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Araújo CRG, Araújo RCD, Araújo CG, Carvalho AP, Cota LOM, Martins-Júnior PA, Pelegrine AA. Bone Regeneration in the Anterior Maxilla With Titanium Mesh and Advanced-Platelet-Rich Fibrin: A Case Report With 2-Year Follow-up. J ORAL IMPLANTOL 2024; 50:514-518. [PMID: 39158854 DOI: 10.1563/aaid-joi-d-23-00154] [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: 08/21/2023] [Revised: 08/08/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
Guided bone regeneration involving the use of titanium mesh and platelet-rich fibrin could be a feasible approach in cases of severely atrophic ridges. The purpose of this case report was to present an esthetic and functional rehabilitation in the anterior maxilla with the installation of dental implants in conjunction with guided bone regeneration using titanium mesh and advanced platelet-rich fibrin (A-PRF). A 60-year-old patient presented bone atrophy and partial edentulism in the anterior maxilla. After clinical and cone beam computed tomography assessment, guided bone regeneration was planned using a titanium mesh and A-PRF with xenograft bone. After 8 months of healing, the dental implants were placed with the aid of a surgical guide to obtain accurate 3-dimensional positioning. Prosthetic rehabilitation was carried out with individualized crowns. After 2 years of follow-up, radiographic analysis demonstrated a good quality and density of the bone tissue adjacent to the dental implants. No radiolucent areas were observed, and there were no clinical signs of failure. In cases of severe atrophy, using a titanium mesh and A-PRF proved to be a feasible alternative for bone reconstruction prior to dental implant placement. This approach can aid dental professionals in achieving an ideal implant positioning for rehabilitation with individualized crowns.
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Affiliation(s)
- Carlos Roberto Garcia Araújo
- Department of Implant Dentistry, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, Campinas, Brazil
- IMPLA, Belo Horizonte, Brazil
| | - Roberto Carlos de Araújo
- IMPLA, Belo Horizonte, Brazil
- Department of Dental Prosthesis, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, Campinas, Brazil
| | - Cristiano Garcia Araújo
- IMPLA, Belo Horizonte, Brazil
- Department of Dental Prosthesis, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, Campinas, Brazil
| | - Ana Paula Carvalho
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas, Brazil
| | | | - André Antonio Pelegrine
- Department of Implant Dentistry, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, Campinas, Brazil
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Pan P, Wang J, Wang X, Yu X, Chen T, Jiang C, Liu W. Barrier Membrane with Janus Function and Structure for Guided Bone Regeneration. ACS APPLIED MATERIALS & INTERFACES 2024; 16:47178-47191. [PMID: 39222394 DOI: 10.1021/acsami.4c08737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Guided bone regeneration (GBR) technology has been demonstrated to be an effective method for reconstructing bone defects. A membrane is used to cover the bone defect to stop soft tissue from growing into it. The biosurface design of the barrier membrane is key to the technology. In this work, an asymmetric functional gradient Janus membrane was designed to address the bidirectional environment of the bone and soft tissue during bone reconstruction. The Janus membrane was simply and efficiently prepared by the multilayer self-assembly technique, and it was divided into the polycaprolactone isolation layer (PCL layer, GBR-A) and the nanohydroxyapatite/polycaprolactone/polyethylene glycol osteogenic layer (HAn/PCL/PEG layer, GBR-B). The morphology, composition, roughness, hydrophilicity, biocompatibility, cell attachment, and osteogenic mineralization ability of the double surfaces of the Janus membrane were systematically evaluated. The GBR-A layer was smooth, dense, and hydrophobic, which could inhibit cell adhesion and resist soft tissue invasion. The GBR-B layer was rough, porous, hydrophilic, and bioactive, promoting cell adhesion, proliferation, matrix mineralization, and expression of alkaline phosphatase and RUNX2. In vitro and in vivo results showed that the membrane could bind tightly to bone, maintain long-term space stability, and significantly promote new bone formation. Moreover, the membrane could fix the bone filling material in the defect for a better healing effect. This work presents a straightforward and viable methodology for the fabrication of GBR membranes with Janus-based bioactive surfaces. This work may provide insights for the design of biomaterial surfaces and treatment of bone defects.
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Affiliation(s)
- Peng Pan
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P. R. China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei 230026, P. R. China
| | - Jian Wang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, P. R. China
| | - Xi Wang
- Department of Emergency and Oral Medicine, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, P. R. China
| | - Xinding Yu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P. R. China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei 230026, P. R. China
| | - Tiantian Chen
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P. R. China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei 230026, P. R. China
| | - Chundong Jiang
- Chongqing Institute of Mesoscopic Medical Porous Materials, Chongqing 401120, P. R. China
| | - Wentao Liu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P. R. China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei 230026, P. R. China
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Cucchi A, Bettini S, Fiorino A, Maglio M, Marchiori G, Corinaldesi G, Sartori M. Histological and histomorphometric analysis of bone tissue using customized titanium meshes with or without resorbable membranes: A randomized clinical trial. Clin Oral Implants Res 2024; 35:114-130. [PMID: 37966057 DOI: 10.1111/clr.14202] [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: 03/28/2023] [Revised: 10/29/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES To date, no clinical studies have investigated the effect of using resorbable collagen membrane in conjunction with customized titanium mesh to promote bone formation in guided bone regeneration. Therefore, a non-inferiority analysis (one-sided 95% CI approach) was designed to compare the augmented bone gained using meshes with and without collagen membranes, through histological and histomorphometric investigations. MATERIALS AND METHODS Thirty patients undergoing bone augmentation procedures at both maxillary and mandible sites were randomly treated with customized titanium meshes alone (M-, n = 15) or covered with resorbable membrane (M+, n = 15), in both cases filled with autogenous bone and xenograft. After 6 months of healing, bone tissue biopsies were taken from the augmented region. The bone tissue (B.Ar), grafting material (G.Ar), and non-mineralized tissue (NMT.Ar) areas were quantified through histomorphometric analysis, as were the osteoid area (O.Ar) and its width. RESULTS Collagen membrane did not appear to significantly influence the investigated parameters: B.Ar, G.Ar, NMT.Ar, and O.Ar were similar between Group M- (34.3%, 11.5%, 54.1%, 1.95 μm2 , respectively) and Group M+ (35.3%, 14.6%, 50.2%, and 1.75 μm2 , respectively). Considering the overall population, significantly higher rates of newly formed bone were obtained in mandibular sites, while non-mineralized and dense connective tissue rates were higher in the maxilla (p < .05). CONCLUSIONS The application of collagen membrane over titanium mesh did not lead to significant results. Bone formation appeared significantly different in the maxilla compared with the mandible. Additional studies are required to further investigate the issues observed.
