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Li H, Yang C, Chen G, Wang B, Li J, Xu L. Effect of radiation cross-linked collagen scaffold in alveolar ridge preservation of extraction socket. J Biomed Mater Res A 2024; 112:1699-1711. [PMID: 38606694 DOI: 10.1002/jbm.a.37723] [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: 11/21/2023] [Revised: 03/13/2024] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
This study aimed to evaluate the properties of radiation cross-linked collagen scaffold (RCS) and its efficacy for alveolar ridge preservation (ARP). RCS was prepared from collagen dispersion by electron beam irradiation and freeze-drying. The microstructure, swelling ratio, area alteration and mechanical properties of RCS were characterized. Fifty-four New Zealand rabbits performing incisor extraction on maxilla and mandible were randomly assigned into positive, sham operation or treatment groups. Micro-computed tomography (micro-CT) scans, performed after 1, 4, and 12 weeks of surgery, were to assess changes in ridge height at buccal and palatal side, in ridge width and in micromorphological parameters. Histological analysis accessed socket microarchitecture. The results showed that RCS had stable mechanical properties and morphologic features that provided a reliable physical support for ARP. Dimensional changes in treatment group revealed significantly greater vertical height at buccal (5.32 [3.37, 7.26] mm, p < .0001) and palatal (4.37 [2.66, 6.09] mm, p < .0001) side, and horizontal width at the maxilla (0.16 [0.04, 0.28] mm, p < .01) and mandible (0.33 [0.11, 0.54] mm, p < .01) than those in sham operation group after 12 weeks. The treatment group had advantage than positive group in vertical height preservation, quantitatively. The order and density of bone trabeculae were improved in treatment group. These findings indicated that RCS had the potential to serve as an effective scaffold for ARP.
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Affiliation(s)
- Hongwei Li
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Chen Yang
- Department of Stomatology, Xiang An Hospital of Xiamen University, Xiamen, People's Republic of China
| | - Gong Chen
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Bozhao Wang
- Department of Stomatology, Xiang An Hospital of Xiamen University, Xiamen, People's Republic of China
| | - Jian Li
- Department of Stomatology, Xiang An Hospital of Xiamen University, Xiamen, People's Republic of China
| | - Ling Xu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, People's Republic of China
- Shenzhen Research Institute of Xiamen University, Shenzhen, People's Republic of China
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Shin HJ, Park JY, Tien HK, Strauss FJ, Cha JK, Lee JS. In vivo experimental study comparing alveolar ridge preservation versus guided bone regeneration after unassisted socket healing at intact and damaged sites in narrow alveolar ridges. J Periodontol 2024. [PMID: 39007847 DOI: 10.1002/jper.24-0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/30/2024] [Accepted: 06/24/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND To compare bone regeneration and dimensional alteration of alveolar ridge at intact and damaged extraction sockets after alveolar ridge preservation (ARP) and implant placement versus unassisted socket healing followed by guided bone regeneration (GBR) with simultaneous implant placement. METHODS In 6 beagle dogs, 3 types of extraction sockets in the mandible were created: (1) intact sockets, (2) 1-wall defect sockets and (3) 2-wall defect sockets. The sockets were allocated to undergo either (1) ARP and implant placement 8 weeks later (ARP group) or (2) GBR with simultaneous implant placement after 8 weeks of unassisted socket healing (GBR group). After an additional healing period of 8 weeks, bone regeneration and dimensional changes were evaluated radiographically and histologically. RESULTS GBR showed superior bone formation and greater bone gains compared to ARP, regardless of the initial extraction-socket configuration. Although ARP maintained the preexisting alveolar ridge dimensions, peri-implant bone defects were still detected at 8 weeks of follow-up. Histomorphometric analyses confirmed that GBR increased dimensions of the alveolar ridge compared to baseline, and the augmentation and bone regeneration were greater with GBR than with ARP. CONCLUSION Early implant placement with ARP can mitigate alveolar ridge changes in the narrow alveolar ridge. However, early implant placement with simultaneous GBR creates the conditions for enhanced bone regeneration around the implant and greater ridge augmentation compared to ARP, irrespective of the extraction-socket configuration.
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Affiliation(s)
- Hae Jee Shin
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jin-Young Park
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Hsu Kuo Tien
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
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Wüster J, Neckel N, Sterzik F, Xiang-Tischhauser L, Barnewitz D, Genzel A, Koerdt S, Rendenbach C, Müller-Mai C, Heiland M, Nahles S, Knabe C. Effect of a synthetic hydroxyapatite-based bone grafting material compared to established bone substitute materials on regeneration of critical-size bone defects in the ovine scapula. Regen Biomater 2024; 11:rbae041. [PMID: 38903563 PMCID: PMC11187503 DOI: 10.1093/rb/rbae041] [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: 12/13/2023] [Revised: 03/11/2024] [Accepted: 03/30/2024] [Indexed: 06/22/2024] Open
Abstract
Lately, the potential risk of disease transmission due to the use of bovine-derived bone substitutes has become obvious, demonstrating the urgent need for a synthetic grafting material with comparable bioactive behaviour and properties. Therefore, the effect of a synthetic hydroxyapatite (HA) (Osbone®) bone grafting material on bone regeneration was evaluated 2 weeks, 1 month, and 3, 6, 12 and 18 months after implantation in critical-size bone defects in the ovine scapula and compared to that of a bovine-derived HA (Bio-Oss®) and β-tricalcium phosphate (TCP) (Cerasorb® M). New bone formation and the biodegradability of the bone substitutes were assessed histomorphometrically. Hard tissue histology and immunohistochemical analysis were employed to characterize collagen type I, alkaline phosphatase, osteocalcin, as well as bone sialoprotein expression in the various cell and matrix components of the bone tissue to evaluate the bioactive properties of the bone grafting materials. No inflammatory tissue response was detected with any of the bone substitute materials studied. After 3 and 6 months, β-TCP (Cerasorb® M) showed superior bone formation when compared to both HA-based materials (3 months: β-TCP 55.65 ± 2.03% vs. SHA 49.05 ± 3.84% and BHA 47.59 ± 1.97%; p ≤ 0.03; 6 months: β-TCP 62.03 ± 1.58%; SHA: 55.83 ± 2.59%; BHA: 53.44 ± 0.78%; p ≤ 0.04). Further, after 12 and 18 months, a similar degree of bone formation and bone-particle contact was noted for all three bone substitute materials without any significant differences. The synthetic HA supported new bone formation, osteogenic marker expression, matrix mineralization and good bone-bonding behaviour to an equal and even slightly superior degree compared to the bovine-derived HA. As a result, synthetic HA can be regarded as a valuable alternative to the bovine-derived HA without the potential risk of disease transmission.
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Affiliation(s)
- Jonas Wüster
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Norbert Neckel
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Florian Sterzik
- Department of Experimental Orofacial Medicine, Philipps University Marburg, Germany
| | - Li Xiang-Tischhauser
- Department of Experimental Orofacial Medicine, Philipps University Marburg, Germany
| | | | - Antje Genzel
- Veterinary Research Centre, Bad Langensalza, Germany
| | - Steffen Koerdt
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christian Müller-Mai
- Department of Orthopaedics and Traumatology, Hospital for Special Surgery, Lünen, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christine Knabe
- Department of Experimental Orofacial Medicine, Philipps University Marburg, Germany
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Batas L, Xanthopoulou V, Gnigou M, Vagdouti T, Fragkioudakis I, Vouros I. The Long-Term Esthetic and Radiographic Outcome of Implants Placed in the Anterior Maxilla after Ridge Preservation, Combining Bovine Xenograft with Collagen Matrix. Dent J (Basel) 2024; 12:80. [PMID: 38534304 DOI: 10.3390/dj12030080] [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: 01/14/2024] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
The objective of the study was to evaluate the long-term esthetic and radiographic results of implants placed in the anterior maxilla after ridge preservation, combining bovine xenograft with collagen matrix. Fifteen patients who required a single tooth extraction because of fracture, root resorption, or extended caries were included in the study. After extraction, all sites were grafted using Deproteinized Bovine Bone Mineral (DBBM) with collagen and covered by a resorbable collagen matrix (CM). Five months after socket grafting, implants were successfully installed. The implant diameter range was between 3.8 and 4.2 mm. All patients were monitored for over 7 years, both clinically and radiographically. Three independent observers evaluated the long-term esthetic outcome, employing the Pink Esthetic Score (PES) technique. Over a period exceeding seven years, a 100% survival rate was observed for all 15 implants, with minimal marginal bone loss. The mean PES was 11.40 (±1.44) at the first assessment and 11.38 (±1.63) at the second assessment. The difference was not statistically significant (p = 0.978), and the scores of PES measurements indicated excellent esthetic results even after seven years. Based on these preliminary results, it seems that placing collagen bovine bone in a fresh extraction socket, covered with a collagen matrix, can preserve the alveolar ridge and provide long-term stable esthetic results.
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Affiliation(s)
- Leonidas Batas
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Vithleem Xanthopoulou
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Maria Gnigou
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Triantafyllia Vagdouti
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Ioannis Fragkioudakis
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Ioannis Vouros
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
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Kwon YH, Song YW, Park JY, Cha JK, Thoma DS, Jung UW, Jung RE. Ridge preservation using a self-retaining block type bone substitute for extraction sockets with buccal dehiscence defects - A preclinical study. Clin Oral Implants Res 2024; 35:330-339. [PMID: 38126121 DOI: 10.1111/clr.14229] [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: 07/11/2023] [Revised: 11/30/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To evaluate the effect of a self-retaining block-type bone substitute (srBB) on the dimensional stability of the horizontal ridge width at the coronal level in a buccal dehiscence model. MATERIALS AND METHODS Four box-shaped bone defects with a buccal dehiscence were surgically prepared in the partially edentulous mandible (n = 6). Experimental biomaterials were randomly assigned to each site: (1) Control group: no treatment, (2) particle-type bone substitute (PBS) group, (3) collagenated soft block bone substitute (csBB) group, and (4) self-retaining synthetic block bone (srBB) group. In all grafted groups, a collagen membrane covered the biomaterials. At 16 weeks, clinical, histological, and radiographic analyses were performed. RESULTS Three of the six blocks in the srBB group became exposed and fell out during the first week after surgery. Therefore, the remaining three specimens were renamed RsrBB group. The RsrBB group showed an increase horizontal ridge compared to the pristine bone width at 2-4 mm below the CEJ, while the other groups showed resorption (augmented width at 2 mm below: 4.2, 42.4, 36.2, and 110.1% in the control, PBS, csBB, and RsrBB groups, respectively). The mineralized bone area was largest in the RsrBB group (4.74, 3.44, 5.67, and 7.77 mm2 in the control, PBS, csBB, and RsrBB groups, respectively.). CONCLUSIONS The srBB group demonstrated the highest volume stability at the coronal level. These findings would potentially suggest that self-retaining block bone substitute might be a good candidate for alveolar ridge preservation.
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Affiliation(s)
- Yoon-Hee Kwon
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
- Department of Periodontology, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Daniel S Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
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Mirdad A. Particulate bone grafting with a resorbable collagen membrane and horizontal alveolar ridge augmentation with tenting screws in dental implant placement: A case report. Clin Case Rep 2024; 12:e8359. [PMID: 38193035 PMCID: PMC10772354 DOI: 10.1002/ccr3.8359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
Key Clinical Message We used a mixture of particulate bone grafts (xenografts/allografts) with tenting screws to prevent membrane collapse and covered the graft with a resorbable collagen membrane to guide bone regeneration. This strategy can exclude the need for additional procedures, such as non-resorbable membranes and major block grafting surgeries. Although the initial outcomes are promising, continuous follow-up is required to examine the stability of the newly regenerated bone and the long-term success of the implant. Abstract This case demonstrates the use of particulate bone grafts covered with a resorbable collagen membrane and supported by tenting screws to correct horizontal alveolar ridge defects. A man in his 40s presented with missing maxillary anterior central and lateral incisors and required a fixed dental prosthesis. One year before, #12, #11, #21, and #22 had been extracted. The area showed horizontal and slight vertical bone loss. We used a mixture of particulate bone grafts (xenografts and allografts) with tenting screws to prevent membrane collapse and covered the graft with a resorbable collagen membrane to guide bone regeneration. After 6 months, complete bone regeneration was achieved, and the dental implants were submerged in the bone. After another 6 months, the patient was administered with a fixed dental prosthesis. This method can be used to correct horizontal alveolar ridge defects and achieve esthetic restoration without the need for more extensive procedures.
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Affiliation(s)
- Amani Mirdad
- Department of Periodontics and Community Dentistry, College of DentistryKing Saud UniversityRiyadhSaudi Arabia
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Araújo MG, Dias DR, Matarazzo F. Anatomical characteristics of the alveolar process and basal bone that have an effect on socket healing. Periodontol 2000 2023; 93:277-288. [PMID: 37533162 DOI: 10.1111/prd.12506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 08/04/2023]
Abstract
Following tooth extraction, a sequence of events takes place in order to close the wound and restore tissue homeostasis, a process called socket healing. The outcome of socket healing includes a marked reduction of the ridge dimensions. The amount of tissue loss that occurs during healing is influenced by several local and systemic factors. Thus, the aim of the present review was to describe the effect of anatomical characteristics of the alveolar process and basal bone on the socket healing outcome. The studies included showed that the quantity (number) and quality (composition) of socket walls exhibited a significant influence on the ridge diminution. A damaged socket (3 walls or less), as well as a thin buccal bone wall, which quickly resorbs negatively affected the healing outcome. Periodontally compromised sockets appeared to promote more extensive dimensional changes. Angulation between tooth and basal bone in addition to basal bone dimensions may also have altered the wound environment and influenced socket healing. The findings from the present review suggest that some anatomical characteristics of the alveolar process and basal bone have an effect on socket healing.
