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Frigério PB, de Moura J, Pitol-Palin L, Monteiro NG, Mourão CF, Shibli JA, Okamoto R. Combination of a Synthetic Bioceramic Associated with a Polydioxanone-Based Membrane as an Alternative to Autogenous Bone Grafting. Biomimetics (Basel) 2024; 9:284. [PMID: 38786494 PMCID: PMC11117809 DOI: 10.3390/biomimetics9050284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/02/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
The purpose of this study was to evaluate the repair process in rat calvaria filled with synthetic biphasic bioceramics (Plenum® Osshp-70:30, HA:βTCP) or autogenous bone, covered with a polydioxanone membrane (PDO). A total of 48 rats were divided into two groups (n = 24): particulate autogenous bone + Plenum® Guide (AUTOPT+PG) or Plenum® Osshp + Plenum® Guide (PO+PG). A defect was created in the calvaria, filled with the grafts, and covered with a PDO membrane, and euthanasia took place at 7, 30, and 60 days. Micro-CT showed no statistical difference between the groups, but there was an increase in bone volume (56.26%), the number of trabeculae (2.76 mm), and intersection surface (26.76 mm2) and a decrease in total porosity (43.79%) in the PO+PG group, as well as higher values for the daily mineral apposition rate (7.16 µm/day). Histometric analysis presented material replacement and increased bone formation at 30 days compared to 7 days in both groups. Immunostaining showed a similar pattern between the groups, with an increase in proteins related to bone remodeling and formation. In conclusion, Plenum® Osshp + Plenum® Guide showed similar and sometimes superior results when compared to autogenous bone, making it a competent option as a bone substitute.
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Affiliation(s)
- Paula Buzo Frigério
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba 16015-050, Brazil; (P.B.F.); (J.d.M.); (L.P.-P.); (N.G.M.)
| | - Juliana de Moura
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba 16015-050, Brazil; (P.B.F.); (J.d.M.); (L.P.-P.); (N.G.M.)
| | - Letícia Pitol-Palin
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba 16015-050, Brazil; (P.B.F.); (J.d.M.); (L.P.-P.); (N.G.M.)
| | - Naara Gabriela Monteiro
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba 16015-050, Brazil; (P.B.F.); (J.d.M.); (L.P.-P.); (N.G.M.)
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil;
| | - Roberta Okamoto
- Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba 16066-840, Brazil;
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Lee JH, An HW, Im JS, Kim WJ, Lee DW, Yun JH. Evaluation of the clinical and radiographic effectiveness of treating peri-implant bone defects with a new biphasic calcium phosphate bone graft: a prospective, multicenter randomized controlled trial. J Periodontal Implant Sci 2023; 53:306-317. [PMID: 37524378 PMCID: PMC10465810 DOI: 10.5051/jpis.2300640032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/01/2023] [Accepted: 05/03/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE Biphasic calcium phosphate (BCP), a widely used biomaterial for bone regeneration, contains synthetic hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), the ratio of which can be adjusted to modulate the rate of degradation. The aim of this study was to evaluate the clinical and radiographic benefits of reconstructing peri-implant bone defects with a newly developed BCP consisting of 40% β-TCP and 60% HA compared to demineralized bovine bone mineral (DBBM). METHODS This prospective, multicenter, parallel, single-blind randomized controlled trial was conducted at the periodontology departments of 3 different dental hospitals. Changes in clinical (defect width and height) and radiographic (augmented horizontal bone thickness) parameters were measured between implant surgery with guided bone regeneration (GBR) and re-entry surgery. Postoperative discomfort (severity and duration of pain and swelling) and early soft-tissue wound healing (dehiscence and inflammation) were also assessed. Data were compared between the BCP (test) and DBBM (control) groups using the independent t-test and the χ² test. RESULTS Of the 53 cases included, 27 were in the test group and 26 were in the control group. After a healing period of 18 weeks, the full and mean resolution of buccal dehiscence defects were 59.3% (n=16) and 71.3% in the test group and 42.3% (n=11) and 57.9% in the control group, respectively. There were no significant differences between the groups in terms of the change in mean horizontal bone augmentation (test group: -0.50±0.66 mm vs. control groups: -0.66±0.83 mm, P=0.133), postoperative discomfort, or early wound healing. No adverse or fatal complications occurred in either group. CONCLUSION The GBR procedure with the newly developed BCP showed favorable clinical, radiographic, postoperative discomfort-related, and early wound healing outcomes for peri-implant dehiscence defects that were similar to those for DBBM. TRIAL REGISTRATION Clinical Research Information Service Identifier: KCT0006428.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Hyun-Wook An
- Research & Development Center, MegaGen Implant Co., Ltd., Daegu, Korea
| | - Jae-Seung Im
- Research & Development Center, MegaGen Implant Co., Ltd., Daegu, Korea
| | - Woo-Joo Kim
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Korea
| | - Dong-Won Lee
- Department of Periodontology, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea.
