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Menini M, Canullo L, Iacono R, Triestino A, Caponio VCA, Savadori P, Pesce P, Pedetta A, Guerra F. Effect of Different Graft Material Consistencies in the Treatment of Minimal Bone Dehiscence: A Retrospective Pilot Study. Dent J (Basel) 2024; 12:198. [PMID: 39056985 PMCID: PMC11275297 DOI: 10.3390/dj12070198] [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: 05/10/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Among different therapeutic strategies proposed in the case of bone volume deficit, guided bone regeneration (GBR) is a consolidated surgical procedure. The objective of this study is to retrospectively evaluate the behavior of two bone grafts with different consistencies in the GBR procedure by measuring the volumetric tissue changes 1 year after surgery. For this retrospective analysis, 25 cases of GBR with simultaneous implant insertion were selected. A total of 13 were grafted with a porcine cortico-cancellous bone mix (CCBM group), and 12 were grafted with a pre-hydrated granulated cortico-cancellous bone mix of porcine origin blended with 20% TSV gel (Collagenated-CCBM). A collagen membrane was fixed to cover the bone defect. A total of 42 implants were placed with computer-guided surgery. Preoperative and 12-month postoperative digital impressions were used to evaluate dimensional changes. Student's t-test used for independent samples showed no statistically significant differences between the integrated distance (p = 0.995) and mean distance (p = 0.734). The mean integrated distance in the CCBM group was 41.80 (SD. 101.18) compared to a mean of 42.04 (SD. 66.71) in the Collagenated-CCBM group. Given the limitations of this study, in patients with peri-implant bone dehiscence, simple heterologous and collagenated heterologous cortico-cancellous bone grafts are suitable for filling the bone defect to promote bone regeneration, although further studies are needed.
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Affiliation(s)
- Maria Menini
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Roberta Iacono
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.I.); (F.G.)
| | | | - Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 1, 7100 Foggia, Italy;
| | - Paolo Savadori
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Via Della Commenda, 10/12, 20122 Milan, Italy
- IRCCS Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Andrea Pedetta
- Private Practice, Via Colledoro 41, 00034 Colleferro, Italy;
| | - Fabrizio Guerra
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.I.); (F.G.)
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Menchini-Fabris GB, Toti P, Covani U, Trasarti S, Cosola S, Crespi R. Volume assessment of the external contour around immediate implant with or without immediate tooth-like crown provisionalization: A digital intraoral scans study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101418. [PMID: 36758898 DOI: 10.1016/j.jormas.2023.101418] [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: 09/18/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023]
Abstract
PURPOSES To examine differences between immediate and delayed dental implant loading in maxillary aesthetic areas. METHODS In this retrospective controlled analysis, 43 subjects who underwent immediate placement of the dental implant in a post-extraction socket were ranked into either immediate (24 implants loaded with non-occlusal tooth-like profile provisional prostheses fabricated by virtual diagnostic impressions and an in-office dental milling machine) or delayed group (19 implants loaded with conventional cover screws and secondary intention healing). Intraoperatively and then four months later, scans of the external layers were acquired with an optical scanner. The width of the alveolar crest and Jemt papilla index were acquired. Non-parametric tests were applied with a level of significance set at p < 0.01. RESULTS In both groups, the volumes and areas showed significant reductions from the baseline to the 4-month survey. Reductions in volume appeared to be statistically different between the two groups (-39±31 mm3 for the immediate and 89 ± 30 mm3 for the delayed group). The final Jemt papilla index appeared significantly different between the immediate (mesial, 2.5 and, distal, 3) and delayed groups (2 for both aspects). CONCLUSIONS Immediate provisionalization significantly reduced volume loss and area shrinkage at the external layer when data were compared to a delayed rehabilitation strategy.
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Affiliation(s)
- Giovanni Battista Menchini-Fabris
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy; San Rossore Dental Unit, San Rossore Private Hospital, Pisa, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy.
| | - Paolo Toti
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Ugo Covani
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Stefano Trasarti
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Saverio Cosola
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Roberto Crespi
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
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Strasding M, Jeong Y, Marchand L, Hicklin SP, Sailer I, Sun M, Lee H. Three-Dimensional Peri-Implant Tissue Changes in Immediately vs. Early Placed Tapered Implants Restored with Two Different Ceramic Materials-1 Year Results. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5636. [PMID: 37629928 PMCID: PMC10456968 DOI: 10.3390/ma16165636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND A prospective multi-center randomized controlled clinical trial was performed to digitally analyze tissue volume changes in immediately and early placed implants with simultaneous bone augmentation restored with two different all-ceramic materials. METHODS A total of 60 patients received 60 bone-level tapered implants (BLT, Straumann AG) immediately (n = 30) or early placed, 8-10 weeks after tooth extraction, (n = 30). Implants were restored with all-ceramic single crowns fabricated out of zirconia (Lava Plus, 3M), or lithium disilicate (E.max CAD, Ivoclar Vivadent AG) bonded to titanium base abutments (Variobase for Cerec, Straumann AG). Impressions were taken at baseline (BL), 6 and 12 months, and STL data were used to define an area of interest (AOI) to analyze peri-implant volume changes and midfacial recessions. RESULTS For immediate placement, a mean volume loss of -5.56 mm3 (±5.83 mm3) was found at 6 months, and of -6.62 mm3 (±6.56 mm3) at 12 months. For early placement, a mean volume loss of -1.99 mm3 (±5.82 mm3) at 6 months, and of -3.7 mm3 (±5.62 mm3) at 12 months was found. The differences in volume loss at 12 months between the two implant placement protocols were significant (p = 0.005). In both groups, mean midfacial recessions of 0.48 mm (±0.52) occurred. CONCLUSIONS A more pronounced peri-implant volume loss can be expected 12 months after immediate implant placement compared with early placement.
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Affiliation(s)
- Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Yuwon Jeong
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Laurent Marchand
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Stefan P. Hicklin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland;
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Minji Sun
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Hyeonjong Lee
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
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Neves RG, Lazari-Carvalho PC, Carvalho MA, Carvalho AL, de Souza JB, Torres ÉM. Socket shield technique: Stress distribution analysis. J Indian Soc Periodontol 2023; 27:392-398. [PMID: 37593548 PMCID: PMC10431233 DOI: 10.4103/jisp.jisp_356_22] [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: 08/01/2022] [Revised: 03/25/2023] [Accepted: 04/22/2023] [Indexed: 08/19/2023] Open
Abstract
Background To analyze through finite element analysis the stress distribution in peri-implant bone tissues, implants, and prosthetic components induced by the socket shield (SS) technique in comparison to other techniques used to treat tooth loss. Materials and Methods A three-dimensional model of a superior central incisor crown supported by implant was modeled and three different placement conditions were simulated: SS - 2.0-mm-thick root dentin fragment positioned between the alveolar buccal wall and implant; heterologous bone graft (HBG) - bovine bone graft positioned the alveolar buccal wall and implant; and control (C) - implant fully placed in bone tissue of a healed alveolus. The model was restricted at the lateral surfaces of the bone tissue and the following loads were simulated: Both oblique (45°) loads of 100 N on the lingual surface of the crown (maximal habitual intercuspation) and 25.5 N on the incisal edge of the crown (tooth contact during mandibular protrusion) were simultaneously applied. Tensile stress, shear stress, compression, and displacement were analyzed in the cortical bone, trabecular bone, dentin root fragment, and bone graft; while equivalent von Mises stresses were quantified in the implant and prosthetic components. Results Stress values of SS and HBG in the bone tissues were higher than C, while slight differences within models were observed for dentin root fragment, bone graft, implant, and prosthetic components. Conclusions The SS technique presented the highest stress concentration in the peri-implant tissues.
