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Choi H, Sohn DS. Retrospective Study of Maxillary Sinus Augmentation Using Demineralized Tooth Block Bone for Dental Implant. Bioengineering (Basel) 2024; 11:633. [PMID: 38927869 PMCID: PMC11201244 DOI: 10.3390/bioengineering11060633] [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: 05/30/2024] [Revised: 06/16/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: When placing implants in the maxillary posterior region with insufficient alveolar bone, a maxillary sinus elevation is necessary. Autogenous bone, though biologically ideal, poses risks and discomfort due to donor site harvesting. Block-type autogenous tooth bone graft material, made from the patient's own extracted tooth, offers similar biological stability without these drawbacks. (2) Methods: This study observed the progress of 19 implant patients who were treated with maxillary sinus elevation procedures using block-type autogenous tooth bone graft material at the Daegu Catholic University Medical Center. Extracted teeth were processed into demineralized tooth block bone. After elevating the sinus membrane, implants and the tooth bone graft material were placed in the space, and the bony window was repositioned. Postoperative evaluations through clinical observation and radiographic imaging assessed sinus membrane elevation, alveolar bone height increase, and implant osseointegration. (3) Results: Results showed proportional increases in alveolar bone height to the graft material size, with long-term stability. No postoperative complications occurred, even with sinus membrane perforation, and implants remained stable. (4) Conclusions: The study concludes that maxillary sinus lifts using block-type autogenous tooth bone graft material provide excellent bone induction and biocompatibility, making this a highly beneficial method for both dentists and patients.
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Affiliation(s)
- Hyunsuk Choi
- Department of Dentistry and Prosthodontics, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea;
| | - Dong-Seok Sohn
- Department of Dentistry and Oral and Maxillofacial Surgery, Daegu Catholic University Medical Center, Daegu 42472, Republic of Korea
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2
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Fok MR, Pelekos G, Jin L. Efficacy of Alveolar Ridge Preservation in Periodontally Compromised Molar Extraction Sites: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:1198. [PMID: 38592010 PMCID: PMC10931845 DOI: 10.3390/jcm13051198] [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: 01/11/2024] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 04/10/2024] Open
Abstract
AIM To investigate the efficacy of alveolar ridge preservation (ARP) in periodontally compromised molar extraction sites. METHODS An electronic search was performed on 10th November 2023 across five databases, seeking randomised/non-randomised controlled trials (RCTs/NCTs) that included a minimum follow-up duration of four months. The RoB2 and Robins-I tools assessed the risk of bias for the included studies. Data on alveolar ridge dimensional and volumetric changes, keratinized mucosal width, and need for additional bone augmentation for implant placement were collected. Subsequently, a meta-analysis was carried out to derive the pooled estimates. RESULTS Six studies were incorporated in the present review, and a total of 135 molar extraction sockets in 130 subjects were included in the meta-analysis. ARP was undertaken in 68 sites, and 67 sites healed spontaneously. The follow-up time ranged from 4 to 6 months. The meta-analysis of both RCTs and NCTs showed significant differences in mid-buccal ridge width changes at 1 mm level below ridge crest with a mean difference (MD) of 3.80 (95% CI: 1.67-5.94), mid-buccal ridge height changes (MD: 2.18; 95% CI: 1.25-3.12) and volumetric changes (MD: 263.59; 95% CI: 138.44-388.74) in favour of ARP, while the certainty of evidence is graded low to very low. Moreover, ARP appeared to reduce the need for additional sinus and bone augmentation procedures at implant placement with low certainty of evidence. CONCLUSIONS Within the limitations of this study, alveolar ridge preservation in periodontally compromised extraction sites may, to some extent, preserve the ridge vertically and horizontally with reference to spontaneous healing. However, it could not eliminate the need for additional augmentation for implant placement. Further, longitudinal studies with large sample sizes and refined protocols are needed.
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Affiliation(s)
- Melissa Rachel Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Guan D, Zhao R, Guo Y, Li J, Ma N, Gong J. Efficacy of autogenous tooth block for lateral ridge augmentation compared with autogenous bone block: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e35326. [PMID: 37773788 PMCID: PMC10545093 DOI: 10.1097/md.0000000000035326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Autogenous tooth block (ATB) has been used as an alternative material for bone regeneration, but its efficacy compared with autogenous bone block (ABB) remains uncertain. The aim of this systematic review was to investigate and compare the clinical and histological performance of ATB and ABB grafts in lateral alveolar ridge augmentation (LARA). METHODS Electronic retrieval of MEDLINE, Embase, Cochrane Library (CENTRAL), Scopus, Web of Science, China national knowledge infrastructure, Wanfang data, SinoMed, and manual searching until July 2023 were used to identify controlled clinical trials employing ATB grafts in LARA. The identified reports included at least one of the following outcome variables: ridge width gain, graft resorption, postoperative complications, histology, and histomorphometry. Weighted or mean differences (MD), relative risk, and corresponding 95% confidence intervals (CI) were calculated. Descriptive analysis was applied to the qualitative statistics. The protocol followed the preferred reporting items for systematic reviews and meta-analyses statement and was prospectively registered in PROSPERO (CRD42023399611). RESULTS Four controlled clinical trials with 77 participants each using ATB and ABB grafts were included. Meta-analysis indicated that ATB grafts resulted in greater bone width (MD = 1.31, 95% CI [0.92, 1.71], P < .00001) and less graft resorption (MD = -0.71, 95% CI [-1.22, -0.21], P = .005) than ABB grafts on LARA. There was no statistical difference in postoperative complications between ATB and ABB grafts (relative risk = 0.81, 95% CI [0.32, 2.04], P = .66). Furthermore, the ATB grafts exhibited positive replacement resorption with alveolar bone for favorable signs of new bone activity on histology and histomorphometry. CONCLUSION Within the limitations of this study, ATB grafts could serve as an alternative material for ABB to support LARA. Further research with a longer follow-up period is required to verify these findings.
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Affiliation(s)
- Delin Guan
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
| | - Ruimin Zhao
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
- Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People’s Hospital), Department of Stomatology, Quzhou City, China
| | - Yan Guo
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
| | - Jianxue Li
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
| | - Na Ma
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Out-patient department, Lanzhou City, China
| | - Jiaming Gong
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
- Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People’s Hospital), Department of Stomatology, Quzhou City, China
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Song H, Xing L, Wei J, Wang X, Yang Y, Zhe P, Luan M, Xu J. Preparation of Gelatin-Quaternary Ammonium Salt Coating on Titanium Surface for Antibacterial/Osteogenic Properties. Molecules 2023; 28:4570. [PMID: 37375125 DOI: 10.3390/molecules28124570] [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: 04/17/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
Titanium (Ti) and its alloys are widely used in medical treatment, engineering, and other fields because of their excellent properties including biological activity, an elastic modulus similar to that of human bones, and corrosion resistance. However, there are still many defects in the surface properties of Ti in practical applications. For example, the biocompatibility of Ti with bone tissue can be greatly reduced in implants due to a lack of osseointegration as well as antibacterial properties, which may lead to osseointegration failure. To address these problems and to take advantage of the amphoteric polyelectrolyte properties of gelatin, a thin layer of gelatin was prepared by electrostatic self-assembly technology. Diepoxide quaternary ammonium salt (DEQAS) and maleopimaric acid quaternary ammonium salt (MPA-N+) were then synthesized and grafted onto the thin layer. The cell adhesion and migration experiments demonstrated that the coating has excellent biocompatibility, and those grafted with MPA-N+ promoted cell migration. The bacteriostatic experiment showed that the mixed grafting with two ammonium salts had excellent bacteriostatic performance against Escherichia coli and Staphylococcus aureus, with bacteriostasis rates of 98.1 ± 1.0% and 99.2 ± 0.5%, respectively.
