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Li Z, Yang C, Wang J, Zheng K, Luo W. The application of CGF combined with GBR in alveolar bone increment for patients with anxiety disorder: A rare case report and literature review. Medicine (Baltimore) 2023; 102:e35905. [PMID: 37960737 PMCID: PMC10637472 DOI: 10.1097/md.0000000000035905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
RATIONALE Selective serotonin reuptake inhibitors (SSRIs), one of the commonly used anti-anxiety drugs, may have impacts on bone metabolism and potentially lead to drug-induced osteoporosis. The traditional approach of oral implantation in individuals with both anxiety disorder and drug-induced osteoporosis poses a significant challenge. To address this issue, concentrated growth factor (CGF) has been utilized in patients undergoing concurrent alveolar ridge augmentation during oral implantation, resulting in favorable clinical outcomes. Consequently, combining CGF with guided bone regeneration (GBR) in alveolar bone increment may represent a promising new surgical approach for such patients. In this report, we present a case study of a 25-year-old male with anxiety disorder and drug-induced osteoporosis, in who CGF combined with GBR was employed in alveolar bone increment. PATIENT CONCERNS This article reports the case of a 25-year-old male who underwent cone beam computed tomography (CBCT) due to the absence of his right lower second molar for a period of six months. The CBCT scan revealed significant bone defects, which were attributed to the tooth loss and prolonged use of anti-anxiety drugs. Consequently, the patient sought medical assistance from our department. DIAGNOSES Based on the patient's self-report, he was diagnosed with an anxiety disorder. Additionally, the CBCT scan confirmed the loss of the right mandibular second molar and revealed the presence of dental irregularity and an alveolar bone defect. INTERVENTIONS During the patient's course of treatment with anti-anxiety medication, a combination of CGF and GBR was employed for the simultaneous implantation of the missing right mandibular second molar, along with bone augmentation. OUTCOMES The patient had a follow-up visit two weeks after the surgical procedure, and the wound in the operation area had healed satisfactorily. Six months later, CBCT images revealed excellent osseointegration. The buccal and lingual width of the alveolar bone measured 6.95mm, which was an increase of 1.35mm compared to the pre-implantation stage. LESSONS This article presents a case study in which CGF combined with GBR were utilized to address alveolar bone augmentation during the implantation phase in patients taking anti-anxiety medication. The results demonstrated that CGF combined with GBR, as a cutting-edge platelet concentrate technique, could effectively stimulate bone tissue proliferation in individuals who have been on long-term anti-anxiety medication, specifically in oral implant areas. This approach can help prevent poor osseointegration, promote higher osseointegration rates, and facilitate wound healing.
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Affiliation(s)
- Zhixin Li
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Chao Yang
- Department of Stomatology, The People's Hospital of Longhua, Shenzhen, China
- Research and Development Department, Shenzhen Uni-medica Technology CO., Ltd, Shenzhen, China
| | - Jinrong Wang
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Kaiyue Zheng
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Wen Luo
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
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Stavropoulos A, Marcantonio CC, de Oliveira VXR, Marcantonio É, de Oliveira GJPL. Fresh-frozen allogeneic bone blocks grafts for alveolar ridge augmentation: Biological and clinical aspects. Periodontol 2000 2023; 93:139-152. [PMID: 38194350 DOI: 10.1111/prd.12543] [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: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 01/10/2024]
Abstract
The possibilities for oral bone regeneration procedures vary depending on the type of bone defect to be treated, which in turn dictate the type of graft to be used. Atrophic alveolar ridges are non-contained defects and pose a challenging defect morphology for bone regeneration/augmentation. Successful results are regularly obtained with the use of particulate grafts in combination with barrier membranes. In cases of very narrow ridges with need of larger amount of bone augmentation, block grafts are often used. Fresh-frozen allogeneic bone block grafts have been proposed as an alternative to autogenous (AT) bone blocks. Based on a systematic appraisal of pre-clinical in vivo studies and clinical trials including a direct comparison of fresh-frozen bone (FFB) blocks versus AT bone blocks it can be concluded that a FFB block graft: (a) cannot be considered as a reliable replacement of a AT bone block, and (b) should only be considered in cases where the amount of necessary augmentation-in a lateral direction-is relatively limited, so that the main portion of the body of the implant lies within the inner (i.e., the vital) aspect of the block.
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Affiliation(s)
- Andreas Stavropoulos
- Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Camila Chierici Marcantonio
- Department of Diagnosis and Surgery School of Dentistry at Araraquara, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Vithor Xavier Resende de Oliveira
- Department of Periodontology/Implantodontology, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Élcio Marcantonio
- Department of Diagnosis and Surgery School of Dentistry at Araraquara, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
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Garg S, Kapoor R, Tyagi P, Wadhawan A. Treatment of Human Intraosseous Periodontal Defects Using Recombinant Human Bone Morphogenetic Protein-2: A Randomized Controlled Clinical Trial. Cureus 2023; 15:e40395. [PMID: 37456371 PMCID: PMC10345880 DOI: 10.7759/cureus.40395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Aim The purpose of this research was to assess the clinical and radiographic outcomes of recombinant human bone morphogenetic protein-2 (rhBMP-2) for the treatment of intraosseous abnormalities after periodontal flap surgery. Material and methods Patients aged 35-55 years who had undergone periodontal treatment at Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, and had a total of 14 intraosseous abnormalities were included in the research. Those in the control group had open flap debridement with alloplast, whereas those in the experimental group underwent the same procedure with the addition of rhBMP-2. Clinical indicators, such as plaque index (PI), gingival index, probing pocket depth (PPD), clinical attachment level, and radiographic defect fill, were collected at baseline at three months, six months, and nine months. Results The findings demonstrated that following periodontal treatment, both sets of patients had considerable improvements in their PI, gingival index, and PPD. The degree of relative connection improved significantly in both groups. When comparing the two groups radiographically, we saw that the test group had significantly better defect fill than the control group. Conclusion According to this research, there was a statistically significant decrease in PI, gingival index, PPD, clinical attachment level, and radiographic bone fill in patients who received rhBMP-2. Open flap debridement with rhBMP-2 and alloplastic bone grafts showed better reduction than open flap debridement with alloplastic bone grafts group in the radiographic defect fill.
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Affiliation(s)
- Shashank Garg
- Department of Periodontology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, IND
| | - Radhika Kapoor
- Department of Periodontology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, IND
| | - Prashant Tyagi
- Department of Periodontology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, IND
| | - Amit Wadhawan
- Department of Periodontology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, IND
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Alveolar bone remodeling in virtually planned, bone-grafted vs non-grafted guided flapless implant surgery in the anterior maxilla: a cross-sectional retrospective follow-up study. Oral Maxillofac Surg 2023; 27:43-52. [PMID: 35175458 PMCID: PMC9938045 DOI: 10.1007/s10006-022-01048-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/10/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE In patients who underwent virtual planning and guided flapless implant surgery for teeth missing in the anterior maxilla, we compared buccal bone loss between those treated with and without autogenous bone augmentation. METHODS Of 22 patients with teeth missing because of trauma or aplasia, 10 (18 implant sites) were reconstructed with buccally placed bone graft harvested from the mandibular ramus, and 12 were non-reconstructed (16 sites). Baseline cone-beam computed tomography allowed for implant planning using the NobelClinician® software and was performed again at 1 year after functional loading. The marginal bone level was assessed radiographically at post-implant baseline and at follow-up. RESULTS At follow-up, buccal bone loss differed significantly between groups at the central level of the implant (p = 0.0005) but not at the coronal level (p = 0.329). The mean marginal bone level change was 0.6 mm, with no significant between-group difference (p = 0.876). The actual implant position often deviated in the vertical or sagittal plane by an average of 0.3-0.6 mm from the planned position. CONCLUSION Compared with non-reconstructed patients, reconstructed patients experienced significantly more buccal bone loss at the central level of implants. The groups did not differ at the coronal level or in marginal bone loss, possibly because of the more augmented bone at the central level among reconstructed patients. Differences between planned versus actual implant positions should be considered in situations of limited bone volume at the planned implant site.
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The use of 3D ceramic block graft compared with autogenous block graft for rehabilitation of the atrophic maxilla: a randomized controlled clinical trial. Trials 2022; 23:903. [DOI: 10.1186/s13063-022-06843-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Dental implant placement may require a bone graft for vertical and horizontal alveolar ridge augmentation. Due to its osteoconduction, osteoinductive, and osteogenesis, autogenous bone graft characteristics are considered the standard gold treatment. However, autografts can promote postoperative morbidity and implicate difficulties concerning the graft adaptation to the recipient's bone since it can eventually avoid gaps. To overcome these issues, this trial will compare the performance of Plenum® Oss 3Dβ fit, an alloplastic graft, and a 3D-printed patient-specific graft based on β-tricalcium phosphate to the autograft procedure.
Methods
This is a split-mouth randomized clinical study designed to evaluate the performance of personalized (patient-specific) bioceramic bone grafts (Plenum® Oss 3Dβ fit) for bone augmentation of the atrophic anterior maxilla in comparison to the autogenous bone graft. We hypothesize that the gain and maintenance of the grafted area volume and the quality of the newly formed bone tissue after eight months postoperative with the synthetic patient-specific graft will be superior to the autogenous bone graft. To assess the quantity and the quality of bone neoformation, volumetric and histological analyses will be performed.