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Affiliation(s)
| | | | - Marco Aurélio Carvalho
- Department of Oral Rehabilitation, School of Dentistry, Evangelical University of Goias, Anápolis, GO, Brazil
| | | | - João Batista de Souza
- Department of Restorative Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Érica Miranda Torres
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
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Chisci G, Hatia A, Chisci E, Chisci D, Gennaro P, Gabriele G. Socket Preservation after Tooth Extraction: Particulate Autologous Bone vs. Deproteinized Bovine Bone. Bioengineering (Basel) 2023; 10:bioengineering10040421. [PMID: 37106608 PMCID: PMC10136074 DOI: 10.3390/bioengineering10040421] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/11/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Background: The technique of socket preservation after tooth extraction allows for less volumetric decrease after tooth extraction. The aim of this retrospective study was to evaluate differences between alveolar socket preservation performed with deproteinized bovine bone graft and autologous particulate bone graft taken from the mandibular ramus. Materials and Methods: This retrospective study enrolled a total of 21 consecutive patients. A total of 11 patients underwent socket preservation with deproteinized bovine bone graft and collagen matrix (group A), and 10 patients underwent socket preservation performed with particulate autologous bone taken from the mandibular ramus and collagen matrix (group B). All patients received cone beam computed tomography (CBCT) before socket preservation and after four months. Alveolar bone width (ABW) values and alveolar bone height (ABH) values were measured at the first and second CBCT, and the reduction of the values in the two groups was compared. Statistical analysis was performed using Student’s t-test for independent variables, and p values < 0.05 were considered statistically significant. Results: There were no statistically significant differences between ABW reduction of group A and ABW reduction of group B (t-test value p = 0.28). There were no statistically significant differences between ABH reduction of group A and ABH reduction of group B (t-test value p = 0.10). Conclusions: In this retrospective study, no statistical differences were found between the group that received autologous particulate bone compared to the group that received deproteinized bovine bone in socket preservation.
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Affiliation(s)
- Glauco Chisci
- Centro Dentistico Chisci, Via Ricasoli 18, 58100 Grosseto, Italy
- Correspondence:
| | - Arjeta Hatia
- Department of Orthodontics, University of Siena, 53100 Siena, Italy
| | - Elettra Chisci
- Centro Dentistico Chisci, Via Ricasoli 18, 58100 Grosseto, Italy
| | - Dafne Chisci
- Centro Dentistico Chisci, Via Ricasoli 18, 58100 Grosseto, Italy
| | - Paolo Gennaro
- Department of Maxillofacial Surgery, University of Siena, 53100 Siena, Italy
| | - Guido Gabriele
- Department of Maxillofacial Surgery, University of Siena, 53100 Siena, Italy
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Huang X, Wang H, Wang C, Cao Z. The Applications and Potentials of Extracellular Vesicles from Different Cell Sources in Periodontal Regeneration. Int J Mol Sci 2023; 24:ijms24065790. [PMID: 36982864 PMCID: PMC10058679 DOI: 10.3390/ijms24065790] [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: 02/18/2023] [Revised: 03/08/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Periodontitis is a chronic infectious disease worldwide that can cause damage to periodontal supporting tissues including gingiva, bone, cementum and periodontal ligament (PDL). The principle for the treatment of periodontitis is to control the inflammatory process. Achieving structural and functional regeneration of periodontal tissues is also essential and remains a major challenge. Though many technologies, products, and ingredients were applied in periodontal regeneration, most of the strategies have limited outcomes. Extracellular vesicles (EVs) are membranous particles with a lipid structure secreted by cells, containing a large number of biomolecules for the communication between cells. Numerous studies have demonstrated the beneficial effects of stem cell-derived EVs (SCEVs) and immune cell-derived EVs (ICEVs) on periodontal regeneration, which may be an alternative strategy for cell-based periodontal regeneration. The production of EVs is highly conserved among humans, bacteria and plants. In addition to eukaryocyte-derived EVs (CEVs), a growing body of literature suggests that bacterial/plant-derived EVs (BEVs/PEVs) also play an important role in periodontal homeostasis and regeneration. The purpose of this review is to introduce and summarize the potential therapeutic values of BEVs, CEVs and PEVs in periodontal regeneration, and discuss the current challenges and prospects for EV-based periodontal regeneration.
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Affiliation(s)
- Xin Huang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Huiyi Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Chuan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Zhengguo Cao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
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A Narrative Review on the Effectiveness of Bone Regeneration Procedures with OsteoBiol® Collagenated Porcine Grafts: The Translational Research Experience over 20 Years. J Funct Biomater 2022; 13:jfb13030121. [PMID: 35997459 PMCID: PMC9397035 DOI: 10.3390/jfb13030121] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Over the years, several bone regeneration procedures have been proposed using natural (autografts, allografts, and xenografts) and synthetic (i.e., metals, ceramics, and polymers) bone grafts. In particular, numerous in vitro and human and animal in vivo studies have been focused on the discovery of innovative and suitable biomaterials for oral and maxillofacial applications in the treatment of severely atrophied jaws. On this basis, the main objective of the present narrative review was to investigate the efficacy of innovative collagenated porcine bone grafts (OsteoBiol®, Tecnoss®, Giaveno, Italy), designed to be as similar as possible to the autologous bone, in several bone regeneration procedures. The scientific publications were screened by means of electronic databases, such as PubMed, Scopus, and Embase, finally selecting only papers that dealt with bone substitutes and scaffolds for bone and soft tissue regeneration. A total of 201 papers have been detected, including in vitro, in vivo, and clinical studies. The effectiveness of over 20 years of translational research demonstrated that these specific porcine bone substitutes are safe and able to improve the biological response and the predictability of the regenerative protocols for the treatment of alveolar and maxillofacial defects.
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Di Tinco R, Consolo U, Pisciotta A, Orlandi G, Bertani G, Nasi M, Bertacchini J, Carnevale G. Characterization of Dental Pulp Stem Cells Response to Bone Substitutes Biomaterials in Dentistry. Polymers (Basel) 2022; 14:polym14112223. [PMID: 35683895 PMCID: PMC9182880 DOI: 10.3390/polym14112223] [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: 05/10/2022] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 02/05/2023] Open
Abstract
Bone substitute biomaterials (BSBs) represent a promising alternative to bone autografts, due to their biocompatibility, osteoconduction, slow resorption rates, and the ability to define and maintain volume for bone gain in dentistry. Many biomaterials are tailored to provide structural and biological support for bone regeneration, and allow the migration of bone-forming cells into the bone defect. Neural crest-derived stem cells isolated from human dental pulp (hDPSCs) represent a suitable stem cell source to study the biological effects of BSBs on osteoprogenitor cells involved in the physiological bone regenerative processes. This study aimed to evaluate how three different BSBs affect the stem cell properties, osteogenic differentiation, and inflammatory properties of hDPSCs. Our data highlight that BSBs do not alter cell proliferation and stemness markers expression, nor induce any inflammatory responses. Bone metabolism data show that hDPSCs exposed to the three BSBs distinctively secrete the factors supporting osteoblast activity and osteoclast activity. Our data indicate that (i) hDPSCs are a suitable stem cell source to study the effects of BSBs, and that (ii) the formulation of BSBs may condition the biological properties of stem cells, suggesting their versatile suitability to different dentistry applications.