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Affiliation(s)
- Hongyang Song
- Shandong Provincial Key Laboratory of Molecular Engineering, School of Chemistry and Chemical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Lei Xing
- Shandong Provincial Key Laboratory of Molecular Engineering, School of Chemistry and Chemical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Jinjian Wei
- College of Chemistry, Chemical Engineering and Materials Science, Shandong Normal University, Jinan 250100, China
| | - Xue Wang
- Shandong Provincial Key Laboratory of Molecular Engineering, School of Chemistry and Chemical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Yaozhen Yang
- Shandong Provincial Key Laboratory of Molecular Engineering, School of Chemistry and Chemical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Pengbo Zhe
- Shandong Provincial Key Laboratory of Molecular Engineering, School of Chemistry and Chemical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Mingming Luan
- Shandong Provincial Key Laboratory of Molecular Engineering, School of Chemistry and Chemical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Jing Xu
- Shandong Provincial Key Laboratory of Molecular Engineering, School of Chemistry and Chemical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
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Schwarz F, Becker K, Lukman F, Müller KM, Sarabhai V, Rauch N, Kerberger R, Ramanauskaite A, Sader R, Obreja K. Influence of antiresorptive/antiangiogenic therapy on the extension of experimentally induced peri-implantitis lesions. Clin Oral Investig 2023; 27:3009-3019. [PMID: 36800025 PMCID: PMC10264532 DOI: 10.1007/s00784-023-04904-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVES To investigate the extension of experimentally induced peri-implantitis lesions under various antiresorptive and antiangiogenic medications. MATERIAL AND METHODS Fourty-eight albino rats had randomly received the following medications (dual application, n = 8 each): (1) amino-bisphosphonate (zoledronate) (Zo), (2) RANKL inhibitor (denosumab) (De), (3) antiangiogenic (bevacizumab) (Be), (4) Zo+Be, (5) De+Be, or (6) no medication (Co). Ligature- and lipopolysaccharide-induced peri-implantitis lesions were established at 2 maxillary implants over a period of 16 weeks. Histological (e.g., apical extension and surface area of the inflammatory cell infiltrate-aICT, ICT; defect length; defect width; CD68 positive cells) and bone micromorphometric (μCT) outcomes were assessed. The animal was defined as a statistical unit. RESULTS A total of n = 38 animals (Zo = 6, De = 6, Be = 8, Zo + Be = 6, De + Be = 5, Co = 7) were analyzed. ICT's were commonly marked by a positive CD68 antigen reactivity. Comparable median aICT (lowest-Zo: 0.53 mm; highest-Be: 1.22 mm), ICT (lowest-De + Be: 0.00 mm2; highest-Co: 0.49 mm2), defect length (lowest-Zo: 0.90 mm; highest-Co: 1.93 mm) and defect width (lowest-De+Be: 1.27 mm; highest-Be: 1.80 mm) values were noted in all test and control groups. Within an inner (diameter: 0.8 mm) cylindric volume of interest, the bone microstructure did not significantly differ between groups. CONCLUSIONS The present analysis did not reveal any marked effects of various antiresorptive/ antiangiogenic medications on the extension of experimentally induced peri-implantitis lesions. CLINICAL RELEVANCE The extension of peri-implantitis lesions may not be facilitated by the antiresorptive and antiangiogenic medications investigated.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt am Main, Germany.
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Fanya Lukman
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt am Main, Germany
| | | | - Victoria Sarabhai
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Robert Kerberger
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University, Frankfurt am Main, Germany
| | - Karina Obreja
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt am Main, Germany
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Korsch M, Alt KW, Mock FR. Frozen Stored Teeth: Autogenous Dentin as an Alternative Augmentation Material in Dentistry. Bioengineering (Basel) 2023; 10:bioengineering10040456. [PMID: 37106643 PMCID: PMC10135693 DOI: 10.3390/bioengineering10040456] [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: 03/01/2023] [Revised: 04/01/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Tooth Shell Technique (TST) with the use of autologous dentin has proven to be a suitable method of grafting in the context of lateral ridge augmentation. This present feasibility study aimed to retrospectively evaluate the preservation by lyophilization of processed dentin. Thus, the frozen stored processed dentin matrix (FST: 19 patients with 26 implants) was re-examined with that of processed teeth used immediately after extraction (IUT: 23 patients with 32 implants). Parameters of biological complications, horizontal hard tissue loss, osseointegration, and buccal lamella integrity were used for evaluation. For complications, the observation period was 5 months. Only one graft was lost (IUT group). In the area of minor complications, without the loss of an implant or augmentation, there were two cases of wound dehiscence and one case with inflammation and suppuration (IUT: n = 3, FST: n = 0). Osseointegration and integrity of the buccal lamella were present in all implants without exception. Statistically, there was no difference between the groups studied for the mean resorption of the crestal width and the buccal lamella. Results of this study show that prepared autologous dentin preserved with a conventional freezer had no disadvantage compared to immediately use autologous dentin in terms of complications and graft resorption in the context of TST.
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Affiliation(s)
- Michael Korsch
- Dental Academy for Continuing Professional Development, Karlsruhe, Lorenzstrasse 7, 76135 Karlsruhe, Germany
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421 Homburg, Germany
- Private Practice, Center for Implantology and Oral Surgery, Berliner Str. 41, 69120 Heidelberg, Germany
| | - Kurt Werner Alt
- Center of Natural and Cultural Human History, Danube Private University, Steiner Landstrasse 124, 3500 Krems-Stein, Austria
| | - Frederick Reza Mock
- Private Practice, Practice for Dentistry, Oral Surgery and Implantology, Marienstrasse 9, 66287 Quierschied, Germany
- Private Practice, 32 Route de Luxembourg, 6130 Junglinster, Luxembourg
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Dentin Particulate for Bone Regeneration: An In Vitro Study. Int J Mol Sci 2022; 23:ijms23169283. [PMID: 36012558 PMCID: PMC9408967 DOI: 10.3390/ijms23169283] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022] Open
Abstract
The aim of this in vitro study was to investigate the commitment and behavior of dental pulp stem cells (DPSCs) seeded onto two different grafting materials, human dentin particulate (DP) and deproteinized bovine bone matrix (BG), with those cultured in the absence of supplements. Gene expression analyses along with epigenetic and morphological tests were carried out to examine odontogenic and osteogenic differentiation and cell proliferation. Compressive testing of the grafting materials seeded with DPSCs was performed as well. DPSC differentiation into odontoblast-like cells was identified from the upregulation of odontogenic markers (DSPP and MSX) and osteogenic markers (RUNX2, alkaline phosphatase, osteonectin, osteocalcin, collagen type I, bmp2, smad5/8). Epigenetic tests confirmed the presence of miRNAs involved in odontogenic or osteogenic commitment of DPSCs cultured for up to 21 days on DP. Compressive strength values obtained from extracellular matrix (ECM) synthesized by DPSCs showed a trend of being higher when seeded onto DP than onto BG. High expression of VEGF factor, which is related to angiogenesis, and of dentin sialoprotein was observed only in the presence of DP. Morphological analyses confirmed the typical phenotype of adult odontoblasts. In conclusion, the odontogenic and osteogenic commitment of DPSCs and their respective functions can be achieved on DP, which enables exceptional dentin and bone regeneration.