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Affiliation(s)
| | - Sofia Bettini
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Antonino Fiorino
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Melania Maglio
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Gregorio Marchiori
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giuseppe Corinaldesi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Maria Sartori
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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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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Bokobza A, Nicot R, Raoul G, Afota F, Choukroun J, Savoldelli C. Management of postoperative outcomes of polytetrafluoroethylene membranes in alveolar ridge reconstruction: a systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101641. [PMID: 37739223 DOI: 10.1016/j.jormas.2023.101641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
Guided bone regeneration (GBR) is a validated technique with satisfactory outcomes during 30 years of follow-up. The use of polytetrafluoroethylene (PTFE) membrane for vertical augmentation has been studied extensively. However, studies have reported exposure rates of up to 31%, there is no consensus on the management of postoperative exposure. The objective of this study was to propose a management approach for postoperative exposure of polytetrafluoroethylene (PTFE) membranes in alveolar ridge reconstruction. MATERIAL AND METHOD An electronic search in PubMed Central's and additional electronic databases was performed. The search strategy was limited to human studies, full-text English or French articles published from 1990 until april 2023. The extracted data included defect location, membrane type, biomaterials, time to postoperative exposure, and Fontana classification stage. Protocol bias assessment was performed using an adaptation of the QUADAS-2 tool. This review has been registered on PROSPERO (ID: CRD42023445497). RESULTS A total of 43 articles were found to be eligible, and 11 of these met the predefined inclusion and exclusion criteria. Based on the results of this systematic review, an algorithm for the management of PTFE membrane exposure is proposed. CONCLUSION Postoperative membrane exposure is not a determining factor for the success of bone grafting. In cases with postoperative complications, the majority of cases still achieved adequate implant-prosthetic rehabilitation. Lastly, this series of 11 articles was insufficient to draw conclusions regarding good practice recommendations. A larger series is required to validate the specific management approaches.
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Affiliation(s)
- Allan Bokobza
- Univ. Lille, CHU Lille, Department of Oral and Maxillofacial Surgery, F-59000 Lille, France.
| | - Romain Nicot
- Univ. Lille, CHU Lille, Inserm, Department of Oral and Maxillofacial Surgery, U1008 - Advanced Drug Delivery Systems, F-59000 Lille, France
| | - Gwénaël Raoul
- Univ. Lille, CHU Lille, Inserm, Department of Oral and Maxillofacial Surgery, U1008 - Advanced Drug Delivery Systems, F-59000 Lille, France
| | - Franck Afota
- Head and Neck Institute, University Hospital of Nice, 31 avenue de Valombrose, 06100 Nice, France
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Bontá H, Bugiolachi J, Perrote CA, Sánchez LM, Pulitano Manisagian GE, Galli FG, Caride F. Alveolar ridge reconstruction with a digitally customized bone block allograft. Clin Adv Periodontics 2023. [PMID: 37957843 DOI: 10.1002/cap.10270] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/09/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Reduced alveolar ridge volume is an often consequence after tooth loss, compromising implant placement and prosthetic rehabilitation. The digital customization of bone block allografts (BBA) is an alternative that incorporates advantages such as intimate contact with the recipient bed, increasing graft stability and reduced surgical time. In addition, enamel matrix derivate (EMD) has attracted interest for its effect on osteogenic gene expression and cell adhesion; few studies have focused on the benefits of bone regeneration with EMD. The aim of this case report is to present the reconstruction of a severely atrophic alveolar ridge defect with a digitally customized bone block allograft (CBBA) in combination with EMD as an adjuvant for bone regeneration and soft tissue healing. METHODS Initially, the digital planning and manufacture of the BBA was performed based on an initial cone beam computed tomography (CBCT) scan. EMD was applied to the recipient site and to the CBBA before graft fixation. After 6 months, bone biopsies were obtained on re-entry surgery for prosthetically guided implant placement. RESULTS Clinically, bone block showed good integration with the adjacent tissue and no signs of rejection or necrosis were found. On the histological evaluation, new bone was observed in intimate contact with the allograft and showed viable osteocytes and osteoblasts along its entire length. Residual allograft particles were observed to be highly osteoconductive. CONCLUSION According to the clinical and histological results presented, the digital customization of the BBA allows an ideal graft fit to the recipient bed with excellent results in bone regeneration.
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Affiliation(s)
- Hernán Bontá
- Department of Periodontology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Juliana Bugiolachi
- Department of Periodontology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Carla A Perrote
- Department of Periodontology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Luciana M Sánchez
- Department of Histology and Embryology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Gisela E Pulitano Manisagian
- Department of Histology and Embryology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Federico G Galli
- Department of Periodontology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Facundo Caride
- Department of Periodontology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
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Shido R, Ohba S, Tominaga R, Sumita Y, Asahina I. A Prospective Study of the Assessment of the Efficacy of a Biodegradable Poly(l-lactic acid/ε-caprolactone) Membrane for Guided Bone Regeneration. J Clin Med 2023; 12:5994. [PMID: 37762935 PMCID: PMC10532217 DOI: 10.3390/jcm12185994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Biodegradable guided bone regeneration (GBR) membranes consist primarily of collagen and aliphatic polyesters. This study assessed the comparative efficacy of a poly(l-lactic-caprolactone) [P(LA/CL)] membrane versus that of a collagen membrane in GBR. Patients requiring GBR simultaneously or before dental implant placement in edentulous regions were randomly assigned to one of two membranes. Within each membrane, they were subdivided into 3 groups: dental implants were placed simultaneously with GBR in groups A and B, and 180 days post-GBR in group C. The augmented bone width was measured at 1, 3, and 6 mm from the implant's neck (groups A and B) or the reference line (group C), utilizing cone-beam computed tomography images, immediately and 150 days post-surgery. A histological study was performed to evaluate bone formation in group C. No adverse events were observed. In the collagen group, the absorbed ratios of the augmented bone were 40.9 ± 36.7%, 29.4 ± 30.1%, and 11.1 ± 22.0% at 1, 3, and 6 mm, respectively; the ratio at 6 mm was significantly lower than that at 1 mm (p = 0.0442). In the P(LA/CL) group, those were 26.2 ± 27.3%, 17.1 ± 19.7%, and 13.3 ± 16.4% at 1, 3, and 6 mm, respectively, with no significant difference at each point. No significant inter-membrane differences were observed. The bone augmentation potential of the P(LA/CL) membrane matched that of the collagen membrane. P(LA/CL) could be used as a safe and effective membrane in GBR.
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Affiliation(s)
- Rena Shido
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (R.S.); (R.T.); (I.A.)
- Center for Oral Implant, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan
| | - Seigo Ohba
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (R.S.); (R.T.); (I.A.)
- Center for Oral Implant, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan
| | - Risa Tominaga
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (R.S.); (R.T.); (I.A.)
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Tokyo 113-8510, Japan
| | - Yoshinori Sumita
- Department of Medical Research and Development for Oral Disease, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan;
| | - Izumi Asahina
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (R.S.); (R.T.); (I.A.)
