocol. Material and methods This series of cases was summarized by retrospective study that 4 patients who received a total of 20 immediately loaded implants. These patients had suffered from trauma-induced loss of 8-9 adjacent anterior teeth. The 4-axial-implants were inserted with the assistance of digital pioneer drill guides. The surgical procedure involved alveolar bone trimming or ultrasonic osteotomy, eliminating the need for traditional large-area bone augmentation. Pre- and post-operative CBCT was matched using DTX Studio Implant software, the deviation of implant between actual position and preoperative design was measured and compared using SPSS software package. Results The average follow-up duration 48 months after implant prostheses, the cumulative retention rate of the implants was 100%, the marginal bone loss averaged 0.53 mm (SD 0.15 mm), and buccal plate bone loss averaged 0.62 mm (SD 0.41 mm). Conclusions This retrospective clinical report demonstrates the successful treatment of several patients with multiple adjacent maxillary or mandibular anterior teeth using four implant-supported screws to fix the frame and employing immediate loading. The approach resulted in long-term stable clinical outcomes. Moreover, the method not only shortens the period of edentulism but also facilitates easy disassembly, maintenance, and cleaning. Consequently, it emerges as a highly favorable clinical option for patients suffering from extensive tooth loss.
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Affiliation(s)
- Shuang Wang
- Graduate School, China Medical University, Shenyang, China
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Siyi Duan
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
- Graduate School, Dalian Medical University, Dalia, China
| | - Rui Chen
- Graduate School, China Medical University, Shenyang, China
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Zijian Wang
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
- Graduate School, Dalian Medical University, Dalia, China
| | - Yulong Tang
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
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Pellegrino G, Zaccheroni Z, Lizio G. Immediate full-arch fixed rehabilitation of a narrow mandible with newly conceived connection system implants: A case report. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2024; 16:64-71. [PMID: 39027210 PMCID: PMC11252157 DOI: 10.34172/japid.2024.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/27/2024] [Indexed: 07/20/2024]
Abstract
Rehabilitating thin jaws without reconstructive surgery entails using narrow implants. The proposed treatment adopted an innovative implant system, allowing the mini-screws to be parallel and immediately loaded. A mandible, wearing an overdenture, was functionalized contextually to the residual dental extraction and the placement of six 2.4-mm thick one-piece implants. Low-profile intermediate abutments, the LEMs, able to rotate over the spherical heads of the fixtures, were connected after suturing, oriented, and blocked in a mutual parallel position. The copings, engaging with a tapered juncture of the LEMs, resulted in their alignment to be intraorally wedged together. The provisional superstructure enclosed the copings and was immediately connected to the implants, and the definitive prosthesis was delivered after three months. No clinical signs of peri-implantitis or radiographically evident bone loss were recorded after a two-year follow-up without any prosthetic complication. No cases have been published regarding mini-implants bearing fixed prosthesis rehabilitation.
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Affiliation(s)
- Gerardo Pellegrino
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Aludden H, Starch-Jensen T, Dahlin C, Sdik J, Cederlund A, Mordenfeld A. Histological and radiological outcome after horizontal guided bone regeneration with bovine bone mineral alone or in combination with bone in edentulous atrophic maxilla: A randomized controlled trial. Clin Oral Implants Res 2024; 35:396-406. [PMID: 38291545 DOI: 10.1111/clr.14235] [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: 06/28/2023] [Revised: 11/30/2023] [Accepted: 12/16/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE To assess the radiological and histological outcome after horizontal guided bone regeneration (GBR) with deproteinized bovine bone mineral (DBBM) alone or in combination with particulate autogenous bone (PAB). MATERIALS AND METHODS Eighteen edentulous patients with an alveolar ridge of ≤4 mm were included in this split-mouth randomized controlled trial. Horizontal GBR with a graft composition of 100% DBBM (100:0) on one side and 90% DBBM and 10% PAB (90:10) on the other side were conducted in all patients. Cone beam computed tomography (CBCT) was obtained preoperatively, immediately postoperative, and after 10 months of healing. Width and volumetric changes in the alveolar process were measured on CBCT. Implants were placed after 10 months of graft healing where biopsies were obtained for histomorphometrical evaluation. RESULTS The gained widths were 4.9 (±2.4) mm (100:0) and 4.5 (±2.0) mm (90:10) at 3 mm from the top of the crest, and 5.6 (±1.3) mm (100:0) and 4.6 (±2.1) mm (90:10) at 6 mm from the top of the crest. The mean volumetric reductions were 32.8% (±23.8) (100:0) and 38.2% (±23.2) (90:10). Histomorphometry revealed that mean percentages of bone were 50.8% (±10.7) (100:0) and 46.4% (±11.3) (90:10), DBBM were 31.6% (±12.6) (100:0) and 35.4% (±14.8) (90:10), and non-mineralized tissue were 17.6% (±11.7; 100:0) and 18.2% (±18.2) (90:10). No significant differences were evident between in any evaluated parameters. CONCLUSIONS There were no additional effects of adding PAB to DBBM regarding bone formation, width changes, or volumetric changes after 10 months of graft healing.
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Affiliation(s)
- Hanna Aludden
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral and Maxillofacial Surgery, NU-Hospital, Organization Trollhättan, Trollhättan, Sweden
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Christer Dahlin
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral and Maxillofacial Surgery, NU-Hospital, Organization Trollhättan, Trollhättan, Sweden
| | | | - Andreas Cederlund
- Department of Oral Radiology, Eastman Institute, Stockholm County Council, Region Stockholm, Stockholm, Sweden
| | - Arne Mordenfeld
- Plastic and Oral & Maxillofacial Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Bayram F, Göçmen G, Özkan Y. Evaluating risk factors and complications in mandibular ramus block grafting: a retrospective cohort study. Clin Oral Investig 2024; 28:226. [PMID: 38514518 PMCID: PMC10957589 DOI: 10.1007/s00784-024-05613-6] [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: 12/13/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES This retrospective cohort study aimed to identify the complications and risk factors associated with alveolar grafting using autologous mandibular ramus grafts, guided by the research question: What are the complications encountered in patients undergoing alveolar bone grafting using autologous mandibular ramus block and what are the risk factors associated with the development of these complications? MATERIALS AND METHODS The study included 70 patients who underwent alveolar crest augmentation with autologous mandibular ramus block grafting. Intraoperative, early postoperative, and late postoperative complications were analyzed, as were various risk factors. RESULTS The results showed that the majority of patients had successful outcomes with minimal complications. Sex was found to significantly influence the visibility of the inferior alveolar nerve (IAN). Early postoperative complications were associated with IAN visibility and the use of a single screw for graft fixation. Late postoperative complications were significantly associated with the presence of infection. CONCLUSION The findings emphasize the importance of careful surgical techniques, infection prevention, and patient selection in minimizing complications. CLINICAL RELEVANCE This article may contribute to clinicians' and so patients' understanding of potential risk factors associated with over all ramus block grafting procedure. Based on this information, clinicians can also improve their ability to manage risk factors and associated complications and compare ramus block grafting with other alternatives to determine the best treatment approach for that particular patient.
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Affiliation(s)
- Ferit Bayram
- Department of Oral and Maxillofacial Surgery, Marmara University School of Dentistry, Istanbul, 34854, Turkey.
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Marmara, Basibuyuk Yolu 9/3 34854 Basibuyuk / Maltepe / Istanbul, Istanbul, 34854, Turkey.
| | - Gökhan Göçmen
- Department of Oral and Maxillofacial Surgery, Marmara University School of Dentistry, Istanbul, 34854, Turkey
| | - Yaşar Özkan
- Department of Oral and Maxillofacial Surgery, Marmara University School of Dentistry, Istanbul, 34854, Turkey
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Lotfazar M, Amid R, Moscowchi A. Potentials of pure xenograft materials in maxillary ridge augmentation: A case series. Saudi Dent J 2024; 36:187-191. [PMID: 38375397 PMCID: PMC10874793 DOI: 10.1016/j.sdentj.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 02/21/2024] Open
Abstract
Many patients require edentulous ridge augmentation for dental implant placement. The main objective of this study was to evaluate the results of maxillary edentulous ridge augmentation exclusively with xenograft materials with and without simultaneous sinus floor elevation. This study reports the data retrieved from the records of 16 patients. The treatment outcome was assessed at least 6 months, postoperatively. Paired samples t-test or Wilcoxon Signed Rank test was used to compare the pre-and postoperative ridge dimensions. Dental implants were placed simultaneously in 7 patients, while 9 patients underwent delayed implant placement. In total, 68 implants were placed, and 12 patients also underwent maxillary sinus floor augmentation. A significant bone gain was achieved in both horizontal and vertical dimensions of edentulous maxillary ridges (P < 0.001). Ridge width increased by an average of 4.35 ± 1.90 mm (95% CI: 3.84 to 4.85 mm) while ridge height in areas of sinus floor augmentation increased by 8.19 ± 2.91 mm (95% CI: 7.33 to 9.05 mm). Within the study limitations, it appears that maxillary ridge augmentation according to the guided bone regeneration (GBR) protocols with exclusive use of xenograft particulate materials can provide optimal bone quantity for dental implant placement.