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Affiliation(s)
- Maurício G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Flavia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
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Mardas N, Macbeth N, Donos N, Jung RE, Zuercher AN. Is alveolar ridge preservation an overtreatment? Periodontol 2000 2023; 93:289-308. [PMID: 37622682 DOI: 10.1111/prd.12508] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/24/2023] [Accepted: 05/19/2023] [Indexed: 08/26/2023]
Abstract
The morphology and dimensions of the postextraction alveolar ridge are important for the surgical and restorative phases of implant treatment. Adequate new bone formation and preservation of alveolar ridge dimensions following extraction will facilitate installation of the implant in a restorative position, while preservation of soft tissue contour and volume is essential for an aesthetic and implant-supported restoration with healthy peri-implant tissues. Alveolar ridge preservation (ARP) refers to any procedure that aims to: (i) limit dimensional changes in the alveolar ridge after extraction facilitating implant placement without additional extensive bone and soft tissue augmentation procedures (ii) promote new bone formation in the healing alveolus, and (iii) promote soft tissue healing at the entrance of the alveolus and preserve the alveolar ridge contour. Although ARP is a clinically validated and safe approach, in certain clinical scenarios, the additional clinical benefit of ARP over unassisted socket healing has been debated and it appears that for some clinicians may represent an overtreatment. The aim of this critical review was to discuss the evidence pertaining to the four key objectives of ARP and to determine where ARP can lead to favorable outcomes when compared to unassisted socket healing.
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Affiliation(s)
- Nikos Mardas
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
| | - Neil Macbeth
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
- Defence Centre for Rehabilitative Dentistry, Defence Primary Health Care (DPHC), Dental Centre Aldershot, Guildford, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
| | - Ronald Ernst Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Anina Nives Zuercher
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Lee D, Koo KT, Seol YJ, Lee YM, Lee J. Comparison of osteogenesis and osseointegration following implant placement with simultaneous maxillary sinus augmentation using particulate and collagenated block types of deproteinized porcine bone mineral: a radiographic and histomorphometric analysis. Clin Oral Investig 2023; 27:5865-5874. [PMID: 37552320 DOI: 10.1007/s00784-023-05197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES This study aimed to compare osseointegration and osteogenesis after single-stage maxillary sinus augmentation with the lateral window using particulate deproteinized porcine bone mineral (PDPBM) and collagenated block deproteinized porcine bone mineral (BDPBM). MATERIALS AND METHODS Bi-maxillary premolars of six beagle dogs were extracted. Eight weeks later, an implant was placed into each augmented sinus with PDPBM or BDPBM according to a split-mouth design. Eight weeks later, all specimens were harvested. Each specimen was separated into the region of interest with the implant (ROI-I) and region of interest with sinus augmented area (ROI-S) 5 mm away from ROI-I. ROI-I and ROI-S were evaluated through micro-computed tomography and histomorphometry. RESULTS Bone substitute insertion took longer for the PDPBM group than for the BDPBM group (P = 0.002). In ROI-I, three-dimensional bone-to-implant contact (BIC) did not show statistically significant differences between the groups. Two-dimensional BIC also showed comparable values for both groups. In ROI-S, the graft material volume/tissue volume, trabecular bone pattern factor, and structural model index were higher in the BDPBM group than in the PDPBM group (P < 0.05). The proportions of new bone, graft material, and connective tissue were not significantly statistically different between groups. Less new bone was found in the apical area than in the coronal or middle areas in the BCPBM group (P < 0.05). CONCLUSIONS BDPBM may save time in inserting bone substitutes and provide comparable osteogenesis and osseointegration to PDPBM. CLINICAL RELEVANCE When performing sinus augmentation, BDPBM might improve operator's convenience with comparable biological results compared to PDPBM.
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Affiliation(s)
- Dongseob Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
- National Dental Care Center for Persons With Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Jungwon Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea.
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Couso-Queiruga E, Weber HA, Garaicoa-Pazmino C, Barwacz C, Kalleme M, Galindo-Moreno P, Avila-Ortiz G. Influence of healing time on the outcomes of alveolar ridge preservation using a collagenated bovine bone xenograft: A randomized clinical trial. J Clin Periodontol 2023; 50:132-146. [PMID: 36345818 PMCID: PMC10100450 DOI: 10.1111/jcpe.13744] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/26/2022] [Accepted: 11/04/2022] [Indexed: 11/10/2022]
Abstract
AIM To evaluate the healing outcomes in non-molar post-extraction sockets filled with deproteinized bovine bone mineral with collagen (DBBM-C) as a function of time. MATERIALS AND METHODS Patients in need of non-molar tooth extraction were randomly allocated into one of three groups according to the total healing time (A-3 months; B-6 months; C-9 months). The effect of alveolar ridge preservation (ARP) therapy via socket filling using DBBM-C and socket sealing with a porcine collagen matrix (CM) was assessed based on a panel of clinical, digital, histomorphometric, implant-related, and patient-reported outcomes. RESULTS A total of 42 patients completed the study (n = 14 in each group). Histomorphometric analysis of bone core biopsies obtained at the time of implant placement showed a continuous increase in the proportion of mineralized tissue with respect to non-mineralized tissue, and a decrease in the proportion of remaining xenograft material over time. All volumetric bone and soft tissue contour assessments revealed a dimensional reduction of the alveolar ridge overtime affecting mainly the facial aspect. Linear regression analyses indicated that baseline buccal bone thickness is a strong predictor of bone and soft tissue modelling. Ancillary bone augmentation at the time of implant placement was needed in 16.7% of the sites (A:2; B:1; C:4). Patient-reported discomfort and wound healing index scores progressively decreased over time and was similar across groups. CONCLUSIONS Healing time influences the proportion of tissue compartments in non-molar post-extraction sites filled with DBBM-C and sealed with a CM. A variable degree of alveolar ridge atrophy, affecting mainly the facial aspect, occurs even after performing ARP therapy. These changes are more pronounced in sites exhibiting thin facial bone (≤1 mm) at baseline (Clinicaltrials.gov NCT03659617).
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Affiliation(s)
- Emilio Couso-Queiruga
- Department of Oral Surgery and Stomatology, University of Bern School of Dental Medicine, Bern, Switzerland.,Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Holly A Weber
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Carlos Garaicoa-Pazmino
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA.,Investigation Center, School of Dentistry, Espiritu Santo University, Samborondón, Ecuador
| | - Christopher Barwacz
- Department of Family Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Marisa Kalleme
- Division of Biostatistics and Computational Biology, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA.,Private Practice, Atelier Dental Madrid, Madrid, Spain
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11
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Song YW, Bienz SP, Benic GI, Cha JK, Hämmerle CHF, Jung UW, Jung RE. Soft-tissue dimensional change following guided bone regeneration on peri-implant defects using soft-type block or particulate bone substitutes: 1-year outcomes of a randomized controlled clinical trial. J Clin Periodontol 2023; 50:147-157. [PMID: 36330670 DOI: 10.1111/jcpe.13738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/19/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
AIM To compare the peri-implant soft-tissue dimensional changes following guided bone regeneration between particulate (particle group) and collagenated soft-block-type (block group) biphasic calcium phosphate (BCP). MATERIALS AND METHODS This study investigated 35 subjects: 18 in the particle group and 17 in the block group. Cone-beam computed tomography obtained at 6 months post surgery and optical impressions taken periodically (before surgery, 6 months post surgery, and 1 year post surgery) were superimposed. The ridge contour changes over time and the peri-implant mucosal thicknesses were measured diagonally and horizontally, and analysed statistically. RESULTS The increases in diagonal (1.12 ± 0.78 mm) and horizontal (2.79 ± 1.90 mm) ridge contour of the block group were significantly higher than those in the particle group during the first 6 months (p < .05); however, the contour hardly changed thereafter (diagonal: 0.07 ± 0.75 mm; horizontal: -0.34 ± 1.26 mm), resulting in the 1-year contour changes similar between the two groups. Regardless of the type of BCP, the ridge contour increased significantly over 1 year when the dehiscence defect had a contained configuration (p < .05). CONCLUSIONS The increase in soft-tissue dimensions for 1 year was similar between the two groups. The mucosal contour increase was larger when the surgery was conducted in a more contained defect, and this was not influenced by the type of BCP.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Stefan P Bienz
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Goran I Benic
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland.,Institute for Research and Education in Dental Medicine, Lugano, Switzerland
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
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12
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Pinto N, Klein Y, David E, Polak D, Steinberg D, Mizrahi G, Khoury Y, Barenholz Y, Chaushu S. Resolvin D1 improves allograft osteointegration and directly enhances osteoblasts differentiation. Front Immunol 2023; 14:1086930. [PMID: 36923414 PMCID: PMC10008843 DOI: 10.3389/fimmu.2023.1086930] [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: 11/01/2022] [Accepted: 02/03/2023] [Indexed: 03/02/2023] Open
Abstract
Introduction Allografts are the most common bone grafts for repairing osseous defects. However, their use is associated with an increased risk for infections, donor disease transmission and osteointegration deficiency. Resolvin D1 (RvD1) is an endogenous lipid with a scientifically proven pivotal role in inflammation resolution and osteoclastogenesis inhibition. Yet, its biological relevance as a potential bone regenerative drug has been scarcely studied. Here, we aim to investigate the RvD1 effect on allograft osteointegration in the alveolar bone regeneration (ABR) murine model. Methods ABR model consisted of osseous defects that were generated by the extraction of the maxillary first molar in C57BL/6 mice. The sockets were filled with allograft and analyzed via RNA sequencing. Then they were locally injected with either RvD1 or saline via single or repeated administrations. The mice were sacrificed 2W after the procedure, and regenerated sites were analyzed using µCT and histology. First, MC3T3-E1 preosteoblasts were plated with IL-17 pro-inflammatory medium, and RANKL/OPG ratio was measured. Secondly, the MC3T3-E1 were cultured w/o RvD1, for 3W. Osteoblasts' markers were evaluated in different days, using qRT-PCR and Alizarin Red staining for calcified matrix. Results In vivo, neither allograft alone nor single RvD1 administration promote bone regeneration in comparison to the control of spontaneous healing and even triggered an elevation in NR1D1 and IL1RL1 expression, markers associated with inflammation and inhibition of bone cell differentiation. However, repeated RvD1 treatment increased bone content by 135.92% ± 45.98% compared to its specific control, repeated sham, and by 39.12% ± 26.3% when compared to the spontaneous healing control group (n=7/group). Histologically, repeated RvD1 reduced the number of TRAP-positive cells, and enhanced allograft osteointegration with new bone formation. In vitro, RvD1 rescued OPG expression and decreased RANKL/OPG ratio in IL-17 pro-inflammatory conditions. Furthermore, RvD1 increased the expression of RUNX2, OSX, BSP and OC/BGLAP2 and the mineralized extracellular matrix during MC3T3-E1 osteoblasts differentiation. Conclusions Repeated administrations of RvD1 promote bone regeneration via a dual mechanism: directly, via enhancement of osteoblasts' differentiation and indirectly, through reduction of osteoclastogenesis and RANKL/OPG ratio. This suggests that RvD1 may be a potential therapeutic bioagent for osseous regeneration following allograft implantation.
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Affiliation(s)
- Noy Pinto
- Institute of Dental Sciences, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Institute for Medical Research Israel-Canada, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yehuda Klein
- Institute of Dental Sciences, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Institute for Medical Research Israel-Canada, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Orthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eilon David
- Institute of Dental Sciences, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Institute for Medical Research Israel-Canada, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Polak
- Department of Periodontics, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniel Steinberg
- The Lautenberg Center for Immunology and Cancer Research, Department of Immunology and Cancer Research-Medical Research, Israel-Canada (IMRIC), Jerusalem, Israel.,Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gilad Mizrahi
- Institute of Dental Sciences, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Orthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yasmin Khoury
- Institute of Dental Sciences, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yechezkel Barenholz
- Institute for Medical Research Israel-Canada, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Stella Chaushu
- Department of Orthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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13
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Gallo P, Díaz‐Báez D, Perdomo S, Aloise AC, Tattan M, Saleh MHA, Pelegrine AA, Ravidà A, Wang H. Comparative analysis of two biomaterials mixed with autogenous bone graft for vertical ridge augmentation: A histomorphometric study in humans. Clin Implant Dent Relat Res 2022; 24:709-719. [PMID: 35916287 PMCID: PMC9804607 DOI: 10.1111/cid.13124] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The vertical increase of the alveolar ridge dimension using allograft or xenograft mixed with autogenous bone graft and covered by a nonabsorbable high-density polytetrafluoroethylene (d-PTFE) membrane is well documented in the literature. PURPOSE The aim of this study was to assess vital mineralized tissue formation in vertical ridge augmentation (VRA) procedures using autogenous bone chips mixed either with an allograft or a xenograft. METHODS This prospective clinical trial recruited 16 partially edentulous patients to undergo vertical ridge augmentation in one or more sites, making up a total of 24 samples for histological evaluation. Patients were sequentially stratified into Group A (treated with a freeze-dried bone allograft [FDBA] mixed with autogenous bone) or to Group B (treated with a bovine xenograft mixed with autogenous bone). Histological samples were analyzed according to the biomaterial used for VRA. Histological samples were obtained on the same day of membrane removal and implant placement. RESULTS Thirty-three implants were placed in 16 sites of regenerated bone via VRA, 13 patients with ridge augmentation in the posterior mandible, and 3 patients with VRA in the anterior maxilla. Group A (FDBA + autogenous) and Group B (xenograft + autogenous) showed a percent vital mineralized tissue (VMT) area of 67.64 ± 16.84 and 60.93 ± 18.25, respectively. A significant difference between the two biomaterials was not observed. CONCLUSION When mixed with autogenous bone, either allografts or xenografts may provide a successful augmentation. Either mixture could serve as reliable alternative in VRA for obtaining a high percentage of VMT.
