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Menini M, Canullo L, Iacono R, Triestino A, Caponio VCA, Savadori P, Pesce P, Pedetta A, Guerra F. Effect of Different Graft Material Consistencies in the Treatment of Minimal Bone Dehiscence: A Retrospective Pilot Study. Dent J (Basel) 2024; 12:198. [PMID: 39056985 PMCID: PMC11275297 DOI: 10.3390/dj12070198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Among different therapeutic strategies proposed in the case of bone volume deficit, guided bone regeneration (GBR) is a consolidated surgical procedure. The objective of this study is to retrospectively evaluate the behavior of two bone grafts with different consistencies in the GBR procedure by measuring the volumetric tissue changes 1 year after surgery. For this retrospective analysis, 25 cases of GBR with simultaneous implant insertion were selected. A total of 13 were grafted with a porcine cortico-cancellous bone mix (CCBM group), and 12 were grafted with a pre-hydrated granulated cortico-cancellous bone mix of porcine origin blended with 20% TSV gel (Collagenated-CCBM). A collagen membrane was fixed to cover the bone defect. A total of 42 implants were placed with computer-guided surgery. Preoperative and 12-month postoperative digital impressions were used to evaluate dimensional changes. Student's t-test used for independent samples showed no statistically significant differences between the integrated distance (p = 0.995) and mean distance (p = 0.734). The mean integrated distance in the CCBM group was 41.80 (SD. 101.18) compared to a mean of 42.04 (SD. 66.71) in the Collagenated-CCBM group. Given the limitations of this study, in patients with peri-implant bone dehiscence, simple heterologous and collagenated heterologous cortico-cancellous bone grafts are suitable for filling the bone defect to promote bone regeneration, although further studies are needed.
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Affiliation(s)
- Maria Menini
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Roberta Iacono
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.I.); (F.G.)
| | | | - Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 1, 7100 Foggia, Italy;
| | - Paolo Savadori
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Via Della Commenda, 10/12, 20122 Milan, Italy
- IRCCS Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Andrea Pedetta
- Private Practice, Via Colledoro 41, 00034 Colleferro, Italy;
| | - Fabrizio Guerra
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.I.); (F.G.)
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Jing L, Su B. Resorption Rates of Bone Graft Materials after Crestal Maxillary Sinus Floor Elevation and Its Influencing Factors. J Funct Biomater 2024; 15:133. [PMID: 38786644 PMCID: PMC11121861 DOI: 10.3390/jfb15050133] [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: 03/28/2024] [Revised: 05/03/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
The aim of this study is to analyze the resorption rate of bone graft materials after crestal sinus floor elevation, study its influencing factors, and improve the long-term success rate of implants after crestal maxillary sinus floor elevation. Measurement and analysis were conducted at six postoperative timepoints (0 months, 6 months, 12 months, 18 months, 24 months, and 30 months) using cone beam computed tomography (CBCT) data on 31 patients from the Chenghuaxinguanghua Dental Clinic who underwent crestal maxillary sinus floor elevation, involving 38 graft sites. The materials resorption rates of the bone graft height (BH) and bone graft width (BW) were assessed. BH and BW resorption rates followed the same trend (p = 0.07), with BH and BW resorption rates decreasing with time (rBH = -0.32, p < 0.01; rBW = -0.18, p < 0.01), and were maximal in the 0-6 month interval, with BH and BW resorption rates of 3.42%/mth and 3.03%/mth, respectively. The average monthly BH and BW resorption rates in the 6-12 month interval rapidly decreased to 1.75%/mth and 1.29%/mth, respectively. The monthly BH and BW resorption rates in the 12-30 month intervals stabilized at 1.45%/mth (p > 0.05) and 1.22%/mth (p > 0.05), respectively. The higher the initial bone graft height (BH0), the lower the BH resorption rates (rBH = -0.98, p < 0.05), and the BW resorption rate was different for different graft sites (p = 0.01). The resorption rates of bone graft materials implanted through crestal maxillary sinus floor elevation decreased rapidly within the first 12 months post operation and remained stable after 12 months. BH0 was identified as a significant factor influencing the resorption rates of bone graft materials. These results could suggest dentists should pay attention to the trend of resorption rates over time and carefully manage the initial height of bone grafts and inspire the research of new bone grafting materials for crestal maxillary sinus floor elevation.