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Becker K, Kerberger R, Brunello G, Rockhoff J, Rauch N, Schwarz F. Volumetric analysis of the periodontal microstructure under antiresorptive therapy: an experimental study in rabbits. Clin Oral Investig 2022; 26:5359-5368. [PMID: 35449246 DOI: 10.1007/s00784-022-04503-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The objective of this study was to volumetrically assess changes in the periodontal microstructure under antiresorptive therapy. MATERIALS AND METHODS Microtomographic scans from a total of 9 Dutch Belted rabbits having been randomly allocated to either the intravenous administration of amino-bisphosphonate (zoledronic acid) (Za) (n = 5) or a negative control group (nZa) (n = 4) were obtained at 10 months following a repeated drug administration. A quantification of the periodontal space thickness (P.Th) of both maxillary and mandibular most posterior premolars, as well as of the 2nd molars was performed. Bone micromorphometry was assessed by means of bone volume per total volume (BV/TV), the bone mineral density (BMD), trabecular thickness (Tb.Th), trabecular number (Tb.N), bone surface (BS), and the specific bone surface (BS/BV). RESULTS Za was associated with significantly higher P.Th (P = 0.010), which was most pronounced in the upper jaw. Bone micromorphometry revealed no significant differences among the two groups, i.e., Za and nZa, for all the investigated parameters. CONCLUSIONS Volumetric analysis revealed that antiresorptive therapy was associated with periodontal space widening, whereas major effects on the bone micro-morphology could not be observed. CLINICAL RELEVANCE A deep understanding of specific periodontal and alveolar bone alterations in patients under antiresorptive therapy might help to prevent the onset of medication-related osteonecrosis of the jaw.
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Affiliation(s)
- Kathrin Becker
- Department for Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Robert Kerberger
- Department for Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Giulia Brunello
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
- Department of Neuroscience, Dental School, University of Padova, Padova, Italy
| | - Joel Rockhoff
- Department for Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany.
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Elraee L, Abdel Gaber HK, Elsayed HH, Adel-Khattab D. Autogenous dentin block versus bone block for horizontal alveolar ridge augmentation and staged implant placement: A randomized controlled clinical trial including histologic assessment. Clin Oral Implants Res 2022; 33:723-734. [PMID: 35509125 DOI: 10.1111/clr.13936] [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: 11/27/2021] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to compare the dentin block (D-group) harvested from impacted wisdom teeth with autogenous ramus bone block (A-group) for horizontal alveolar ridge augmentation. MATERIALS AND METHODS Forty two patients with anterior missing teeth and horizontal ridge defect were randomly assigned to two groups (n = 21 per group) to receive either dentin block group or autogenous bone block. Six months after the augmentation, dental implants were placed in all patients, and a core biopsy was performed for histological evaluation in addition to clinical and radiographic evaluation using cone beam computed tomography. Primary outcome was the mean overall clinical ridge width gain (CRWG) after 6 months of augmentation. Secondary outcomes were the overall radiographic ridge width gain (RRWG) after 6 months of augmentation and descriptive histological analysis with histomorphometric assessment of bone fraction %. RESULTS All sites healed uneventfully, and the mean overall CRWG 6 months after augmentation was 3.52 ± 0.56 mm and 2.24 ± 0.86 mm in the D and A groups, respectively, with statistically significant difference between them (P = < 0.001). The overall mean RRWG was 3.61 ± 0.61 mm and 3.41 ± 1.15 mm in D and A groups, respectively, without any statistically significant difference between them (P = 0.062) . The histomorphometric analysis of the bone area fraction was 42.6% and 41.3% in D and A groups, respectively, without any statistically significant difference between the two values (P = 0.89, Student's t-test). Histological evaluation in the D-group revealed new bone formation, viable cells, and matrix formation on the dentin block periphery, in addition to well-organized woven bone that suggests dentin block remodeling and supports new bone deposition. CONCLUSION The present clinical study revealed that dentin block may serve as an alternative graft to support horizontal alveolar ridge augmentation. Dentin blocks showed less resorption than autogenous bone blocks.
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Affiliation(s)
- Leila Elraee
- Oral medicine, Periodontology and Diagnosis Department, Faculty of Dentistry, Modern Science and arts University, Egypt
| | - Hala Kamal Abdel Gaber
- Oral Medicine, Periodontology and Diagnosis, Faculty of Dentistry, Ain shams University, Egypt
| | - Hakem H Elsayed
- Oral Medicine, Periodontology and Diagnosis, Faculty of Dentistry Modern Science and arts University, Egypt
| | - Doaa Adel-Khattab
- Oral Medicine, Periodontology and Diagnosis Department, Faculty of Dentistry, Ain Shams University, Egypt
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van Orten A, Goetz W, Bilhan H. Tooth-Derived Granules in Combination with Platelet-Rich Fibrin (“Sticky Tooth”) in Socket Preservation: A Histological Evaluation. Dent J (Basel) 2022; 10:dj10020029. [PMID: 35200254 PMCID: PMC8871177 DOI: 10.3390/dj10020029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The maintenance of ridge volume following tooth extraction has gained more importance in the last few years. This clinical study aimed to assess the impact of autologous dentin particles mixed with injectable platelet-rich fibrin (i-PRF) on a sticky tooth mixture for socket preservation in terms of consecutive need for horizontal guided bone regeneration and histological findings. Methods: Eight extraction sockets in seven patients were included in this study. Autologous dentin particles were mixed with PRF, filled in the sockets, and covered with a cross-linked collagen membrane exposed to the oral cavity and fixated by crisscross sutures. An orthopantomogram was taken before the first surgical procedure and a CBCT prior to static computer-aided implant surgery. At the time of implant placement, cores were harvested with the aid of a trephine for histological examinations for every preserved socket. Results: No further horizontal GBR intervention was required in any cases, and the histological findings were unremarkable. The new bone was mostly cancellous and in direct contact with the remaining dentin granules. Conclusions: Within the limits of this clinical study, it may be concluded that this method is valuable for socket preservation and obtaining vital and good quality bone structure. The sticky tooth technique seems to be very efficient despite the more complex equipment.
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Affiliation(s)
- Andreas van Orten
- Private Dental Practice Do24, Dortmunderstr. 24–28, 45731 Waltrop, Germany;
| | - Werner Goetz
- Policlinic of Orthodontics, Centre for Dental Care, Basic Science Research in Oral Biology, Friedrich-Wilhelms University, Welschnonnenstr. 17, 53111 Bonn, Germany;
| | - Hakan Bilhan
- Department of Periodontology, School for Health Sciences, Witten/Herdecke UniversityAlfred-Herrhausen-Str. 45, 58448 Witten, Germany
- Correspondence: ; Tel.: +49-2302-926-608; Fax: +49-2302-926-681
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Inchingolo F, Hazballa D, Inchingolo AD, Malcangi G, Marinelli G, Mancini A, Maggiore ME, Bordea IR, Scarano A, Farronato M, Tartaglia GM, Lorusso F, Inchingolo AM, Dipalma G. Innovative Concepts and Recent Breakthrough for Engineered Graft and Constructs for Bone Regeneration: A Literature Systematic Review. MATERIALS 2022; 15:ma15031120. [PMID: 35161065 PMCID: PMC8839672 DOI: 10.3390/ma15031120] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 02/06/2023]
Abstract
Background: For decades, regenerative medicine and dentistry have been improved with new therapies and innovative clinical protocols. The aim of the present investigation was to evaluate through a critical review the recent innovations in the field of bone regeneration with a focus on the healing potentials and clinical protocols of bone substitutes combined with engineered constructs, growth factors and photobiomodulation applications. Methods: A Boolean systematic search was conducted by PubMed/Medline, PubMed/Central, Web of Science and Google scholar databases according to the PRISMA guidelines. Results: After the initial screening, a total of 304 papers were considered eligible for the qualitative synthesis. The articles included were categorized according to the main topics: alloplastic bone substitutes, autologous teeth derived substitutes, xenografts, platelet-derived concentrates, laser therapy, microbiota and bone metabolism and mesenchymal cells construct. Conclusions: The effectiveness of the present investigation showed that the use of biocompatible and bio-resorbable bone substitutes are related to the high-predictability of the bone regeneration protocols, while the oral microbiota and systemic health of the patient produce a clinical advantage for the long-term success of the regeneration procedures and implant-supported restorations. The use of growth factors is able to reduce the co-morbidity of the regenerative procedure ameliorating the post-operative healing phase. The LLLT is an adjuvant protocol to improve the soft and hard tissues response for bone regeneration treatment protocols.
