Allogenic Bone Graft in Dentistry: A Review of Current Trends and Developments

In an effort to prepare non-autologous bone graft or biomaterial that would possess characteristics comparable to autologous bone, many different allogenic bone derivatives have been created. Although different existing processing methods aim to achieve the very same results, the specific parameters applied during different stages material preparation can result in significant differences in the material's mechanical and biological properties The properties, including osteoconductive, osteoinductive, and even osteogenic potential, can differ vastly depending on particular preparation and storage techniques used. Osteogenic properties, which have long been thought to be characteristic to autogenic bone grafts only, now seem to also be achievable in allogenic materials due to the possibility to seed the host's stem cells on a graft before its implantation. In this article, we aim to review the available literature on allogenic bone and its derivatives as well as the influence of different preparation methods on its performance.

Investigation of Different Types of Micro- and Nanostructured Materials for Bone Grafting Application

The insufficient volume of dental ridges is one of the most severe problems regarding an oral cavity. An inadequate amount can cause problems during various types of dental treatment. Its complexity originates from the etiopathogenesis of this problem. In this study, the representatives of auto-, allo-, and xenografts are compared. The physic-chemical differences between each of them were evaluated using XRD (X-ray Powder Diffraction), a SEM (Scanning Electron Microscopy), FT-IR (Fourier transformed infrared spectroscopy), and TGA (thermogravimetric analysis). Based on the SEM images, it was observed that the origin of the material has an influence on collagen fiber compact level and porosity. Following a comparison of FT-IR spectra and XRD, the crystal and chemical structures were described. Based on TGA, different water concentrations of the investigated materials, their high thermal stability, and concentration of inorganic phase, hydroxyapatite was determined. The presented study is important because it delivers information about chemical structure and its impact on bone regeneration. This knowledge should be taken into consideration by dental clinicians, because different types of bone grafts can accommodate the achievement of various goals.

PRF versus xenograft in sinus augmentation in case of HA-coating implant placement: A 36-month retrospective study

BACKGROUND

Sinus lift with a simultaneous implant placement in the residual maxilla is a common technique used worldwide. Nevertheless, choosing an ideal grafting material remains an object of dispute. The use of an autologous blood-derived graft, known as platelet-rich fibrin (PRF), has not yet been recognized to be as good as xenografts and alloplastic materials. However, initial results have been promising.

OBJECTIVES

To conduct a clinical and radiological comparison of implantation with a simultaneous sinus lift using xenograft or PRF clots.

MATERIAL AND METHODS

Thirty sinus lifts with simultaneous implantation were conducted using a lateral window approach and the tent pole technique, with xenograft (group 1 (G1)) or PRF (group 2 (G2)) as a filling material. To be included in the study, patients must have had an alveolar ridge height of 4-5 mm, no signs of inflammatory processes, good oral hygiene, and no other grafting procedures performed in region of implant insertion. In each case, the measurements taken were probing pocket depth (PPD), height of keratinized tissue (HKT), clinical attachment level (CAL), recession depth/width (RD/RW), and, on panoramic X-rays, marginal bone loss (MBL), grafted sinus high (GSH), and bone gain (BG). Preand post-operative treatment was applied to reduce the chance of infection.

RESULTS

During the study, 30 implants (hydroxyapatite-coated implants manufactured by SGS - 10 mm in length and 4.2 mm in diameter) were placed. The survival rate of implants in both groups was 100% with no implant mobility, pain, paresthesia, or inflammatory processes in the direct vicinity of the implants observed, except in 1 patient. After 36 months of follow-up, the radiological assessments for G1 were: GSH 4.5 mm, MBL 0.46 mm and BG 4.53 mm; and for G2: 3.4 mm, 0.6 mm and 3.4 mm, respectively. Results of the clinical measurements were for G1: HKT after 36 months (HKT36) 2.46 mm, CAL 0.47 mm and PPD 2 mm; and for G2: HKT36 3.13 mm, CAL 0.6 mm and PPD 2.07 mm.

CONCLUSIONS

After 3 years of follow-up, the results of sinus lifting solely using PRF with simultaneous implantation were promising, especially in terms of soft tissue management. Therefore, PRF can be regarded as an alternative to previously used materials.