| | - Jeong-Ho Yun
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
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Miyauchi Y, Izutani T, Teranishi Y, Iida T, Nakajima Y, Xavier SP, Baba S. Healing Patterns of Non-Collagenated Bovine and Collagenated Porcine Xenografts Used for Sinus Floor Elevation: A Histological Study in Rabbits. J Funct Biomater 2022; 13:jfb13040276. [PMID: 36547536 PMCID: PMC9787467 DOI: 10.3390/jfb13040276] [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: 11/22/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Objective: To compare healing of collagenated and non-collagenated xenografts used for maxillary sinus floor elevation. Materials and Methods: Two different xenografts were used: deproteinized bovine bone (DBBM group) and collagenated corticocancellous porcine bone (collagenated group). Healing was studied after 2, 4, and 8 weeks. The loss of dimensions of the elevated area and the percentages of new bone, xenograft remnants, osteoclastic zones, vessels, inflammatory infiltrates, and soft tissues were analyzed. Three regions were evaluated: close to the bone walls (bone wall region), subjacent the sinus mucosa (submucosa region), and the center of the elevated area (middle region). The primary variables were the percentage of new bone and xenograft remnants. Results: Between 2 and 8 weeks, the elevated areas showed a reduction of 16.3% and 52.2% in the DBBM and collagenated groups, respectively (p < 0.01 between the two areas after 8 weeks). After 8 weeks, the highest content of new bone was observed in the bone wall region, which was higher in the collagenated group than in the DBBM group (41.6% and 28.6%, respectively; p < 0.01). A similar quantity of new bone was found between the two groups in other regions. A higher percentage of vessels in all regions evaluated (p < 0.01) and soft tissue in the sub-mucosa region (p < 0.05) was found in the collagenated group than in the DBBM group. Conclusions: The present study showed that both xenografts allowed new bone formation. In comparison with the non-collagenated xenograft, the collagenated xenograft underwent higher resorption, resulting in greater shrinkage of the elevated space after sinus lifting and a higher content of new bone in the regions close to the bone walls. Clinical relevance: In this study, the region adjacent to the bone wall showed the highest new bone content. This region resembles the base of the sinus, closest to the sinus floor and walls, and is the most important region from a clinical point of view because it is where the implant will be installed. Residues of the biomaterial remained after 8 weeks of healing. Other reports have shown that these biomaterial residues may interfere with the integration of implants.
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Affiliation(s)
- Yuhei Miyauchi
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Takayuki Izutani
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Yuki Teranishi
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Takahisa Iida
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
| | - Samuel Porfirio Xavier
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, São Paulo, Brazil
- Correspondence:
| | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
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Omori Y, Botticelli D, Migani S, Ferreira Balan V, Pires Godoy E, Xavier SP. Sinus Mucosal Damage Triggered by Synthetic or Xenogeneic Bone Substitutes: A Histological Analysis in Rabbits. J Funct Biomater 2022; 13:257. [PMID: 36412898 PMCID: PMC9680494 DOI: 10.3390/jfb13040257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Background: It has been shown in rabbit models that the sinus mucosa in contact with graft particles might experience a progressive thinning and perforations. The phenomenon depends on the graft used. Hence, the aim of the present study was to compare the damaging effects of a synthetic of a xenogeneic graft. Methods: Forty New Zealand rabbits received a bilateral sinus elevation. Both sinuses of twenty rabbits were grafted with a biphasic 60% hydroxyapatite and 40% β-tricalcium phosphate while the other twenty received a deproteinized bovine bone mineral graft. Thinned sites (<40 µm) and perforations on the mucosa in contact with graft particles were evaluated after 2 and 10 weeks (ten animals each period). The width of the pseudostratified epithelium was also measured as control. Results: After 2 weeks of healing, 61 thinned sites were detected in the Synthetic group and 49 in the Xenogeneic group. After 10 weeks, the number of thinned mucosae increased to 79 sites in the Synthetic group (p = 0.222 between periods), and to 114 sites in the Xenogeneic group (p = 0.030 between groups; p = 0.001 between periods). Perforations were few in the 2-week period, two in two sinuses out of 20 in the Synthetic group, and four in two sinuses out of 20 in the Xenogeneic group (p = 0.721). In the 10-week period, the perforations increased to eight in the Synthetic group, distributed in six sinuses out of 20, and to sixteen in the Xenogeneic group, distributed in 11 sinuses out of 20 (p = 0.082). The pseudostratified epithelium presented a reduced width at the thinned sites. Conclusions: The contact with synthetic or xenogeneic grafts will induce thinning and possible perforations of the sinus mucosa. This effect will increase over time, and it is stronger at the xenogeneic than the synthetic graft.
