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Gasparro R, Di Lauro AE, Campana MD, Rosiello N, Mariniello M, Sammartino G, Marenzi G. Effectiveness of Autologous Platelet Concentrates in the Sinus Lift Surgery: Findings from Systematic Reviews and Meta-Analyses. Dent J (Basel) 2024; 12:101. [PMID: 38668013 PMCID: PMC11049363 DOI: 10.3390/dj12040101] [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: 01/31/2024] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Maxillary sinus augmentation is one of the most predictable procedures for the rehabilitation of the posterior maxilla. The current overview aimed to summarize the findings provided by systematic reviews (SRs) and meta-analyses on the effectiveness of autologous platelet concentrates (APCs) in sinus lift and to assess the methodological quality of the included SRs. Three electronic databases have been explored. SRs and meta-analyses addressing the effectiveness of APCs in sinus lift technique were included. Clinical, radiographic and histomorphometric findings were considered for APCs as solely grafting materials and APCs in combination with biomaterials. Outcomes were implant survival rate (ISR), implant stability (IS), implant failure (IF), postoperative complications, histomorphometric findings, radiographic bone gain, bone volume and bone density. The methodological quality of the included SRs was assessed using the updated version of "A Measurement Tool to Assess Systematic Review" (AMSTAR-2). Thirty SRs were included. The methodological quality of the included reviews ranged from critically low (3 studies) to high (9 studies). The included SRs showed favorable clinical outcomes, short-term new bone formation and no biological complications when APCs were used both as solely graft material or in combination with other biomaterials. However, no significant additional effects in the long-term period were observed. APCs did not add any further positive effects compared to the physiological healing derived by the natural blood clot. The current overview of SRs highlighted the need for high-quality SRs evaluating the role of APCs in sinus lift though network meta-analyses, in order to identify the most powerful material for sinus lift augmentation. The use of APCs improves the healing of soft tissues and the postoperative quality of life in the short-term period. Thus, its application can be recommended.
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Affiliation(s)
| | | | | | | | | | - Gilberto Sammartino
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.G.); (A.E.D.L.); (M.D.C.); (N.R.); (M.M.); (G.M.)
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Takafuji K, Oyamada Y, Hatakeyama W, Kihara H, Shimazaki N, Fukutoku A, Satoh H, Kondo H. Quantitative analysis of change in bone volume 5 years after sinus floor elevation using plate-shaped bone substitutes: a prospective observational study. Int J Implant Dent 2024; 10:9. [PMID: 38372934 PMCID: PMC10876503 DOI: 10.1186/s40729-023-00501-2] [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: 10/28/2022] [Accepted: 09/09/2023] [Indexed: 02/20/2024] Open
Abstract
PURPOSE Tricalcium phosphate (TCP) has osteoconductive ability and reportedly offers similar clinical results as autogenous bone grafts in dental implant treatment. However, few reports quantify temporal changes in augmented bone volume after sinus augmentation. We aimed to establish a three-dimensional (3D) quantification method to assess bone volume after sinus augmentation and to evaluate biocompatibility of the TCP plate. METHODS Maxillary sinus floor augmentation was performed employing the lateral window technique, and plate-shaped β-TCP (TCP plate) was used instead of granular bone grafting materials. After lifting the sinus membrane, the TCP plate was inserted and supported by dental implants or micro-screws. The changes in bone volumes in the maxillary sinus before and after surgery were recorded using cone-beam computed tomography, saved as Digital Imaging and Communications in Medicine-formatted files, and transformed to Standard Triangle Language (STL)-formatted files. Pre- and post-operative STL data of bone volume were superimposed, and the augmented bone volume was calculated. Moreover, changes in bone volumes, TCP plate resorption rates, and bone heights surrounding the implants were three dimensionally quantified. RESULTS Fifteen implants in nine subjects were included in this study. TCP plates secured long-term space making, with results similar to those of granular bone substitutes. Newly formed bone was identified around the implant without bone graft material. TCP plate was absorbed and gradually disappeared. CONCLUSIONS A novel 3D quantification method was established to evaluate changes in bone volume. Clinical application of TCP plate in sinus augmentation could be a better procedure in terms of prognosis and safety.