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Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Maria Elena Maggiore
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Farronato
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
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12
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Wang W, Jiang Y, Wang D, Mei D, Xu H, Zhao B. Clinical efficacy of autogenous dentin grafts with guided bone regeneration for horizontal ridge augmentation: a prospective observational study. Int J Oral Maxillofac Surg 2021; 51:837-843. [PMID: 34924269 DOI: 10.1016/j.ijom.2021.06.012] [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: 04/01/2020] [Revised: 04/27/2021] [Accepted: 06/28/2021] [Indexed: 10/19/2022]
Abstract
The aim of this study was to evaluate the efficacy of autogenous dentin grafts with guided bone regeneration (GBR) for horizontal ridge augmentation. Nineteen patients with dentition and bone defects in whom tooth/teeth extraction was indicated were recruited. Autogenous teeth were prepared, fixed on the buccal sides of the defects, and covered with bone powder and resorbable membranes before implantation. The horizontal bone mass at 0 mm (W1), 3 mm (W2), and 6 mm (W3) from the alveolar crest was recorded using cone beam computed tomography, before, immediately after, and 6 months after dentin grafting. All adverse effects were recorded. The implant stability quotient (ISQ) was measured 6 months after implantation. Twenty-eight implants were placed 6 months after dentin grafting. At this time point, the bone mass was 4.72 ± 0.72 mm (W1), 7.35 ± 1.57 mm (W2), and 8.96 ± 2.38 mm (W3), which was significantly different from that before the surgery (P < 0.05). The bone gain was 2.50 ± 0.72 mm (W1), 4.10 ± 1.42 mm (W2), and 4.56 ± 2.09 mm (W3). No soft tissue dehiscence or infection was observed. Overall, 26.3% of the patients experienced severe pain after dentin grafting. The ISQ was 78.31 ± 6.64 at 6 months after implantation. Autogenous tooth roots with GBR might be effective for horizontal ridge augmentation. This technique could be an alternative to augmentation using autogenous bone grafts.
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Affiliation(s)
- W Wang
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China; School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Y Jiang
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - D Wang
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - D Mei
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - H Xu
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - B Zhao
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China; State Key Laboratory of Military Stomatology, Shanxi, China.
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13
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Nasirzade J, Kargarpour Z, Panahipour L, Gruber R. Acid Dentin Lysate Modulates Macrophage Polarization and Osteoclastogenesis In Vitro. MATERIALS 2021; 14:ma14226920. [PMID: 34832320 PMCID: PMC8622705 DOI: 10.3390/ma14226920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022]
Abstract
Dentin prepared from extracted teeth is used as autograft for alveolar bone augmentation. Graft consolidation involves the acid lysis of dentin thereby generating a characteristic paracrine environment. Acid lysate of dentin is mimicking this environment. Acid dentin lysate (ADL) potentially targets hematopoietic cells thereby affecting their differentiation towards macrophages and osteoclasts; however, the question remains if ADL controls macrophage polarization and osteoclastogenesis. Here, we show that ADL reduced lipopolysaccharide (LPS)-induced macrophage polarization of the pro-inflammatory (M1) phenotype, indicated by attenuated Interleukin 1 (IL1), Interleukine 6 (IL6)and cyclooxygenase 2 (COX2) expression. This decrease in M1 macrophages was confirmed by the reduced phosphorylation and nuclear translocation of p65 in the LPS-exposed RAW 264.7 macrophages. Similarly, when RAW 264.7 macrophages were incubated with other agonists of Toll-like receptor (TLR) signaling e.g., FSL1, Polyinosinic-polycytidylic acid High Molecular Weight (Poly (1:C) HMW), Pam3CSK4, and imiquimod, ADL reduced the IL6 expression. We further show herein that ADL decreased osteoclastogenesis indicated by the reduced formation of multinucleated cell expressing cathepsin K and tartrate-resistant acid phosphatase in murine bone marrow cultures. Overall, our results suggest that acid dentin lysate can affect the differentiation of hematopoietic cells to M1 macrophage polarization and a decrease in osteoclastogenesis in bone marrow cultures.
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Affiliation(s)
- Jila Nasirzade
- Department of Oral Biology, Dental School, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Zahra Kargarpour
- Department of Oral Biology, Dental School, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Layla Panahipour
- Department of Oral Biology, Dental School, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Biology, Dental School, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
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14
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Li S, Gao M, Zhou M, Zhu Y. Bone augmentation with autologous tooth shell in the esthetic zone for dental implant restoration: a pilot study. Int J Implant Dent 2021; 7:108. [PMID: 34748111 PMCID: PMC8575770 DOI: 10.1186/s40729-021-00389-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/20/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives To investigate the outcome and short-term follow-up of autogenous tooth shell (TS) grafting for bone augmentation in the esthetic zone, as well as stability and esthetics of implant-supported restoration. Materials and methods A total of 8 patients with 11 implants in 11 sites were enrolled in this study. All the horizontal and/or vertical bone defects in the esthetic zone were augmented by tooth shells, which were fixed laterally to the residual bone with osteosynthesis screws. The gap between the shell and residual bone was filled with Bio-Oss® granules. Four months after bone augmentation, dimensionally sufficient dental implants were inserted and implants-supported prostheses were made 3 months later. The esthetic outcome was evaluated by pink esthetic score (PES) and white esthetic score (WES) one year after prosthetic restoration. Horizontal ridge width (HRW) was assessed before and immediately after bone augmentation, as well as 4 and 19 months post-augmentation by radiography. The stability and absorption of TS grafts were evaluated at the 4th and 19th months post-augmentation. Results Though wound dehiscences occurred in 3 cases, secondary healings were obtained after TS modification and irrigation. The other 5 cases went through uneventful healing during the whole observation period. Radiographic examination showed that HRW was 8.01 ± 0.93 mm (median: 7.80, 95% CI 7.38, 8.64) 4 months after TS augmentation, which was statistically different compared to HRW (2.72 ± 1.73 mm) at the baseline. Mean HRW gain was 5.29 ± 2.03 mm (median: 4.60, 95% CI 3.92, 6.66). Three-dimensional bone volume in all the augmented sites was sufficient for dental implants insertion and prosthetic restoration. Follow-up of one year showed stable marginal bone around dental implants. The implant survival rate was 100%. HRW losses were 0.65 ± 0.43 mm (the 4th month) and 1.05 ± 0.54 mm (the 19th month) compared to HRW immediately after augmentation. The PES and WES of final prosthetic restorations were 8.09 ± 0.70 and 8.91 ± 0.54, respectively. Conclusions Autogenous tooth shell grafting is a reliable approach for bone augmentation in the esthetic zone for dental implant treatment, allowing for favorable stability and esthetic outcome of implant-supported prosthesis within the one-year follow-up period.
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Affiliation(s)
- Shuyi Li
- Department of Stomatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510000, China.,Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, 1081, LA, The Netherlands
| | - Ming Gao
- Fourth Division, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Miao Zhou
- Department of Stomatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510000, China.
| | - Yibo Zhu
- Fourth Division, Peking University School and Hospital of Stomatology, Beijing, 100081, China.