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Affiliation(s)
- Yuki Omori
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Osaka 573-1121, Japan
| | | | - Stefano Migani
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
| | - Vitor Ferreira Balan
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto 14040-904, Brazil
| | - Eduardo Pires Godoy
- Department of Oral Biology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto 14040-904, Brazil
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Microstructure Evolution and Properties of β-TCP/Mg-Zn-Ca Biocomposite Processed by Hot Extrusion Combined with Multi-Pass ECAP. METALS 2022. [DOI: 10.3390/met12040685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To further improve the comprehensive performance of Mg-based alloy, hot extrusion combined with multi-pass equal channel angular pressing (ECAP) was applied to process Mg-3 wt%Zn-0.2 wt%Ca alloy and 1 wt%β-TCP/Mg-3 wt%Zn-0.2 wt%Ca biocomposites. The microstructure evolution, mechanical properties, corrosion behavior, and cell biocompatibility of the experimental specimens were systematically investigated. The average grain size of 13.4 ± 0.6 μm in MgZnCa alloy and 9.6 ± 0.3 μm in composites materials can be achieved by six ECAP passes. The uniaxial compressive strength (UCS) of 388.4 ± 7.3 MPa and the strain at failure of 14.3 ± 1.5% were confirmed in MgZnCa alloy, while the UCS of 405.3 ± 7.4 MPa and the strain at failure of 9.8 ± 1.9% were achieved by the addition of β-TCP after six ECAP passes. In spite of different compositions, the minimum corrosion rate of 0.895 mm·Y−1 and 1.117 mm·Y−1 can be achieved by two ECAP passes at 593 K. The cytocompatibility evaluation revealed that the experimental materials processed by six ECAP passes had no significant cytotoxicity to L929 cells, and the addition of β-TCP improved the cytocompatibility.
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Kotsu M, Apaza Alccayhuaman KA, Ferri M, Iezzi G, Piattelli A, Fortich Mesa N, Botticelli D. Osseointegration at Implants Installed in Composite Bone: A Randomized Clinical Trial on Sinus Floor Elevation. J Funct Biomater 2022; 13:jfb13010022. [PMID: 35323222 PMCID: PMC8950152 DOI: 10.3390/jfb13010022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 02/08/2023] Open
Abstract
Osseointegration of implants installed in conjunction with sinus floor elevation might be affected by the presence of residual graft. The implant surface characteristics and the protection of the access window using a collagen membrane might influence the osseointegration. To evaluate these factors, sinus floor elevation was performed in patients using a natural bovine bone grafting material. The access windows were either covered with a collagen membrane made of porcine corium (Mb group) or left uncovered (No-Mb group) and, after six months, two mini-implants with either a moderate rough or turned surfaces were installed. After 3 months, biopsies containing the mini-implants were retrieved, processed histologically, and analyzed. Twenty patients, ten in each group, were included in the study. The two mini-implants were retrieved from fourteen patients, six belonging to the Mb group, and eight to the No-Mb group. No statistically significant differences were found in osseointegration between groups. However, statistically significant differences were found between the two surfaces. It was concluded that implants with a moderately rough surface installed in a composite bone presented much higher osseointegration compared to those with a turned surface. The present study failed to show an effect of the use of a collagen membrane on the access window.
