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Heimes D, Pabst A, Becker P, Hartmann A, Kloss F, Tunkel J, Smeets R, Kämmerer PW. Comparison of morbidity-related parameters between autologous and allogeneic bone grafts for alveolar ridge augmentation from patients' perspective-A questionnaire-based cohort study. Clin Implant Dent Relat Res 2024; 26:170-182. [PMID: 37438839 DOI: 10.1111/cid.13242] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Alveolar ridge augmentation is often required before dental implant placement. In this context, autologous bone grafts are considered the biological gold standard. Still, bone block harvesting is accompanied by some serious potential disadvantages and possible complications, such as pain, bleeding, and nerve irritation. Several studies aimed to compare autologous to allogeneic bone grafts concerning bone quality and implant survival rates; this is the first prospective study analyzing and comparing morbidity-related parameters after alveolar ridge augmentation using autogenous and allogeneic bone blocks from patients' perspective. METHODS Using a questionnaire, 36 patients were asked to evaluate the surgery as well as the post-operative period concerning pain, stress, sensibility deficits, satisfaction with, and consequences from the surgery as well as the preferred procedure for future alveolar ridge augmentations. RESULTS No significant differences were shown regarding stress and pain during and after surgery, whereas the rate of nerve irritations was twice as high in the autologous group. The swelling was significantly higher in patients with autologous bone blocks (p = 0.001). Nevertheless, the overall satisfaction of patients of both groups was very high, with over 8/10 points. CONCLUSIONS The swelling was the main reason for patients' discomfort in both groups and was significantly higher after autologous bone augmentation. Since this side effect seems to be a highly relevant factor for patients' comfort and satisfaction, it needs to be discussed during preoperative consultation to allow shared decision-making considering the anticipated morbidity.
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Affiliation(s)
- Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Koblenz, Germany
| | - Philipp Becker
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Koblenz, Germany
| | - Amely Hartmann
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
- Private Practice for Oral Surgery, Filderstadt, Germany
| | - Frank Kloss
- Private Practice for Oral and Maxillofacial Surgery, Lienz, Austria
| | - Jochen Tunkel
- Private Practice for Oral Surgery and Periodontology, Bad Oeynhausen, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
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Testosterone Enanthate: An In Vitro Study of the Effects Triggered in MG-63 Cells. Biomolecules 2022; 12:biom12081159. [PMID: 36009053 PMCID: PMC9406132 DOI: 10.3390/biom12081159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to investigate the effects of the androgenic hormone testosterone enanthate (TE) on human MG-63 cells. MG-63 were cultured for 24 h in the presence of TE at increasing concentrations to assess its lethal dose. Therefore, the suitable concentration for a prolonged use of TE in vitro was assessed by viability assay over 9 days. Finally, MG-63 were exposed to TE for 14 days and assayed for differentiation by qPCR and Alizarin Red S staining. TE in the amount of 100 µM resulted as the maximum dose tolerated by MG-63 cells after 24 h. However, a prolonged exposure in culture TE in the amount of 100 µM showed a cytostatic effect on cell proliferation. On the contrary, TE 10 µM was tolerated by the cells and did not boost cell proliferation, but did enhance new bone formation, as revealed by COL1A1, ALPL, BGLAP, and IBSP gene expression after 3, 7, and 14 days, and calcium deposition by Alizarin Red S staining after 14 days. Based on the current study, 10 µM is the critical dose of TE that should be used in vitro to support bone differentiation of MG-63 cells.
