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Lima-Sánchez B, Baus-Domínguez M, Serrera-Figallo MA, Torres-Lagares D. Advances in Synthetic Polymer Membranes for Guided Bone Regeneration in Dental Implants: A Scoping Review. J Funct Biomater 2025; 16:149. [PMID: 40422814 DOI: 10.3390/jfb16050149] [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: 03/16/2025] [Revised: 04/15/2025] [Accepted: 04/17/2025] [Indexed: 05/28/2025] Open
Abstract
BACKGROUND Different approaches are proposed for bone volume gain in the case of atrophic alveolar ridges, with guided bone regeneration (GBR) and guided tissue regeneration (GTR) being the most used techniques. These techniques require the placement of barrier membranes, which is the main element of the bone growth strategy, among which there is a wide range depending on their origin or degradation. This literature review aims to provide an update on the latest advances in polymeric membranes of synthetic origin currently used in bone regeneration. MATERIALS AND METHODS Two bibliographic searches were carried out in the PubMed (MEDLINE) and Scopus databases using a search strategy in which inclusion and exclusion criteria were applied. RESULTS For the selection of articles, the PRISMA guide flow chart was followed, and after a selection process, 11 articles were analyzed based on the characteristics of the marketed membranes and the results obtained after their use. CONCLUSIONS It can be concluded that polymeric membranes play a fundamental role in guided bone regeneration, providing an effective barrier that facilitates bone growth and improves the success of dental implantology treatments.
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Affiliation(s)
- Belén Lima-Sánchez
- Department of Stomatology, Faculty of Odontology, University of Seville, C/Avicena S/N, 41009 Seville, Spain
| | - María Baus-Domínguez
- Department of Stomatology, Faculty of Odontology, University of Seville, C/Avicena S/N, 41009 Seville, Spain
| | | | - Daniel Torres-Lagares
- Department of Stomatology, Faculty of Odontology, University of Seville, C/Avicena S/N, 41009 Seville, Spain
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2
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Wang W, Li X, Mei D, Zhao B. Autogenous solid dentin for horizontal ridge augmentation with simultaneous implantation in a severe bone defect: A 3.5-year follow-up clinical report. J Prosthet Dent 2025; 133:948-953. [PMID: 37442750 DOI: 10.1016/j.prosdent.2023.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 07/15/2023]
Abstract
Autogenous dental root placement is an available approach for horizontal alveolar ridge augmentation in patients with severe bony defects. However, in previous reports, bone augmentation has been done before the implant placement. This clinical report describes the use of dentin grafting for alveolar ridge augmentation and simultaneous implant placement in the maxillary left central incisor region with a severe horizontal bone defect. Under strict adherence to the recommended indications, dentin grafting and simultaneous implantation could be clinically feasible protocols.
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Affiliation(s)
- Wenxue Wang
- Postgraduate student, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - Xin Li
- Attending, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - Dongmei Mei
- Attending, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - Baodong Zhao
- Professor, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, School of Stomatology of Qingdao University, Qingdao, Shandong, PR China.
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Elboraey MO, Alqutaibi AY, Aboalrejal AN, Borzangy S, Zafar MS, Al-Gabri R, Alghauli MA, Ramalingam S. Regenerative approaches in alveolar bone augmentation for dental implant placement: Techniques, biomaterials, and clinical decision-making: A comprehensive review. J Dent 2025; 154:105612. [PMID: 39909139 DOI: 10.1016/j.jdent.2025.105612] [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: 12/17/2024] [Revised: 01/29/2025] [Accepted: 02/02/2025] [Indexed: 02/07/2025] Open
Abstract
OBJECTIVES This review aimed to evaluate the outcomes of ridge augmentation techniques and bio-materials for alveolar bone regeneration, addressing inconsistencies across studies. A decision tree is provided to guide clinicians in selecting optimal approaches for diverse clinical scenarios. DATA AND SOURCES An extensive search was conducted across electronic databases, including PubMed, Scopus, and Embase, alongside dental implant and prosthodontics journal portals. Reference lists of relevant articles were also manually reviewed up to October 2024. STUDY SELECTION Inclusion criteria were established to emphasize English-language human clinical trials investigating regenerative techniques and materials utilized for ridge augmentation prior to implant placement. CONCLUSIONS Selecting defect-specific regenerative approaches is crucial for successful outcomes in alveolar bone augmentation. While autografts remain the gold standard, advancements in allografts, xenografts, synthetics, and biological enhancers are transforming the field. Distraction osteogenesis is also gaining prominence as a promising technique. Clinicians should leverage these innovations to tailor treatments to individual patient needs for optimal results. The decision tree developed categorizes alveolar bone defects and suggests tailored approaches based on anticipated resorption patterns. CLINICAL SIGNIFICANCE Careful patient evaluation and tailored technique selection, combined with advancements in biomaterials and tissue engineering, are essential for achieving optimal outcomes in ridge augmentation, particularly for challenging vertical defects.
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Affiliation(s)
- Mohamed Omar Elboraey
- Preventive Dental Science Department, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia; Oral Medicine, Periodontology, Oral Diagnosis and Radiology Department, Faculty of Dentistry, Tanta University, Tanta 31527, Egypt
| | - Ahmed Yaseen Alqutaibi
- Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia; Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | | | - Sary Borzangy
- Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE; Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, UAE; School of Dentistry, University of Jordan, Amman 11942, Jordan.
| | - Redhwan Al-Gabri
- Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | | | - Sundar Ramalingam
- Department of Oral and Maxillofacial Surgery, College of Dentistry and Dental University Hospital, King Saud University Medical City, Riyadh, 11545, Saudi Arabia
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4
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Hernandez AE, Bahr NL, Blois MC, Cuevas-Suarez CE, Piva E, dos Santos MBF, Peña CLD, Lund RG. Polymers for Osmotic Self-Inflating Expanders in Oral Surgical Procedures: A Comprehensive Review. Polymers (Basel) 2025; 17:441. [PMID: 40006103 PMCID: PMC11859471 DOI: 10.3390/polym17040441] [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: 12/20/2024] [Revised: 01/29/2025] [Accepted: 02/06/2025] [Indexed: 02/27/2025] Open
Abstract
Soft-tissue expansion is a critical challenge in regenerative oral surgeries. This scoping review maps the research on polymers used in osmotic self-inflating expanders, assessing their applications, characteristics, and potential in oral surgical procedures. The study analyzed 19 articles from the PubMed, Scopus, Web of Science, and Embase databases, primarily focusing on in vivo research (78.9%) investigating polymeric tissue expanders. The review examined polymer compositions, methodologies, and tissue responses across various animal models. Osmed® hydrogel was the most studied material, with research exploring its expansion capabilities in rabbits, goats, pigs, rats, and beagle dogs. The findings showed diverse tissue expansion ranges and minimal inflammatory responses, indicating the potential for oral surgical applications. Despite promising results, gaps such as inconsistent expansion measurements and the lack of standardized protocols were identified. These findings highlight the need for further research to develop new polymer formulations and optimize device design to enhance safety, efficacy, and clinical predictability. This review provides a foundation for advancing polymeric tissue expander technologies, offering the potential for safer and more effective minimally invasive regenerative oral surgeries.
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Affiliation(s)
- Alejandro Elizalde Hernandez
- Graduate Program in Dentistry, Pelotas Dental School, Federal University of Pelotas, Pelotas 96015-560, Brazil; (A.E.H.); (M.C.B.); (C.E.C.-S.); (E.P.); (M.B.F.d.S.); (C.L.D.P.)
| | - Natália Link Bahr
- School of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, Room 503—Centro, Pelotas 96015-560, Brazil;
| | - Matheus Coelho Blois
- Graduate Program in Dentistry, Pelotas Dental School, Federal University of Pelotas, Pelotas 96015-560, Brazil; (A.E.H.); (M.C.B.); (C.E.C.-S.); (E.P.); (M.B.F.d.S.); (C.L.D.P.)
| | - Carlos Enrique Cuevas-Suarez
- Graduate Program in Dentistry, Pelotas Dental School, Federal University of Pelotas, Pelotas 96015-560, Brazil; (A.E.H.); (M.C.B.); (C.E.C.-S.); (E.P.); (M.B.F.d.S.); (C.L.D.P.)
| | - Evandro Piva
- Graduate Program in Dentistry, Pelotas Dental School, Federal University of Pelotas, Pelotas 96015-560, Brazil; (A.E.H.); (M.C.B.); (C.E.C.-S.); (E.P.); (M.B.F.d.S.); (C.L.D.P.)
| | - Mateus Bertolini Fernandes dos Santos
- Graduate Program in Dentistry, Pelotas Dental School, Federal University of Pelotas, Pelotas 96015-560, Brazil; (A.E.H.); (M.C.B.); (C.E.C.-S.); (E.P.); (M.B.F.d.S.); (C.L.D.P.)
| | - Carla Lucia David Peña
- Graduate Program in Dentistry, Pelotas Dental School, Federal University of Pelotas, Pelotas 96015-560, Brazil; (A.E.H.); (M.C.B.); (C.E.C.-S.); (E.P.); (M.B.F.d.S.); (C.L.D.P.)
| | - Rafael Guerra Lund
- Graduate Program in Dentistry, Pelotas Dental School, Federal University of Pelotas, Pelotas 96015-560, Brazil; (A.E.H.); (M.C.B.); (C.E.C.-S.); (E.P.); (M.B.F.d.S.); (C.L.D.P.)
