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Deng F, Chen B, Guo H, Chen Q, Wang F. Effectiveness and safety analysis of titanium mesh grafting versus bone grafting in the treatment of spinal Tuberculosis: a systematic review and meta-analysis. BMC Surg 2023; 23:377. [PMID: 38087216 PMCID: PMC10717474 DOI: 10.1186/s12893-023-02283-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND To systematically assess the safety and effectiveness of titanium mesh grafting compared with bone grafting in the treatment of spinal tuberculosis. METHODS Electronic databases, including PubMed, Embase, Web of Science, and Cochrane Library, were searched from their inception until April 2023. The outcome indicators for patients treated with titanium mesh grafting or bone grafting for spinal tuberculosis include surgical duration, intraoperative blood loss, graft fusion time, American Spinal Injury Association (ASIA) Spinal Cord Injury Grade E assessment, VAS score, lumbar pain score, post-graft kyphotic angle, and postoperative complications. The Newcastle-Ottawa Scale (NOS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach were used for quality assessment and evidence grading of clinical studies. Funnel plots and Begg's test were employed for bias assessment. RESULTS A total of 8 studies were finally included, comprising 523 patients, with 267 cases of titanium mesh fixation and 256 cases of bone grafting. The meta-analysis showed no significant statistical differences in surgical duration (Weighted Mean Difference (WMD) = -7.20, 95% Confidence Interval (CI): -28.06 to 13.67, P = 0.499), intraoperative blood loss (WMD = 16.22, 95% CI: -40.62 to 73.06, P = 0.576), graft fusion time (WMD = 0.97, 95% CI: -0.88 to 2.81, P = 0.304), ASIA Spinal Cord Injury Grade E assessment (Relative Risk (RR) = 1.03, 95% CI: 0.97 to 1.09, P = 0.346), and overall complications (RR = 0.87, 95% CI: 0.49 to 1.55, P = 0.643). Differences in VAS score, ODI lumbar pain score, and post-graft kyphotic angle between the titanium mesh grafting group and the bone grafting group were not significant within the 95% CI range. The rate of postoperative implant subsidence was slightly lower in bone grafting than in titanium mesh grafting (RR = 9.30, 95% CI: 1.05 to 82.22, P = 0.045). CONCLUSIONS Both bone grafting and titanium mesh grafting are effective and safe for the surgery, with no significant statistical differences in the results. Considering the limitations of the present study, large-scale randomized controlled trials are warranted to further verify the reliability of this finding.
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Affiliation(s)
- Fangfang Deng
- The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang Hubei, 443000, China
| | - Bo Chen
- The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang Hubei, 443000, China
| | - Huali Guo
- The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang Hubei, 443000, China
| | - Qingqing Chen
- The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang Hubei, 443000, China
| | - Feifan Wang
- The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang Hubei, 443000, China.
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Stavropoulos A, Marcantonio CC, de Oliveira VXR, Marcantonio É, de Oliveira GJPL. Fresh-frozen allogeneic bone blocks grafts for alveolar ridge augmentation: Biological and clinical aspects. Periodontol 2000 2023; 93:139-152. [PMID: 38194350 DOI: 10.1111/prd.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 01/10/2024]
Abstract
The possibilities for oral bone regeneration procedures vary depending on the type of bone defect to be treated, which in turn dictate the type of graft to be used. Atrophic alveolar ridges are non-contained defects and pose a challenging defect morphology for bone regeneration/augmentation. Successful results are regularly obtained with the use of particulate grafts in combination with barrier membranes. In cases of very narrow ridges with need of larger amount of bone augmentation, block grafts are often used. Fresh-frozen allogeneic bone block grafts have been proposed as an alternative to autogenous (AT) bone blocks. Based on a systematic appraisal of pre-clinical in vivo studies and clinical trials including a direct comparison of fresh-frozen bone (FFB) blocks versus AT bone blocks it can be concluded that a FFB block graft: (a) cannot be considered as a reliable replacement of a AT bone block, and (b) should only be considered in cases where the amount of necessary augmentation-in a lateral direction-is relatively limited, so that the main portion of the body of the implant lies within the inner (i.e., the vital) aspect of the block.