- Department of Oral and Maxillofacial Surgery, School of Medicine, Juntendo University, 3-1-3 Hongo, Tokyo 113-8421, Japan
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Zhang Z, He Q, Zhu J, Lin X, Yang Y, Chen H, Huang X, Xu R, Deng F. Optimizing the combined soft tissue repair and osteogenesis using double surfaces of crosslinked collagen scaffolds. J Biomed Mater Res B Appl Biomater 2023; 111:1271-1285. [PMID: 36779616 DOI: 10.1002/jbm.b.35231] [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: 11/03/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/14/2023]
Abstract
Excessive tissue damage or loss has been solved by guided tissue regeneration and guided bone regeneration theories. However, the unfavorable degradation property of the resorbable collagen scaffold brings a big challenge to support soft tissue stabilization and time-consuming osteogenesis. The combined effect for soft tissue and bone of the collagen scaffold with better degradation pattern has not been clearly proven. This study determined whether the double surfaces of crosslinked collagen scaffolds could optimize the combined soft tissue repair and osteogenesis. In this study, we applied the chemically crosslinking treatment to the commercially available collagen scaffolds. Surface characterization, mechanical property and cell proliferation in vitro were evaluated. Combined bilateral skin and bone defects were established with the smooth surface of scaffold facing the skin defect and the rough surface facing the bone defect on the calvaria of rat. Micro-CT and histological evaluation were applied to determine the scaffold degradation pattern, soft tissue repair and osteogenesis. The crosslinked collagen scaffolds showed comparably favorable surface porosity, structure intactness, superhydrophilicity and mechanical properties. Compared to the native scaffolds, the crosslinked scaffolds could optimize the combined soft tissue repair and osteogenesis by preferably prolonged degradation time. Early pro-angiogenesis facilitated soft tissue repair and osteogenesis by upregulated soft tissue matrix degradation and balanced pro-osteogenesis with limited osteoclast-mediated bone resorption. Taken together, this study offers a promising repair strategy for the combined soft tissue and bone defects. Further, the possible mechanism of controllable scaffold degradation should be conducted.
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Affiliation(s)
- Zhengchuan Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Qifen He
- Department of Stomatology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jinhao Zhu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaoxuan Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yang Yang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Hongcheng Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaoqiong Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Ruogu Xu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Özer T, Guliyeva V, Aktaş A, Barış E, Ocak M. Effects of a locally administered risedronate/autogenous bone graft combination on bone healing in a critical-size rabbit defect model. J Orthop Surg Res 2023; 18:88. [PMID: 36737772 PMCID: PMC9898954 DOI: 10.1186/s13018-023-03568-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Risedronate is a bisphosphonate with poor oral absorption. An extremely hydrophilic molecule that has a high affinity for bone, risedronate also inhibits the farnesyl diphosphate synthase enzyme, inhibiting osteoclastic activity and reducing bone turnover and resorption. Autogenous bone grafts contain osteogenic cells and osteoinductive factors that are essential for bone regeneration and are therefore considered the gold standard. Thus, this study aimed to investigate the impact of local risedronate administered with autogenous bone grafts on the healing of defects in rabbit skulls using histological, histomorphometric, immunohistochemical, and three-dimensional radiological methods. METHODS Two 10-mm-diameter critical-size defects were created in 16 rabbits and filled with autogenous bone graft and autogenous bone graft + 5 mg risedronate in the control (C) and risedronate (RIS) groups, respectively. Residual graft, new bone, soft tissue areas, and bone volume were evaluated in the 4- and 8-week study groups. RESULTS There were no statistically significant differences in bone graft, new bone, or soft tissue area between the groups at 4 weeks (p > 0.05). At 8 weeks, the new bone area was significantly higher in the RIS group than in the C group (p < 0.05). The h scores obtained from sialoprotein and osteopontin did not differ significantly between the groups (p > 0.05). The radiologically measured total bone volume was significantly higher in the RIS group than in the C group at both time points (p < 0.05). CONCLUSIONS In this study, risedronate enhanced the osteoconductive properties of autogenous bone grafts and rapidly created better-quality bone. This could improve future patient outcomes.
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Affiliation(s)
- Taha Özer
- grid.14442.370000 0001 2342 7339Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Türkiye
| | - Vusala Guliyeva
- grid.14442.370000 0001 2342 7339Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Türkiye
| | - Alper Aktaş
- grid.14442.370000 0001 2342 7339Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Türkiye
| | - Emre Barış
- grid.25769.3f0000 0001 2169 7132Department of Oral Pathology, Gazi University, Ankara, Turkey
| | - Mert Ocak
- grid.7256.60000000109409118Vocational School of Health, Ankara University, Ankara, Turkey
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10
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Cucchi A, Bettini S, Ghensi P, Fiorino A, Corinaldesi G. Vertical ridge augmentation with Ti-reinforced dense polytetrafluoroethylene (d-PTFE) membranes or Ti-meshes and collagen membranes: 3-year results of a randomized clinical trial. Clin Implant Dent Relat Res 2023; 25:352-369. [PMID: 36646986 DOI: 10.1111/cid.13173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/01/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND The present study aimed to evaluate hard and soft tissue parameters around implants placed in augmented posterior mandible, comparing Ti-reinforced d-PTFE membranes with Ti-meshes covered with collagen membranes, after 3 years of follow-up. MATERIALS AND METHODS Forty eligible patients were randomly assigned to group A (Ti-reinforced d-PTFE membrane) or group B (mesh covered with collagen membrane) for vertical ridge augmentation (VRA) and simultaneous implants. Implants were evaluated using specific peri-implant parameters for bone and soft tissues: probing pocket depth (PPD), modified plaque index (mPI), bleeding on probing (BoP), modified gingival index (mGI), thickness of keratinized tissue (tKT), width of keratinized tissue (wKT), fornix depth (FD), peri-implant bone level (PBL), interproximal bone peaks (IBP), marginal bone loss (MBL), interproximal bone loss (IBL). RESULTS A total of 28 patients with 79 implants were evaluated after 3 years of follow-up. The mean value of MBL was 0.70 mm (group A = 0.73 mm; group B = 0.71 mm), while mean IBL was 0.54 mm (group A = 0.64 mm; group B = 0.40 mm). The treatment with meshes resulted not inferior to PTFE and their clinical results appeared similar. A strong correlation between PBL and IBP was confirmed. Both study groups showed an increase of tKT and wKT values. CONCLUSION In the posterior mandible, VRA using both techniques provides stable PBLs up to 3 years. A correct soft tissue management and a strict professional oral hygiene protocol play a crucial role on peri-implant health over time.