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Affiliation(s)
- Rosanna Di Tinco
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (U.C.); (A.P.); (G.O.); (G.B.); (M.N.); (J.B.)
| | - Ugo Consolo
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (U.C.); (A.P.); (G.O.); (G.B.); (M.N.); (J.B.)
- Operative Unit of Dentistry and Maxillofacial Surgery, Department Integrated Activity-Specialist Surgeries, University-Hospital of Modena, 41125 Modena, Italy
| | - Alessandra Pisciotta
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (U.C.); (A.P.); (G.O.); (G.B.); (M.N.); (J.B.)
| | - Giulia Orlandi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (U.C.); (A.P.); (G.O.); (G.B.); (M.N.); (J.B.)
| | - Giulia Bertani
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (U.C.); (A.P.); (G.O.); (G.B.); (M.N.); (J.B.)
| | - Milena Nasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (U.C.); (A.P.); (G.O.); (G.B.); (M.N.); (J.B.)
| | - Jessika Bertacchini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (U.C.); (A.P.); (G.O.); (G.B.); (M.N.); (J.B.)
- CNR-Institute of Molecular Genetics “Luigi Luca Cavalli-Sforza”, Unit of Bologna, 40136 Bologna, Italy
| | - Gianluca Carnevale
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (R.D.T.); (U.C.); (A.P.); (G.O.); (G.B.); (M.N.); (J.B.)
- Correspondence: ; Tel.: +39-0594-224-852
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Multi-Layer Technique (MLT) with Porcine Collagenated Cortical Bone Lamina for Bone Regeneration Procedures and Immediate Post-Extraction Implantation in the Esthetic Area: A Retrospective Case Series with a Mean Follow-Up of 5 Years. MATERIALS 2021; 14:ma14185180. [PMID: 34576416 PMCID: PMC8469553 DOI: 10.3390/ma14185180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/24/2021] [Accepted: 09/07/2021] [Indexed: 01/12/2023]
Abstract
Background: Augmentation of the edentulous atrophic anterior region is a challenging situation. The purpose of this article was to evaluate the effectiveness of a collagenated cortical bone lamina of porcine origin for horizontal ridge augmentation in patients with inadequate alveolar ridge width undergoing immediate post-extraction implantation in the anterior sites, and to report on implant survival rates/complications. Materials and methods: The cases were extracted electronically from a large database according to these specific inclusion criteria: patients with inadequate alveolar ridge width in the anterior maxilla or mandible, who underwent immediate post-extraction implant placement and simultaneous alveolar bone reconstruction using xenogeneic cortical bone lamina. An additional layer of palatal connective tissue graft was inserted between lamina and the vestibular mucosa, for improving soft tissue healing. A collagenated bone substitute was additionally placed in the gap between the lamina and implant surface in all patients. The main outcomes were implant survival and complications. Results: Forty-nine patients with 65 implants were included. Patients’ mean age at the time of implant surgery was 60.0 ± 13.6 years. The mean follow-up was 60.5 ± 26.6 months after implant placement. The implant survival was 100%. Four postoperative complications occurred in four patients. No specific factor was found to be associated with complication occurrence. Conclusion: The use of collagenated cortical bone lamina can be considered as a successful option for alveolar reconstruction in immediate post-extraction implant insertion procedures in anterior regions with inadequate alveolar ridge width.
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Atieh MA, Alsabeeha NH, Payne AG, Ali S, Faggion CMJ, Esposito M. Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development. Cochrane Database Syst Rev 2021; 4:CD010176. [PMID: 33899930 PMCID: PMC8092674 DOI: 10.1002/14651858.cd010176.pub3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Alveolar bone changes following tooth extraction can compromise prosthodontic rehabilitation. Alveolar ridge preservation (ARP) has been proposed to limit these changes and improve prosthodontic and aesthetic outcomes when implants are used. This is an update of the Cochrane Review first published in 2015. OBJECTIVES To assess the clinical effects of various materials and techniques for ARP after tooth extraction compared with extraction alone or other methods of ARP, or both, in patients requiring dental implant placement following healing of extraction sockets. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 19 March 2021), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2021, Issue 2), MEDLINE Ovid (1946 to 19 March 2021), Embase Ovid (1980 to 19 March 2021), Latin American and Caribbean Health Science Information database (1982 to 19 March 2021), Web of Science Conference Proceedings (1990 to 19 March 2021), Scopus (1966 to 19 March 2021), ProQuest Dissertations and Theses (1861 to 19 March 2021), and OpenGrey (to 19 March 2021). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. A number of journals were also handsearched. SELECTION CRITERIA We included all randomised controlled trials (RCTs) on the use of ARP techniques with at least six months of follow-up. Outcome measures were: changes in the bucco-lingual/palatal width of alveolar ridge, changes in the vertical height of the alveolar ridge, complications, the need for additional augmentation prior to implant placement, aesthetic outcomes, implant failure rates, peri-implant marginal bone level changes, changes in probing depths and clinical attachment levels at teeth adjacent to the extraction site, and complications of future prosthodontic rehabilitation. DATA COLLECTION AND ANALYSIS We selected trials, extracted data, and assessed risk of bias in duplicate. Corresponding authors were contacted to obtain missing information. We estimated mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes, with 95% confidence intervals (95% CI). We constructed 'Summary of findings' tables to present the main findings and assessed the certainty of the evidence using GRADE. MAIN RESULTS We included 16 RCTs conducted worldwide involving a total of 524 extraction sites in 426 adult participants. We assessed four trials as at overall high risk of bias and the remaining trials at unclear risk of bias. Nine new trials were included in this update with six new trials in the category of comparing ARP to extraction alone and three new trials in the category of comparing different grafting materials. ARP versus extraction: from the seven trials comparing xenografts with extraction alone, there is very low-certainty evidence of a reduction in loss of alveolar ridge width (MD -1.18 mm, 95% CI -1.82 to -0.54; P = 0.0003; 6 studies, 184 participants, 201 extraction sites), and height (MD -1.35 mm, 95% CI -2.00 to -0.70; P < 0.0001; 6 studies, 184 participants, 201 extraction sites) in favour of xenografts, but we found no evidence of a significant difference for the need for additional augmentation (RR 0.68, 95% CI 0.29 to 1.62; P = 0.39; 4 studies, 154 participants, 156 extraction sites; very low-certainty evidence) or in implant failure rate (RR 1.00, 95% CI 0.07 to 14.90; 2 studies, 70 participants/extraction sites; very low-certainty evidence). From the one trial comparing alloplasts versus extraction, there is very low-certainty evidence of a reduction in loss of alveolar ridge height (MD -3.73 mm; 95% CI -4.05 to -3.41; 1 study, 15 participants, 60 extraction sites) in favour of alloplasts. This single trial did not report any other outcomes. Different grafting materials for ARP: three trials (87 participants/extraction sites) compared allograft versus xenograft, two trials (37 participants, 55 extraction sites) compared alloplast versus xenograft, one trial (20 participants/extraction sites) compared alloplast with and without membrane, one trial (18 participants, 36 extraction sites) compared allograft with and without synthetic cell-binding peptide P-15, and one trial (30 participants/extraction sites) compared alloplast with different particle sizes. The evidence was of very low certainty for most comparisons and insufficient to determine whether there are clinically significant differences between different ARP techniques based on changes in alveolar ridge width and height, the need for additional augmentation prior to implant placement, or implant failure. We found no trials which evaluated parameters relating to clinical attachment levels, specific aesthetic or prosthodontic outcomes for any of the comparisons. No serious adverse events were reported with most trials indicating that the procedure was uneventful. Among the complications reported were delayed healing with partial exposure of the buccal plate at suture removal, postoperative pain and swelling, moderate glazing, redness and oedema, membrane exposure and partial loss of grafting material, and fibrous adhesions at the cervical part of previously preserved sockets, for the comparisons xenografts versus extraction, allografts versus xenografts, alloplasts versus xenografts, and alloplasts with and without membrane. AUTHORS' CONCLUSIONS ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction but the evidence is very uncertain. There is lack of evidence of any differences in the need for additional augmentation at the time of implant placement, implant failure, aesthetic outcomes, or any other clinical parameters due to lack of information or long-term data. There is no evidence of any clinically significant difference between different grafting materials and barriers used for ARP. Further long-term RCTs that follow CONSORT guidelines (www.consort-statement.org) are necessary.