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Affiliation(s)
- Andreas Stavropoulos
- Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Camila Chierici Marcantonio
- Department of Diagnosis and Surgery School of Dentistry at Araraquara, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Vithor Xavier Resende de Oliveira
- Department of Periodontology/Implantodontology, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Élcio Marcantonio
- Department of Diagnosis and Surgery School of Dentistry at Araraquara, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
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Osseointegration Levels of Implants Placed With Allogenic and Xenogenic Bone Ring: An Experimental Biomechanical Analysis. J Craniofac Surg 2022; 34:926-930. [PMID: 36730628 DOI: 10.1097/scs.0000000000009130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/14/2022] [Indexed: 02/04/2023] Open
Abstract
This in vivo study aimed to do a biomechanical analysis of the early period bone-implant connection of titanium implants simultaneously inserted with xsenogenic and allogenic bone ring. In this study, 28 Sprague Dawley female rats were used. Four rats were killed to obtain an allogenic bone ring, and after this, the remaining rats were divided into control (n=8), xsenogenic (n=8), and allogenic (n=8) bone ring groups. Titanium-machined surfaced implants were integrated right tibias of the rats. In controls, only implants were integrated into right tibias. In the greft groups, the implants were integrated simultaneously with bone rings. After 2 weeks of the experimental period, the rats were killed ,and titanium implants and surrounding bone tissues were removed for biomechanic analysis. After biomechanical reverse torque analysis bone-implant connection was determined as Newton/cm2; in controls 3.26 (1.2 to 4.5), in allogenic ring group 3.37 (2 to 4.4), in xsenogenic ring group 5.93 (2.8 to 10). Statistically significant differences were not detected between the groups (P>0.05). Within the limitation of this study, both allogenic and xsenogenic bone grafts could be successfully used in bone augmentation in implant surgery.
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Biomechanical Examination of Osseointegration of Titanium Implants Placed Simultaneously With Allogeneic Bone Transfer. J Craniofac Surg 2021; 33:350-353. [PMID: 34292244 DOI: 10.1097/scs.0000000000007880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The aim of this study was to conduct a biomechanical analysis of the early period bone-implant connection of titanium implants in the same type of subjects. In this study, 18 Sprague Dawley rats were used. Four rats were killed to provide the allogeneic bone before the experiment, and the remaining were divided into a control group and an experimental allogeneic bone transfer group. Titanium machined surfaced implants were integrated in tibias in the controls and in the experimental group; simultaneously, implants were integrated into allogeneic bone in the bone transfer group. All the rats were sacrificed 14 days later. Bone tissues with titanium implants were removed for biomechanical analysis, which found that the resistance to force of the control group and the allogeneic graft group was 2.04 and 2.00 Newtons, respectively, and there was no significant difference between the two groups at 14 days, although numerically a higher figure was detected in the controls (P > 0.05). It was concluded, within the limitations of this study, that an allogeneic bone transfer can be used as an alternative to an autogenous graft.
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Yi C, Zheng J, Li R, Lan Y, He M, Lai J, Guan T, Pang F, Mo Z, Chen P, Li Y, Zhou N, Yang X, Fang B. Preliminary proposal: a classification system for reconstruction with autologous femoral head after periacetabular tumors resection. J Orthop Surg Res 2021; 16:119. [PMID: 33557910 PMCID: PMC7869519 DOI: 10.1186/s13018-021-02275-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/01/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Although researchers have adopted various methods for the resection and reconstruction of periacetabular tumors, the total incidence rate of complications remains high. Aiming for preserving the acetabulum and reducing the risk of complications, we applied a surgery method using tumor-free autologous femoral head to reconstruct the defective acetabulum after resection of periacetabular tumors followed by performing a conventional total hip arthroplasty (THA). Moreover, we proposed a preliminary classification system for these surgery methods. METHODS We retrospectively reviewed 6 patients treated with acetabulum reconstruction combined with autologous femoral head following peri-acetabulum resection between April 2010 and May 2018. All patients were diagnosed as periacetabular tumors including chondrosarcoma (n = 5) and chondroblastoma (n = 1). Clinical data such as age, diagnosis, complications, local recurrence or metastasis, and function (Musculoskeletal Tumor Society 1993, MSTS93) were documented. The average time of follow-up was 62.5 months (range, 17 to 106 months). RESULTS A total of 5 patients survive with average MSTS93 score of 27.8 points (range, 26-30). One patient, suffering from multiple bone metastasis prior treatment, ended up dying. One who had received radiotherapy before surgery had poor incision healing. Further, a classification system was preliminary proposed in 2 patients involving the pubis (type A) and 4 patients involving ischium (type B). CONCLUSIONS Based on the results, we preliminary proposed a classification system for reconstruction with autologous femoral head after periacetabular low malignant tumors resection. The clinical results suggested that surgery methods involving pubis (type A) and ischium (Type B) are safe and feasible. However, further researches should be conducted to verify our classification system.