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Affiliation(s)
| | - Baohui Su
- College of Biomedical Engineering, Sichuan University, Chengdu 610065, China;
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Coronel Zabalbu B, Cáceres OA, Vergara-Buenaventura A. [Graftless maxillary sinus lift with simultaneous implant placement: a case report]. REVISTA CIENTÍFICA ODONTOLÓGICA 2024; 12:e202. [PMID: 39119129 PMCID: PMC11304858 DOI: 10.21142/2523-2754-1202-2024-202] [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: 03/06/2024] [Accepted: 04/16/2024] [Indexed: 08/10/2024] Open
Abstract
A maxillary sinus lift was performed without bone grafting in a 23-year-old female patient who required the placement of a dental implant in the edentulous area of tooth 16. The clinical and tomographic evaluation made it possible to plan and perform the maxillary sinus lift using the transcrestal approach and without the need for bone grafting. The residual ridge of 6mm allowed the placement of a simultaneous dental implant. After 6 months of tomographic follow-up, before prosthetic loading, a vertical bone height of 8.83 mm was achieved, resulting in a vertical bone gain of 2.83 mm. Additionally, an adequate integration of the dental implant was observed without postoperative complications. Transcrestal sinus lift without the use of bone graft is shown to be a viable, safe and effective technique for the simultaneous placement of dental implants in patients with bone atrophy in the maxillary area. This technique offers advantages such as reduced surgical time, less morbidity, lower cost and a faster healing process compared to conventional methods.
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Affiliation(s)
- Brayam Coronel Zabalbu
- Departamento de Periodoncia, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas. Lima, Perú. , , Universidad Peruana de Ciencias Aplicadas Departamento de Periodoncia Facultad de Ciencias de la Salud Universidad Peruana de Ciencias Aplicadas Lima Peru
| | - Oswaldo Andreé Cáceres
- Departamento de Periodoncia, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas. Lima, Perú. , , Universidad Peruana de Ciencias Aplicadas Departamento de Periodoncia Facultad de Ciencias de la Salud Universidad Peruana de Ciencias Aplicadas Lima Peru
| | - Andrea Vergara-Buenaventura
- Departamento de Periodoncia, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas. Lima, Perú. , , Universidad Peruana de Ciencias Aplicadas Departamento de Periodoncia Facultad de Ciencias de la Salud Universidad Peruana de Ciencias Aplicadas Lima Peru
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Jeanneau C, Catherine JH, Giraud T, Lan R, About I. The Added Value of a Collagenated Thermosensitive Bone Substitute as a Scaffold for Bone Regeneration. MATERIALS (BASEL, SWITZERLAND) 2024; 17:625. [PMID: 38591482 PMCID: PMC10856128 DOI: 10.3390/ma17030625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 04/10/2024]
Abstract
A pre-hydrated thermosensitive collagenated biomaterial which sets at body temperature and maintains the space of the missing alveolar bone volume, OsteoBiol GTO® (GTO), has been released as a bone substitute. This study was designed to check its angiogenic and osteogenic potentials compared to OsteoBiol Gen-Os® (Gen-Os) and Geistlich Bio-Oss® (Bio-Oss). Samples of materials were incubated in culture media to obtain the extracts. Collagen release was measured in the extracts, which were used to investigate human periodontal ligament (hPDL) cell proliferation (MTT), colonization (Scratch assays) and growth factor release (ELISA). The effects on endothelial cell proliferation (MTT) and organization (Matrigel® assays) were also studied. Finally, endothelial and mesenchymal Stem Cell (hMSC) recruitment (Boyden Chambers) were investigated, and hMSC Alkaline Phosphatase (ALP) activity was measured. A higher collagen concentration was found in GTO extract, which led to significantly higher hPDL cell proliferation/colonization. All materials increased VEGF/FGF-2 growth factor secretion, endothelial cell recruitment, proliferation, and organization, but the increase was highest with GTO. All materials increased hMSC recruitment and ALP activity. However, the increase was highest with collagenated GTO and Gen-Os, which enhanced C5a and BMP-2 secretion. Overall, GTO has higher angiogenic/osteogenic potentials than the collagenated Gen-Os and the anorganic Bio-Oss. It provides a suitable scaffold for endothelial and mesenchymal stem cell recruitment, which represent essential bone regeneration requirements.
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Affiliation(s)
| | - Jean-Hugues Catherine
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France (J.-H.C.)
- APHM, Hôpital Timone, Pôle Odontologie, Service de Chirurgie Orale, 13005 Marseille, France;
| | - Thomas Giraud
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France (J.-H.C.)
- APHM, Hôpital Timone, Pôle Odontologie, Service de Chirurgie Orale, 13005 Marseille, France;
| | - Romain Lan
- APHM, Hôpital Timone, Pôle Odontologie, Service de Chirurgie Orale, 13005 Marseille, France;
- Aix-Marseille University, CNRS, EFS, ADES, 13385 Marseille, France
| | - Imad About
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France (J.-H.C.)