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Affiliation(s)
| | - Reza Amid
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mirdad A. Particulate bone grafting with a resorbable collagen membrane and horizontal alveolar ridge augmentation with tenting screws in dental implant placement: A case report. Clin Case Rep 2024; 12:e8359. [PMID: 38193035 PMCID: PMC10772354 DOI: 10.1002/ccr3.8359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
Key Clinical Message We used a mixture of particulate bone grafts (xenografts/allografts) with tenting screws to prevent membrane collapse and covered the graft with a resorbable collagen membrane to guide bone regeneration. This strategy can exclude the need for additional procedures, such as non-resorbable membranes and major block grafting surgeries. Although the initial outcomes are promising, continuous follow-up is required to examine the stability of the newly regenerated bone and the long-term success of the implant. Abstract This case demonstrates the use of particulate bone grafts covered with a resorbable collagen membrane and supported by tenting screws to correct horizontal alveolar ridge defects. A man in his 40s presented with missing maxillary anterior central and lateral incisors and required a fixed dental prosthesis. One year before, #12, #11, #21, and #22 had been extracted. The area showed horizontal and slight vertical bone loss. We used a mixture of particulate bone grafts (xenografts and allografts) with tenting screws to prevent membrane collapse and covered the graft with a resorbable collagen membrane to guide bone regeneration. After 6 months, complete bone regeneration was achieved, and the dental implants were submerged in the bone. After another 6 months, the patient was administered with a fixed dental prosthesis. This method can be used to correct horizontal alveolar ridge defects and achieve esthetic restoration without the need for more extensive procedures.
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Affiliation(s)
- Amani Mirdad
- Department of Periodontics and Community Dentistry, College of DentistryKing Saud UniversityRiyadhSaudi Arabia
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Gao Y, Gao S, Yao Y, Cai X. Hard tissue stability outside the buccal bone arch contour after guided bone regeneration in the anterior maxilla: A retrospective cohort radiographic study. Clin Oral Implants Res 2023; 34:1373-1384. [PMID: 37771049 DOI: 10.1111/clr.14181] [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: 04/27/2023] [Revised: 08/28/2023] [Accepted: 09/10/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES To radiographically evaluate the stability of the bone substitute augmented outside the buccal bony arch contour in the maxillary esthetic zone. MATERIALS AND METHODS Patients who missed a single anterior tooth and received simultaneous GBR in implant surgery were included. The contralateral homonymous area of the implant site was horizontally mirrored as the individual bone arch contour. According to the relative position of the postoperative buccal grafts and bone arch contour at the implant shoulder, 62 patients were allocated into the outside-contour (OC) and inside-contour (IC) groups. Cone-beam computed tomography was performed before surgery, after implant insertion, before re-entry surgery, and at follow-up. The profilometric changes of the buccal bone plate were analyzed via the bone distance to the mirrored bony contour. RESULTS At the implant shoulder, the bone distance in the OC group was higher than that in the IC group, with statistically significant differences at re-entry surgery and follow-up. However, the bone grafts outside the bone arch contour were reduced into the contour after remodeling and showed more bone resorption than the IC group. At other vertical levels below the implant shoulder, bony grafting of overcontour 1-2 mm range was favorable to regenerate stable bone plates reaching the individual contour at follow-up. CONCLUSIONS The overaugmented bone outside the buccal bone arch contour tended to remodel into the original contour, which indicates that the anterior bone arch contour is worthy of careful observation for deciding buccolingual implant position and bone augmentation width.
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Affiliation(s)
- Yang Gao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shaojingya Gao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yangxue Yao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoxiao Cai
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Li Z, Yang C, Wang J, Zheng K, Luo W. The application of CGF combined with GBR in alveolar bone increment for patients with anxiety disorder: A rare case report and literature review. Medicine (Baltimore) 2023; 102:e35905. [PMID: 37960737 PMCID: PMC10637472 DOI: 10.1097/md.0000000000035905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
RATIONALE Selective serotonin reuptake inhibitors (SSRIs), one of the commonly used anti-anxiety drugs, may have impacts on bone metabolism and potentially lead to drug-induced osteoporosis. The traditional approach of oral implantation in individuals with both anxiety disorder and drug-induced osteoporosis poses a significant challenge. To address this issue, concentrated growth factor (CGF) has been utilized in patients undergoing concurrent alveolar ridge augmentation during oral implantation, resulting in favorable clinical outcomes. Consequently, combining CGF with guided bone regeneration (GBR) in alveolar bone increment may represent a promising new surgical approach for such patients. In this report, we present a case study of a 25-year-old male with anxiety disorder and drug-induced osteoporosis, in who CGF combined with GBR was employed in alveolar bone increment. PATIENT CONCERNS This article reports the case of a 25-year-old male who underwent cone beam computed tomography (CBCT) due to the absence of his right lower second molar for a period of six months. The CBCT scan revealed significant bone defects, which were attributed to the tooth loss and prolonged use of anti-anxiety drugs. Consequently, the patient sought medical assistance from our department. DIAGNOSES Based on the patient's self-report, he was diagnosed with an anxiety disorder. Additionally, the CBCT scan confirmed the loss of the right mandibular second molar and revealed the presence of dental irregularity and an alveolar bone defect. INTERVENTIONS During the patient's course of treatment with anti-anxiety medication, a combination of CGF and GBR was employed for the simultaneous implantation of the missing right mandibular second molar, along with bone augmentation. OUTCOMES The patient had a follow-up visit two weeks after the surgical procedure, and the wound in the operation area had healed satisfactorily. Six months later, CBCT images revealed excellent osseointegration. The buccal and lingual width of the alveolar bone measured 6.95mm, which was an increase of 1.35mm compared to the pre-implantation stage. LESSONS This article presents a case study in which CGF combined with GBR were utilized to address alveolar bone augmentation during the implantation phase in patients taking anti-anxiety medication. The results demonstrated that CGF combined with GBR, as a cutting-edge platelet concentrate technique, could effectively stimulate bone tissue proliferation in individuals who have been on long-term anti-anxiety medication, specifically in oral implant areas. This approach can help prevent poor osseointegration, promote higher osseointegration rates, and facilitate wound healing.
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Affiliation(s)
- Zhixin Li
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Chao Yang
- Department of Stomatology, The People's Hospital of Longhua, Shenzhen, China
- Research and Development Department, Shenzhen Uni-medica Technology CO., Ltd, Shenzhen, China
| | - Jinrong Wang
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Kaiyue Zheng
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Wen Luo
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
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Yu SH, Saleh MHA, Wang HL. Simultaneous or staged lateral ridge augmentation: A clinical guideline on the decision-making process. Periodontol 2000 2023; 93:107-128. [PMID: 37529966 DOI: 10.1111/prd.12512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
Lateral ridge augmentation is a standard surgical procedure that can be performed prior to (staged) or simultaneously with implant placement. The decision between a simultaneous or staged approach involves considering multiple variables. This paper proposed a decision-making process that serves as a guideline for choosing the best treatment choice based on the available evidence and the author's clinical experience.
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Affiliation(s)
- Shan-Huey Yu
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Private Practice, Vienna, Virginia, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Čandrlić M, Tomas M, Matijević M, Kačarević ŽP, Bićanić M, Udiljak Ž, Butorac Prpić I, Miškulin I, Čandrlić S, Včev A. Regeneration of Buccal Wall Defects after Tooth Extraction with Biphasic Calcium Phosphate in Injectable Form vs. Bovine Xenograft: A Randomized Controlled Clinical Trial. Dent J (Basel) 2023; 11:223. [PMID: 37754343 PMCID: PMC10528832 DOI: 10.3390/dj11090223] [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: 07/28/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
Bone healing after tooth extraction may be affected by defects of the alveolus buccal wall, such as fenestrations and dehiscences. Therefore, to minimize dimensional changes it is advisable to perform alveolar ridge preservation after tooth extractions. Different biomaterials are used for this purpose. The aim of this study was to investigate the qualitative and quantitative histological changes in human biopsies taken after 6 months of healing of extraction sockets with buccal wall defects. For this purpose, the defects of 36 patients (18 per group) were treated with injectable biphasic calcium phosphate (I-BCP) or bovine xenograft (BX) after extraction. After six months of healing, biopsies were taken and proceeded to the histology laboratory. No evidence of an inflammatory response of the tissue was observed in the biopsies of either group, and the newly formed bone (NB) was in close contact with the remaining biomaterial (BM). The histomorphometric results showed that there was no statistically significant difference between the groups in the mean percentage of NB (p = 0.854), BM (p = 0.129), and soft tissue (p = 0.094). To conclude, both biomaterials exhibited osteoconductivity and biocompatibility and achieved satisfactory bone regeneration of buccal wall defects after tooth extraction.