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Affiliation(s)
- Chunzhi Yi
- Department of Orthopedic Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Jiaqian Zheng
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Ruoyu Li
- Department of Orthopedic Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Yun Lan
- Department of Orthopedic Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Mincong He
- Department of Orthopedic Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Jieqing Lai
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Tianan Guan
- Department of Orthopedic Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Fengxiang Pang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Zongquan Mo
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Peng Chen
- Department of Orthopedic Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Yue Li
- Department of Orthopedic Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Nannan Zhou
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Xingfu Yang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Bin Fang
- Department of Orthopedic Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China.
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Pires LCDA, da Silva RC, Poli PP, Ruas Esgalha F, Hadad H, Palin LP, Piquera Santos AF, Teixiera Colombo L, Kawamata de Jesus L, Bassi APF, Maiorana C, Okamoto R, de Carvalho PSP, Souza FÁ. Evaluation of Osteoconduction of a Synthetic Hydroxyapatite/β-Tricalcium Phosphate Block Fixed in Rabbit Mandibles. MATERIALS 2020; 13:ma13214902. [PMID: 33142881 PMCID: PMC7662777 DOI: 10.3390/ma13214902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/21/2020] [Accepted: 10/29/2020] [Indexed: 12/12/2022]
Abstract
(1) Background: This study aimed to evaluate the incorporation of hydroxyapatite/β-tricalcium phosphate blocks grafted in rabbit mandibles. (2) Methods: Topographic characterization of biomaterial was performed through scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM-EDX). Ten rabbits randomly received autogenous bone graft harvested from the tibia (Autogenous Group—AG) or synthetic biomaterial manufactured in β-tricalcium phosphate (Biomaterial Group—BG) at their right and left mandibular angles. Euthanasia was performed at 30 and 60 postoperative days; (3) Results: SEM-EDX showed a surface with the formation of crystals clusters. Histological analyses in BG at 30 days showed a slower process of incorporation than AG. At 60 days, BG showed remnants of biomaterial enveloped by bone tissue in the anabolic modeling phase. Histometric analysis showed that mean values of newly formed bone-like tissue in the AG (6.56%/9.70%) were statistically higher compared to BG (3.14%/6.43%) in both periods, respectively. Immunohistochemical analysis demonstrated early bone formation and maturation in the AG with more intense osteopontin and osteocalcin staining. (4) Conclusions: The biomaterial proved to be a possible bone substitute, being incorporated into the receiving bed; however, it showed delayed bone incorporation compared to autogenous bone.
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Affiliation(s)
- Luis Carlos de Almeida Pires
- Implant Dentistry Post-Graduation Program, São Leopoldo Mandic School of Dentistry and Research Center, Campinas, SP 13 045 755, São Paulo, Brazil; (L.C.d.A.P.); (F.R.E.); (P.S.P.d.C.)
| | - Rodrigo Capalbo da Silva
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy;
- Correspondence: ; Tel.: +39-02-55032621
| | - Fernando Ruas Esgalha
- Implant Dentistry Post-Graduation Program, São Leopoldo Mandic School of Dentistry and Research Center, Campinas, SP 13 045 755, São Paulo, Brazil; (L.C.d.A.P.); (F.R.E.); (P.S.P.d.C.)