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Affiliation(s)
- Pier Gallo
- Department of Implant Dentistry, Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo MandicCampinasBrazil
| | - David Díaz‐Báez
- Researcher of Oral Basic Research Unit ‐UIBO, School of DentistryEl Bosque UniversityBogotáColombia
| | - Sandra Perdomo
- Researcher of Oral Basic Research Unit ‐UIBO, School of DentistryEl Bosque UniversityBogotáColombia
| | - Antonio Carlos Aloise
- Department of Implant Dentistry, Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo MandicCampinasBrazil
| | - Mustafa Tattan
- Department of PeriodonticsCollege of Dentistry, University of IowaIowa CityIowaUSA
| | - Muhammad H. A. Saleh
- Department of Periodontics and Oral MedicineUniversity of Michigan, School of DentistryAnn ArborMichiganUSA
| | - André Antonio Pelegrine
- Department of Implant Dentistry, Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo MandicCampinasBrazil
| | - Andrea Ravidà
- Department of Periodontics and Oral MedicineUniversity of Michigan, School of DentistryAnn ArborMichiganUSA
| | - Hom‐Lay Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan, School of DentistryAnn ArborMichiganUSA
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14
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Araújo MG, Hürzeler MB, Dias DR, Matarazzo F. Minimal invasiveness in the alveolar ridge preservation, with or without concomitant implant placement. Periodontol 2000 2022; 91:65-88. [PMID: 35913046 DOI: 10.1111/prd.12441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/04/2022] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
The aim of this systematic review was to evaluate the benefit of ridge preservation (RP) with minimally invasive (MI) approaches with or without concomitant implant placement on morbidity, esthetics, and patient-related outcomes. Three Internet sources were used to search for appropriate papers. The search strategy was designed to include any clinical study published on RP with MI approaches such as flapless surgery, socket shield and socket sealing techniques and, use of biological agents. Characteristics of the individual studies, regarding methodological aspects, quantitative and qualitative data were extracted. The potential risk of bias was estimated, and the acquired evidence was graded. Independent screening of 860 reports resulted in 26 included original articles. Nine publications evaluated MI approaches for RP without concomitant implant placement. Eleven studies evaluated interventions for RP with immediate implant placement (IIP). Six studies compared RP with IIP vs RP without IIP. This systematic review found that MI approaches in most of the studies failed to improve clinical variables regarding morbidity, esthetics, and patient-related outcomes. Based on the limited number of studies analyzed and the methodological discrepancies observed, it is not possible to confirm that MI approaches promote a significant benefit when applied to RP procedures.
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Affiliation(s)
- Maurício G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Markus B Hürzeler
- Private Practice Hürzeler/Zuhr, Munich, Germany.,Department of Operative Dentistry and Periodontology, Albert Ludwigs University, Freiburg, Germany
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Flavia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
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15
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Jain G, Blaauw D, Chang S. A Comparative Study of Two Bone Graft Substitutes–InterOss® Collagen and OCS-B Collagen®. J Funct Biomater 2022; 13:jfb13010028. [PMID: 35323228 PMCID: PMC8951741 DOI: 10.3390/jfb13010028] [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: 02/17/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 02/05/2023] Open
Abstract
Bone is a complex hierarchical tissue composed of organic and inorganic materials that provide structure, support, and protection to organs. However, there are some critical size defects that are unable to regenerate on their own and therefore require clinical repair. Bone graft substitutes allow repair by providing a temporary resorbable device. Among the common filler materials that aid in regeneration is hydroxyapatite particles of either animal or human origin which is used to fill or reconstruct periodontal and bony defects in the mouth. However, particulate graft substitutes suffer from localized migration away from the implantation site, necessitating the use of a barrier membrane. In this study, we designed InterOss Collagen, combining bovine hydroxyapatite granules with porcine-skin derived collagen to form a bone filler composite. Physiochemical properties of InterOss Collagen and a commercially available product, OsteoConductive Substitute-Bovine(OCS-B) Collagen, referred to as OCS-B Collagen, were examined. We found two bone graft substitutes to be mostly similar, though InterOss Collagen showed comparatively higher surface area and porosity. We conducted an in vivo study in rabbits to evaluate local tissue responses, percent material resorption and bone formation and showed that the two materials exhibited similar degradation profiles, inflammatory and healing responses following implantation. Based on these results, InterOss Collagen is a promising dental bone grafting material for periodontal and maxillofacial surgeries.
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16
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Assessment of the Effects of Si Addition to a New TiMoZrTa System. MATERIALS 2021; 14:ma14247610. [PMID: 34947201 PMCID: PMC8706845 DOI: 10.3390/ma14247610] [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: 10/16/2021] [Revised: 11/21/2021] [Accepted: 12/08/2021] [Indexed: 12/31/2022]
Abstract
Ti-based alloys are widely used in medical applications. When implant devices are used to reconstruct disordered bone, prevent bone resorption and enhance good bone remodeling, the Young's modulus of implants should be close to that of the bone. To satisfy this requirement, many titanium alloys with different biocompatible elements (Zr, Ta, Mo, Si etc.) interact well with adjacent bone tissues, promoting an adequate osseointegration. Four new different alloys were obtained and investigated regarding their microstructure, mechanical, chemical and biological behavior (in vitro and in vivo evaluation), as follows: Ti20Mo7Zr15Ta, Ti20Mo7Zr15Ta0.5Si, Ti20Mo7Zr15Ta0.75Si and Ti20Mo7Zr15TaSi. 60 days after implantation, both in control and experimental rabbits, at the level of implantation gap and into the periimplant area were found the mesenchymal stem cells which differentiate into osteoblasts, then osteocytes and osteoclasts which are involved in the new bone synthesis and remodeling, the periimplant fibrous capsule being continued by newly spongy bone tissue, showing a good osseointegration of alloys. A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay confirmed the in vitro cytocompatibility of the prepared alloys.
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17
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Canullo L, Del Fabbro M, Khijmatgar S, Panda S, Ravidà A, Tommasato G, Sculean A, Pesce P. Dimensional and histomorphometric evaluation of biomaterials used for alveolar ridge preservation: a systematic review and network meta-analysis. Clin Oral Investig 2021; 26:141-158. [PMID: 34826029 DOI: 10.1007/s00784-021-04248-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/23/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES This systematic review and network meta-analysis aimed to answer to the following questions: (a) In patients undergoing alveolar ridge preservation after tooth extraction, which grafting material best attenuates horizontal and vertical ridge resorption, as compared to spontaneous healing?, and (b) which material(s) promotes bone formation in the extraction socket? MATERIALS AND METHODS The MEDLINE, SCOPUS, CENTRAL, and EMBASE databases were screened in duplicate for RCTs up to March 2021. Two independent authors extracted the data and assessed the risk of bias of the included studies. Primary outcomes were ridge horizontal and vertical dimension changes and new bone formation into the socket. Both pairwise and network meta-analysis (NMA) were undertaken to obtain estimates for primary outcomes and compare different grafting materials. RESULTS Eighty-eight RCTs were included, with a total of 2805 patients and 3073 sockets. Overall, a total of 1740 sockets underwent alveolar ridge preservation with different materials (1432 were covered by a membrane). Pairwise meta-analysis showed that, as compared to spontaneous healing, all materials statistically significantly reduced horizontal and vertical shrinkage. According to the multidimensional scale ranking of the NMA, xenografts (XG) and allografts (AG), alone or combined with bioactive agents (Bio + AG), were the most predictable materials for horizontal and vertical ridge dimension preservation, while platelet concentrates performed best in the percentage of new bone formation. CONCLUSIONS Alveolar ridge preservation is effective in reducing both horizontal and vertical shrinkage, as compared to untreated sockets. NMA confirmed the consistency of XG for ridge dimension preservation, but several other materials and combinations like AG, Bio + AG, and AG + alloplasts, produced even better results than XG in clinical comparisons. Further evidence is needed to confirm the value of such alternatives to XG for alveolar ridge preservation. Bio + AG performed better than the other materials in preserving ridge dimension and platelet concentrates in new bone formation. However, alloplasts, xenografts, and AG + AP performed consistently good in majority of the clinical comparisons. CLINICAL RELEVANCE XG and Bio + AG demonstrated significantly better performance in minimizing post-extraction horizontal and vertical ridge dimension changes as compared with other grafting materials or with spontaneous healing, even if they presented the worst histological outcomes. Allografts and other materials or combinations (AG + AP) presented similar performances while spontaneous healing ranked last.
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Affiliation(s)
- L Canullo
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - M Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - S Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - S Panda
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Department of Periodontics and Oral Implantology, Siksha 'O' Anusandhan University, Bhubaneswar, India
| | - A Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - G Tommasato
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - A Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - P Pesce
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
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18
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LED photobiomodulation therapy combined with biomaterial as a scaffold promotes better bone quality in the dental alveolus in an experimental extraction model. Lasers Med Sci 2021; 37:1583-1592. [PMID: 34767116 DOI: 10.1007/s10103-021-03407-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/20/2021] [Indexed: 10/19/2022]
Abstract
A bone scaffold added to the dental alveolus immediately after an extraction avoids bone atrophy and deformity at the tooth loss site, enabling rehabilitation with implants. Photobiomodulation accelerates bone healing by stimulating blood flow, activating osteoblasts, diminishing osteoclastic activity, and improving the integration of the biomaterial with the bone tissue. The aim of the present study was to evaluate the effect of photobiomodulation with LED at a wavelength of 850 nm on bone quality in Wistar rats submitted to molar extraction with and without a bone graft using hydroxyapatite biomaterial (Straumann® Cerabone®). Forty-eight rats were distributed among five groups (n = 12): basal (no interventions); control (extraction) (basal and control were the same animal, but at different sides); LED (extraction + LED λ = 850 nm); biomaterial (extraction + biomaterial), and biomaterial + LED (extraction + biomaterial + LED λ = 850 nm). Euthanasia occurred at 15 and 30 days after the induction of the extraction. The ALP analysis revealed an improvement in bone formation in the control and biomaterial + LED groups at 15 days (p = 0.0086 and p = 0.0379, Bonferroni). Moreover, the LED group had better bone formation compared to the other groups at 30 days (p = 0.0007, Bonferroni). In the analysis of AcP, all groups had less resorption compared to the basal group. Bone volume increased in the biomaterial, biomaterial + LED, and basal groups in comparison to the control group at 15 days (p < 0.05, t-test). At 30 days, the basal group had greater volume compared to the control and LED groups (p < 0.05, t-test). LED combined with the biomaterial improved bone formation in the histological analysis and diminished bone degeneration (demonstrated by the reduction in AcP), promoting an increase in bone density and volume. LED may be an important therapy to combine with biomaterials to promote bone formation, along with the other known benefits of this therapy, such as the control of pain and the inflammatory process.
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19
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Lee JB, Chu S, Ben Amara H, Song HY, Son MJ, Lee J, Kim HY, Koo KT, Rhyu IC. Effects of hyaluronic acid and deproteinized bovine bone mineral with 10% collagen for ridge preservation in compromised extraction sockets. J Periodontol 2021; 92:1564-1575. [PMID: 33484160 DOI: 10.1002/jper.20-0832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the efficacy of deproteinized bovine bone mineral with 10% collagen (DBBM-C) soaked with hyaluronic acid (HA) for ridge preservation in compromised extraction sockets. METHODS Bilateral third, fourth premolars and first molar were hemisected, distal roots were extracted, and then combined endodontic periodontal lesion was induced in the remaining mesial roots. After 4 months, the mesial roots were extracted and the following four treatments were randomly performed: Absorbable collagen sponge (ACS), ACS soaked with HA (ACS+HA), ridge preservation with DBBM-C covered with a collagen membrane (RP), ridge preservation with DBBM-C mixed with HA and covered with a collagen membrane (RP+HA). Animals were sacrificed at 1 and 3 months following treatment. Ridge dimensional changes and bone formation were examined using microcomputed tomography, histology, and histomorphometry. RESULTS At 1 month, ridge width was significantly higher in the RP and RP+HA groups than in the ACS and ACS+HA groups, while the highest proportion of mineralized bone was observed in ACS+HA group. At 3 months, ridge width remained significantly higher in the RP and RP+HA groups than in the ACS and ACS+HA groups. ACS+HA and RP+HA treatments featured the highest proportion of mineralized bone and bone volume density compared with the other groups. No statistical difference was observed between ACS+HA and RP+HA treatments. CONCLUSIONS Ridge preservation with the mixture DBBM-C/HA prevented dimensional shrinkage and improved bone formation in compromised extraction sockets at 1 and 3 months.