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Affiliation(s)
- Kyoko Takafuji
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
- Department of Fixed Prosthodontics and Oral Implantology, Aichi Gakuin University, Nagoya, Japan
| | - Yutaro Oyamada
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Nobuko Shimazaki
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Akihiro Fukutoku
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hiroaki Satoh
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan.
- Department of Fixed Prosthodontics and Oral Implantology, Aichi Gakuin University, Nagoya, Japan.
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Yamaguchi K, Munakata M, Sato D, Kataoka Y, Kawamata R. The Effectiveness and Practicality of a Novel Barrier Membrane for the Open Window in Maxillary Sinus Augmentation with a Lateral Approach, with Risk Indicators for Bone Graft Displacement and Bone Height Decrease: A Prospective Study in Humans. Bioengineering (Basel) 2023; 10:1110. [PMID: 37892840 PMCID: PMC10604179 DOI: 10.3390/bioengineering10101110] [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: 08/19/2023] [Revised: 09/09/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
Maxillary sinus augmentation with a lateral approach (MSA) is a well-established treatment. In this prospective study, we evaluated risk factors for postoperative bone graft displacement and reported the clinical application of long-term resorbable L-lactic acid/-caprolactone (PLA/PCL) as a barrier membrane to cover the open window in the lateral wall in MSA. Twenty-four patients underwent MSA according to the relevant criteria; CT data obtained before and 1 week (1 w) and 5-6 months (5 m) post-MSA, bone height changes, bone height reduction rates at 1 w and 5 m post-MSA, bone graft displacement measurements, and risk factors were examined. All patients showed bone height increments (p < 0.005). However, no difference was observed between 1 w and 5 m post-MSA. Bone graft displacement was observed in eight patients; the reduction rate from 1 w to 5 m post-MSA was 8.38% ± 4.88%. Sex, septa, maxillary sinus floor-palatal bone distance, and maxillary sinus floor-maxillary ostium distance were associated with bone graft displacement (p < 0.05). The height from the maxillary sinus floor to the palatal bone and the sinus angle influenced the augmentation degree (p < 0.05). The PLA/PCL membrane is compared favorably with other membranes and may be useful as a barrier membrane for the MSA open window.
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Affiliation(s)
- Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Yu Kataoka
- Department of Dental Education, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 1428555, Japan
- Department of Biomaterials and Engineering, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 14228555, Japan
| | - Ryota Kawamata
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
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Jacob RGM, Ervolino da Silva AC, Chaushu L, Lang NP, Borges Duailibe de Deus C, Botticelli D, Rangel Garcia Júnior I. Evaluation of Two Configurations of Hydroxyapatite and Beta-Tricalcium Phosphate in Sinus Grafts with Simultaneous Implant Installation: An Experimental Study in Rabbits. Dent J (Basel) 2023; 11:121. [PMID: 37232771 PMCID: PMC10217008 DOI: 10.3390/dj11050121] [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: 03/08/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND This study aimed to evaluate peri-implant bone formation in rabbits after sinus grafting mediated by hydroxyapatite and beta-tricalcium phosphate (HA + β-TCP) in granule or paste configurations, concomitant with immediate implant installation. MATERIAL & METHODS Thirty-four rabbit maxillary sinuses were grafted with HA + β-TCP, half of which were applied in a granule and half in a paste composition. Implant placement was performed simultaneously. At 7 and 40 days postoperatively, the animals were euthanized, and samples were prepared for tomographic, microtomographic, histological, histometric (hematoxylin and eosin staining, HE), and immunohistochemical (labeling of transcription factor Runx-2 [RUNX2], vascular endothelial growth factor [VEGF], osteocalcin [OCN], and tartrate-resistant acid phosphatase [TRAP]) analysis. Implant removal torque was also measured. RESULTS On tomography, maintenance of sinus membrane integrity was observed in both the groups. Higher values of morphometric parameters evaluated by micro-CT were found in the "paste group" after seven days. At 40 days, there were no significant differences between the groups in most of the microtomographic parameters evaluated. In histological sections stained with HE, a higher percentage of newly formed bone was observed in the "granule group" after 40 days. Similar positive immunolabeling was observed for both RUNX2 and OCN in both the experimental groups. TRAP immunolabeling was similar in both groups as well. VEGF labeling increased in the "granule group", indicating a higher osteoconductive potential in this biomaterial. Similar removal torque values were observed in both groups. Thus, the two HA + β-TCP configurations showed similar healing patterns of simultaneously installed implants adjacent to sinus floor elevation. However, significantly higher bone values were observed for the "granule configuration". CONCLUSIONS The HA + β-TCP granules and paste presentations showed favorable long-term healing results, with bone formation in similar quantities and quality adjacent to the implants.