| | - Henrique Hadad
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Letícia Pitol Palin
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Ana Flávia Piquera Santos
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Luara Teixiera Colombo
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Laís Kawamata de Jesus
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Ana Paula Farnezi Bassi
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy;
| | - Roberta Okamoto
- Department of Basic Science, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil;
| | - Paulo Sérgio Perri de Carvalho
- Implant Dentistry Post-Graduation Program, São Leopoldo Mandic School of Dentistry and Research Center, Campinas, SP 13 045 755, São Paulo, Brazil; (L.C.d.A.P.); (F.R.E.); (P.S.P.d.C.)
| | - Francisley Ávila Souza
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
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Zou W, Li X, Li N, Guo T, Cai Y, Yang X, Liang J, Sun Y, Fan Y. A comparative study of autogenous, allograft and artificial bone substitutes on bone regeneration and immunotoxicity in rat femur defect model. Regen Biomater 2020; 8:rbaa040. [PMID: 33732488 PMCID: PMC7947581 DOI: 10.1093/rb/rbaa040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/20/2020] [Accepted: 08/23/2020] [Indexed: 12/15/2022] Open
Abstract
Repair and reconstruction of large bone defect were often difficult, and bone substitute materials, including autogenous bone, allogenic bone and artificial bone, were common treatment strategies. The key to elucidate the clinical effect of these bone repair materials was to study their osteogenic capacity and immunotoxicological compatibility. In this paper, the mechanical properties, micro-CT imaging analysis, digital image analysis and histological slice analysis of the three bone grafts were investigated and compared after different time points of implantation in rat femur defect model. Autogenous bone and biphasic calcium phosphate particular artificial bone containing 61.4% HA and 38.6% β-tricalcium phosphate with 61.64% porosity and 0.8617 ± 0.0068 g/cm3 density (d ≤ 2 mm) had similar and strong bone repair ability, but autogenous bone implant materials caused greater secondary damage to experimental animals; allogenic bone exhibited poor bone defect repair ability. At the early stage of implantation, the immunological indexes such as Immunoglobulin G, Immunoglobulin M concentration and CD4 cells' population of allogenic bone significantly increased in compared with those of autologous bone and artificial bone. Although the repair process of artificial bone was relatively inefficient than autologous bone graft, the low immunotoxicological indexes and acceptable therapeutic effects endowed it as an excellent alternative material to solve the problems with insufficient source and secondary trauma of autogenous bone.
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Affiliation(s)
- Wen Zou
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China.,Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Xing Li
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Na Li
- Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Tianwei Guo
- Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Yongfu Cai
- Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Xiaoqin Yang
- Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Jie Liang
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China.,Sichuan Testing Centre for Biomaterials and Medical Devices, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Yong Sun
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, Sichuan, China
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Bertassoli BM, Silva GAB, Albergaria JD, Jorge EC. In vitro analysis of the influence of mineralized and EDTA-demineralized allogenous bone on the viability and differentiation of osteoblasts and dental pulp stem cells. Cell Tissue Bank 2020; 21:479-493. [PMID: 32385788 DOI: 10.1007/s10561-020-09834-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 04/07/2020] [Indexed: 01/09/2023]
Abstract
Grafting based on both autogenous and allogenous human bone is widely used to replace areas of critical loss to induce bone regeneration. Allogenous bones have the advantage of unlimited availability from tissue banks. However, their integration into the remaining bone is limited because they lack osteoinduction and osteogenic properties. Here, we propose to induce the demineralization of the allografts to improve these properties by exposing the organic components. Allografts fragments were demineralized in 10% EDTA at pH 7.2 solution. The influence of the EDTA-DAB and MAB fragments was evaluated with respect to the adhesion, growth and differentiation of MC3'T3-E1 osteoblasts, primary osteoblasts and dental pulp stem cells (DPSC). Histomorphological analyses showed that EDTA-demineralized fragments (EDTA-DAB) maintained a bone architecture and porosity similar to those of the mineralized (MAB) samples. BMP4, osteopontin, and collagen III were also preserved. All the cell types adhered, grew and colonized both the MAB and EDTA-DAB biomaterials after 7, 14 and 21 days. However, the osteoblastic cell lines showed higher viability indexes when they were cultivated on the EDTA-DAB fragments, while the MAB fragments induced higher DPSC viability. The improved osteoinductive potential of the EDTA-DAB bone was confirmed by alkaline phosphatase activity and calcium deposition analyses. This work provides guidance for the choice of the most appropriate allograft to be used in tissue bioengineering and for the transport of specific cell lineages to the surgical site.
