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Agliardi EL, Romeo D, Panigatti S, D'Orto B, Agliardi J, Gherlone E, Del Fabbro M. Trans-crestal dental implants in the rehabilitation of a severely atrophic maxilla: A retrospective case series. Clin Implant Dent Relat Res 2024. [PMID: 39315729 DOI: 10.1111/cid.13388] [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: 06/21/2024] [Revised: 08/14/2024] [Accepted: 08/24/2024] [Indexed: 09/25/2024]
Abstract
PURPOSE To evaluate the mid-term clinical and radiographic results of immediate fixed full-arch prosthesis supported by two anterior axial and two posterior trans-crestally placed tilted implants in patients with severely atrophic posterior maxilla. MATERIALS AND METHODS Patients with posterior maxillary ridge less than 4 mm high and 3 mm wide were rehabilitated with an immediate fixed provisional prosthesis supported by two anterior axially placed and two trans-crestal posterior tilted implants within 3 h after implant surgery. The final prosthesis, consisting of a CAD-CAM titanium framework and composite teeth was delivered 6 months later. Patients were scheduled for follow-up visits every 6 months to assess clinical and radiological parameters. Patients' satisfaction was assessed by a questionnaire up to 5 years. RESULTS From April 2008 to May 2017, 56 implants (28 axial and 28 tilted) were inserted in 14 subjects (eight female and six male). The average bone loss for the anterior axial implants was 0.99 ± 0.19 mm at 1 year (n = 28 implants), 1.37 ± 0.31 mm at 5 years (n = 28), and 2.05 ± 0.32 mm at 10 years (n = 14). Only for three implants in two subjects the marginal bone loss was higher than 2 mm after 60 months. No implant was lost, and no prosthetic failure occurred after a mean follow-up of 125 months (range 79-186 months), leading to 100% implant and prosthesis survival rates. The upper 95% confidence limit of the failure rate was 23% and 6% at patient and implant level, respectively. High level of satisfaction was reported at 5-year follow-up. CONCLUSION Wider sample sizes will be required to determine whether the presented technique is a reliable treatment option for the immediate rehabilitation of the atrophic maxilla.
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Affiliation(s)
- Enrico Luigi Agliardi
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Davide Romeo
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Stefano Panigatti
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Bianca D'Orto
- Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Jacopo Agliardi
- Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Enrico Gherlone
- Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Seidel A, Leira Y, Batalla P, Caneiro L, Wichmann M, Blanco J. Three-dimensional imaging analysis of CAD/CAM custom-milled versus prefabricated allogeneic block remodelling at 6 months and long-term follow-up of dental implants: A retrospective cohort study. J Clin Periodontol 2024; 51:1005-1016. [PMID: 38710641 DOI: 10.1111/jcpe.13995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 05/08/2024]
Abstract
AIM This retrospective cohort study aimed to volumetrically investigate the bone stability rate of prefabricated allogeneic bone blocks (PBB) and computer-aided design (CAD)/computer-aided manufacturing (CAM) custom-milled allogeneic bone blocks (CCBB) for ridge augmentation. MATERIALS AND METHODS Nineteen patients were treated with 20 allografts: 11 CCBB, 9 PBB; 10 in the maxilla and 10 in the mandible. Clinical treatment history and cone beam computed tomography scans before surgery (t0), directly after graft surgery (t1) and after 6 months of healing prior to implant insertion (t2) were evaluated using a three-dimensional evaluation software for absolute bone volume, stability as well as vertical and horizontal bone gain. Furthermore, the inserted implants were analysed for survival, marginal bone loss (MBL) and complications for a mean follow-up period of 43.75 (±33.94) months. RESULTS A mean absolute volume of 2228.1 mm3 (±1205) was grafted at t1. The bone stability rate was 87.6% (±9.9) for CCBB and 83.0% (±14.5) for PBB. The stability was higher in the maxilla (91.6%) than in the mandible (79.53%). Surgery time of PBB was longer than for CCBB (mean Δ = 52 min). The survival rate of the inserted implants was 100% with a mean MBL of 0.41 mm (±0.37). CONCLUSION The clinical performance of both allograft block designs was equally satisfactory for vertical and horizontal bone grafting prior to implant placement. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT06027710.