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Affiliation(s)
| | - Sofia Bettini
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Ghensi
- Department CIBIO, University of Trento, Trento, Italy
| | - Antonino Fiorino
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Giuseppe Corinaldesi
- Section of Oral Science, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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11
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Cunha G, Carvalho PHDA, Quirino LC, Torres LHS, Filho VAP, Gabrielli MFR, Gabrielli MAC. Titanium Mesh Exposure After Bone Grafting: Treatment Approaches-A Systematic Review. Craniomaxillofac Trauma Reconstr 2022; 15:397-405. [PMID: 36387308 PMCID: PMC9647381 DOI: 10.1177/19433875211046114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023] Open
Abstract
Study Design A systematic review according to PRISMA statement has been designed to answer the preliminary question: "In titanium mesh exposures, is there a treatment alternative which leads to an increased graft maintenance?" and fill the PICO assessment out. Objective To review studies published in the past 20 years (1999-2019) in which mesh exposure has occurred, detecting the suitable approaches to treat exposure allowing the graft maintenance. Methods Initial search on PUBMED, SCOPUS, and COCHRANE databases resulted in 777 articles, and hand-searching identified 6 articles. After removing duplicates and unrelated articles, eligibility criteria were applied, and 31 studies were selected (randomized clinical trials, retrospective/prospective clinical trials, and case series). Results A total of 677 surgical sites and 225 cases of mesh exposure were identified. Eleven treatments have been identified. Chlorhexidine was the primary approach in 46% of cases, followed by oral hygiene instructions and follow-up with 22.5% of occurrences. In 21% of clinical situations, titanium mesh removal was the treatment of choice, associated with other measures (i.e., antibiotic prescription). There seems to be a consensus in cases of infection. When this complication was associated with tissue dehiscence, the primary treatment was mesh removal. The same does not occur when the site needs to be cleaned for long-term periods. Conclusion In 2 decades of use of titanium meshes, the available treatments do not seem to have evolved, and there is not enough data to establish a guideline.
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Affiliation(s)
- Giovanni Cunha
- Department of Diagnosis and Surgery,
Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State
University (Unesp), Araraquara, Brazil
- Department of Oral and
Cranio-Maxillofacial Surgery, University Hospital Basel, Switzerland
| | - Pedro Henrique de Azambuja Carvalho
- Department of Diagnosis and Surgery,
Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State
University (Unesp), Araraquara, Brazil
| | - Lílian Caldas Quirino
- Department of Diagnosis and Surgery,
Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State
University (Unesp), Araraquara, Brazil
| | - Luiz Henrique Soares Torres
- Department of Diagnosis and Surgery,
Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State
University (Unesp), Araraquara, Brazil
| | - Valfrido Antônio Pereira Filho
- Department of Diagnosis and Surgery,
Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State
University (Unesp), Araraquara, Brazil
| | - Mario Francisco Real Gabrielli
- Department of Diagnosis and Surgery,
Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State
University (Unesp), Araraquara, Brazil
| | - Marisa Aparecida Cabrini Gabrielli
- Department of Diagnosis and Surgery,
Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State
University (Unesp), Araraquara, Brazil
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12
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Ren Y, Fan L, Alkildani S, Liu L, Emmert S, Najman S, Rimashevskiy D, Schnettler R, Jung O, Xiong X, Barbeck M. Barrier Membranes for Guided Bone Regeneration (GBR): A Focus on Recent Advances in Collagen Membranes. Int J Mol Sci 2022; 23:ijms232314987. [PMID: 36499315 PMCID: PMC9735671 DOI: 10.3390/ijms232314987] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
Guided bone regeneration (GBR) has become a clinically standard modality for the treatment of localized jawbone defects. Barrier membranes play an important role in this process by preventing soft tissue invasion outgoing from the mucosa and creating an underlying space to support bone growth. Different membrane types provide different biological mechanisms due to their different origins, preparation methods and structures. Among them, collagen membranes have attracted great interest due to their excellent biological properties and desired bone regeneration results to non-absorbable membranes even without a second surgery for removal. This work provides a comparative summary of common barrier membranes used in GBR, focusing on recent advances in collagen membranes and their biological mechanisms. In conclusion, the review article highlights the biological and regenerative properties of currently available barrier membranes with a particular focus on bioresorbable collagen-based materials. In addition, the advantages and disadvantages of these biomaterials are highlighted, and possible improvements for future material developments are summarized.
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Affiliation(s)
- Yanru Ren
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
- BerlinAnalytix GmbH, 12109 Berlin, Germany
| | - Lu Fan
- NMI Natural and Medical Sciences Institute, University of Tübingen, 72770 Reutlingen, Germany
| | | | - Luo Liu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing 100013, China
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
| | - Stevo Najman
- Scientific Research Center for Biomedicine, Department for Cell and Tissue Engineering, Faculty of Medicine, University of Niš, 18000 Niš, Serbia
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18000 Niš, Serbia
| | - Denis Rimashevskiy
- Department of Traumatology and Orthopedics, Peoples’ Friendship University of Russia, 117198 Moscow, Russia
| | - Reinhard Schnettler
- University Medical Centre, Justus Liebig University of Giessen, 35390 Giessen, Germany
| | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
| | - Xin Xiong
- NMI Natural and Medical Sciences Institute, University of Tübingen, 72770 Reutlingen, Germany
| | - Mike Barbeck
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
- BerlinAnalytix GmbH, 12109 Berlin, Germany
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing 100013, China
- Correspondence: ; Tel.: +49-(0)-176-81022467
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13
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Doval Neto J, Marques RFC, Motta AC, Duek EADR, Oliveira GJPLD, Marcantonio C. Analysis of the biocompatibility of a biocelulose and a poly L- lactic acid membrane. BRAZILIAN JOURNAL OF ORAL SCIENCES 2022. [DOI: 10.20396/bjos.v21i00.8670616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The use of selective barriers as resorbable membranes has become a routine clinical procedure for guided bone regeneration. Therefore, the production of membranes with a low inflammatory potential during their resorption process has become the goal of a considerable number of researches. Aim: The purpose of the present study was to evaluate the biocompatibility of poly (L- lactic acid) (PLLA) and biocelulose membranes (BC) inserted in the subcutaneous tissue on the dorsum of rats. Methods: Fifteen animals underwent surgical procedures for the insertion of 4 types of membranes: COL (Collagen membrane) – Control Group; BC (Biocellulose membrane); BCAg (Biocellulose membrane impregnated with Silver); PLLA (Poly (L-lactic acid) membrane). All membrane types were inserted into each animal. Animals were euthanized after 3, 7, and 15 days of the surgical procedure. Descriptive histological analyses were carried out to investigate host tissue reaction to membrane presence by assessing the anti-inflammatory process composition associated with the membrane resorption and the presence of foreign-body reaction or encapsulation. Results: The BC membranes showed a higher degree of inflammation and poor pattern of integration with the surrounding tissues than the PLLA and COL membranes. Conclusion: The PLLA and COL membranes present better biocompatibility than the BC membranes.
