1
|
Shanbhag S, Kampleitner C, Sanz-Esporrin J, Lie SA, Gruber R, Mustafa K, Sanz M. Regeneration of alveolar bone defects in the experimental pig model: A systematic review and meta-analysis. Clin Oral Implants Res 2024; 35:467-486. [PMID: 38450852 DOI: 10.1111/clr.14253] [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: 12/05/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Pigs are emerging as a preferred experimental in vivo model for bone regeneration. The study objective was to answer the focused PEO question: in the pig model (P), what is the capacity of experimental alveolar bone defects (E) for spontaneous regeneration in terms of new bone formation (O)? METHODS Following PRISMA guidelines, electronic databases were searched for studies reporting experimental bone defects or extraction socket healing in the maxillae or mandibles of pigs. The main inclusion criteria were the presence of a control group of untreated defects/sockets and the assessment of regeneration via 3D tomography [radiographic defect fill (RDF)] or 2D histomorphometry [new bone formation (NBF)]. Random effects meta-analyses were performed for the outcomes RDF and NBF. RESULTS Overall, 45 studies were included reporting on alveolar bone defects or extraction sockets, most frequently in the mandibles of minipigs. Based on morphology, defects were broadly classified as 'box-defects' (BD) or 'cylinder-defects' (CD) with a wide range of healing times (10 days to 52 weeks). Meta-analyses revealed pooled estimates (with 95% confidence intervals) of 50% RDF (36.87%-63.15%) and 43.74% NBF (30.47%-57%) in BD, and 44% RDF (16.48%-71.61%) and 39.67% NBF (31.53%-47.81%) in CD, which were similar to estimates of socket-healing [48.74% RDF (40.35%-57.13%) and 38.73% NBF (28.57%-48.89%)]. Heterogeneity in the meta-analysis was high (I2 > 90%). CONCLUSION A substantial body of literature revealed a high capacity for spontaneous regeneration in experimental alveolar bone defects of (mini)pigs, which should be considered in future studies of bone regeneration in this animal model.
Collapse
Affiliation(s)
- Siddharth Shanbhag
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Carina Kampleitner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, The Research Center in Cooperation with AUVA, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Javier Sanz-Esporrin
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Stein-Atle Lie
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Reinhard Gruber
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Kamal Mustafa
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mariano Sanz
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| |
Collapse
|
2
|
Calciolari E, Corbella S, Gkranias N, Viganó M, Sculean A, Donos N. Efficacy of biomaterials for lateral bone augmentation performed with guided bone regeneration. A network meta-analysis. Periodontol 2000 2023; 93:77-106. [PMID: 37752820 DOI: 10.1111/prd.12531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023]
Abstract
Bone regeneration is often required concomitant with implant placement to treat a bone fenestration, a dehiscence, and for contouring. This systematic review assessed the impact of different biomaterials employed for guided bone regeneration (GBR) simultaneous to implant placement on the stability of radiographic peri-implant bone levels at ≥12 months of follow-up (focused question 1), as well as on bone defect dimension (width/height) changes at re-assessment after ≥4 months (focused question 2). Only randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared different biomaterials for GBR were considered. A Bayesian network meta-analysis (NMA) was performed using a random-effects model. A ranking probability between treatments was obtained, as well as an estimation of the surface under the cumulative ranking value (SUCRA). Overall, whenever the biological principle of GBR was followed, regeneration occurred in a predictable way, irrespective of the type of biomaterial used. A lower efficacy of GBR treatments was suggested for initially large defects, despite the trend did not reach statistical significance. Regardless of the biomaterial employed, a certain resorption of the augmented bone was observed overtime. While GBR was shown to be a safe and predictable treatment, several complications (including exposure, infection, and soft tissue dehiscence) were reported, which tend to be higher when using cross-linked collagen membranes.
Collapse
Affiliation(s)
- Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Dental School, Department of Medicine and Dentistry, Università di Parma, Parma, Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS, Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Nikolaos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Marco Viganó
- Medacta International SA, Castel San Pietro, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
3
|
Mizraji G, Davidzohn A, Gursoy M, Gursoy U, Shapira L, Wilensky A. Membrane barriers for guided bone regeneration: An overview of available biomaterials. Periodontol 2000 2023; 93:56-76. [PMID: 37855164 DOI: 10.1111/prd.12502] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/21/2023] [Accepted: 05/29/2023] [Indexed: 10/20/2023]
Abstract
Dental implants revolutionized the treatment options for restoring form, function, and esthetics when one or more teeth are missing. At sites of insufficient bone, guided bone regeneration (GBR) is performed either prior to or in conjunction with implant placement to achieve a three-dimensional prosthetic-driven implant position. To date, GBR is well documented, widely used, and constitutes a predictable and successful approach for lateral and vertical bone augmentation of atrophic ridges. Evidence suggests that the use of barrier membranes maintains the major biological principles of GBR. Since the material used to construct barrier membranes ultimately dictates its characteristics and its ability to maintain the biological principles of GBR, several materials have been used over time. This review, summarizes the evolution of barrier membranes, focusing on the characteristics, advantages, and disadvantages of available occlusive barrier membranes and presents results of updated meta-analyses focusing on the effects of these membranes on the overall outcome.