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Affiliation(s)
- Momen A Atieh
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel Hm Alsabeeha
- RAK Dental Centre, Ministry of Health and Prevention, Ras Al-Khaimah, United Arab Emirates
| | - Alan Gt Payne
- Private practice, Northland Prosthodontics Ltd, c/o NorthShore Oral and Maxillofacial Surgeons, Auckland, New Zealand
| | - Sara Ali
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
| | | | - Marco Esposito
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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11
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Collagenated Porcine Heterologous Bone Grafts: Histomorphometric Evaluation of Bone Formation Using Different Physical Forms in a Rabbit Cancellous Bone Model. Molecules 2021; 26:molecules26051339. [PMID: 33801547 PMCID: PMC7958959 DOI: 10.3390/molecules26051339] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 12/16/2022] Open
Abstract
Collagenated porcine-derived bone graft materials exhibit osteoconductive properties and the development of different formulations intends to enhance bone regeneration. This study aims to evaluate bone healing in a rabbit cancellous bone defect in response to grafting with different physicochemical forms of heterologous porcine bone. Twenty-six adult male New Zealand White rabbits received two critical size femoral bone defects per animal (n = 52), each randomly assigned to one of the five tested materials (Apatos, Gen-Os, mp3, Putty, and Gel 40). Animals were sacrificed at 15- and 30-days post-surgery. Qualitative and quantitative (new bone, particle and connective tissue percentages) histological analyses were performed. Histomorphometry showed statistically significant differences in all evaluated parameters between mp3 and both Putty and Gel 40 groups, regardless of the timepoint (p < 0.05). Moreover, statistical differences were observed between Apatos and both Putty (p = 0.014) and Gel 40 (p = 0.007) groups, at 30 days, in regard to particle percentage. Within each group, regarding new bone formation, mp3 showed significant differences (p = 0.028) between 15 (40.93 ± 3.49%) and 30 (52.49 ± 11.04%) days. Additionally, intragroup analysis concerning the percentage of particles revealed a significant reduction in particle occupied area from 15 to 30 days in mp3 and Gen-Os groups (p = 0.009). All mp3, Gen-Os and Apatos exhibited promising results in terms of new bone formation, thus presenting suitable alternatives to be used in bone regeneration.
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12
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Friedmann A, Meskeleviciene V, Yildiz MS, Götz W, Park JC, Fischer KR. Open healing of contained and non-contained extraction sockets covered with a ribose cross-linked collagen membrane: a pilot study. J Periodontal Implant Sci 2020; 50:406-417. [PMID: 33350180 PMCID: PMC7758302 DOI: 10.5051/jpis.2000400020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/21/2020] [Accepted: 08/27/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This study investigated whether the placement of ribose cross-linked collagen (RCLC) membranes without primary soft tissue closure predictably resulted in sufficient alveolar ridge preservation in contained and non-contained extraction sockets. METHODS Membranes were positioned across extraction sockets, undermining full-thickness flaps, and the gingival margins were fixed by double-interrupted sutures without crossed horizontal mattress sutures for 1 week. In non-contained sockets, a bone substitute was used to support the membrane within the bony envelope. Radiographs and clinical images obtained 4 months later were analyzed by ImageJ software using non-parametric tests. RESULTS In 18 patients, 20 extraction sockets healed uneventfully and all sites received standard-diameter implants (4.1, 4.8, or 5.0 mm) without additional bone augmentation. Soft tissues and the muco-gingival border were well maintained. A retrospective analysis of X-rays and clinical photographs showed non-significant shrinkage in the vertical and horizontal dimensions (P=0.575 and P=0.444, respectively). The new bone contained vital bone cells embedded in mineralized tissues. CONCLUSIONS Within the limitations of this pilot study, open healing of RCLC membranes may result in sufficient bone volume for implant placement without additional bone augmentation in contained and non-contained extraction sockets.
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Affiliation(s)
- Anton Friedmann
- Department of Periodontology, Witten/Herdecke University Faculty of Health, Witten, Germany.
| | | | - Mehmet Selim Yildiz
- Department of Periodontology, Witten/Herdecke University Faculty of Health, Witten, Germany.,Department of Periodontology, Altınbaş University Faculty of Dentistry, Istanbul, Turkey
| | - Werner Götz
- Department of Orthodontics, Oral Biology Laboratory, University of Bonn, Bonn, Germany
| | - Jung Chul Park
- Department of Periodontology, Dankook University College of Dentistry, Seoul, Korea
| | - Kai R Fischer
- Department of Periodontology, Witten/Herdecke University Faculty of Health, Witten, Germany.,Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, University of Zurich, Zürich, Switzerland
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13
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Natto ZS, Parashis AO, Jeong YN. Soft-Tissue Changes After Using Collagen Matrix Seal or Collagen Sponge With Allograft in Ridge Preservation: A Randomized Controlled Volumetric Study. J ORAL IMPLANTOL 2020; 46:588-593. [PMID: 32369569 DOI: 10.1563/aaid-joi-d-19-00080] [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] [Indexed: 11/22/2022]
Abstract
The objective of this study is to assess alterations in buccal soft-tissue contour after alveolar ridge preservation (ARP) using either a collagen matrix seal (CMS) or a collagen sponge (CS) as barriers with freeze-dried bone allograft (FDBA). Participants (28 total) were randomly assigned to the CMS group or CS group (14 participants each). The same clinical steps were used in both barriers. Cast models were taken at baseline and 4 months, and both models were then optically scanned and digitally superimposed. Volumetric, surface, and distance-adjusted measurements were calculated to assess buccal soft-tissue alterations. Surface area and volume loss in the CMS group were observed to be 71.44 ± 1189.09 mm2 and 239.58 ± 231.89 mm3, respectively. The CS group showed measurements of 139.56 ± 557.92 mm2 and 337.23 ± 310.18 mm3. Mean buccal soft-tissue loss and minimum-maximum distance loss were less in the CMS group (0.88 ± 0.52 mm and 0.2-2.15 mm, respectively) as compared with the CS group (1.63 ± 1.03 mm and 0.3-3.68 mm, respectively), with no statistically significant difference between the groups (P = .2742). Both alveolar ridge preservation barriers were unable to entirely prevent soft-tissue contour changes after extraction. However, collagen matrix seal application was slightly better in minimizing the amount of soft-tissue reduction compared with the CS.