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Caramês JMM, Vieira FA, Caramês GB, Pinto AC, Francisco HCO, Marques DNDS. Guided Bone Regeneration in the Edentulous Atrophic Maxilla Using Deproteinized Bovine Bone Mineral (DBBM) Combined with Platelet-Rich Fibrin (PRF)-A Prospective Study. J Clin Med 2022; 11:jcm11030894. [PMID: 35160343 PMCID: PMC8837059 DOI: 10.3390/jcm11030894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Bone regeneration procedures represent a major challenge in oral surgery. This study aimed to evaluate a composite PRF/particulate xenograft in guided bone regeneration. Methods: Edentulous patients with horizontal ridge deficiencies in the anterior maxilla and candidates to an immediate-loading full-arch rehabilitation were included. Horizontal linear measurements indicating bone gain were assessed from computer beam computer tomography (CBCT) scans obtained at pre-surgery, post-surgery, and the 12-month follow-up. Mean bone values were presented as mean ± 95% CI. Non-parametric tests were used as appropriate, and the effect size was calculated with Cohen’s d repeated measures. Results: Eighteen patients were rehabilitated with 72 implants. The mean horizontal bone width was 4.47 [4.13–4.80] mm pre-surgically, 9.25 [8.76–9.75] mm post-surgically, and 7.71 [7.28–8.14] mm 12 months after. Conclusions: PRF associated with a xenograft seems to promote an effective horizontal bone gain. Randomized clinical trials are needed to confirm the benefits of this surgical approach.
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Affiliation(s)
- João Manuel Mendez Caramês
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal
- Correspondence: ; Tel.: +351-919727353; Fax: +351-217210989
| | - Filipe Araújo Vieira
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
| | - Gonçalo Bártolo Caramês
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
| | - Ana Catarina Pinto
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
| | - Helena Cristina Oliveira Francisco
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
| | - Duarte Nuno da Silva Marques
- Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n° 50, 1070-064 Lisbon, Portugal; (F.A.V.); (G.B.C.); (A.C.P.); (H.C.O.F.); (D.N.d.S.M.)
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal
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Boller LA, McGough MA, Shiels SM, Duvall CL, Wenke JC, Guelcher SA. Settable Polymeric Autograft Extenders in a Rabbit Radius Model of Bone Formation. MATERIALS 2021; 14:ma14143960. [PMID: 34300888 PMCID: PMC8305944 DOI: 10.3390/ma14143960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
Autograft (AG) is the gold standard for bone grafts, but limited quantities and patient morbidity are associated with its use. AG extenders have been proposed to minimize the volume of AG while maintaining the osteoinductive properties of the implant. In this study, poly(ester urethane) (PEUR) and poly(thioketal urethane) (PTKUR) AG extenders were implanted in a 20-mm rabbit radius defect model to evaluate new bone formation and graft remodeling. Outcomes including µCT and histomorphometry were measured at 12 weeks and compared to an AG (no polymer) control. AG control examples exhibited new bone formation, but inconsistent healing was observed. The implanted AG control was resorbed by 12 weeks, while AG extenders maintained implanted AG throughout the study. Bone growth from the defect interfaces was observed in both AG extenders, but residual polymer inhibited cellular infiltration and subsequent bone formation within the center of the implant. PEUR-AG extenders degraded more rapidly than PTKUR-AG extenders. These observations demonstrated that AG extenders supported new bone formation and that polymer composition did not have an effect on overall bone formation. Furthermore, the results indicated that early cellular infiltration is necessary for harnessing the osteoinductive capabilities of AG.
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Affiliation(s)
- Lauren A. Boller
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA; (L.A.B.); (M.A.P.M.); (C.L.D.)
| | - Madison A.P. McGough
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA; (L.A.B.); (M.A.P.M.); (C.L.D.)
| | - Stefanie M. Shiels
- U.S. Army Institute of Surgical Research, 3698 Chambers Rd, San Antonio, TX 78234, USA; (S.M.S.); (J.C.W.)
| | - Craig L. Duvall
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA; (L.A.B.); (M.A.P.M.); (C.L.D.)
| | - Joseph C. Wenke
- U.S. Army Institute of Surgical Research, 3698 Chambers Rd, San Antonio, TX 78234, USA; (S.M.S.); (J.C.W.)
| | - Scott A. Guelcher
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA; (L.A.B.); (M.A.P.M.); (C.L.D.)