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15
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Blanc-Sylvestre N, Bouchard P, Chaussain C, Bardet C. Pre-Clinical Models in Implant Dentistry: Past, Present, Future. Biomedicines 2021; 9:1538. [PMID: 34829765 PMCID: PMC8615291 DOI: 10.3390/biomedicines9111538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
Biomedical research seeks to generate experimental results for translation to clinical settings. In order to improve the transition from bench to bedside, researchers must draw justifiable conclusions based on data from an appropriate model. Animal testing, as a prerequisite to human clinical exposure, is performed in a range of species, from laboratory mice to larger animals (such as dogs or non-human primates). Minipigs appear to be the animal of choice for studying bone surgery around intraoral dental implants. Dog models, well-known in the field of dental implant research, tend now to be used for studies conducted under compromised oral conditions (biofilm). Regarding small animal models, research studies mostly use rodents, with interest in rabbit models declining. Mouse models remain a reference for genetic studies. On the other hand, over the last decade, scientific advances and government guidelines have led to the replacement, reduction, and refinement of the use of all animal models in dental implant research. In new development strategies, some in vivo experiments are being progressively replaced by in vitro or biomaterial approaches. In this review, we summarize the key information on the animal models currently available for dental implant research and highlight (i) the pros and cons of each type, (ii) new levels of decisional procedures regarding study objectives, and (iii) the outlook for animal research, discussing possible non-animal options.
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Affiliation(s)
- Nicolas Blanc-Sylvestre
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Philippe Bouchard
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Catherine Chaussain
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Dental Medicine Department, Bretonneau Hospital, GHN-Université de Paris, 75018 Paris, France
| | - Claire Bardet
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
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16
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Clinical performance of tooth root blocks for alveolar ridge reconstruction. Int J Oral Maxillofac Surg 2021; 51:680-689. [PMID: 34507879 DOI: 10.1016/j.ijom.2021.08.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/25/2021] [Accepted: 08/13/2021] [Indexed: 11/20/2022]
Abstract
This systematic literature review set out to investigate the clinical outcomes of autogenous tooth root blocks used for ridge augmentation: survival rates, block resorption, implant survival, post-surgical complications, and histology findings. This review followed PRISMA guidelines. An automated search was made in four databases, supplemented by a manual search for relevant articles published before December 2020. The quality of evidence provided was assessed with the Newcastle-Ottawa Quality Assessment Scale and the Joanna Briggs Institute Critical Appraisal tool. Seven articles fulfilled the inclusion criteria and underwent analysis. The articles included a total of 136 patients, who received 118 autogenous tooth root blocks and 26 autogenous bone blocks showing block survival rates of 99.15% and 100%, respectively. Tooth root blocks presented a mean bone gain that was similar to autologous bone blocks but showed less resorption. The implant survival rate was 98.32% for autogenous tooth root blocks. Reconstruction of alveolar crests by means of autogenous tooth root blocks appears to be a satisfactory option for single-tooth gaps and low grades of bone atrophy in terms of the survival of the bone block and the implants placed subsequently. More research providing long-term data is needed to confirm these findings.
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17
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Retrospective Study on Tooth Shell Technique Using Endodontically Treated Teeth in Lateral Ridge Augmentation. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11135882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Autogenous dentin has been reported to be a suitable grafting material for certain indications. The purpose of this study was to assess the feasibility of using endodontically treated teeth for this application. In the present retrospective study, one-stage augmentation of lateral ridge defects with a dentin shell and particulate (tooth shell technique (TST)) either obtained from endodontically treated teeth (ETT, 17 patients with 21 implants) or non-endodontically treated teeth (NETT, 17 patients with 24 implants) were analyzed. Follow-up was conducted 3 months after augmentation. The target parameters were biological complications, horizontal hard tissue loss, osseointegration, and the integrity of the buccal lamella. Only minor complications occurred in three implants from three patients, including two cases of wound dehiscence (one each in ETT and NETT) and a localized three-walled defect in the NETT group, which was solved by re-augmentation. All the implants were osseointegrated and the integrity of the buccal lamella was preserved. The mean difference of the resorption of the crestal width and the buccal lamella did not differ statistically between the two groups. As TST using ETT showed, the results comparable to those of NETT dentin from endodontically treated teeth can be safely applied with predictable results for this grafting technique.
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18
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Proteomic and genomic analysis of acid dentin lysate with focus on TGF-β signaling. Sci Rep 2021; 11:12247. [PMID: 34112817 PMCID: PMC8192760 DOI: 10.1038/s41598-021-89996-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/19/2021] [Indexed: 02/05/2023] Open
Abstract
Particulate autologous tooth roots are increasingly used for alveolar bone augmentation; however, the proteomic profile of acid dentin lysate and the respective cellular response have not been investigated. Here we show that TGF-β1 is among the 226 proteins of acid dentin lysate (ADL) prepared from porcine teeth. RNA sequencing identified 231 strongly regulated genes when gingival fibroblasts were exposed to ADL. Out of these genes, about one third required activation of the TGF-β receptor type I kinase including interleukin 11 (IL11) and NADPH oxidase 4 (NOX4). Reverse transcription-quantitative polymerase chain reaction and immunoassay confirmed the TGF-β-dependent expression of IL11 and NOX4. The activation of canonical TGF-β signaling by ADL was further confirmed by the phosphorylation of Smad3 and translocation of Smad2/3, using Western blot and immunofluorescence staining, respectively. Finally, we showed that TGF-β activity released from dentin by acid lysis adsorbs to titanium and collagen membranes. These findings suggest that dentin particles are a rich source of TGF-β causing a major response of gingival fibroblasts.
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19
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Retrospective Study: Lateral Ridge Augmentation Using Autogenous Dentin: Tooth-Shell Technique vs. Bone-Shell Technique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063174. [PMID: 33808616 PMCID: PMC8003557 DOI: 10.3390/ijerph18063174] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/16/2022]
Abstract
In the literature, autogenous dentin is considered a possible alternative to bone substitute materials and autologous bone for certain indications. The aim of this proof-of-concept study was to use autogenous dentin for lateral ridge augmentation. In the present retrospective study, autogenous dentin slices were obtained from teeth and used for the reconstruction of lateral ridge defects (tooth-shell technique (TST): 28 patients (15 females, 13 males) with 34 regions and 38 implants). The bone-shell technique (BST) according to Khoury (31 patients (16 females, 15 males) with 32 regions and 41 implants) on autogenous bone served as the control. Implants were placed simultaneously in both cases. Follow-up was made 3 months after implantation. Target parameters during this period were clinical complications, horizontal hard tissue loss, osseointegration, and integrity of the buccal lamella. The prosthetic restoration with a fixed denture was carried out after 5 months. The total observation period was 5 months. A total of seven complications occurred. Of these, three implants were affected by wound dehiscences (TST: 1, BST: 2) and four by inflammations (TST: 0, BST: 4). There were no significant differences between the two groups in terms of the total number of complications. One implant with TST exhibited a horizontal hard tissue loss of 1 mm and one with BST of 0.5 mm. Other implants were not affected by hard tissue loss. There were no significant differences between the two groups. Integrity of the buccal lamella was preserved in all implants. All implants were completely osseointegrated in TST and BST. All implants could be prosthetically restored with a fixed denture 5 months after augmentation. TST showed results comparable to those of the BST. Dentin can therefore serve as an alternative material to avoid bone harvesting procedures and thus reduce postoperative discomfort of patients.