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Affiliation(s)
- Jun-Beom Lee
- Department of Periodontology and Dental research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Seoyoon Chu
- Department of Periodontology and Dental research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Heithem Ben Amara
- Department of Periodontology and Dental research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Hyun-Young Song
- Department of Periodontology and Dental research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Min-Jung Son
- Department of Periodontology and Dental research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jungwon Lee
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Hae-Young Kim
- Department of Health Policy and Management, College of Health Science & Department of Health Care Sciences, Graduate School & BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - In-Chul Rhyu
- Department of Periodontology and Dental research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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20
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Silva CGB, Sapata VM, Llanos AH, Romano MM, Jung RE, Hämmerle CHF, Cesar-Neto JB, Pannuti CM, Romito GA. Peri-implant tissue changes at sites treated with alveolar ridge preservation in the aesthetic zone: Twenty-two months follow-up of a randomized clinical trial. J Clin Periodontol 2021; 49:39-47. [PMID: 34708422 DOI: 10.1111/jcpe.13570] [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: 06/29/2021] [Revised: 09/30/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022]
Abstract
AIM To compare tissue changes at implant sites previously treated with two biomaterials for alveolar ridge preservation (ARP) in the aesthetic zone, 1 year after restoration. MATERIALS AND METHODS Sixty-six participants were treated with ARP using demineralized bovine bone mineral (DBBM) or DBBM +10% of collagen (DBBM-C), both covered with a collagen matrix (CM). Dental implants were placed, and definitive crowns were installed. Silicon impressions were taken before tooth extraction (T0), 2 weeks after crown insertion (T1) and 1 year after restoration (T2). Mid-facial mucosal level change (MLC), soft tissue thickness changes (TT), and marginal bone loss (MBL) were analysed using inter-group comparisons. RESULTS Fifty-four participants were included in the analysis. The mid-facial level change between T0-T1 and T1-T2 showed no statistical difference between DBBM and DBBM-C. Between T0 and T1 for soft tissue thickness, DBBM performed significantly better at 3 and 5 mm below the mucosal margin. From T1 to T2, no significant differences between groups were found at any level for soft tissue thickness and MBL. CONCLUSION At the aesthetic zone, advanced recession from tooth extraction to crown placement can be expected at sites treated with ARP regardless of biomaterial used. However, after crown insertion, tissue stability can be predicted.
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Affiliation(s)
| | - Vitor Marques Sapata
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Alexandre Hugo Llanos
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Multidisciplinary Clinic Division, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marcelo Munhoes Romano
- Multidisciplinary Clinic Division, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ronald Ernst Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | | | | | - Cláudio Mendes Pannuti
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
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21
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Beretta M, Maiorana C, Manfredini M, Signorino F, Poli PP, Vinci R. Marginal Bone Resorption Around Dental Implants Placed in Alveolar Socket Preserved Sites: A 5 Years Follow-up Study. J Maxillofac Oral Surg 2021; 20:381-388. [PMID: 34408364 DOI: 10.1007/s12663-020-01367-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 04/07/2020] [Indexed: 11/30/2022] Open
Abstract
Aim The present study evaluated the clinical and radiological stability of hard and soft tissues following alveolar socket preservation (ASP) procedure with a follow-up of 5 year from implant insertion. Materials and methods The initial sample consisted of seven patients who underwent single tooth extraction and ASP procedure by means of demineralized bovine bone mineral particles covered with a porcine-derived non-cross-linked collagen matrix (CM). Each patient received a submerged single implant in the healed site. Mesial and distal peri-implant marginal bone resorption (MBR) rates were assessed radiographically at 1 year (T 1) and 5 years (T 2) after implant placement (baseline value). Results and Statistics No dropouts occurred up to 5 years. At T 1, the MBR was 0.08 ± 0.16 mm at the mesial aspect and 0.1 ± 0.12 mm at the distal aspect. This difference was not statistically significant (P = 0.867). At T 2, the mesial MBR was 0.15 ± 0.17 mm and the distal MBR was 0.11 ± 0.14 mm, with a non-statistically significant difference (P = 0.532). Therefore, no statistically significant differences were detected comparing mesial and distal MBR at any time point. With respect to the intra-group comparisons, no differences were observed comparing the different study periods within each variable. Indeed, the comparison between T 0, T 1 and T 2 was non-statistically significant at both mesial (P = 0.06) and distal (P = 0.06) aspects. After 5 years, the volume of the soft tissues appeared clinically well maintained with a natural aspect around dental implants and adjacent teeth. Conclusion ASP using demineralized bovine bone mineral in combination with CM proved to be an effective technique to maintain stable dimensional volumes of both hard and soft tissues.
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Affiliation(s)
- Mario Beretta
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Mattia Manfredini
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Fabrizio Signorino
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Raffaele Vinci
- Department of Dentistry, Vita-Salute University, IRCCS San Raffaele Hospital, 20132 Milan, Italy
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22
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Roccuzzo M, Mirra D, Pittoni D, Ramieri G, Roccuzzo A. Reconstructive treatment of peri-implantitis infrabony defects of various configurations: 5-year survival and success. Clin Oral Implants Res 2021; 32:1209-1217. [PMID: 34352140 PMCID: PMC9290544 DOI: 10.1111/clr.13818] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/30/2021] [Accepted: 07/07/2021] [Indexed: 12/28/2022]
Abstract
Aim To present the 5 years outcomes of a reconstructive surgical protocol for peri‐implantitis defects with different morphologies, by means of deproteinized bovine bone mineral with 10% collagen (DBBMC). Material and Methods The original population of this case series consisted of 75 patients with one crater‐like defect and probing depth (PD) ≥6 mm. After flap elevation, defects were assigned to one characteristic class and treated by means of DBBMC. Following healing, patients were enrolled in an individualized supportive periodontal/peri‐implant (SPT) program. Results Fifty‐one patients reached the 5 years examination, as 11 patients were lost to follow‐up and 13 implants were removed. Overall treatment success was registered in 29 patients (45.3%). Mean PD and BOP significantly decreased at one year and remained stable for the rest of observation period. No correlation was found between implant survival rate and defect configuration (p = 0.213). Patients, who did not fully adhere to the SPT, experienced more complications and implant loss than those who regularly attended recall appointments (p = 0.009). Conclusions The proposed reconstructive treatment resulted in a high 5 years implant survival rate in patients who fully adhered to SPT. The resolution of the peri‐implantitis defect does not seem significantly associated with the defect configuration at the time of treatment.
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Affiliation(s)
- Mario Roccuzzo
- Private practice, Torino, Italy.,Department of Maxillo-facial Surgery, University of Torino, Torino, Italy.,Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Guglielmo Ramieri
- Department of Maxillo-facial Surgery, University of Torino, Torino, Italy
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillo-facial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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23
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Song YW, Jung HJ, An YZ, Jung UW, Lee JS. Addition of autogenous bone chips to deproteinized bovine bone mineral does not have additional benefit in lateral ridge augmentation-A preclinical in vivo experimental study. Clin Oral Implants Res 2021; 32:1105-1114. [PMID: 34219293 DOI: 10.1111/clr.13805] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare the outcome after extensive lateral guided bone regeneration using deproteinized bovine bone mineral (DBBM) with or without autogenous bone chips in a canine model of chronic horizontal alveolar ridge defect. MATERIALS AND METHODS The second, third and fourth lower premolars of both sides were extracted, and the buccal bone walls were completely removed in five beagle dogs. After 4 weeks, DBBM particles mixed with autogenous bone chips at a ratio of 1:1 were grafted at one side (DBBM/Auto group), while DBBM particles alone were grafted at the contralateral side (DBBM group). The graft materials on both sides were covered by a resorbable collagen membrane and fixation pins. Microcomputed tomographic volume and histomorphometric analyses were performed at 16 weeks post-surgery. RESULTS The ridges of both groups were recovered horizontally, but new bone formation beyond the original ridge contour at the defect site was not found. The DBBM group exhibited a larger total radiographic augmented volume and new bone volume compared with the DBBM/Auto group, but the differences were minimal (p > .05). Histologically, the regenerated area and new bone area were also slightly larger without any statistical significance in the DBBM group than in the DBBM/Auto group (p > .05). CONCLUSION The addition of autogenous bone chips to DBBM for lateral ridge augmentation may confer no advantage over grafting DBBM alone with respect to both space maintenance and de novo bone formation in dogs.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Hyun-Jun Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Yin-Zhe An
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
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24
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Atieh MA, Alsabeeha NH, Payne AG, Ali S, Faggion CMJ, Esposito M. Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development. Cochrane Database Syst Rev 2021; 4:CD010176. [PMID: 33899930 PMCID: PMC8092674 DOI: 10.1002/14651858.cd010176.pub3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Alveolar bone changes following tooth extraction can compromise prosthodontic rehabilitation. Alveolar ridge preservation (ARP) has been proposed to limit these changes and improve prosthodontic and aesthetic outcomes when implants are used. This is an update of the Cochrane Review first published in 2015. OBJECTIVES To assess the clinical effects of various materials and techniques for ARP after tooth extraction compared with extraction alone or other methods of ARP, or both, in patients requiring dental implant placement following healing of extraction sockets. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 19 March 2021), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2021, Issue 2), MEDLINE Ovid (1946 to 19 March 2021), Embase Ovid (1980 to 19 March 2021), Latin American and Caribbean Health Science Information database (1982 to 19 March 2021), Web of Science Conference Proceedings (1990 to 19 March 2021), Scopus (1966 to 19 March 2021), ProQuest Dissertations and Theses (1861 to 19 March 2021), and OpenGrey (to 19 March 2021). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. A number of journals were also handsearched. SELECTION CRITERIA We included all randomised controlled trials (RCTs) on the use of ARP techniques with at least six months of follow-up. Outcome measures were: changes in the bucco-lingual/palatal width of alveolar ridge, changes in the vertical height of the alveolar ridge, complications, the need for additional augmentation prior to implant placement, aesthetic outcomes, implant failure rates, peri-implant marginal bone level changes, changes in probing depths and clinical attachment levels at teeth adjacent to the extraction site, and complications of future prosthodontic rehabilitation. DATA COLLECTION AND ANALYSIS We selected trials, extracted data, and assessed risk of bias in duplicate. Corresponding authors were contacted to obtain missing information. We estimated mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes, with 95% confidence intervals (95% CI). We constructed 'Summary of findings' tables to present the main findings and assessed the certainty of the evidence using GRADE. MAIN RESULTS We included 16 RCTs conducted worldwide involving a total of 524 extraction sites in 426 adult participants. We assessed four trials as at overall high risk of bias and the remaining trials at unclear risk of bias. Nine new trials were included in this update with six new trials in the category of comparing ARP to extraction alone and three new trials in the category of comparing different grafting materials. ARP versus extraction: from the seven trials comparing xenografts with extraction alone, there is very low-certainty evidence of a reduction in loss of alveolar ridge width (MD -1.18 mm, 95% CI -1.82 to -0.54; P = 0.0003; 6 studies, 184 participants, 201 extraction sites), and height (MD -1.35 mm, 95% CI -2.00 to -0.70; P < 0.0001; 6 studies, 184 participants, 201 extraction sites) in favour of xenografts, but we found no evidence of a significant difference for the need for additional augmentation (RR 0.68, 95% CI 0.29 to 1.62; P = 0.39; 4 studies, 154 participants, 156 extraction sites; very low-certainty evidence) or in implant failure rate (RR 1.00, 95% CI 0.07 to 14.90; 2 studies, 70 participants/extraction sites; very low-certainty evidence). From the one trial comparing alloplasts versus extraction, there is very low-certainty evidence of a reduction in loss of alveolar ridge height (MD -3.73 mm; 95% CI -4.05 to -3.41; 1 study, 15 participants, 60 extraction sites) in favour of alloplasts. This single trial did not report any other outcomes. Different grafting materials for ARP: three trials (87 participants/extraction sites) compared allograft versus xenograft, two trials (37 participants, 55 extraction sites) compared alloplast versus xenograft, one trial (20 participants/extraction sites) compared alloplast with and without membrane, one trial (18 participants, 36 extraction sites) compared allograft with and without synthetic cell-binding peptide P-15, and one trial (30 participants/extraction sites) compared alloplast with different particle sizes. The evidence was of very low certainty for most comparisons and insufficient to determine whether there are clinically significant differences between different ARP techniques based on changes in alveolar ridge width and height, the need for additional augmentation prior to implant placement, or implant failure. We found no trials which evaluated parameters relating to clinical attachment levels, specific aesthetic or prosthodontic outcomes for any of the comparisons. No serious adverse events were reported with most trials indicating that the procedure was uneventful. Among the complications reported were delayed healing with partial exposure of the buccal plate at suture removal, postoperative pain and swelling, moderate glazing, redness and oedema, membrane exposure and partial loss of grafting material, and fibrous adhesions at the cervical part of previously preserved sockets, for the comparisons xenografts versus extraction, allografts versus xenografts, alloplasts versus xenografts, and alloplasts with and without membrane. AUTHORS' CONCLUSIONS ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction but the evidence is very uncertain. There is lack of evidence of any differences in the need for additional augmentation at the time of implant placement, implant failure, aesthetic outcomes, or any other clinical parameters due to lack of information or long-term data. There is no evidence of any clinically significant difference between different grafting materials and barriers used for ARP. Further long-term RCTs that follow CONSORT guidelines (www.consort-statement.org) are necessary.