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Affiliation(s)
- Ricardo Garcia Mureb Jacob
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil
| | - Ana Cláudia Ervolino da Silva
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
| | - Liat Chaushu
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dentistry, Tel Aviv University, Tel Aviv 69978, Israel;
| | - Niklaus Peter Lang
- School of Dental Medicine, University of Berne, CH-3010 Berne, Switzerland
| | - Ciro Borges Duailibe de Deus
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil
| | | | - Idelmo Rangel Garcia Júnior
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
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Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Maxillary bar overdentures on four or six posterior implants: 10-year results from a randomized clinical trial. Clin Oral Implants Res 2022; 33:1147-1156. [PMID: 36151932 PMCID: PMC9828494 DOI: 10.1111/clr.13997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To compare clinical and patient-reported outcomes when providing maxillary overdentures on four and six splinted implants placed in the posterior region during a 10-year follow-up period. MATERIALS AND METHODS Sixty-six edentulous participants with functional maxillary denture complaints and insufficient bone volume to allow implant placement were scheduled for a bone augmentation procedure. After healing, participants were randomized to receive either four or six implants in the posterior maxilla. After 3 months of osseointegration, a bar overdenture was constructed. Implant survival, overdenture survival, clinical scores, peri-implant bone height changes, and patient satisfaction were assessed. RESULTS Forty-six participants completed the 10-year follow-up. Implant survival was 100% in the 4-implant group and 96.7% in the 6-implant group. Seven new overdentures were made in the 4-implant group and 12 new overdentures were made in the 6-implant group due to excessive wear of the denture base and teeth. Clinical parameters did not differ significantly between groups. Mean marginal bone loss compared to baseline was 0.41 ± 0.37 mm in the 4-implant group and 0.70 ± 1.07 mm in the 6-implant group. Overall, patient satisfaction improved significantly, but did not differ between groups. CONCLUSION From this 10-year follow-up trial, it was concluded that bar maxillary overdentures on four or six implants in the posterior region of an augmented maxilla resulted in a comparable treatment outcome with high implant survival, limited loss of peri-implant marginal bone, and high patients' satisfaction. (Clinical trial registration number: NTR9729).
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Affiliation(s)
- Wim Slot
- Department of Implant Dentistry, Dental School, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Gerry M. Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Marco S. Cune
- Department of Fixed Prosthodontics, Dental School, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Henny J. A. Meijer
- Department of Implant Dentistry, Dental School, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands,Department of Oral and Maxillofacial Surgery, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Han JJ, Moon JE, Lee EH, Yang HJ, Hwang SJ. Clinical and radiographic outcomes of dental implant after maxillary sinus floor augmentation with rhBMP-2/hydroxyapatite compared to deproteinized bovine bone. PLoS One 2022; 17:e0273399. [PMID: 36007001 PMCID: PMC9409565 DOI: 10.1371/journal.pone.0273399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives This study aimed to evaluate the clinical and radiographic outcomes of early implant placement and functional loading in maxillary sinus floor augmentation (MSFA) using recombinant human bone morphogenetic protein 2/hydroxyapatite (rhBMP-2/HA) and to compare these outcomes with those of the conventional protocol in MSFA using deproteinized bovine bone (DBB). Materials and methods The rhBMP-2/HA and DBB groups consisted of 14 and 13 patients who underwent MSFA with BMP and DBB, respectively. After placement of 22 implants and 21 implants in the rhBMP-2/HA and DBB groups, respectively, abutment connections were performed 3 months after implant placement for the rhBMP-2/HA group and 6 months after implant placement for the DBB group. Changes in grafted sinus height (GSH), marginal bone loss (MBL), and implant stability were evaluated up to one year after functional loading. Results Survival rates for the rhBMP-2/HA and DBB groups after one year of functional loading were 90.9% and 90.5%, respectively. Both groups exhibited no significant time-course changes in GSH until one year of functional loading (rhBMP-2/HA, p = 0.124; DBB, p = 0.075). Although significant MBL occurred after one year of functional loading for both groups (rhBMP-2/HA, p < 0.001; DBB, p < 0.001), there were no significant differences in time-course changes in MBL between the two groups (p = 0.450). The mean implant stability quotient values in the rhBMP-2/HA and DBB groups were 75.3 and 75.4 after one year of functional loading, respectively, and there were no significant differences between the two groups (p = 0.557). Conclusions MSFA using rhBMP-2/HA allowed implant rehabilitation with early implant placement and functional loading and led to a comparable survival rate and implant stability after 1 year of functional loading with acceptable MBL and stable maintenance of GSH compared to the MSFA using DBB with 6 months of healing after implant placement.