Discussion
The fabrication of medical devices by additive manufacturing presents advantages over conventional manufacturing processes, mostly related to the precision of geometry and anatomy. Additionally, the osteoconductive proprieties of β-tricalcium phosphate enable this synthetic bone substitute as an alternative solution over autogenous graft for bone defect reconstruction. Thus, patient-specific bone grafts can potentially improve patient satisfaction, reducing the need for autogenous bone grafts, consequently avoiding implications related to this type of treatment, such as patient morbidity.
Trial registration
This study is registered in REBEC (Registro Brasileiro de Ensaios Clínicos): RBR-76wmm3q; UTN: U1111-1272-7773. Registration date: 14 September 2021.
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Zufía J, Abella Sans F. Applications of maxillary tuberosity block autograft. J ESTHET RESTOR DENT 2022; 34:1015-1028. [PMID: 35384291 PMCID: PMC9790261 DOI: 10.1111/jerd.12911] [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: 01/24/2022] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Autogenous bone grafts are considered the gold standard due to their compatibility and osteogenic potential to induce new bone formation through osteogenesis, osteoinduction, and osteoconduction. The aim of this paper was to describe clinical applications of the maxillary tuberosity block autograft in small and moderate localized defects of the alveolar process around implants and teeth. CLINICAL CONSIDERATIONS Maxillary tuberosity is often used as a particulate graft for augmentation of deficient alveolar ridge or maxillary sinus prior to or simultaneously with implant insertion, but not as a bone block graft. The maxillary tuberosity block autograft may also provide a valuable bone source for challenging situations such as immediate implant placement into types II and III extraction sockets, treatment of horizontal and vertical bone defects with simultaneous implantation, reconstruction of circumferential defects around implants, and preservation of alveolar ridge. CONCLUSIONS The advantages of the maxillary tuberosity include intraoral corticocancellous autogenous graft with fewer intraoperative difficulties, no need for donor site restoration, less morbidity, and an excellent correction of localized alveolar ridge defects. CLINICAL SIGNIFICANCE Within the limitations of the presented case reports, the use of maxillary tuberosity block autograft has shown to be successful in alveolar ridges augmentation that lack both width and height.
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Affiliation(s)
| | - Francesc Abella Sans
- Department of Restorative Dentistry and EndodonticsUniversitat Internacional de CataluñaBarcelonaSpain
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Zhang S, Zhang X, Li Y, Mao X, Liu R, Qi Y, Lee ES, Jiang HB. Clinical Reference Strategy for the Selection of Treatment Materials for Maxillofacial Bone Transplantation: A Systematic Review and Network Meta-Analysis. Tissue Eng Regen Med 2022; 19:437-450. [PMID: 35532735 PMCID: PMC9130380 DOI: 10.1007/s13770-022-00445-5] [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: 09/18/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 10/18/2022] Open
Abstract
Bone graft materials have mixed effects of bone repair in the field of oral maxillofacial surgery. The qualitative analyses performed by previous studies imply that autogenous odontogenic materials and autogenous bone have similar effects on bone repair in clinical jaw bone transplantation. This retrospective systematic assessment and network meta-analysis aimed to analyze the best effect of clinical application of autogenous odontogenic materials and autogenous, allogeneic, and xenogeneic bone grafts in bone defect repair. A systematic review was performed by searching the PubMed, Cochrane Library, and other journal databases using selected keywords and Medical Subject Headings search terms. 10 Papers (n = 466) that met the inclusion criteria were selected. The assessment of heterogeneity did not reveal any overall statistical difference or heterogeneity (P = 0.051 > 0.05), whereas the comparison between autogenous and allogeneic bone grafts revealed local heterogeneity (P = 0.071 < 0.1). Risk of bias revealed nine unclear studies and one high-risk study. The overall consistency was good (P = 0.065 > 0.05), and the local inconsistency test did not reveal any inconsistency. The publication bias was good. The confidence regarding the ranking of bone graft materials after GRADE classification was moderate. The effects on bone repair in the descending order were as follows: autogenous odontogenic materials, xenogeneic bone, autogenous bone, and allogeneic bone. This result indicates that the autogenous odontogenic materials displayed stronger effects on bone repair compared to other bone graft materials. Autogenous odontogenic materials have broad development prospects in oral maxillofacial surgery.
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Affiliation(s)
- Shuxin Zhang
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Xinyi Zhang
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Yanli Li
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Xuran Mao
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Rui Liu
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Yanxin Qi
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Eui-Seok Lee
- Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dentistry, Korea University, Seoul, 08308, Korea.
| | - Heng Bo Jiang
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China.
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Smeets R, Matthies L, Windisch P, Gosau M, Jung R, Brodala N, Stefanini M, Kleinheinz J, Payer M, Henningsen A, Al-Nawas B, Knipfer C. Horizontal augmentation techniques in the mandible: a systematic review. Int J Implant Dent 2022; 8:23. [PMID: 35532820 PMCID: PMC9086020 DOI: 10.1186/s40729-022-00421-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/25/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose Placement of dental implants has evolved to be an advantageous treatment option for rehabilitation of the fully or partially edentulous mandible. In case of extensive horizontal bone resorption, the bone volume needs to be augmented prior to or during implant placement in order to obtain dental rehabilitation and maximize implant survival and success. Methods Our aim was to systematically review the available data on lateral augmentation techniques in the horizontally compromised mandible considering all grafting protocols using xenogeneic, synthetic, or allogeneic material. A computerized and manual literature search was performed for clinical studies (published January 1995 to March 2021). Results Eight studies ultimately met the inclusion criteria comprising a total of 276 procedures of xenogeneic, allogeneic, or autogenous bone graft applications in horizontal ridge defects. Particulate materials as well as bone blocks were used as grafts with a mean follow-up of 26.0 months across all included studies. Outcome measures, approaches and materials varied from study to study. A gain of horizontal bone width of the mandible with a mean of 4.8 mm was observed in seven of eight studies. All but one study, reported low bone graft failure rates of 4.4% in average. Conclusions Only limited data are available on the impact of different horizontal augmentation strategies in the mandible. The results show outcomes for xenogeneic as well as autologous bone materials for horizontal ridge augmentation of the lower jaw. The use of allogeneic bone-block grafts in combination with resorbable barrier membranes must be re-evaluated. Randomized controlled clinical trials are largely missing. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-022-00421-7.
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Biomechanical Examination of Osseointegration of Titanium Implants Placed Simultaneously With Allogeneic Bone Transfer. J Craniofac Surg 2021; 33:350-353. [PMID: 34292244 DOI: 10.1097/scs.0000000000007880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The aim of this study was to conduct a biomechanical analysis of the early period bone-implant connection of titanium implants in the same type of subjects. In this study, 18 Sprague Dawley rats were used. Four rats were killed to provide the allogeneic bone before the experiment, and the remaining were divided into a control group and an experimental allogeneic bone transfer group. Titanium machined surfaced implants were integrated in tibias in the controls and in the experimental group; simultaneously, implants were integrated into allogeneic bone in the bone transfer group. All the rats were sacrificed 14 days later. Bone tissues with titanium implants were removed for biomechanical analysis, which found that the resistance to force of the control group and the allogeneic graft group was 2.04 and 2.00 Newtons, respectively, and there was no significant difference between the two groups at 14 days, although numerically a higher figure was detected in the controls (P > 0.05). It was concluded, within the limitations of this study, that an allogeneic bone transfer can be used as an alternative to an autogenous graft.
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Kaba YN, Öner Nİ, Amuk M, Bilge S, Soylu E, Demirbaş AE. Evaluation of trabecular bone healing using fractal dimension analysis after augmentation of alveolar crests with autogenous bone grafts: a preliminary study. Oral Radiol 2021; 38:139-146. [PMID: 34003449 DOI: 10.1007/s11282-021-00536-4] [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: 01/24/2021] [Accepted: 05/08/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate bone remodeling after alveolar crest augmentation with autogenous bone grafts. METHODS 50 patients who were applied augmentation due to alveolar deficiency were included in this study. Fractal dimensions were measured on the radiographs in the preoperative, postoperative, follow-up periods. The ROI was selected specific to each patient, but repeated in a standardized manner on subsequent radiographs. RESULTS A total of 50 patients were included in the study; There were 31 females and 19 males. Implants were placed in all patients without any complications. The mean fractal dimensions on the graft recipient side were statistically higher in the postoperative 5th month compared to the postoperative 1st week (p = 0.002). The mean fractal dimensions on the donor side were statistically higher in the preoperative and postoperative 5th month compared to the postoperative 1st week (p < 0.001). CONCLUSION Any clinical imaging method cannot fully reflect the histological microstructures of the bone. Evaluating the fractal analysis together with the clinical results can demonstrate adequate bone healing and quality prior to implant placement. Fractal analysis is a non-invasive, reproducible, method but further, prospective, randomized, controlled clinical studies are needed to estimate bone quality prior to implant placement.