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Affiliation(s)
- Momen A Atieh
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel Hm Alsabeeha
- RAK Dental Centre, Ministry of Health and Prevention, Ras Al-Khaimah, United Arab Emirates
| | - Alan Gt Payne
- Private practice, Northland Prosthodontics Ltd, c/o NorthShore Oral and Maxillofacial Surgeons, Auckland, New Zealand
| | - Sara Ali
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
| | | | - Marco Esposito
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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25
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Canellas JVDS, Drugos L, Ritto FG, Fischer RG, Medeiros PJD. Xenograft materials in maxillary sinus floor elevation surgery: a systematic review with network meta-analyses. Br J Oral Maxillofac Surg 2021; 59:742-751. [PMID: 34120778 DOI: 10.1016/j.bjoms.2021.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 02/16/2021] [Indexed: 12/12/2022]
Abstract
A systematic review and network meta-analysis was conducted to compare different commercially available xenograft materials used in maxillary sinus floor elevation surgery (MSFES). Embase, PubMed, the Cochrane Library, Web of Science, Scopus, LILACS, and grey literature were searched up to 13 July 2020. Only randomised controlled trials (RCTs) were included. A frequentist network meta-analysis using a random effects model compared different commercially available xenograft materials. The primary outcomes were the percentage of newly-formed bone and residual bone-substitute rate. Both were measured by histomorphometric analysis from bone biopsies obtained during preparation of the implant site. Of the 659 studies initially identified, 11 involving 242 MSFES were included in the quantitative analyses. A total of six bone-substitute materials were analysed (Bio-Oss® (Geistlich Pharma), InduCera® Dual Coat, Lumina-Bone Porous® (Critéria), Osseous® (SIN - Sistema de Implantes Nacional), THE Graft® (Purgo Biologics), and Osteoplant Osteoxenon® (Bioteck)). The P-score estimation showed that Osteoplant Osteoxenon® produced the most newly-formed bone and reabsorbed faster than other xenograft materials after six months. The combination of Bio-Oss® plus bone marrow aspirate concentrate (BMAC) significantly increased the percentage of newly-formed bone compared with Bio-Oss® alone. In contrast, the addition of Emdogain® (Straumann) and leucocyte and platelet-rich fibrin (L-PRF) to Bio-Oss® did not significantly improve the amount of regenerated bone. Study-level data indicated that the percentage of newly-formed bone differs among commercially available xenograft materials. Osteoplant Osteoxenon® seems to result in the highest amount of new bone in MSFES.
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Affiliation(s)
- J V D S Canellas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil.
| | - L Drugos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil
| | - F G Ritto
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil
| | - R G Fischer
- Department of Periodontology, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil
| | - P J D Medeiros
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil
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26
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Yosouf K, Heshmeh O, Darwich K. Alveolar Ridge Preservation Utilizing Composite (Bioceramics/Collagen) Graft: A Cone-Beam Computed Tomography Assessment in a Randomized Split-Mouth Controlled Trial. ACTA ACUST UNITED AC 2021. [DOI: 10.4236/jbise.2021.142007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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27
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Histological analysis of socket preservation using DBBM. A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:729-735. [DOI: 10.1016/j.jormas.2020.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/22/2020] [Indexed: 12/20/2022]
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28
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Mayer Y, Ginesin O, Zigdon-Giladi H. Socket Preservation Using Xenograft Does Not Impair Implant Primary Stability in Sheep: Clinical, Histological, and Histomorphometric Study. J ORAL IMPLANTOL 2020; 46:580-588. [PMID: 32315436 DOI: 10.1563/aaid-joi-d-19-00237] [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: 11/22/2022]
Abstract
Implant primary stability, which depends mainly on the amount and quality of bone, is important for implant survival. Socket preservation aims to reduce bone volumetric changes after tooth extraction. This animal study aims to examine whether preserving a ridge by using xenograft impairs the primary stability of the implant. Eighteen artificial bone defects were prepared in 4 sheep (5- and 8-mm length). Defects were randomly grafted with xenografts: Bio-Oss (BO), Bio-Active bone (BB), or left for natural healing (control). After 8 weeks, bone biopsy was harvested and dental implants installed. During installation, peak insertion torque (IT) was measured by hand ratchet, and primary stability by the Osstell method. Histomorphometric analysis showed a higher percentage of new bone formation in the naturally healed defects compared to sites with xenograft (control: 68.66 ± 4.5%, BB: 48.75 ± 4.34%, BO: 50.33 ± 4.0%). Connective tissue portion was higher in the BO and BB groups compared to control (44.25 ± 2.98%, 41 ± 6%, and 31.33 ± 4.5%, P < .05, respectively). Residual grafting material was similar in BO and BB (7 ± 2.44%, 8.66 ± 2.1%, respectively). Mean IT and implant stability quotient (ISQ) values were not statistically different among the groups. A positive correlation was found between IT and ISQ (r = 0.65, P = 0). In conclusion, previously grafted defects with xenograft did not influence primary stability and implant insertion torque in delayed implant placement. These results may be attributed to a relatively high bone fill of the defect (∼50%) 2 months after grafting.
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Affiliation(s)
- Yaniv Mayer
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
| | - Ofir Ginesin
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
| | - Hadar Zigdon-Giladi
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel.,Laboratory for Hard Tissue Regeneration, Clinical Research Institute at Rambam Health Care Campus, Haifa, Israel.,Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
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29
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Benetti F, Bueno CRE, Reis-Prado AHD, Souza MT, Goto J, Camargo JMPD, Duarte MAH, Dezan-Júnior E, Zanotto ED, Cintra LTA. Biocompatibility, Biomineralization, and Maturation of Collagen by RTR®, Bioglass and DM Bone® Materials. Braz Dent J 2020; 31:477-484. [PMID: 33146330 DOI: 10.1590/0103-6440202003660] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/25/2020] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the biocompatibility, biomineralization, and collagen fiber maturation induced by Resorbable Tissue Replacement (RTR®; β-tricalcium phosphate [TCP]), Bioglass (BIOG; bioactive glass), and DM Bone® (DMB; hydroxyapatite and β-TCP) in vivo. Sixty-four polyethylene tubes with or without (control group; CG) materials (n=8/group/period) were randomly implanted in the subcutaneous tissue of 16 male Wistar rats (four per rat), weighting 250 to 280 g. The rats were killed after 7 and 30 days (n=8), and the specimens were removed for analysis of inflammation using hematoxylin-eosin; biomineralization assay using von Kossa (VK) staining and polarized light (PL); and collagen fiber maturation using picrosirius red (PSR). Nonparametric data were statistically analyzed by Kruskal-Wallis and Dunn tests, and parametric data by one-way ANOVA test (p<0.05). At 7 days, all groups induced moderate inflammation (p>0.05). At 30 days, there was mild inflammation in the BIOG and CG, and moderate inflammation in the RTR and DMB groups, with a significant difference between the CG and RTR (p<0.05). The fibrous capsule was thick at 7 days and predominantly thin at 30 days in all groups. All materials exhibited structures that stained positively for VK and PL. Immature collagen fibers were predominant at 7 and 30 days in all groups (p>0.05), although DMB exhibited more mature fibers than BIOG at 30 days (p<0.05). RTR, BIOG, and DMB were biocompatible, inducing inflammation that reduced over time and biomineralization in the subcutaneous tissue of rats. DMB exhibited more mature collagen fibers than BIOG over a longer period.
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Affiliation(s)
- Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, UFMG - Universidade Federal de Minas Gerais, , Belo Horizonte, MG, Brazil.,Department of Endodontics, School of Dentistry, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | | | - Marina Trevelin Souza
- Department of Materials Engineering, Vitreous Materials Laboratory (LaMaV) UFSCar - Universidade Federal de São Carlos, SP, Brazil
| | - Juliana Goto
- Department of Endodontics, School of Dentistry, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | - Marco Antônio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, School of Dentistry, USP - Universidade de São Paulo, Bauru, SP, Brazil
| | - Elói Dezan-Júnior
- Department of Endodontics, School of Dentistry, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Edgar Dutra Zanotto
- Department of Materials Engineering, Vitreous Materials Laboratory (LaMaV) UFSCar - Universidade Federal de São Carlos, SP, Brazil
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30
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Song YW, Rafikov K, Paeng KW, Kim MJ, Cha JK, Thoma DS, Jung RE, Jung UW. Dimensional changes of the maxillary sinus augmented with a collagenated synthetic bone block or synthetic bone particulates: A pre-clinical study in rabbits. J Clin Periodontol 2020; 47:1416-1426. [PMID: 32888335 DOI: 10.1111/jcpe.13363] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/08/2020] [Accepted: 08/27/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To compare the efficacy of a collagenated synthetic bone substitute (C-SBS) to a particulated synthetic bone substitute (P-SBS) in volume maintenance and new bone formations in a rabbit sinus model. MATERIALS AND METHODS Either C-SBS or P-SBS was grafted in both sinuses of 16 rabbits. Four (N = 8) or 12 (N = 8) weeks after the surgery, total augmented volume (TAV) and area (TAA), as well as new bone volume (NBV) and area (NBA), were statistically compared by radiographic and histomorphometric analyses (p < .05). RESULTS The differences in TAV, NBV, TAA and NBA between C-SBS and P-SBS groups at 4 weeks were not statistically significant. The TAV (267.13 ± 62.08 vs. 200.18 ± 40.32 mm3 ) and NBV (103.26 ± 10.50 vs. 71.10 ± 7.58 mm3 ) in group C-SBS were significantly higher than in group P-SBS at 12 weeks (p < .05). The TAA (19.36 ± 2.88 vs. 14.48 ± 2.08 mm2 ) and NBA (5.43 ± 1.20 vs. 3.76 ± 0.78 mm2 ) in group C-SBS were significantly higher than in group P-SBS at 12 weeks (p < .05). CONCLUSIONS Collagenated synthetic bone substitute grafted in rabbit sinuses demonstrated more favourable outcomes across all outcome measures compared to P-SBS at 12 weeks.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Komoliddin Rafikov
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea.,Department of Oral Surgery and Dental Implantology, Tashkent State Dental Institute, Tashkent, Uzbekistan
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Myong Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Daniel S Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
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31
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Pignaton TB, Spin-Neto R, Ferreira CEDA, Martinelli CB, de Oliveira GJPL, Marcantonio E. Remodelling of sinus bone grafts according to the distance from the native bone: A histomorphometric analysis. Clin Oral Implants Res 2020; 31:959-967. [PMID: 32716570 DOI: 10.1111/clr.13639] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate graft remodelling according to the distance from the native bone in maxillary sinuses grafted with anorganic bovine bone (ABB). MATERIAL AND METHODS Bilateral sinus grafting was performed in twenty patients with residual bone height <5 mm before implant placement. After 8 months, biopsy samples were harvested, and histomorphometric analysis was performed to examine bone formation according to the distance (in mm) from the native bone (sinus floor). In the grafted area, the percentages of new bone (NB), residual graft material (rABB), and soft tissue (ST) were evaluated. RESULTS A total of 103 biopsy samples were evaluated, and the percentages of NB, rABB, and ST were 31.62 ± 9.85%, 18.94 ± 7.88%, and 49.41 ± 9.52%, respectively, in the 1st mm; 27.15 ± 9.83%, 23.33 ± 9.45%, and 49.53 ± 11.73%, respectively, in the 2nd mm; 23.61 ± 13.02%, 21.35 ± 11.08%, and 55.03 ± 16.14%, respectively, in the 3rd mm; and 21.67 ± 12.29%, 19.67 ± 10.28%, and 58.66 ± 12.46%, respectively, in the 4th mm. The 1st millimetre of the grafted area (closer to the native bone) presented a larger amount of NB than the other portions of the grafted areas and a smaller amount of rABB than the 2nd mm of the grafted area (p < .05). The amount of ST was larger in the 3rd and 4th mm of the grafted area than in the first 2 millimetres (p < .05). CONCLUSION The distance from the native bone influences bone formation following maxillary sinus augmentation.