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Affiliation(s)
- Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Ji Eun Moon
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Eun-Hyuk Lee
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Republic of Korea
- * E-mail:
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Hwang Soon Jung’s Dental Clinic for Oral and Maxillofacial Surgery, Seoul, Republic of Korea
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Histomorphometric Comparison of New Bone Formed After Maxillary Sinus Lift With Lateral and Crestal Approaches Using Periostal Mesenchymal Stem Cells and Beta-Tricalcium Phosphate: A Controlled Clinical Trial. J Craniofac Surg 2022; 33:1607-1613. [DOI: 10.1097/scs.0000000000008319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 09/27/2021] [Indexed: 11/26/2022] Open
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Molina A, Sanz-Sánchez I, Sanz-Martín I, Ortiz-Vigón A, Sanz M. Complications in sinus lifting procedures: Classification and management. Periodontol 2000 2022; 88:103-115. [PMID: 35103321 DOI: 10.1111/prd.12414] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Open and closed sinus lifting procedures are predictable methods to augment the bone needed for appropriate implant placement in the posterior maxilla in cases where available bone is limited. However, these techniques may give rise to complications and associated comorbidities. In the case of open sinus lifting, perforation of the Schneiderian membrane during osteotomy is the most common complication, with an incidence rate of around 20%-25%. Apart from those complications associated with oral surgery in general (such as swelling or hematoma), there are specific complications of open sinus lifting procedures that may arise less frequently (chronic rhinosinusitis, hemorrhage, or ostium blockage by overfilling) but which may nevertheless compromise the viability of the graft and/or the implants and cause substantial discomfort to the patient. Closed sinus lifting is a less invasive approach that allows transcrestal placement of the implants in cases where there is sufficient residual bone height. However, it may also be associated with specific complications, including membrane perforation, benign paroxysmal positional vertigo, and implant displacement to the sinus cavity. New technologies have been proposed to reduce these complications and comorbidities associated with conventional sinus lifting procedures, such as the use of piezoelectric devices and hydraulic sinus lift or reamer burs. The evidence supporting their effectiveness and safety, however, is still lacking. A detailed medical history together with a thorough radiographic and clinical examination are essential prior to any kind of bone regenerative augmentation involving the maxillary sinus. Moreover, it is recommended to employ the most appropriate surgical technique for the specific characteristics of the case and, at the same time, accommodating the experience and skills of the surgeon.