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Affiliation(s)
- Zuhair S Natto
- Department of Dental Public Health, School of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Periodontology, School of Dental Medicine, Tufts University, Boston, Mass.,Department of Oral Health Policy and Epidemiology, School of Dental Medicine, Harvard University Boston, Mass
| | - Andreas O Parashis
- Department of Periodontology, School of Dental Medicine, Tufts University, Boston, Mass
| | - Y Natalie Jeong
- Department of Periodontology, School of Dental Medicine, Tufts University, Boston, Mass
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14
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Avila-Ortiz G, Gubler M, Romero-Bustillos M, Nicholas C, Zimmerman M, Barwacz C. Efficacy of Alveolar Ridge Preservation: A Randomized Controlled Trial. J Dent Res 2020; 99:402-409. [DOI: 10.1177/0022034520905660] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Alveolar ridge preservation (ARP) therapy is indicated to attenuate the physiologic resorptive events that occur as a consequence of tooth extraction with the purpose of facilitating tooth replacement therapy. This randomized controlled trial was primarily aimed at testing the efficacy of ARP as compared with unassisted socket healing. A secondary objective was to evaluate the effect that local phenotypic factors play in the volumetric reduction of the alveolar bone. A total of 53 subjects completed the study. Subjects were randomized into either the control group, which involved only tooth extraction (EXT n = 27), or the experimental group, which received ARP using a combination of socket grafting with a particulate bone allograft and socket sealing with a nonabsorbable membrane (dPTFE) following tooth extraction (ARP n = 26). A set of clinical, linear, volumetric, implant-related, and patient-reported outcomes were assessed during a 14-wk healing period. All linear bone assessments (horizontal, midbuccal, and midlingual reduction) revealed that ARP is superior to EXT. Likewise, volumetric bone resorption was significantly higher in the control group (mean ± SD: EXT = −15.83% ± 4.48%, ARP = −8.36% ± 3.81%, P < 0.0001). Linear regression analyses revealed that baseline buccal bone thickness is a strong predictor of alveolar bone resorption in both groups. Interestingly, no significant differences in terms of soft tissue contour change were observed between groups. Additional bone augmentation to facilitate implant placement in a prosthetically acceptable position was deemed necessary in 48.1% of the EXT sites and only 11.5% of the ARP sites ( P < 0.004). Assessment of perceived postoperative discomfort at each follow-up visit revealed a progressive decrease over time, which was comparable between groups. Although some extent of alveolar ridge remodeling occurred in both groups, ARP therapy was superior to EXT as it was more efficacious in the maintenance of alveolar bone and reduced the estimated need for additional bone augmentation at the time of implant placement (ClinicalTrials.gov NCT01794806).
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Affiliation(s)
- G. Avila-Ortiz
- Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - M. Gubler
- Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Private practice, Saint George, UT, USA
| | - M. Romero-Bustillos
- Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - C.L. Nicholas
- Department of Orthodontics, University of Illinois at Chicago, Chicago, IL, USA
| | - M.B. Zimmerman
- Biostatistics Consulting Center, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - C.A. Barwacz
- Department of Family Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
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15
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Sapata VM, Llanos AH, Cesar Neto JB, Jung RE, Thoma DS, Hämmerle CHF, Pannuti CM, Romito GA. Deproteinized bovine bone mineral is non-inferior to deproteinized bovine bone mineral with 10% collagen in maintaining the soft tissue contour post-extraction: A randomized trial. Clin Oral Implants Res 2020; 31:294-301. [PMID: 31886909 DOI: 10.1111/clr.13570] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 12/10/2019] [Accepted: 12/17/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To test the non-inferiority of demineralized bovine bone mineral (DBBM) compared to demineralized bovine bone mineral with 10% collagen (DBBM-C) for the maintenance of the soft tissue contour after tooth extraction in the esthetic zone. MATERIAL AND METHODS Sixty-five patients randomly received ridge preservation at a single site in the anterior maxilla with DBBM or DBBM-C. Both, DBBM and DBBM-C, were covered with a collagen matrix. Profilometric analyses were performed at baseline (BL), immediately after treatment (PO), and at 4 months (FU; day of implant placement). The main outcome was the horizontal mean change (HC) at the buccal aspect. The measurements also included changes of the estimated soft tissue thickness (eTT) at 1, 3, and 5 mm below the buccal gingival margin. Descriptive analysis was performed, and differences between groups were analyzed using independent samples t test. The non-inferiority test was performed for HC. RESULTS At 4 months, the horizontal mean change (HC) was -1.43 mm (±0.53 mm) (DBBM-C) and -1.32 mm (±0.53 mm) (DBBM). Change of the estimated soft tissue thickness (eTT) between baseline (BL) and four months of follow-up (FU) at 1, 3, and 5 mm amounted to -4.58 mm (±2.02 mm), -2.40 mm (±0.97 mm), and -1.37 mm (±0.78 mm) for DBBM-C and to -4.12 mm (±1.80 mm), -2.09 mm (±0.91 mm), and -1.23 mm (±0.72 mm) for DBBM. The differences between the groups were not statistically significantly for any of the outcome measures (p > .05). CONCLUSIONS DBBM is non-inferior to DBBM-C for the maintenance of the soft tissue contour 4 months after tooth extraction.
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Affiliation(s)
- Vítor M Sapata
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Alexandre H Llanos
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - João B Cesar Neto
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Cláudio M Pannuti
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Giuseppe A Romito
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
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16
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Diaz-Rodriguez P, López-Álvarez M, Serra J, González P, Landín M. Current Stage of Marine Ceramic Grafts for 3D Bone Tissue Regeneration. Mar Drugs 2019; 17:md17080471. [PMID: 31443166 PMCID: PMC6723791 DOI: 10.3390/md17080471] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/10/2019] [Accepted: 08/12/2019] [Indexed: 12/19/2022] Open
Abstract
Bioceramic scaffolds are crucial in tissue engineering for bone regeneration. They usually provide hierarchical porosity, bioactivity, and mechanical support supplying osteoconductive properties and allowing for 3D cell culture. In the case of age-related diseases such as osteoarthritis and osteoporosis, or other bone alterations as alveolar bone resorption or spinal fractures, functional tissue recovery usually requires the use of grafts. These bone grafts or bone void fillers are usually based on porous calcium phosphate grains which, once disposed into the bone defect, act as scaffolds by incorporating, to their own porosity, the intergranular one. Despite their routine use in traumatology and dental applications, specific graft requirements such as osteoinductivity or balanced dissolution rate are still not completely fulfilled. Marine origin bioceramics research opens the possibility to find new sources of bone grafts given the wide diversity of marine materials still largely unexplored. The interest in this field has also been urged by the limitations of synthetic or mammalian-derived grafts already in use and broadly investigated. The present review covers the current stage of major marine origin bioceramic grafts for bone tissue regeneration and their promising properties. Both products already available on the market and those in preclinical phases are included. To understand their clear contribution to the field, the main clinical requirements and the current available biological-derived ceramic grafts with their advantages and limitations have been collected.