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Affiliation(s)
- Yusuf Nuri Kaba
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Neşe İspekter Öner
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey. .,Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey.
| | - Mehmet Amuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Suheyb Bilge
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Emrah Soylu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Ahmet Emin Demirbaş
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
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Menezes JD, Pereira RDS, Santos AMDS, de Siqueira NB, Boos-Lima FBDJ, Hochuli-Vieira E. Three-dimensional volumetric changes of 5 different bone grafts in human maxillary sinuses reconstruction: a randomized clinical study. Oral Maxillofac Surg 2021; 25:541-547. [PMID: 33715054 DOI: 10.1007/s10006-021-00940-4] [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: 06/17/2020] [Accepted: 01/13/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to compare the three-dimensional volumetric changes of human maxillary sinuses after reconstruction using 5 different bone grafts. PATIENTS AND METHODS Patients underwent unilateral maxillary sinus bone height reconstruction using 5 bone substitutes allocated in different groups as follows: group 1 was grafted with autogenous bone graft alone; group 2 with beta-tricalcium phosphate (β-TCP); group 3 with β-TCP + autogenous bone graft 1:1; group 4 with bioactive glass; and group 5 with bioactive glass + autogenous bone graft 1:1. The patients were submitted to cone beam computed tomography in two periods: 15 days after the surgical procedure (T1) and after 6 months (T2). The results were evaluated as the formula T2-T1 expressing the three-volumetric changes of the biomaterials in elapsed time. RESULTS The resorption rate of autogenous bone graft was -630.699 ± 300.9 mm3; in the β-TCP group, it was -315.772 ± 125.6 mm3; in the group with β-TCP + autogenous bone graft 1:1, it was -336.205 ± 195.7 mm3; and in groups with bioactive glass and with the addition of autogenous bone graft 1:1, it was -428.878 ± 311.6 mm3 and -576.917 ± 471.6 mm3, respectively, without statistical difference (p = 0.167). Pearson's correlated test revealed a strong correlation as well as a progressive resorption of the grafts during bone healing. CONCLUSION The similar outcomes for the three-dimensional volumetric changes using the bone substitutes evaluated after 6 months of bone healing suggest that all these grafts can be performed to maxillary sinus reconstruction.
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Affiliation(s)
| | - Rodrigo Dos Santos Pereira
- Universidade do Grande Rio - UNIGRANRIO, Duque de Caxias, Brazil. .,UNIFESO - Centro Universitário Serra dos Órgãos, Teresópolis, Brazil.
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Stricker A, Jacobs R, Maes F, Fluegge T, Vach K, Fleiner J. Resorption of retromolar bone grafts after alveolar ridge augmentation-volumetric changes after 12 months assessed by CBCT analysis. Int J Implant Dent 2021; 7:7. [PMID: 33474648 PMCID: PMC7817723 DOI: 10.1186/s40729-020-00285-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 12/28/2020] [Indexed: 11/15/2022] Open
Abstract
In this pilot study, a volumetric analysis of retromolar onlay bone grafts over a period of 12 months was conducted, using repeated CBCT imaging combined with automated image registration. Eleven patients being treated with 16 bone grafts taken from the retromolar area were examined by CBCT scanning prior to bone augmentation (T0), immediately after bone augmentation (T1) and after a healing time of 12 months after augmentation (T2). Graft volumes were measured at each time point after automated image registration of consecutive CBCT scans. The mean volume of the augmented site was 372.2 ± 179.4 mm3. Resorption relative to the original augmented volume was 43.7% ± 19.0% after 12 months. Three-dimensional graft resorption could be precisely depicted by the use of automated image registration for CBCT data over a period of 12 months and demonstrated extensive volumetric changes of bone grafts taken from the ascending ramus of the mandible. Graft resorption and continuous bony remodeling of the grafted site before and after implant insertion have to be carefully considered by the clinician.
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Affiliation(s)
- Andres Stricker
- Center of Implantology, Periodontology and 3D Head-and-Neck Imaging, Konstanz, Germany. .,Department of Oral and Maxillofacial Surgery, Medical Center, University of Freiburg, Freiburg, Germany. .,Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Frederik Maes
- ESAT/PSI & Medical Imaging Research Center, Faculty of Engineering Sciences, University of Leuven, Leuven, Belgium
| | - Tabea Fluegge
- Department of Oral and Maxillofacial Surgery, Charité University of Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Jonathan Fleiner
- Center of Implantology, Periodontology and 3D Head-and-Neck Imaging, Konstanz, Germany.,OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium
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Gandhi V, Lowney A, Cardarelli L, Yadav S, Tadinada A. Three-dimensional evaluation of the mandibular symphyseal region in block graft harvesting for dental implants using cone-beam computed tomography. Imaging Sci Dent 2020; 50:217-226. [PMID: 33005579 PMCID: PMC7506094 DOI: 10.5624/isd.2020.50.3.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/01/2020] [Accepted: 06/25/2020] [Indexed: 12/20/2022] Open
Abstract
Purpose The purpose of this study was to analyze the quantity and quality of the mandibular anterior alveolar bone in terms of alveolar width, density, and total alveolar height (TAH) based on dental status, gender, and age. Additionally, this study aimed to quantitatively evaluate the available alveolar height for graft harvesting (AHGH) and examine its variability based on the aforementioned factors. Materials and Methods This retrospective cone-beam computed tomographic study included a total of 100 subjects. On the basis of gender, dental status, and age, the scans were divided into 3 primary groups and 8 subgroups. The mandibular alveolar width and density were measured 5 mm mesial to the mental foramen bilaterally and at the midline. The TAH was measured at the midline, and the AHGH was measured as the midline distance between 5 mm apical to the root of the canines and 5 mm superior to the lower border. Results The mandibular alveolar width was statistically similar between dentulous and edentulous patients (P>0.05). A significantly greater density was observed at the midline in edentulous patients (P<0.05). The TAH was significantly greater in edentulous male patients than in edentulous female patients (P<0.05). Dentulous and male patients had significantly greater AHGH than edentulous and female patients, respectively (P<0.05). Conclusion Based on the data evaluated in this study, it can be concluded that the mandibular symphyseal area has adequate bone quality and quantity for bone graft harvesting for dental implant therapy.
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Affiliation(s)
- Vaibhav Gandhi
- Division of Orthodontics, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Arianna Lowney
- School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Lauren Cardarelli
- School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Sumit Yadav
- Division of Orthodontics, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Aditya Tadinada
- Division of Oral and Maxillofacial Radiology, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
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14
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Starch-Jensen T, Deluiz D, Tinoco EMB. Horizontal Alveolar Ridge Augmentation with Allogeneic Bone Block Graft Compared with Autogenous Bone Block Graft: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2020; 11:e1. [PMID: 32377325 PMCID: PMC7191383 DOI: 10.5037/jomr.2020.11101] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/04/2020] [Indexed: 12/19/2022]
Abstract
Objectives The objective of the present systematic review was to test the hypothesis of no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block. Material and Methods A MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted including human studies published in English through March 13, 2019. Comparative and non-comparative studies evaluating horizontal ridge augmentation with allogeneic bone block were included. Cochrane risk of bias tool and Newcastle-Ottawa Scale were used to evaluate risk of bias. Results One comparative study with high quality and 12 non-comparative studies fulfilled the inclusion criteria. Considerable heterogeneity prevented meta-analysis from being performed. The comparative retrospective short-term study demonstrated no significant difference in implant treatment outcome between the two treatment modalities. Non-comparative long-term studies revealed high implant survival, gain in alveolar ridge width and bone regeneration with allogeneic bone block. However, non-comparative studies disclosed high incidence of complications including dehiscence, exposure of allogeneic bone block and partial or total loss of the grafts. Conclusions There seemed to be no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block. However, increased risk of complications was frequently reported with allogeneic bone block.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
| | - Daniel Deluiz
- Department of Periodontology, Rio de Janeiro State University, Rio de JaneiroBrazil
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15
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Moraschini V, Almeida DCF, Calasans‐Maia MD, Kischinhevsky ICC, Louro RS, Granjeiro JM. Immunological response of allogeneic bone grafting: A systematic review of prospective studies. J Oral Pathol Med 2020; 49:395-403. [DOI: 10.1111/jop.12998] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/18/2019] [Accepted: 01/18/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Vittorio Moraschini
- Department of Oral Surgery Dentistry School Fluminense Federal University Niterói Rio de Janeiro Brazil
| | | | | | | | - Rafael Seabra Louro
- Department of Oral Surgery Dentistry School Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - José Mauro Granjeiro
- Department of Dental Technics School of Dentistry Fluminense Federal University Niterói Rio de Janeiro Brazil
- Researcher at National Institute of Metrology Quality and Technology (INMETRO) Niterói Rio de Janeiro Brazil
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16
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Ogawa M, Katagiri S, Koyanagi T, Maekawa S, Shiba T, Ohsugi Y, Takeuchi Y, Ikawa T, Takeuchi S, Sekiuchi T, Arai Y, Kazama R, Wakabayashi N, Izumi Y, Iwata T. Accuracy of cone beam computed tomography in evaluation of palatal mucosa thickness. J Clin Periodontol 2020; 47:479-488. [PMID: 31912948 DOI: 10.1111/jcpe.13254] [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: 05/22/2019] [Revised: 11/26/2019] [Accepted: 01/04/2020] [Indexed: 12/12/2022]
Abstract
AIM The purpose of this study was to investigate the accuracy of the measurement of palatal mucosa thickness using cone beam computed tomography (CBCT) and to create a conversion formula to evaluate palatal mucosa thickness more accurately. We then evaluated the palatal mucosa thickness in a Japanese population using CBCT and the conversion formula. MATERIALS AND METHODS We evaluated palatal mucosa thickness in 10 healthy subjects at 15 sites using CBCT, digital impression, and K file. Multiple regression analysis was performed to create a conversion formula to measure thickness accurately. We then obtained CBCT data from 174 patients retrospectively, applied the conversion formula, and evaluated palatal mucosa thickness. RESULTS Sites of measurement affected measurement error. Measurement using CBCT was 0.34 ± 0.04 mm smaller than actual measurement; therefore, a conversion formula was created. Male, age ≥60 years, and probing pocket depth ≥4 mm had significant and positive associations with palatal mucosa thickness; however, no association was observed between bleeding on probing and palatal mucosa thickness. CONCLUSION CBCT is useful for the noninvasive and accurate measurement of palatal mucosa thickness.