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Affiliation(s)
- Anna Seidel
- Department of Prosthodontics, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Yago Leira
- Department of Periodontology and Oral Surgery, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pilar Batalla
- Department of Periodontology and Oral Surgery, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Leticia Caneiro
- Department of Periodontology and Oral Surgery, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Manfred Wichmann
- Department of Prosthodontics, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Juan Blanco
- Department of Periodontology and Oral Surgery, Faculty of Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Tunkel J, Hoffmann F, Schmelcher Y, Kloss-Brandstätter A, Kämmerer PW. Allogeneic versus autogenous shell technique augmentation procedures: a prospective-observational clinical trial comparing surgical time and complication rates. Int J Implant Dent 2023; 9:52. [PMID: 38117445 PMCID: PMC10733239 DOI: 10.1186/s40729-023-00505-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/04/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVES Autogenous and allogeneic blocks for shell augmentation of the jaw have shown comparable results. This observational clinical study aimed to compare both materials for shell augmentation concerning surgery time and intra- and postoperative complications. MATERIAL AND METHODS Bone augmentation with the shell technique using autogenous or allogenous bone was performed in 117 patients with segmental jaw atrophy. The primary study parameter was the surgical time, comparing both materials. Subsequently, intra- and postoperative complications were recorded. RESULTS Allogeneic (n = 60), autogenous (n = 52), or both materials (n = 5) were used. The use of allogeneic material led to a significantly shorter operation time (p < 0.001). A more experienced surgeon needed significantly less time than a less experienced surgeon (p < 0.001). An increasing number of bone shells (p < 0.001), an additional sinus floor elevation, and intraoperative complications also significantly increased the operation time (p = 0.001). Combining allogeneic and autogenous shells (p = 0.02) and simultaneous sinus floor elevation (p = 0.043) significantly impacted intraoperative complications. No correlations were found between the included variables for postoperative complications (all p > 0.05). In total, 229 implants were inserted after a healing time of 4-6 months, with a survival of 99.6% after a mean follow-up duration of 9 months. CONCLUSIONS Compared to the autogenous technique, allogeneic shell augmentation has a shorter surgical time and a similar rate of intra- and postoperative complications as autogenous bone. Together with its promising clinical results, this technique can be recommended.
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Affiliation(s)
- Jochen Tunkel
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Frederik Hoffmann
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Yannik Schmelcher
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Anita Kloss-Brandstätter
- Department of Engineering & IT, Carinthia University of Applied Sciences, Europastraße 4, 9524, Villach, Austria
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Sakaguchi R, Xavier SP, Morinaga K, Botticelli D, Silva ER, Nakajima Y, Baba S. Histological Comparison of Collagenated Cancellous Equine Bone Blocks Used as Inlay or Onlay for Lateral Bone Augmentation in Rabbits. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6742. [PMID: 37895725 PMCID: PMC10608602 DOI: 10.3390/ma16206742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The conformation of the recipient site for an inlay graft presents an increased contact with the parent bone compared to an onlay graft. This might favor bone growth within the inlay compared to onlay grafts. Hence, the objective of this study was to compare the bone incorporation and remodeling processes of xenogeneic en bloc grafts placed using two bone grafting techniques, i.e., onlay vs. inlay. METHODS In this prospective, randomized, split-mouth study (test and control sides in the same animal), two bone grafting techniques were comparatively evaluated. The lateral aspect of the rabbit mandible was used as the recipient site, bilaterally. On one side of the mandible, the cortical bone was perforated with drills to allow a better bone formation from the bone wound and the marrow spaces. A xenogeneic bone block was fixed in the center of the prepared region, representing the onlay site. On the other side of the mandible, a 7 mm wide and 3 mm deep circumferential defect was prepared using trephines and drills. A xenogeneic bone block was fixed in the center of the defect, representing the inlay site. Two healing periods were applied in the study: 2 and 10 weeks, each represented by 10 rabbits (n = 10 for each period). RESULTS After 2 weeks of healing, the mean percentage of new bone was 10.4% and 23.3% at the onlay and inlay grafts, respectively (p = 0.022). After 10 weeks of healing, new bone increased to 13.2% at the onlay sites and 25.4% at the inlay sites (p = 0.080). In the 10-week period, the inlay grafts presented a homogeneous growth of new bone in all regions, while in the onlay grafts, low percentages of new bone were observed in the external regions. CONCLUSION The percentage of new bone increased faster and was higher in the inlay grafts than in the onlay grafts. This outcome might be related to the self-contained conformation of the recipient site in the inlay group, which offered more sources for new bone formation compared to the one-wall conformation of the recipient sites in the onlay group. The osteoconductive properties of the biomaterial allowed the newly formed bone to reach the most peripheral regions in both groups. The osteoconductive properties of the biomaterial, together with the protection offered by the collagen membrane, allowed marginal closure of the defects by newly formed bone in the inlay group.