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Affiliation(s)
- Tulio Bonna Pignaton
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP, Araraquara, Brazil
| | - Rubens Spin-Neto
- Section of Oral Radiology, School of Dentistry,, Aarhus University, Aarhus, Denmark
| | | | | | | | - Elcio Marcantonio
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP, Araraquara, Brazil
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Song YW, Yoon SW, Cha JK, Jung UW, Jung RE, Thoma DS. Soft Tissue Dimensions Following Tooth Extraction in the Posterior Maxilla: A Randomized Clinical Trial Comparing Alveolar Ridge Preservation to Spontaneous Healing. J Clin Med 2020; 9:jcm9082583. [PMID: 32784997 PMCID: PMC7464084 DOI: 10.3390/jcm9082583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 12/13/2022] Open
Abstract
Background: To assess the soft tissue dimension following tooth extraction and alveolar ridge preservation in the posterior maxilla compared to spontaneous healing. Methods: Thirty-five patients randomly assigned to alveolar ridge preservation (ARP) and spontaneous healing (SH) after maxillary molar extraction. The crestal, buccal, and palatal gingival thickness at 6 months was measured around virtually placed implant fixtures using superimposed cone-beam computed tomography and intraoral scan taken at 6 months. Buccal mucogingival junction (MGJ) level change over 6 months was estimated using intraoral scans obtained at suture-removal and 6 months. Results: The crestal gingiva was significantly thinner in group ARP (−1.16 mm) compared to group SH (p < 0.05). The buccal and palatal gingiva was significantly thinner at the implant shoulder (IS) level in group ARP (buccal: −0.75 mm; palatal: −0.85 mm) compared to group SH (p < 0.05). The thickness at 2 mm below the IS of both sides and the buccal MGJ level change were similar in both groups (p > 0.05). Conclusions: ARP in the posterior maxilla resulted in a thinner soft tissue on top of and at the prospective level of the implant shoulder at 6 months. The buccal MGJ level changed minimal for 6 months in both groups.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul 03722, Korea; (Y.W.S.); (S.-W.Y.); (J.-K.C.); (D.S.T.)
| | - Sung-Wook Yoon
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul 03722, Korea; (Y.W.S.); (S.-W.Y.); (J.-K.C.); (D.S.T.)
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul 03722, Korea; (Y.W.S.); (S.-W.Y.); (J.-K.C.); (D.S.T.)
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul 03722, Korea; (Y.W.S.); (S.-W.Y.); (J.-K.C.); (D.S.T.)
- Correspondence: ; Tel.: +82-2-2228318
| | - Ronald E. Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland;
| | - Daniel S. Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul 03722, Korea; (Y.W.S.); (S.-W.Y.); (J.-K.C.); (D.S.T.)
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland;
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Borges CD, Faria PEP, Pessôa de Oliveira PGF, Sales de Melo Soares M, Ricoldi MST, Costa MS, Novaes Júnior AB, Tambasco de Oliveira P, Taba Júnior M. Influence of collagen membrane on bone quality in titanium mesh reconstructions—Study in rats. J Periodontol 2020; 91:1673-1681. [DOI: 10.1002/jper.19-0399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 12/28/2019] [Accepted: 01/08/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Cristine D'Almeida Borges
- Department of Oral Surgery and Periodontology University of São Paulo – Ribeirão Preto School of Dentistry Ribeirão Preto SP Brazil
| | | | | | - Mariana Sales de Melo Soares
- Department of Oral Surgery and Periodontology University of São Paulo – Ribeirão Preto School of Dentistry Ribeirão Preto SP Brazil
| | - Milla Sprone Tavares Ricoldi
- Department of Oral Surgery and Periodontology University of São Paulo – Ribeirão Preto School of Dentistry Ribeirão Preto SP Brazil
| | - Monalisa Sena Costa
- Department of Dentistry University of Ribeirão Preto Ribeirão Preto SP Brazil
| | - Arthur Belém Novaes Júnior
- Department of Oral Surgery and Periodontology University of São Paulo – Ribeirão Preto School of Dentistry Ribeirão Preto SP Brazil
| | - Paulo Tambasco de Oliveira
- Department of Oral Surgery and Periodontology University of São Paulo – Ribeirão Preto School of Dentistry Ribeirão Preto SP Brazil
| | - Mário Taba Júnior
- Department of Oral Surgery and Periodontology University of São Paulo – Ribeirão Preto School of Dentistry Ribeirão Preto SP Brazil
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Papadopoulou AK, Papageorgiou SN, Hatzopoulos SA, Tsirlis A, Athanasiou AE. Alveolar ridge alterations in the maxillary anterior region after tooth extraction through orthodontic forced eruption for implant site development: a clinical CBCT study. Eur J Orthod 2020; 42:295-304. [PMID: 31081905 DOI: 10.1093/ejo/cjz028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To investigate the effects of orthodontic forced eruption (OFE) with the straight-wire appliance in the dimensions of the alveolar process when used for extracting compromised maxillary anterior teeth and implant site development. MATERIAL AND METHODS Cone-beam computed tomography (CBCT) scans of 7 patients needing extraction of 17 maxillary anterior teeth were obtained before and immediately after OFE. Alveolar plate height and thickness measurements were performed on the buccal and palatal socket walls in CBCT sagittal cross sections. Statistical analysis included sample size calculation, paired t-test, and Wilcoxon test to evaluate alveolar plate dimensional changes and linear regression analysis to assess whether bone changes and the feasibility of implant insertion were associated to tooth type and root length, baseline alveolar plate thickness, and age. RESULTS OFE caused statistically significant reduction of the buccal alveolar plate height (1.95 ± 1.83 mm) and significant increase of the palatal alveolar plate height (1.31 ± 2.41 mm) in the central tooth socket areas. Buccal reduction was associated positively to the baseline root length and negatively to the thickness of the corresponding plate in the apical level. A non-significant increase was noted in both buccal (0.23 ± 0.93 mm) and palatal (0.63 ± 1.59 mm) proximal bone. Inadequate buccal bone support hindered immediate implant placement in six sockets; however, all inserted implants showed adequate and gradually increasing stability from insertion to final restoration. CONCLUSIONS OFE resulted in favourable increase in the heights of the palatal and proximal alveolar bone and significant reduction in the buccal plate height, which inhibited implant placement in 35% of the treated sockets.
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Affiliation(s)
- Alexandra K Papadopoulou
- Discipline of Orthodontics, School of Dentistry, Faculty of Medicine and Health, University of Sydney and Sydney Dental Hospital, Sydney Local Health District, Australia
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Stavros A Hatzopoulos
- Department of Statistics and Operational Research, School of Mathematics, Aristotle University of Thessaloniki, Greece
| | - Anastasios Tsirlis
- Department of Oral Surgery, Implantology and Dental Radiology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Greece
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Schwarz F, John G, Becker J, Grötz KA, Sader R, Mihatovic I. Influence of ridge preservation procedures on extraction socket healing under antiresorptive therapy: An experimental study in rabbits. Clin Implant Dent Relat Res 2020; 22:477-485. [PMID: 32537909 DOI: 10.1111/cid.12916] [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: 03/02/2020] [Revised: 04/07/2020] [Accepted: 04/12/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND To assess the influence of ridge preservation procedures on the healing of extraction sockets under antiresorptive therapy. MATERIAL AND METHODS A total of 10 Dutch Belted rabbits were randomly allocated to either the intravenous administration of amino-bisphosphonate (zoledronic acid) (Za) (n = 5) or a negative control group (no Za [nZa]) (n = 5). At 6 months, the mandibular and maxillary molars were extracted and the four experimental sites randomly allocated to the following subgroups: (a) socket grafting using a collagen-coated natural bone mineral (BOC) + primary wound closure, (b) coronectomy (CO), or (c) spontaneous healing + primary wound closure (SP). Za medication was continued for another 4 months. Histomorphometrical analyses considered, for example, crestal hard tissue closure of the extraction site (C) and mineralized tissue (MT) formation. RESULTS Za-SP was associated with an incomplete median C (31.76% vs 100% in nZa-SP) and signs of bone arrosion along the confines of the socket. BOC had no major effects on increases in C and MT values in the Za group. CO commonly resulted in an encapsulation and partial replacement resorption of residual roots by MT without any histological signs of osteonecrosis. CONCLUSIONS (a) Za-SP was commonly associated with a compromised socket healing and signs of osteonecrosis, (b) BOC had no major effect on socket healing in the Za group, and (c) CO at noninfected teeth might be a feasible measure for the prevention of a Za-related osteonecrosis of the jaw.
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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
| | - Gordon John
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Jürgen Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Knut Achim Grötz
- Department of Oral and Maxillofacial Surgery, Dr. Horst Schmidt Clinic, Wiesbaden, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ilja Mihatovic
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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Kim MJ, Cha JK, Paeng KW, Song YW, Thoma DS, Jung RE, Jung UW. Immediate versus delayed application of bone morphogenetic protein-2 solution in damaged extraction sockets: a preclinical in vivo investigation. Clin Oral Investig 2020; 25:275-282. [PMID: 32451759 DOI: 10.1007/s00784-020-03362-w] [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: 03/17/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To compare the clinical, radiographic, and histological healing patterns between the immediate and delayed applications of bone morphogenetic protein-2 (BMP-2) in damaged extraction sockets in dogs. MATERIALS AND METHODS The distal roots of the fourth premolars of the mandible were extracted bilaterally in five beagle dogs, and buccal bone defects (4 mm wide and 9 mm high) were surgically created. Collagenated biphasic calcium phosphate (CBCP) soaked for 10 min in 100 μL of BMP-2 solution was applied immediately to the defect site in the control group. In the test group, the BMP-2 solution of same dose was injected into the grafted site 2 weeks after grafting with a saline-soaked CBCP. The dogs were sacrificed 2 weeks later. Clinical, histological, and radiographic analyses were followed. RESULTS Swelling and inflammatory reactions were predominantly observed in the control group at 2 weeks. The area of new bone formation was significantly larger in the control group compared with the test group (10.8 ± 7.0 mm2 [mean ± SD] and 6.3 ± 3.1 mm2, respectively; p = 0.043). No significant difference was found in ridge width at 2 mm, 4 mm and 6 mm below the lingual bone crest between the control (2.6 ± 1.0 mm, 3.2 ± 0.9 mm and 4.5 ± 0.5 mm, respectively) and test group (3.3 ± 1.0 mm, 3.7 ± 1.3 mm and 4.2 ± 1.0 mm; all p > 0.05). CONCLUSIONS Delayed application of BMP-2 2 weeks after surgery did not show any advantage over immediate application of BMP-2 in terms of new bone formation. CLINICAL RELEVANCE This study suggests that it might be better to apply BMP-2 immediately in alveolar ridge preservation, instead of delayed application, in order to enhance new bone formation.
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Affiliation(s)
- Myong Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Daniel S Thoma
- Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Paik JW, Cha JK, Paeng KW, Kim MJ, Thoma DS, Jung RE, Jung UW. Volume stability of the augmented sinus using a collagenated bovine bone mineral grafted in case of a perforated Schneiderian membrane: An experimental study in rabbits. J Clin Periodontol 2020; 47:649-656. [PMID: 32092169 DOI: 10.1111/jcpe.13273] [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: 08/01/2019] [Revised: 12/16/2019] [Accepted: 02/21/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To determine the volume stability of a sinus augmented with a collagenated bovine bone mineral (CBBM) in case of an intact or perforated Schneiderian membrane (SM). MATERIALS AND METHODS A bilateral sinus augmentation procedure was performed in eight rabbits. The SM was intentionally perforated in one side (SMP group), while it remained intact in contra-lateral side (control group) and the same amount of CBBM was then grafted. At 12 weeks, the animals were euthanized for radiographic and histomorphometric analyses. RESULTS The augmented volume did not differ significantly between the two groups: 262.2 ± 32.1 mm3 in SMP group and 261.9 ± 48.5 mm3 in the control group (p = .959). There was no significant difference in the total augmented area: 24.7 ± 5.2 mm2 in SMP group and 23.2 ± 2.9 mm2 in the control group (p = .773). The areas of newly formed bone also did not differ significantly between the two groups, but was significantly lower at the centre of the augmented region than in the region of the surgical window in both groups (p < .05). CONCLUSION A perforation of the SM in a rabbit model does neither impact the augmented volume nor new bone formation following grafting of the sinus with a CBBM.
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Affiliation(s)
- Jeong-Won Paik
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Myong-Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Ridge Alterations following Socket Preservation Using a Collagen Membrane in Dogs. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1487681. [PMID: 32190649 PMCID: PMC7073485 DOI: 10.1155/2020/1487681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 11/17/2022]
Abstract
Background The healing process following tooth extraction results in alveolar ridge resorption. The dimensional changes may complicate the subsequent implant procedure. Socket preservation using absorbable collagen membranes or a combination of membranes with calcium phosphate cement (CPC) particles might ensure that the alveolar ridge retains a suitable morphology for implant placement. Objective To evaluate the quality and quantity of new bone regenerated after application of either collagen membranes alone covering the sockets or a combination of membranes with CPC particles added into the sockets in dogs. Materials and Methods. Six dogs were included in this study. The mandibular premolars were extracted. For each hemimandible, three premolar extraction sites were randomly assigned to one of the following treatments: a covering collagen membrane, CPC with a covering collagen membrane, and a socket left empty. Cone-beam computed tomography (CBCT) measurements, polyfluorochrome sequential labeling, and histological assessments were performed to investigate the healing ability and repair processes within a 6-month observation period. Results Buccal bone height in the membrane group was significantly higher than that in the membrane+CPC and blank groups at 4 and 6 months after extraction. The mineral apposition rate over 2-4 months and the alizarin red-stained area in the membrane group were significantly higher than those in the other two groups. Histological analysis after 6 months of healing showed significantly higher amounts of newly formed bone in the membrane group than in the other groups. Conclusion Extraction sites treated with collagen barrier membranes showed better protection than sites not covered with membranes. And the buccal bone wall of the socket was well preserved by collagen membrane without extra CPC materials. Socket preservation using absorbable membranes alone yielded better quality and quantity of regenerated bone inside the socket site.