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Affiliation(s)
- Miho Ogawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsuro Koyanagi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shogo Maekawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiko Shiba
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiro Ikawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shogo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Sekiuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Arai
- Department of Removable Partial Prosthodontics, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryunosuke Kazama
- Department of Removable Partial Prosthodontics, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriyuki Wakabayashi
- Department of Removable Partial Prosthodontics, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Oral Care Perio Center, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Fukushima, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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17
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Cohen DJ, Scott KM, Kulkarni AN, Wayne JS, Boyan BD, Schwartz Z. Acellular mineralized allogenic block bone graft does not remodel during the 10 weeks following concurrent implant placement in a rabbit femoral model. Clin Oral Implants Res 2019; 31:37-48. [PMID: 31545532 DOI: 10.1111/clr.13544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/22/2019] [Accepted: 09/08/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Due to bone loss, endosseous implants often require addition of a bone graft to support adequate primary fixation, bone regeneration, and osseointegration. The aim of this study was to compare effectiveness of autogenic and allogenic bone grafts when used during simultaneous insertion of the implant. MATERIALS AND METHODS 4-mm-diameter rabbit diaphyseal bone autografts or allografts (n = 16/group) with a 3.2-mm pre-drilled hole in the center were placed into a 4 mm defect in the proximal femur of 3.5 kg male New Zealand White rabbits. Machined 3.2 × 10 mm grit-blasted, acid-etched titanium-aluminum-vanadium (Ti6Al4V) implants were placed. Control implants were placed into progressively drilled 3.2-mm holes in the contralateral limbs. Post-insertion day 70, samples were analyzed by micro-CT and calcified histology, or by mechanical torque and push-out testing followed by decalcified histology. RESULTS Both grafts were integrated with the native bone. Micro-CT showed less bone volume (BV) and bone volume/total volume (BV/TV) in the allograft group, but histology showed no differences in BV or BV/TV between groups. Allograft lacked living cells, whereas autograft was cellularized. No difference was found in maximum removal torque between groups. Compressive loading at the graft-to-bone interface was significantly lower in allograft compared with autograft groups. CONCLUSIONS There was less bone in contact with the implant and significantly less maximum compressive load in the allograft group compared with autograft. The allograft remained acellular as demonstrated by empty lacunae. Taken together, block allograft implanted simultaneously with an implant produces a poorer quality bone compared with autograft.
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Affiliation(s)
- D Joshua Cohen
- College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Kayla M Scott
- College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Aniket N Kulkarni
- College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Jennifer S Wayne
- College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Barbara D Boyan
- College of Engineering, Virginia Commonwealth University, Richmond, VA, USA.,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Zvi Schwartz
- College of Engineering, Virginia Commonwealth University, Richmond, VA, USA.,Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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18
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Procopio O, Trojan D, Frigo AC, Paolin A. Use of homologous bone for alveolar crest reconstruction in 483 patients with 5 years' outcomes post implantation. Oral Maxillofac Surg 2019; 23:353-363. [PMID: 31147787 PMCID: PMC6689316 DOI: 10.1007/s10006-019-00781-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 05/21/2019] [Indexed: 01/28/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the clinical course of bone reconstruction of the alveolar crest using homologous fresh-frozen bone harvested from deceased donors. METHODS A retrospective survey was based on the Castelfranco Veneto Hospital database, in which 3264 clinical records with a primary or secondary diagnosis of alveolar atrophy were collected over a 10-year period. A random sample of 483 patients with at least 5 years' follow-up was included in the survey. Patients were contacted by telephone and administered a questionnaire with specific questions to build a significant sample. RESULTS Of the patients, 449 (93% of the sample) had an uneventful follow-up after surgery and 93.2% received at least one implant, with a mean of 3.4 implants per patient. At the time of the survey, 93% of the patients were wearing a dental prosthesis, 86.9% had not lost any implants, and 6.7% had lost at least one implant, while 6.4% still had implants but presented some clinical problems. Finally, patients were asked to provide an index score (1-10 points) on the therapy as a whole, i.e., bone graft, implants, and prostheses. A score of insufficient (up to 5 points) was given by 5.3% of patients, of sufficient (6 to 7 points) by 6.1%, and of good/very good (over 7) by 88.6%. CONCLUSIONS Homologous bone for alveolar crest reconstruction can be a valid alternative to autologous grafting if specific tissue limitations are considered when planning therapy. Creeping substitution is partial and slower than in autologous grafts, especially in cases where cortical bone is thick or volume graft is very large. The quality of soft tissue coverage and mucosa lining is also important, possibly due to slower tissue revascularization, so future implants should predictably be positioned primarily within the original host bone.
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Affiliation(s)
- Olindo Procopio
- Maxillofacial Surgery Unit, Castelfranco Veneto Hospital, Treviso, Italy
| | - Diletta Trojan
- Treviso Tissue Bank Foundation, Piazzale Ospedale, 1, Treviso, Italy.
| | - Anna Chiara Frigo
- Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padua, Italy
| | - Adolfo Paolin
- Treviso Tissue Bank Foundation, Piazzale Ospedale, 1, Treviso, Italy
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19
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Use of homologous bone for alveolar crest reconstruction in 483 patients with 5 years' outcomes post implantation. Oral Maxillofac Surg 2019. [PMID: 31147787 DOI: 10.1007/s10006-019-00781-2.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the clinical course of bone reconstruction of the alveolar crest using homologous fresh-frozen bone harvested from deceased donors. METHODS A retrospective survey was based on the Castelfranco Veneto Hospital database, in which 3264 clinical records with a primary or secondary diagnosis of alveolar atrophy were collected over a 10-year period. A random sample of 483 patients with at least 5 years' follow-up was included in the survey. Patients were contacted by telephone and administered a questionnaire with specific questions to build a significant sample. RESULTS Of the patients, 449 (93% of the sample) had an uneventful follow-up after surgery and 93.2% received at least one implant, with a mean of 3.4 implants per patient. At the time of the survey, 93% of the patients were wearing a dental prosthesis, 86.9% had not lost any implants, and 6.7% had lost at least one implant, while 6.4% still had implants but presented some clinical problems. Finally, patients were asked to provide an index score (1-10 points) on the therapy as a whole, i.e., bone graft, implants, and prostheses. A score of insufficient (up to 5 points) was given by 5.3% of patients, of sufficient (6 to 7 points) by 6.1%, and of good/very good (over 7) by 88.6%. CONCLUSIONS Homologous bone for alveolar crest reconstruction can be a valid alternative to autologous grafting if specific tissue limitations are considered when planning therapy. Creeping substitution is partial and slower than in autologous grafts, especially in cases where cortical bone is thick or volume graft is very large. The quality of soft tissue coverage and mucosa lining is also important, possibly due to slower tissue revascularization, so future implants should predictably be positioned primarily within the original host bone.
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20
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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.
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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
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21
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Hartlev J, Spin‐Neto R, Schou S, Isidor F, Nørholt SE. Cone beam computed tomography evaluation of staged lateral ridge augmentation using platelet‐rich fibrin or resorbable collagen membranes in a randomized controlled clinical trial. Clin Oral Implants Res 2019; 30:277-284. [DOI: 10.1111/clr.13413] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Jens Hartlev
- Department of Dentistry and Oral Health, Section for Oral Surgery and Oral Pathology Aarhus University Aarhus C Denmark
- Department of Oral and Maxillofacial Surgery Aarhus University Hospital Aarhus C Denmark
| | - Rubens Spin‐Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology Aarhus University Aarhus C Denmark
| | - Søren Schou
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Faculty of Health Sciences University of Copenhagen Copenhagen N Denmark
| | - Flemming Isidor
- Department of Dentistry and Oral Health, Section for Prosthetics Aarhus University Aarhus C Denmark
| | - Sven Erik Nørholt
- Department of Dentistry and Oral Health, Section for Oral Surgery and Oral Pathology Aarhus University Aarhus C Denmark
- Department of Oral and Maxillofacial Surgery Aarhus University Hospital Aarhus C Denmark
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22
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Altay MA, Quereshy FA, Nijhawan SK, Teppa JF, Horan MP, Yıldırımyan N, Baur DA. Comparative assessment of 3D reconstruction technique and Cavalieri's principle in predicting the mandibular bone defect volumes. Eur Oral Res 2019; 52:105-110. [PMID: 30775711 DOI: 10.26650/eor.2018.478] [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: 08/09/2017] [Revised: 11/13/2017] [Accepted: 12/12/2017] [Indexed: 11/20/2022] Open
Abstract
Purpose The objective of this study was to compare the accuracy of the Cavalieri's principle and 3D reconstruction in predicting the volume of a bony defect. Materials and Methods Defects of the same approximate size were created on nine artificial mandibles. The actual volume of the defect on each mandible was measured by water displacement, and served as the control. Each mandible was then scanned using a CBCT and volume measurements were made for each defect using two techniques: Cavalieri's principle and 3D reconstruction. For each defect, the volume obtained by each of the two techniques was compared to the control volume using the analysis of variances (ANOVA) with p<0.05. Results ANOVA between the control, 3D reconstruction and Cavalieri's principle groups showed no statistically significant differences (p=.058). When the control group was further analyzed by Dunnett's post-hoc test, the results from Cavalieri's principle were found to be statistically different than the control group (p=.035), whereas the results of 3D reconstruction technique did not reach the level of significance (p=.523). Conclusion Cavalieri's principle significantly underestimates the actual control volume, and is less accurate than the 3D reconstruction technique. The 3D reconstruction method is a reliable technique in measuring volume of bony defects.
