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Blanco J, Caramês J, Quirynen M. A narrative review on the use of autologous platelet concentrates during alveolar bone augmentation: Horizontal (simultaneous/staged) & vertical (simultaneous/staged). Periodontol 2000 2024. [PMID: 39198993 DOI: 10.1111/prd.12604] [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: 03/23/2024] [Revised: 07/29/2024] [Accepted: 08/11/2024] [Indexed: 09/01/2024]
Abstract
This review aimed to answer the general question of whether autologous platelet concentrates (APCs, an autologous blood-derivative) can improve the outcome of alveolar bone augmentation. Three clinical scenarios were assessed: horizontal/vertical bone augmentation in combination with implant placement (simultaneous approach), horizontal bone augmentation in a staged approach, and vertical bone augmentation in a staged approach. An electronic literature search strategy was conducted for each review from the outset to July 1st, 2023. The titles and abstracts (when available) of all identified studies were screened and imported into a database. If articles appeared to meet the inclusion criteria or their title and abstract had insufficient data, the full text was obtained to make the final decision. All studies that met the inclusion criteria underwent data extraction. Moreover, the references of the identified papers were screened for additional studies. After title and abstract screening and selection criteria application, 14 clinical studies were included for the qualitative analysis: seven for horizontal/vertical bone augmentation in a simultaneous approach, five for horizontal bone augmentation in a staged approach, and two for vertical bone augmentation in a staged approach. There is scarce literature regarding the added value of APCs in bone augmentation, and most studies had small sample sizes, a lack of standardized protocols, and different outcome variables, which makes comparisons between studies difficult. Out of the 14 studies, four were well-designed randomized clinical trials, where we could find better results for the APCs groups. Most studies, particularly comparative and well-designed studies, demonstrated beneficial and promising results of using APCs in alveolar bone augmentation. However, before high-level evidence-based conclusions can be drawn, more randomized clinical trials must compare the benefits of adding APCs to the gold-standard approach.
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Affiliation(s)
- J Blanco
- Department of Surgery and Medical-Surgical Specialties (Area of Stomatology. Unit of Periodontology), Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - J Caramês
- Department of Oral Surgery and Implantology, Unit of Oral Surgery, Faculty of Dental Medicine, University of Lisbon, Lisbon, Portugal
| | - M Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
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Jia K, You J, Zhu Y, Li M, Chen S, Ren S, Chen S, Zhang J, Wang H, Zhou Y. Platelet-rich fibrin as an autologous biomaterial for bone regeneration: mechanisms, applications, optimization. Front Bioeng Biotechnol 2024; 12:1286035. [PMID: 38689760 PMCID: PMC11058865 DOI: 10.3389/fbioe.2024.1286035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
Platelet-rich fibrin, a classical autologous-derived bioactive material, consists of a fibrin scaffold and its internal loading of growth factors, platelets, and leukocytes, with the gradual degradation of the fibrin scaffold and the slow release of physiological doses of growth factors. PRF promotes vascular regeneration, promotes the proliferation and migration of osteoblast-related cells such as mesenchymal cells, osteoblasts, and osteoclasts while having certain immunomodulatory and anti-bacterial effects. PRF has excellent osteogenic potential and has been widely used in the field of bone tissue engineering and dentistry. However, there are still some limitations of PRF, and the improvement of its biological properties is one of the most important issues to be solved. Therefore, it is often combined with bone tissue engineering scaffolds to enhance its mechanical properties and delay its degradation. In this paper, we present a systematic review of the development of platelet-rich derivatives, the structure and biological properties of PRF, osteogenic mechanisms, applications, and optimization to broaden their clinical applications and provide guidance for their clinical translation.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Yanmin Zhou
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