- School of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, Room 503—Centro, Pelotas 96015-560, Brazil;
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Chowdhary R, V M. Vertical Ridge Augmentation Using Deproteinized Bovine Bone Material Without Covering With a Membrane: A Tunnel Pouch Technique-4-Year Follow-up-A Pilot Clinical Study. J ORAL IMPLANTOL 2025; 51:27-35. [PMID: 39690915 DOI: 10.1563/aaid-joi-d-24-00131] [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] [Indexed: 12/19/2024]
Abstract
The present pilot clinical trial was planned to evaluate the effect of particulate deproteinized bovine bone graft mixed with blood used as a vertical ridge augmentation material without covering with any form of collagen membrane in a tunnel pouch technique, resulting in sufficient bone formation to allow placement of dental implants with maintenance of the newly formed bone after final restoration. Eight patients (3 males and 5 females) were selected for this procedure and treated between February 2016 and December 2017. All these patients had a deficient vertical height of the posterior mandibular alveolar bone above the inferior alveolar canal. The particulate deproteinized organic bovine bone graft (Bio-Oss) mixed with blood was placed through the tunnel in the defected area and compacted firmly to form a dense pack. The average gain of alveolar bone in the first implant site immediately postoperative was 13.51 ± 0.85 and in the second implant site was 13.84 ± 0.62. Histomorphometric analysis showed that about 70.31% of the area analyzed was occupied by the vital bone, the newly formed bone, whereas only 29.69% of the residual graft remained. In the present pilot study, the deproteinized bovine bone graft placed to enhance vertical and horizontal bone gain showed positive results in regaining the bone needed to place implants and maintaining the bone around restored implants for 4 years of follow-up.
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Affiliation(s)
| | - Midhula V
- Brånemark Osseointegration Center India, Vijaynagar, Bengaluru
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Li H, Lorenz J, Sader R. Long-Term Survival in Grafted Sites of Dental Implants. Oral Maxillofac Surg Clin North Am 2025; 37:77-84. [PMID: 39578014 DOI: 10.1016/j.coms.2024.09.002] [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] [Indexed: 11/24/2024]
Abstract
OBJECTIVE Vertical and horizontal bone insufficiency in both the maxilla and mandible has long been a contraindication for implants. This review provides an overview of the long-term survival rates of implants in augmented alveolar bone after the guided bone regeneration (GBR) technique. RESULTS GBR in a combination of allogeneic or xenogeneic graft material with a barrier membrane and simultaneous or delayed placement of dental implants has proven to be a very effective and feasible treatment option in long-term studies up to 35 years. CONCLUSION Bone reconstruction with various materials is a standard therapy in implantology today.
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Affiliation(s)
- Haoran Li
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany.
| | - Jonas Lorenz
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
| | - Robert Sader
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
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7
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Palkovics D, Hegyi A, Molnar B, Frater M, Pinter C, García-Mato D, Diaz-Pinto A, Windisch P. Assessment of hard tissue changes after horizontal guided bone regeneration with the aid of deep learning CBCT segmentation. Clin Oral Investig 2025; 29:59. [PMID: 39804427 PMCID: PMC11729120 DOI: 10.1007/s00784-024-06136-w] [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: 11/14/2024] [Accepted: 12/23/2024] [Indexed: 01/16/2025]
Abstract
OBJECTIVES To investigate the performance of a deep learning (DL) model for segmenting cone-beam computed tomography (CBCT) scans taken before and after mandibular horizontal guided bone regeneration (GBR) to evaluate hard tissue changes. MATERIALS AND METHODS The proposed SegResNet-based DL model was trained on 70 CBCT scans. It was tested on 10 pairs of pre- and post-operative CBCT scans of patients who underwent mandibular horizontal GBR. DL segmentations were compared to semi-automated (SA) segmentations of the same scans. Augmented hard tissue segmentation performance was evaluated by spatially aligning pre- and post-operative CBCT scans and subtracting preoperative segmentations obtained by DL and SA segmentations from the respective postoperative segmentations. The performance of DL compared to SA segmentation was evaluated based on the Dice similarity coefficient (DSC), intersection over the union (IoU), Hausdorff distance (HD95), and volume comparison. RESULTS The mean DSC and IoU between DL and SA segmentations were 0.96 ± 0.01 and 0.92 ± 0.02 in both pre- and post-operative CBCT scans. While HD95 values between DL and SA segmentations were 0.62 mm ± 0.16 mm and 0.77 mm ± 0.31 mm for pre- and post-operative CBCTs respectively. The DSC, IoU and HD95 averaged 0.85 ± 0.08; 0.78 ± 0.07 and 0.91 ± 0.92 mm for augmented hard tissue models respectively. Volumes mandible- and augmented hard tissue segmentations did not differ significantly between the DL and SA methods. CONCLUSIONS The SegResNet-based DL model accurately segmented CBCT scans acquired before and after mandibular horizontal GBR. However, the training database must be further increased to increase the model's robustness. CLINICAL RELEVANCE Automated DL segmentation could aid treatment planning for GBR and subsequent implant placement procedures and in evaluating hard tissue changes.
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Affiliation(s)
- Daniel Palkovics
- Department of Periodontology, Semmelweis University, Budapest, Hungary.
- Dent.AI Medical Imaging Ltd, Budapest, Hungary.
| | - Alexandra Hegyi
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Balint Molnar
- Department of Periodontology, Semmelweis University, Budapest, Hungary
- Dent.AI Medical Imaging Ltd, Budapest, Hungary
| | - Mark Frater
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Csaba Pinter
- Dent.AI Medical Imaging Ltd, Budapest, Hungary
- Empresa de Base Technológica Internacional de Canarias, S.L. (EBATINCA), Las Palmas De Gran Canaria, Spain
| | | | - Andres Diaz-Pinto
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Peter Windisch
- Department of Periodontology, Semmelweis University, Budapest, Hungary
- Dent.AI Medical Imaging Ltd, Budapest, Hungary
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8
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Majzoub J, Steigmann M, Chan HL. Secured Anatomy-Driven Flap Extension (SAFE) for Guided Bone Regeneration: A Modified Flap Release Technique Description and Retrospective Study. J ORAL IMPLANTOL 2024; 50:569-577. [PMID: 39231417 DOI: 10.1563/aaid-joi-d-24-00014] [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] [Indexed: 09/06/2024]
Abstract
Current flap-releasing designs for guided bone regeneration (GBR) emphasize preserving subperiosteal microvasculature by adapting a deep-slit approach, separating the periosteum from the flap. Although biologically sound, a biomechanical disadvantage may be encountered. This study aimed to describe a modified design, the Secured Anatomy-driven Flap Extension (SAFE) technique, for effective facial flap release and to preliminarily evaluate the clinical outcomes of this technique retrospectively. Chart reviews were conducted to identify patients treated by facial flap release in staged GBR procedures between May 2020 and March 2022. The anatomical, biological, and biomechanical rationale of this technique were described. The following clinical data were collected: intraoperative and postoperative complications, initial and final horizontal ridge width before and 5-6 months after the GBR, and implant performance. A total of 10 patients were identified. At baseline, these patients presented with a mean ridge width of 2.05 ± 0.52 mm. No intraoperative and postoperative complications were observed in these patients (bleeding, wound opening, neurosensory disturbance, etc.) at the 2-3-week follow-up visit. At the re-entry, a mean ridge width of 6.50 ± 0.55 mm was measured (P < .01), resulting in a mean of 4.45 ± 0.65 mm ridge width gain. Twenty-one implants were successfully placed, integrated, and in function without signs/symptoms of peri-implantitis after a mean 21.5 ± 9.2 months follow-up period. Preliminary results suggest that the SAFE technique is a safe and predictable approach for releasing facial flaps during GBR procedures.
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Affiliation(s)
- Jad Majzoub
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Marius Steigmann
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
- Division of Periodontics, the Ohio State University College of Dentistry, Columbus, OH, USA
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Lee D, Ko YC, Koo KT, Seol YJ, Lee YM, Lee J. A Flexible Membrane May Improve Bone Regeneration by Increasing Hydrophilicity and Conformability in Lateral Bone Augmentation. Biomater Res 2024; 28:0113. [PMID: 39559494 PMCID: PMC11570787 DOI: 10.34133/bmr.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 09/26/2024] [Accepted: 11/02/2024] [Indexed: 11/20/2024] Open
Abstract
Collagen membranes play a crucial role in guided bone regeneration (GBR) by preventing soft tissue infiltration and maintaining space for bone formation. This study investigated the impact of collagen membrane flexibility on GBR outcomes through in vitro and in vivo analyses. Flexible (0.3 mm in width) and stiff (0.5 mm in width) porcine collagen membranes were compared. In vitro tests assessed hydrophilicity, enzymatic degradation, conformability, space maintenance, and tensile strength. An in vivo study using a canine model evaluated bone regeneration in standardized mandibular defects filled with deproteinized porcine bone mineral and covered with no membrane, flexible membrane, or stiff membrane. Micro-computed tomography and histomorphometric analyses were performed at 8 and 16 weeks. The flexible membrane demonstrated superior hydrophilicity, faster enzymatic degradation, and greater conformability in vitro. In vivo, micro-computed tomography analysis revealed similar alveolar ridge widths across all groups. Histomorphometric analysis at 16 weeks showed significantly larger regenerated areas in the flexible membrane group compared to controls in coronal, middle, and apical regions. Both membrane groups exhibited higher regeneration ratios than controls, with significant differences in the coronal area. The flexible membrane group demonstrated significantly higher new bone formation in all regions compared to controls at 16 weeks. These findings suggest that flexible membrane substantially enhances GBR outcomes by increasing hydrophilicity and conformability. The study highlights the potential clinical benefits of incorporating flexible membranes in GBR procedures for improved bone regeneration outcomes.