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Zhou Y, Gao J, Sheng M, Qi W, Jin J, He F. Facial alveolar bone alterations and gray value changes based on cone beam computed tomography around maxillary anterior implants: A clinical retrospective study of 1-3 years. Clin Oral Implants Res 2020; 31:476-487. [PMID: 31990412 DOI: 10.1111/clr.13583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 11/14/2019] [Accepted: 01/08/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The purpose of this cone beam computed tomography (CBCT) study was to describe facial alveolar bone alterations and gray value (GV) changes around implants in aesthetic anterior maxilla with simultaneous guided bone regeneration (GBR) and to investigate potential influence of factors related to vertical alveolar bone stability, such as particle sizes of the deproteinized bovine bone mineral (DBBM) used. MATERIALS AND METHODS A retrospective study design was adopted. Four facio-palatal cross-sectional CBCT images of 166 implants from 124 patients who had maxillary anterior implants were obtained. Measurements of the vertical facial alveolar bone level (VFBL), horizontal facial alveolar bone thickness (HFBT), and GV were identified of 1-3 years. Then, correlation coefficients for those parameters were calculated. Finally, linear mixed models were established to investigate potential factors influencing vertical alveolar bone resorption. RESULTS Facial alveolar bone underwent fast bone modeling and remodeling during the first 6 months, with decreases of 1.00 ± 1.19 and 0.74 ± 0.86 mm in VFBL and HFBT in implant shoulder, respectively, and there was positive and significant correlation between the alterations in VFBL and HFBT1 (rs = .516, p = .000). Linear mixed models identified particle size of DBBM as a critical factor associated with vertical bone resorption (p = .000). The GV gradually increased during the follow-up period. CONCLUSIONS Rapid and unavoidable peri-implant bone resorption usually happened during the first 6 months after implant placement. GBR is a predictable treatment for maxillary anterior implants, since GV has an increasing trend. Large bone particles of DBBM help maintain vertical alveolar bone stability.
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Affiliation(s)
- Yi Zhou
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Jiayu Gao
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Min Sheng
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Wenting Qi
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Jiali Jin
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Fuming He
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
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Impact of Hyperbaric Oxygen on the Healing of Teeth Extraction Sockets and Alveolar Ridge Preservation. Clin Oral Investig 2019; 24:2591-2601. [PMID: 31797170 DOI: 10.1007/s00784-019-03117-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the role of hyperbaric oxygen (HBO) in the healing of teeth extraction sockets and in alveolar ridge preservation. This may provide an experimental basis for the widespread application of HBO in oral implantation. METHODS A total of 32 beagle dogs were included in the study and randomly divided equally between an HBO group treated with hyperbaric oxygen (100% O2, 2.4 atm, 90 min/day, 5 times/week, 6 weeks) and a normobaric oxygen (NBO) group treated with normal air in the same chamber. The lateral incisors of the maxillary and mandible of each dog were extracted, and the right upper and lower incisor extraction sockets (A2C2) were allowed to heal naturally, while left upper and lower incisor sockets (B2D2) received implants of a commercial bone substitute. At 4 and 8 weeks after surgery, clinical observation, cone-beam computerized tomography (CBCT), histomorphology observation, and expression levels of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2) were analyzed to evaluate new bone formation, mineralization, and reconstruction. RESULTS After 4 and 8 weeks, bone width and lip contour of the extraction socket in the NBO group were significantly reduced and collapsed in comparison with the HBO group. CBCT showed that the difference in vertical height between the alveolar crest of the labial tongue and palatal side of the extraction sockets was smaller in the HBO than NBO group. There was a significant difference in new bone formation (P < 0.05) and bone mineral density (P < 0.05) between the HBO and NBO groups, and the HBO group showed significantly greater new bone and bone reconstruction based on histology. Furthermore, the expression levels of VEGF and BMP-2 were higher in the HBO group. CONCLUSION HBO reduced bone resorption and promoted early bone formation, bone mineralization, and reconstruction in the extraction sockets. HBO greatly reduced the healing time of the extraction sockets and promoted alveolar ridge preservation, thus showing promise for the clinic.
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Lin HK, Pan YH, Salamanca E, Lin YT, Chang WJ. Prevention of Bone Resorption by HA/β-TCP + Collagen Composite after Tooth Extraction: A Case Series. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4616. [PMID: 31766327 PMCID: PMC6926561 DOI: 10.3390/ijerph16234616] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/08/2019] [Accepted: 11/17/2019] [Indexed: 01/27/2023]
Abstract
After tooth extraction, alveolar ridge loss due to resorption is almost inevitable. Most of this bone loss occurs during the first six months after the extraction procedure. Many studies have indicated that applying socket-filling biomaterials after extraction can effectively reduce the resorption rate of the alveolar ridge. The purpose of this study was to investigate the clinical efficacy of the application of a hydroxyapatite/β-tricalcium plus collagen (HA/β-TCP + collagen) dental bone graft in dental sockets immediately after tooth extraction, so as to prevent socket resorption. The study was conducted on 57 extraction sockets located in the mandible and maxilla posterior regions in 51 patients. HA/β-TCP + collagen was inserted into all of the dental sockets immediately after extraction, and was covered with a flap. Follow-up was performed for three months after extraction, using radiographs and stents for the vertical and horizontal alveolar ridge measurements. A minimal alveolar bone width reduction of 1.03 ± 2.43 mm (p < 0.05) was observed. The height reduction showed a slight decrease to 0.62 ± 1.46 mm (p < 0.05). Radiographically, the bone height was maintained after three months, indicating a good HA/β-TCP + collagen graft performance in preserving alveolar bone. In conclusion, the HA/β-TCP + collagen graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction.
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Affiliation(s)
- Hsi Kuei Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110 Taiwan; (H.K.L.); (Y.H.P.); (E.S.)
- Dental Department, Taipei Medical University, Shuang-Ho hospital, Taipei 235, Taiwan
| | - Yu Hwa Pan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110 Taiwan; (H.K.L.); (Y.H.P.); (E.S.)
- Department of General Dentistry, Chang Gung Memorial Hospital, Taipei 105, Taiwan
- Graduate Institute of Dental & Craniofacial Science, Chang Gung University, Taoyuan 333, Taiwan
| | - Eisner Salamanca
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110 Taiwan; (H.K.L.); (Y.H.P.); (E.S.)
| | - Yu Te Lin
- Sunmax Biotech Co. Ltd., Tainan 744, Taiwan;
| | - Wei Jen Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110 Taiwan; (H.K.L.); (Y.H.P.); (E.S.)
- Dental Department, Taipei Medical University, Shuang-Ho hospital, Taipei 235, Taiwan
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Munerato MS, Biguetti CC, Parra da Silva RB, Rodrigues da Silva AC, Zucon Bacelar AC, Lima da Silva J, Rondina Couto MC, Húngaro Duarte MA, Santiago-Junior JF, Bossini PS, Matsumoto MA. Inflammatory response and macrophage polarization using different physicochemical biomaterials for oral and maxillofacial reconstruction. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 107:110229. [PMID: 31761241 DOI: 10.1016/j.msec.2019.110229] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/19/2019] [Accepted: 09/18/2019] [Indexed: 12/11/2022]
Abstract
Knowledge about the action of immune system in the recognition of biomaterials has been extremely helpful when it comes about understanding host response and biomaterials' fate in human body. This study aimed to investigate inflammatory response and macrophage polarization during bone healing process of rat's calvaria critical defects using different bone materials in order to evaluate their influence on bone repair and on the quality of the newly formed bone tissue. Eighty male albinus Wistar rats underwent surgical procedure for the confectioning of a 5-mm diameter bone defect in their right parietal bone, and divided in four groups (n = 20 each), according the biomaterial: AG - Control, particulate intramembranous autogenous bone graft, HA/TCP - particulate biphasic calcium phosphate with HA/TCP (60/40), DBB - particulate deproteinized bovine bone, VC - particulate bioactive vitroceramic. After 3, 7, 21, and 45 days, the specimens were removed and prepared for microcomputed tomography (microCT), light and polarized microscopy, immunohistochemical analysis, and histomorphometry. No significant differences were detected considering percentage of leukocytes among the groups and periods, as well as in relation to immunolabeling for inflammatory (M1) and reparative (M2) macrophages. However, immunolabeling for bone marker indicated a delayed osteoblast differentiation in VC group, resulting in a decrease in mineralized bone matrix parameters in this group, revealed by microCT. In addition, AG and HA/TCP presented a satisfactory bone collagenous content. Despite the distinct origins and physicochemical properties of the tested biomaterials, they presented similar immune-inflammatory responses in the present experimental model, influencing bone-related proteins and bone quality, which must be considered according to their use.
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Affiliation(s)
- Marcelo Salles Munerato
- Department of Health Sciences, Sagrado Coração University - USC, Rua Irmã Arminda 10-50, 17011-160, Bauru, SP, Brazil
| | - Claudia Cristina Biguetti
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Rua José Bonifácio 1193, 16015-050, Araçatuba, SP, Brazil
| | - Raquel Barroso Parra da Silva
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Rua José Bonifácio 1193, 16015-050, Araçatuba, SP, Brazil
| | - Ana Claudia Rodrigues da Silva
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Rua José Bonifácio 1193, 16015-050, Araçatuba, SP, Brazil
| | - Ana Carolina Zucon Bacelar
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Rua José Bonifácio 1193, 16015-050, Araçatuba, SP, Brazil
| | - Jordan Lima da Silva
- Department of Health Sciences, Sagrado Coração University - USC, Rua Irmã Arminda 10-50, 17011-160, Bauru, SP, Brazil
| | - Maira Cristina Rondina Couto
- Department of Health Sciences, Sagrado Coração University - USC, Rua Irmã Arminda 10-50, 17011-160, Bauru, SP, Brazil
| | - Marco Antônio Húngaro Duarte
- Department of Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo - FOB/USP, Al. Octávio Pinheiro Brisola, 9-75, 17012-901, Bauru, SP, Brazil
| | - Joel Ferreira Santiago-Junior
- Department of Health Sciences, Sagrado Coração University - USC, Rua Irmã Arminda 10-50, 17011-160, Bauru, SP, Brazil
| | - Paulo Sérgio Bossini
- Research and Education Center for Phototherapy in Health Science (Nupen), Rua Pedro Fernandes Alonso, 766, Jardim Alvorada, 13562-380, São Carlos, SP, Brazil
| | - Mariza Akemi Matsumoto
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Rua José Bonifácio 1193, 16015-050, Araçatuba, SP, Brazil.
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KOZUMA W, KON K, KAWAKAMI S, BOBOTHIKE A, IIJIMA H, SHIOTA M, KASUGAI S. Osteoconductive potential of a hydroxyapatite fiber material with magnesium: In vitro and in vivo studies. Dent Mater J 2019; 38:771-778. [DOI: 10.4012/dmj.2018-333] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Wataru KOZUMA
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University
| | - Kazuhiro KON
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University
| | - Sawako KAWAKAMI
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University
| | - Aung BOBOTHIKE
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University
| | - Hajime IIJIMA
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University
| | - Makoto SHIOTA
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University
| | - Shohei KASUGAI
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University
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Moest T, Schlegel KA, Kesting M, Fenner M, Lutz R, Beck DM, Nkenke E, von Wilmowsky C. A new standardized critical size bone defect model in the pig forehead for comparative testing of bone regeneration materials. Clin Oral Investig 2019; 24:1651-1661. [PMID: 31414271 DOI: 10.1007/s00784-019-03020-w] [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: 01/10/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The preclinical study aimed to establish a standardized preclinical model to investigate osseous graft consolidation in defect configurations of limited regenerative capacity. MATERIAL AND METHODS Critical size defects (CSD) were prepared and titanium tubes inserted for defect separation from local bone in the forehead area of 18 pigs. Defects were filled with demineralized bovine bone mineral (DBBM) or served as empty controls and were covered with a resorbable collagen membrane (CM) or left untreated. Six randomly selected pigs were sacrificed after 4, 8 and 12 weeks. Specimens were histologically and histomorphometrically analysed focusing on newly formed bone (NFB), demineralized bovine bone mineral (DBBM) and soft tissue (ST) proportions. RESULTS Four weeks after defect preparation, no statistically significant difference concerning NFB quantity could be detected within the groups. Defects covered with the CM showed lower amounts of DBBM. After 6 and 12 weeks, defects augmented with DBBM in combination with a CM (8 weeks: 43.12 ± 4.31; 12 weeks: 43.05 ± 3.01) showed a statistically significant higher NFB rate compared to empty control defects covered with 8 weeks: 7.66 ± 0.59; 12 weeks or without a CM; 8 weeks: 8.62 ± 2.66; 12 weeks: 18.40 ± 2.40. CM application showed no significant impact on osseous defect regeneration or soft tissue formation. Superior NFB could be detected for basal aspect for several evaluation time points. CONCLUSIONS The modification of CSD with titanium tubes represents a suitable model to imitate a one-wall defect regeneration situation. CLINICAL RELEVANCE The established model represents a promising method to evaluate graft consolidation in one-wall defect configuration.