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA
- Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, 1211 Medical Center Dr., Nashville, TN 37212, USA
- Correspondence:
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A Retrospective Analysis of Treatment Outcomes Following Guided Bone Regeneration at Sites Exhibiting Severe Alveolar Ridge Atrophy. J Craniofac Surg 2021; 32:e572-e578. [PMID: 34054093 DOI: 10.1097/scs.0000000000007735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Severely atrophic alveolar ridges represent a great challenge for implant-prosthetic rehabilitations. The aim of this study was to clinically and histologically evaluate horizontal and vertical bone gain, as well as implant survival/success rate after guided bone regeneration (GBR) for the reconstruction of large bone defects. Fourteen subjects (7 males and 7 females; mean age: 48.9 ± 14.1) were enrolled in the study. They were selected according to specific inclusion criteria and all patients required GBR procedures for placing implants in severe atrophic jaws (bone height ≤6 mm). Guided bone regeneration was performed using dense polytetrafluoroethylene nonresorbable titanium-reinforced membranes associated with particulate heterologous bone grafts. Implant placement was performed 6 months after surgery at the same time as the removal of the membrane. Furthermore, a biopsy sample from the grafted sites was collected to conduct a histological analysis of the regenerated bone. Forty-seven dental implants were placed and followed up after prosthetic loading. Seventeen sites, 8 in the maxilla and 9 in the mandible, were suitable for the GBR procedure. The healing period was uneventful in 13 sites. The average value of vertical bone regeneration was 5.88 ± 1.17 mm. Postloading follow-up ranged from 24 to 59 months. During the follow-up, clinical and radiographic exams showed no significant bone resorption and, in each case, the criteria for implants' survival were respected with no signs of any complications. Histological analysis of the bone biopsy samples revealed residual graft particulate in close contact with newly formed bone. Guided bone regeneration is a reliable technique for reconstruction of severe atrophic ridges. Larger long-term follow-up studies are needed to evaluate the condition of the bone grafted over time and its ability to support functional loading of the implants.
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Parisi L, Rivara F, Costa CA, Abuna RP, Palioto DB, Macaluso GM. Aptamers recognizing fibronectin confer improved bioactivity to biomaterials and promote new bone formation in a periodontal defect in rats. Biomed Mater 2020; 16:015016. [PMID: 33325378 DOI: 10.1088/1748-605x/abb6b2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The use of alloplastic materials in periodontal regenerative therapies is limited by their incapacity to establish a dynamic dialog with the surrounding milieu. The aim of the present study was to control biomaterial surface bioactivity by introducing aptamers to induce the selective adsorption of fibronectin from blood, thus promoting platelets activation in vitro and bone regeneration in vivo. A hyaluronic acid/polyethyleneglycole-based hydrogel was enriched with aptamers selected for recognizing and binding fibronectin. In vitro, the capacity of constructs to support osteoblast adhesion, as well as platelets aggregation and activation was assessed by chemiluminescence within 24 h. Matrices were then evaluated in a rat periodontal defect to assess their regenerative potential by microcomputed tomography (µCT) and their osteogenic capacity by Luminex assay 5, 15 and 30 d postoperatively. Aptamers were found to confer matrices the capacity of sustaining firm cell adhesion (p = 0.0377) and to promote platelets activation (p = 0.0442). In vivo, aptamers promoted new bone formation 30 d post-operatively (p < 0.001) by enhancing osteoblastic lineage commitment maturation. Aptamers are a viable surface modification, which confers alloplastic materials the potential capacity to orchestrate blood clot formation, thus controlling bone healing.