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Affiliation(s)
- Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Akdeniz University Faculty of Dentistry, Antalya, Turkey
| | - Faisal A Quereshy
- Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Faculty of Dental Medicine, Cleveland, OH, USA
| | - Sumit K Nijhawan
- Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Faculty of Dental Medicine, Cleveland, OH, USA
| | - Jose F Teppa
- Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Faculty of Dental Medicine, Cleveland, OH, USA
| | - Michael P Horan
- Oral and Maxillofacial Surgery Section at Cleveland Clinic, Cleveland, OH, USA
| | - Nelli Yıldırımyan
- Department of Oral and Maxillofacial Surgery, Akdeniz University Faculty of Dentistry, Antalya, Turkey
| | - Dale A Baur
- Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Faculty of Dental Medicine, Cleveland, OH, USA
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23
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Lee KH, Jeong HG, Kwak EJ, Park W, Kim KD. Ultrasound Guided Free Gingival Graft: Case Report. J ORAL IMPLANTOL 2018; 44:385-388. [DOI: 10.1563/aaid-joi-d-17-00298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Kang-Hee Lee
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ho-Gul Jeong
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | | | - Wonse Park
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kee-Deog Kim
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
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24
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Bertl K, Domic D, Hirtler L, Heimel P, Esfandeyari A, Stavropoulos A, Ulm C. Micro-CT evaluation of the cortical bone micro-architecture in the anterior and posterior maxilla and the maxillary sinus floor. Clin Oral Investig 2018; 23:1453-1459. [PMID: 30112634 DOI: 10.1007/s00784-018-2573-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 08/09/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To perform a within-subject comparison of the cortical bone micro-architecture of the maxillary sinus floor (MSF) to that of the buccal aspect of the anterior and posterior maxilla. METHODS Micro-CT scans of the buccal aspect of the anterior and posterior maxilla and of the MSF in 14 human anatomical specimens were recorded. Within-subject comparisons were performed for cortical thickness (Ct.Th) and porosity (Ct.Po), average pore volume (AvgPo.V), and pore density (Po.Dn). RESULTS The MSF presented the lowest and the anterior maxilla the highest Ct.Th, while Ct.Po was significantly higher at the MSF compared to the posterior maxilla (p = 0.021). No relevant differences were recorded for AvgPo.V and Po.Dn among regions (p > 0.067). Further, an increased Ct.Th at the MSF was significantly associated with a lower Po.Dn, while a higher Ct.Th and an increased AvgPo.V in the anterior maxilla were associated with a higher Ct.Th and an increased AvgPo.V, respectively, in the posterior maxilla and MSF. Finally, within each region, the AvgPo.V was associated positively with Ct.Po and negatively with Po.Dn. CONCLUSIONS The cortical bone of the MSF is slightly less thick and slightly more porous compared to the cortical bone at the buccal aspect of the anterior and posterior maxilla. CLINICAL RELEVANCE During lateral and vertical bone augmentation procedures, the cortical recipient bone is perforated several times to open the bone marrow compartment to facilitate provision of osteoinductive cells and molecules in the augmented space. Whether it is meaningful to approach the MSF in a similar way during MSF augmentation procedures or whether the slightly more porous structure of the MSF observed herein reduces the cortical barrier function already sufficiently has to be assessed in future clinical trials.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs väg 34, 20506, Malmö, Sweden
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Danijel Domic
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Lena Hirtler
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Medical University of Vienna, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna, Austria
| | - Azadeh Esfandeyari
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs väg 34, 20506, Malmö, Sweden.
| | - Christian Ulm
- Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
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25
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Menezes JD, Pereira RDS, Bonardi JP, Griza GL, Okamoto R, Hochuli-Vieira E. Bioactive glass added to autogenous bone graft in maxillary sinus augmentation: a prospective histomorphometric, immunohistochemical, and bone graft resorption assessment. J Appl Oral Sci 2018; 26:e20170296. [PMID: 29898173 PMCID: PMC6007965 DOI: 10.1590/1678-7757-2017-0296] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 01/05/2018] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to compare the bone resorption rate, histomorphometry and immunohistochemical findings of bioactive glass (Biogran; Biomet, Warsaw, IN, USA) mixed with autogenous bone grafts (1:1) and autogenous bone graft isolate in maxillary sinus elevation surgery. Material and Methods A total of 9 maxillary sinuses were grafted with Biogran with autogenous bone graft (group 1) and 12 were mixed with autogenous bone graft (group 2). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T1), and 6 months later, another CBCT scan was performed to evaluate the final graft volume (T2) and determine the graft resorption rate. The resorption outcomes were 37.9%±18.9% in group 1 and 45.7%±18.5% in group 2 (P=0.82). After 6 months, biopsies were obtained concurrent with the placement of dental implants; these implants were subjected to histomorphometric analysis and immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). Results The average bone formation in group 1 was 36.6%±12.9 in the pristine bone region, 33.2%±13.3 in the intermediate region, and 45.8%±13.8 in the apical region; in group 2, the values were 34.4%±14.4, 35.0%±13.9, and 42.0%±16.6 of new bone formation in the pristine bone, intermediate, and apical regions, respectively. Immunostaining for TRAP showed poor clastic activity in both groups, which can indicate that those were in the remodeling phase. Conclusions The similarity between the groups in the formation and maintenance of the graft volume after 6 months suggests that the bioactive glass mixed with autogenous bone (1:1) can be used safely as a bone substitute for the maxillary sinus lift.
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Affiliation(s)
- Juliana Dreyer Menezes
- Univ. Estadual Paulista , Faculdade de Odontologia de Araraquara , Araraquara , São Paulo , Brasil
| | | | - João Paulo Bonardi
- Univ. Estadual Paulista , Faculdade de Odontologia de Araçatuba , Araçatuba , São Paulo , Brasil
| | - Geraldo Luiz Griza
- Univ. Estadual Paulista , Faculdade de Odontologia de Araçatuba , Araçatuba , São Paulo , Brasil
| | - Roberta Okamoto
- Univ. Estadual Paulista , Faculdade de Odontologia de Araçatuba , Departamento de Ciências Básicas , Araçatuba , São Paulo , Brasil
| | - Eduardo Hochuli-Vieira
- Univ. Estadual Paulista , Faculdade de Odontologia de Araraquara , Departamento de Cirurgia e Diagnóstico , Araraquara , São Paulo , Brasil
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Nunes FAS, Pignaton TB, Novaes AB, Taba M, Messora MR, Palioto DB, Spin-Neto R, de Souza SLS. Evaluation of a bone substitute covered with a collagen membrane for ridge preservation after tooth extraction. Clinical and tomographic randomized controlled study in humans. Clin Oral Implants Res 2018; 29:424-433. [DOI: 10.1111/clr.13140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Felipe Anderson Sousa Nunes
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Túlio B. Pignaton
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Arthur B. Novaes
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Mário Taba
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Michel R. Messora
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Daniela B. Palioto
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Rubens Spin-Neto
- Oral Radiology; Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
| | - Sérgio Luís Scombatti de Souza
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
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Fretwurst T, Gad LM, Steinberg T, Schmal H, Zeiser R, Amler AK, Nelson K, Altmann B. Detection of major histocompatibility complex molecules in processed allogeneic bone blocks for use in alveolar ridge reconstruction. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:S2212-4403(18)30054-3. [PMID: 29571656 DOI: 10.1016/j.oooo.2018.01.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/14/2017] [Accepted: 01/20/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Because processed allogenic bone blocks contain remnants of cells and other organic material, the present study examined the putative presence of major histocompatibility complex (MHC) molecules in protein extracts derived from processed allogeneic bone blocks. STUDY DESIGN Protein content and the immunogenic potential of 3 different processed allografts (Osteograft, DIZG, Berlin, Germany; Caput femoris, DIZG, Berlin, Germany; Human Spongiosa, Charité Tissue Bank, Berlin, Germany) were assessed by protein extraction and analysis of the presence of MHC class 1 and 2 molecules prior to grafting. MHC concentration was measured by using enzyme-linked immunosorbent assay. RESULTS Protein content in the allograft materials varied between 0.87 and 1.61 µg protein/mg. In the allograft Human Spongiosa, no MHC was detected, whereas in the allogeneic bone blocks Osteograft and Caput femoris MHC 1 (0.04-0.037 ng/mg graft material) and in Osteograft MHC class 2 molecules were detectable. CONCLUSIONS The results of the present study suggest that despite thorough processing, a potential antigenicity of allografts is not eliminated. MHC molecules in allografts may sensitize the immune system.