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Affiliation(s)
- Dongseob Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute,
Seoul National University, Seoul, Korea
- National Dental Care Center for Persons with Special Needs,
Seoul National University Dental Hospital, Seoul, Korea
| | - Young-Chang Ko
- Department of Periodontology, School of Dentistry and Dental Research Institute,
Seoul National University, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology, School of Dentistry and Dental Research Institute,
Seoul National University, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology, School of Dentistry and Dental Research Institute,
Seoul National University, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute,
Seoul National University, Seoul, Korea
| | - Jungwon Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute,
Seoul National University, Seoul, Korea
- One-Stop Specialty Center,
Seoul National University Dental Hospital, Seoul, Korea
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Giovanetti K, Tuma RB, Sant'Ana Pegorin Brasil G, Miranda MCR, Borges FA, Tanaka JL, Burd BS, Cortellazzi KL, Guerra NB, Mussagy CU, Floriano JF, Dos Santos LS, de Melo Silva W, Cao W, Herculano RD, Caria PHF. β-Tricalcium phosphate incorporated natural rubber latex membranes for calvarial bone defects: Physicochemical, in vitro and in vivo assessment. Int J Biol Macromol 2024; 282:137328. [PMID: 39515716 DOI: 10.1016/j.ijbiomac.2024.137328] [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: 08/06/2024] [Revised: 10/30/2024] [Accepted: 11/05/2024] [Indexed: 11/16/2024]
Abstract
Natural rubber latex membrane (NRL) is a biocompatible macromolecule that stimulates angiogenesis and promotes bone repair. Similarly, β-tricalcium phosphate (β-TCP) is an osteoconductive and osteoinductive bioceramic widely used as a bone substitute. Here, we investigated the combined use of these biomaterials in the guided bone regeneration process for calvarial defects in rats. Physicochemical characterization was performed to evaluate the interaction between β-TCP and NRL. Membrane toxicity was assessed using MC3T3 osteoblasts culture and in vivo assays with Caenorhabditis elegans. Lastly, NRL membranes, NRL incorporated with β-TCP membranes (NRL-β-TCP), and a periosteum-only (control group) were tested on rodents. MC3T3 cells adhered to membranes, preserving their morphology and intercellular connections. NRL-β-TCP membranes demonstrated no toxicity in larvae, which maintained their sinusoidal wave shape. Tests results on rodents revealed statistical difference between the groups at 60 days post-operation. NRL-β-TCP (56.1 ± 14.0 %) had an average 1.48-fold higher than the control group (38.0 ± 9.1 %), with tissue production and bone remodeling. Our qualitative histological analyses revealed that membranes significantly accelerated bone formation without any signs of inflammatory reactions. We conclude that NRL-β-TCP has potential to be used for flat bone regeneration, with osteoconductive properties, being a cheap, biocompatible, and effective occlusive barrier.
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Affiliation(s)
- Karina Giovanetti
- Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
| | - Rafael Brull Tuma
- Bioengineering & Biomaterials Group, School of Pharmaceutical Science, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| | - Giovana Sant'Ana Pegorin Brasil
- Bioengineering & Biomaterials Group, School of Pharmaceutical Science, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| | - Matheus Carlos Romeiro Miranda
- Institute of Environmental, Chemical and Pharmaceutical Sciences, Federal University of São Paulo (USP), Diadema, SP, Brazil
| | - Felipe Azevedo Borges
- Bioengineering & Biomaterials Group, School of Pharmaceutical Science, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| | - Jean Lucas Tanaka
- Bioengineering & Biomaterials Group, School of Pharmaceutical Science, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| | - Betina Sayeg Burd
- Bioengineering & Biomaterials Group, School of Pharmaceutical Science, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| | - Karine Laura Cortellazzi
- Departmentof Social Dentistry, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Nayrim Brizuela Guerra
- School of Science, São Paulo State University (UNESP), Bauru, São Paulo 17033-360, Brazil
| | - Cassamo Ussemane Mussagy
- Escuela de Agronomía, Facultad de Ciencias Agronómicas y de los Alimentos, Pontificia Universidad Católica de Valparaíso, Chile
| | - Juliana Ferreira Floriano
- Bioengineering & Biomaterials Group, School of Pharmaceutical Science, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil; National Heart and Lung Institute, Imperial College London, London, UK
| | - Lindomar Soares Dos Santos
- Faculty of Philosophy, Sciences and Languages of Ribeirão Preto, University of São Paulo (USP), 3900 Bandeirantes Avenue, Ribeirão Preto, SP 14.040-901, Brazil
| | - William de Melo Silva
- Institute of Biotechnology, São Paulo State University (UNESP), University Avenue 3780, 18610-034, Botucatu, Brazil
| | - Wei Cao
- Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA
| | - Rondinelli Donizetti Herculano
- Bioengineering & Biomaterials Group, School of Pharmaceutical Science, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA.
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11
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Zeller AN, Schenk R, Bonsmann M, Stockbrink G, Becher S, Pabst A. Complication rates of guided bone regeneration using titanium-reinforced PTFE membranes: a retrospective analysis. Clin Oral Investig 2024; 28:616. [PMID: 39475990 DOI: 10.1007/s00784-024-06007-4] [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: 08/09/2024] [Accepted: 10/21/2024] [Indexed: 11/16/2024]
Abstract
INTRODUCTION This study analyzed complication rates of guided bone regeneration (GBR) using titanium-reinforced polytetrafluoroethylene (PTFE) membranes for alveolar ridge augmentation. MATERIAL AND METHODS 84 patients treated with GBR using titanium-reinforced PTFE membranes (91 sites) were retrospectively analyzed. Complications such as membrane exposure and early removal were analyzed concerning patient age, defect site position, size, simultaneous vs. two-stage implant placement, smoking, and the use of bone grafts (BG) and substitutes (BS). RESULTS Early removal due to membrane exposure was necessary in 14/91 sites (15.4%). No correlation was found between early removal and patient age (p = 0.917). Analyzing early removal between the upper and lower jaw and between both jaws' anterior and posterior tooth regions revealed no correlations (p = 0.381 and 0.477, respectively). Defect sites sizes of 5-6 mm exhibited the highest rate of membrane exposure, requiring early removal, accounting for 57.1% of these sites (8/14). No correlation was observed between the defect sites size and early removal (p = 0.660). Comparison of simultaneous (74 sites) vs. two-stage implant placement (16 sites) showed no correlation with early removal (p = 0.706). Membrane exposure incidence was 42.9% among smokers (27 patients, 32.1%) and 57.1% among non-smokers (57 patients, 67.9%), without correlation. No correlation was found between the type of BG and BS and early removal (p = 0.500). CONCLUSION GBR using titanium-reinforced PTFE membranes is effective for alveolar ridge augmentation and has favorable long-term outcomes. CLINICAL RELEVANCE Careful surgical technique and postoperative care can minimize the notable risk of PTFE membrane exposure.
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Affiliation(s)
- Alexander-N Zeller
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- Private Practice for Oral and Maxillofacial Surgery, Plastic Facial Surgery and Implantology, Theaterstr. 61, 52062, Aachen, Germany.
| | - Rainer Schenk
- Private Practice for Oral and Maxillofacial Surgery, Oral Surgery, Implantology and Periodontology, Marktplatz 18 B, 83607, Holzkirchen, Germany
| | - Martin Bonsmann
- MVZ Oral and Maxillofacial Surgery Königsallee GmbH, Königsallee 68, 40212, Düsseldorf, Germany
| | - Gereon Stockbrink
- Private Practice for Oral and Maxillofacial Surgery, Plastic Facial Surgery and Implantology, Theaterstr. 61, 52062, Aachen, Germany
| | - Sebastian Becher
- MVZ Oral and Maxillofacial Surgery Königsallee GmbH, Königsallee 68, 40212, Düsseldorf, Germany
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, German Armed Forces Central Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany
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12
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Hong G, Hu Z, Zhou Y, Chen M, Wu H, Lu W, Jin W, Yao K, Xie Z, Shi J. An Integrated Dual-Layer Heterogeneous Polycaprolactone Scaffold Promotes Oral Mucosal Wound Healing through Inhibiting Bacterial Adhesion and Mediating HGF-1 Behavior. RESEARCH (WASHINGTON, D.C.) 2024; 7:0499. [PMID: 39691765 PMCID: PMC11651385 DOI: 10.34133/research.0499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 09/18/2024] [Accepted: 09/20/2024] [Indexed: 12/19/2024]
Abstract
Recently, the high incidence of oral mucosal defects and the subsequent functional impairments have attracted widespread attention. Controlling scaffold geometry pattern has been proposed as a strategy to promote cell behavior and facilitate soft tissue repair. In this study, we innovatively construct an integrated dual-layer heterogeneous polycaprolactone (PCL) scaffold using melt electrowriting (MEW) technology. The outer layer was disordered, while the inner layer featured oriented fiber patterns: parallel (P-par), rhombic (P-rhomb), and square (P-sq). Our findings revealed that the P-rhomb and P-sq scaffolds exhibited superior surface wettability, roughness, and tensile strength compared to the pure disordered PCL scaffolds (P) and P-par. Compared to the commercial collagen membranes, the outer layer of PCL can effectively inhibit bacterial adhesion and biofilm formation. Furthermore, the P-rhomb and P-sq groups demonstrated higher gene and protein expression levels related to cell adhesion and cell migration rates than did the P and P-par groups. Among them, P-sq plays an important role in inducing the differentiation of gingival fibroblasts into myofibroblasts rich in α-smooth muscle actin (α-SMA). Additionally, P-sq could reduce inflammation, promote epithelial regeneration, and accelerate wound healing when used in full-thickness oral mucosal defects in rabbits. Overall, the integrated dual-layer heterogeneous PCL scaffold fabricated by MEW technology effectively inhibited bacterial adhesion and guided tissue regeneration, offering advantages for clinical translation and large-scale production. This promising material holds important potential for treating full-thickness mucosal defects in a bacteria-rich oral environments.
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Affiliation(s)
- Gaoying Hong
- Stomatology Hospital,
School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
| | - Zihe Hu
- Stomatology Hospital,
School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
| | - Yanyan Zhou
- Stomatology Hospital,
School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
| | - Mumian Chen
- Stomatology Hospital,
School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
| | - Haiyan Wu
- Stomatology Hospital,
School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
| | - Weiying Lu
- Stomatology Hospital,
School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
| | - Wenjing Jin
- Stomatology Hospital,
School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
| | - Ke Yao
- State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering,
Zhejiang University, Hangzhou 310027, China
| | - Zhijian Xie
- Stomatology Hospital,
School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
| | - Jue Shi
- Stomatology Hospital,
School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
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13
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Luo F, Mo Y, Jiang J, Wen J, Ji Y, Li L, Wan Q. Advancements in dental implantology: The alveolar ridge split technique for enhanced osseointegration. Clin Implant Dent Relat Res 2024; 26:1012-1031. [PMID: 39075020 DOI: 10.1111/cid.13363] [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: 03/12/2024] [Revised: 06/24/2024] [Accepted: 07/02/2024] [Indexed: 07/31/2024]
Abstract
The alveolar ridge split (ARS) technique is a pivotal advancement in dental implantology, addressing the limitation of insufficient bone width for implant placement. This review traces the historical development of ARS from its initial conceptualization to current practices and future directions. Emphasizing the technique's development, indications, procedural overview, and osteotomy variations, we highlight its minimally invasive nature, which reduces patient morbidity and treatment time. This article reviews various osteotomy methods within ARS, examining their applications, benefits, and limitations. Furthermore, it discusses the technique's role in expanding treatment options for patients with compromised alveolar structures, underpinned by a high implant survival rate and the potential for immediate implant placement. We also cover the necessity of meticulous surgical technique, the importance of patient-specific factors, and the promising future of ARS facilitated by advancements in biomaterials and regenerative medicine. In summary, this review provides a comprehensive overview of ARS, offering valuable insights for dental professionals and informing future clinical practices and research in implantology.