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Affiliation(s)
- Ryuichi Sakaguchi
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata 573-1121, Japan; (R.S.); (K.M.); (Y.N.); (S.B.)
| | - 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), Ribeirao Preto 14040-904, SP, Brazil; (S.P.X.); (E.R.S.)
| | - Kenzo Morinaga
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata 573-1121, Japan; (R.S.); (K.M.); (Y.N.); (S.B.)
| | - Daniele Botticelli
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata 573-1121, Japan; (R.S.); (K.M.); (Y.N.); (S.B.)
- ARDEC Academy, 47923 Rimini, Italy
| | - Erick Ricardo Silva
- 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), Ribeirao Preto 14040-904, SP, Brazil; (S.P.X.); (E.R.S.)
| | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata 573-1121, Japan; (R.S.); (K.M.); (Y.N.); (S.B.)
- 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), Ribeirao Preto 14040-904, SP, Brazil; (S.P.X.); (E.R.S.)
| | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata 573-1121, Japan; (R.S.); (K.M.); (Y.N.); (S.B.)
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Stavropoulos A, Marcantonio CC, de Oliveira VXR, Marcantonio É, de Oliveira GJPL. Fresh-frozen allogeneic bone blocks grafts for alveolar ridge augmentation: Biological and clinical aspects. Periodontol 2000 2023; 93:139-152. [PMID: 38194350 DOI: 10.1111/prd.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 01/10/2024]
Abstract
The possibilities for oral bone regeneration procedures vary depending on the type of bone defect to be treated, which in turn dictate the type of graft to be used. Atrophic alveolar ridges are non-contained defects and pose a challenging defect morphology for bone regeneration/augmentation. Successful results are regularly obtained with the use of particulate grafts in combination with barrier membranes. In cases of very narrow ridges with need of larger amount of bone augmentation, block grafts are often used. Fresh-frozen allogeneic bone block grafts have been proposed as an alternative to autogenous (AT) bone blocks. Based on a systematic appraisal of pre-clinical in vivo studies and clinical trials including a direct comparison of fresh-frozen bone (FFB) blocks versus AT bone blocks it can be concluded that a FFB block graft: (a) cannot be considered as a reliable replacement of a AT bone block, and (b) should only be considered in cases where the amount of necessary augmentation-in a lateral direction-is relatively limited, so that the main portion of the body of the implant lies within the inner (i.e., the vital) aspect of the block.
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Affiliation(s)
- Andreas Stavropoulos
- Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Camila Chierici Marcantonio
- Department of Diagnosis and Surgery School of Dentistry at Araraquara, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Vithor Xavier Resende de Oliveira
- Department of Periodontology/Implantodontology, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Élcio Marcantonio
- Department of Diagnosis and Surgery School of Dentistry at Araraquara, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
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Al-Qahtani F, Alqhtani N, Divakar DD, Alkhtani F, Alqarawi FK. Levels of whole salivary advanced glycation end products and interleukin-17 and peri-implant clinical and radiographic status in patients with osteoporosis at 6-years' follow-up. BMC Oral Health 2022; 22:526. [PMID: 36424586 PMCID: PMC9685916 DOI: 10.1186/s12903-022-02591-7] [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: 07/13/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There are no studies that have assessed advanced glycation end products (AGEs) and interleukin 17A (IL-17A) levels in whole saliva (WS) of patients with dental implants. The aim was to compare levels of AGEs and IL-17A in WS and peri-implant clinical and radiographic status of patients