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Affiliation(s)
| | | | - Mauro Ferri
- ARDEC Foundation, Cartagena de Indias 130001, Colombia;
| | - Giovanna Iezzi
- Department of Medical Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (G.I.); (A.P.)
| | - Adriano Piattelli
- Department of Medical Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (G.I.); (A.P.)
| | - Natalia Fortich Mesa
- School of Dentistry, University Corporation Rafael Núñez, Cartagena de Indias 130001, Colombia;
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Omori Y, Botticelli D, Ferri M, Delgado-Ruiz R, Ferreira Balan V, Porfirio Xavier S. Argon Bioactivation of Implants Installed Simultaneously to Maxillary Sinus Lifting without Graft. An Experimental Study in Rabbits. Dent J (Basel) 2021; 9:dj9090105. [PMID: 34562979 PMCID: PMC8466067 DOI: 10.3390/dj9090105] [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: 08/02/2021] [Revised: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The treatment of the surface of titanium implants with argon plasma improved its hydrophilicity and cell adhesion, resulting in higher bone apposition on implant and graft surfaces. The spontaneous perforation over time of the sinus mucosa after sinus augmentation has been documented in experimental studies at both implants and graft particles. The aim of the present study was to evaluate the influence of plasma argon treatment of the implant surface on bone apposition and on the rate of sinus mucosa perforations. Methods: A sinus lifting procedure was performed bilaterally in sixteen rabbits, and implants, either treated with argon plasma or left without treatment (control), were placed simultaneously without grafts. After 8 weeks, histological analyses were carried out. Results: A collapse of the sinus mucosa was observed at all implants. Twenty-four out of thirty-two implants presented sinus mucosa perforations at the apex. Several perforations were also found at the threads. Thinned mucosa sites (width < 40 µm) were found around almost all implants. About 2.6–2.9 mm of the apical regions of the implant did not present signs of osseointegration and about 1.3 mm were exposed to the sinus cavity. No statistically significant differences were found between plasma and control sites. Conclusions: In conclusion, the sinus mucosa was damaged and perforated by direct contact with treated and non-treated implant surfaces. The treatment of the implant surface with argon plasma did not affect the outcomes.
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Affiliation(s)
- Yuki Omori
- Department of Oral Implantology, Osaka Dental University, Osaka 565-0871, Japan;
- ARDEC Academy, 47923 Rimini, Italy;
| | | | - Mauro Ferri
- ARDEC Foundation, Cartagena de Indias 130001, Colombia;
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, New York, NY 11794-8712, USA
- Correspondence:
| | - Vitor Ferreira Balan
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (V.F.B.); (S.P.X.)
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (V.F.B.); (S.P.X.)
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Costa MM, Botticelli D, Moses O, Omori Y, Fujiwara S, Silva ER, Xavier SP. Maxillary Sinus Augmentation Using Ceramic Alloplastic Granules or Paste: An Experimental Study in Rabbits. Dent J (Basel) 2021; 9:65. [PMID: 34205201 PMCID: PMC8226577 DOI: 10.3390/dj9060065] [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: 05/03/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Due to the lack of data comparing the biological behavior of two formulations, granules and paste, of alloplastic graft from microtomographic and histomorphometric points of view, the aim of the present experiment was to compare the histomorphometric and microtomographic healing of two formulations, i.e., granules (MR sites) or paste (MR-inject sites) of an alloplastic graft composed of a combination of beta-tricalcium phosphate and hydroxyapatite used for maxillary sinus lifting. METHODS A sinus lifting procedure was carried out bilaterally in 20 rabbits, and the elevated space was filled with either paste or granules of an alloplastic material. A collagen membrane was placed on the antrostomy and the animals were euthanized after 2 or 10 weeks, 10 animals each group. Microtomographic and histological analyses were performed. RESULTS Higher proportions of new bone formation were found at the MR, compared to the MR-inject sites both after 2 weeks (2.65 ± 2.89% vs. 0.08 ± 0.12%; p < 0.01) and 10 weeks of healing (34.20 ± 13.86 vs. 23.28 ± 10.35%; p = 0.022). CONCLUSIONS It was concluded that new bone formation was faster in the MR sites, compared to the MR-inject. However, a longer time of healing should be allowed to make final conclusions about the efficiency in bone formation of the paste formulation of the biomaterial used in the present study.
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Affiliation(s)
- Michael Medeiros Costa
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
| | | | - Ofer Moses
- Department of Periodontology and Dental Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Yuki Omori
- ARDEC Academy, 47923 Rimini, Italy; (D.B.); (Y.O.); (S.F.)
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan
| | | | - Erick Ricardo Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
| | - Samuel Porfirio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil; (M.M.C.); (E.R.S.); (S.P.X.)
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