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Affiliation(s)
- Feng Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Yafei Mo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Jiapei Jiang
- Outpatient Department, Sichuan Electrical Power Hospital, Chengdu, China
| | - Jing Wen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Yixuan Ji
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Lei Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Qianbing Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
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14
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Somodi K, Dobos A, Bartha F, Solyom E, Windisch P, Palkovics D, Molnar B. Changes in soft tissue dimensions following horizontal guided bone regeneration with a split-thickness flap design - evaluation of 8 cases with a digital method. Head Face Med 2024; 20:53. [PMID: 39342334 PMCID: PMC11438005 DOI: 10.1186/s13005-024-00456-8] [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: 05/29/2024] [Accepted: 09/11/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Peri-implant soft tissue corrections are often indicated following alveolar ridge augmentation, due to the distortion of the keratinized mucosa at the area of augmentation. The objective of the current study was to evaluate the dimensional soft tissue changes following horizontal guided bone regeneration (GBR) utilizing 3D digital data. METHODS 8 mandibular surgical sites with horizontal alveolar ridge deficiencies were treated utilizing a resorbable collagen membrane and a split-thickness flap design. Baseline and 6-month follow-up cone-beam computed tomography (CBCT) scans were reconstructed as 3D virtual models and were superimposed with the corresponding intraoral scan. Linear changes of supracrestal vertical- horizontal soft tissue alterations were measured in relation to the alveolar crest at the mesial- middle- and distal aspect of the surgical area. Soft tissue dimensions were measured at baseline and at 6-month follow-up. RESULTS Preoperative supracrestal soft tissue height measured midcrestally averaged at 2.37 mm ± 0.68 mm, 2.37 mm ± 0.71 mm and 2.64 mm ± 0.87 mm at the mesial-, middle- and distal planes. Whereas postoperative supracrestal soft tissue height was measured at 2.62 mm ± 0.72 mm, 2.67 mm ± 0.67 mm and 3.69 mm ± 1.02 mm at the mesial, middle and distal planes, respectively. Supracrestal soft tissue width changed from 2.14 mm ± 0.72 mm to 2.47 mm ± 0.46 mm at the mesial, from 1.72 mm ± 0.44 mm to 2.07 mm ± 0.67 mm and from 2.15 mm ± 0.36 mm to 2.36 mm ± 0.59 mm at the mesial, middle and distal planes, respectively. Additionally the buccal horizontal displacement of supracrestal soft tissues could be observed. CONCLUSIONS The current study did not report significant supracrestal soft tissue reduction following horizontal GBR with a split-thickness flap. Even though there was a slight increase in both vertical and horizontal dimensions, differences are clinically negligible. TRAIL REGISTRATION The trail was approved by the U.S. National Library of Medicine ( www. CLINICALTRIALS gov ); trial registration number: NCT05538715; registration date: 09/09/2022.
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Affiliation(s)
- Kristof Somodi
- Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088, Hungary.
| | - Andrea Dobos
- Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088, Hungary
| | - Ferenc Bartha
- Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088, Hungary
| | - Eleonora Solyom
- Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088, Hungary
| | - Peter Windisch
- Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088, Hungary
| | - Daniel Palkovics
- Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088, Hungary
| | - Balint Molnar
- Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088, Hungary
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15
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Giragosyan K, Chenchev I, Ivanova V. Linear bone gain and healing complication rate comparative outcomes following ridge augmentation with custom 3D printed titanium mesh vs Ti-reinforced dPTFE. A randomized clinical trial. Folia Med (Plovdiv) 2024; 66:505-514. [PMID: 39257255 DOI: 10.3897/folmed.66.e123766] [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: 03/22/2024] [Accepted: 06/21/2024] [Indexed: 09/12/2024] Open
Abstract
AIM The aim of this randomized clinical trial was to compare the qualitative (linear alveolar ridge changes) and quantitative (healing complications) outcomes after guided bone regeneration (GBR) using a custom-made 3D printed titanium mesh versus titanium reinforced dense PTFE membrane for vertical and horizontal augmentation of deficient alveolar ridges.
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16
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Goudarzimoghaddam F, Ekhlasmandkermani M, Houshmand B, Sabri H. Internal Allo-Cortical Tenting: A Modified Ridge Split Technique in Three-Dimensional Ridge Augmentation. J ORAL IMPLANTOL 2024; 50:384-390. [PMID: 38895832 DOI: 10.1563/aaid-joi-d-24-00004] [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] [Indexed: 06/21/2024]
Abstract
Three-dimensional (3D) alveolar ridge deficiencies necessitate horizontal and vertical bone reconstruction for optimal implant positioning. Despite several available techniques, achieving desired augmentation outcomes remains challenging. This case study aims to present a modified ridge split technique for bone reconstruction in horizontal and vertical dimensions. The proposed technique was used to reconstruct the horizontal and vertical ridge defect from removing a previously failed implant. This technique includes placing a cortical allograft plate as an internal tent in the split ridge. A portion of the plate was inserted into the ridge, while the other part was placed in the coronal of the vertical defect. Additional guided bone regeneration was performed around the tented plate on both the buccal and lingual sides. After 5 months, cone beam computerized tomography revealed sufficient bone formation in horizontal and vertical dimensions. Within the limitations of the present case study, internal cortical tenting would be a reliable method for 3D bone reconstruction in cases where the ridge split is feasible.
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Affiliation(s)
- Fatemeh Goudarzimoghaddam
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Ekhlasmandkermani
- Department of Periodontics, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Behzad Houshmand
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamoun Sabri
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
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17
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Dolińska E, Skurska A, Dymicka-Piekarska V, Milewski R, Pietruska M. Matrix Metalloproteinase 9 (MMP-9) and Interleukin-8 (IL-8) in Gingival Crevicular Fluid after Minimally Invasive Periodontal Surgery with or without Er:YAG and Nd:YAG Laser Application. Antibiotics (Basel) 2024; 13:704. [PMID: 39200004 PMCID: PMC11350890 DOI: 10.3390/antibiotics13080704] [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: 06/16/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND This study aimed to evaluate alterations in the concentrations of matrix metalloproteinase-9 (MMP-9) and interleukin-8 (IL-8) within gingival crevicular fluid (GCF) extracted from the intrabony periodontal defect site before and after minimally invasive regenerative surgery, with or without supplemental laser application. The surgical procedure was performed using the modified minimally invasive surgical technique (M-MIST). METHODS Thirty-eight patients, each presenting with a single vertical defect, were randomly assigned to either the test (M-MIST + Er:YAG + Nd:YAG) or the control group (M-MIST). IL-8 and MMP-9 levels (primary outcomes of the study) were assessed prior to therapy, after 2 and 4 weeks, and 6 months following the surgical procedure by means of dedicated ELISA kits. RESULTS Both procedures were clinically effective as evidenced by probing depth (PD) reduction and clinical attachment level (CAL) gain at the 6-month follow-up. No statistical differences were observed in the levels of MMP-9 and IL-8 between the groups at any time point assessed. The changes in the level of MMP-9 and IL-8 over time were not statistically significant in any group. IL-8 was positively correlated with MMP-9 in the control group throughout the study and in the test group 2 weeks and 6 months post-op. CONCLUSIONS Within the limitations of this study, the additional application of Er:YAG + Nd:YAG lasers alongside the M-MIST procedure did not enhance the clinical and biochemical treatment outcomes compared to M-MIST alone.
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Affiliation(s)
- Ewa Dolińska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.S.); (M.P.)
| | - Anna Skurska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.S.); (M.P.)
- Department of Integrated Dentistry, Medical University of Bialystok, ul. M. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland
| | - Violetta Dymicka-Piekarska
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, ul. Waszyngtona 15, 15-269 Bialystok, Poland;
| | - Robert Milewski
- Department of Biostatistics and Medical Informatics, Medical University of Bialystok, ul. Szpitalna 37, 15-295 Bialystok, Poland;
| | - Małgorzata Pietruska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (A.S.); (M.P.)
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18
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Ashfaq R, Kovács A, Berkó S, Budai-Szűcs M. Developments in Alloplastic Bone Grafts and Barrier Membrane Biomaterials for Periodontal Guided Tissue and Bone Regeneration Therapy. Int J Mol Sci 2024; 25:7746. [PMID: 39062989 PMCID: PMC11277074 DOI: 10.3390/ijms25147746] [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: 06/18/2024] [Revised: 07/04/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Periodontitis is a serious form of oral gum inflammation with recession of gingival soft tissue, destruction of the periodontal ligament, and absorption of alveolar bone. Management of periodontal tissue and bone destruction, along with the restoration of functionality and structural integrity, is not possible with conventional clinical therapy alone. Guided bone and tissue regeneration therapy employs an occlusive biodegradable barrier membrane and graft biomaterials to guide the formation of alveolar bone and tissues for periodontal restoration and regeneration. Amongst several grafting approaches, alloplastic grafts/biomaterials, either derived from natural sources, synthesization, or a combination of both, offer a wide variety of resources tailored to multiple needs. Examining several pertinent scientific databases (Web of Science, Scopus, PubMed, MEDLINE, and Cochrane Library) provided the foundation to cover the literature on synthetic graft materials and membranes, devoted to achieving periodontal tissue and bone regeneration. This discussion proceeds by highlighting potential grafting and barrier biomaterials, their characteristics, efficiency, regenerative ability, therapy outcomes, and advancements in periodontal guided regeneration therapy. Marketed and standardized quality products made of grafts and membrane biomaterials have been documented in this work. Conclusively, this paper illustrates the challenges, risk factors, and combination of biomaterials and drug delivery systems with which to reconstruct the hierarchical periodontium.