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Affiliation(s)
- Tobias Fretwurst
- Department of Oral and Craniomaxillofacial Surgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Lames M Gad
- Department of Oral and Craniomaxillofacial Surgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thorsten Steinberg
- Department of Oral Biotechnology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Hagen Schmal
- Department of Orthopedics and Traumatology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense M, Denmark
| | - Robert Zeiser
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna-K Amler
- Department of Oral and Craniomaxillofacial Surgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katja Nelson
- Department of Oral and Craniomaxillofacial Surgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Brigitte Altmann
- Department of Oral and Craniomaxillofacial Surgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Coutinho LF, Amaral JBD, Santos ÉBD, Martinez EF, Montalli VAM, Junqueira JLC, Araújo VCD, Napimoga MH. Presence of Cells in Fresh-Frozen Allogeneic Bone Grafts from Different Tissue Banks. Braz Dent J 2018; 28:152-157. [PMID: 28492743 DOI: 10.1590/0103-6440201701206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 01/04/2017] [Indexed: 11/22/2022] Open
Abstract
Bone replacement materials have been widely used to reconstruct atrophic jawbones. Based on previous reports demonstrating the presence of viable cells in bone blocks even after processing by musculoskeletal tissue banks for orthopedic use, the aim of this study was to evaluate the presence of cells in bone blocks from three Brazilian tissue banks for maxillary reconstructions. All samples were processed by the respective tissue banks, according to the guidelines of the Brazilian National Sanitary Surveillance Agency. Three samples were removed from each block for subsequent histological processing and stained using hematoxylin & eosin. Further evaluation included section staining by the Feulgen method and ultrastructural analysis using scanning electron microscopy (SEM). Light microscopy images from all bone samples showed presence of osteocyte-like cells in all groups and intense Feulgen staining, demonstrating presence of DNA in bone even after tissue processing. The ultrastructural analysis showed red blood cells in lacunae within the bone tissue. In conclusion, despite bone tissue processing by the musculoskeletal tissue banks, cells may be found within the bone used for allogeneic grafts.
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Chiapasco M, Casentini P. Horizontal bone-augmentation procedures in implant dentistry: prosthetically guided regeneration. Periodontol 2000 2018; 77:213-240. [DOI: 10.1111/prd.12219] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Use of Bone Allograft With or Without Bone Marrow Aspirate Concentrate in Appositional Reconstructions. IMPLANT DENT 2017; 26:915-921. [DOI: 10.1097/id.0000000000000669] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Rocha LRS, Aloise AC, Oliveira RDM, Teixeira ML, Pelegrine AA, Macedo LGS. Long-term Retrospective Study of Implants Placed after Sinus Floor Augmentation with Fresh-frozen homologous block. Contemp Clin Dent 2017; 8:248-252. [PMID: 28839411 PMCID: PMC5551330 DOI: 10.4103/ccd.ccd_63_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Aim: The aim of this study was to analyze and follow-up implants placed in the posterior maxillary regions previously grafted with homologous bone. Materials and Methods: Forty-one grafts with homologous bone blocks were performed in maxillary sinuses, and 121 implants were placed in premolar and molar regions approximately 6 months after the grafts. Patients were followed up for periods varying from 12 to 124 months after rehabilitation. Results: The results showed two implant failures, for a 98.3% success rate during the follow-up period. Discussion: The implants placed had an average torque of 40 N-cm, regardless of the, design, diameter, and length of the implants used. Conclusion: After following up on the implants placed in this study, we concluded that those placed in regions of the maxillary sinuses previously grafted with homologous bone blocks had high long-term success rates and met the functional masticatory requirements.
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Affiliation(s)
| | - Antonio Carlos Aloise
- Department of Plastic Surgery of the Federal São Paulo University UNIFESP, Campinas, SP, Brazil
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Groenendijk E, Staas TA, Graauwmans FEJ, Bronkhorst E, Verhamme L, Maal T, Meijer GJ. Immediate implant placement: the fate of the buccal crest. A retrospective cone beam computed tomography study. Int J Oral Maxillofac Surg 2017; 46:1600-1606. [PMID: 28734634 DOI: 10.1016/j.ijom.2017.06.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 04/03/2017] [Accepted: 06/29/2017] [Indexed: 12/25/2022]
Abstract
This retrospective study aimed to analyse the fate of the buccal crest after immediate implant placement (IIP) through the use of cone beam computed tomography (CBCT). In 16 consecutive patients, an implant was placed in a more palatal position after extraction, thereby creating a gap of at least 2mm between the implant and the buccal crest. Subsequently, this gap was filled with a bone substitute. Preoperatively, immediate postoperatively, and late postoperatively, a CBCT was made to measure the thickness of the buccal crest. After application of the bone substitute, the buccal crest increased in thickness from 0.9mm to 2.4mm (mean). At a mean of 103 weeks after IIP, late postoperative CBCT scans showed that the thickness of the buccal crest was compacted to 1.8mm. In the same period, the height of the buccal crest increased by 1.6mm (mean) to, on average, 1.2mm above the implant shoulder. The aesthetic outcome was analysed using the White and Pink Esthetic Score (WES and PES). Both scored high: 8.4 and 11.8, respectively. Within the limitations of this study, the results of this IIP protocol are promising. Long-term prospective research on this topic on a large number of patients is necessary.
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Affiliation(s)
| | - T A Staas
- Dental Implant Clinic, 's-Hertogenbosch, The Netherlands
| | - F E J Graauwmans
- Section Implantology & Periodontology, Department of Dentistry, Radboudumc, Nijmegen, The Netherlands
| | - E Bronkhorst
- Department of Preventive and Curative Dentistry, Radboudumc, Nijmegen, The Netherlands
| | - L Verhamme
- Department of Oral and Maxillofacial Surgery, Radboudumc, Nijmegen, The Netherlands; 3D Facial Imaging research Group, Radboudumc, Nijmegen, The Netherlands
| | - T Maal
- Department of Oral and Maxillofacial Surgery, Radboudumc, Nijmegen, The Netherlands
| | - G J Meijer
- Section Implantology & Periodontology, Department of Dentistry, Radboudumc, Nijmegen, The Netherlands; Department of Preventive and Curative Dentistry, Radboudumc, Nijmegen, The Netherlands; Department of Oral and Maxillofacial Surgery, Radboudumc, Nijmegen, The Netherlands; 3D Facial Imaging research Group, Radboudumc, Nijmegen, The Netherlands
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Iliac Crest Fresh-Frozen Allografts Versus Autografts in Oral Pre-Prosthetic Bone Reconstructive Surgery: Histologic and Histomorphometric Study. IMPLANT DENT 2017; 25:731-738. [PMID: 27749380 DOI: 10.1097/id.0000000000000451] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this work was to compare histologically bone biopsies obtained during dental implant placement in atrophic jaws reconstructed with fresh-frozen bone (FFB) or autologous bone blocks. MATERIALS AND METHODS Twenty partially or totally edentulous patients were treated either with iliac crest FFB grafts (14 patients; group A) or with iliac crest autografts (6 patients; group B). Seven to 9 months later, dental implants were placed in the reconstructed jaws and bone biopsies were harvested. RESULTS The reconstructive procedure was uneventful in 9 patients of group A and in all patients of group B. Samples from both groups did not show relevant differences concerning the proportion of lamellar bone, newly formed bone, and bone marrow. In group A, the decreasing proportion of blood vessels from the apical to the coronal portion, the larger amount of lacunae in the apical portion, and the fewer vessels in the coronal portion than in group B evoke an effort of the host bone to "integrate" the graft from the apical portion. CONCLUSIONS FFB cannot be considered as successful and safe in alveolar bone reconstruction as autogenous bone grafting.
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de Molon RS, de Paula WN, Spin-Neto R, Verzola MHA, Tosoni GM, Lia RCC, Scaf G, Marcantonio E. Correlation of fractal dimension with histomorphometry in maxillary sinus lifting using autogenous bone graft. Braz Dent J 2016; 26:11-8. [PMID: 25672378 DOI: 10.1590/0103-6440201300290] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 12/11/2014] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to determine the pattern of bone remodeling after maxillary sinus lifting in humans by means of fractal dimension (FD) and histomorphometric analysis. Therefore, the correlation between FD and the histomorphometric findings was evaluated. Sixteen patients with posterior edentulous maxilla were enrolled in this study. Maxillary sinus lifting was performed using autogenous bone grafted from the mandibular retromolar area. Three direct digital panoramic radiographs were obtained: before surgery (Group 1), immediately postoperatively (Group 2) and after 6 months of healing (Group 3) for FD analysis. Biopsies were taken after 6 months, processed and submitted to histological and histomorphometric analysis. Data were analyzed by Shapiro-Wilk test and ANOVA test followed by a Tukey test (a = 0.05). The bone volume fraction of newly trabecular bone (TB) and medullary area (MA) was measured as 62.75% ± 17.16% and 37.25 ± 17.16%, respectively. Significant difference in FD analysis was measured between Group 1 and Group 3. No significant difference was found in the correlation between FD and histomorphometric analysis for TB and MA (p = 0.84). In conclusion, all performed analyses were effective in assessing the bone-remodeling pattern in the maxillary sinus, offering complementary information about healing and predictable outcomes. There were no correlations between FD and histomorphometric analysis.
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Affiliation(s)
- Rafael Scaf de Molon
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil
| | - Wagner Nunes de Paula
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil
| | - Rubens Spin-Neto
- Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - Mario Henrique Arruda Verzola
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil
| | - Guilherme Monteiro Tosoni
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil
| | | | - Gulnara Scaf
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, Brazil
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Deluiz D, Oliveira LS, Fletcher P, Pires FR, Tinoco JM, Tinoco EMB. Histologic and Tomographic Findings of Bone Block Allografts in a 4 Years Follow-up: A Case Series. Braz Dent J 2016; 27:775-780. [DOI: 10.1590/0103-6440201601100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 09/30/2016] [Indexed: 12/26/2022] Open
Abstract
Abstract The aim of this paper is to report histologic and tomographic findings of fresh frozen bone block allografts bearing dental implants in functional occlusion in a long-term follow-up. Four patients with implants functionally loaded for 4 years on augmented ridges requiring additional mucogingival surgery or implant placement were included in this case series. Cone-beam tomography scans were compared volumetrically between the baseline (first implant placement) and current images. Biopsies of the grafts were retrieved and sent to histological analysis. Volumetric reduction of the grafts varied from 2.1 to 7.7%. Histological evaluation demonstrated well-incorporated grafts with different degrees of remodeling. While data presented in this report are from a small sample size and do not allow definitive conclusions, the biopsies of the grafted sites were very similar to the host's native bone. Remodeling of the cortical portion of the allografts seems to take longer than the cancellous portion. The presence of unincorporated graft remains did not impair the implant success or the health of the surrounding tissues. This is the first time histologic and tomographic long term data of bone allograft have been made available in dentistry.