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Affiliation(s)
- Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Marko Matijević
- Community Healthcare Center of Osijek-Baranja County, 31 000 Osijek, Croatia;
| | - Željka Perić Kačarević
- Department of Anatomy, Histology, Embriology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia;
- Botiss Biomaterials GmbH, 15806 Zossen, Germany
| | - Marijana Bićanić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Žarko Udiljak
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Ivana Butorac Prpić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Ivan Miškulin
- Department of Public Health, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Slavko Čandrlić
- Department of Interdisciplinary Areas, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia;
| | - Aleksandar Včev
- Department of Pathophysiology, Physiology and Immunology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia
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Vargas SM, Johnson TM, Pfaff AS, Bumpers AP, Wagner JC, Retrum JK, Colamarino AN, Bunting ME, Wilson JP, McDaniel CR, Herold RW, Stancoven BW, Lincicum AR. Clinical protocol selection for alveolar ridge augmentation at sites exhibiting slight, moderate, and severe horizontal ridge deficiencies. Clin Adv Periodontics 2023; 13:174-196. [PMID: 36760073 DOI: 10.1002/cap.10239] [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: 10/07/2022] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
FOCUSED CLINICAL QUESTION What factors identify the optimal bone augmentation techniques for managing slight, moderate, and severe horizontal alveolar ridge deficiency (ARD) at dental implant sites? SUMMARY Horizontal ARD is a concern at a high proportion of sites receiving dental implants, and clinicians have developed a variety of surgical procedures to address such defects. In a particular case, selection of the optimal treatment may depend predominantly on defect severity, location (anterior versus posterior), and configuration (contained versus noncontained). This report provides a framework for selecting an augmentation method when presented with a slight, moderate, or severe horizontal ARD at a site requiring dental implant placement. CONCLUSION Multiple treatment options are available for planned implant sites exhibiting horizontal ARD; severe posterior and slight anterior defects intuitively call for different approaches. Although rigid guidelines for selecting the optimal augmentation method do not exist, some techniques are poorly suited for esthetically demanding sites. A framework considering defect severity, location, and configuration may help guide clinical decisions on this topic.
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Affiliation(s)
- Sarah M Vargas
- Department of Periodontics, United States Army Dental Health Activity, Fort Bragg, North Carolina, USA
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Aaron S Pfaff
- Department of Periodontics, United States Army Dental Health Activity, Fort Wainwright, Alaska, USA
| | - April P Bumpers
- Department of Periodontics, United States Army Dental Health Activity, Fort Jackson, South Carolina, USA
| | - Jennah C Wagner
- Department of Periodontics, United States Army Dental Health Activity, Fort Meade, Maryland, USA
| | - Joseph K Retrum
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Aaron N Colamarino
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Megan E Bunting
- Department of Periodontics, United States Army Dental Health Activity, Fort Drum, New York, USA
| | - James P Wilson
- Department of Periodontics, United States Army Dental Health Activity, Fort Campbell, Kentucky, USA
| | - Carsen R McDaniel
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Robert W Herold
- Department of Periodontics, Veterans Administration Medical Center, Augusta, Georgia, USA
| | - Brian W Stancoven
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Adam R Lincicum
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
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13
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Urban I, Sanz-Sánchez I, Monje A, Montero E. Complications and treatment errors in peri-implant hard tissue management. Periodontol 2000 2023; 92:278-298. [PMID: 37016554 DOI: 10.1111/prd.12472] [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: 04/22/2022] [Revised: 08/14/2022] [Accepted: 08/21/2022] [Indexed: 04/06/2023]
Abstract
Bone augmentation procedures aim to regenerate the deficient alveolar ridge to properly place dental implants that are completely surrounded by bone. However, these are invasive and technically demanding surgeries that are not free of either complications or treatment errors. Careful patient selection and preparation is a mandatory process to reduce the rate of complications in bone regeneration procedures, irrespective of the technique used. It is important to assess the cost benefit of the intervention and to evaluate the potential impact on the patient's quality of life, especially in the elderly and medically compromised patients. Most common postoperative complications are wound dehiscences, which may be reduced, at least partially, by proper knowledge of the surgical technique and the craniofacial anatomy. Other complications that may appear are postoperative infections or nerve injuries. The aim of this narrative review is to summarize the best available scientific evidence on the incidence of complications, as well as the ideal strategies for their prevention and management. Depending on the severity of the complication, treatment approaches may vary and can include drug prescription or even surgical re-entries to remove exposed barrier membranes or contaminated bone grafts. Adequate prevention and proper management of complications associated with bone augmentation interventions are a requirement for clinicians carrying out these demanding procedures. A series of cases illustrating proper management of complications in different clinical scenarios is presented.
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Affiliation(s)
- Istvan Urban
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontology and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Alberto Monje
- Department of Periodontology, School of Dentistry, International University of Catalonia, Barcelona, Spain
- Department of Periodontology and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
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14
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Ordóñez-Chávez GDC, Rodríguez-Fuentes N, Peñaloza-Cuevas R, Cervantes-Uc JM, Alcántara-Quintana LE, Maya-García IA, Herrera-Valencia VA, Mendiburu-Zavala CE. In vitro evaluation of crosslinked bovine pericardium as potential scaffold for the oral cavity. Biomed Mater Eng 2023; 34:561-575. [PMID: 37545206 PMCID: PMC10657658 DOI: 10.3233/bme-230027] [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: 03/01/2023] [Accepted: 07/27/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Bovine pericardium (BP) is a scaffold widely used in soft tissues regeneration; however, its calcification in contact with glutaraldehyde, represent an opportunity for its application in hard tissues, such as bone in the oral cavity. OBJECTIVE To develop and to characterize decellularized and glutaraldehyde-crosslinked bovine pericardium (GC-BP) as a potential scaffold for guided bone regeneration GBR. METHODS BP samples from healthy animals of the bovine zebu breed were decellularized and crosslinked by digestion with detergents and glutaraldehyde respectively. The resulting cell-free scaffold was physical, chemical, mechanical, and biologically characterized thought hematoxylin and eosin staining, DNA quantification, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), uniaxial tensile test, cell viability and live and dead assay in cultures of dental pulp stem cells (DPSCs). RESULTS The decellularization and crosslinking of BP appeared to induce conformational changes of the CLG molecules, which led to lower mechanical properties at the GC-BP scaffold, at the same time that promoted cell adhesion and viability of DPSCs. CONCLUSION This study suggests that the decellularized and GC-BP is a scaffold with the potential to be used promoting DPSCs recruitment, which has a great impact on the dental area.