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Affiliation(s)
| | | | - Juliano Douglas Albergaria
- Laboratório de Biologia Oral E Do Desevolvimento, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil.
| | - Erika Cristina Jorge
- Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Starch-Jensen T, Deluiz D, Tinoco EMB. Horizontal Alveolar Ridge Augmentation with Allogeneic Bone Block Graft Compared with Autogenous Bone Block Graft: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2020; 11:e1. [PMID: 32377325 PMCID: PMC7191383 DOI: 10.5037/jomr.2020.11101] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/04/2020] [Indexed: 12/19/2022]
Abstract
Objectives The objective of the present systematic review was to test the hypothesis of no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block. Material and Methods A MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted including human studies published in English through March 13, 2019. Comparative and non-comparative studies evaluating horizontal ridge augmentation with allogeneic bone block were included. Cochrane risk of bias tool and Newcastle-Ottawa Scale were used to evaluate risk of bias. Results One comparative study with high quality and 12 non-comparative studies fulfilled the inclusion criteria. Considerable heterogeneity prevented meta-analysis from being performed. The comparative retrospective short-term study demonstrated no significant difference in implant treatment outcome between the two treatment modalities. Non-comparative long-term studies revealed high implant survival, gain in alveolar ridge width and bone regeneration with allogeneic bone block. However, non-comparative studies disclosed high incidence of complications including dehiscence, exposure of allogeneic bone block and partial or total loss of the grafts. Conclusions There seemed to be no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block. However, increased risk of complications was frequently reported with allogeneic bone block.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
| | - Daniel Deluiz
- Department of Periodontology, Rio de Janeiro State University, Rio de JaneiroBrazil
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Ashour AA, Zaghloul M, Mahmoud W, Helal ME, Grawish ME. Gelfoam haemostatic agent with or without autologous bone marrow-derived stem cells for the regeneration of critical-size mandibular defects in the rabbit. Int J Oral Maxillofac Surg 2018; 47:1488-1494. [PMID: 29753427 DOI: 10.1016/j.ijom.2018.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/24/2018] [Accepted: 04/20/2018] [Indexed: 11/24/2022]
Abstract
This study evaluated the effect of Gelfoam sponge with and without autologous bone marrow-derived stem cells (BMSCs) on bone regeneration in critical-size mandibular defects. The study involved 56 New Zealand rabbits assigned to four groups (14 in each). The osseous defects in group I were irrigated with normal saline, those in group II were grafted with autogenous tibial bone, and those in group III were filled with Gelfoam sponge. Group IV defects were treated as for group III, but the interface between the Gelfoam sponge and bone surface was injected with BMSCs. At the end of 4weeks, seven rabbits in each group were euthanized; the remaining animals were euthanized at the end of the experiment, at 8 weeks postoperative. The percentage area of newly formed bone was significantly higher in group IV at week 4 (0.030±0.01%) and week 8 (0.060±0.03%) than in group I (0.01±0.00% and 0.02±0.00%, respectively) and group III (0.08±0.01% and 0.015±0.02%, respectively), but was lower than that in group II (0.038±0.02% and 0.082±0.01%, respectively). Thus, the combination of Gelfoam and autologous BMSCs promoted the regeneration of mandibular critical-size defects better than the use of Gelfoam alone. However, the amount of newly generated bone was lower than in defects grafted with autogenous bone.
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Affiliation(s)
- A A Ashour
- Ministry of Health, Faculty of Dentistry, Gharian University, Gharian, Libya
| | - M Zaghloul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - W Mahmoud
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - M E Helal
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - M E Grawish
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt; Department of Oral Biology, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Gamasa, Mansoura, Egypt.
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