Collapse
Affiliation(s)
- Gabriel Mizraji
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Mervi Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
- Oral Health Care, Welfare Division, City of Turku, Turku, Finland
| | - Ulvi Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Asaf Wilensky
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
4
|
Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol 2000 2023; 93:26-55. [PMID: 37615306 DOI: 10.1111/prd.12518] [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: 02/10/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune-inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non-invasive imaging and with patient-reported outcome measures. We also envisage that the integration of multi-omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
Collapse
Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Ninad Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Dentistry, Dental School, University of Parma, Parma, Italy
| |
Collapse
|
5
|
Lee RSB, Hamlet SM, Moon HJ, Ivanovski S. Re-establishment of macrophage homeostasis by titanium surface modification in type II diabetes promotes osseous healing. Biomaterials 2020; 267:120464. [PMID: 33130322 DOI: 10.1016/j.biomaterials.2020.120464] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/19/2020] [Accepted: 10/18/2020] [Indexed: 12/27/2022]
Abstract
Titanium surface mediated immunomodulation may address compromised post-implantation bone healing in diabetes mellitus. To assess in vitro phenotypic changes, M1 and M2 polarised Type 2 diabetic rat (Goto Kakizaki, GK) macrophages were cultured on micro-rough (SLA) or hydrophilic nanostructured SLA (modSLA) titanium. The in vivo effects of the SLA and modSLA surfaces on macrophage phenotype, wound-associated protein expression and bone formation were investigated using a critical-sized calvarial defect model. Compared to healthy macrophages, GK M2 macrophage function was compromised, secreting significantly lower levels of the anti-inflammatory cytokine IL-10. The modSLA surface attenuated the pro-inflammatory cellular environment, reducing pro-inflammatory cytokine production and promoting M2 macrophage phenotype differentiation. ModSLA also suppressed gene expression associated with macrophage multinucleation and giant cell formation and stimulated pro-osteogenic genes in co-cultured osteoblasts. In vivo, modSLA enhanced osteogenesis compared to SLA in GK rats. During early healing, proteomic analysis of both surface adherent and wound exudate material showed that modSLA promoted an immunomodulatory pro-reparative environment. The modSLA surface therefore successfully compensated for the compromised M2 macrophage function in Type 2 diabetes by attenuating the pro-inflammatory response and promoting M2 macrophage activity, thus restoring macrophage homeostasis and resulting in a cellular environment favourable for enhanced osseous healing.
Collapse
Affiliation(s)
- Ryan S B Lee
- The University of Queensland, School of Dentistry, Herston, Australia; School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Stephen M Hamlet
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Ho-Jin Moon
- Department of Dental Materials, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Saso Ivanovski
- The University of Queensland, School of Dentistry, Herston, Australia.
| |
Collapse
|
6
|
Yin L, Zhu Y, He M, Chang Y, Xu F, Lai H. Preparation and characteristics of electrospinning PTH‐Fc/PLCL/SF membranes for bioengineering applications. J Biomed Mater Res A 2019; 108:157-165. [PMID: 31566865 DOI: 10.1002/jbm.a.36801] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/22/2019] [Accepted: 09/04/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Lihua Yin
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of StomatologyShanghai JiaoTong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology Shanghai China
- Department of ImplantologySchool/Hospital of Stomatology Lanzhou University Lanzhou Gansu China
| | - Yidan Zhu
- Department of Stomatology Technology, School of MedicineXi'an International University Xi'an Shaanxi China
| | - Miaomiao He
- Department of VIP Dental Care Center of Hangzhou West Dental Hospital Zhejiang Hangzhou China
| | - Yaoren Chang
- Department of ImplantologySchool/Hospital of Stomatology Lanzhou University Lanzhou Gansu China
| | - Fangfang Xu
- Department of ImplantologySchool/Hospital of Stomatology Lanzhou University Lanzhou Gansu China
| | - Hong‐Chang Lai
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of StomatologyShanghai JiaoTong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology Shanghai China
| |
Collapse
|
7
|
Acharya A, Leung MCT, Ng KT, Fan MHM, Fokas G, Mattheos N. Peri-implant marginal bone loss rate pre- and post-loading: An exploratory analysis of associated factors. Clin Oral Implants Res 2019; 30:410-419. [PMID: 30921476 DOI: 10.1111/clr.13424] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 02/21/2019] [Accepted: 03/05/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To perform an exploratory analysis of factors influencing annual rates of peri-implant marginal bone loss (RBL) calculated over different time frames, at implants unaffected by peri-implantitis. MATERIAL AND METHODS A total of 154 implants from 86 patients were reviewed at 1.6-6.8 years after placement. Marginal bone levels (MBL) were assessed on intraoral radiographs at three time-points: immediately post-placement, time of loading, and least 1-year post-loading. RBLs (mm/year) were computed using these three time frames and corresponding MBL changes as: RBL placement-loading, RBL loading-review, RBL placement-review. Exploratory ordination of three RBLs, corresponding time durations, and 17 background factors were used for visualization. Hierarchical linear mixed-effects models (MEM) with predictor selection were applied to RBL outcomes. The correlation of actual MBL with MBLs predicted by RBL placement-loading and RBL loading-review was tested. RESULTS Median RBL placement-loading was 0.9 mm/year (IQR = 2.02), loading-review was 0.06 mm/year (IQR = 0.16), and overall RBL placement-review was 0.21 mm/year (IQR = 0.33). Among-patient variance was highest for RBL placement-loading (SD = 0.66). Longer time predicted lower RBL in all time frames. Shorter time of loading significantly predicted lower RBL placement-review. Augmentation predicted lower RBL placement-loading, while anterior location and older age predicted lower RBLs placement-loading placement-review. Only MBL projected using RBL placement-loading significantly correlated with actual MBL. CONCLUSIONS Exploratory analysis indicated RBL varied with the time duration used for calculation in pre- and post-loading, and overall periods. In each period, RBL declined with increasing time. Earlier loading predicted lower overall RBL. Higher pre-loading RBL predicted worse actual bone level.
Collapse
Affiliation(s)
- Aneesha Acharya
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Department of Periodontology, Dr. D.Y.Patil Dental College and Hospital, Pimpri, Pune
| | - Ming Chi Terrence Leung
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - King Tung Ng
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Michael H M Fan
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - George Fokas
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Nikos Mattheos
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
8
|
Wang E, Han J, Zhang X, Wu Y, Deng XL. Efficacy of a mineralized collagen bone-grafting material for peri-implant bone defect reconstruction in mini pigs. Regen Biomater 2019; 6:107-111. [PMID: 30967965 PMCID: PMC6447001 DOI: 10.1093/rb/rby029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 12/18/2018] [Accepted: 12/21/2018] [Indexed: 11/24/2022] Open
Abstract
The mechanism of the mineralization process induced by natural mineralized collagen (MC) has been investigated for decades. The purpose of this study was to investigate the efficacy of self-assembled MC for peri-implant bone defect reconstruction in a mini pig. A standardized peri-implant bone defect model was created using 14 mini pig mandibles. Two materials were evaluated, i.e. a mixture of hydroxyapatite and collagen (Type A, TA), and self-assembled MC (Type B, TB). Bio-Oss (BO) and untreated (blank control, BC) groups were used as controls. After 3- and 6-month healing periods, the mini pigs were sacrificed for histomorphometric and microcomputed tomography analysis. After 3 months of healing, the average alveolar ridge height was 3.27 ± 1.57 mm for group TA, 3.28 ± 2.02 mm for group TB and 3.37 ± 1.09 mm for group BO, while group BC showed the lowest height of 2.68 ± 0.47 mm. After 6 months of healing, the average alveolar ridge height was 2.64 ± 1.13 mm for group TA, 4.31 ± 1.80 mm for group TB and 3.87 ± 1.38 mm for group BO, while group BC showed the lowest height of 2.48 ± 1.80 mm. The experimental groups and control group showed similar bone volume density, bone complexity and histological reaction. The self-assembled MC (Type B) stimulated new bone formation in the reconstruction of deficient alveolar ridges around the dental implant; it also displayed excellent clinical operability compared with bone grafts without collagen.