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Affiliation(s)
- Patricia Diaz-Rodriguez
- R + D Pharma Group (GI-1645), Department of Pharmacology, Pharmacy and Pharmaceutical Technology, School of Pharmacy, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain.
- Department of Chemical Engineering and Pharmaceutical Technology, School of Sciences, Universidad de La Laguna (ULL), Campus de Anchieta, 38200 La Laguna (Tenerife), Spain.
| | - Miriam López-Álvarez
- New Materials Group, Department of Applied Physics, University of Vigo, IISGS, MTI-Campus Lagoas-Marcosende, Vigo 36310, Spain
| | - Julia Serra
- New Materials Group, Department of Applied Physics, University of Vigo, IISGS, MTI-Campus Lagoas-Marcosende, Vigo 36310, Spain
| | - Pío González
- New Materials Group, Department of Applied Physics, University of Vigo, IISGS, MTI-Campus Lagoas-Marcosende, Vigo 36310, Spain
| | - Mariana Landín
- R + D Pharma Group (GI-1645), Department of Pharmacology, Pharmacy and Pharmaceutical Technology, School of Pharmacy, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
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17
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Intraosteal Behavior of Porous Scaffolds: The mCT Raw-Data Analysis as a Tool for Better Understanding. Symmetry (Basel) 2019. [DOI: 10.3390/sym11040532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The aim of the study is to determine the existing correlation between high-resolution 3D imaging technique obtained through Micro Computed Tomography (mCT) and histological-histomorphometric images to determine in vivo bone osteogenic behavior of bioceramic scaffolds. A Ca-Si-P scaffold ceramic doped and non-doped (control) with a natural demineralized bone matrix (DBM) were implanted in rabbit tibias for 1, 3, and 5 months. A progressive disorganization and disintegration of scaffolds and bone neoformation occurs, from the periphery to the center of the implants, without any differences between histomorphometric and radiological analysis. However, significant differences (p < 0.05) between DMB-doped and non-doped materials where only detected through mathematical analysis of mCT. In this way, average attenuation coefficient for DMB-doped decreased from 0.99 ± 0.23 Hounsfield Unit (HU) (3 months) to 0.86 ± 0.32 HU (5 months). Average values for non-doped decreased from 0.86 ± 0.25 HU (3 months) to 0.66 ± 0.33 HU. Combination of radiological analysis and mathematical mCT seems to provide an adequate in vivo analysis of bone-implanted biomaterials after surgery, obtaining similar results to the one provided by histomorphometric analysis. Mathematical analysis of Computed Tomography (CT) would allow the conducting of long-term duration in vivo studies, without the need for animal sacrifice, and the subsequent reduction in variability.
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18
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Lee JS, Cha JK, Kim CS. Alveolar ridge regeneration of damaged extraction sockets using deproteinized porcine versus bovine bone minerals: A randomized clinical trial. Clin Implant Dent Relat Res 2018; 20:729-737. [PMID: 30051954 PMCID: PMC6220803 DOI: 10.1111/cid.12628] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/26/2018] [Accepted: 05/02/2018] [Indexed: 11/30/2022]
Abstract
Backgrounds Clinical benefits in bone grafting of intact extraction socket have been widely known, but limited evidence is available for the procedure in damaged extraction sockets due to periodontal disease. Purpose This study aimed to determine the dimensional alteration of alveolar ridge following bone grafting of damaged extraction sockets, and compare the outcomes of using deproteinized bovine (DBBM) versus porcine bone mineral (DPBM) in the damaged sockets. Materials and Methods One hundred patients (n = 50 for each group) with periodontitis‐induced damaged extraction socket were included in this randomized, single‐blind trial. After removal of tooth and granulation tissue, sites were grafted with either DBBM (DBBM group) or DPBM (DPBM group), and covered with collagen membrane. Linear/volumetric analyses of hard and soft‐tissue dimensions were performed on reconstructed/superimposed computed tomography and scanned cast images, taken immediately and 4 months after surgery. Results The two groups showed comparable hard tissue augmentation with minimal reductions in the grafted volume, as well as in vertical (1.22 ± 2.16 and 1.45 ± 1.92 mm for DPBM and DBBM group, respectively) and horizontal (1.43 ± 3.40 and 1.83 ± 2.85 mm on the central section, respectively) dimensions at 4 months after surgery. However, several cases showed large variations in maintenance of the grafted volume. None of the measured parameters in hard and soft tissue dimensions differed significantly between DBBM and DPBM sites. Conclusions DBBM and DPBM can comparably augment damaged extraction sockets with minimal postoperative reduction of the grafted volume. However, the large variations in the results should be further evaluated for application in routine dental clinics.
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Affiliation(s)
- Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea.,Department of Applied Life Science, BK21 PLUS Project, College of Dentistry, Seoul, Republic of Korea.,Department of Mechanical Engineering, College of Engineering, Yonsei University, Seoul, Republic of Korea
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19
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Naenni N, Sapata V, Bienz SP, Leventis M, Jung RE, Hämmerle CHF, Thoma DS. Effect of flapless ridge preservation with two different alloplastic materials in sockets with buccal dehiscence defects-volumetric and linear changes. Clin Oral Investig 2018; 22:2187-2197. [PMID: 29280075 DOI: 10.1007/s00784-017-2309-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 12/12/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To test whether or not one out of two alloplastic materials used for ridge preservation (RP) is superior to the other in terms of volumetric and linear ridge changes over time. MATERIALS AND METHODS In 16 adult beagle dogs, the distal roots of P3 and P4 were extracted and 50% of the buccal bone plate removed. Ridge preservation was performed randomly using two different alloplastic bone grafting substitutes (poly lactic-co-glycolic acid (PLGA) coated biphasic calcium phosphate particles consisting of 60% hydroxyapatite (HA) and 40% beta-tricalcium phosphate (ß-TCP=test 1), (a biphasic calcium phosphate consisting 60% HA and 40% ß-TCP=test 2) and a resorbable collagen membrane or a control group (sham). Sacrifice was performed at three time-points (4, 8, 16 weeks later). Impressions were taken before extraction, after RP, and at sacrifice, allowing for assessment of volumetric changes. A multi-way ANOVA was computed, and partial Type-II F tests were performed. RESULTS Both ridge preservation procedures minimized the volume loss compared to spontaneous healing. The median buccal volume changes between pre-extraction and sacrifice were - 1.76 mm (Q1 = - 2.56; Q3 = - 1.42) for test 1, - 1.62 mm (Q1 = - 2.06; Q3 = - 1.38) for test 2, and - 2.42 mm (Q1 = - 2.63; Q3 = - 2.03) for control. The mean ridge width measurements did not show statistically significant differences between test 1 (- 2.51 mm; Q1 = - 3.25; Q3 = - 1.70) and test 2 (- 2.04 mm; Q1 = - 3.82; Q3 = - 1.81) (p = 0.813), but between test and control (- 3.85 mm; Q1 = - 5.02; Q3 = - 3.27) (p = 0.003). CONCLUSIONS Both RP techniques were successful in maintaining the buccal contour from pre-extraction to sacrifice to a similar extent and more favorable compared to spontaneous healing. CLINICAL RELEVANCE Alloplastic materials can successfully be used for RP procedures.