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Affiliation(s)
- Ana Molina
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Ignacio Sanz-Martín
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain
| | - Alberto Ortiz-Vigón
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
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Implant survival after graftless sinus floor augmentation in highly atrophic maxillae: a randomized controlled trial in a split mouth study. Int J Implant Dent 2021; 7:107. [PMID: 34661774 PMCID: PMC8523734 DOI: 10.1186/s40729-021-00387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The success rate of dental implants after graftless sinus augmentation versus conventional sinus augmentation surgery in atrophic maxillae in edentulous patients was investigated. METHODS This randomized study was performed in ten edentulous patients with marked maxillary atrophy. On the graftless side, the sinus membrane was lifted by a resorbable membrane. The control side was augmented with a mixture of autografts and xenografts. Implant placement followed 6 months postoperatively. Outcomes were implant survival, success of prosthetic rehabilitation and stability of vertical bone gain. RESULTS Ten patients were included. Postoperative radiology showed sufficient bone gain on both maxillary sides. Follow-up varied from 57 to 88 months. The conventional side showed significant (p = 0.041) more bone gain than the experimental side (respectively, 9.69 mm and 6.20 mm). A total of 59 implants were placed: 30 after conventional, 29 after graftless augmentation. One implant was lost on the conventional side and four on the experimental side. The implant survival was significantly higher on the conventional side (96.7% vs. 86.2%, p < 0.001, RR = 4.14). Prosthetic restoration was functionally successful in all cases. CONCLUSION Bone gain and implant survival were significantly lower in the non-grafted side versus the grafted side. Prosthetic rehabilitation was possible in all ten patients. The non-grafted technique may have some potential for clinical use, although it showed poorer results. Trial registration The Netherlands Trialregister. NTR NL3541 (NTR3696). Registered 20 January 2013, https://www.trialregister.nl/trial/3541 .
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Yamaguchi Y, Matsuno T, Miyazawa A, Hashimoto Y, Satomi T. Bioactivity Evaluation of Biphasic Hydroxyapatite Bone Substitutes Immersed and Grown with Supersaturated Calcium Phosphate Solution. MATERIALS 2021; 14:ma14185143. [PMID: 34576367 PMCID: PMC8468353 DOI: 10.3390/ma14185143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 01/12/2023]
Abstract
Recently, the frequency of use of bone substitute materials for the purpose of bone augmentation has increased in implant treatment, but bone formation with bone substitute materials alone is limited. Calcification of bone in the body progresses as Ca2+, H2PO4-, and HPO42- in the body form hydroxyapatite (HA) crystals. In this study, therefore, we prepared a biphasic bone substitute with biological activity to promote bone formation by inducing precipitation and growth of HA crystals on the surface of a bone substitute and evaluated it. Biphasic bone substitute granules were prepared by immersing HA granules in a supersaturated calcium phosphate solution prepared by mixing five medical infusion solutions, the precipitate was analyzed, and the biological activities of biphasic HA granules were evaluated in vitro and in vivo. As a result, the precipitated calcium phosphate crystals were identified as low crystalline HA. On the surface of the HA granules, low-crystalline HA grew markedly as needle-shaped crystals and significantly promoted cell proliferation and bone differentiation. In animal experiments, biphasic HA granules had a significantly higher bone mineral density, new bone volume ratio, and new bone area ratio. Therefore, it suggests that biphasic hydroxyapatite is a useful bone substitute for bone augmentation in dental implant treatment.
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Affiliation(s)
- Yusuke Yamaguchi
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo 102-8159, Japan; (Y.Y.); (A.M.); (T.S.)
| | - Tomonori Matsuno
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo 102-8159, Japan; (Y.Y.); (A.M.); (T.S.)
- Oral and Maxillofacial Surgery, The Nippon Dental University Hospital, 2-3-16 Fujimi, Chiyoda-ku, Tokyo 102-8158, Japan
- Correspondence: ; Tel.: +81-3-3261-4112
| | - Atsuko Miyazawa
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo 102-8159, Japan; (Y.Y.); (A.M.); (T.S.)
| | - Yoshiya Hashimoto
- Department of Biomaterials, Osaka Dental University, 8-1, Kuzuhahanazonocho, Hirakata 573-1121, Osaka, Japan;
| | - Takafumi Satomi
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo 102-8159, Japan; (Y.Y.); (A.M.); (T.S.)