with and without osteoporosis at 6-years' follow-up. METHODS Osteoporotic (Group-1) and systemically healthy controls (Group-2) having undergone dental implant therapy at least 5 years ago were included. A questionnaire was used to collect information about age, gender, duration and treatment of osteoporosis, number and duration of implants in function, and frequencies of toothbrushing, flossing and hygiene visits. Modified bleeding and plaque indies (mBI and mPI), peri-implant probing depth (PD) and crestal bone loss (CBL) were recorded. WS was collected and levels of AGEs and IL-17A were determined using enzyme linked immunosorbent assay. Sample-size estimation was done and statistical analyses were doing using the independent t- and Wilcoxon rank-sum tests. Statistical significance was marked for P-values that were below 0.01. RESULTS In patients with (n = 24) and without (n = 27) osteoporosis, implants were in function for 6.3 ± 0.27 and 6.6 ± 0.5 years, respectively. There was no significant difference in peri-implant mBI, PD, mPI and CBL in both groups. Levels of AGE in patients with (119.6 ± 26.5 μg/ml) and without (91.5 ± 14.6 μg/ml) osteoporosis were comparable. Levels of whole salivary IL-17A in patients without and with osteoporosis were 4.6 ± 0.3 and 5.1 ± 0.8 pg/ml, respectively. Flossing of full mouth interproximal spaces once and twice daily toothbrushing daily was reported by 100% patients with osteoporosis. Among patients with osteoporosis 75% and 25% individuals were receiving professional dental prophylaxis every 4 and 6 months, respectively. CONCLUSION Within the limitations of the present study osteoporotic patients are not at an increased risk of peri-implant diseases and can demonstrate salivary AGE and IL-17A levels comparable to non-osteoporotic individuals as long as oral hygiene is stringently maintained.
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Affiliation(s)
- Fawaz Al-Qahtani
- grid.449553.a0000 0004 0441 5588Department of Prosthodontics, School of Dentistry, Prince-Sattam Bin Abdulaziz University, Al-Kharj, 11942 Saudi Arabia
| | - Nasser Alqhtani
- grid.449553.a0000 0004 0441 5588Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942 Saudi Arabia
| | - Darshan Devang Divakar
- Department of Dental Medicine, Sharavathi Dental College and Hospital, Shivamogga, Karnataka 577204 India
| | - Fahad Alkhtani
- grid.449553.a0000 0004 0441 5588Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, 11942, Al-Kharj, Saudi Arabia
| | - Firas K. Alqarawi
- grid.411975.f0000 0004 0607 035XDepartment of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 31441 Saudi Arabia
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Rahman B, Acharya AB, Siddiqui R, Verron E, Badran Z. Photodynamic Therapy for Peri-Implant Diseases. Antibiotics (Basel) 2022; 11:antibiotics11070918. [PMID: 35884171 PMCID: PMC9311944 DOI: 10.3390/antibiotics11070918] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
Peri-implant diseases are frequently presented in patients with dental implants. This category of inflammatory infections includes peri-implant mucositis and peri-implantitis that are primarily caused by the oral bacteria that colonize the implant and the supporting soft and hard tissues. Other factors also contribute to the pathogenesis of peri-implant diseases. Based on established microbial etiology, mechanical debridement has been the standard management approach for peri-implant diseases. To enhance the improvement of therapeutic outcomes, adjunctive treatment in the form of antibiotics, probiotics, lasers, etc. have been reported in the literature. Recently, the use of photodynamic therapy (PDT)/antimicrobial photodynamic therapy (aPDT) centered on the premise that a photoactive substance offers benefits in the resolution of peri-implant diseases has gained attention. Herein, the reported role of PDT in peri-implant diseases, as well as existing observations and opinions regarding PDT, are discussed.