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Affiliation(s)
| | - Nayeli Rodríguez-Fuentes
- CONACYT-Centro de Investigación Científica de Yucatán, Yucatan, Mexico
- Centro de Investigación Científica de Yucatán, Yucatan, Mexico
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15
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Suárez-López Del Amo F, Monje A. Efficacy of biologics for alveolar ridge preservation/reconstruction and implant site development: An American Academy of Periodontology best evidence systematic review. J Periodontol 2022; 93:1827-1847. [PMID: 35841608 PMCID: PMC10092438 DOI: 10.1002/jper.22-0069] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The use of biologics may be indicated for alveolar ridge preservation (ARP) and reconstruction (ARR), and implant site development (ISD). The present systematic review aimed to analyze the effect of autologous blood-derived products (ABPs), enamel matrix derivative (EMD), recombinant human platelet-derived growth factor-BB (rhPDGF-BB), and recombinant human bone morphogenetic protein-2 (rhBMP-2), on the outcomes of ARP/ARR and ISD therapy (i.e., alveolar ridge augmentation [ARA] and maxillary sinus floor augmentation [MSFA]). METHODS An electronic search for eligible articles published from January 2000 to October 2021 was conducted. Randomized clinical trials evaluating the efficacy of ABPs, EMD, rhBMP-2, and rhPDGF-BB for ARP/ARR and ISD were included according to pre-established eligibility criteria. Data on linear and volumetric dimensional changes, histomorphometric findings, and a variety of secondary outcomes (i.e., clinical, implant-related, digital imaging, safety, and patient-reported outcome measures [PROMs]) were extracted and critically analyzed. Risk of bias assessment of the selected investigations was also conducted. RESULTS A total of 39 articles were included and analyzed qualitatively. Due to the high level of heterogeneity across studies, quantitative analyses were not feasible. Most studies in the topic of ARP/ARR revealed that the use of biologics rendered similar results compared with conventional protocols. However, when juxtaposed to unassisted healing or socket filling using collagen sponges, the application of biologics did contribute to attenuate post-extraction alveolar ridge atrophy in most investigations. Additionally, histomorphometric outcomes were positively influenced by the application of biologics. The use of biologics in ARA interventions did not yield superior clinical or radiographic outcomes compared with control therapies. Nevertheless, ABPs enhanced new bone formation and reduced the likelihood of early wound dehiscence. The use of biologics in MSFA interventions did not translate into superior clinical or radiographic outcomes. It was observed, though, that the use of some biologics may promote bone formation during earlier stages of healing. Only four clinical investigations evaluated PROMs and reported a modest beneficial impact of the use of biologics on pain and swelling. No severe adverse events in association with the use of the biologics evaluated in this systematic review were noted. CONCLUSIONS Outcomes of therapy after post-extraction ARP/ARR and ARA in edentulous ridges were comparable among different therapeutic modalities evaluated in this systematic review. Nevertheless, the use of biologics (i.e., PRF, EMD, rhPDGF-BB, and rhBMP-2) in combination with a bone graft material generally results into superior histomorphometric outcomes and faster wound healing compared with control groups.
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Affiliation(s)
| | - Alberto Monje
- Department of Periodontology, International University of Catalonia (UIC), Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Division of Periodontology, CICOM-MONJE Institute, Badajoz, Spain.,Department of Periodontics, University of Bern, Bern, Switzerland
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16
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Maxillary Reconstruction with Xenogeneic Bone Graft, Platelet-Rich Fibrin, and Titanium Mesh for Rehabilitation with Implants: A 5-year Follow-Up Study. Case Rep Dent 2022; 2022:3412190. [PMID: 36397751 PMCID: PMC9666031 DOI: 10.1155/2022/3412190] [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: 07/01/2022] [Revised: 10/20/2022] [Accepted: 10/31/2022] [Indexed: 11/10/2022] Open
Abstract
Aim Alveolar deficiency is considered one of the main limitations for placement of osseointegrated implants, as well as for their long-term success, especially in the anterior region of the maxilla. Objective To report a clinical case of reconstruction of atrophic maxilla with deproteinized bovine bone associated with platelet-rich fibrin (PRF) and titanium mesh and to assess the linear and volumetric bone gains and rehabilitation with implants in a 5-year follow-up. Case Patient with bone deficiency in the anterior maxilla region underwent bone reconstruction with deproteinized bovine bone associated with PRF and titanium mesh. After six months, the necessary bone height and volume were obtained for placement of implants, and the bone contour was restored in the anterior region, providing functional and aesthetic improvement. The amount of linear and volumetric bone gains was compared to baseline computed tomography scans. Three implants were placed in the grafted region, and a bone tissue sample was obtained at the time of their placement. Histological analysis showed neo-formed bone tissue in contact with the remaining particles of the biomaterial. After six months, the implants were activated, and the prosthesis was placed on the implants, which were monitored for five years. Conclusion Implants can be placed predictably in regions with vertical and horizontal bone augmentations by using xenogeneic bone grafts associated with titanium mesh and PRF.
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17
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Mekcha P, Wongpairojpanich J, Thammarakcharoen F, Suwanprateeb J, Buranawat B. Customized 3D printed nanohydroxyapatite bone block grafts for implant sites: a case series. J Prosthodont Res 2022; 67:311-320. [PMID: 35858803 DOI: 10.2186/jpr.jpr_d_22_00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PATIENTS A case series of 12 patients (mean age, 53.5 years) with horizontal ridge deficiencies had augmentations with customized 3D printed nanohydroxyapatite (3DHA) block grafts prior to implant placement. 3DHA graft materials were fabricated to fit the individual patient defects using DICOMs from CBCT images obtained from each patient. The CBCT images were then converted into the STL file format and 3DHA was reconstructed by 3D printing. Surgical bone augmentation consisted of 3DHA incorporating concentrated growth factors (CGFs) and platelet-rich fibrin (PRF) membrane. At 6 months, a bone biopsy and implantation were performed. The primary outcome was horizontal bone gain after 6 months. The secondary outcomes included information on the clinical outcomes, dimensions, and histomorphometric results. DISCUSSION The 3DHA block graft was successful in 10 of 12 patients. Graft adjustment was not required. All 3DHA adapted and fit well at all defect sites. Maximum mean horizontal bone gains were 3.06 ± 1.02 and 3.56 ± 0.23 mm from the DICOMs and STL data sets, respectively. The volume gain was 229.8 ± 82.96 mm3. A low pain score after surgery was reported of 1.41 ± 0.51, while the healing index score increased with a maximum mean of 4.7 ± 0.67. Thirteen implants were placed with good primary stability (ISQ = 65 ± 4.08), without additional guided bone regeneration. Histomorphometric analysis revealed that new bone formation, bone tissue, residual grafts, and connective tissue were 28.6 ± 1.88, 30.48 ± 4.81, 19.82 ± 4.07, and 20.81 ± 4.41%, respectively. CONCLUSIONS A customized 3DHA block graft is a viable treatment option for primary implant-site augmentation.
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Affiliation(s)
- Pichaya Mekcha
- Department of Implantology, Faculty of Dentistry, Thammasat University, Thailand
| | | | - Faungchat Thammarakcharoen
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center, National Science and Technology Development Agency, Thailand
| | - Jintamai Suwanprateeb
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center, National Science and Technology Development Agency, Thailand
| | - Borvornwut Buranawat
- Department of Implantology, Faculty of Dentistry, Thammasat University, Thailand
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18
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Aboelela SAA, Atef M, Shawky M, Fattouh H. Ridge augmentation using autologous concentrated growth factors enriched bone graft matrix versus guided bone regeneration using native collagen membrane in horizontally deficient maxilla: A randomized clinical trial. Clin Implant Dent Relat Res 2022; 24:569-579. [PMID: 35811435 DOI: 10.1111/cid.13121] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Facial resorption of maxillary alveolar ridges is a challenging situation for implant rehabilitation, which mandates a preparatory surgery of bone augmentation. Guided bone regeneration using a 1:1 mixture of autogenous particulate and anorganic bovine bone mineral (ABBM) showed reliable outcomes in treating horizontally deficient ridges. METHODS Twenty-eight patients were randomly assigned into two groups; in the control group, the 1:1 mixture of particulate autogenous bone and ABBM was covered with native collagen membrane, while in the study group, it was mixed with autologous fibrin glue (AFG) to make a sticky bone that was covered by concentrated growth factor (CGF) membrane. For each proposed implant site, the average bone width gain was calculated preoperatively, immediately after augmentation and after 6 months. Implants were placed after 6 months and the implant stability quotient (ISQ) was measured after insertion and after 6 more months. RESULTS The graft consolidation period went uneventful in both groups; however, two cases in the sticky bone group showed total resorption of the graft upon re-entry. The mean horizontal bone width after 6 months was 9 mm ± 0.71 in the guided bone regeneration (GBR) group which was higher than 7.9 mm ± 0.92 for the sticky bone group. The mean primary stability was higher in the GBR group; 67.19 ± 2.23 compared to 66.7 ± 3.22 for the sticky bone group, while the mean secondary stability was higher in the sticky bone group; 72 ± 2.15 compared to 71.7 ± 2.27 for the GBR group. Results of Shapiro-Wilk's for bone width data and model residuals were both statistically not significant (p > 0.05). CONCLUSION Comparing CGF membrane versus native collagen membrane as barriers for GBR showed no statistically significant difference regarding bone gain. However, from a clinical point of view, CGF membrane is not a predictable barrier for guided bone regeneration.