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Affiliation(s)
| | | | | | - Mária Budai-Szűcs
- Institute of Pharmaceutical Technology and Regulatory Affairs, Faculty of Pharmacy, University of Szeged, Eötvös u. 6, H-6720 Szeged, Hungary; (R.A.); (A.K.); (S.B.)
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19
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Belleggia F. Effects of intentional early dense-polytetrafluoroethylene membrane removal on vertical ridge augmentation. Clin Adv Periodontics 2024. [PMID: 38853695 DOI: 10.1002/cap.10298] [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: 01/20/2024] [Revised: 04/03/2024] [Accepted: 05/07/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Vertical ridge augmentation (VRA) requires long healing times for bone maturation. This case study deals with the intentional early removal of a titanium-reinforced dense polytetrafluoroethylene (TR-dPTFE) membrane that allowed for treatment times reduction and improvement of bone quality. METHODS A TR-dPTFE membrane was used for VRA in the premolar region of the upper right maxilla. The defect was filled with a mix of particulate autogenous bone and porcine xenograft in a 1:1 ratio. After a 4-month uneventful healing period, the membrane was removed, and the thick keratinized palatal tissue was moved toward the buccal side via a pedicle flap. Implants insertion and healing abutments application were carried out 3 months later, when bone graft could have been revascularized and nourished by the periosteum. RESULTS The histologic evaluation of a bone sample harvested during implant bed preparation revealed a huge amount of mature newly formed bone even in the most coronal part. Two screw-retained crowns were delivered 2 months after implant insertion and the 3.5-year follow-up showed perfectly maintained hard and soft tissues. CONCLUSIONS Intentional early removal of TR-dPTFE membrane after a 4-month healing time, with simultaneous soft tissue augmentation via a buccally reposioned pedicle flap, allowed graft revascularization from the periosteum, and resulted in optimal quantity and quality of the regenerated bone. This process shortened the overall treatment times, taking only 9 months from VRA to prosthetic loading. Both augmented hard and soft tissues allowed for crestal bone maintenance around implants. KEY POINTS Titanium-reinforced dense polytetrafluoroethylene (TR-dPTFE) membranes, due to their closed structure, do not allow the passage of cells and vessels from the periosteum, and revascularization from the residual bone alone is not enough for proper graft maturation and long-term crestal bone maintenance. Early removal of TR-dPTFE membrane allows graft revascularization from the periosteum, and results in optimal quantity and quality of the regenerated bone. Increasing the thickness of the soft tissues, increasing the width of the keratinized mucosa, and repositioning the mucogingival line, via a free gingival graft or a pedicle flap, should be performed simultaneously in the membrane removal phase to reduce the number of surgical interventions, decrease patient morbidity, and shorten the total treatment time.
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20
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Khaddour AS, Ghiță RE, Ionescu M, Rîcă RG, Mercuț V, Manolea HO, Camen A, Drăghici EC, Radu A, Popescu SM. Healing of Extraction Sites after Alveolar Ridge Preservation Using Advanced Platelet-Rich Fibrin: A Retrospective Study. Bioengineering (Basel) 2024; 11:566. [PMID: 38927802 PMCID: PMC11201034 DOI: 10.3390/bioengineering11060566] [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: 05/14/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Over time, numerous surgical procedures and biomaterials have been proposed for the reconstruction of post-extraction bone defects, each with their advantages and disadvantages. The main objective of this study was to evaluate dimensional changes in the alveolar bone 3 months after tooth extraction, before implant planning, comparing alveolar ridge preservation (ARP) with spontaneous healing. METHODS A total of 84 patients with non-restorable molars were included in the study. Forty-two patients received ARP with advanced platelet-rich fibrin (A-PRF) and spontaneous healing was evaluated in these patients. Cone beam computed tomography (CBCT) analysis performed before and after surgical intervention was used to determine the changes in vertical and horizontal bone dimensions produced after tooth extraction. RESULTS CBCT measurements showed reduction in both vertical and horizontal alveolar bone size in both groups. For the study group, the alveolar parameters (height, width) were higher compared to the control group. The percentage variations between dimensional differences from the two groups were 38.58% for height, and for width were 36.88% at 0 mm, 35.56% at 3 mm, 36.61% at 5 mm, and 38.73% at 7 mm. The differences were statistically significant (p ˂ 0.0005). CONCLUSIONS The results obtained after ARP with A-PRF showed a reduced loss of bone volume compared to spontaneous healing.
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Affiliation(s)
- Antonia Samia Khaddour
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
| | - Răzvan Eugen Ghiță
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
| | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Radu Gabriel Rîcă
- Department of Dental Technology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Veronica Mercuț
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Horia Octavian Manolea
- Department of Dental Materials, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Adrian Camen
- Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Emma Cristina Drăghici
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
| | - Andrei Radu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
| | - Sanda Mihaela Popescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
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Shaker AE, Salem AS, El-Farag SA, Abdel-Rahman FH, El-Kenawy MH. Comparison of Khoury's Bone Shell Technique vs Titanium-reinforced Polytetrafluoroethylene Membrane for 3D-bone Augmentation in Atrophic Posterior Mandible: A Randomized Clinical Trial. J Contemp Dent Pract 2024; 25:518-526. [PMID: 39364817 DOI: 10.5005/jp-journals-10024-3704] [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] [Indexed: 10/05/2024]
Abstract
AIM This study was designed to compare between the use of Khoury's bone shell technique vs titanium-reinforced PTFE membrane for 3D-ridge augmentation of atrophic posterior mandible. MATERIALS AND METHODS Sixteen patients were equally and randomly assigned to either the Khoury or PTFE group. In Khoury group, a mandibular bone block was harvested, split and then fixed to augment the mandibular defect using osteosynthesis screws. In PTFE group, augmentation was achieved using Titanium-reinforced PTFE membranes fixed with bone tacks/screws. A mixture of autogenous and xenogenic graft material at a 1:1 ratio was used in both groups. Vertical and horizontal bone gain were obtained using cone-beam computed tomography (CBCT). Preoperative dimensions were compared with the final dimensions obtained 6 months postoperatively. RESULTS No significant complications or neurosensory dysfunction were encountered. A solitary patient in the Khoury group experienced limited wound dehiscence, which was treated conservatively. For both groups, there were no significant differences between preoperative and postoperative vertical (p = 0.849 and 0.569) and horizontal (p = 0.778 and 0.367) dimensions. CONCLUSION No significant differences exist between the augmentation dimension which can be obtained using either Khoury of Ti-PTFE membranes. CLINICAL SIGNIFICANCE Both approaches are delicate and necessitate surgical expertise and experience. Both techniques can be used to achieve predictable augmentation results with a low rate of complications. How to cite this article: Shaker AES, Salem AS, El-Farag SAA, et al. Comparison of Khoury's Bone Shell Technique vs Titanium-reinforced Polytetrafluoroethylene Membrane for 3D-bone Augmentation in Atrophic Posterior Mandible: A Randomized Clinical Trial. J Contemp Dent Pract 2024;25(6):518-526.
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Affiliation(s)
- Ahmed Es Shaker
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Addakahliya, Egypt; Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Delta University for Science and Technology Surgery, Gamasa, Mansoura, Addakahliya, Egypt, Phone: +11152, e-mail: , Orcid: https://orcid.org/0009-0002-9055-5220
| | - Ahmed S Salem
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Addakahliya, Egypt, Orcid: https://orcid.org/0000-0002-0839-9939
| | - Shaimaa Aa El-Farag
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Addakahliya, Egypt, Orcid: https://orcid.org/0000-0003-4171-8054
| | - Fakhreldin H Abdel-Rahman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Addakahliya, Egypt, Orcid: https://orcid.org/0000-0003-4654-2078
| | - Mohamed H El-Kenawy
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Addakahliya, Egypt, Orcid: https://orcid.org/0009-0007-2024-0158
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22
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Alazmi SO. A review on guided bone regeneration using titanium mesh. Bioinformation 2024; 20:562-565. [PMID: 39132237 PMCID: PMC11309112 DOI: 10.6026/973206300200562] [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: 05/01/2024] [Revised: 05/31/2024] [Accepted: 05/31/2024] [Indexed: 08/13/2024] Open
Abstract
The gold standard for bone regeneration in atrophic ridge patients is guided bone regeneration (GBR). This makes it possible to get enough bone volume for an appropriate implant-prosthetic rehabilitation. The barrier membranes must meet the primary GBR design requirements, which include adequate integration with the surrounding tissue, spaciousness and clinical manageability. Titanium mesh's superior mechanical qualities and biocompatibility have broadened the indications of GBR technology, enabling it to be used to restore alveolar ridges with more significant bone defects. GBR with titanium mesh is being used in many clinical settings and for a range of clinical procedures. Furthermore, several advancements in digitalization and material modification have resulted from the study of GBR using titanium mesh. Hence, we report a review on the various characteristics of titanium mesh and its current use in clinical settings for bone augmentation.
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Affiliation(s)
- Saad Obaid Alazmi
- Department of Periodontology and Implant Dentistry, College of Dentistry, Qassim University, Saudi Arabia
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23
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Wang X, Shen P, Gu N, Shao Y, Lu M, Tang C, Wang C, Chu C, Xue F, Bai J. Dual Mg-Reinforced PCL Membrane with a Janus Structure for Vascularized Bone Regeneration and Bacterial Elimination. ACS Biomater Sci Eng 2024; 10:537-549. [PMID: 38065085 DOI: 10.1021/acsbiomaterials.3c01360] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Commercially available guided bone regeneration (GBR) membranes often exhibit limited mechanical properties or bioactivity, leading to poor performance in repairing bone defects. To surmount this limitation, we developed a Janus structural composite membrane (Mg-MgO/PCL) reinforced by dual Mg (Mg sheets and MgO NPs) by using a combined processing technique involving casting and electrospinning. Results showed that the addition of Mg sheets and MgO NPs enhanced the mechanical properties of the composite membrane for osteogenic space maintenance, specifically tensile strength (from 10.2 ± 1.2 to 50.3 ± 4.5 MPa) and compression force (from 0 to 0.94 ± 0.09 N mm-1), through Mg sheet reinforcement and improved crystallization. The dense cast side of the Janus structure membrane displayed better fibroblast barrier capacity than a single fiber structure; meanwhile, the PCL matrix protected the Mg sheet from severe corrosion due to predeformation. The porous microfibers side supported preosteoblast cell adhesion, enhanced osteogenesis, and angiogenesis in vitro, through the biomimetic extracellular matrix and sustainable Mg2+ release. Furthermore, the Mg-MgO/PCL membrane incorporating 2 wt % MgO NPs exhibited remarkable antimicrobial properties, inducing over 88.75% apoptosis in Staphylococcus aureus. An in vivo experiment using the rat skull defect model (Φ = 5 mm) confirmed that the Mg-MgO/PCL membrane significantly improved new bone formation postsurgery. Collectively, our investigation provides valuable insights into the design of multifunctional membranes for clinical oral GBR application.