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14
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Lim J, Jun SH, Tallarico M, Park JB, Park DH, Hwang KG, Park CJ. A Randomized Controlled Trial of Guided Bone Regeneration for Peri-Implant Dehiscence Defects with Two Anorganic Bovine Bone Materials Covered by Titanium Meshes. MATERIALS 2022; 15:ma15155294. [PMID: 35955229 PMCID: PMC9369984 DOI: 10.3390/ma15155294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 12/10/2022]
Abstract
The aim of this study is to compare two low-temperature sintered anorganic bovine bone materials (ABBMs), Bio-Oss (Geistlich, Wolhusen, Switzerland) and A-Oss (Osstem, Seoul, Korea), for GBR in dehiscence defects. A single implant was placed simultaneously with GBR in the buccal or bucco-proximal osseous defect by double-layering of inner allograft and outer ABBM, covered by a preformed ultrafine titanium mesh and an absorbable collagen membrane. Grafted volume changes were evaluated by cone-beam computed tomography, taken preoperatively (T0), immediately after implant surgery (T1), after re-entry surgery (T2), and after delivery of the final restoration (T3). The density of the regenerated bone was assessed by measuring the probing depth on the buccal mid-center of the mesh after removing the mesh at T2. Postoperative sequelae were also recorded. Grafted volume shrinkage of 46.0% (0.78 ± 0.37 cc) and 40.8% (0.79 ± 0.33 cc) in the Bio-Oss group (8 patients) and A-Oss group (8 patients), respectively, was observed at T3 (p < 0.001). There were no significant differences in grafted volume changes according to time periods or bone density between the two groups. Despite postoperative mesh exposure (3 patients), premature removal of these exposed meshes and additional grafting was not necessary, and all implants were functional over the 1-year follow-up period. Both ABBMs with titanium meshes showed no significant difference in the quantity and density of the regenerated bone after GBR for peri-implant defects.
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Affiliation(s)
- JaeHyung Lim
- Department of Oral and Maxillofacial Surgery, Korea University Ansan Hospital, Ansan-si 15355, Korea;
| | - Sang Ho Jun
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul 02841, Korea;
| | - Marco Tallarico
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy;
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Dae-Ho Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
| | - Kyung-Gyun Hwang
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
| | - Chang-Joo Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
- Correspondence: ; Tel.: +82-2-2290-8646
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15
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Morphological and Biological Evaluations of Human Periodontal Ligament Fibroblasts in Contact with Different Bovine Bone Grafts Treated with Low-Temperature Deproteinisation Protocol. Int J Mol Sci 2022; 23:ijms23095273. [PMID: 35563664 PMCID: PMC9101062 DOI: 10.3390/ijms23095273] [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: 04/06/2022] [Revised: 04/24/2022] [Accepted: 05/05/2022] [Indexed: 12/04/2022] Open
Abstract
Several types of deproteinised bovine bone mineral (DBBM) are available on the market, and each one is obtained with a thermic and chemical process that can differ, achieving different results. Currently, several protocols using low temperature are suggested to reduce the possible particle crystallisation during the production process. This study aimed to evaluate the biomorphological reaction of periodontal fibroblast cultures in contact with different DBBM particles treated with a low-temperature protocol (Thermagen®) and without exposure to sodium hydroxide (NaOH). Morphological evaluation was performed using light, confocal laser, and scanning electron microscopy, and the biological reaction in terms of proliferation was performed using an XTT proliferation assay at 24 h (T1), 72 h (T2), and 7 days (T3). The morphological analysis highlighted how the presence of the materials stimulated a change in the morphology of the cells into a polygonal shape, surface reactions with the thickening of the membrane, and expression of actin. In particular, the morphological changes were appreciable from T1, with a progressive increase in the considered morphological characteristics at T2 and T3 follow-ups. The proliferation assay showed a statistical significance between the different experimental materials and the negative control in T2 and T3 follow-ups. The post hoc analysis did not reveal any differences between the materials. In conclusion, the grafts obtained with the low-temperature extractions protocol and not exposed to NaOH solution showed positive morphological reactions with no differences in the sizes of particles.
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16
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Bizelli VF, Ramos EU, Veras ASC, Teixeira GR, Faverani LP, Bassi APF. Calvaria Critical Size Defects Regeneration Using Collagen Membranes to Assess the Osteopromotive Principle: An Animal Study. MEMBRANES 2022; 12:membranes12050461. [PMID: 35629786 PMCID: PMC9143843 DOI: 10.3390/membranes12050461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022]
Abstract
Guided bone regeneration (GBR) is a common practice in implantology, and it is necessary to use membranes in this process. The present study aimed to evaluate the osteopromotive principle of two porcine collagen membranes in critical-size defects at rats calvaria. Ninety-six Albinus Wistar rats were divided into BG (positive control), JS, CS, and CG (negative control) groups and were sacrificed at 7, 15, 30, and 60 days postoperatively. The samples were assessed by histological, histometric, immunohistochemical, and microtomographic analyses. More intense inflammatory profile was seen in the JS and CS groups (p < 0.05). At 60 days, the JS group showed a satisfactory osteopromotive behavior compared to BG (p = 0.193), while CS did not demonstrate the capacity to promote bone formation. At the immunohistochemical analysis, the CS showed mild labeling for osteocalcin (OC) and osteopontin (OP), the JS demonstrated mild to moderate for OC and OP and the BG demonstrated moderate to intense for OC and OP. The tridimensional analysis found the lowest average for the total volume of newly formed bone in the CS (84,901 mm2), compared to the BG (319,834 mm2) (p < 0.05). We conclude that the different thicknesses and treatment techniques of each membrane may interfere with its biological behavior.
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Affiliation(s)
- Vinícius Ferreira Bizelli
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (E.U.R.); (L.P.F.); (A.P.F.B.)
- Correspondence: ; Tel.: +55-(014)-981713458
| | - Edith Umasi Ramos
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (E.U.R.); (L.P.F.); (A.P.F.B.)
| | - Allice Santos Cruz Veras
- Multicenter Graduate Program in Physiological Sciences, SBFIS, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente 19060-900, SP, Brazil; (A.S.C.V.); (G.R.T.)
| | - Giovana Rampazzo Teixeira
- Multicenter Graduate Program in Physiological Sciences, SBFIS, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente 19060-900, SP, Brazil; (A.S.C.V.); (G.R.T.)
| | - Leonardo P. Faverani
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (E.U.R.); (L.P.F.); (A.P.F.B.)
| | - Ana Paula Farnezi Bassi
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (E.U.R.); (L.P.F.); (A.P.F.B.)