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Mekcha P, Wongpairojpanich J, Thammarakcharoen F, Suwanprateeb J, Buranawat B. Customized 3D printed nanohydroxyapatite bone block grafts for implant sites: a case series. J Prosthodont Res 2022; 67:311-320. [PMID: 35858803 DOI: 10.2186/jpr.jpr_d_22_00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PATIENTS A case series of 12 patients (mean age, 53.5 years) with horizontal ridge deficiencies had augmentations with customized 3D printed nanohydroxyapatite (3DHA) block grafts prior to implant placement. 3DHA graft materials were fabricated to fit the individual patient defects using DICOMs from CBCT images obtained from each patient. The CBCT images were then converted into the STL file format and 3DHA was reconstructed by 3D printing. Surgical bone augmentation consisted of 3DHA incorporating concentrated growth factors (CGFs) and platelet-rich fibrin (PRF) membrane. At 6 months, a bone biopsy and implantation were performed. The primary outcome was horizontal bone gain after 6 months. The secondary outcomes included information on the clinical outcomes, dimensions, and histomorphometric results. DISCUSSION The 3DHA block graft was successful in 10 of 12 patients. Graft adjustment was not required. All 3DHA adapted and fit well at all defect sites. Maximum mean horizontal bone gains were 3.06 ± 1.02 and 3.56 ± 0.23 mm from the DICOMs and STL data sets, respectively. The volume gain was 229.8 ± 82.96 mm3. A low pain score after surgery was reported of 1.41 ± 0.51, while the healing index score increased with a maximum mean of 4.7 ± 0.67. Thirteen implants were placed with good primary stability (ISQ = 65 ± 4.08), without additional guided bone regeneration. Histomorphometric analysis revealed that new bone formation, bone tissue, residual grafts, and connective tissue were 28.6 ± 1.88, 30.48 ± 4.81, 19.82 ± 4.07, and 20.81 ± 4.41%, respectively. CONCLUSIONS A customized 3DHA block graft is a viable treatment option for primary implant-site augmentation.
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Affiliation(s)
- Pichaya Mekcha
- Department of Implantology, Faculty of Dentistry, Thammasat University, Thailand
| | | | - Faungchat Thammarakcharoen
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center, National Science and Technology Development Agency, Thailand
| | - Jintamai Suwanprateeb
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center, National Science and Technology Development Agency, Thailand
| | - Borvornwut Buranawat
- Department of Implantology, Faculty of Dentistry, Thammasat University, Thailand
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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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Özcan M, Magini EB, Volpato GM, Cruz A, Volpato CAM. Additive Manufacturing Technologies for Fabrication of Biomaterials for Surgical Procedures in Dentistry: A Narrative Review. J Prosthodont 2022; 31:105-135. [PMID: 35313027 DOI: 10.1111/jopr.13484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To screen and critically appraise available literature regarding additive manufacturing technologies for bone graft material fabrication in dentistry. MATERIAL AND METHODS PubMed and Scopus were searched up to May 2021. Studies reporting the additive manufacturing techniques to manufacture scaffolds for intraoral bone defect reconstruction were considered eligible. A narrative review was synthesized to discuss the techniques for bone graft material fabrication in dentistry and the biomaterials used. RESULTS The databases search resulted in 933 articles. After removing duplicate articles (128 articles), the titles and abstracts of the remaining articles (805 articles) were evaluated. A total of 89 articles were included in this review. Reading these articles, 5 categories of additive manufacturing techniques were identified: material jetting, powder bed fusion, vat photopolymerization, binder jetting, and material extrusion. CONCLUSIONS Additive manufacturing technologies for bone graft material fabrication in dentistry, especially 3D bioprinting approaches, have been successfully used to fabricate bone graft material with distinct compositions.
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Affiliation(s)
- Mutlu Özcan
- Division of Dental Biomaterials, Center of Dental Medicine, Clinic for Reconstructive Dentistry, University of Zürich, Zürich, Switzerland
| | - Eduarda Blasi Magini
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Ariadne Cruz
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
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Caramês JMM, Vieira FA, Caramês GB, Pinto AC, Francisco HCO, Marques DNDS. Guided Bone Regeneration in the Edentulous Atrophic Maxilla Using Deproteinized Bovine Bone Mineral (DBBM) Combined with Platelet-Rich Fibrin (PRF)-A Prospective Study. J Clin Med 2022; 11:jcm11030894. [PMID: 35160343 PMCID: PMC8837059 DOI: 10.3390/jcm11030894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Bone regeneration procedures represent a major challenge in oral surgery. This study aimed to evaluate a composite PRF/particulate xenograft in guided bone regeneration. Methods: Edentulous patients with horizontal ridge deficiencies in the anterior maxilla and candidates to an immediate-loading full-arch rehabilitation were included. Horizontal linear measurements indicating bone gain were assessed from computer beam computer tomography (CBCT) scans obtained at pre-surgery, post-surgery, and the 12-month follow-up. Mean bone values were presented as mean ± 95% CI. Non-parametric tests were used as appropriate, and the effect size was calculated with Cohen’s d repeated measures. Results: Eighteen patients were rehabilitated with 72 implants. The mean horizontal bone width was 4.47 [4.13–4.80] mm pre-surgically, 9.25 [8.76–9.75] mm post-surgically, and 7.71 [7.28–8.14] mm 12 months after. Conclusions: PRF associated with a xenograft seems to promote an effective horizontal bone gain. Randomized clinical trials are needed to confirm the benefits of this surgical approach.