Collapse
Affiliation(s)
- Enbo Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Street, Haidian District, Beijing, China
| | - Jianmin Han
- Department of Dental Materials, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Street, Haidian District, Beijing, China
| | - Xuehui Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Street, Haidian District, Beijing, China
| | - Yuhan Wu
- Department of Dental Materials, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Street, Haidian District, Beijing, China
| | - Xu-Liang Deng
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Street, Haidian District, Beijing, China
| |
Collapse
|
9
|
Vital Bone Formation After Grafting of Autogenous Bone and Biphasic Calcium Phosphate Bioceramic in Extraction Sockets of Rats. IMPLANT DENT 2018; 27:615-622. [DOI: 10.1097/id.0000000000000815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Li H, Zheng J, Zhang S, Yang C, Kwon YD, Kim YJ. Experiment of GBR for repair of peri-implant alveolar defects in beagle dogs. Sci Rep 2018; 8:16532. [PMID: 30410063 PMCID: PMC6224530 DOI: 10.1038/s41598-018-34805-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 10/26/2018] [Indexed: 02/08/2023] Open
Abstract
To guide barrier membrane choice in the treatment of peri-implant alveolar bone defects, we evaluated guided bone regeneration (GBR) using titanium (Ti) mesh or Bio-Gide membrane, independently or in combination, for repair of alveolar bone defects in Beagle dogs. Six months after extraction of the mandibular premolars and first molars from three beagle dogs, we inserted implants assigned into 3 groups and covered with the following membrane combinations: Group A: Implant + Bio-Oss + Ti-mesh, Group B: Implant + Bio-Oss + Bio-Gide, and Group C: Implant + Bio-Oss + Ti-mesh + Bio-Gide. At 6 months, micro-CT revealed that bone volume/total volume (BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th) was significantly greater in Group C than the other two groups, while trabecular separation (Tb.Sp) was significantly lower, suggesting improved bone regeneration. The distance between bands of three fluorescent tracking dyes was significantly greater in Group C, indicating faster deposition of new bone. The Bio-Oss particles were ideally integrated with newly deposited bone and bone thickness was significantly larger in Group C. These findings suggest that combination of Bio-Gide membrane and titanium mesh can effectively repair peri-implant alveolar bone defects, achieving enhanced bone regeneration compared to titanium mesh or Bio-Gide alone, and therefore providing a novel treatment concept for clinical implant surgery.
Collapse
Affiliation(s)
- HuiPing Li
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China
| | - JiSi Zheng
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China
| | - Shanyong Zhang
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China.
| | - Chi Yang
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Gwangneung, South Korea.
| | - Yong-Jin Kim
- Department of Oral and Maxillofacial Surgery, Insan Apsun Dental Clinic, Gwangneung, South Korea
| |
Collapse
|
11
|
Jonker BP, Wolvius EB, van der Tas JT, Pijpe J. The effect of resorbable membranes on one-stage ridge augmentation in anterior single-tooth replacement: A randomized, controlled clinical trial. Clin Oral Implants Res 2017; 29:235-247. [PMID: 29266485 DOI: 10.1111/clr.13106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2017] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the effect of resorbable membranes on one-stage ridge augmentation procedures in small (2-4 mm) buccal bony dehiscences in anterior maxillary single-tooth replacement. MATERIALS AND METHODS Patients with a buccal bony dehiscence after implant placement in the esthetic zone were randomly allocated to one-stage ridge augmentation with (M+) or without a membrane (M-). Second-phase surgery was performed after 8 weeks, and follow-up was performed 1, 6, and ≥12 months after loading. Outcomes included implant survival and success, complications, clinical and radiographic parameters, esthetic results and patient satisfaction. RESULTS Fifty-two patients were randomized to one-stage ridge augmentation with (n = 25) or without use of a membrane (n = 27). No significant differences in implant survival and success have been observed. The risk of having a small mucosal dehiscence was more than six times higher in the M+ group than in the M- group (RR 6.24, 95% CI 0.81 to 48.21). At the last follow-up, the bleeding index (BI) was marginally higher in the M+ group (14/9/2/0) compared to the M- group (24/2/0/0) (U = 205, Z = -2.97, p = .003, r = .42). The median change in marginal bone level was statistically lower in the M+ group (0.06 mm) than the M- group (0.60 mm) at last follow-up (U = 120, Z = -2.73 a p = .006 r = .42). Total pink esthetic index (PES) and white esthetic score (WES) and combined PES/WES were not significantly different between treatment groups at more than 12 months after loading. Only the subcategory root convexity/soft tissue color scored significantly lower in the M+ group (1.5) compared to the M- group (2.0) at the last follow-up (U = 172, Z = -2.34, p = .019 r = .34). No differences were found in patient satisfaction. CONCLUSION The use of a resorbable membrane in small buccal bony dehiscences in anterior maxillary single-tooth replacement resulted in less marginal bone loss, but showed more mucosal dehiscences, higher bleeding scores and lower scores on root convexity and soft tissue color after at least one year of loading. No effect was seen on implant survival and success, overall esthetic results, and patient satisfaction. The research protocol was registered at the Dutch Trial Register (NTR) with ID NTR6137.