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Affiliation(s)
- Xianli Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Peiqi Shen
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Nannan Gu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Yi Shao
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Mengmeng Lu
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
| | - Chunbo Tang
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
| | - Cheng Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Feng Xue
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
- Jiangsu Key Laboratory for Light Metal Alloys, Nanjing 211224, Jiangsu, China
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Li Z, Yang C, Wang J, Zheng K, Luo W. The application of CGF combined with GBR in alveolar bone increment for patients with anxiety disorder: A rare case report and literature review. Medicine (Baltimore) 2023; 102:e35905. [PMID: 37960737 PMCID: PMC10637472 DOI: 10.1097/md.0000000000035905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
RATIONALE Selective serotonin reuptake inhibitors (SSRIs), one of the commonly used anti-anxiety drugs, may have impacts on bone metabolism and potentially lead to drug-induced osteoporosis. The traditional approach of oral implantation in individuals with both anxiety disorder and drug-induced osteoporosis poses a significant challenge. To address this issue, concentrated growth factor (CGF) has been utilized in patients undergoing concurrent alveolar ridge augmentation during oral implantation, resulting in favorable clinical outcomes. Consequently, combining CGF with guided bone regeneration (GBR) in alveolar bone increment may represent a promising new surgical approach for such patients. In this report, we present a case study of a 25-year-old male with anxiety disorder and drug-induced osteoporosis, in who CGF combined with GBR was employed in alveolar bone increment. PATIENT CONCERNS This article reports the case of a 25-year-old male who underwent cone beam computed tomography (CBCT) due to the absence of his right lower second molar for a period of six months. The CBCT scan revealed significant bone defects, which were attributed to the tooth loss and prolonged use of anti-anxiety drugs. Consequently, the patient sought medical assistance from our department. DIAGNOSES Based on the patient's self-report, he was diagnosed with an anxiety disorder. Additionally, the CBCT scan confirmed the loss of the right mandibular second molar and revealed the presence of dental irregularity and an alveolar bone defect. INTERVENTIONS During the patient's course of treatment with anti-anxiety medication, a combination of CGF and GBR was employed for the simultaneous implantation of the missing right mandibular second molar, along with bone augmentation. OUTCOMES The patient had a follow-up visit two weeks after the surgical procedure, and the wound in the operation area had healed satisfactorily. Six months later, CBCT images revealed excellent osseointegration. The buccal and lingual width of the alveolar bone measured 6.95mm, which was an increase of 1.35mm compared to the pre-implantation stage. LESSONS This article presents a case study in which CGF combined with GBR were utilized to address alveolar bone augmentation during the implantation phase in patients taking anti-anxiety medication. The results demonstrated that CGF combined with GBR, as a cutting-edge platelet concentrate technique, could effectively stimulate bone tissue proliferation in individuals who have been on long-term anti-anxiety medication, specifically in oral implant areas. This approach can help prevent poor osseointegration, promote higher osseointegration rates, and facilitate wound healing.
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Affiliation(s)
- Zhixin Li
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Chao Yang
- Department of Stomatology, The People's Hospital of Longhua, Shenzhen, China
- Research and Development Department, Shenzhen Uni-medica Technology CO., Ltd, Shenzhen, China
| | - Jinrong Wang
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Kaiyue Zheng
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Wen Luo
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
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25
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Wang X, Qian Y, Wang S, Wang M, Sun K, Cheng Z, Shao Y, Zhang S, Tang C, Chu C, Xue F, Tao L, Lu M, Bai J. Accumulative Rolling Mg/PLLA Composite Membrane with Lamellar Heterostructure for Enhanced Bacteria Inhibition and Rapid Bone Regeneration. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023; 19:e2301638. [PMID: 37345962 DOI: 10.1002/smll.202301638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/19/2023] [Indexed: 06/23/2023]
Abstract
Developing composite materials with optimized mechanics, degradation, and bioactivity for bone regeneration has long been a crucial mission. Herein, a multifunctional Mg/Poly-l-lactic acid (Mg/PLLA) composite membrane based on the "materials plain" concept through the accumulative rolling (AR) method is proposed. Results show that at a rolling ratio of 75%, the comprehensive mechanical properties of the membrane in the rolling direction are self-reinforced significantly (elongation at break ≈53.2%, tensile strength ≈104.0 MPa, Young's modulus ≈2.13 GPa). This enhancement is attributed to the directional arrangement and increased crystallization of PLLA molecular chains, as demonstrated by SAXS and DSC results. Furthermore, the AR composite membrane presents a lamellar heterostructure, which not only avoids the accumulation of Mg microparticles (MgMPs) but also regulates the degradation rate. Through the contribution of bioactive MgMPs and their photothermal effect synergistically, the membrane effectively eliminates bacterial infection and accelerates vascularized bone regeneration both in vitro and in vivo. Notably, the membrane exhibits outstanding rat skull bone regeneration performance in only 4 weeks, surpassing most literature reports. In short, this work develops a composite membrane with a "one stone, four birds" effect, opening an efficient avenue toward high-performance orthopedic materials.
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Affiliation(s)
- Xianli Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Yuxin Qian
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Shuang Wang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Mingxi Wang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Ke Sun
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Zhaojun Cheng
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Yi Shao
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Shixuan Zhang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Chunbo Tang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Feng Xue
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Li Tao
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Mengmeng Lu
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
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Urban IA, Montero E, Amerio E, Palombo D, Monje A. Techniques on vertical ridge augmentation: Indications and effectiveness. Periodontol 2000 2023; 93:153-182. [PMID: 36721380 DOI: 10.1111/prd.12471] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 02/02/2023]
Abstract
Vertical ridge augmentation techniques have been advocated to enable restoring function and esthetics by means of implant-supported rehabilitation. There are three major modalities. The first is guided bone regeneration, based on the principle of compartmentalization by means of using a barrier membrane, which has been demonstrated to be technically demanding with regard to soft tissue management. This requisite is also applicable in the case of the second modality of bone block grafts. Nonetheless, space creation and maintenance are provided by the solid nature of the graft. The third modality of distraction osteogenesis is also a valid and faster approach. Nonetheless, owing to this technique's inherent shortcomings, this method is currently deprecated. The purpose of this review is to shed light on the state-of-the-art of the different modalities described for vertical ridge augmentation, including the indications, the step-by-step approach, and the effectiveness.
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Affiliation(s)
- Istvan A Urban
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Eduardo Montero
- Department of Periodontics, Universidad Complutense de Madrid, Madrid, Spain
| | - Ettore Amerio
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - David Palombo
- Department of Periodontics, Universidad Complutense de Madrid, Madrid, Spain
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
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Park WB, Han JY, Kang P. The Bone Bridge Technique Utilizing Bone from the Lateral Wall of the Maxillary Sinus for Ridge Augmentation: Case Reports of a 1-7 Year Follow-Up. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1626. [PMID: 37763747 PMCID: PMC10536201 DOI: 10.3390/medicina59091626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
The post-extraction socket of a periodontally compromised tooth/implant is oftentimes accompanied by a very wide-deep alveolar ridge defect. The commonly utilized treatment is ridge preservation followed by delayed implant placement 4 to 6 months after extraction. In the four cases presented in this study, a novel technique of utilizing a bone block obtained from the lateral wall of the maxillary sinus is introduced. Due to the severe localized vertical ridge deficiency, an intraoral autogenous bone block was obtained from the ipsilateral sinus bony window. After the obtained bone block was properly trimmed, it was fixed in the form of a bridge over the vertical defect by the press-fit method. In two cases, the gap between the autogenous bone and defect was filled with a particulate synthetic bone graft, and in another two cases, the gap was left without grafting. All cases were covered with a resorbable collagen membrane. At the time of re-entry after 5 to 6 months, the bone bridge was well incorporated beside the adjacent native bone and helped by the implant placement. Uncovering was performed after 3 to 6 months, and prostheses were delivered after 2 months. Oral function was maintained without any change in the marginal bone level even after the 1- to 7-year post-prosthesis delivery. This case series showed that the bone bridge technique performed using an ipsilateral sinus bony window for a localized vertical deficiency of a post-extraction socket can be used for successful vertical ridge augmentation (VRA).
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea;
- Private Practice in Periodontics and Implant Dentistry, Seoul 02771, Republic of Korea
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences Columbia University College of Dental Medicine, #PH7E-110, 630 W. 168 St., New York, NY 10032, USA
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Scribante A, Ghizzoni M, Pellegrini M, Pulicari F, Manfredini M, Poli PP, Maiorana C, Spadari F. Full-Digital Customized Meshes in Guided Bone Regeneration Procedures: A Scoping Review. PROSTHESIS 2023; 5:480-495. [DOI: 10.3390/prosthesis5020033] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Meshes, especially titanium ones, are being widely applied in oral surgery. In guided bone regeneration (GBR) procedures, their use is often paired with membranes, being resorbable or non-resorbable. However, they present some limitations, such as difficulty in the treatment of severe bone defects, alongside frequent mesh exposure. Customized meshes, produced by a full-digital process, have been recently introduced in GBR procedures. Therefore, the focus of the present review is to describe the main findings in recent years of clinical trials regarding patient-specific mesh produced by CAD/CAM and 3D printing workflow, made in titanium or even PEEK, applied to GBR surgeries. The purpose is to analyze their clinical management, advantages, and complications. This scoping review considered randomized clinical trials, observational studies, cohort studies, and case series/case reports studies. Studies that did not meet inclusion criteria were excluded. The preferred reporting items for scoping reviews (PRISMA-ScR) consensus was followed. A total of 15 studies were selected for this review. Based on the studies included, the literature suggests that meshes produced by a digital process are used to restore complex and severe bone defects. Moreover, they give satisfactory aesthetic results and fit the defects, counteracting grid exposure. However, more clinical trials should be conducted to evaluate long-term results, the rate of complications, and new materials for mesh manufacturing.