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Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Vitor Sapata
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Minas Leventis
- Laboratory of Experimental Surgery and Surgical Research N. S. Christeas, Medical School, University of Athens, Athens, Greece
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
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20
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Tomasi C, Donati M, Cecchinato D, Szathvary I, Corrà E, Lindhe J. Effect of socket grafting with deproteinized bone mineral: An RCT on dimensional alterations after 6 months. Clin Oral Implants Res 2018. [DOI: 10.1111/clr.13141] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Cristiano Tomasi
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
| | - Mauro Donati
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
| | | | | | | | - Jan Lindhe
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
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21
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Naenni N, Bienz SP, Muñoz F, Hämmerle CHF, Jung RE, Thoma DS. Volumetric changes following ridge preservation or spontaneous healing and early implant placement with simultaneous guided bone regeneration. J Clin Periodontol 2018; 45:484-494. [PMID: 29266354 DOI: 10.1111/jcpe.12860] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2017] [Indexed: 11/30/2022]
Abstract
AIM To assess volumetric and linear changes following ridge preservation (RP) or spontaneous healing plus early implant placement with or without simultaneous guided bone regeneration (GBR). MATERIALS AND METHODS In eight adult beagle dogs, the mesial roots of the mandibular P3, P4 and M1 were extracted. Sites were randomized to either ridge preservation (RP) or spontaneous healing (SH). Four weeks later dental implants were placed either with (RP2) or without removing non-integrated DBBM (RP1). In RP2 and SH sites, GBR was applied using a demineralized bovine bone mineral and a resorbable membrane. Impressions were taken postextraction (SH)/postridge preservation (RP1; RP2), before and after implant placement and after healing of 4 and 12 weeks. Casts were digitized to allow for superimposition and measurement of contour alterations. RESULTS Median ridge width reduction from postextraction (SH)/postridge preservation (RP1;RP2) to implant placement ranged from -13.9% (SH) to -19.7% (RP) (p > .05), whereas from implant placement to sacrifice, it was statistically significantly lower in group RP1 (-5.5%) compared to group SH (-23.4%; p = .0013) and group RP2 (-22.1%; p = .0026). Encompassing the entire study period, median ridge width changes ranged between -17.8% (SH), -24.8% (RP2) and -32.5% (RP1) (p > .05). CONCLUSIONS Irrespective of the treatment modality and the healing period, part of the ridge contour was lost. Early implant placement after ridge preservation without additional GBR resulted in a more stable ridge contour after implant placement compared to controls.
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Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Fernando Muñoz
- Department of Veterinary Clinical Sciences, University of Santiago de Compostela, Lugo, Spain
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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22
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Early volumetric changes after vertical augmentation of the atrophic posterior mandible with interpositional block graft versus onlay bone graft: A retrospective radiological study. J Craniomaxillofac Surg 2017; 45:1438-1447. [PMID: 28705523 DOI: 10.1016/j.jcms.2017.01.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 12/16/2016] [Accepted: 01/11/2017] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate volumetric and clinical outcomes of atrophic posterior mandibles treated with inlay or onlay bone grafting techniques. MATERIALS AND METHODS In posterior mandibles, alveolar ridges were treated either with interpositional equine cancellous bone block (inlay group) or with onlay autogenous bone block (onlay group). Bone volumes at baseline and at 4 months after surgery were measured by computed tomography. RESULTS A total of 20 subjects were enrolled in the present study: 10 in the inlay group and 10 in the onlay group. After surgery, atrophic posterior mandibles showed a mean vertical augmentation height of 6.0 mm in the inlay group and 7.4 mm in the onlay group. No significant differences were recorded between the two groups regarding volume loss of the grafted bone or decrease in vertical bone height of the augmented site (29% and 1.9 mm for the onlay group, and 35% and 1.7 mm for the inlay group) during healing. Two complications (1 wound dehiscence and 1 mandibular fracture) occurred postoperatively in the inlay group; on the other hand, the onlay group had three complications (wound dehiscence). A total of 80 dental implants were placed in augmented areas: 46 in the inlay group with a peri-implant marginal bone loss of 0.8 mm, and 34 in the onlay group with a peri-implant marginal bone loss of 1.3 mm (p = 0.0006). CONCLUSIONS Inlay xenogeneic grafts showed volumetric bone remodeling similar to that recorded for onlay autogenous bone. The success of the autogenous onlay blocks (82.4%) appeared to be lower than that registered for the inlay group (93.8%), but the difference was not significant.
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23
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Guarnieri R, Stefanelli L, De Angelis F, Mencio F, Pompa G, Di Carlo S. Extraction Socket Preservation Using Porcine-Derived Collagen Membrane Alone or Associated with Porcine-Derived Bone. Clinical Results of Randomized Controlled Study. J Oral Maxillofac Res 2017; 8:e5. [PMID: 29142657 PMCID: PMC5676315 DOI: 10.5037/jomr.2017.8305] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 09/28/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of present randomized controlled clinical trial was to clinically evaluate hard tissue changes after extraction socket preservation procedures compared to natural spontaneous healing. MATERIAL AND METHODS Thirty patients were enrolled in the present study and underwent single-tooth extraction in the premolar/molar areas. Ten sites were grafted with porcine-derived bone covered by collagen membrane, 10 covered by porcine-derived collagen membrane alone, and 10 underwent natural spontaneous healing. Vertical and horizontal bone changes after 3-month were evaluated at implant placement. RESULTS The vertical and horizontal bone changes at the extraction sockets treated with collagen membrane alone (vertical: -0.55 [SD 0.11] mm, and horizontal: -1.21 [SD 0.69] mm) and collagen membrane plus porcine-derived bone (vertical: -0.37 [SD 0.7] mm, and horizontal: -0.91 [SD 0.53] mm) were found significantly lower (P < 0.001), when compared to non-grafted sockets (vertical: -2.09 [SD 0.19] mm, and horizontal: -3.96 [SD 0.87] mm).In type 1 extraction sockets, in premolar sites, and in presence of vestibular bone thicknesses ≥ 1.5 mm, the use of collagen membrane alone revealed similar outcomes to those with additional graft material. CONCLUSIONS At the re-entry surgery, extraction sockets grafted with porcine-derived bone and covered by collagen membrane, and extraction sockets covered by porcine-derived collagen membrane alone, showed significantly lower vertical and horizontal bone changes, compared to extraction sockets sites underwent natural spontaneous healing. However, a complete prevention of remodelling is not achievable, irrespective of the technique used.