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Affiliation(s)
- João Manuel Mendez Caramês
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal
- Correspondence: ; Tel.: +351-919727353; Fax: +351-217210989
| | - Filipe Araújo Vieira
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
| | - Gonçalo Bártolo Caramês
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
| | - Ana Catarina Pinto
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
| | - Helena Cristina Oliveira Francisco
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
| | - Duarte Nuno da Silva Marques
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal
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Survival Rates of Dental Implants in Autogenous and Allogeneic Bone Blocks: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121388. [PMID: 34946333 PMCID: PMC8705565 DOI: 10.3390/medicina57121388] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/11/2021] [Accepted: 12/14/2021] [Indexed: 12/17/2022]
Abstract
Background and Objectives: Preliminary studies emphasize the similar performance of autogenous bone blocks (AUBBs) and allogeneic bone blocks (ALBBs) in pre-implant surgery; however, most of these studies include limited subjects or hold a low level of evidence. The purpose of this review is to test the hypothesis of indifferent implant survival rates (ISRs) in AUBB and ALBB and determine the impact of various material-, surgery- and patient-related confounders and predictors. Materials and Methods: The national library of medicine (MEDLINE), Excerpta Medica database (EMBASE) and Cochrane Central Register of Controlled Trials (CENTRAL) were screened for studies reporting the ISRs of implants placed in AUBB and ALBB with ≥10 participants followed for ≥12 months from January 1995 to November 2021. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed via several scoring tools, dependent on the study design. Means of sub-entities were presented as violin plots. Results: An electronic data search resulted in the identification of 9233 articles, of which 100 were included in the quantitative analysis. No significant difference (p = 0.54) was found between the ISR of AUBB (96.23 ± 5.27%; range: 75% to 100%; 2195 subjects, 6861 implants) and that of ALBB (97.66 ± 2.68%; range: 90.1% to 100%; 1202 subjects, 3434 implants). The ISR in AUBB was increased in blocks from intraoral as compared to extraoral donor sites (p = 0.0003), partially edentulous as compared to totally edentulous (p = 0.0002), as well as in patients younger than 45 as compared to those older (p = 0.044), cortical as compared to cortico-cancellous blocks (p = 0.005) and in delayed implantations within three months as compared to immediate implantations (p = 0.018). The ISR of ALBB was significantly increased in processed as compared to fresh-frozen ALBB (p = 0.004), but also in horizontal as compared to vertical augmentations (p = 0.009). Conclusions: The present findings widely emphasize the feasibility of achieving similar ISRs with AUBB and ALBB applied for pre-implant bone grafting. ISRs were negatively affected in sub-entities linked to more extensive augmentation procedures such as bone donor site and dentition status. The inclusion and pooling of literature with a low level of evidence, the absence of randomized controlled clinical trials (RCTs) comparing AUBB and ALBB and the limited count of comparative studies with short follow-ups increases the risk of bias and complicates data interpretation. Consequently, further long-term comparative studies are needed.
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Dellavia C, Canciani E, Pellegrini G, Tommasato G, Graziano D, Chiapasco M. Histological assessment of mandibular bone tissue after guided bone regeneration with customized computer-aided design/computer-assisted manufacture titanium mesh in humans: A cohort study. Clin Implant Dent Relat Res 2021; 23:600-611. [PMID: 34139056 DOI: 10.1111/cid.13025] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/07/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Innovative customized computer-aided design/computer-assisted manufacture (CAD-CAM) titanium meshes have been proposed for guided alveolar bone regeneration. Histological confirmation on the quality of the regenerated bone is needed. Purpose of the study is to assess the integration capabilities of these innovative meshes and to evaluate the histological features of the regenerated alveolar bone. MATERIALS AND METHODS Twenty partially edentulous patients, with severe posterior mandibular atrophy, underwent a guided bone regeneration technique by means of customized CAD-CAM titanium mesh in association with a mixture of autologous bone in chips and deproteinized bovine bone (1:1). At 9 months of healing, titanium meshes and bone samples were collected and histomorphometrically analyzed. RESULTS In all patients, implants were placed according to the original plan. At histologic analysis, mesh appeared well osseointegrated, except that in sites where membrane exposure occurred. In all sites, newly formed tissue resulted highly mineralized, well-organized, and formed by 35.88% of new lamellar bone, 16.42% of woven bone, 10.88% of osteoid matrix, 14.10% of grafted remnants, and 22.72% of medullary spaces. Blood vessels were the 4% of the tissue. CONCLUSIONS Data from this study support the use of customized CAD/CAM titanium mesh for regeneration of vital, well-structured, and vascularized alveolar bone.