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Affiliation(s)
- Daniel Deluiz
- Universidade do Estado do Rio de Janeiro, Brazil; Pontifícia Universidade Católica, Brazil
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Deluiz D, Oliveira L, Fletcher P, Pires FR, Nunes MA, Tinoco EM. Fresh-Frozen Bone Allografts in Maxillary Alveolar Augmentation: Analysis of Complications, Adverse Outcomes, and Implant Survival. J Periodontol 2016; 87:1261-1267. [DOI: 10.1902/jop.2016.160155] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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37
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Deluiz D, Santos Oliveira L, Ramôa Pires F, Reiner T, Armada L, Nunes MA, Muniz Barretto Tinoco E. Incorporation and Remodeling of Bone Block Allografts in the Maxillary Reconstruction: A Randomized Clinical Trial. Clin Implant Dent Relat Res 2016; 19:180-194. [DOI: 10.1111/cid.12441] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/30/2016] [Accepted: 07/11/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel Deluiz
- Postdoctoral researcher, Department of Periodontology; State University of Rio de Janeiro; RJ, Rio de Janeiro Brazil
| | - Luciano Santos Oliveira
- Professor, Department of Implantology; Pontifical Catholic University of Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - Fábio Ramôa Pires
- Professor, Department of Stomatology, Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - Teresita Reiner
- Investigator, Geriatric Research, Education and Clinical Center - Bruce W. Carter Veterans Affairs Medical Center; Miami FL USA
| | - Luciana Armada
- Professor, Department of Endodontics, Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - Marcus A. Nunes
- Professor, Department of Statistics, Federal University of Rio Grande do Norte; Natal RN Brazil
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Lehmijoki M, Holming H, Thorén H, Stoor P. Rehabilitation of the severely atrophied dentoalveolar ridge in the aesthetic region with corticocancellous grafts from the iliac crest and dental implants. Med Oral Patol Oral Cir Bucal 2016; 21:e614-20. [PMID: 27475690 PMCID: PMC5005100 DOI: 10.4317/medoral.21146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 03/11/2016] [Indexed: 12/18/2022] Open
Abstract
Background The aim of this study was to assess changes in bone volume after block bone augmentation and placement of dental implants and further evaluate the aesthetic outcome of the treatment. Material and Methods 9 Patients with atrophied anterior maxilla were included in this study. They received total of 21 implants. Dimensions of the alveolar ridge were measured from cone-beam computed tomography x-rays. The bone level at the implant sites was analysed from intraoral x-rays and the aesthetic outcome was assessed from clinical photographs using a pink aesthetic score (PES) scaling. Results The mean gained horizontal bone width at the marginal crest and 5 mm apically was accordingly 2.7mm and 5.0 mm. The mean PES rating was 9.8/14. The survival rate of. Conclusions Reconstruction of the atrophied anterior maxilla with bone blocks and dental implants is a safe procedure with high survival rate and acceptable aesthetic outcome. Key words:Dental implants, aesthetic region, corticocancellous bone grafts, pink aesthetic score, survival rate.
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Affiliation(s)
| | | | | | - P Stoor
- Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Kasarminkatu 11-13, 000 29 HUS, Helsinki, Finland,
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Motamedian SR, Khojaste M, Khojasteh A. Success rate of implants placed in autogenous bone blocks versus allogenic bone blocks: A systematic literature review. Ann Maxillofac Surg 2016; 6:78-90. [PMID: 27563613 PMCID: PMC4979349 DOI: 10.4103/2231-0746.186143] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The aim of this study is to review and compare survival/success rate of dental implants inserted in autogenous and allogenic bone blocks (ALBs). A PubMed search was performed from January 1990 to June 2014 limited to English language and human studies. Studies that reported treatment outcome of implants inserted in augmented alveolar ridges with autogenous or ALBs were included. Primary search identified 470 studies. For autogenous bone block (ABB) 36 articles and for ALB 23 articles met the inclusion criteria. Evidence on implant survival/success rate of both techniques was limited to observational studies with relatively small sample sizes. Study design, treatment methods, follow-ups, defect location, and morphology varied among studies. The range of implant survival and success rates in ABB was from 73.8% to 100% and 72.8% to 100%, respectively. The corresponding numbers for ALB were 95.3-100% and 93.7-100%, respectively. A definite conclusion could not be reached. Future studies with long-term follow-ups are required to further elucidate this issue.
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Affiliation(s)
- Saeed Reza Motamedian
- Department of Orthodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Moein Khojaste
- Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Troeltzsch M, Troeltzsch M, Kauffmann P, Gruber R, Brockmeyer P, Moser N, Rau A, Schliephake H. Clinical efficacy of grafting materials in alveolar ridge augmentation: A systematic review. J Craniomaxillofac Surg 2016; 44:1618-1629. [PMID: 27622971 DOI: 10.1016/j.jcms.2016.07.028] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 06/22/2016] [Accepted: 07/29/2016] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To evaluate the efficacy of grafting materials in lateral and vertical ridge augmentations. MATERIALS AND METHODS A systematic review of the literature on the clinical use of grafting materials of the years 1995 to April 2015 was conducted using electronic search of PubMed and Cochrane libraries and hand search of eight print journals. A total of 184 papers were included, comprising 6182 patients. Parameters evaluated were observation period [months], bone formation [histologic area%], defect fill [%], horizontal and vertical gain [mm], loss of augmented volume [mm], complication rate [%], and implant survival rate [%]. Results are expressed as weighted means ± SD. RESULTS Results were obtained after a weighted mean observation period of 27.4 months (range 3-168 months). Bone formation in the augmented areas varied from 33.2 ± 14.9% for allogeneic grafts to 56.0 ± 25.6% for mixtures of autogenous and other grafting materials. Defect fill in dehiscence defects ranged from 51.0 ± 13.6% (synthetic) to 85.8 ± 13.4% (xenogeneic) for the different materials, with an overall weighted mean of 79.8 ± 18.7%. Weighted mean horizontal gain for all particulate grafting materials was 3.7 ± 1.2 mm, with variation between 2.2 ± 1.2 mm (synthetic) and 4.5 ± 1.0 mm (mixtures of autogenous bone with allogeneic/xenogeneic grafting material) without statistical significance. Weighted overall mean vertical gain was 3.7 ± 1.4 mm. Vertical gain was substantially higher when space-making barrier materials such as titanium meshes were used; however this was also associated with strong increase in complication rate. Block grafts achieved higher horizontal gain by approximately 1 mm. The use of block grafts achieved significantly increased vertical gain compared to particulate material only when autogenous block grafts from extraoral donor sites were used. CONCLUSION Horizontal and vertical gain by 3.7 mm on average can be achieved using particulate materials. This can be increased by using titanium meshes. Substantial vertical gains beyond this dimension require the use of extraoral bone block grafts.
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Affiliation(s)
- Markus Troeltzsch
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany.
| | - Matthias Troeltzsch
- Department of Maxillofacial Surgery, Ludwig - Maximilians - University of Munich, Germany
| | - Philipp Kauffmann
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
| | - Rudolph Gruber
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
| | - Phillipp Brockmeyer
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
| | - Norman Moser
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
| | - Anna Rau
- Department of Anesthesiology, University of Goettingen, Germany
| | - Henning Schliephake
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany
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Zizzari VL, Zara S, Tetè G, Vinci R, Gherlone E, Cataldi A. Biologic and clinical aspects of integration of different bone substitutes in oral surgery: a literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:392-402. [PMID: 27496576 DOI: 10.1016/j.oooo.2016.04.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/12/2016] [Indexed: 12/21/2022]
Abstract
Many bone substitutes have been proposed for bone regeneration, and researchers have focused on the interactions occurring between grafts and host tissue, as the biologic response of host tissue is related to the origin of the biomaterial. Bone substitutes used in oral and maxillofacial surgery could be categorized according to their biologic origin and source as autologous bone graft when obtained from the same individual receiving the graft; homologous bone graft, or allograft, when harvested from an individual other than the one receiving the graft; animal-derived heterologous bone graft, or xenograft, when derived from a species other than human; and alloplastic graft, made of bone substitute of synthetic origin. The aim of this review is to describe the most commonly used bone substitutes, according to their origin, and to focus on the biologic events that ultimately lead to the integration of a biomaterial with the host tissue.