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Affiliation(s)
| | - Mohammed Atef
- Department of Oral and Maxillofacial surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohamed Shawky
- Department of Oral and Maxillofacial surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Hesham Fattouh
- Department of Oral and Maxillofacial surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
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19
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Wang J, Luo Y, Qu Y, Man Y. Horizontal ridge augmentation in the anterior maxilla with in situ onlay bone grafting: a retrospective cohort study. Clin Oral Investig 2022; 26:5893-5908. [PMID: 35583662 DOI: 10.1007/s00784-022-04547-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/08/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aimed to introduce a digitally guided in situ autogenous onlay grafting technique and compare its effectiveness with the conventional (ex situ) onlay technique in augmenting horizontal bone defects of the anterior maxilla. MATERIALS AND METHODS This retrospective cohort study included 24 patients who had received autogenous onlay bone grafts combined with guided bone regeneration (GBR) in the anterior maxilla. Fourteen patients were recruited into the in situ onlay grafting group (EG), and 10 were recruited into the ex situ onlay group (CG), defined by the donor sites. The clinical parameters, radiographic changes, micro-CT, and histological processes were evaluated after a mean follow-up period of 1.7 years. RESULTS The horizontal bone width reflected significant bone modeling over time (p < 0.001) in the first 6 months. Multivariable analysis showed that the treatment modality (grouping) was a critical factor positively associated with vertical bone height alteration. However, neither the alteration rate of horizontal bone width nor the bone volume was associated with the treatment modality. The number of periosteal screws per graft positively affected horizontal contour maintenance (p < 0.05). No significant differences were observed between the groups in the clinical parameters (complications, success rate, and peri-implant parameters). The micro-CT and histological outcomes were similar between the groups. CONCLUSION Despite the limitations of this study, in situ onlay grafting combined with GBR was an effective and reliable approach for horizontal bone augmentation in the anterior maxilla and appeared to demonstrate better stability in vertical bone remodeling. CLINICAL RELEVANCE This study introduces a modified and minimally invasive technique of onlay grafting for horizontal bone augmentation. This in situ onlay grafting demonstrates superior stability in vertical bone remodeling. The trial registration number is ChiCTR2100054683.
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Affiliation(s)
- Jing Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yilin Luo
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China.,Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Man
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China. .,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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20
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Biopolymer Material from Human Spongiosa for Regenerative Medicine Application. Polymers (Basel) 2022; 14:polym14050941. [PMID: 35267766 PMCID: PMC8912892 DOI: 10.3390/polym14050941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 01/02/2023] Open
Abstract
Natural biopolymers demonstrate significant bone and connective tissue-engineering application efficiency. However, the quality of the biopolymer directly depends on microstructure and biochemical properties. This study aims to investigate the biocompatibility and microstructural properties of demineralized human spongiosa Lyoplast® (Samara, Russian Federation). The graft’s microstructural and biochemical properties were analyzed by scanning electron microscopy (SEM), micro-computed tomography, Raman spectroscopy, and proteomic analysis. Furthermore, the cell adhesion property of the graft was evaluated using cell cultures and fluorescence microscopy. Microstructural analysis revealed the hierarchical porous structure of the graft with complete removal of the cellular debris and bone marrow components. Moreover, the proteomic analysis confirmed the preservation of collagen and extracellular proteins, stimulating and inhibiting cell adhesion, proliferation, and differentiation. We revealed the adhesion of chondroblast cell cultures in vitro without any evidence of cytotoxicity. According to the study results, demineralized human spongiosa Lyoplast® can be effectively used as the bioactive scaffold for articular hyaline cartilage tissue engineering.
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21
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Čandrlić M, Tomas M, Karl M, Malešić L, Včev A, Perić Kačarević Ž, Matijević M. Comparison of Injectable Biphasic Calcium Phosphate and a Bovine Xenograft in Socket Preservation: Qualitative and Quantitative Histologic Study in Humans. Int J Mol Sci 2022; 23:ijms23052539. [PMID: 35269686 PMCID: PMC8910217 DOI: 10.3390/ijms23052539] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 02/04/2023] Open
Abstract
This study is the first histologic evaluation of an injectable biphasic calcium phosphate (IBCP) in humans six months after socket preservation according to the principles of guided bone regeneration. After tooth extraction, the alveolar ridge of 21 patients was augmented with IBCP (maxresorb® inject) in the test group, while 20 patients in the control group received a bovine xenograft (BX) (cerabone®). Six months after augmentation, a reentry procedure was performed to collect biopsies of regenerated bone for qualitative and quantitative histologic analysis. A total of 20 biopsies were taken for analysis. Qualitative histologic analysis showed complete integration of the biomaterial and no inflammatory tissue reaction, indicating the biocompatibility of the bone grafts and the surrounding tissue in both groups. Histomorphometric analysis showed comparable results in terms of newly formed bone (IBCP: 26.47 ± 14.71%, BX: 30.47 ± 16.39%) and residual biomaterial (IBCP: 13.1 ± 14.07%, BX: 17.89 ± 11.81%), with no significant difference found across groups (p > 0.05, Mann—Whitney U test). Statistical significance between groups was found in the result of soft tissue percentage (IBCP: 60.43 ± 12.73%, BX: 51.64 ± 14.63%, p = 0.046, Mann—Whitney U test). To conclude, IBCP and BX showed good osteoconductivity and biocompatibility with comparable new bone formation six months after alveolar ridge preservation.
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Affiliation(s)
- Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.Č.); (M.T.); (M.K.)
- Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.Č.); (M.T.); (M.K.)
| | - Matej Karl
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.Č.); (M.T.); (M.K.)
- Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia
- Private Dental Practice Matej Karl, Prilaz Vilka Ivekovića 1, 31511 Belišće, Croatia
| | - Lucija Malešić
- Department of Anatomy, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia;
| | - Aleksandar Včev
- Department of Pathophysiology, Physiology and Immunology, Faculty of Dental medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Željka Perić Kačarević
- Department of Anatomy, Histology, Embriology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia
- Correspondence: (Ž.P.K.); (M.M.)
| | - Marko Matijević
- Community Healthcare Center of Osijek-Baranja County, 31000 Osijek, Croatia
- Correspondence: (Ž.P.K.); (M.M.)
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22
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SEVERITY OF ADENTIA AS A RISK FACTOR OF REPEATED DENTAL IMPLANT OPERATIONS. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-2-80-33-37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Survival Rates of Dental Implants in Autogenous and Allogeneic Bone Blocks: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121388. [PMID: 34946333 PMCID: PMC8705565 DOI: 10.3390/medicina57121388] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/11/2021] [Accepted: 12/14/2021] [Indexed: 12/17/2022]
Abstract
Background and Objectives: Preliminary studies emphasize the similar performance of autogenous bone blocks (AUBBs) and allogeneic bone blocks (ALBBs) in pre-implant surgery; however, most of these studies include limited subjects or hold a low level of evidence. The purpose of this review is to test the hypothesis of indifferent implant survival rates (ISRs) in AUBB and ALBB and determine the impact of various material-, surgery- and patient-related confounders and predictors. Materials and Methods: The national library of medicine (MEDLINE), Excerpta Medica database (EMBASE) and Cochrane Central Register of Controlled Trials (CENTRAL) were screened for studies reporting the ISRs of implants placed in AUBB and ALBB with ≥10 participants followed for ≥12 months from January 1995 to November 2021. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed via several scoring tools, dependent on the study design. Means of sub-entities were presented as violin plots. Results: An electronic data search resulted in the identification of 9233 articles, of which 100 were included in the quantitative analysis. No significant difference (p = 0.54) was found between the ISR of AUBB (96.23 ± 5.27%; range: 75% to 100%; 2195 subjects, 6861 implants) and that of ALBB (97.66 ± 2.68%; range: 90.1% to 100%; 1202 subjects, 3434 implants). The ISR in AUBB was increased in blocks from intraoral as compared to extraoral donor sites (p = 0.0003), partially edentulous as compared to totally edentulous (p = 0.0002), as well as in patients younger than 45 as compared to those older (p = 0.044), cortical as compared to cortico-cancellous blocks (p = 0.005) and in delayed implantations within three months as compared to immediate implantations (p = 0.018). The ISR of ALBB was significantly increased in processed as compared to fresh-frozen ALBB (p = 0.004), but also in horizontal as compared to vertical augmentations (p = 0.009). Conclusions: The present findings widely emphasize the feasibility of achieving similar ISRs with AUBB and ALBB applied for pre-implant bone grafting. ISRs were negatively affected in sub-entities linked to more extensive augmentation procedures such as bone donor site and dentition status. The inclusion and pooling of literature with a low level of evidence, the absence of randomized controlled clinical trials (RCTs) comparing AUBB and ALBB and the limited count of comparative studies with short follow-ups increases the risk of bias and complicates data interpretation. Consequently, further long-term comparative studies are needed.