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20
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Nasirzade J, Kargarpour Z, Panahipour L, Schwarz F, Gruber R. Cleaning Teeth Reduces the Inflammatory Response of Macrophages to Acid Dentine Lysate. Int J Mol Sci 2020; 21:ijms21239207. [PMID: 33276685 PMCID: PMC7730611 DOI: 10.3390/ijms21239207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 12/13/2022] Open
Abstract
Particulate autogenous tooth roots are used for alveolar bone augmentation surgery; however, dental plaque may provoke an inflammatory response that may counteract the desired graft consolidation process. Traditional mechanical cleaning of extracted teeth may be of support to lower a possible inflammatory response of the autograft. To test this assumption, extracted porcine teeth were left either uncleaned or underwent mechanical cleaning with a toothbrush and toothpaste before being fragmented and subjected to acid lysis, termed as unclean acid dentine lysate (ucADL) and clean acid dentine lysate (cADL), respectively. The inflammatory responses of murine macrophage RAW 264.7 cells being exposed to the respective acid dentine lysates were evaluated at the level of inflammatory gene expression and IL6 immunoassays. We report here that acid lysates obtained from uncleaned teeth provoked a robust increase in IL1β, IL6, and COX2 in RAW 264.7 cells. The mechanical removal of dental plaque significantly reduced the inflammatory response. Consistently, Limulus tests revealed that tooth cleaning lowers the presence of endotoxins in dentine lysates. To further prove the involvement of endotoxins, a toll-like receptor 4 (TLR4) inhibitor TAK242 was introduced. TAK242 abolished the inflammatory response provoked by acid lysates obtained from uncleaned teeth in RAW 264.7 cells. Moreover, nuclear translocation and phosphorylation of the TLR4 downstream NFκB-p65 were attenuated at the presence of cleaned versus uncleaned dentine lysates. Taken together, our data support the importance of dental plaque removal of teeth being extracted for alveolar bone augmentation surgery.
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Affiliation(s)
- Jila Nasirzade
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (J.N.); (Z.K.); (L.P.)
| | - Zahra Kargarpour
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (J.N.); (Z.K.); (L.P.)
| | - Layla Panahipour
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (J.N.); (Z.K.); (L.P.)
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, 60596 Frankfurt, Germany;
| | - Reinhard Gruber
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (J.N.); (Z.K.); (L.P.)
- Department of Periodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40070-2660
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21
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Elraee L, Moussa M, Adel-Khattab D. Autogenous Dentin Block of A Non Restorable Wisdom Tooth for Localized Horizontal Ridge Augmentation: Radiographic and Histological Analysis: A Preliminary Case Report. Clin Adv Periodontics 2020; 12:106-112. [PMID: 33058564 DOI: 10.1002/cap.10130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/03/2020] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Tooth roots proved in different studies clinically and radiographically to be an alternative to autogenous bone. However, the histological evaluation of the tooth block following ridge augmentation is still missing. The aim of this case report was to evaluate histologically and radiographically the effect of autogenous dentin block (DB) to restore a horizontal ridge deficiency at a single tooth gap. CASE PRESENTATION A healthy 36-years old female patient presented with a missing lower first molar (30), after clinical and radiographic examination, the site showed a class III defect horizontal atrophy. The procedure performed was the surgical removal of the wisdom tooth (32), shaping and fixation of a separated DB at the defect site using an osteosynthesis screw. A cone beam computed tomography was performed immediately and 6 month following the surgery. During implant placement, a core biopsy specimen was retrieved, stored and prepared for histological evaluation. The radiographic analysis showed a horizontal width gain of about 4 mm. The histologic assessment revealed cortical bone formation at the buccal and lingual aspects between the tooth and the bone. During implant placement, the core biopsy exhibited a slight separation upon removal from the grafted side, at 6 month following implant placement, the implant was successfully osteointegrated. CONCLUSION DB was successfully used for horizontal alveolar ridge augmentation, thus allowing a prosthetically driven implant placement. More cases assessing implant survival and success are needed to confirm the results of this case report.
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Affiliation(s)
- Leila Elraee
- Oral medicine, Periodontology and Diagnosis Department, Faculty of Dentistry, Modern Science and arts University, Egypt
| | - Mahmoud Moussa
- Oral medicine, Periodontology and Diagnosis Department, Faculty of Dentistry, Modern Science and arts University, Egypt
| | - Doaa Adel-Khattab
- Oral Medicine, Periodontology and Diagnosis Department, Faculty of Dentistry, Ain Shams University, Egypt
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22
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Parvini P, Schwarz F, Hüfner MK, Rauch N, Nienkemper M, Becker K. Microstructural volumetric analysis of vertical alveolar ridge augmentation using autogenous tooth roots. Clin Implant Dent Relat Res 2020; 22:647-653. [PMID: 32876385 DOI: 10.1111/cid.12947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND To volumetrically assess the bone microstructure following vertical alveolar ridge augmentation using differently conditioned autogenous tooth roots (TR) and second-stage implant placement. MATERIALS AND METHODS The upper premolars were bilaterally extracted in n = 4 beagle dogs and randomly assigned to either autoclavation (TR-A) or no additional treatment (TR-C). Subsequently, TR were used as block grafts for vertical alveolar ridge augmentation in both lower quadrants. At 12 weeks, titanium implants were inserted and left to heal 3 weeks. Microcomputed tomography was used to quantify bone volume per tissue volume (BV/TV), trabecular thickness (Tb.Th), and trabecular spacing (Tb.Sp) at vestibular (v) and oral (o) aspects along the implant and in the augmented upper half of the implant, respectively. RESULTS Median BV/TV [TR-C: 51.33% (v) and 70.42% (o) vs TR-A: 44.05% (v) and 64.46% (o)], Tb.th [TR-C: 0.22 mm (v) and 0.27 mm (o) vs TR-A: 0.23 mm (v) and 0.29 mm (o)] and Tb.Sp [TR-C: 0.26 mm (v) and 0.13 mm (o) vs TR-A: 0.29 μm (v) and 0.15 mm (o)] values were comparable in both groups. CONCLUSION Both TR-C and TR-A grafts were associated with a comparable bone microstructure within the grafted area.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt, Germany
| | - Mira Kristin Hüfner
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Manuel Nienkemper
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Kathrin Becker
- Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurt, Germany.,Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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Parvini P, Sahin D, Becker K, Sader R, Becker J, Schwarz F. Short-term outcomes of lateral extraction socket augmentation using autogenous tooth roots: A prospective observational study. Clin Oral Implants Res 2020; 31:881-888. [PMID: 32645746 DOI: 10.1111/clr.13633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 03/10/2020] [Accepted: 06/08/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the short-term clinical outcomes of lateral augmentation of deficient extraction sockets and two-stage implant placement using autogenous tooth roots (TR). MATERIAL AND METHODS A total of n = 13 patients (13 implants) were available for the analysis. At the time of tooth extraction, each subject had received lateral augmentation using the respective non-retainable but non-infected tooth root where the thickness of the buccal bone was <0.5 mm or where a buccal dehiscence-type defect was present. Titanium implants were placed after a submerged healing period of 6 months and loaded after 20 ± 2 weeks (V8). Clinical parameters (e.g., bleeding on probing-BOP, probing pocket depth-PD, mucosal recession-MR, clinical attachment level-CAL) were recorded at V8 and after 26 ± 4 weeks (V9) of implant loading. RESULTS At V9, all patients investigated revealed non-significant changes in mean BOP (-19.23 ± 35.32%), PD (0.24 ± 0.49 mm), MR (0.0 ± 0.0 mm) and CAL (0.24 ± 0.49 mm) values, respectively. There was no significant correlation between the initial gain in ridge width and changes in BOP and PD values. CONCLUSIONS The surgical procedure was associated with stable peri-implant tissues on the short-term.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - Didem Sahin
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Kathrin Becker
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany.,Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Juergen Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany.,Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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Parvini P, Schliephake C, Al-Maawi S, Schwarz K, Sader R, Ghanaati S, Schwarz F. Histomorphometrical assessment of vertical alveolar ridge augmentation using extracted tooth roots in the canine. Clin Oral Investig 2019; 24:317-323. [DOI: 10.1007/s00784-019-02960-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/09/2019] [Indexed: 12/23/2022]
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Schwarz F, Sahin D, Becker K, Sader R, Becker J. Autogenous tooth roots for lateral extraction socket augmentation and staged implant placement. A prospective observational study. Clin Oral Implants Res 2019; 30:439-446. [DOI: 10.1111/clr.13429] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 02/14/2019] [Accepted: 03/24/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum Goethe University Frankfurt Germany
- Department of Oral Surgery Universitätsklinikum Düsseldorf Düsseldorf Germany
| | - Didem Sahin
- Department of Oral Surgery Universitätsklinikum Düsseldorf Düsseldorf Germany
| | - Kathrin Becker
- Department of Oral Surgery Universitätsklinikum Düsseldorf Düsseldorf Germany
- Department of Orthodontics Universitätsklinikum Düsseldorf Düsseldorf Germany
| | - Robert Sader
- Department for Oral, Cranio‐Maxillofacial and Facial Plastic Surgery Medical Center of the Goethe University Frankfurt Frankfurt am Main Germany
| | - Jürgen Becker
- Department of Oral Surgery Universitätsklinikum Düsseldorf Düsseldorf Germany
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Schwarz F, Mihatovic I, Popal-Jensen I, Parvini P, Sader R. Influence of autoclavation on the efficacy of extracted tooth roots used for vertical alveolar ridge augmentation. J Clin Periodontol 2019; 46:502-509. [PMID: 30791121 DOI: 10.1111/jcpe.13090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/09/2019] [Accepted: 02/16/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the influence of autoclavation on the efficacy of extracted tooth roots (TR) used for vertical alveolar ridge augmentation and two-stage osseointegration. MATERIAL AND METHODS Maxillary premolars were randomly assigned to either autoclavation (TR-A) or were left untreated (TR-C) and used as block grafts for vertical alveolar ridge augmentation in both lower quadrants (n = 4 beagle dogs). At 12 weeks, titanium implants were inserted and left to heal for 3 weeks. Histological analyses considered vertical bone gain (BD-BC), augmented area (AA) and bone-to-implant contact (BIC) at vestibular (v) and oral (o) aspects. RESULTS Both TR-C and TR-A (exposures n = 3) grafts were associated with a replacement resorption and marked vertical bone gain. Median BD-BC (TR-C: 1.45 [v] to 1.62 mm [o] versus TR-A: 0.97 [v] to 1.79 mm [o]) and AA (TR-C: 0.64 [v] to 2.36 mm2 [o] versus TR-A: 0.22 [v] to 2.36 mm2 [o]) values were comparable in both groups. V BIC (TR-C: 49.32 [v] to 52.97% [o] versus TR-A: 25.34 [v] to 46.11% [o]) values were significantly higher in the TR-C group. CONCLUSIONS Both TR-C and TR-A grafts equally supported vertical alveolar ridge augmentation; however, osseointegration was partially facilitated in the TR-C group.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt, Germany.,Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Ilja Mihatovic
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - Puria Parvini
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
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Ramanauskaite A, Sahin D, Sader R, Becker J, Schwarz F. Efficacy of autogenous teeth for the reconstruction of alveolar ridge deficiencies: a systematic review. Clin Oral Investig 2019; 23:4263-4287. [DOI: 10.1007/s00784-019-02869-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 02/19/2019] [Indexed: 02/03/2023]
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28
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Del Canto-Díaz A, de Elío-Oliveros J, Del Canto-Díaz M, Alobera-Gracia MA, Del Canto-Pingarrón M, Martínez-González JM. Use of autologous tooth-derived graft material in the post-extraction dental socket. Pilot study. Med Oral Patol Oral Cir Bucal 2019; 24:e53-e60. [PMID: 30573707 PMCID: PMC6344012 DOI: 10.4317/medoral.22536] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 10/19/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The objectives of the present pilot study are to compare via CBCT the alveolar contraction suffered both vertically and horizontally between the control group and the group using autologous dental material (ADM), as well as to study the densitometric differences between both post-extraction sockets. MATERIAL AND METHODS A split-mouth study was performed in n = 9 patients who required two extraction of single-rooted teeth deemed suitable for deferred rehabilitation with osseointegrated implants. Two groups were formed - a control group, in which the post-extraction socket was not filled, and an ADM group, in which the alveolar defect was filled with freshly processed autogenous dental material. Both dimensional and densitometric analyses of the alveoli were performed in both groups immediately after surgery (baseline), as well as 8 weeks and 16 weeks later. RESULTS The mean height of alveolar bone loss was: VL (Control 1.77 mm, loss of 16.87% of initial alveolar height; ADM 0.42 mm, loss of 4.2% of initial alveolar height), HL-BCB (Control 2.22 mm, ADM 0.16 mm, p= 0.067 at 16 weeks). The mean bone loss of the vestibular width (VL-BCB) was much higher in the control group (1.91 mm at 1 mm, 1.3 mm at 3 mm, and 0.89 mm at 5 mm) than in the ADM group (0.46 mm at 1 mm, 0.21 mm at 3 mm, 0.01 at 5 mm, p=0.098 at 16 weeks). At 16 weeks, densitometric analysis of the coronal alveolar area revealed a bone density of 564.35 ± 288.73 HU in the control group and 922.68 ± 250.82 HU in the ADM group (p=0.045 ). CONCLUSIONS In light of these preliminary results, autologous dentine may be considered a promising material for use in socket preservation techniques.