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17
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Azhar I, Ayulita D, Laksono H, Margaretha T. The efficiency of PRF, PTFE, and titanium mesh with collagen membranes for vertical alveolar bone addition in dental implant therapy: A narrative review. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_7_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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18
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Belleggia F. Hard and soft tissue augmentation of vertical ridge defects with the “hard top double membrane technique”: introduction of a new technique and a case report. AIMS BIOENGINEERING 2022. [DOI: 10.3934/bioeng.2022003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
<abstract>
<p>Vertical ridge defects (VRD) of the jaws often require both bone and keratinized mucosa (KM) reconstruction. A new staged procedure is proposed to restore both hard and soft tissues in the VRD through a case report. A patient required the lower right second premolar and first molar rehabilitation. The first surgery aimed to restore the bone architecture through the use of a titanium reinforced dense-PTFE (TR-dPTFE) membrane, positioned and stabilized on top of tenting screws. This membrane didn't cover the whole defect, it just created an hard top that avoided the collapse of a collagen membrane that was placed over it. This resorbable membrane was stabilized with tacks and covered the whole defect, protecting a mixture of autogenous bone and porcine xenograft both lingually and buccally. The second surgery was performed after a 5 month healing time either to remove the tenting screws and the TR-dPTFE membrane, and to augment KM with a gingival graft harvested from the palate. Both regenerated hard and soft tissues were left to mature for 7 months before the third surgery. In this last stage implants insertion and healing abutments application were carried out in a straightforward way, since bone and KM had been previously restored. Two bone samples, harvested for histologic evaluation, stated a great amount of new bone formation. This new approach allowed inserting implants in matured and stable regenerated bone and augmented KM, avoiding the hard and soft tissue loss around implant neck that can affect the VRD treatments during healing.</p>
</abstract>
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19
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Ottenbacher N, Alkildani S, Korzinskas T, Pissarek J, Ulm C, Jung O, Sundag B, Bellmann O, Stojanovic S, Najman S, Zechner W, Barbeck M. Novel Histomorphometrical Approach to Evaluate the Integration Pattern and Functionality of Barrier Membranes. Dent J (Basel) 2021; 9:dj9110127. [PMID: 34821591 PMCID: PMC8618445 DOI: 10.3390/dj9110127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 12/15/2022] Open
Abstract
GBR (guided bone regeneration) is a standard procedure for building up bony defects in the jaw. In this procedure, resorbable membranes made of bovine and porcine collagen are increasingly being used, which, in addition to many possible advantages, could have the potential disadvantage of a shorter barrier functionality, especially when augmenting large-volume defects. Thus, it is of importance to evaluate the integration behavior and especially the standing time of barrier membranes using specialized methods to predict its respective biocompatibility. This study is intended to establish a new histomorphometrical analysis method to quantify the integration rate of collagen-based barrier membranes. Three commercially available barrier membranes, i.e., non-crosslinked membranes (BioGide® and Jason® membrane), a ribose-crosslinked membrane (Ossix® Plus), and a newly developed collagen–hyaluronic acid-based (Coll-HA) barrier membrane were implanted in the subcutaneous tissue of 48 6–8-week-old Wistar rats. The explants, after three timepoints (10, 30, and 60 days), were processed and prepared into histological sections for histopathological (host tissue response) and histomorphometrical (cellular invasion) analyses. 10 days after implantation, fragmentation was not evident in any of the study groups. The sections of the Coll-HA, Jason® and BioGide® membranes showed a similar mild inflammatory reaction within the surrounding tissue and an initial superficial cell immigration. Only in the Ossix® Plus group very little inflammation and no cell invasion was detected. While the results of the three commercially available membranes remained intact in the further course of the study, only fragments of the Coll-HA membrane were found 30 and 60 days after implantation. Histomorphometrically, it can be described that although initially (at 10 days post-implantation) similar results were found in all study groups, after 30 days post-implantation the cellular penetration depth of the hyaluronic acid-collagen membrane was significantly increased with time (**** p < 0.0001). Similarly, the percentage of cellular invasion per membrane thickness was also significantly higher in the Coll-HA group at all timepoints, compared to the other membranes (**** p < 0.0001). Altogether, these results show that the histomorphometrical analysis of the cellular migration can act as an indicator of integration and duration of barrier functionality. Via this approach, it was possible to semi-quantify the different levels of cellular penetration of GBR membranes that were only qualitatively analyzed through histopathological approaches before. Additionally, the results of the histopathological and histomorphometrical analyses revealed that hyaluronic acid addition to collagen does not lead to a prolonged standing time, but an increased integration of a collagen-based biomaterial. Therefore, it can only partially be used in the dental field for indications that require fast resorbed membranes and a fast cell or tissue influx such as periodontal regeneration processes.
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Affiliation(s)
- Nicola Ottenbacher
- Clinical Division of Oral Surgery, Dental University Clinic, Medical University of Vienna, 1090 Vienna, Austria; (N.O.); (C.U.); (W.Z.)
| | - Said Alkildani
- BerlinAnalytix GmbH, 12109 Berlin, Germany; (S.A.); (T.K.)
| | | | | | - Christian Ulm
- Clinical Division of Oral Surgery, Dental University Clinic, Medical University of Vienna, 1090 Vienna, Austria; (N.O.); (C.U.); (W.Z.)
| | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (O.J.); (B.S.)
| | - Bernd Sundag
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (O.J.); (B.S.)
| | - Olaf Bellmann
- Research Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany;
| | - Sanja Stojanovic
- Scientific Research Center for Biomedicine, Department for Cell and Tissue Engineering, Faculty of Medicine, University of of Niš, 18000 Niš, Serbia; (S.S.); (S.N.)
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18000 Niš, Serbia
| | - Stevo Najman
- Scientific Research Center for Biomedicine, Department for Cell and Tissue Engineering, Faculty of Medicine, University of of Niš, 18000 Niš, Serbia; (S.S.); (S.N.)
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18000 Niš, Serbia
| | - Werner Zechner
- Clinical Division of Oral Surgery, Dental University Clinic, Medical University of Vienna, 1090 Vienna, Austria; (N.O.); (C.U.); (W.Z.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
| | - Mike Barbeck
- Department of Ceramic Materials, Chair of Advanced Ceramic Materials, Institute for Materials Science and Technologies, Technical University Berlin, 10623 Berlin, Germany
- Correspondence: ; Tel.: +49-(0)-176-8102-2467
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20
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Cucchi A, Vignudelli E, Franceschi D, Randellini E, Lizio G, Fiorino A, Corinaldesi G. Vertical and horizontal ridge augmentation using customized CAD/CAM titanium mesh with versus without resorbable membranes. A randomized clinical trial. Clin Oral Implants Res 2021; 32:1411-1424. [PMID: 34551168 PMCID: PMC9293224 DOI: 10.1111/clr.13841] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023]
Abstract
Objectives The aim was to evaluate the role of resorbable membranes applied over customized titanium meshes related to soft tissue healing and bone regeneration after vertical/horizontal bone augmentation. Materials and Methods Thirty patients with partial edentulism of the maxilla/mandible, with vertical/horizontal reabsorption of the alveolar bone, and needing implant‐supported restorations, were randomly divided into two groups: Group A was treated using only custom‐made meshes (Mesh‐) and Group B using custom‐made meshes with cross‐linked collagen membranes (Mesh+). Data collection included surgical/technical and healing complications, “pseudo‐periosteum” thickness, bone density, planned bone volume (PBV), regenerated bone volume (RBV), regeneration rate (RR), vertical bone gain (VBG), and implant survival in regenerated areas. Statistical analysis was performed between the two study groups using a significance level of α = .05. Results Regarding the healing complications, the noninferiority analysis proved to be inconclusive, despite the better results of group Mesh+ (13%) compared to group Mesh‐ (33%): estimated value −1.13 CI‐95% from −0.44 to 0.17. Superiority approach confirmed the absence of significant differences (p = .39). RBV was 803.27 mm3 and 843.13 mm3, respectively, and higher RR was observed in group Mesh+ (82.3%) compared to Mesh‐ (74.3%), although this value did not reach a statistical significance (p = .44). All 30 patients completed the study, receiving 71 implants; 68 out of them were clinically stable and in function. Conclusion The results showed that customized meshes alone do not appear to be inferior to customized meshes covered by cross‐linked collagen membranes in terms of healing complication rates and regeneration rates, although superior results were observed in group Mesh+compared to group Mesh‐ for all variables.