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Affiliation(s)
- Ludovica Parisi
- Centro Universitario di Odontoiatria, University of Parma, Via Gramsci 14, Parma 43126, Italy
- Dipartimento di Medicina e Chirurgia, University of Parma, Via Gramsci 14, Parma 43126, Italy
- Laboratory for Oral Molecular Biology, Dental Research Center, Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 3, Bern 3010, Switzerland
| | - Federico Rivara
- Centro Universitario di Odontoiatria, University of Parma, Via Gramsci 14, Parma 43126, Italy
- Dipartimento di Medicina e Chirurgia, University of Parma, Via Gramsci 14, Parma 43126, Italy
| | - Camila A Costa
- Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. Do Cafè, Ribeirão Preto, SP 14040-904, Brazil
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goias, Avenida Arumã, Goiâna, GO 74835-320, Brazil
| | - Rodriguo Pf Abuna
- Cell Culture Laboratory, School of Dentistry of Ribeirao Preto, University of São Paulo, Av. Do Cafè, Ribeirão Preto, SP 14040-904, Brazil
- Fiocruz-Bi-Instituional Translational Medicine Project, Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Rua dos Técnicos, Ribeirão Preto, SP 14040-030, Brazil
| | - Daniela B Palioto
- Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. Do Cafè, Ribeirão Preto, SP 14040-904, Brazil
| | - Guido M Macaluso
- Centro Universitario di Odontoiatria, University of Parma, Via Gramsci 14, Parma 43126, Italy
- Dipartimento di Medicina e Chirurgia, University of Parma, Via Gramsci 14, Parma 43126, Italy
- Istituto dei Materiali per l'Elettronica ed il Magnetismo, Consiglio Nazionale delle Ricerche, Parco Area delle Scienze 37/A, Parma 43124, Italy
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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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Cottrill E, Lazzari J, Pennington Z, Ehresman J, Schilling A, Dirckx N, Theodore N, Sciubba D, Witham T. Oxysterols as promising small molecules for bone tissue engineering: Systematic review. World J Orthop 2020; 11:328-344. [PMID: 32908817 PMCID: PMC7453739 DOI: 10.5312/wjo.v11.i7.328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/08/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bone tissue engineering is an area of continued interest within orthopaedic surgery, as it promises to create implantable bone substitute materials that obviate the need for autologous bone graft. Recently, oxysterols – oxygenated derivatives of cholesterol – have been proposed as a novel class of osteoinductive small molecules for bone tissue engineering. Here, we present the first systematic review of the in vivo evidence describing the potential therapeutic utility of oxysterols for bone tissue engineering.
AIM To systematically review the available literature examining the effect of oxysterols on in vivo bone formation.
METHODS We conducted a systematic review of the literature following PRISMA guidelines. Using the PubMed/MEDLINE, Embase, and Web of Science databases, we queried all publications in the English-language literature investigating the effect of oxysterols on in vivo bone formation. Articles were screened for eligibility using PICOS criteria and assessed for potential bias using an expanded version of the SYRCLE Risk of Bias assessment tool. All full-text articles examining the effect of oxysterols on in vivo bone formation were included. Extracted data included: Animal species, surgical/defect model, description of therapeutic and control treatments, and method for assessing bone growth. Primary outcome was fusion rate for spinal fusion models and percent bone regeneration for critical-sized defect models. Data were tabulated and described by both surgical/defect model and oxysterol employed. Additionally, data from all included studies were aggregated to posit the mechanism by which oxysterols may mediate in vivo bone formation.
RESULTS Our search identified 267 unique articles, of which 27 underwent full-text review. Thirteen studies (all preclinical) met our inclusion/exclusion criteria. Of the 13 included studies, 5 employed spinal fusion models, 2 employed critical-sized alveolar defect models, and 6 employed critical-sized calvarial defect models. Based upon SYRCLE criteria, the included studies were found to possess an overall “unclear risk of bias”; 54% of studies reported treatment randomization and 38% reported blinding at any level. Overall, seven unique oxysterols were evaluated: 20(S)-hydroxycholesterol, 22(R)-hydroxycholesterol, 22(S)-hydroxycholesterol, Oxy4/Oxy34, Oxy18, Oxy21/Oxy133, and Oxy49. All had statistically significant in vivo osteoinductive properties, with Oxy4/Oxy34, Oxy21/Oxy133, and Oxy49 showing a dose-dependent effect in some cases. In the eight studies that directly compared oxysterols to rhBMP-2-treated animals, similar rates of bone growth occurred in the two groups. Biochemical investigation of these effects suggests that they may be primarily mediated by direct activation of Smoothened in the Hedgehog signaling pathway.
CONCLUSION Present preclinical evidence suggests oxysterols significantly augment in vivo bone formation. However, clinical trials are necessary to determine which have the greatest therapeutic potential for orthopaedic surgery patients.