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Affiliation(s)
- A Del Canto-Díaz
- C/ Plaza del Ferrocarril, 12 Bajo, Las Rozas de Madrid (Las Matas) 28290, Madrid, Spain,
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Becker K, Jandik K, Stauber M, Mihatovic I, Drescher D, Schwarz F. Microstructural volumetric analysis of lateral ridge augmentation using differently conditioned tooth roots. Clin Oral Investig 2018; 23:3063-3071. [DOI: 10.1007/s00784-018-2723-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 10/18/2018] [Indexed: 11/28/2022]
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30
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Parvini P, Sader R, Sahin D, Becker J, Schwarz F. Radiographic outcomes following lateral alveolar ridge augmentation using autogenous tooth roots. Int J Implant Dent 2018; 4:31. [PMID: 30264332 PMCID: PMC6160378 DOI: 10.1186/s40729-018-0142-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/17/2018] [Indexed: 11/23/2022] Open
Abstract
Background To assess and compare the radiographic outcomes following lateral alveolar ridge augmentation using autogenous tooth roots (TR) and autogenous bone (AB) blocks. Methods In a total of 30 patients, lateral ridge augmentation was conducted in parallel groups using either (1) healthy autogenous tooth roots (e.g., retained wisdom or impacted teeth) (n = 15) or (2) cortical autogenous bone blocks harvested from the retromolar area. Cone-beam computed tomographic (CBCT) scans taken at 26 weeks of submerged healing were analyzed for the basal graft integration (i.e., contact between the graft and the host bone in %) (BI26) and the cross-sectional grafted area (mm2) (SA26). Results Both groups revealed a comparable clinical width of the alveolar ridge at baseline (CWb). Mean BI26 and SA26 values amounted to 69.26 ± 26.01% (median 72.44) and 22.07 ± 12.98 mm2 (median 18.83) in the TR group and 79.67 ± 15.66% (median 78.85) and 12.42 ± 10.11 mm2 (median 11.36) in the AB group, respectively. Between-group differences in mean SA26 values were statistically significant (p = 0.031). Linear regression analysis failed to reveal any significant correlations between BI26 and CWb/SA26 values in either group. Conclusions TR grafts may be associated with improved SA26 values following lateral alveolar ridge augmentation. Trial registration DRKS00009586. Registered 10 February 2016.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt, Germany
| | - Didem Sahin
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Jürgen Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University, Frankfurt, Germany. .,Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
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Schwarz F, Hazar D, Becker K, Sader R, Becker J. Efficacy of autogenous tooth roots for lateral alveolar ridge augmentation and staged implant placement. A prospective controlled clinical study. J Clin Periodontol 2018; 45:996-1004. [PMID: 29972245 DOI: 10.1111/jcpe.12977] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/01/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess and compare the efficacy and safety of autogenous tooth roots (TR) and autogenous bone blocks (AB) for lateral alveolar ridge augmentation and two-stage implant placement. MATERIAL AND METHODS A total of 30 patients in need of implant therapy and lateral ridge augmentation were allocated to parallel groups receiving either (a) healthy autogenous tooth roots (e.g. retained wisdom or impacted teeth) (n = 15) or (b) cortical autogenous bone blocks harvested from the retromolar area. After 26 weeks of submerged healing, the primary endpoint was defined as the crestal ridge width (mm) (CW26) being sufficient to place an adequately dimensioned titanium implant at the respective sites. RESULTS Soft tissue healing was uneventful in both groups. CW26 at V isit 6 allowed for a successful implant placement in all patients of both TR (15/15) and AB groups (15/15). Mean CW26 values amounted to 10.06 ± 1.85 mm (median: 11.0) in the TR and 9.20 ± 2.09 mm (median: 8.50) in the AB group, respectively. The difference between both groups did not reach statistical significance (p = 0.241). CONCLUSIONS TR may serve as an alternative graft to support lateral alveolar ridge augmentation and two-stage implant placement.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany.,Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Didem Hazar
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Kathrin Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.,Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jürgen Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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A comparison of micro-CT and histomorphometry for evaluation of osseointegration of PEO-coated titanium implants in a rat model. Sci Rep 2017; 7:16270. [PMID: 29176604 PMCID: PMC5701240 DOI: 10.1038/s41598-017-16465-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/13/2017] [Indexed: 11/16/2022] Open
Abstract
The aim of the present study was to determine the correlation between bone volume density (BV/TV) around a titanium implant determined by micro-computed tomography (micro-CT) and bone area density (BA/TA) measurements obtained using histomorphometry. An intramedullary rat femur implant model was evaluated to compare raw titanium implants with plasma electrolytic oxidation (PEO)-coated titanium implants. Titanium and PEO-treated titanium pins were inserted into rat femurs under general anesthesia. The animals were sacrificed and femurs harvested at 0, 2, 4 and 6 weeks, and subsequently, histomorphometry and micro-CT were performed. BV/TV and BA/TA values were strongly and positively correlated at all time points and locations (with all correlation coefficients being >0.8 and with P < 0.001). BV/TV and BA/TA were significantly higher proximal to the growth plate than distal to the growth plate, with estimated differences of 14.10% (P < 0.001) and 11.95% (P < 0.001), respectively. BV/TV and BA/TA were significantly higher on the PEO-coated surface than on the raw titanium surface, with estimated differences of 3.20% (P = 0.044) and 4.10% (P = 0.018), respectively. Therefore, quantitative micro-CT analysis of BV/TV is correlated with BA/TA determined by histomorphometry when artifacts around titanium implants are minimized by a region of interest modification.
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Ortiz-Vigón A, Martinez-Villa S, Suarez I, Vignoletti F, Sanz M. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement. Int J Implant Dent 2017. [PMID: 28634845 PMCID: PMC5478548 DOI: 10.1186/s40729-017-0087-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures. METHODS In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed using CCXBB as bone replacement grafts. Twenty-six weeks postoperatively, a re-entry procedure was performed to evaluate the bone width for adequate implant placement and two histological specimens were retrieved from each patient, one being processed for ground sectioning and the other for decalcified paraffin-included sections. In non-decalcified sections, the relative proportions occupied by bone, biomaterials, and connective tissue present in the biopsies were identified. In de-calcified sections, structures and cells positive for osteopontin (OPN), tartrate-resistant acid phosphatase activity (TRAP), osteocalcin (OSC), and alkaline phosphatase (ALP) were assessed. RESULTS Soft tissue dehiscence occurred during the follow-up in 5 out of 15 patients (33.3%). The mean crest width at baseline was 2.78 mm (SD 0.57) and the mean crest width at re-entry was 6.90 mm (SD 1.22), with a mean ridge width increase of 4.12 mm (SD 1.32). Twenty-six bone biopsies were obtained from 13 patients. Histomorphometric analysis showed a mean of 26.90% (SD 12.21) of mineralized vital bone (MVB), 21.37% (SD 7.36) of residual CCXBB, 47.13% (SD 19.15) of non-mineralized tissue, and 0.92% of DBBM. The immunohistochemical analysis revealed a large number of OPN-positive cells 8.12% (SD 4.73), a lower proportion of TRAP positive multinuclear cells 5.09% (SD 4.91), OSC-positive cells 4.09% (SD 4.34), and a limited amount of ALP positive cells 1.63% (SD 2). CONCLUSIONS CCXBB achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. In light of the histological outcomes and implant failures, special attention must be placed to prevent soft tissue dehiscence when CCXBB is used in severe atrophic alveolar crests.
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Affiliation(s)
- Alberto Ortiz-Vigón
- ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
| | - Sergio Martinez-Villa
- ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
| | - Iñaki Suarez
- ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
| | - Fabio Vignoletti
- ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
| | - Mariano Sanz
- ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain.
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Schwarz F, Schmucker A, Becker J. Initial case report of an extracted tooth root used for lateral alveolar ridge augmentation. J Clin Periodontol 2016; 43:985-989. [PMID: 27440735 DOI: 10.1111/jcpe.12602] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Recent animal studies have indicated, that tooth roots reveal a structural and biological potential to serve as alternative autografts for localized ridge augmentation. This proof-of-concept initial report aimed at investigating, whether this new surgical concept may be applied to humans. MATERIAL & METHODS In one patient, who was in need for horizontal ridge augmentation, the roots of a retained upper wisdom tooth were separated and rigidly fixed at the defect site. After 24 weeks of submerged healing, the primary endpoint was defined as gain in ridge width (mm) being sufficient to place an adequately dimensioned titanium implant at the respective site. Secondary outcomes included safety assessments. RESULTS Soft tissue healing was uneventful during the entire observation period. Clinical re-entry at 24 weeks revealed, that the transplanted root was homogeneously incorporated at the former defect site and mainly replaced by a newly formed hard tissue. The gain in ridge width amounted to 4.5 mm and allowed for a successful implant placement with good primary stability. The procedure was not associated with any wound infection or adverse events. CONCLUSIONS This novel approach may be further investigated in implant site development procedures.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
| | - Andrea Schmucker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Jürgen Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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Schwarz F, Golubovic V, Mihatovic I, Becker J. Periodontally diseased tooth roots used for lateral alveolar ridge augmentation. A proof-of-concept study. J Clin Periodontol 2016; 43:797-803. [DOI: 10.1111/jcpe.12579] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery; Universitätsklinikum Düsseldorf; Düsseldorf Germany
| | - Vladimir Golubovic
- Department of Oral Surgery; Universitätsklinikum Düsseldorf; Düsseldorf Germany
| | - Ilja Mihatovic
- Department of Oral Surgery; Universitätsklinikum Düsseldorf; Düsseldorf Germany
| | - Jürgen Becker
- Department of Oral Surgery; Universitätsklinikum Düsseldorf; Düsseldorf Germany
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