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Affiliation(s)
- Betul Rahman
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
| | - Anirudh Balakrishna Acharya
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
| | - Ruqaiyyah Siddiqui
- College of Arts and Sciences, University City, American University of Sharjah, Sharjah P.O. Box 26666, United Arab Emirates;
| | - Elise Verron
- CNRS, UMR 6230, CEISAM, UFR Sciences et Techniques, Université de Nantes, 2, rue de la Houssinière, BP 92208, CEDEX 3, 44322 Nantes, France;
| | - Zahi Badran
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
- Correspondence:
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Ji D, Lu D. Efficiency of Nanohydroxyapatite on Repairing Type II Diabetes Dental Implant-Bone Defect. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7459139. [PMID: 35800219 PMCID: PMC9256423 DOI: 10.1155/2022/7459139] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/21/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to see how a nanohydroxyapatite (n-HA) composite polyamide 66 (PA66) affected the repair of bone defects in diabetics with titanium implants, as well as to develop experimental materials for the creation of the interface between bone tissue and titanium implants. Rabbit bone marrow mesenchymal stem cells (MSCs) were isolated using n-HA/PA66 composite material, and the effect of coculture with the material on cell proliferation was analyzed after induction of mineralization. Bone defect models of diabetic experimental rabbits and titanium implants were prepared. Normal rabbits with bone defects were used as control (NC group, N = 8). After the diabetic bone defect (DM group, N = 8) and the implantation of n-HA/PA66 composite material (n-HA/PA66 group, N = 8), the differences in body weight, blood glucose, scanning electron microscopy of the implant-bone interface, bone mineral density, new bone trabecular parameters, histomorphology, and biomechanical properties of the implant-bone interface were compared and analyzed. In vitro test results showed that MSC cell growth could be promoted by mineralization induction, the cell growth condition was good after coculture with n-HA/PA66, and the proliferation activity of MSCs was not affected by the material. In vivo test results showed that the body weight of the DM group and n-HA/PA66 group was considerably inferior to that of the NC group, and the blood glucose was dramatically superior to that of the NC group (P < 0.05). However, the body weight of the n-HA/PA66 group was dramatically superior to that of the DM group (P < 0.05). The bone mineral density, bone volume fraction (BV/TV), bone surface area fraction (BS/BV), bone trabecular thickness (Tb.Th), bone trabecular number (Tb.N), bone trabecular area, and biomechanical properties in the DM group were considerably inferior to those in the NC group and n-HA/PA66 group (P < 0.05). The trabecular space (Tb.Sp) in the NC group and n-HA/PA66 group was dramatically superior to that in the NC group (P < 0.05). The bone mineral density, BV/TV, BS/BV, Tb.Th, Tb.N, trabecular area, and biomechanical properties of the n-HA/PA66 group were dramatically superior to those of the NC group (P < 0.05), while Tb.Sp was considerably inferior to that of the NC group (P < 0.05). These findings showed that the n-HA/PA66 material had good biocompatibility and minimal cytotoxicity, and that filling the space between the surrounding bone and the titanium implant can enhance bone repair. This research paved the way for future research into the tissue-engineered bone in the field of oral surgery.
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Affiliation(s)
- Dong Ji
- Department of Oral and Maxillofacial Surgery, Shanxi Medical University, Taiyuan, 030001 Shanxi, China
| | - Dapeng Lu
- Capital Medical University, Beijing 10000, China
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Pfaffeneder-Mantai F, Meller O, Schneider B, Bloch J, Bytyqi D, Sutter W, Turhani D. Specially designed and CAD/CAM manufactured allogeneic bone blocks using for augmentation of a highly atrophic maxilla show a stable base for an all-on-six treatment concept: a case report. Maxillofac Plast Reconstr Surg 2022; 44:21. [PMID: 35608728 PMCID: PMC9130375 DOI: 10.1186/s40902-022-00351-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/16/2022] [Indexed: 11/27/2022] Open
Abstract
Background In terms of a highly atrophic maxilla, bone augmentation still remains very challenging. With the introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) for allogeneic bone blocks, a new method for the treatment of bone deficiencies was created. This case report demonstrates the successful use of two specially designed and CAD/CAM manufactured allogeneic bone blocks for a full arch reconstruction of a highly atrophic maxilla with an all-on-six concept. Case presentation We report the case of a 55-year-old male patient with a highly atrophic maxilla and severe bone volume deficiencies in horizontal and vertical lines. In order to treat the defects, the surgeon decided to use a combination of two allogeneic bone blocks and two sinus floor augmentations. The bone blocks were fabricated from the data of a cone beam computed tomography (CBCT) using CAD/CAM technology. After the insertion of the two bone blocks and a healing period of 7 months, six dental implants were placed in terms of an all-on-six concept. The loading of the implants took place after an additional healing time of 7 months with a screw-retained prosthetic construction and with a milled titanium framework with acrylic veneers. Conclusion The presented procedure shows the importance of the precise design of CAD/CAM manufactured allogeneic bone blocks for the successful treatment of a highly atrophic maxilla. Proper soft-tissue management is one of the key factors to apply this method successfully.
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Affiliation(s)
- Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria.,Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Oliver Meller
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Benedikt Schneider
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Julius Bloch
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Ditjon Bytyqi
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Walter Sutter
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria.
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