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Affiliation(s)
- Ethan Cottrill
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Julianna Lazzari
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Zach Pennington
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Jeff Ehresman
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Andrew Schilling
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Naomi Dirckx
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Nicholas Theodore
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Daniel Sciubba
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Timothy Witham
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
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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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Pérez-González F, Molinero-Mourelle P, Sánchez-Labrador L, Sáez-Alcaide LM, Limones A, Cortés-Bretón Brinkmann J, López-Quiles J. Assessment of clinical outcomes and histomorphometric findings in alveolar ridge augmentation procedures with allogeneic bone block grafts: A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2020; 25:e291-e298. [PMID: 32040468 PMCID: PMC7103446 DOI: 10.4317/medoral.23353] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 12/09/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis. MATERIAL AND METHODS An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates. RESULTS Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts. CONCLUSIONS Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings.
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Affiliation(s)
- F Pérez-González
- Department of Conservative Dentistry and Orofacial Prosthodontics Faculty of Dentistry, Complutense University of Madrid, Spain Plaza Ramón y Cajal S/N, 28040, Madrid, Spain
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Albanese M, Zotti F, Lanaro L, Trojan D, Paolin A, Montagner G, Iannielli A, Rodella LF, Nocini PF. Fresh-frozen homologous bone in sinus lifting: histological and radiological analysis. ACTA ACUST UNITED AC 2019; 68:226-235. [PMID: 31822046 DOI: 10.23736/s0026-4970.19.04192-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The aim of this study was to evaluate radiological and histological characteristics of fresh-frozen homologous bone as grafting material for maxillary sinus floor augmentation. Radiological, histological and clinical evaluations were made. METHODS Twenty-three patients with a 2 mm to 6 mm alveolar ridge height in the posterior maxilla have been enrolled. Unilateral or bilateral sinus floor augmentations were performed with fresh frozen morcelized homologous bone. Together with implant placement, 7 months after surgery, a bone core was harvested for histological analysis. Radiological measurements were obtained by superimposition of CT scans carried out at the surgery time and six months later. A total of 93 implants were positioned. RESULTS A mean (±SD) increase in mineralized tissue height of 10.74±2.82 mm was noticed by comparing the CT scans. Histological analysis revealed the presence of newly formed bone in the grafted sites. The follow up period after the prosthetic load ranged from 8 to 31 months. One implant failure occurred. CONCLUSIONS Fresh frozen homologous bone seems to have a good healing pattern and to be a successful and steady grafting material for the treatment of maxillary ridge atrophy. It might be considered a valid alternative to autologous bone in sinus floor augmentation procedures.
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Affiliation(s)
- Massimo Albanese
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
| | - Francesca Zotti
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy -
| | - Luca Lanaro
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
| | | | | | | | | | - Luigi F Rodella
- Section of Anatomy and Pathophysiology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Pier F Nocini
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
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12
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G F Tresguerres F, Cortes ARG, Hernandez Vallejo G, Cabrejos-Azama J, Tamimi F, Torres J. Clinical and radiographic outcomes of allogeneic block grafts for maxillary lateral ridge augmentation: A randomized clinical trial. Clin Implant Dent Relat Res 2019; 21:1087-1098. [PMID: 31419002 DOI: 10.1111/cid.12834] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/15/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND A main drawback of bone block graft surgery is the resorption occurring in early stages of healing. To our knowledge, there are no studies comparing outcomes of freeze-dried bone allograft (FDBA) blocks with different architecture. PURPOSE The aim of this work was to investigate different factors that can affect graft resorption and to compare the resorption rates of two different types of allogeneic blocks, corticocancellous and cancellous. MATERIALS AND METHODS A randomized clinical trial was designed. Twenty-eight patients referred for onlay bone augmentation prior to implant placement were included in the study. Preoperative computerized tomography (CT) was taken for all patients. Patients received FDBA blocks of either cancellous or corticocancellous bone obtained from the iliac crest. After a 4-month follow-up, postoperative CT was taken. Then, another surgery was performed, with the purpose to place dental implants. The aforementioned groups were compared for bone resorption and implant outcome using analysis of covariance (ANCOVA) and repeated ANOVA measures, respectively. Demographic data, trabecular bone density, and graft sites were also analyzed. RESULTS A total of 93 implants were placed in the augmented bone sites over 28 patients. A 100% survival rate was achieved during a mean follow-up period of 24 months in both groups. Higher bone resorption rate was found with cancellous bone grafts (29.2% ± 2.6) compared with corticocancellous grafts (19.3% ± 2.3). Moreover, higher resorption rates in patients with lower bone density (<185 Hounsfield Units) (31.7% ± 3.1) and smokers (26.39% ± 2.3) were observed when compared with patients with higher bone density (>185 Hounsfield Units) (16.8% ± 2.1) and nonsmokers (22.1% ± 2.3), respectively. CONCLUSION Within the limitations of this study, these findings indicate that both corticocancellous and cancellous FDBA grafts constitute a clinical acceptable alternative for bone reconstruction, although cancellous grafts present higher resorption rates. Moreover, host factors such as patient's low bone density and smoking habits may also increase graft resorption rates.