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Zamuner A, Brun P, Ciccimarra R, Ravanetti F, Veschini L, Elsayed H, Sivolella S, Iucci G, Porzionato A, Silvio LD, Cacchioli A, Bernardo E, Dettin M. Biofunctionalization of bioactive ceramic scaffolds to increase the cell response for bone regeneration. Biomed Mater 2021; 16. [PMID: 34271554 DOI: 10.1088/1748-605x/ac1555] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/16/2021] [Indexed: 12/12/2022]
Abstract
Biofunctionalization was investigated for polymers and metals considering their scarce integration ability. On the contrary few studies dealt with ceramic biofunctionalization because the bioactive and bioresorbable surfaces of ceramics are able to positively interact with biological environment. In this study the cell-response improvement on biofunctionalized wollastonite and diopside-based scaffolds was demonstrated. The ceramics were first obtained by heat treatment of a silicone embedding reactive oxide fillers and then biofunctionalized with adhesive peptides mapped on vitronectin. The most promisingin vitroresults, in terms of h-osteoblast proliferation and bone-related gene expression, were reached anchoring selectively a peptide stable toward proteolytic degradation induced by serum-enriched medium. Inin vivoassays the anchoring of this protease-stable adhesive peptide was combined with self-assembling peptides, for increasing cell viability and angiogenesis. The results demonstrated external and internal cell colonization of biofunctionalized scaffolds with formation of new blood vessels (neoangiogenesis) and stimulation of ectopic mineralization.
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Affiliation(s)
- Annj Zamuner
- Department of Industrial Engineering, University of Padova, Via Marzolo 9, Padova 35131, Italy
| | - Paola Brun
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, Padova 35127, Italy
| | - Roberta Ciccimarra
- Department of Veterinary Science, University of Parma, Via del Taglio 10, Parma 43126, Italy
| | - Francesca Ravanetti
- Department of Veterinary Science, University of Parma, Via del Taglio 10, Parma 43126, Italy
| | - Lorenzo Veschini
- Academic Centre of Reconstructive Sciences, King's College, Guy's Hospital, London SE1 9RT, United Kingdom
| | - Hamada Elsayed
- Department of Industrial Engineering, University of Padova, Via Marzolo 9, Padova 35131, Italy.,Ceramics Department, National Research Centre, El-Bohous Street, Cairo 12622, Egypt
| | - Stefano Sivolella
- Department of Neurosciences, University of Padova, Via Nicolò Giustiniani, 5, Padova 35128, Italy
| | - Giovanna Iucci
- Department of Science, Roma Tre University of Rome, Via della Vasca Navale 79, 00146 Rome, Italy
| | - Andrea Porzionato
- Department of Neurosciences, University of Padova, Via Nicolò Giustiniani, 5, Padova 35128, Italy
| | - Lucy Di Silvio
- Centre for Oral Clinical and Translational Sciences, King's College London, Guy's Hospital, London SE1 9RT, United Kingdom
| | - Antonio Cacchioli
- Department of Veterinary Science, University of Parma, Via del Taglio 10, Parma 43126, Italy
| | - Enrico Bernardo
- Department of Industrial Engineering, University of Padova, Via Marzolo 9, Padova 35131, Italy
| | - Monica Dettin
- Department of Industrial Engineering, University of Padova, Via Marzolo 9, Padova 35131, Italy
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12
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Nagata K, Fuchigami K, Kitami R, Okuhama Y, Wakamori K, Sumitomo H, Kim H, Okubo M, Kawana H. Comparison of the performances of low-crystalline carbonate apatite and Bio-Oss in sinus augmentation using three-dimensional image analysis. Int J Implant Dent 2021; 7:24. [PMID: 33754242 PMCID: PMC7985233 DOI: 10.1186/s40729-021-00303-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In locations where the alveolar bone height is low, such as at the maxillary molars, implant placement can be difficult, or even impossible, without procedures aimed at generating new bone, such as sinus lifts. Various types of bone graft materials are used after a sinus lift. In our study, a three-dimensional image analysis using a volume analyzer was performed to measure and compare the volume of demineralized bovine bone mineral (Bio-Oss®) and carbonate apatite (Cytrans®) after a sinus lift, as well as the amount of bone graft material resorption. Patient data were collected from cone-beam computed tomography images taken before, immediately following, and 6 months after the sinus lift. Using these images, both the volume and amount of resorption of each bone graft material were measured using a three-dimensional image analysis system. RESULTS The amount of bone resorption in the Bio-Oss®-treated group was 25.2%, whereas that of the Cytrans®-treated group was 14.2%. A significant difference was found between the two groups (P < 0.001). CONCLUSIONS Our findings indicate that the volume of bone resorption was smaller in the Cytrans®-treated group than in the Bio-Oss®-treated group, suggesting that Cytrans® is more promising for successful implant treatments requiring a sinus lift.