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Affiliation(s)
| | - Elisabetta Vignudelli
- Department of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna, Italy
| | - Debora Franceschi
- Department of Experimental and clinical Medicine, University of Florence, Florence, Italy
| | | | - Giuseppe Lizio
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Trans-plant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonino Fiorino
- Catholic University of Sacred Heart, University Polyclinic Foundation A. Gemelli (IRCCS), Rome, Italy
| | - Giuseppe Corinaldesi
- Department of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna, Italy
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21
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Clinical, Radiographic, and Histomorphometric Evaluation of a Vertical Ridge Augmentation Procedure Using a Titanium-Reinforced Microporous Expanded Polytetrafluoroethylene Membrane: A Prospective Case Series with 1-Year Follow-Up. MATERIALS 2021; 14:ma14143828. [PMID: 34300744 PMCID: PMC8307707 DOI: 10.3390/ma14143828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 12/26/2022]
Abstract
Vertical ridge augmentation for long-term implant stability is difficult in severely resorbed areas. We examined the clinical, radiological, and histological outcomes of guided-bone regeneration using novel titanium-reinforced microporous expanded polytetrafluoroethylene (MP-ePTFE) membranes. Eighteen patients who underwent implant placement using a staged approach were enrolled (period: 2018–2019). Vertical ridge augmentation was performed in areas with vertical bone defects ≥4 mm. Twenty-six implant fixtures were placed in 14 patients. At implant placement six fixtures had relatively low stability. On cone-beam computed tomography, the average vertical changes were 4.2 ± 1.9 (buccal), 5.9 ± 2.7 (central), and 4.4 ± 2.8 mm (lingual) at six months after vertical ridge augmentation. Histomorphometric analyses revealed that the average proportions of new bone, residual bone substitute material, and soft tissue were 34.91 ± 11.61%, 7.16 ± 2.74%, and 57.93 ± 11.09%, respectively. Stable marginal bone levels were observed at 1-year post-loading. The residual bone graft material area was significantly lower in the exposed group (p = 0.003). There was no significant difference in the vertical height change in the buccal side between immediately after the augmentation procedure and the implant placement reentry time (p = 0.371). However, all implants functioned well regardless of the exposure during the observation period. Thus, vertical ridge augmentation around implants using titanium-reinforced MP-ePTFE membranes can be successful.
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Dellavia C, Canciani E, Pellegrini G, Tommasato G, Graziano D, Chiapasco M. Histological assessment of mandibular bone tissue after guided bone regeneration with customized computer-aided design/computer-assisted manufacture titanium mesh in humans: A cohort study. Clin Implant Dent Relat Res 2021; 23:600-611. [PMID: 34139056 DOI: 10.1111/cid.13025] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/07/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Innovative customized computer-aided design/computer-assisted manufacture (CAD-CAM) titanium meshes have been proposed for guided alveolar bone regeneration. Histological confirmation on the quality of the regenerated bone is needed. Purpose of the study is to assess the integration capabilities of these innovative meshes and to evaluate the histological features of the regenerated alveolar bone. MATERIALS AND METHODS Twenty partially edentulous patients, with severe posterior mandibular atrophy, underwent a guided bone regeneration technique by means of customized CAD-CAM titanium mesh in association with a mixture of autologous bone in chips and deproteinized bovine bone (1:1). At 9 months of healing, titanium meshes and bone samples were collected and histomorphometrically analyzed. RESULTS In all patients, implants were placed according to the original plan. At histologic analysis, mesh appeared well osseointegrated, except that in sites where membrane exposure occurred. In all sites, newly formed tissue resulted highly mineralized, well-organized, and formed by 35.88% of new lamellar bone, 16.42% of woven bone, 10.88% of osteoid matrix, 14.10% of grafted remnants, and 22.72% of medullary spaces. Blood vessels were the 4% of the tissue. CONCLUSIONS Data from this study support the use of customized CAD/CAM titanium mesh for regeneration of vital, well-structured, and vascularized alveolar bone.
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Affiliation(s)
- Claudia Dellavia
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Elena Canciani
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Gaia Pellegrini
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Grazia Tommasato
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Clinical Unit of Oral Surgery, ASST Santi Paolo e Carlo - San Paolo Hospital, Università degli Studi di Milano, Milan, Italy
| | - Daniele Graziano
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Matteo Chiapasco
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Clinical Unit of Oral Surgery, ASST Santi Paolo e Carlo - San Paolo Hospital, Università degli Studi di Milano, Milan, Italy
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Abstract
The presence of satisfactory bone volume is fundamental for the achievement of osseointegration. This systematic review aims to analyse the use of titanium meshes in guided bone regeneration in terms of bone gain, survival and success rates of implants, and percentages of exposure. An electronic search was conducted Articles were selected from databases in MEDLINE (PubMed), SCOPUS, Scielo, and Cochrane Library databases to identify studies in which bone regeneration was performed through particulate bone and the use of titanium meshes. Twenty-one studies were included in the review. In total, 382 patients, 416 titanium meshes, and 709 implants were evaluated. The average bone gain was 4.3 mm in horizontal width and 4.11 mm in vertical height. The mesh exposure was highly prevalent (28%). The survival rate of 145 simultaneous implants was 99.5%; the survival rate of 507 delayed implants was 99%. The success rate of 105 simultaneous implants was 97%; the success rate of 285 delayed implants was 95.1%. The clinical studies currently available in the literature have shown the predictability of this technique. It has a high risk of soft tissue dehiscence and membrane exposure although the optimal management of membrane exposition permits obtaining a sufficient bone regeneration volume and prevents compromising the final treatment outcome.
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Bassi APF, Bizelli VF, Francatti TM, Rezende de Moares Ferreira AC, Carvalho Pereira J, Al-Sharani HM, de Almeida Lucas F, Faverani LP. Bone Regeneration Assessment of Polycaprolactone Membrane on Critical-Size Defects in Rat Calvaria. MEMBRANES 2021; 11:membranes11020124. [PMID: 33572318 PMCID: PMC7916152 DOI: 10.3390/membranes11020124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 12/13/2022]
Abstract
Biomaterials for use in guided bone regeneration (GBR) are constantly being investigated and developed to improve clinical outcomes. The present study aimed to comparatively evaluate the biological performance of different membranes during the bone healing process of 8 mm critical defects in rat calvaria in order to assess their influence on the quality of the newly formed bone. Seventy-two adult male rats were divided into three experimental groups (n = 24) based on the membranes used: the CG—membrane-free control group (only blood clot, negative control), BG—porcine collagen membrane group (Bio-Guide®, positive control), and the PCL—polycaprolactone (enriched with 5% hydroxyapatite) membrane group (experimental group). Histological and histometric analyses were performed at 7, 15, 30, and 60 days postoperatively. The quantitative data were analyzed by two-way ANOVA and Tukey’s test (p < 0.05). At 7 and 15 days, the inflammatory responses in the BG and PCL groups were significantly different (p < 0.05). The PCL group, at 15 days, showed a large area of newly formed bone. At 30 and 60 days postoperatively, the PCL and BG groups exhibited similar bone healing, including some specimens showing complete closure of the critical defect (p = 0.799). Thus, the PCL membrane was biocompatible, and has the potential to help with GBR procedures.