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Affiliation(s)
| | - Susi Zara
- Department of Pharmacy, University "G. d'Annunzio", Chieti, Italy
| | - Giulia Tetè
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - Raffaele Vinci
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - Enrico Gherlone
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - Amelia Cataldi
- Department of Pharmacy, University "G. d'Annunzio", Chieti, Italy
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42
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de Lacerda PE, Pelegrine AA, Teixeira ML, Montalli VAM, Rodrigues H, Napimoga MH. Homologous transplantation with fresh frozen bone for dental implant placement can induce HLA sensitization: a preliminary study. Cell Tissue Bank 2016; 17:465-72. [DOI: 10.1007/s10561-016-9562-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
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Abstract
PURPOSE OF REVIEW A variety of bone grafting materials is available to facilitate the augmentation of defective alveolar ridges. This review evaluates current literature regarding bone grafting materials with emphasis on autologous and allogeneic bone block augmentation. RECENT FINDINGS Autogenous bone is a reliable grafting material providing predictable long-term results with high implant survival/success rates and low morbidity rates. The resorption properties of the iliac crest are well known and are compared with calvarial grafts more prominent. Recent studies demonstrated surgical techniques to prevent graft resorption after iliac crest grafting. Allogeneic block graft and implant survival rates appear promising in short-term clinical studies. SUMMARY At this stage, iliac crest remains the gold standard in large alveolar bone defects. Autogenous material is not a panacea; however, none of the available materials can currently surpass it. Rather, each material has its specific advantage for certain indications. Evident long-term studies of allogeneic bone grafting are lacking. Detected cells in allogeneic bone substitute material are positive for major histocompatibility complex classes I and II. Despite the promising clinical results achieved with allogeneic bone grafts, the current literature lacks sufficient data on antigenicity.
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44
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Rodella LF, Cocchi MA, Rezzani R, Procacci P, Hirtler L, Nocini P, Albanese M. Fresh frozen bone in oral and maxillofacial surgery. J Dent Sci 2015. [DOI: 10.1016/j.jds.2014.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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45
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Caballé-Serrano J, Schuldt Filho G, Bosshardt DD, Gargallo-Albiol J, Buser D, Gruber R. Conditioned medium from fresh and demineralized bone enhances osteoclastogenesis in murine bone marrow cultures. Clin Oral Implants Res 2015; 27:226-32. [PMID: 25754222 DOI: 10.1111/clr.12573] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Osteoclasts rapidly form on the surface of bone chips at augmentation sites. The underlying molecular mechanism, however, is unclear. Soluble factors released from bone chips in vitro have a robust impact on mesenchymal cell differentiation. Whether these soluble factors change the differentiation of hematopoietic cells into osteoclasts remains unknown. METHODS Osteoclastogenesis, the formation of tartrate-resistant acid phosphatase-positive multinucleated cells, was studied with murine bone marrow cultures exposed to RANKL and M-CSF, and conditioned medium from fresh (BCM) and demineralized bone matrix (DCM). Histochemical staining, gene and protein expression, as well as viability assays were performed. RESULTS This study shows that BCM had no impact on osteoclastogenesis. However, when BCM was heated to 85°C (BCMh), the number of tartrate-resistant acid phosphatase-positive multinucleated cells that developed in the presence of RANKL and M-CSF approximately doubled. In line with the histochemical observations, there was a trend that BCMh increased expression of osteoclast marker genes, in particular the transcription factor c-fos. The expression of c-fos was significantly reduced by the TGF-β receptor I antagonist SB431542. DCM significantly stimulated osteoclastogenesis, independent of thermal processing. CONCLUSIONS These data demonstrate that activated BCM by heat and DBM are able to stimulate osteoclastogenesis in vitro. These in vitro results support the notion that the resorption of autografts may be supported by as yet less defined paracrine mechanisms.
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Affiliation(s)
- Jordi Caballé-Serrano
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Guenther Schuldt Filho
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Implant Dentistry, School of Dentistry, Universidade Federal de Santa Catarina Florianopolis, Florianópolis, Brazil
| | - Dieter D Bosshardt
- Department of Oral Surgery and Stomatology, 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
| | - Jordi Gargallo-Albiol
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Reinhard Gruber
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral Biology, Medical University of Vienna, Vienna, Austria
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46
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On the feasibility of utilizing allogeneic bone blocks for atrophic maxillary augmentation. BIOMED RESEARCH INTERNATIONAL 2014; 2014:814578. [PMID: 25535616 PMCID: PMC4177739 DOI: 10.1155/2014/814578] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/02/2014] [Indexed: 01/11/2023]
Abstract
Purpose. This systematic review was aimed at assessing the feasibility by means of survival rate, histologic analysis, and causes of failure of allogeneic block grafts for augmenting the atrophic maxilla. Material and Methods. A literature search was conducted by one reviewer in several databases. Articles were included in this systematic review if they were human clinical trials in which outcomes of allogeneic bone block grafts were studied by means of survival rate. In addition other factors were extracted in order to assess their influence upon graft failure. Results. Fifteen articles fulfilled the inclusion criteria and subsequently were analyzed in this systematic review. A total of 361 block grafts could be followed 4 to 9 months after the surgery, of which 9 (2.4%) failed within 1 month to 2 months after the surgery. Additionally, a weighed mean 4.79 mm (95% CI: 4.51–5.08) horizontal bone gain was computed from 119 grafted sites in 5 studies. Regarding implant cumulative survival rate, the weighed mean was 96.9% (95% CI: 92.8–98.7%), computed from 228 implants over a mean follow-up period of 23.9 months. Histologic analysis showed that allogeneic block grafts behave differently in the early stages of healing when compared to autogenous block grafts. Conclusion. Atrophied maxillary reconstruction with allogeneic bone block grafts represents a reliable option as shown by low block graft failure rate, minimal resorption, and high implant survival rate.
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Correlation between density and resorption of fresh-frozen and autogenous bone grafts. BIOMED RESEARCH INTERNATIONAL 2014; 2014:508328. [PMID: 25050354 PMCID: PMC4094706 DOI: 10.1155/2014/508328] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 06/11/2014] [Indexed: 12/13/2022]
Abstract
Trial Design. This analysis compared the outcome of fresh-frozen versus autologous bone block grafts for horizontal ridge augmentation in patients with Cawood and Howell class IV atrophies. Methods. Seventeen patients received autologous grafts and 21 patients received fresh-frozen bone grafts. Patients underwent CT scans 1 week and 6 months after surgery for graft volume and density analysis. Results. Two autologous and 3 fresh-frozen grafts failed. Autologous and fresh-frozen grafts lost, respectively, 28% and 46% of their initial volume (P = 0.028). It is noteworthy that less dense fresh-frozen blocks lost more volume than denser grafts (61% versus 16%). Conclusions. According to these 6-month results, only denser fresh-frozen bone graft may be an acceptable alternative to autologous bone for horizontal ridge augmentation. Further studies are needed to investigate its behaviour at longer time points.
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Spin-Neto R, Stavropoulos A, Coletti FL, Pereira LAVD, Marcantonio E, Wenzel A. Remodeling of cortical and corticocancellous fresh-frozen allogeneic block bone grafts - a radiographic and histomorphometric comparison to autologous bone grafts. Clin Oral Implants Res 2014; 26:747-52. [DOI: 10.1111/clr.12343] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2013] [Indexed: 01/04/2023]
Affiliation(s)
- Rubens Spin-Neto
- Department of Dentistry - Oral Radiology; Aarhus University; Aarhus Denmark
| | - Andreas Stavropoulos
- Department of Dentistry - Periodontology; Aarhus University; Aarhus Denmark
- Department of Periodontology; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Felipe L. Coletti
- Department of Periodontology; UNESP - Univ. Estadual Paulista; Araraquara Dental School; Araraquara São Paulo Brazil
| | - Luís A. V. D. Pereira
- Department of Histology and Embryology; UNICAMP - State University of Campinas; Institute of Biology; Campinas São Paulo Brazil
| | - Elcio Marcantonio
- Department of Periodontology; UNESP - Univ. Estadual Paulista; Araraquara Dental School; Araraquara São Paulo Brazil
| | - Ann Wenzel
- Department of Dentistry - Oral Radiology; Aarhus University; Aarhus Denmark
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49
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Hsu YT, Wang HL. How to Select Replacement Grafts for Various Periodontal and Implant Indications. Clin Adv Periodontics 2013. [DOI: 10.1902/cap.2012.120031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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50
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Deluiz D, Oliveira LS, Pires FR, Tinoco EMB. Time-dependent changes in fresh-frozen bone block grafts: tomographic, histologic, and histomorphometric findings. Clin Implant Dent Relat Res 2013; 17:296-306. [PMID: 23837530 DOI: 10.1111/cid.12108] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bone allografts have shown satisfactory clinical results in alveolar ridge reconstructions. However, the process of incorporation and the resorption rates of these grafts are not yet fully understood. PURPOSE The aim of this study was to use computed tomography (CT), histology, and histomorphometry to assess the time-dependent rates of resorption and incorporation of fresh-frozen bone allografts. MATERIALS AND METHODS Twenty-four patients underwent alveolar ridge reconstruction with bone block allografts and were randomly allocated to three groups with different graft healing periods (4, 6, or 8 months) before implant placement. To assess the resorption rates, CT scans were acquired within 7 days after bone graft surgery and at the end of the period. Graft samples were collected and sent for histological and histomorphometric analyses. RESULTS The graft resorption mean rates were 50.78% ± 10.43, 32.77% ± 7.84, and 13.02% ± 3.86 for the 4-, 6-, and 8-month groups, respectively, and were significantly different among the three groups. Newly formed bone with osteocytes near the grafted bone was observed in all three groups. The number of osteocytes was significantly lower at 4 months. Grafted bone remains were significantly higher in the shortest period of time. All of the grafts showed large amounts of calcified tissue. CONCLUSIONS All three groups showed new bone formation and different bone resorption rates. Graft healing periods of 4 months showed less graft resorption and seemed to be the most favorable for implant placement. Healing periods of 8 months showed the largest rate of graft resorption, which could render the grafts unfavorable for implant placement.
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Affiliation(s)
- Daniel Deluiz
- Department of Periodontology, UERJ - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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