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Affiliation(s)
- Francisco G F Tresguerres
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Madrid, Spain
| | - Arthur R G Cortes
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Sao Paulo, Brazil
| | - Gonzalo Hernandez Vallejo
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Madrid, Spain
| | - Jatsue Cabrejos-Azama
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Madrid, Spain
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, Quebec
| | - Jesusis Torres
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Madrid, Spain
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13
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Ghiacci G, Graiani G, Cacchioli A, Galli C, Lumetti S, Ravanetti F, Elviri L, Manfredi E, Macaluso GM, Sala R. Stanozolol-soaked grafts enhance new bone formation in rat calvarial critical-size defects. ACTA ACUST UNITED AC 2017; 12:045016. [PMID: 28746051 DOI: 10.1088/1748-605x/aa71bc] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Androgen hormones play a significant role in regulating bone morphogenesis and in maintaining bone homeostasis throughout life. This study aimed to investigate the local effects of the non-aromatizable androgen stanozolol (ST) on bone regeneration in rats. Bilateral critical-size defects were created in the parietal bone of 26 male Wistar rats: the defect on one side was filled with a deproteinized bovine bone scaffold (DBB) soaked in ST solution (test) and the contralateral with DBB alone (control). Samples were collected at one month and three months. Histomorphometry revealed a significantly higher new bone formation (NB) (24.41% ± 4.14% versus 15.01% ± 2.43%, p < 0.05) and mineral apposition rate (MAR) (9.20 μm/day ± 0.37 versus 6.50 μm/day ± 1.09, p < 0.05) in the test versus control group at one month. Accordingly, real time-polymerase chain reaction revealed a consistently higher Runx2 expression in test samples (fold change test/control: 4.50 ± 1.17, p ≤ 0.05). No morphometrical differences between groups were detected at three months (p > 0.05). However, test samples were characterized by an increase in blood capillary density from one month (11.43 n mm-2 ± 2.01) to three months (28.26 n mm-2 ± 5.62), providing evidence of a vital remodeling tissue. Control samples presented a decrease of anti-Osterix (SP7)/anti-osteocalcin (BGLAP) (3.9 n mm-2 ± 0.32 versus 1.01 n mm-2 ± 0.20) and alkaline phosphatase (ALP) (12.14 n mm-2 ± 6.29 versus 6.29 n mm-2 ± 2.73) immunohistochemical-positive elements, which was suggestive of a stabilized healing phase. Based on these observations, local ST administration boosted bone regeneration in rat calvarial critical-size defects at one month. This study showed the potential of local steroid delivery in bone regeneration.