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Affiliation(s)
- Claudia Dellavia
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Elena Canciani
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Gaia Pellegrini
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Grazia Tommasato
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Clinical Unit of Oral Surgery, ASST Santi Paolo e Carlo - San Paolo Hospital, Università degli Studi di Milano, Milan, Italy
| | - Daniele Graziano
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Matteo Chiapasco
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Clinical Unit of Oral Surgery, ASST Santi Paolo e Carlo - San Paolo Hospital, Università degli Studi di Milano, Milan, Italy
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Hartlev J, Schou S, Isidor F, Nørholt SE. A clinical and radiographic study of implants placed in autogenous bone grafts covered by either a platelet-rich fibrin membrane or deproteinised bovine bone mineral and a collagen membrane: a pilot randomised controlled clinical trial with a 2-year follow-up. Int J Implant Dent 2021; 7:8. [PMID: 33554323 PMCID: PMC7868310 DOI: 10.1186/s40729-021-00289-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/08/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare the survival and clinical performance of implants placed in sites previously augmented with autogenous bone grafts covered by either a platelet-rich fibrin (PRF) membrane (PRF group) or a standard procedure (gold standard) involving coverage of the autogenous bone graft with deproteinised bovine bone mineral and a resorbable collagen membrane (control group). Methods A total of 27 partially edentulous patients (test n = 14, control n = 13) with indication for staged lateral bone block augmentation and dental implant placement were included. Twenty-four months after crown placement (range: 14–32 months), patients were recalled for a final clinical and radiographic follow-up. Outcome measures were implant survival, implant crown survival, clinical parameters of the implant, peri-implant marginal bone level, marginal bone level of adjacent tooth surfaces, biological and technical complications and patient-related outcome measures. Results Two implants were lost in the control group (85% survival rate); none were lost in the PRF group (100% survival rate). None of the 26 initially placed implant crowns were lost, but one implant and therefore one implant crown were lost after 20 months. Consequently, the definitive implant crown survival was 92% (95% confidence interval (CI): 73–110%) in the control group and 100% in the PRF group. No statistical difference in implant survival rate (p = 0.13) or implant crown survival was seen between the groups (p = 0.28). The mean marginal bone level at the follow-up was 0.26 mm (95% CI: 0.01–0.50 mm) in the PRF group and 0.68 mm (95% CI: 0.41–0.96 mm) in the control group. The difference between the groups was − 0.43 mm (95% CI: − 0.80 to − 0.05 mm, p = 0.03), which was statistically significant (p = 0.03). Both groups demonstrated similar healthy peri-implant soft tissue values at the final follow-up. Conclusion Although the current study is based on a small sample of participants, the findings suggest that the methodology of the PRF and the control group approach can both be used for bone augmentation with a similar outcome. A significant, but clinically irrelevant, higher peri-implant marginal bone level was registered in the PRF group than in the control group. Patients in both groups were highly satisfied with the treatment. Trial registration ClinicalTrials.gov Identifier: NCT04350749. Registered 17 April 2020. Retrospectively registered.
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Affiliation(s)
- Jens Hartlev
- Section for Oral Surgery and Oral Pathology, Department of Dentistry and Oral Health, Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark.
| | - Søren Schou
- Department of Periodontology, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Noerre Alle 20, DK-2200, Copenhagen N, Denmark
| | - Flemming Isidor
- Section for Prosthetics, Department of Dentistry and Oral Health, Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark
| | - Sven Erik Nørholt
- Section for Oral Surgery and Oral Pathology, Department of Dentistry and Oral Health, Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus N, Denmark
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