Collapse
Affiliation(s)
- Brend P Jonker
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eppo B Wolvius
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands.,St. Anna Hospital, Geldrop, The Netherlands
| | - Justin T van der Tas
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Justin Pijpe
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands.,Catharina Hospital, Eindhoven, The Netherlands
| |
Collapse
|
12
|
Donos N, Horvath A, Mezzomo LA, Dedi D, Calciolari E, Mardas N. The role of immediate provisional restorations on implants with a hydrophilic surface: A randomised, single-blind controlled clinical trial. Clin Oral Implants Res 2017; 29:55-66. [PMID: 28833613 DOI: 10.1111/clr.13038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To compare the radiographic bone changes, clinical parameters and aesthetic outcomes of immediately provisionalised and conventionally restored implants at 12- and 24-months post-implant placement. MATERIAL AND METHODS In 24 patients, 24 bone level implants with a hydrophilic (SLActive) surface were placed in healed sites and they were either immediately provisionalised with a non-occluding temporary crown (test group) or left without a crown (control group). In both groups, the definitive restoration was placed 16 weeks after implant placement. Clinical and radiographic parameters were calculated at 12- and 24-months post-implant placement, together with implant success/survival rates according to three different sets of criteria. The aesthetic outcome was evaluated through the Papilla Fill Index and the Pink Aesthetic Score. RESULTS The mean marginal bone loss at 1 year was -0.73 mm (SD 0.83 mm) in the test group and -0.22 mm (SD 0.46 mm) in the control group (p > .05). Whilst 100% survival rate and positive aesthetic outcomes were recorded in both groups, three patients of the test group did not fulfil all success criteria. CONCLUSIONS Immediate provisionalisation may represent a viable option for the replacement of single missing teeth, with radiographic, clinical and aesthetic results comparable to those of conventionally loaded implants at 2 years of follow-up.
Collapse
Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Attila Horvath
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Luis André Mezzomo
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Dina Dedi
- Continuing Professional Development, UCL Eastman Dental Institute, London, UK
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Nikos Mardas
- Centre for Adult Oral Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| |
Collapse
|
13
|
Salvi GE, Bosshardt DD, Lang NP, Abrahamsson I, Berglundh T, Lindhe J, Ivanovski S, Donos N. Temporal sequence of hard and soft tissue healing around titanium dental implants. Periodontol 2000 2017; 68:135-52. [PMID: 25867984 DOI: 10.1111/prd.12054] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 12/22/2022]
Abstract
The objective of the present review was to summarize the evidence available on the temporal sequence of hard and soft tissue healing around titanium dental implants in animal models and in humans. A search was undertaken to find animal and human studies reporting on the temporal dynamics of hard and soft tissue integration of titanium dental implants. Moreover, the influence of implant surface roughness and chemistry on the molecular mechanisms associated with osseointegration was also investigated. The findings indicated that the integration of titanium dental implants into hard and soft tissue represents the result of a complex cascade of biological events initiated by the surgical intervention. Implant placement into alveolar bone induces a cascade of healing events starting with clot formation and continuing with the maturation of bone in contact with the implant surface. From a genetic point of view, osseointegration is associated with a decrease in inflammation and an increase in osteogenesis-, angiogenesis- and neurogenesis-associated gene expression during the early stages of wound healing. The attachment and maturation of the soft tissue complex (i.e. epithelium and connective tissue) to implants becomes established 6-8 weeks following surgery. Based on the findings of the present review it can be concluded that improved understanding of the mechanisms associated with osseointegration will provide leads and targets for strategies aimed at enhancing the clinical performance of titanium dental implants.
Collapse
|
14
|
Bone integration behavior of hydroxyapatite/β-tricalcium phosphate graft implanted in dental alveoli: a histomorphometric and scanning electron microscopy study. IMPLANT DENT 2016; 23:710-5. [PMID: 25343320 DOI: 10.1097/id.0000000000000172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated the bone integration ability of a biphasic calcium phosphate bioceramic implanted in dental alveolus of rats. MATERIALS AND METHODS A total of 21 male rats were submitted to upper right incisor extraction and implanted with a synthetic bioceramic (Straumann Bone Ceramic). The animals were killed on 7th, 21st, and 42nd day after surgery for light and scanning electron microscopy (SEM) analysis of bone, bioceramic, and soft tissue volume as well as the quality of graft in its interface. RESULTS Light histology results showed no persistent inflammatory and foreign body reactions, a newly formed bone adhered on the ceramic surface without interposition of soft tissue, which was confirmed by SEM analysis. Histometrically, reduction/resorption, between 7 and 42 days, in the percentage of bioceramic implanted (α = 1%) left gaps for a gradual increase in vital bone formation (α = 1%) around the particles. CONCLUSIONS The bioceramic in question is biocompatible, has good bone integration, being gradually resorbed and replaced by it, featuring a viable bone substitute for grafting procedures.
Collapse
|
15
|
Dos Santos PL, de Molon RS, Queiroz TP, Okamoto R, de Souza Faloni AP, Gulinelli JL, Luvizuto ER, Garcia IR. Evaluation of bone substitutes for treatment of peri-implant bone defects: biomechanical, histological, and immunohistochemical analyses in the rabbit tibia. J Periodontal Implant Sci 2016; 46:176-96. [PMID: 27382506 PMCID: PMC4928206 DOI: 10.5051/jpis.2016.46.3.176] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/28/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose We sought to evaluate the effectiveness of bone substitutes in circumferential peri-implant defects created in the rabbit tibia. Methods Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant (4.1 mm × 8.5 mm) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss® (BI), and Bio-Oss® Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated. Results For biomechanics, BC showed a better biological response (61.00±15.28 Ncm) than CO (31.60±14.38 Ncm) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group. Conclusions Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps.