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Guided Bone Regeneration with Concentrated Growth Factor Enriched Bone Graft Matrix (Sticky Bone) vs. Bone-Shell Technique in Horizontal Ridge Augmentation: A Retrospective Study. J Clin Med 2021; 10:jcm10173953. [PMID: 34501399 PMCID: PMC8432031 DOI: 10.3390/jcm10173953] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 12/12/2022] Open
Abstract
Background: The purpose of this study was to compare clinical results of two different horizontal ridge augmentation techniques: guided bone regeneration with sticky bone (SB) and the bone-shell technique (BS). Methods: Records of patients who underwent horizontal ridge augmentation with SB (test) and BS (control) were screened for inclusion. Pre-operative and 6-month post-operative ridge widths were measured on cone beam computer tomography (CBCT) and compared. Post-operative complications and implant survival rate were recorded. Results: Eighty consecutive patients were included in the present study. Post-operative complications (flap dehiscence, and graft infection) occurred in ten patients, who dropped out from the study (12.5% complication rate). Stepwise multivariate logistic regression analysis showed a significant inverse correlation between the occurrence of post-operative complications and ridge width (p = 0.025). Seventy patients (35 test; 35 control) with a total of 127 implants were included in the final analysis. Mean ridge width gain was 3.7 ± 1.2 mm in the test and 3.7 ± 1.1 mm in the control group, with no significant difference between the two groups. No implant failure was recorded, with a mean follow-up of 42.7 ± 16.0 months after functional loading. Conclusions: SB and BS showed comparable clinical outcomes in horizontal ridge augmentation, resulting in sufficient crestal width increase to allow implant placement in an adequate bone envelope.
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Song YW, Jung HJ, An YZ, Jung UW, Lee JS. Addition of autogenous bone chips to deproteinized bovine bone mineral does not have additional benefit in lateral ridge augmentation-A preclinical in vivo experimental study. Clin Oral Implants Res 2021; 32:1105-1114. [PMID: 34219293 DOI: 10.1111/clr.13805] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare the outcome after extensive lateral guided bone regeneration using deproteinized bovine bone mineral (DBBM) with or without autogenous bone chips in a canine model of chronic horizontal alveolar ridge defect. MATERIALS AND METHODS The second, third and fourth lower premolars of both sides were extracted, and the buccal bone walls were completely removed in five beagle dogs. After 4 weeks, DBBM particles mixed with autogenous bone chips at a ratio of 1:1 were grafted at one side (DBBM/Auto group), while DBBM particles alone were grafted at the contralateral side (DBBM group). The graft materials on both sides were covered by a resorbable collagen membrane and fixation pins. Microcomputed tomographic volume and histomorphometric analyses were performed at 16 weeks post-surgery. RESULTS The ridges of both groups were recovered horizontally, but new bone formation beyond the original ridge contour at the defect site was not found. The DBBM group exhibited a larger total radiographic augmented volume and new bone volume compared with the DBBM/Auto group, but the differences were minimal (p > .05). Histologically, the regenerated area and new bone area were also slightly larger without any statistical significance in the DBBM group than in the DBBM/Auto group (p > .05). CONCLUSION The addition of autogenous bone chips to DBBM for lateral ridge augmentation may confer no advantage over grafting DBBM alone with respect to both space maintenance and de novo bone formation in dogs.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Hyun-Jun Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Yin-Zhe An
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
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Kyyak S, Pabst A, Heimes D, Kämmerer PW. The Influence of Hyaluronic Acid Biofunctionalization of a Bovine Bone Substitute on Osteoblast Activity In Vitro. MATERIALS 2021; 14:ma14112885. [PMID: 34072146 PMCID: PMC8198444 DOI: 10.3390/ma14112885] [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: 04/27/2021] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 12/13/2022]
Abstract
Bovine bone substitute materials (BSMs) are used for oral bone regeneration. The objective was to analyze the influence of BSM biofunctionalization via hyaluronic acid (HA) on human osteoblasts (HOBs). BSMs with ± HA were incubated with HOBs including HOBs alone as a negative control. On days 3, 7 and 10, cell viability, migration and proliferation were analyzed by fluorescence staining, scratch wound assay and MTT assay. On days 3, 7 and 10, an increased cell viability was demonstrated for BSM+ compared with BSM− and the control (each p ≤ 0.05). The cell migration was enhanced for BSM+ compared with BSM− and the control after day 3 and day 7 (each p ≤ 0.05). At day 10, an accelerated wound closure was found for the control compared with BSM+/− (each p < 0.05). The highest proliferation rate was observed for BSM+ on day 3 (p ≤ 0.05) followed by BSM− and the control (each p ≤ 0.05). At day 7, a non-significantly increased proliferation was shown for BSM+ while the control was higher than BSM− (each p < 0.05). The least proliferation activity was observed for BSM− (p < 0.05) at day 10. HA biofunctionalization of the BSMs caused an increased HOB activity and might represent a promising alternative to BSM− in oral bone regeneration.
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Affiliation(s)
- Solomiya Kyyak
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany; (S.K.); (D.H.)
| | - Andreas Pabst
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, 56072 Koblenz, Germany;
| | - Diana Heimes
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany; (S.K.); (D.H.)
| | - Peer W. Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany; (S.K.); (D.H.)
- Correspondence: ; Tel.: +49-6131-17-5458
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Toledano-Osorio M, Toledano M, Manzano-Moreno FJ, Vallecillo C, Vallecillo-Rivas M, Rodriguez-Archilla A, Osorio R. Alveolar Bone Ridge Augmentation Using Polymeric Membranes: A Systematic Review and Meta-Analysis. Polymers (Basel) 2021; 13:1172. [PMID: 33917475 PMCID: PMC8038790 DOI: 10.3390/polym13071172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/16/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023] Open
Abstract
Alveolar bone ridge resorption occurred after natural teeth loss and it can restrict the possibility of dental implants placement. The use of bone regenerative procedures is frequently required. The existing evidence regarding the efficacy of horizontal bone ridge augmentation trough guided bone regeneration (GBR) using polymeric membranes was stated. A systematic review and meta-analysis were performed. Electronic and manual literature searches were conducted. Screening process was done using the National Library of Medicine (MEDLINE by PubMed), Embase, and the Cochrane Oral Health. Included articles were randomized controlled trials and observational studies. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). If I2 > 50% a random-effects model was applied. It was found that the mean of horizontal bone gain was 3.95 mm, ranging from 3.19 to 4.70 mm (confidence interval 95%). Heterogeneity is I2 = 99% (confidence interval 95%) and significance of the random-effects model was p < 0.001. The complications rate was 8.4% and membrane exposure was the most frequent. Through this study, we were able to conclude that the existing scientific evidence suggests that GBR using polymeric membranes is a predictable technique for achieving horizontal bone augmentation, thus, permitting a proper further implant placement.
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Affiliation(s)
- Manuel Toledano-Osorio
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
- Medicina Clínica y Salud Pública PhD Programme, University of Granada, 18071 Granada, Spain
| | - Manuel Toledano
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Francisco Javier Manzano-Moreno
- Biomedical Group (BIO277), Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto Investigación Biosanitaria, ibs. Granada, 18071 Granada, Spain
| | - Cristina Vallecillo
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Marta Vallecillo-Rivas
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Alberto Rodriguez-Archilla
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Raquel Osorio
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
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Ding Y, Wang L, Su K, Gao J, Li X, Cheng G. Horizontal bone augmentation and simultaneous implant placement using xenogeneic bone rings technique: a retrospective clinical study. Sci Rep 2021; 11:4947. [PMID: 33654142 PMCID: PMC7925558 DOI: 10.1038/s41598-021-84401-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/15/2021] [Indexed: 11/09/2022] Open
Abstract
This study evaluated the use of bone ring technique with xenogeneic bone grafts in treating horizontal alveolar bone defects. In total, 11 patients in need of horizontal bone augmentation treatment before implant placement were included in this retrospective study. All patients received simultaneous bone augmentation surgery and implant placement with xenogeneic bone ring grafts. We evaluated the postoperative efficacy of the bone ring technique with xenogeneic bone grafts using radiographical and clinical parameters. Survival rates of implants were 100%. Cone-beam computed tomography revealed that the xenogeneic bone ring graft had significantly sufficient horizontal bone augmentation below the implant neck platform to 0 mm, 1 mm, 2 mm, and 3 mm. It could also provide an excellent peri-implant tissue condition during the 1-year follow-up after loading. The bone ring technique with xenogeneic bone ring graft could increase and maintain horizontal bone mass in the region of the implant neck platforms in serious horizontal bone defects.
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Affiliation(s)
- Yude Ding
- Department of Stomatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Lianfei Wang
- Department of Stomatology of Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Kuiwei Su
- Department of Stomatology of Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Jinxing Gao
- Department of Stomatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Xiao Li
- Department of Stomatology of Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Gang Cheng
- Department of Stomatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China.