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Affiliation(s)
- Ana Paula Farnezi Bassi
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University—UNESP, Araçatuba, São Paulo 16015-050, Brazil; (V.F.B.); (T.M.F.); (A.C.R.d.M.F.); (J.C.P.); (L.P.F.)
- Correspondence: ; Tel.: +55-18-36363242
| | - Vinícius Ferreira Bizelli
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University—UNESP, Araçatuba, São Paulo 16015-050, Brazil; (V.F.B.); (T.M.F.); (A.C.R.d.M.F.); (J.C.P.); (L.P.F.)
| | - Tamires Mello Francatti
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University—UNESP, Araçatuba, São Paulo 16015-050, Brazil; (V.F.B.); (T.M.F.); (A.C.R.d.M.F.); (J.C.P.); (L.P.F.)
| | - Ana Carulina Rezende de Moares Ferreira
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University—UNESP, Araçatuba, São Paulo 16015-050, Brazil; (V.F.B.); (T.M.F.); (A.C.R.d.M.F.); (J.C.P.); (L.P.F.)
| | - Járede Carvalho Pereira
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University—UNESP, Araçatuba, São Paulo 16015-050, Brazil; (V.F.B.); (T.M.F.); (A.C.R.d.M.F.); (J.C.P.); (L.P.F.)
| | - Hesham Mohammed Al-Sharani
- School of Dentistry, Faculty of Dentistry, Ibb University, Ibb, Yemen;
- Department of Maxillofacial Surgery, School of Stomatology, Harbin Medical University, Harbin 150081, China
| | - Flavia de Almeida Lucas
- Araçatuba Veterinary Medicine School, UNESP—São Paulo State University, Araçatuba, São Paulo 16050-680, Brazil;
| | - Leonardo Perez Faverani
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University—UNESP, Araçatuba, São Paulo 16015-050, Brazil; (V.F.B.); (T.M.F.); (A.C.R.d.M.F.); (J.C.P.); (L.P.F.)
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Cucchi A, Vignudelli E, Fiorino A, Pellegrino G, Corinaldesi G. Vertical ridge augmentation (VRA) with Ti-reinforced d-PTFE membranes or Ti meshes and collagen membranes: 1-year results of a randomized clinical trial. Clin Oral Implants Res 2020; 32:1-14. [PMID: 33017060 DOI: 10.1111/clr.13673] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 09/07/2020] [Accepted: 09/19/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate hard and soft tissues around implants placed in posterior mandible 1 year after vertical ridge augmentation (VRA). MATERIALS AND METHODS 40 patients with vertical defects were enrolled and treated according to the study protocol. Patients were randomly divided into two study groups: reinforced PTFE membranes (group A) and titanium meshes plus collagen membranes (group B). All patients received simultaneous implants which were evaluated after prosthetic restoration at baseline and after 1 year, using the following parameters: peri-implant bone levels (PBLs), interproximal bone peaks (IBPs), pocket probing depth (PPD), bleeding on probing (BoP), plaque index (mPI), gingival index (mGI), keratinized tissue thickness/width (tKT and wKT), and fornix depth (FD). Statistical analysis was performed to investigate any statistically significant differences and/or correlations (p = .05). RESULTS 30 patients were completely followed up according to the study protocol. After 1 year, implants showed a change in PBL from 0.12 to 0.76 mm, with marginal bone loss of 0.67 and 0.61 mm for group A and group B, respectively, without significant differences (p > .9337). The estimated difference between treatments for the change from baseline in PBL was -0.05 (95% CI -0.27 to 0.16). Statistical analysis revealed strong correlations between PBL and IBP (p < .0001). However, no significant differences were observed for PPD, mPI, mGI, tKT, wKT, and FD (p > .05). CONCLUSION The results indicate that GBR treatment with titanium meshes plus collagen membranes (Group B) compared to reinforced PTFE membranes does not appear to be inferior or superior in terms of PBL change. In both groups, hard and soft tissues were stable after 1 year of follow-up, with a peri-implant bone loss less than 1.0 mm in the first year (study registered at ClinicalTrials.gov NCT04332679).
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Affiliation(s)
| | - Elisabetta Vignudelli
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Antonino Fiorino
- Unit of Dentistry and Maxillofacial Surgery, Catholic University of Sacred Heart, University Polyclinic Foundation A. Gemelli (IRCCS), Rome, Italy
| | - Gerardo Pellegrino
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Giuseppe Corinaldesi
- Unit of First Consultation, Risk Patients and Oral Pathology, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum - University of Bologna, Bologna, Italy
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Cucchi A, Bianchi A, Calamai P, Rinaldi L, Mangano F, Vignudelli E, Corinaldesi G. Clinical and volumetric outcomes after vertical ridge augmentation using computer-aided-design/computer-aided manufacturing (CAD/CAM) customized titanium meshes: a pilot study. BMC Oral Health 2020; 20:219. [PMID: 32758217 PMCID: PMC7409710 DOI: 10.1186/s12903-020-01205-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background One of the most recent innovations in bone augmentation surgery is represented by computer-aided-design/computer-aided-manufacturing (CAD/CAM) customized titanium meshes, which can be used to restore vertical bone defects before implant-prosthetic rehabilitations. The aim of this study was to evaluate the effectiveness/reliability of this technique in a consecutive series of cases. Methods Ten patients in need of bone augmentation before implant therapy were treated using CAD/CAM customized titanium meshes. A digital workflow was adopted to design virtual meshes on 3D bone models. Then, Direct Metal Laser Sintering (DMLS) technology was used to produce the titanium meshes, and vertical ridge augmentation was performed according to an established surgical protocol. Surgical complications, healing complications, vertical bone gain (VBG), planned bone volume (PBV), lacking bone volume (LBV), regenerated bone volume (RBV), average regeneration rate (RR) and implant success rate were evaluated. Results All augmented sites were successfully restored with definitive implant-supported fixed partial dentures. Measurements showed an average VBG of 4.5 ± 1.8 mm at surgical re-entry. Surgical and healing complications occurred in 30% and 10% of cases, respectively. Mean values of PBV, LBV, and RBV were 984, 92, and 892 mm3, respectively. The average RR achieved was 89%. All 26 implants were successfully in function after 1 year of follow-up. Conclusions The results of this study suggest that the bone augmentation by means of DMLS custom-made titanium meshes can be considered a reliable and effective technique in restoring vertical bone defects.
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Affiliation(s)
- Alessandro Cucchi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.
| | - Alessandro Bianchi
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | | | - Lisa Rinaldi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Francesco Mangano
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, Moscow, Russia
| | - Elisabetta Vignudelli
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Giuseppe Corinaldesi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
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