Collapse
Affiliation(s)
- Pâmela Letícia Dos Santos
- Department of Oral and Maxillofacial Surgery and Implantology, Sagrado Coracao University - USC, Bauru, SP, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, Sao Paulo State University - UNESP School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Thallita Pereira Queiroz
- Department of Health Sciences, Implantology Post Graduation Course, University Center of Araraquara - UNIARA Dental School, SP, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, Sao Paulo State University - UNESP School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
| | - Ana Paula de Souza Faloni
- Department of Health Sciences, Implantology Post Graduation Course, University Center of Araraquara - UNIARA Dental School, SP, Brazil
| | - Jéssica Lemos Gulinelli
- Department of Oral and Maxillofacial Surgery and Implantology, Sagrado Coracao University - USC, Bauru, SP, Brazil
| | - Eloá Rodrigues Luvizuto
- Department of Surgery and Integrated Clinic, Sao Paulo State University - UNESP School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
| | - Idelmo Rangel Garcia
- Department of Surgery and Integrated Clinic, Sao Paulo State University - UNESP School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
| |
Collapse
|
16
|
Thoma DS, Jung UW, Park JY, Bienz SP, Hüsler J, Jung RE. Bone augmentation at peri-implant dehiscence defects comparing a synthetic polyethylene glycol hydrogel matrix vs. standard guided bone regeneration techniques. Clin Oral Implants Res 2016; 28:e76-e83. [PMID: 27206342 DOI: 10.1111/clr.12877] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The aim of the study was to test whether or not the use of a polyethylene glycol (PEG) hydrogel with or without the addition of an arginylglycylaspartic acid (RGD) sequence applied as a matrix in combination with hydroxyapatite/tricalciumphosphate (HA/TCP) results in similar peri-implant bone regeneration as traditional guided bone regeneration procedures. MATERIAL AND METHODS In 12 beagle dogs, implant placement and peri-implant bone regeneration were performed 2 months after tooth extraction in the maxilla. Two standardized box-shaped defects were bilaterally created, and dental implants were placed in the center of the defects with a dehiscence of 4 mm. Four treatment modalities were randomly applied: i)HA/TCP mixed with a synthetic PEG hydrogel, ii)HA/TCP mixed with a synthetic PEG hydrogel supplemented with an RGD sequence, iii)HA/TCP covered with a native collagen membrane (CM), iv)and no bone augmentation (empty). After a healing period of 8 or 16 weeks, micro-CT and histological analyses were performed. RESULTS Histomorphometric analysis revealed a greater relative augmented area for groups with bone augmentation (43.3%-53.9% at 8 weeks, 31.2%-42.8% at 16 weeks) compared to empty controls (22.9% at 8 weeks, 1.1% at 16 weeks). The median amount of newly formed bone was greatest in group CM at both time-points. Regarding the first bone-to-implant contact, CM was statistically significantly superior to all other groups at 8 weeks. CONCLUSIONS Bone can partially be regenerated at peri-implant buccal dehiscence defects using traditional guided bone regeneration techniques. The use of a PEG hydrogel applied as a matrix mixed with a synthetic bone substitute material might lack a sufficient stability over time for this kind of defect.
Collapse
Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| |
Collapse
|
17
|
Carlisle PL, Guda T, Silliman DT, Lien W, Hale RG, Brown Baer PR. Investigation of a pre-clinical mandibular bone notch defect model in miniature pigs: clinical computed tomography, micro-computed tomography, and histological evaluation. J Korean Assoc Oral Maxillofac Surg 2016; 42:20-30. [PMID: 26904491 PMCID: PMC4761569 DOI: 10.5125/jkaoms.2016.42.1.20] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/22/2015] [Accepted: 12/29/2015] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To validate a critical-size mandibular bone defect model in miniature pigs. MATERIALS AND METHODS Bilateral notch defects were produced in the mandible of dentally mature miniature pigs. The right mandibular defect remained untreated while the left defect received an autograft. Bone healing was evaluated by computed tomography (CT) at 4 and 16 weeks, and by micro-CT and non-decalcified histology at 16 weeks. RESULTS In both the untreated and autograft treated groups, mineralized tissue volume was reduced significantly at 4 weeks post-surgery, but was comparable to the pre-surgery levels after 16 weeks. After 16 weeks, CT analysis indicated that significantly greater bone was regenerated in the autograft treated defect than in the untreated defect (P=0.013). Regardless of the treatment, the cortical bone was superior to the defect remodeled over 16 weeks to compensate for the notch defect. CONCLUSION The presence of considerable bone healing in both treated and untreated groups suggests that this model is inadequate as a critical-size defect. Despite healing and adaptation, the original bone geometry and quality of the pre-injured mandible was not obtained. On the other hand, this model is justified for evaluating accelerated healing and mitigating the bone remodeling response, which are both important considerations for dental implant restorations.
Collapse
Affiliation(s)
- Patricia L Carlisle
- Department of Craniomaxillofacial Regenerative Medicine, The United States Army Dental and Trauma Research Detachment, Fort Sam Houston, USA
| | - Teja Guda
- Department of Craniomaxillofacial Regenerative Medicine, The United States Army Dental and Trauma Research Detachment, Fort Sam Houston, USA.; Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - David T Silliman
- Department of Craniomaxillofacial Regenerative Medicine, The United States Army Dental and Trauma Research Detachment, Fort Sam Houston, USA
| | - Wen Lien
- Department of Craniomaxillofacial Regenerative Medicine, The United States Army Dental and Trauma Research Detachment, Fort Sam Houston, USA
| | - Robert G Hale
- Department of Craniomaxillofacial Regenerative Medicine, The United States Army Dental and Trauma Research Detachment, Fort Sam Houston, USA
| | - Pamela R Brown Baer
- Department of Craniomaxillofacial Regenerative Medicine, The United States Army Dental and Trauma Research Detachment, Fort Sam Houston, USA
| |
Collapse
|
18
|
Wen B, Li Z, Nie R, Liu C, Zhang P, Miron RJ, Dard MM. Influence of biphasic calcium phosphate surfaces coated with Enamel Matrix Derivative on vertical bone growth in an extra-oral rabbit model. Clin Oral Implants Res 2015; 27:1297-1304. [PMID: 26689728 DOI: 10.1111/clr.12740] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Bo Wen
- Department of Oral & Maxillofacial Surgery; Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Zhen Li
- Department of Oral & Maxillofacial Surgery; Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Rongrong Nie
- Department of Prosthdontics; Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Chao Liu
- Department of Orthodontics; Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Peng Zhang
- Department of Prosthdontics; Nanjing Stomatological Hospital; Medical School of Nanjing University; Nanjing China
| | - Richard J. Miron
- Department of Periodontology; Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Michel M. Dard
- Department of Periodontology and Implant Dentistry; College of Dentistry; New York University; New York NY USA
| |
Collapse
|
19
|
Sumida T, Otawa N, Kamata YU, Kamakura S, Mtsushita T, Kitagaki H, Mori S, Sasaki K, Fujibayashi S, Takemoto M, Yamaguchi A, Sohmura T, Nakamura T, Mori Y. Custom-made titanium devices as membranes for bone augmentation in implant treatment: Clinical application and the comparison with conventional titanium mesh. J Craniomaxillofac Surg 2015; 43:2183-8. [PMID: 26603108 DOI: 10.1016/j.jcms.2015.10.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 10/03/2015] [Accepted: 10/13/2015] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Development of new custom-made devices to reconstruct alveolar bone for implantation, and comparison with conventional methods were the goals of this study. MATERIALS AND METHODS Using a computer-aided design technique, three-dimensional images were constructed. From these data, custom-made devices were produced by a selective laser melting method with pure titanium. Clinical trials also have been conducted with 26 participants who needed bone reconstruction before implantation; they were divided into 2 groups with 13 patients each. The first group uses custom-made devices; the other uses commercial titanium meshes that need to bend during operation. Some clinical aspects are evaluated after the trial. RESULTS The custom-made devices can be produced closely by following the data precisely. Devices are fit for bone defect site. Moreover, the operation time of the custom-made group (75.4 ± 11.6 min) was significantly shorter than that of the conventional group (111.9 ± 17.8 min) (p < 0.01). Mucosal rupture occurs, without significant difference (p = 0.27), in a patient in the custom-made without severe infection (7.7%), and 3 in conventional (23.1%), respectively. The retaining screw is significantly fewer in the custom-made group than commercial mesh group (p < 0.01). CONCLUSION These results indicate that our novel protocol could be simple and safe for providing powerful support for guided bone regeneration.