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Affiliation(s)
- Renzo Guarnieri
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, RomeItaly.
| | - Luigi Stefanelli
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, RomeItaly.
| | - Francesca De Angelis
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, RomeItaly.
| | - Francesca Mencio
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, RomeItaly.
| | - Giorgio Pompa
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, RomeItaly.
| | - Stefano Di Carlo
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, RomeItaly.
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Lim HC, Jung UW, You H, Lee JS. Randomized clinical trial of ridge preservation using porcine bone/cross-linked collagen vs. bovine bone/non-cross-linked collagen: cone beam computed tomographic analysis. Clin Oral Implants Res 2017; 28:1492-1500. [PMID: 28370361 DOI: 10.1111/clr.13017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to radiographically compare horizontal and vertical alterations of the alveolar ridge after ridge preservation using different combinations of biomaterials. MATERIALS AND METHODS The patients were randomly assigned into two groups: (a) the test group, which received collagenated porcine bone plus cross-linked collagen membrane (n = 15), and (b) the control group, which received collagenated bovine bone plus non-cross-linked collagen membrane (n = 15). Cone beam computed tomography (CBCT) was performed immediately after ridge preservation and 4 months thereafter to compare the horizontal and vertical alterations of the ridge. Intention-to-treat (ITT) and per protocol (PP) analyses were performed. RESULTS In both analyses, there was no statistically significant difference in the horizontal alteration of the alveolar ridge between the test and control groups: -1.3 ± 0.6 (ITT)/1.2 ± 0.5 (PP) vs. -1.5 ± 0.9 mm at the 1-mm level; -1.2 ± 0.7 (ITT and PP) vs. -1.2 ± 0.7 mm at the 3-mm level; and -0.9 ± 0.7 (ITT)/ -0.9 ± 0.7 (PP) vs. -0.9 ± 0.9 mm at the 5-mm level, whereas the vertical height in the midfacial area was significantly reduced in the test group compared with the control group: --1.1 ± 2.8 (ITT)/1.5 ± 3.0 (PP) vs. -0.7 ± 1.8 mm. CONCLUSIONS The horizontal ridge alteration in ridge preservation did not differ significantly between using the test the control groups, but the vertical ridge alteration was more pronounced when using the test group (KCT0001709).
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Affiliation(s)
- Hyun-Chang Lim
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hoon You
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
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Temmerman A, Vandessel J, Castro A, Jacobs R, Teughels W, Pinto N, Quirynen M. The use of leucocyte and platelet-rich fibrin in socket management and ridge preservation: a split-mouth, randomized, controlled clinical trial. J Clin Periodontol 2016; 43:990-999. [PMID: 27509214 DOI: 10.1111/jcpe.12612] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 12/30/2022]
Abstract
AIM To investigate the influence of the use L-PRF as a socket filling material and its ridge preservation properties. MATERIALS AND METHODS Twenty-two patients in need of single bilateral and closely symmetrical tooth extractions in the maxilla or mandible were included in a split-mouth RCT. Treatments were randomly assigned (L-PRF socket filling versus natural healing). CBCT scans were obtained after tooth extraction and three months. Scans were evaluated by superimposition using the original DICOM data. Mean ridge width differences between timepoints were measured at three levels below the crest on both the buccal and lingual sides (crest -1 mm (primary outcome variable), -3 mm and -5 mm). RESULTS Mean vertical height changes at the buccal were -1.5 mm (±1.3) for control sites and 0.5 mm (±2.3) for test sites (p < 0.005). At the buccal side, control sites values were, respectively, -2.1 (±2.5), -0.3 mm (±0.3) (p < 0.005) and -0.1 mm (±0.0), and test sites values were, respectively, -0.6 mm (±2.2) (p < 0.005), -0.1 mm (±0.3) and 0.0 mm (±0.1). Significant differences (p < 0.005) were found for total width reduction between test (-22.84%) and control sites (-51.92%) at 1 mm below crest level. Significant differences were found for socket fill (visible mineralized bone) between test (94.7%) and control sites (63.3%). CONCLUSION The use of L-PRF as a socket filling material to achieve preservation of horizontal and vertical ridge dimension at three months after tooth extraction is beneficial.
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Affiliation(s)
- Andy Temmerman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, KU Leuven, Leuven, Belgium.
| | - Jeroen Vandessel
- OMFS-Impath Research Group, Department of Oral and Maxillofacial Surgery, University Hospitals, KU Leuven, Leuven, Belgium
| | - Ana Castro
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-Impath Research Group, Department of Oral and Maxillofacial Surgery, University Hospitals, KU Leuven, Leuven, Belgium
| | - Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Nelson Pinto
- Department of Oral Implantology, University De Los Andes, Santiago, Chile
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
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Lee JS, Shin HK, Yun JH, Cho KS. Randomized Clinical Trial of Maxillary Sinus Grafting using Deproteinized Porcine and Bovine Bone Mineral. Clin Implant Dent Relat Res 2016; 19:140-150. [PMID: 27324175 DOI: 10.1111/cid.12430] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Deproteinized porcine bone mineral (DPBM) was recently developed and commercially available in maxillary sinus grafting, in which demineralized bovine bone mineral (DBBM) was widely used. OBJECTIVES The present randomized controlled clinical trial aimed to compare histological bone quality and radiographic volume stability in maxillary sinuses grafted with DPBM and DBBM. MATERIALS AND METHODS Twenty sinuses in 16 participants were enrolled and randomly allocated to control and test groups using sequentially numbered, sealed envelopes; laterally approached sinus grafting with DBBM and DPBM, respectively. All participants were blinded to the group assignment during the entire experiment. After standardized osteotomy at the lateral wall of the maxillary sinus, the sinus membrane was elevated, and the control or test biomaterial was grafted. Computed tomography (CT) images were taken immediately after surgery, and another CT and trephine biopsy was taken for radiographic and histological analyses after 6 months. The histological bone quality was measured as a primary outcome, and changes in the height and volume of the graft were evaluated in the reconstructed CT images as secondary outcomes. RESULTS Fifteen sites (7 and 8 sites for control and test group) in 11 participants were finally included in the per protocol (PP) analysis, and 16 sites (7 and 9 sites, respectively) in 12 participants were included in the intention-to-treat (ITT) analysis; there were four drop-outs and one minor protocol violation. In both statistical analyses, the test groups showed comparable new bone formation and residual biomaterials in histology, and both groups exhibited minimal volume/height changes in radiographies. However, smaller sizes of residual biomaterials were observed in the histological samples from the test compared to control sites, despite the use of the same sizes of both biomaterials. CONCLUSIONS The results suggested that DPBM might produce comparable bone formation and volumetric stability with DBBM in maxillary sinus grafting, however, further clinical study with longer-term periods and larger sample sizes should be needed for confirming this suggestion.
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Affiliation(s)
- Jung-Seok Lee
- Department of Periodontology, Research Institute for periodontal regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Hyun-Ki Shin
- Department of Periodontology, Research Institute for periodontal regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jeong-Ho Yun
- Department of Periodontology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju, Republic of Korea
| | - Kyoo-Sung Cho
- Department of Periodontology, Research Institute for periodontal regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
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