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Arpornmaeklong P, Sareethammanuwat M, Apinyauppatham K, Boonyuen S. Characteristics and biologic effects of thermosensitive quercetin-chitosan/collagen hydrogel on human periodontal ligament stem cells. J Biomed Mater Res B Appl Biomater 2021; 109:1656-1670. [PMID: 33644957 DOI: 10.1002/jbm.b.34823] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 01/05/2021] [Accepted: 02/14/2021] [Indexed: 12/11/2022]
Abstract
Thermosensitive hydrogels could function as scaffolds and delivery vehicle of natural flavonoids. The current study aimed to investigate effects of chitosan/collagen ratios on properties of thermosensitive beta-glycerophosphate (bGP) chitosan/collagen hydrogels as delivery vehicle of quercetin and then examined effects of quercetin-hydrogels on growth and cell viability of human periodontal ligament stem cells (hPDLSCs). Microstructure and physical, mechanical and antioxidant properties and quercetin release profiles of the hydrogels were investigated. Fourier transform infrared spectroscopy and X-ray powder diffraction analyses were performed to examine gelation process of the hydrogels. Antioxidant assays were conducted to measure antioxidant capacity of quercetin-hydrogels. It was found that bGP-chitosan/collagen hydrogels exhibited porous structures with interconnected pore architecture and could sustain quercetin release. Chitosan content improved well defined porous structure, increased porosity of the hydrogels and decreased releasing rate of quercetin from the hydrogels. The quercetin-bGP-2:1 (wt/wt) chitosan/collagen hydrogels exhibited antioxidant capacity and were able to promote growth of hPDLSCs in a dose dependent manner. In conclusion, the thermosensitive quercetin-bGP-2:1 (wt/wt) chitosan/collagen hydrogel demonstrated optimal properties of scaffolds for bone tissue engineering and sustained release of natural flavonoids. Incorporating quercetin in the chitosan/collagen hydrogel enhanced bioactive microenvironment that supported stem cell encapsulation.
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Affiliation(s)
- Premjit Arpornmaeklong
- Oral and Maxillofacial Surgery Division, Faculty of Dentistry, Thammasat University-Rangsit campus, Khlong Luang, Pathum Thani, Thailand
| | - Maytha Sareethammanuwat
- Master of Science Program in Dental Implantology, Faculty of Dentistry, Thammasat University-Rangsit campus, Khlong Luang, Pathum Thani, Thailand
| | - Komsan Apinyauppatham
- Oral and Maxillofacial Surgery Division, Faculty of Dentistry, Thammasat University-Rangsit campus, Khlong Luang, Pathum Thani, Thailand
| | - Supakorn Boonyuen
- Department of Chemistry, Faculty of Science and Technology, Thammasat University-Rangsit campus, Khlong Luang, Pathum Thani, Thailand
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Gherasim O, Grumezescu AM, Grumezescu V, Negut I, Dumitrescu MF, Stan MS, Nica IC, Holban AM, Socol G, Andronescu E. Bioactive Coatings Based on Hydroxyapatite, Kanamycin, and Growth Factor for Biofilm Modulation. Antibiotics (Basel) 2021; 10:160. [PMID: 33562515 PMCID: PMC7914914 DOI: 10.3390/antibiotics10020160] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
The occurrence of opportunistic local infections and improper integration of metallic implants results in severe health conditions. Protective and tunable coatings represent an attractive and challenging selection for improving the metallic devices' biofunctional performances to restore or replace bone tissue. Composite materials based on hydroxyapatite (HAp), Kanamycin (KAN), and fibroblast growth factor 2 (FGF2) are herein proposed as multifunctional coatings for hard tissue implants. The superior cytocompatibility of the obtained composite coatings was evidenced by performing proliferation and morphological assays on osteoblast cell cultures. The addition of FGF2 proved beneficial concerning the metabolic activity, adhesion, and spreading of cells. The KAN-embedded coatings exhibited significant inhibitory effects against bacterial biofilm development for at least two days, the results being superior in the case of Gram-positive pathogens. HAp-based coatings embedded with KAN and FGF2 protein are proposed as multifunctional materials with superior osseointegration potential and the ability to reduce device-associated infections.
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Affiliation(s)
- Oana Gherasim
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania; (I.N.); (G.S.)
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
- Research Institute of the University of Bucharest–ICUB, University of Bucharest, 050657 Bucharest, Romania; (I.C.N.); (A.M.H.)
| | - Valentina Grumezescu
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania; (I.N.); (G.S.)
| | - Irina Negut
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania; (I.N.); (G.S.)
| | - Marius Florin Dumitrescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
| | - Miruna Silvia Stan
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
- Research Institute of the University of Bucharest–ICUB, University of Bucharest, 050657 Bucharest, Romania; (I.C.N.); (A.M.H.)
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Ionela Cristina Nica
- Research Institute of the University of Bucharest–ICUB, University of Bucharest, 050657 Bucharest, Romania; (I.C.N.); (A.M.H.)
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Alina Maria Holban
- Research Institute of the University of Bucharest–ICUB, University of Bucharest, 050657 Bucharest, Romania; (I.C.N.); (A.M.H.)
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest, 077206 Bucharest, Romania
| | - Gabriel Socol
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania; (I.N.); (G.S.)
| | - Ecaterina Andronescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest, 011061 Bucharest, Romania; (O.G.); (A.M.G.); (M.F.D.); (M.S.S.); (E.A.)
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Aludden H, Mordenfeld A, Cederlund A, Dahlin C, Spin-Neto R, Veiss-Pedersen P, Sritharan B, Starch-Jensen T. Radiographic changes in height and volume after lateral GBR procedures with different ratios of deproteinized bovine bone mineral and autogenous bone at different time points. An experimental study. Clin Oral Implants Res 2020; 32:167-179. [PMID: 33217060 DOI: 10.1111/clr.13687] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/14/2020] [Accepted: 10/19/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Estimate changes in augmentation height and volume after lateral guided bone regeneration (GBR) augmentation with different ratios of deproteinized bovine bone mineral (DBBM) and particulate autogenous bone (PAB) and autogenous bone block (ABB), at different time points. MATERIAL AND METHODS Twenty-four minipigs were randomly allocated into three healing periods. Lateral augmentation in 96 sites with standardized quantity of graft material was performed with different ratios of DBBM and PAB (50:50, 75:25, and 100:0) and ABB in combination with DBBM, covered by a collagen membrane. Changes in augmentation height and volume were assessed on CT volumes acquired 10, 20, and 30 weeks after surgery. RESULTS Reduction in bone augmentation height was as follows: 50:50-1.7 mm (-33.1%), 75:25-1.8 mm (-37.8%), 100:0-1.7 mm (-35.8%), and ABB - 0.2 mm (-3.7%), after 30 weeks. The augmentation height was significantly better preserved with ABB compared to 50:50, 75:25, and 100:0, while no significant difference was present among particulate grafts. No significant difference in volumetric reduction was found among 50:50, 75:25, 100:0 and ABB after 30 weeks, while 100:0 presented significant less reduction compared to 50:50, 75:25 and ABB after 10 and 20 weeks. CONCLUSIONS Augmentation height following GBR was better preserved with ABB covered with DBBM. Addition of PAB to DBBM did not affect the changes in height of the graft. The volumetric stability seems to be comparable for ABB covered by DBBM and all particulate grafts after 30 weeks. However, DBBM alone revealed significant less volume reduction in the early healing phase.