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Affiliation(s)
- G Ghiacci
- Dipartimento di Medicina e Chirurgia, Centro Universitario di Odontoiatria, Università degli Studi di Parma, Via Gramsci 14, 43126, Parma. Italy
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14
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Garbin Junior EA, de Lima VN, Momesso GAC, Mello-Neto JM, Érnica NM, Magro Filho O. Potential of autogenous or fresh-frozen allogeneic bone block grafts for bone remodelling: a histological, histometrical, and immunohistochemical analysis in rabbits. Br J Oral Maxillofac Surg 2017; 55:589-593. [PMID: 28404212 DOI: 10.1016/j.bjoms.2017.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 03/12/2017] [Indexed: 12/22/2022]
Abstract
Our aim was to compare the wound healing of autogenous bone grafts with that of fresh-frozen allogeneic block bone in rabbits. We used 25 animals. One was killed before the experiment to provide the allogeneic bone, and the remainder were killed at four time points (n=6 in each group). On histometrical analysis there was a significant difference between the two groups only at 45days and between 15 and 45days in the intergroup analysis. However, there was significantly more revascularisation (p<0.05), resorption (p<0.05), and bony replacement (p<0.05) in the autogenous group in the immunohistochemical analysis. In later periods, the autogenous bone was replaced by newly-formed bone in all samples, whereas it was always possible to find regions of devitalised bone in the fresh-frozen allogeneic bone grafts. Autogenous grafts were completely replaced whereas, in the fresh- frozen allogeneic grafts, we found acellular tissue that had been incorporated into the receptor bed interface during the later evaluation times.
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Affiliation(s)
- E A Garbin Junior
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil
| | - V N de Lima
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil.
| | - G A C Momesso
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil
| | - J M Mello-Neto
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil
| | - N M Érnica
- School of Dentistry, West Parana State University-UNIOESTE, Cascavel, PR, Brazil
| | - O Magro Filho
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil
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15
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Hruschka V, Tangl S, Ryabenkova Y, Heimel P, Barnewitz D, Möbus G, Keibl C, Ferguson J, Quadros P, Miller C, Goodchild R, Austin W, Redl H, Nau T. Comparison of nanoparticular hydroxyapatite pastes of different particle content and size in a novel scapula defect model. Sci Rep 2017; 7:43425. [PMID: 28233833 PMCID: PMC5324075 DOI: 10.1038/srep43425] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/24/2017] [Indexed: 11/09/2022] Open
Abstract
Nanocrystalline hydroxyapatite (HA) has good biocompatibility and the potential to support bone formation. It represents a promising alternative to autologous bone grafting, which is considered the current gold standard for the treatment of low weight bearing bone defects. The purpose of this study was to compare three bone substitute pastes of different HA content and particle size with autologous bone and empty defects, at two time points (6 and 12 months) in an ovine scapula drillhole model using micro-CT, histology and histomorphometry evaluation. The nHA-LC (38% HA content) paste supported bone formation with a high defect bridging-rate. Compared to nHA-LC, Ostim® (35% HA content) showed less and smaller particle agglomerates but also a reduced defect bridging-rate due to its fast degradation The highly concentrated nHA-HC paste (48% HA content) formed oversized particle agglomerates which supported the defect bridging but left little space for bone formation in the defect site. Interestingly, the gold standard treatment of the defect site with autologous bone tissue did not improve bone formation or defect bridging compared to the empty control. We concluded that the material resorption and bone formation was highly impacted by the particle-specific agglomeration behaviour in this study.
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Affiliation(s)
- Veronika Hruschka
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Stefan Tangl
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria
| | - Yulia Ryabenkova
- Department of Materials Science and Engineering, The University of Sheffield, Sheffield, United Kingdom
| | - Patrick Heimel
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria
| | - Dirk Barnewitz
- Research Center for Medical Technology and Biotechnology, Bad Langensalza, Germany
| | - Günter Möbus
- Department of Materials Science and Engineering, The University of Sheffield, Sheffield, United Kingdom
| | - Claudia Keibl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - James Ferguson
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | | | - Cheryl Miller
- The School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | | | | | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Thomas Nau
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
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16
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Tardive Dyskinesia, Oral Parafunction, and Implant-Supported Rehabilitation. Case Rep Dent 2016; 2016:7167452. [PMID: 28050290 PMCID: PMC5168480 DOI: 10.1155/2016/7167452] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 10/26/2016] [Accepted: 11/15/2016] [Indexed: 01/05/2023] Open
Abstract
Oral movement disorders may lead to prosthesis and implant failure due to excessive loading. We report on an edentulous patient suffering from drug-induced tardive dyskinesia (TD) and oral parafunction (OP) rehabilitated with implant-supported screw-retained prostheses. The frequency and intensity of the movements were high, and no pharmacological intervention was possible. Moreover, the patient refused night-time splint therapy. A series of implant and prosthetic failures were experienced. Implant failures were all in the maxilla and stopped when a rigid titanium structure was placed to connect implants. Ad hoc designed studies are desirable to elucidate the mutual influence between oral movement disorders and implant-supported rehabilitation.