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Affiliation(s)
- Andrea Scribante
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Martina Ghizzoni
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Matteo Pellegrini
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Federica Pulicari
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Mattia Manfredini
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Pier Paolo Poli
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Carlo Maiorana
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Francesco Spadari
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
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Guided Bone Regeneration with Occlusive Titanium Barrier: A Case Report and Clinical Considerations. Biomimetics (Basel) 2023; 8:biomimetics8010106. [PMID: 36975336 PMCID: PMC10046855 DOI: 10.3390/biomimetics8010106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
The need to obtain adequate bone volumes for prosthetic rehabilitation supported by implants, using different techniques and materials, represents an urgent need in modern dentistry. We report a case regarding the management of implant-prosthetic rehabilitation of the first and second upper right molars, in which no less than 4 mm of crestal bone remained to insert two implants. Regeneration of the residual bone was previously performed using a customized titanium barrier and a filler of a blood clot with tricalcium beta phosphate. The bone gain (3 mm) was evaluated by comparing CBCT images, while the implant stability (mean 70) was assessed with the ISQ measurement. A regenerated bone sample was taken for histological analysis. Guided bone regeneration obtained with a titanium barrier and blood clot allowed for the insertion of stable implants in a mature bone without heterologous material.
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Palkovics D, Solyom E, Somodi K, Pinter C, Windisch P, Bartha F, Molnar B. Three-dimensional volumetric assessment of hard tissue alterations following horizontal guided bone regeneration using a split-thickness flap design: A case series. BMC Oral Health 2023; 23:118. [PMID: 36810076 PMCID: PMC9945662 DOI: 10.1186/s12903-023-02797-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES To analyze morphological, volumetric, and linear hard tissue changes following horizontal ridge augmentation using a three-dimensional radiographic method. METHODS As part of a larger ongoing prospective study, 10 lower lateral surgical sites were selected for evaluation. Horizontal ridge deficiencies were treated with guided bone regeneration (GBR) using a split-thickness flap design and a resorbable collagen barrier membrane. Following the segmentation of baseline and 6-month follow-up cone-beam computed tomography scans, volumetric, linear, and morphological hard tissue changes and the efficacy of the augmentation were assessed (expressed by the volume-to-surface ratio). RESULTS Volumetric hard tissue gain averaged 605.32 ± 380.68 mm3. An average of 238.48 ± 127.82 mm3 hard tissue loss was also detected at the lingual aspect of the surgical area. Horizontal hard tissue gain averaged 3.00 ± 1.45 mm. Midcrestal vertical hard tissue loss averaged 1.18 ± 0.81 mm. The volume-to-surface ratio averaged 1.19 ± 0.52 mm3/mm2. The three-dimensional analysis showed slight lingual or crestal hard tissue resorption in all cases. In certain instances, the greatest extent of hard tissue gain was observed 2-3 mm apical to the initial level of the marginal crest. CONCLUSIONS With the applied method, previously unreported aspects of hard tissue changes following horizontal GBR could be examined. Midcrestal bone resorption was demonstrated, most likely caused by increased osteoclast activity following the elevation of the periosteum. The volume-to-surface ratio expressed the efficacy of the procedure independent of the size of the surgical area.
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Affiliation(s)
- Daniel Palkovics
- Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088, Hungary.
| | - Eleonora Solyom
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
| | - Kristof Somodi
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
| | - Csaba Pinter
- Empresa de Base Technológica Internacional de Canarias, S.L., Alcalde Jose Ramirez Bethencourt Avenue 17 Las Palmas De Gran Canaria, 35004 Las Palmas De Gran Canaria, Spain
| | - Peter Windisch
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
| | - Ferenc Bartha
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
| | - Balint Molnar
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
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Yang W, Chen D, Wang C, Apicella D, Apicella A, Huang Y, Li L, Zheng L, Ji P, Wang L, Fan Y. The effect of bone defect size on the 3D accuracy of alveolar bone augmentation performed with additively manufactured patient-specific titanium mesh. BMC Oral Health 2022; 22:557. [PMID: 36456929 PMCID: PMC9713982 DOI: 10.1186/s12903-022-02557-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Additively manufactured (3D-printed) titanium meshes have been adopted in the dental field as non-resorbable membranes for guided bone regeneration (GBR) surgery. However, according to previous studies, inaccuracies between planned and created bone volume and contour are common, and many reasons have been speculated to affect its accuracy. The size of the alveolar bone defect can significantly increase patient-specific titanium mesh design and surgical difficulty. Therefore, this study aimed to analyze and investigate the effect of bone defect size on the 3D accuracy of alveolar bone augmentation performed with additively manufactured patient-specific titanium meshes. METHODS Twenty 3D-printed patient-specific titanium mesh GBR surgery cases were enrolled, in which 10 cases were minor bone defect/augmentation (the planned bone augmentation surface area is less than or equal to 150 mm2 or one tooth missing or two adjacent front-teeth/premolars missing) and another 10 cases were significant bone defect/augmentation (the planned bone augmentation surface area is greater than 150 mm2 or missing adjacent teeth are more than two (i.e. ≥ three teeth) or missing adjacent molars are ≥ two teeth). 3D digital reconstruction/superposition technology was employed to investigate the bone augmentation accuracy of 3D-printed patient-specific titanium meshes. RESULTS There was no significant difference in the 3D deviation distance of bone augmentation between the minor bone defect/augmentation group and the major one. The contour lines of planned-CAD models in two groups were basically consistent with the contour lines after GBR surgery, and both covered the preoperative contour lines. Moreover, the exposure rate of titanium mesh in the minor bone defect/augmentation group was slightly lower than the major one. CONCLUSION It can be concluded that the size of the bone defect has no significant effect on the 3D accuracy of alveolar bone augmentation performed with the additively manufactured patient-specific titanium mesh.
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Affiliation(s)
- Wei Yang
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Oral Higher Education Biomedical Engineering, Chongqing, 401147 China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147 China
| | - Dan Chen
- grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
| | - Chao Wang
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
| | - Davide Apicella
- Marrelly Health, calabrodental hospital, 88900 Crotone, Italy
| | - Antonio Apicella
- Advanced Materials Lab, Department of Architecture and Industrial Design, University of Campania, 81031 Aversa, Italy
| | - Yuanding Huang
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Oral Higher Education Biomedical Engineering, Chongqing, 401147 China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147 China
| | - Linzhi Li
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Oral Higher Education Biomedical Engineering, Chongqing, 401147 China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147 China
| | - Lingling Zheng
- grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
| | - Ping Ji
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Oral Higher Education Biomedical Engineering, Chongqing, 401147 China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147 China
| | - Lizhen Wang
- grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
| | - Yubo Fan
- grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
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Ayari H. The use of periodontal membranes in the field of periodontology: spotlight on collagen membranes. J Appl Biomed 2022; 20:154-162. [PMID: 36708721 DOI: 10.32725/jab.2022.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Periodontal regenerative techniques are performed to accomplish the restitution of soft and hard teeth-supporting tissues that have been lost due to trauma or inflammatory disease. Periodontal membranes are used for these techniques to provide support and a framework for cell growth and tissue regeneration. They act as a temporary and selective barrier to cell proliferation. Easy clinical handling, biomechanical specifications, high biocompatibility, cell-occlusivity, and satisfactory bioresorption rate are essential properties a membrane needs to be effective. The creation and maintenance of a secluded space is also a fundamental rule in periodontal regenerative techniques. The use of barrier membranes in the field of restorative dentistry has progressed toward the use of minimally invasive approaches optimizing wound closure and limiting patient morbidity. This review intends to provide an overview of the major cellular events in the surgical wound and membrane surface. It was also performed to assess, from literature data, the pertinence of using non-resorbable and resorbable membranes for this regenerative purpose. Special attention will be given to collagen membranes.
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Affiliation(s)
- Hanene Ayari
- Universite Claude Bernard Lyon 1, Villeurbanne, France.,Universite de Lyon, Faculte de medecine dentaire, Lyon, France
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Palkovics D, Bolya-Orosz F, Pinter C, Molnar B, Windisch P. Reconstruction of vertical alveolar ridge deficiencies utilizing a high-density polytetrafluoroethylene membrane /clinical impact of flap dehiscence on treatment outcomes: case series/. BMC Oral Health 2022; 22:490. [PMCID: PMC9664701 DOI: 10.1186/s12903-022-02513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Objectives
The aim of this study was to evaluate the effects of membrane exposure during vertical ridge augmentation (VRA) utilizing guided bone regeneration with a dense polytetrafluoroethylene (d-PTFE) membrane and a tent-pole space maintaining approach by registering radiographic volumetric, linear and morphological changes.
Methods
In 8 cases alveolar ridge defects were accessed utilizing a split-thickness flap design. Following flap elevation VRA was performed with tent-pole space maintaining approach utilizing the combination of a non-reinforced d-PTFE membrane and a composite graft (1:1 ratio of autogenous bone chips and bovine derived xenografts). Three-dimensional radiographic evaluation of hard tissue changes was carried out with the sequence of cone-beam computed tomography (CBCT) image segmentation, spatial registration and 3D subtraction analysis.
Results
Class I or class II membrane exposure was observed in four cases. Average hard tissue gain was found to be 0.70 cm3 ± 0.31 cm3 and 0.82 cm3 ± 0.40 cm3 with and without membrane exposure resulting in a 17% difference. Vertical hard tissue gain averaged 4.06 mm ± 0.56 mm and 3.55 mm ± 0.43 mm in case of submerged and open healing, respectively. Difference in this regard was 14% between the two groups. Horizontal ridge width at 9-month follow-up was 5.89 mm ± 0.51 mm and 5.61 mm ± 1.21 mm with and without a membrane exposure respectively, resulting in a 5% difference.