Collapse
Affiliation(s)
- Tomoki Sumida
- Section of Oral & Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Naruto Otawa
- Section of Oral & Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Y U Kamata
- Section of Oral & Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Satoshi Kamakura
- Ehime Implant Clinic, 806, Tsuruyoshi, Masaki, Iyo-gun, Ehime, 791-3155, Japan
| | - Tomiharu Mtsushita
- Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University, 1200, Matsumotocho, Kasugai-City, Aichi, 487-8501, Japan
| | - Hisashi Kitagaki
- Osaka Yakin Kogyo Co., Ltd., 4-4-8, Zuiko, Yodogawa-ku, Osaka, 533-0005, Japan
| | - Shigeo Mori
- Osaka Yakin Kogyo Co., Ltd., 4-4-8, Zuiko, Yodogawa-ku, Osaka, 533-0005, Japan
| | - Kiyoyuki Sasaki
- Sagawa Printing Co., Ltd., 6-3, Inui, Morimoto, Hyuga-City, Kyoto, 617-8588, Japan
| | - Shunsuke Fujibayashi
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Mitsuru Takemoto
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Atsushi Yamaguchi
- Wada Precision Dental Laboratories Co., Ltd., 5-7-16, Nishiawaji, Higashiyodogawa-ku, Osaka, 533-0031, Japan
| | - Taiji Sohmura
- Wada Precision Dental Laboratories Co., Ltd., 5-7-16, Nishiawaji, Higashiyodogawa-ku, Osaka, 533-0031, Japan
| | - Takashi Nakamura
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yoshihide Mori
- Section of Oral & Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| |
Collapse
|
20
|
Pereira FP, Hochuli-Vieira E, Maté Sánchez de Val JE, De Santis E, Salata LA, Botticelli D. Bone Ceramic® at Implants Installed Immediately into Extraction Sockets in the Molar Region: An Experimental Study in Dogs. Clin Implant Dent Relat Res 2015; 18:360-8. [PMID: 26250898 DOI: 10.1111/cid.12312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this paper was to study the healing of 1-1.4 mm wide buccal defects at implants placed immediately into extraction sockets (IPIES) filled with a mixture of synthetic hydroxyapatite (HA) 60% and beta-tricalciumphosphate (TCP) 40% or left with the clot alone and both covered with collagen membranes. MATERIAL AND METHODS Eight Labrador dogs were used and implants were placed immediately into the extraction sockets of the first molar bilaterally. A mixture of synthetic HA 60% and beta-TCP 40% at the test or the clot alone at the control sites were used to fill the defects. All surgical sites were subsequently covered by a resorbable collagen membrane and a non-submerged healing was allowed. After 4 months, the animals were euthanized, biopsies harvested and processed for histomorphometric analysis. RESULTS At the time of installation, residual buccal defects occurred that were 1.1 mm and 1.4 mm wide and 3 mm and 4 mm deep at the control and test sites, respectively. After 4 months of healing, the top of the bony crest and the coronal level of osseointegration were located respectively at 0.1 ± 1.8 mm and 1.5 ± 1.8 mm at the test, and 0.6 ± 1.6 mm and 1.2 ± 0.7 mm at the control sites apically to the implant shoulder. Bone-to-implant contact at the buccal aspect was 34.9 ± 25.9% and 36.4 ± 17.3% at the test and control sites, respectively. No statistically significant differences were found between test and control sites for any of the variables analyzed at the buccal aspects. CONCLUSIONS The use of a mixture of synthetic HA 60% and beta-TCP 40% to fill residual buccal defects 1-1.4 mm wide at IPIES did not improve significantly the results of healing.
Collapse
Affiliation(s)
| | | | | | | | - Luiz Antonio Salata
- Department of Oral & Maxillofacial Surgery, The University of São Paulo, Faculty of Dentistry of Ribeirão Preto, Ribeirão Preto, Brazil
| | | |
Collapse
|
21
|
Ogawa S, Hoshina H, Nakata K, Yamada K, Uematsu K, Kawase T, Takagi R, Nagata M. High-Resolution Three-Dimensional Computed Tomography Analysis of the Clinical Efficacy of Cultured Autogenous Periosteal Cells in Sinus Lift Bone Grafting. Clin Implant Dent Relat Res 2015; 18:707-16. [PMID: 26017402 PMCID: PMC5032970 DOI: 10.1111/cid.12356] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background and Purpose Sinus lift (SL) using cultured autogenous periosteal cells (CAPCs) combined with autogenous bone and platelet‐rich plasma (PRP) was performed to evaluate the effect of cell administration on bone regeneration, by using high‐resolution three‐dimensional computed tomography (CT). Materials and Methods SL with autogenous bone and PRP plus CAPC [CAPC(+)SL] was performed in 23 patients. A piece of periosteum taken from the mandible was cultured in M199 medium with 10% fetal bovine serum (FBS) for 6 weeks. As control, 16 patients received SL with autogenous bone and PRP [CAPC(−)SL]. Three‐dimensional CT imaging was performed before and 4 months and 1 year after SL, and stratification was performed based on CT numbers (HUs) corresponding to soft tissue and cancellous or cortical bone. Results The augmented bone in CAPC(+)SL revealed an increase in HUs corresponding to cancellous bone as well as a decrease in HUs corresponding to grafted cortical bone. In addition, HUs corresponding to cancellous bone in the graft bed were increased in CAPC(+)SL but were decreased in CAPC(−)SL. Insertion torque during implant placement was significantly higher in CAPC(+)SL. Conclusion By promoting bone anabolic activity both in augmented bone and graft bed, CAPCs are expected to aid primary fixation and osseointegration of implants in clinical applications.