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Affiliation(s)
- Hanna Aludden
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital and Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark.,Department of Oral and Maxillofacial Surgery, NU-Hospital, Organization Trollhättan, Sweden
| | - Arne Mordenfeld
- Plastic and Oral & Maxillofacial Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Christer Dahlin
- Department of Oral and Maxillofacial Surgery, NU-Hospital, Organization Trollhättan, Sweden.,Department of Biomaterials, BIOMATCELL VINN Excellence center, Institute for Surgical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Rubens Spin-Neto
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Denmark
| | | | - Babyasha Sritharan
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital and Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Tay JRH, Lu XJ, Lai WMC, Fu JH. Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management. Int J Implant Dent 2020; 6:76. [PMID: 33241468 PMCID: PMC7688776 DOI: 10.1186/s40729-020-00274-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
It is not uncommon to encounter post-surgical complications after horizontal guided bone regeneration (GBR). The primary aim of this review was to evaluate the incidence and types of complications that occur after horizontal GBR and propose management strategies to deal with these clinical situations. A secondary aim was to conduct a histomorphometric review of the wound healing process at sites that experienced post-surgical complications after GBR. A keyword search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published in English from January 2015 to January 2020 was conducted for the primary aim and 23 studies were selected. A second search addressing the secondary aim was conducted, and five studies were included. Site-level analysis showed that the weighted mean incidence proportion of minor wound dehiscence and minor infections occurring at the augmented site was 9.9% [95% CI 6.4, 13.9, P < 0.01] and 1.5% [95% CI 0.4, 3.1, P = 0.21) respectively. Patient-level analysis showed minor and major complications occurring at a weighted mean incidence proportion of 16.1% [95% CI 11.9, 20.8, P = 0.01] and 1.6% [95% CI 0.0, 4.7, P < 0.01] respectively, while neurosensory alterations at the donor site was 7.0% [95% CI 1.3, 15.5, P < 0.01]. Subgroup analysis also revealed that the use of block grafts increased the incidence proportion of minor post-surgical complications, whereas a staged GBR procedure increased the incidence proportion of both minor and major post-surgical complications. Although exposure of the barrier membrane is often associated with less bone regeneration and graft resorption, the type of membrane used (resorbable or non-resorbable) had no statistically significant influence on any post-surgical complication. Histologically, a layer of fibrous connective tissue instead of bone is commonly observed at the interface between the native bone at the recipient site and the regenerated bone in cases with membrane exposure after GBR procedure. Minor wound dehiscence was the highest incidence proportion of post-surgical complications. Methods ranging from daily application of antiseptics, use of systemic antimicrobials, regular reviews, and total removal of the non-integrated biomaterials are commonly prescribed to manage these post-surgical complications in attempt to minimise the loss of tissue at the surgical site.
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Affiliation(s)
- John Rong Hao Tay
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.,Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, Singapore, 168938, Singapore
| | - Xiaotong Jacinta Lu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Wei Ming Clement Lai
- Statistics Unit, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Jia-Hui Fu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.
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Aludden H, Mordenfeld A, Dahlin C, Hallman M, Starch‐Jensen T. Histological and histomorphometrical outcome after lateral guided bone regeneration augmentation of the mandible with different ratios of deproteinized bovine bone mineral and autogenous bone. A preclinical in vivo study. Clin Oral Implants Res 2020; 31:1025-1036. [DOI: 10.1111/clr.13649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 07/19/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Hanna Aludden
- Department of Oral and Maxillofacial Surgery Aalborg University Hospital Aalborg Denmark
| | - Arne Mordenfeld
- Plastic and Oral & Maxillofacial Surgery Department of Surgical Sciences Uppsala University Uppsala Sweden
| | - Christer Dahlin
- Department of Biomaterials BIOMATCELL VINN Excellence center Institute for Surgical Science The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Oral and Maxillofacial Surgery NU‐Hospital Organization Trollhättan Trollhättan Sweden
| | - Mats Hallman
- Department of Oral and Maxillofacial Surgery Gävle County Hospital Gävle Sweden
| | - Thomas Starch‐Jensen
- Department of Oral and Maxillofacial Surgery Aalborg University Hospital Aalborg Denmark
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Bone Augmentation Procedures in a Patient with Acromegaly. Case Rep Dent 2020; 2020:8479502. [PMID: 32695528 PMCID: PMC7352141 DOI: 10.1155/2020/8479502] [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: 01/02/2020] [Revised: 03/28/2020] [Accepted: 06/18/2020] [Indexed: 11/30/2022] Open
Abstract
The objective of this clinical case is to evaluate if bone augmentation procedures can be successful in a patient with altered bone metabolism due to a systemic disease: acromegaly. Two guided bone regeneration procedures were made on the same patient: horizontal ridge augmentation with lateral wall approach sinus graft of the left maxilla and horizontal ridge augmentation of the front left maxilla. CBCT assessment of the new formed bone was made after a minimum of nine months and dental implants were placed. The results show that bone augmentation procedures can be successful in a patient with acromegaly, after pituitary adenoma removal, when autologous bone is not included in the grafting procedure.
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Horizontal Ridge Augmentation Using a Xenograft Bone Substitute for Implant-Supported Fixed Rehabilitation: A Case Report with Four Years of Follow-Up. Case Rep Dent 2020; 2020:6723936. [PMID: 32509356 PMCID: PMC7245675 DOI: 10.1155/2020/6723936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 05/02/2020] [Indexed: 11/18/2022] Open
Abstract
The guided bone regeneration (GBR) technique has been used to achieve optimal bone volume augmentation and allow dental implant placement in atrophic maxilla and mandible, with predictable results and high survival rates. The use of bone substitutes has reduced the necessity of autogenous bone grafts, reducing the morbidity at the donor areas and thus improving the patients' satisfaction and comfort. This clinical case report shows a clinical and histological evaluation of the bone tissue behavior, in a case that required the horizontal augmentation of the alveolar ridge, with the use of xenograft biomaterial and further dental implant placement. After six months of healing time, six implants were placed, and a bone biopsy was done. The histological analysis depicted some fragments of the xenograft bone graft, integrated with the new-formed bone tissue.
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Xia HB, Zhang YF, Shi B, Wang M. Two bone blocks sandwich technique for horizontal reconstruction of severely atrophic alveolar ridge in anterior maxilla: A case report. World J Clin Cases 2020; 8:971-979. [PMID: 32190635 PMCID: PMC7062619 DOI: 10.12998/wjcc.v8.i5.971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Severe horizontal bone deficiency of the maxillary anterior region is considered a major challenge in reconstruction and successful implant placement. Various approaches have been developed to augment bone volume. Of these approaches, onlay bone graft, alveolar bone splitting, and guided bone regeneration have been suggested.
CASE SUMMARY A 22-year-old female patient, with no previous medical history, presented to the Department of Oral Implantology, Wuhan University due to a missing right maxillary incisor. The X-ray results showed severe horizontal bone deficiency, with an available bone width of 3.1-4.0 mm. The two bone blocks sandwich technique was performed to augment the bone volume. After 6 months healing, X-ray results showed that the newly formed alveolar ridge dimension increased to 4.7-9.5 mm horizontally. Implant insertion surgery was performed and all-ceramic restorations were fabricated. The implant was stable at the 1-year follow-up visit after restoration, and the X-ray showed a stable bone level around the dental implant. The scores for the pink esthetic score and white esthetic score were 12 and 8, respectively, and the patient was satisfied with the esthetic outcome.
CONCLUSION The two bone blocks sandwich technique may be an alternative treatment option in augmenting severe horizontal bone deficiency of the anterior maxilla.
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Affiliation(s)
- Hai-Bin Xia
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Yu-Feng Zhang
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
- The State Key Laboratory Breeding Base of Basic Science of Stomatology, Hubei Province and Key Laboratory of Oral Biomedicine (Wuhan University), Ministry of Education (Hubei-MOST and KLOBM), Wuhan 430079, Hubei Province, China
| | - Bin Shi
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Min Wang
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
- The State Key Laboratory Breeding Base of Basic Science of Stomatology, Hubei Province and Key Laboratory of Oral Biomedicine (Wuhan University), Ministry of Education (Hubei-MOST and KLOBM), Wuhan 430079, Hubei Province, China
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Yuan S, Mu Z, Huang Y, Bai S, Xu P, Chen T. Comparison of in-situ bone ring technique and tent-pole technique for horizontally deficient alveolar ridge in the anterior maxilla. Clin Implant Dent Relat Res 2020; 22:167-176. [PMID: 32022425 DOI: 10.1111/cid.12887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/05/2019] [Accepted: 01/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Limited studies focused on the bone profile maintenance at the alveolar ridge crest applying horizontal bone augmentation. PURPOSE A novel approach named as "in-situ bone ring technique" was introduced to be compared with tent-pole technique to evaluate their horizontal bone gain, resorption, and postoperative perception. MATERIALS AND METHODS A total of 30 patients were included in this retrospective cohort study. All patients required horizontal bone augmentation at anterior site. Accordingly, quantitative and qualitative analyses were conduct radiographically and histologically between in-situ bone ring (ring group) and tent-pole technique (tent group). Moreover, the visual analog scale (VAS) was introduced to assess the patients' perception toward both treatments. RESULTS Cone-beam computed tomography results showed great significant difference regarding horizontal bone width at 0 mm and 3 mm from alveolar ridge crest between two groups (P < .05). On the basis of histological outcomes, delightful bony fusion was shown 6-month postoperatively in ring group. The VAS ratings for pain and swelling reflected similar results between two groups. CONCLUSIONS In-situ bone ring technique evidently increased and maintained horizontal bone mass at the alveolar ridge crest compared to tent-pole technique, which might be favorable for implant rehabilitation in anterior area. Meanwhile, no further discomfort was caused according to VAS scoring between two groups.
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Affiliation(s)
- Shuai Yuan
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhixiang Mu
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yuanding Huang
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Shi Bai
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Peng Xu
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Tao Chen
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
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