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Prajapati S, Ninneman S, Zarrabi I, Daubert D, Wang IC, Hsu YT. Risk factors and longitudinal regenerative outcomes of sinus membrane perforation during lateral window sinus floor elevation: A retrospective analysis up to 9 years. J Periodontol 2023; 94:1045-1054. [PMID: 36748281 DOI: 10.1002/jper.22-0424] [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: 07/18/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Lateral-window sinus floor elevation (LSFE) is a reliable procedure to reconstruct the posterior maxilla for implant therapy. This retrospective study aimed to investigate risk factors associated with Schneiderian membrane perforation (SMP) occurrence during LSFE and longitudinal regenerative outcomes following LSFE up to 9 years. METHODS Patients who had LSFE between 2010 and 2019 were included. All demographic and surgical-related data were retrieved from existing electronic health records. Radiographs were used to evaluate the vertical dimensional changes of ridge and graft materials and the potential anatomic factors of SMP. RESULTS A total of 122 LSFE procedures in 99 patients were included in the study. Mean ridge height gain and graft shrinkages were 9.5 ± 3.47 and 1.57 ± 2.85 mm. The influence of the healing period on graft shrinkage showed a positive trend; the longer the healing period, the greater the graft shrinkage (p = 0.09). The pathology in the sinus showed a positive correlation with SMP (p = 0.07). However, other anatomical factors did not negatively impact SMP and subsequent ridge height gain (p > 0.05). CONCLUSIONS With inherent limitation, the findings with up to 9 years of follow-up indicate a consistent ridge remodeling lasting for about 3 years after LSFE procedures. SMP or membrane thickening may not significantly affect the ridge gain following LSFE. The healing period had the most significant influence on graft shrinkage, showing that the longer the healing time between LSFE and implant placement, the greater the graft shrinkage.
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Affiliation(s)
| | - Shale Ninneman
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | | | - Diane Daubert
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - I-Chung Wang
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Yung-Ting Hsu
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
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Lanis A, Gallucci G, Pedrinaci I. Full mouth oral rehabilitation of a severely worn dentition based on a fully digital workflow. J ESTHET RESTOR DENT 2023; 35:596-608. [PMID: 36715027 DOI: 10.1111/jerd.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To demonstrate the use of a complete digital workflow for a full mouth rehabilitation in a severely worn dentition. CLINICAL CONSIDERATIONS The present case report successfully rehabilitated a full-mouth case of a severely worn dentition based on the use of digital technologies, making the diagnosis and treatment process faster, accurate and less expensive. A long-lasting esthetic and functional result are showed after 30-months follow up. CONCLUSIONS An appropriate knowledge on dental erosion and oral rehabilitation, combined with a digital dentistry approach could lead the clinician to deliver a fast, accurate and predictable noninvasive restorative treatment in cases like the one described. CLINICAL SIGNIFICANCE Bruxism-based severely worn dentition is being found more often in population. In this situation, a detailed diagnosis and tailored treatment are mandatory to obtain a predictable treatment outcome. In this sense, the development of adhesive dentistry, new restorative materials and the incorporation of digital technologies can create a predictable synergy to rehabilitate these types of patients with a modern and less invasive approach.
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Affiliation(s)
- Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Section of Graduate Periodontology, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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Valencia-Llano CH, López-Tenorio D, Saavedra M, Zapata PA, Grande-Tovar CD. Comparison of Two Bovine Commercial Xenografts in the Regeneration of Critical Cranial Defects. Molecules 2022; 27:5745. [PMID: 36144483 PMCID: PMC9506155 DOI: 10.3390/molecules27185745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/20/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Autologous bone is the gold standard in regeneration processes. However, there is an endless search for alternative materials in bone regeneration. Xenografts can act as bone substitutes given the difficulty of obtaining bone tissue from patients and before the limitations in the availability of homologous tissue donors. Bone neoformation was studied in critical-size defects created in the parietal bone of 40 adult male Wistar rats, implanted with xenografts composed of particulate bovine hydroxyapatite (HA) and with blocks of bovine hydroxyapatite (HA) and Collagen, which introduces crystallinity to the materials. The Fourier-transform infrared spectroscopy (FTIR) analysis demonstrated the carbonate and phosphate groups of the hydroxyapatite and the amide groups of the collagen structure, while the thermal transitions for HA and HA/collagen composites established mainly dehydration endothermal processes, which increased (from 79 °C to 83 °C) for F2 due to the collagen presence. The xenograft's X-ray powder diffraction (XRD) analysis also revealed the bovine HA crystalline structure, with a prominent peak centered at 32°. We observed macroporosity and mesoporosity in the xenografts from the morphology studies with heterogeneous distribution. The two xenografts induced neoformation in defects of critical size. Histological, histochemical, and scanning electron microscopy (SEM) analyses were performed 30, 60, and 90 days after implantation. The empty defects showed signs of neoformation lower than 30% in the three periods, while the defects implanted with the material showed partial regeneration. InterOss Collagen material temporarily induced osteon formation during the healing process. The results presented here are promising for bone regeneration, demonstrating a beneficial impact in the biomedical field.