Conclusions
With the help of the currently reported 3D radiographic evaluation method, it can be concluded that exposure of the new-generation d-PTFE membrane had less negative impact on clinical results compared to literature data reporting on expanded polytetrafluoroethylene membranes.
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Funato A, Ishikura C, Naito K, Hasuike A. Resorbable Membrane Pouch Technique for Single-Implant Placement in the Esthetic Zone: A Preliminary Technical Case Report. Bioengineering (Basel) 2022; 9:bioengineering9110649. [PMID: 36354560 PMCID: PMC9687625 DOI: 10.3390/bioengineering9110649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 10/20/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
Abstract
The conventional protocol for lateral guided bone regeneration (GBR) in esthetic areas requires the securing of resorbable collagen membranes using titanium cortical bone pins to immobilize bone grafts. These procedures are highly invasive and can increase patient morbidity and discomfort. Herein, we introduce a minimally invasive novel resorbable membrane pouch technique, wherein collagen membranes can be immobilized by securing them to the periosteum without the need of titanium pins. We describe 11 cases of single-immediate- or delayed-implant placement in the atrophic maxilla esthetic zone. All implants were successful and functional without pain or inflammation and with optimal soft-tissue health and esthetics. Radiographic evaluation with cone-beam computed tomography (CBCT) and esthetic assessment using the pink esthetic score (PES) were performed. At the time of implant placement, the average augmented bone width was 2.8 ± 0.6 mm on CBCT analysis. In all cases, resorption of the augmented bone was confirmed with an average of −1.3 ± 0.8 mm. Soft-tissue outcomes were scored 1 year after permanent restoration. The PES score 1 year after treatment was 11.9 ± 1.4. The resorbable membrane pouch technique with immediate or delayed implant placement for buccal dehiscence in the esthetic area can be predictable and is minimally invasive.
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Affiliation(s)
| | | | - Koji Naito
- DIABUILDING Dental Clinic, Tokyo 104-0033, Japan
| | - Akira Hasuike
- Department of Periodontology, Nihon University School of Dentistry, Tokyo 101-8310, Japan
- Dental Research Center, Nihon University School of Dentistry, Tokyo 101-8310, Japan
- Correspondence:
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Gallo S, Pascadopoli M, Pellegrini M, Pulicari F, Manfredini M, Zampetti P, Spadari F, Maiorana C, Scribante A. Latest Findings of the Regenerative Materials Application in Periodontal and Peri-Implant Surgery: A Scoping Review. Bioengineering (Basel) 2022; 9:594. [PMID: 36290567 PMCID: PMC9598513 DOI: 10.3390/bioengineering9100594] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 07/30/2023] Open
Abstract
Regenerative dentistry represents a therapeutic modern approach involving biomaterials and biologics such as mesenchymal stem cells. The role of regenerative dentistry is promising in all branches of dentistry, especially in periodontology and implantology for the treatment of bony defects around teeth and implants, respectively. Due to the number of different materials that can be used for this purpose, the aim of the present review is to evidence the regenerative properties of different materials both in periodontitis and peri-implantitis as well as to compare their efficacy. Clinical trials, case-control studies, cross-sectional studies, and cohort studies have been considered in this review. The outcome assessed is represented by the regenerative properties of bone grafts, barrier membranes, and biological materials in the treatment of intrabony and furcation defects, peri-implantitis sites, alveolar ridge preservation, and implant site development. Based on the studies included, it can be stated that in the last years regenerative materials in periodontal and peri-implant defects treatments have shown excellent results, thus providing valuable support to surgical therapy. To achieve optimal and predictable results, clinicians should always consider factors like occlusal load control, prevention of microbial contamination, and wound dehiscence. Further evidence is required about the use of enamel matrix derivative in alveolar ridge preservation, as well as of stem cells and bone morphogenetic proteins-2 in furcation defects and peri-implantitis sites. Considering the high amount of research being conducted in this field, further evidence is expected to be obtained soon.
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Affiliation(s)
- Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Matteo Pellegrini
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Federica Pulicari
- Maxillo-Facial and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Mattia Manfredini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paolo Zampetti
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Francesco Spadari
- Maxillo-Facial and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
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Abstract
As a widespread chronical disease, periodontitis progressively destroys tooth-supporting structures (periodontium) and eventually leads to tooth loss. Therefore, regeneration of damaged/lost periodontal tissues has been a major subject in periodontal research. During periodontal tissue regeneration, biomaterials play pivotal roles in improving the outcome of the periodontal therapy. With the advancement of biomaterial science and engineering in recent years, new biomimetic materials and scaffolding fabrication technologies have been proposed for periodontal tissue regeneration. This article summarizes recent progress in periodontal tissue regeneration from a biomaterial perspective. First, various guide tissue regeneration/guide bone regeneration membranes and grafting biomaterials for periodontal tissue regeneration are overviewed. Next, the recent development of multifunctional scaffolding biomaterials for alveolar bone/periodontal ligament/cementum regeneration is summarized. Finally, clinical care points and perspectives on the use of biomimetic scaffolding materials to reconstruct the hierarchical periodontal tissues are provided.
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Affiliation(s)
- Yuejia Deng
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX 75246, USA
| | - Yongxi Liang
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX 75246, USA
| | - Xiaohua Liu
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX 75246, USA.
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Smeets R, Matthies L, Windisch P, Gosau M, Jung R, Brodala N, Stefanini M, Kleinheinz J, Payer M, Henningsen A, Al-Nawas B, Knipfer C. Horizontal augmentation techniques in the mandible: a systematic review. Int J Implant Dent 2022; 8:23. [PMID: 35532820 PMCID: PMC9086020 DOI: 10.1186/s40729-022-00421-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/25/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose Placement of dental implants has evolved to be an advantageous treatment option for rehabilitation of the fully or partially edentulous mandible. In case of extensive horizontal bone resorption, the bone volume needs to be augmented prior to or during implant placement in order to obtain dental rehabilitation and maximize implant survival and success. Methods Our aim was to systematically review the available data on lateral augmentation techniques in the horizontally compromised mandible considering all grafting protocols using xenogeneic, synthetic, or allogeneic material. A computerized and manual literature search was performed for clinical studies (published January 1995 to March 2021). Results Eight studies ultimately met the inclusion criteria comprising a total of 276 procedures of xenogeneic, allogeneic, or autogenous bone graft applications in horizontal ridge defects. Particulate materials as well as bone blocks were used as grafts with a mean follow-up of 26.0 months across all included studies. Outcome measures, approaches and materials varied from study to study. A gain of horizontal bone width of the mandible with a mean of 4.8 mm was observed in seven of eight studies. All but one study, reported low bone graft failure rates of 4.4% in average. Conclusions Only limited data are available on the impact of different horizontal augmentation strategies in the mandible. The results show outcomes for xenogeneic as well as autologous bone materials for horizontal ridge augmentation of the lower jaw. The use of allogeneic bone-block grafts in combination with resorbable barrier membranes must be re-evaluated. Randomized controlled clinical trials are largely missing. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-022-00421-7.
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The Role of Blood Clot in Guided Bone Regeneration: Biological Considerations and Clinical Applications with Titanium Foil. MATERIALS 2021; 14:ma14216642. [PMID: 34772167 PMCID: PMC8587813 DOI: 10.3390/ma14216642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/22/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022]
Abstract
In Guided Bone Regeneration (GBR) materials and techniques are essential to achieve the expected results. Thanks to their properties, blood clots induce bone healing, maturation, differentiation and organization. The preferred material to protect the clot in Guided Bone Regeneration is the titanium foil, as it can be shaped according to the bone defect. Furthermore, its exposition in the oral cavity does not impair the procedure. We report on five clinical cases in order to explain the management of blood clots in combination with titanium foil barriers in different clinical settings. Besides being the best choice to protect the clot, the titanium foil represents an excellent barrier that is useful in GBR due to its biocompatibility, handling, and mechanical strength properties. The clot alone is the best natural scaffold to obtain the ideal bone quality and avoid the persistence of not-resorbed granules of filler materials in the newly regenerated bone. Even though clot contraction still needs to be improved, as it impacts the volume of the regenerated bone, future studies in GBR should be inspired by the clot and its fundamental properties.
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Toledano-Osorio M, Toledano M, Manzano-Moreno FJ, Vallecillo C, Vallecillo-Rivas M, Rodriguez-Archilla A, Osorio R. Alveolar Bone Ridge Augmentation Using Polymeric Membranes: A Systematic Review and Meta-Analysis. Polymers (Basel) 2021; 13:1172. [PMID: 33917475 PMCID: PMC8038790 DOI: 10.3390/polym13071172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/16/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023] Open
Abstract
Alveolar bone ridge resorption occurred after natural teeth loss and it can restrict the possibility of dental implants placement. The use of bone regenerative procedures is frequently required. The existing evidence regarding the efficacy of horizontal bone ridge augmentation trough guided bone regeneration (GBR) using polymeric membranes was stated. A systematic review and meta-analysis were performed. Electronic and manual literature searches were conducted. Screening process was done using the National Library of Medicine (MEDLINE by PubMed), Embase, and the Cochrane Oral Health. Included articles were randomized controlled trials and observational studies. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). If I2 > 50% a random-effects model was applied. It was found that the mean of horizontal bone gain was 3.95 mm, ranging from 3.19 to 4.70 mm (confidence interval 95%). Heterogeneity is I2 = 99% (confidence interval 95%) and significance of the random-effects model was p < 0.001. The complications rate was 8.4% and membrane exposure was the most frequent. Through this study, we were able to conclude that the existing scientific evidence suggests that GBR using polymeric membranes is a predictable technique for achieving horizontal bone augmentation, thus, permitting a proper further implant placement.
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Affiliation(s)
- Manuel Toledano-Osorio
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
- Medicina Clínica y Salud Pública PhD Programme, University of Granada, 18071 Granada, Spain
| | - Manuel Toledano
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Francisco Javier Manzano-Moreno
- Biomedical Group (BIO277), Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto Investigación Biosanitaria, ibs. Granada, 18071 Granada, Spain
| | - Cristina Vallecillo
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Marta Vallecillo-Rivas
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Alberto Rodriguez-Archilla
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Raquel Osorio
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
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