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Affiliation(s)
- Tobias Moest
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany.
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Matthias Fenner
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Daniele Machado Beck
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Emeka Nkenke
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria
| | - Cornelius von Wilmowsky
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
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Tabrizi R, Mohajerani H, Ardalani B, Khiabani K. Does preservation of the socket decrease marginal bone loss in the mandible after extraction of first molars? Br J Oral Maxillofac Surg 2019; 57:886-890. [PMID: 31402193 DOI: 10.1016/j.bjoms.2019.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 07/23/2019] [Indexed: 12/16/2022]
Abstract
The quality of the bone plays an important part in marginal bone loss (MBL) around dental implants. The aim of this study was to compare MBL around implants the sockets of which had been preserved with the bone around healed sites in the mandible after extraction of first molars. It was a prospective, cohort study in which subjects were divided into three groups (n=30 in each): dental implants were placed six months after preservation of the socket in the first group, eight weeks after tooth extraction in the second, and six months after tooth extraction in the third. The changes between the marginal bone level after loading of the implant and 12, 24, and 36 months later were considered to be the MBL. Age and sex were the variables studied, the condition of the bone (healed socket or preservation) was a predictive factor, and MBL was the outcome. Analysis of variance was used to compare MBL and age among groups. There were no differences in the mean MBL among the three groups 12, 24, and 36 months after loading (p=0.55, p=0.22, p=0.38, respectively). Preservation of the socket did not seem to affect MBL of the first molar of the mandible.
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Affiliation(s)
- R Tabrizi
- Dental School, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | - H Mohajerani
- Dental School, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - B Ardalani
- Dental School, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - K Khiabani
- Dental school, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Iorio-Siciliano V, Ramaglia L, Blasi A, Bucci P, Nuzzolo P, Riccitiello F, Nicolò M. Dimensional changes following alveolar ridge preservation in the posterior area using bovine-derived xenografts and collagen membrane compared to spontaneous healing: a 6-month randomized controlled clinical trial. Clin Oral Investig 2019; 24:1013-1023. [PMID: 31286260 DOI: 10.1007/s00784-019-02979-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/20/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess dimensional changes following alveolar ridge preservation using bovine-derived xenograft with 10% collagen and collagen membrane compared to ridge preservation by means of bovine-derived xenograft particles and collagen membrane or spontaneous healing in posterior sites. MATERIALS AND METHODS Forty subjects with 40 posterior teeth or roots candidate to extraction and presenting integrity of alveolar bone walls were randomly allocated into three groups. Patients of test group were treated by ridge preservation technique using bovine-derived xenograft with 10% collagen and collagen membrane; patients of control group 1 were treated by means of bovine-derived xenograft particles and collagen membrane while in patients of control group 2, no grafting was performed. Changes in vertical and horizontal bone dimensions were compared at baseline and after 6-month observation time. RESULTS Statistically significant differences between baseline and 6 month were observed in all groups in terms of vertical and horizontal bone resorption (p < 0.001), except for vertical resorption in control group 2. After 6-month intergroup comparisons showed not statistically significant changes between test and control groups in terms of alveolar bone changes (p > 0.05). CONCLUSIONS Within the limits of this study, the sites grafted using bovine-derived xenograft with 10% collagen in combination with a collagen membrane showed no statistical differences in terms of vertical and horizontal bone resorption compared to control groups. CLINICAL RELEVANCE Ridge preservation in posterior area failed to show clinically relevant benefits in sites presenting integrity of alveolar bone walls and adequate buccal bone wall thickness.
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Affiliation(s)
| | - Luca Ramaglia
- Department of Oral Surgery, University of Naples Federico II, Naples, Italy. .,Università di Napoli Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Andrea Blasi
- Department of Periodontology, University of Naples Federico II, Naples, Italy
| | - Paolo Bucci
- Department of Oral Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Nuzzolo
- Department of Oral Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Riccitiello
- Department of Restorative Dentistry, University of Naples Federico II, Naples, Italy
| | - Michele Nicolò
- Department of Periodontology, University of Naples Federico II, Naples, Italy
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de Sousa Gomes P, Daugela P, Poskevicius L, Mariano L, Fernandes MH. Molecular and Cellular Aspects of Socket Healing in the Absence and Presence of Graft Materials and Autologous Platelet Concentrates: a Focused Review. J Oral Maxillofac Res 2019; 10:e2. [PMID: 31620264 PMCID: PMC6788423 DOI: 10.5037/jomr.2019.10302] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 09/05/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The present manuscript aims to critically detail the physiologic process of socket healing, in the absence or presence of grafting materials or platelet concentrates, addressing the associated molecular and cellular events that culminate in the restoration of the lost tissue architecture and functionality. MATERIAL AND METHODS An electronic search in the National Library of Medicine database MEDLINE through its online site PubMed and Web of Science from inception until May 2019 was conducted to identify articles concerning physiologic process of socket healing, in the absence or presence of grafting materials or platelet concentrates. The search was restricted to English language articles without time restriction. Additionally, a hand search was carried out in oral surgery, periodontology and dental implants related journals. RESULTS In total, 122 literature sources were obtained and reviewed. The detailed biological events, at the molecular and cellular level, that occur in the alveolus after tooth extraction and socket healing process modulated by grafting materials or autologous platelet concentrates were presented as two entities. CONCLUSIONS Tooth extraction initiates a convoluted set of orderly biological events in the alveolus, aiming wound closure and socket healing. The healing process comprises a wide range of events, regulated by the interplay of cytokines, chemokines and growth factors that determine cellular recruitment, proliferation and differentiation in the healing milieu, in a space- and time-dependent choreographic interplay. Additionally, the healing process may further be modulated by the implantation of grafting materials or autologous platelet concentrates within the tooth socket, aiming to enhance the regenerative outcome.
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Affiliation(s)
- Pedro de Sousa Gomes
- BoneLab, Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, U. Porto, PortoPortugal.
- LAQV/REQUIMTE, Faculty of Dental Medicine, U. Porto, PortoPortugal.
| | - Povilas Daugela
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Lukas Poskevicius
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Lorena Mariano
- BoneLab, Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, U. Porto, PortoPortugal.
| | - Maria Helena Fernandes
- BoneLab, Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, U. Porto, PortoPortugal.
- LAQV/REQUIMTE, Faculty of Dental Medicine, U. Porto, PortoPortugal.
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Raveendiran N, Chen S, Davies H, Fitzgerald W, Darby I. The influence of deproteinised bovine bone mineral on dimensional changes in the maxillary second incisor socket. Clin Oral Implants Res 2019; 30:670-681. [PMID: 31050062 DOI: 10.1111/clr.13452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the dimensional changes following the extraction of maxillary second incisors and to evaluate the influence of deproteinised bovine bone mineral on the healing outcomes. MATERIALS AND METHODS The second maxillary incisors in nine dogs were extracted bilaterally in a minimally traumatic manner. Deproteinised bovine bone mineral with collagen (DBBMC) and a collagen matrix (CM) was placed in one socket with the contralateral socket left to heal naturally. After 3 months of healing, the dogs were sacrificed and the pre-maxilla resected. Cone beam computerised tomography scans (CBCTs) were obtained and the specimens prepared for histological preparation and analysis. Surface scans of study models taken pre- and post-extraction were digitally subtracted to analyse volumetric changes. RESULTS All dogs healed uneventfully without any complications. No inflammation was seen, and DBBMC was well integrated into a network of mineralised tissues, bone marrow and connective tissue. The horizontal width of the buccal crest was found to be significantly greater in grafted sockets, but the vertical height to be similar. No significant difference was seen in regard to volumetric changes in sockets over 3 months post-extraction. CONCLUSION Maxillary second incisor sockets of dogs grafted with DBBMC post-extraction had significantly greater horizontal width at the ridge crest compared with ungrafted sockets. Volumetric analysis revealed no significant difference between grafted and non-grafted sockets, suggesting possible soft tissue thickening post-extraction to counteract osseous resorption.
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Affiliation(s)
- Nirushan Raveendiran
- Periodontics, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
| | - Stephen Chen
- Periodontics, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
| | - Helen Davies
- School of Veterinary Science, University of Melbourne, Parkville, Victoria, Australia
| | - Wayne Fitzgerald
- School of Veterinary Science, University of Melbourne, Parkville, Victoria, Australia
| | - Ivan Darby
- Periodontics, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
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Akino N, Tachikawa N, Miyahara T, Ikumi R, Kasugai S. Vertical ridge augmentation using a porous composite of uncalcined hydroxyapatite and poly-DL-lactide enriched with types 1 and 3 collagen. Int J Implant Dent 2019; 5:16. [PMID: 31041549 PMCID: PMC6491530 DOI: 10.1186/s40729-019-0167-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/13/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Previous studies have shown that porous composite blocks containing uncalcined hydroxyapatite (u-HA; 70 wt%) with a scaffold of poly-DL-lactide (PDLLA, 30 wt%) are biodegradable, encourage appropriate bone formation, and are suitable for use as a bone substitute in vertical ridge augmentation. The present study aimed to accelerate osteogenesis in vertical ridge formation by adding types 1 and 3 collagen to the u-HA/PDLLA blocks and assessing the effect. MATERIAL AND METHODS The bone substitute in the present study comprised porous composite blocks of u-HA (70 wt%) with a PDLLA (27-29 wt%) scaffold and enriched with types 1 and 3 collagen (1.7 ~ 3.4 wt%). The control blocks were composed of u-HA (70 wt%) and PDLLA (30 wt%). The materials were formed into 8-mm diameter, 2-mm high discs and implanted onto the cranial bones of six rabbits. The animals were sacrificed 4 weeks after implantation, and histological and histomorphometrical analyses were performed to quantitatively evaluate newly formed bone. RESULTS New bone formation occurred with both block types, showing direct contact with the original bone. Mean ± standard deviation bone formation was significantly greater in the experimental blocks (25.6% ± 4.8%) than in the control blocks (17.0% ± 4.7%). CONCLUSIONS Histological and histomorphometrical observations indicated that new bone was formed with both block types. The u-HA/PDLLA block with types 1 and 3 collagen is a more promising candidate for vertical ridge augmentation than the u-HA/PDLLA alone block.
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Affiliation(s)
- Norio Akino
- Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 113-8510 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
- Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, 113-8510 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
| | - Noriko Tachikawa
- Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 113-8510 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
- Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, 113-8510 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Takayuki Miyahara
- Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 113-8510 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Reo Ikumi
- Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 113-8510 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Shohei Kasugai
- Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 113-8510 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
- Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, 113-8510 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
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50
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Tan L, Zhang Y, Huang Y, Luo Y, Liu Y. Preservation of alveolar ridge after tooth extraction with hypoxia-inducible factor-1α protein in a dog model. Exp Ther Med 2019; 17:2913-2920. [PMID: 30936961 PMCID: PMC6434234 DOI: 10.3892/etm.2019.7301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 10/26/2018] [Indexed: 12/12/2022] Open
Abstract
Hypoxia-inducible factor (HIF)-1α protein, which is upregulated by hypoxia, serves an important role in angiogenesis during osteogenesis. The aim of the present study was to investigate the effect of HIF-1α on alveolar ridge preservation in a dog tooth extraction model. Six beagle dogs were used in the present study. The second and fourth premolar teeth of the lower jaws on both sides were extracted. Two unilateral extraction sockets were randomly selected and filled with Bio-Oss and Bio-Oss + HIF-1α. The contralateral sockets remained unfilled and served as the negative control. Micro-computed tomography examination and histological staining were performed to examine the difference of new bone formation among the three groups. Western blotting and reverse transcription-quantitative polymerase chain reaction analysis were used to detect the expression levels of osteogenesis- and angiogenesis-associated genes in the bone tissues of the three groups. Twelve weeks post-surgery, trabecular bone formation in the Bio-Oss + HIF-1α group was significantly increased compared with the other groups. The expression levels of osteogenesis-associated genes (runt-related transcription factor 2, osteoblast-specific transcription factor osterix and osteocalcin) and angiogenesis-associated genes (HIF-1α and vascular endothelial growth factor) were all significantly increased in the Bio-Oss + HIF-1α group compared with the other two groups (P<0.05). The present results indicated that Bio-Oss with HIF-1α can promote osteogenesis and angiogenesis in vivo and may be used as an effective treatment for the preservation of the alveolar ridge.
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Affiliation(s)
- Luanjun Tan
- Department of Stomatology, Shanghai East Hospital Affiliated with Tongji University, Shanghai 200120, P.R. China
| | - Yingdi Zhang
- Department of Stomatology, Shanghai East Hospital Affiliated with Tongji University, Shanghai 200120, P.R. China
| | - Yuanliang Huang
- Department of Stomatology, Shanghai East Hospital Affiliated with Tongji University, Shanghai 200120, P.R. China
| | - Yuan Luo
- Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai 200031, P.R. China.,Department of Oral Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai 200031, P.R. China
| | - Yuehua Liu
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, Shanghai 200031, P.R. China.,Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai 200031, P.R. China
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