Collapse
Affiliation(s)
- Shin Ogawa
- Oral Implant Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hideyuki Hoshina
- Oral Implant Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Koh Nakata
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kazuho Yamada
- Oral Implant Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kohya Uematsu
- Department of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomoyuki Kawase
- Division of Dental Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ritsuo Takagi
- Department of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masaki Nagata
- Department of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
22
|
Donos N, Dereka X, Mardas N. Experimental models for guided bone regeneration in healthy and medically compromised conditions. Periodontol 2000 2015; 68:99-121. [DOI: 10.1111/prd.12077] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2014] [Indexed: 02/06/2023]
|
23
|
Vierra M, Mau LP, Huynh-Ba G, Schoolfield J, Cochran DL. A lateral ridge augmentation study to evaluate a synthetic membrane for guided bone regeneration: an experiment in the canine mandible. Clin Oral Implants Res 2014; 27:73-82. [DOI: 10.1111/clr.12517] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Matthew Vierra
- Department of Periodontics; University of Texas Health Science Center at San Antonio (UTHSCSA); San Antonio TX USA
| | - Lian Ping Mau
- Department of Dentistry; Chi Mei Medical Center; Tainan City Taiwan
| | - Guy Huynh-Ba
- Department of Periodontics; University of Texas Health Science Center at San Antonio (UTHSCSA); San Antonio TX USA
| | - John Schoolfield
- Department of Periodontics; University of Texas Health Science Center at San Antonio (UTHSCSA); San Antonio TX USA
| | - David L. Cochran
- Department of Periodontics; University of Texas Health Science Center at San Antonio (UTHSCSA); San Antonio TX USA
| |
Collapse
|
24
|
Boudrieau RJ. Initial Experience With rhBMP-2 Delivered in a Compressive Resistant Matrix for Mandibular Reconstruction in 5 Dogs. Vet Surg 2014; 44:443-58. [PMID: 24617340 DOI: 10.1111/j.1532-950x.2014.12171.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 12/01/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To document cumulative initial experience and long-term follow-up of the use of rhBMP-2/CRM for reconstruction of large mandibular defects (≥5 cm) in dogs. STUDY DESIGN Retrospective case series. ANIMALS Dogs (n = 5). METHODS Medical records (October 1999-April 2011) of dogs that had mandibular reconstruction for defects/resections of ≥5 cm using rhBMP-2/CRM were reviewed. Signalment, preoperative assessment/rationale for mandibular reconstruction, surgical methods, postoperative assessment of the reconstruction (evaluation of occlusion), and complications were recorded. A definitive histologic diagnosis was obtained in dogs that had mandibular resection for mass removal. Long-term complications were determined. A minimum time frame of 2-year in-hospital follow-up was required for case inclusion. RESULTS Mandibular reconstruction was successfully performed in all dogs' defects where gaps of 5-9 cm were bridged. Surgical reconstruction rapidly restored cosmetic appearance and function. All dogs healed with new bone formation across the gap. New bone formation was present within the defects as early as 2 weeks after surgery based on palpation, and new bone formation bridging the gap was documented radiographically by 16 weeks. Minor complications occurred in all dogs in the early postoperative period, and included early firm swelling and gingival dehiscence in 1 dog; late plate exposure in 3 dogs; and exuberant/cystic bone formation in 2 dogs (related to concentration/formulation of rhBMP-2/CRM). Two dogs had minor long-term complications of late plate exposure and a non-vital canine tooth; the plates and the affected canine tooth were removed. Long-term in-hospital follow-up was 5.3 years (range, 2-12.5 years); further long-term telephone follow-up was 6.3 years (range, 2-12.5 years). All owners were pleased with the outcome and would repeat the surgery again under similar circumstances. CONCLUSION The efficacy and success of this mandibular reconstruction technique, using rhBMP-2/CRM with plate fixation, was demonstrated with bridging of large mandibular defects regardless of the underlying cause, and with excellent cosmetic and functional results. Complications were common, but considered minor and easily treated. The complications encountered revealed the importance of tailoring the use of BMPs and fixation methods to this specific anatomic location and indication.
Collapse
Affiliation(s)
- Randy J Boudrieau
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, Massachusetts
| |
Collapse
|
25
|
Li X, Wang X, Zhao T, Gao B, Miao Y, Zhang D, Dong Y. Guided bone regeneration using chitosan-collagen membranes in dog dehiscence-type defect model. J Oral Maxillofac Surg 2013; 72:304.e1-14. [PMID: 24438600 DOI: 10.1016/j.joms.2013.09.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 09/05/2013] [Accepted: 09/30/2013] [Indexed: 01/14/2023]
Abstract
PURPOSE The purpose of the present study was to compare a newly developed chitosan-collagen membrane (CCM) with a standard collagen membrane (SCM) regarding their effects on guided bone regeneration. MATERIALS AND METHODS The right mandibular premolars and first molar were extracted from 12 beagle dogs. Four months later, acute buccal dehiscence-type defects (4 × 3 mm in height and width) were surgically created after implant site preparation. The defects were randomly assigned to 4 different groups: CCM-1 (weight ratio of chitosan to collagen of 40:1), CCM-2 (weight ratio of chitosan to collagen of 20:1), SCM, and vehicle control. The dogs were sacrificed after 4, 8, and 12 weeks of healing for radiographic examination, histologic observation, and histometric analysis. RESULTS The membrane-treated sites showed more bone formation than the control sites, although no statistically significant differences were found between the membrane-treated sites and the control sites for new bone-to-implant contact and new bone-filled area at any point. At 8 weeks, the new bone height for the membrane-treated sites was significantly greater statistically than that of the untreated group (P < .05). At 12 weeks, the CCM-1 group showed significantly greater new bone height (1.91 ± 0.25 mm) than the untreated group (1.20 ± 0.34 mm; P < .05). However, the CCMs did not show any statistically significant differences compared with the SCMs for any assessed parameter. CONCLUSIONS The results of the present study have shown that the developed CCMs can enhance bone regeneration and could be a candidate for use in guided bone regeneration.