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17
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Comparison of Bone Resorption Rates after Intraoral Block Bone and Guided Bone Regeneration Augmentation for the Reconstruction of Horizontally Deficient Maxillary Alveolar Ridges. BIOMED RESEARCH INTERNATIONAL 2016; 2016:4987437. [PMID: 27847815 PMCID: PMC5101362 DOI: 10.1155/2016/4987437] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 10/10/2016] [Indexed: 12/15/2022]
Abstract
Purpose. Bone atrophy after tooth loss may leave insufficient bone for implant placement. We compared volumetric changes after autogenous ramus block bone grafting (RBG) or guided bone regeneration (GBR) in horizontally deficient maxilla before implant placement. Materials and Methods. In this retrospective study, volumetric changes at RBG or GBR graft sites were evaluated using cone-beam computed tomography. The primary outcome variable was the volumetric resorption rate. Secondary outcomes were bone gain, graft success, and implant insertion torque. Results. Twenty-four patients (28 grafted sites) were included (GBR, 15; RBG, 13). One patient (RBG) suffered mucosal dehiscence at the recipient site 6 weeks after surgery, which healed spontaneously. Mean volume reduction in the GBR and RBG groups was 12.48 ± 2.67% and 7.20 ± 1.40%, respectively. GBR resulted in significantly more bone resorption than RBG (P < 0.001). Mean horizontal bone gain and width after healing were significantly greater in the GBR than in the RBG group (P = 0.002 and 0.005, resp.). Implant torque was similar between groups (P > 0.05). Conclusions. Both RBG and GBR hard-tissue augmentation techniques provide adequate bone graft volume and stability for implant insertion. However, GBR causes greater resorption at maxillary augmented sites than RBG, which clinicians should consider during treatment planning.
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Long-term outcomes of the use of allogeneic, radiation-sterilised bone blocks in reconstruction of the atrophied alveolar ridge in the maxilla and mandible. Cell Tissue Bank 2015; 16:631-8. [PMID: 26162810 PMCID: PMC4659845 DOI: 10.1007/s10561-015-9512-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 05/29/2015] [Indexed: 11/16/2022]
Abstract
Increasingly dental surgeons face the challenge of reconstruction of the height and/or thickness of the alveolar ridge as more and more patients wish to have permanent restoration of their dental defects based on intraosseous implants. Evaluation of human allogeneic bone tissue grafts in reconstruction of atrophied alveolar ridge as a pre-implantation procedure. The material comprised 21 patients aged 19–63, treated between 2009 and 2012 by the same surgeon. Restoration of bone tissue defects was performed with allogeneic, frozen, radiation-sterilised, corticocancellous blocks. The study included 26 grafting procedures with 7 procedures consisting in reconstruction of the alveolar ridge in the mandible and 19 in the maxilla. In all the cases the atrophied alveolar ridge was successfully reconstructed, which allowed placement of intraosseous implants in compliance with the initial treatment plan. After the treatment was completed the patients reported for follow-up annually. The average time of follow-up amounted to 39 months (28–50 months). None of the implants was lost during the follow-up period. There was one case of gingival recession causing aesthetics deterioration of the prosthetic restoration. In three cases the connector became unscrewed partially, which was corrected at the same visit. Frozen, radiation-sterilised, allogeneic bone blocks constitute good and durable bone-replacement material allowing effective and long-lasting reconstruction of the atrophied alveolar ridge to support durable, implant-based, prosthetic restoration.
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