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Affiliation(s)
| | - Diego López-Tenorio
- Grupo Biomateriales Dentales, Escuela de Odontología, Universidad del Valle, Calle 4B # 36-00, Cali 76001, Colombia
| | - Marcela Saavedra
- Grupo de Polímeros, Facultad de Química y Biología, Universidad de Santiago de Chile (USACH), Santiago 9170020, Chile
| | - Paula A. Zapata
- Grupo de Polímeros, Facultad de Química y Biología, Universidad de Santiago de Chile (USACH), Santiago 9170020, Chile
| | - Carlos David Grande-Tovar
- Grupo de Investigación de Fotoquímica y Fotobiología, Universidad del Atlántico, Carrera 30 Número 8-49, Puerto Colombia 081008, Colombia
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Comuzzi L, Tumedei M, Piattelli A, Tartaglia G, Del Fabbro M. Radiographic Analysis of Graft Dimensional Changes after Lateral Maxillary Sinus Augmentation with Heterologous Materials and Simultaneous Implant Placement: A Retrospective Study in 18 Patients. MATERIALS 2022; 15:ma15093056. [PMID: 35591390 PMCID: PMC9103388 DOI: 10.3390/ma15093056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022]
Abstract
Background: This investigation aimed to radiographically assess the variations of graft dimension following maxillary sinus augmentation by the lateral approach. Methods: Eighteen patients (seven males), with a mean age at surgery of 66.5 ± 9.8 (range 52−82) years, were unilaterally treated. Thirty-five dental implants were positioned in the posterior maxilla simultaneously to grafting with heterologous biomaterials. Intraoral radiographs taken at the time of surgery, after six months, and at the longest follow-up (up to nine years after implant placement) were analyzed. The following distances were measured: mesio-distal width of the graft, vertical distance from implant apex to most coronal level of the graft, distance from the mesial aspect of the (mesial) implant to the mesial graft extension; distance from the distal aspect of the (distal) implant to the distal graft extension, and graft height along the implant axis. The dimensional changes with respect to baseline, after six months and at the longest follow-up were calculated. Results: The patient-based mean follow-up was 38.3 ± 30.1 months (range 12−108 months). The mean residual bone height at the mesial and distal aspect of the implants was 3.19 ± 2.05 mm and 2.65 ± 1.60 mm, respectively (p = 0.38). The mean graft width at baseline was 27.95 ± 5.23 mm, and the mean graft width reduction was 10.2 ± 12.7% (2.98 ± 3.62 mm) and 11.3 ± 14.4% (3.36 ± 4.08 mm) at six months and at the latest follow-up. The change was significant at six months (p = 0.005), but did not show significant further variation (p = 0.11). On the mesial and distal aspect, the mean graft extension decreased by 1.56 ± 2.67 mm and 0.84 ± 2.71 mm at the latest follow-up. No significant difference between mesial and distal changes was found (p = 0.24), suggesting that the biomaterial is resorbed homogeneously on both sides. The mean graft height was 11.92 ± 2.53 mm at baseline and decreased by 9.3 ± 9.05% (1.11 ± 1.09 mm) at six months (p < 0.001). Non-significant further changes were found at the latest follow-up (p = 0.10). Conclusions: after early remodeling, heterologous bone substitutes showed a good dimensional stability in the mid-term for maxillary sinus augmentation.
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Affiliation(s)
- Luca Comuzzi
- Freelance Researcher, San Vendemmiano, 31020 Conegliano Veneto, Italy;
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (G.T.)
| | - Adriano Piattelli
- Dental School, Saint Camillus International University for Health Sciences (Unicamillus), 00131 Rome, Italy;
- Dental School, University of Belgrade, 11000 Belgrade, Serbia
- Casa di Cura Villa Serena, Città Sant’Angelo, 65013 Pescara, Italy
- Fondazione Villaserena per la Ricerca, Città Sant’Angelo, 65013 Pescara, Italy
| | - Gianluca Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (G.T.)
- IRCCS Fondazione Ca’Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (G.T.)
- IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-02-50319950; Fax: +39-02-50319960
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