Collapse
Affiliation(s)
- Xiaojing Li
- MD Student, Department of Prosthetic Dentistry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Xinmu Wang
- Associate Professor, Department of Oral Surgery, First People's Hospital of Hangzhou, Hangzhou, China
| | - Tengfei Zhao
- Resident, Department of Orthopedic Surgery, Second Affiliated Hospital (Binjiang Branch), Hangzhou Binjiang Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Bo Gao
- MD Student, Department of Prosthetic Dentistry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Yuwen Miao
- MD Student, Department of Prosthetic Dentistry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Dandan Zhang
- MD Student, Department of Prosthetic Dentistry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Yan Dong
- Associate Professor, Department of Prosthetic Dentistry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China.
| |
Collapse
|
26
|
Stricker A, Fleiner J, Dard M, Voss P, Sauerbier S, Bosshardt DD. Evaluation of a new experimental model to study bone healing after ridge expansion with simultaneous implant placement - a pilot study in minipigs. Clin Oral Implants Res 2013; 25:1265-1272. [DOI: 10.1111/clr.12265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Andres Stricker
- Department of Oral and Maxillofacial Surgery; University Hospital of Freiburg; Freiburg Germany
| | - Jonathan Fleiner
- Oral Imaging Center; Faculty of Medicine; Katholieke Universiteit Leuven; Leuven Belgium
| | - Michel Dard
- Department of Periodontology and Implant Dentistry; New York University; New York NY USA
| | - Pit Voss
- Department of Oral and Maxillofacial Surgery; University Hospital of Freiburg; Freiburg Germany
| | - Sebastian Sauerbier
- Department of Oral and Maxillofacial Surgery; University Hospital of Freiburg; Freiburg Germany
| | - Dieter D. Bosshardt
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
- Robert K. Schenk Laboratory of Oral Histology; School of Dental Medicine; University of Bern; Bern Switzerland
| |
Collapse
|
27
|
Mardas N, Dereka X, Donos N, Dard M. Experimental Model for Bone Regeneration in Oral and Cranio-Maxillo-Facial Surgery. J INVEST SURG 2013; 27:32-49. [DOI: 10.3109/08941939.2013.817628] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
28
|
A novel three-dimensional analysis of standardized bone defects by means of confocal scanner and micro-computed tomography. Clin Oral Investig 2013; 18:1245-1250. [PMID: 23934200 DOI: 10.1007/s00784-013-1081-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 07/31/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of the study was to introduce a novel three-dimensional (3D) method to quantify the relative amount of different tissue components in bone substitute-treated defects by means of integration of confocal laser imaging into micro-computed tomography (μCT) analysis. MATERIALS AND METHODS One standardized semisaddle intraosseous defect was prepared in the mandibles of six minipigs and scanned by an optical scanner to capture the surface of the fresh defect in a 3D manner. Subsequently, all the defects were filled with a biphasic calcium phosphate material. The animals were divided into two groups of three animals each, which were allowed to heal for 3 and 8 weeks, respectively. μCT analysis followed the two healing periods and was performed on all defect locations. The data from optical scanning and μCT were used for three-dimensional evaluation of bone formation, nonmineralized tissue ratio, and graft degradation. The integration of confocal laser scanning into μCT analysis through a superimposition imaging procedure was conducted using the software Amira (Mercury Computer Systems, Chelmsford, MA, USA). RESULTS The feasibility of combining the confocal imaging into μCT data with regard to obtaining accurate 3D quantification was demonstrated. The amount of tissue components was identified and quantified in all the investigated samples. Quantitative analysis demonstrated that a significant increase in the amount of bone filling the defect was observed in vivo (p < 0.02) while a significant decrease in the amount of nonmineralized tissue occurred (p < 0.04). No difference in the amount of residual grafting material was detected between 3 and 8 weeks in vivo (p > 0.38). CONCLUSIONS The combination of confocal imaging and micro-computed tomography techniques allows for analysis of different tissue types over time in vivo. This method has revealed to be a feasible alternative to current bone regeneration quantification methods. CLINICAL RELEVANCE Assessment of bone formation in a large animal model is a key step in assessing the performance of new bone substitute materials. Reliable and accurate methods are needed for the analysis of the regenerative potential of new materials.
Collapse
|
29
|
Thoma DS, Schneider D, Mir-Mari J, Hämmerle CHF, Gemperli AC, Molenberg A, Dard M, Jung RE. Biodegradation and bone formation of various polyethylene glycol hydrogels in acute and chronic sites in mini-pigs. Clin Oral Implants Res 2013; 25:511-21. [DOI: 10.1111/clr.12203] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - David Schneider
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Javier Mir-Mari
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | | | | | - Michel Dard
- Institut Straumann AG; Basel Switzerland
- Department of Periodontology and Implant Dentistry; College of Dentistry; New York University; New York NY USA
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| |
Collapse
|
30
|
Fu JH, Oh TJ, Benavides E, Rudek I, Wang HL. A randomized clinical trial evaluating the efficacy of the sandwich bone augmentation technique in increasing buccal bone thickness during implant placement surgery. Clin Oral Implants Res 2013; 25:458-67. [DOI: 10.1111/clr.12171] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Jia-Hui Fu
- Discipline of Periodontics; Faculty of Dentistry; National University of Singapore; Singapore
| | - Tae-Ju Oh
- Department of Periodontics and Oral Medicine; School of Dentistry; University of Michigan; Ann Arbor MI USA
| | - Erika Benavides
- Department of Periodontics and Oral Medicine; School of Dentistry; University of Michigan; Ann Arbor MI USA
| | - Ivan Rudek
- Department of Periodontics and Oral Medicine; School of Dentistry; University of Michigan; Ann Arbor MI USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine; School of Dentistry; University of Michigan; Ann Arbor MI USA
| |
Collapse
|