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Affiliation(s)
- Koudai Nagata
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Kei Fuchigami
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Ryoji Kitami
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Yurie Okuhama
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Kana Wakamori
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Hirokazu Sumitomo
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Hyunjin Kim
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Manabu Okubo
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Hiromasa Kawana
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan.
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13
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Menezes JD, Pereira RDS, Santos AMDS, de Siqueira NB, Boos-Lima FBDJ, Hochuli-Vieira E. Three-dimensional volumetric changes of 5 different bone grafts in human maxillary sinuses reconstruction: a randomized clinical study. Oral Maxillofac Surg 2021; 25:541-547. [PMID: 33715054 DOI: 10.1007/s10006-021-00940-4] [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: 06/17/2020] [Accepted: 01/13/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to compare the three-dimensional volumetric changes of human maxillary sinuses after reconstruction using 5 different bone grafts. PATIENTS AND METHODS Patients underwent unilateral maxillary sinus bone height reconstruction using 5 bone substitutes allocated in different groups as follows: group 1 was grafted with autogenous bone graft alone; group 2 with beta-tricalcium phosphate (β-TCP); group 3 with β-TCP + autogenous bone graft 1:1; group 4 with bioactive glass; and group 5 with bioactive glass + autogenous bone graft 1:1. The patients were submitted to cone beam computed tomography in two periods: 15 days after the surgical procedure (T1) and after 6 months (T2). The results were evaluated as the formula T2-T1 expressing the three-volumetric changes of the biomaterials in elapsed time. RESULTS The resorption rate of autogenous bone graft was -630.699 ± 300.9 mm3; in the β-TCP group, it was -315.772 ± 125.6 mm3; in the group with β-TCP + autogenous bone graft 1:1, it was -336.205 ± 195.7 mm3; and in groups with bioactive glass and with the addition of autogenous bone graft 1:1, it was -428.878 ± 311.6 mm3 and -576.917 ± 471.6 mm3, respectively, without statistical difference (p = 0.167). Pearson's correlated test revealed a strong correlation as well as a progressive resorption of the grafts during bone healing. CONCLUSION The similar outcomes for the three-dimensional volumetric changes using the bone substitutes evaluated after 6 months of bone healing suggest that all these grafts can be performed to maxillary sinus reconstruction.
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Affiliation(s)
| | - Rodrigo Dos Santos Pereira
- Universidade do Grande Rio - UNIGRANRIO, Duque de Caxias, Brazil. .,UNIFESO - Centro Universitário Serra dos Órgãos, Teresópolis, Brazil.
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14
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Kyyak S, Blatt S, Schiegnitz E, Heimes D, Staedt H, Thiem DGE, Sagheb K, Al-Nawas B, Kämmerer PW. Activation of Human Osteoblasts via Different Bovine Bone Substitute Materials With and Without Injectable Platelet Rich Fibrin in vitro. Front Bioeng Biotechnol 2021; 9:599224. [PMID: 33681155 PMCID: PMC7925396 DOI: 10.3389/fbioe.2021.599224] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/21/2021] [Indexed: 01/06/2023] Open
Abstract
Introduction The aim of the in vitro study was to compare the effect of four bovine bone substitute materials (XBSM) with and without injectable platelet-reach fibrin for viability and metabolic activity of human osteoblasts (HOB) as well as expression of alkaline phosphatase (ALP), bone morphogenetic protein 2 (BMP-2), and osteonectin (OCN). Materials and Methods Cerabone® (CB), Bio-Oss® (BO), Creos Xenogain® (CX) and MinerOss® X (MO) ± i-PRF were incubated with HOB. At day 3, 7, and 10, cell viability and metabolic activity as well as expression of ALP, OCN, and BMP-2, was examined. Results For non-i-PRF groups, the highest values concerning viability were seen for CB at all time points. Pre-treatment with i-PRF increased viability in all groups with the highest values for CB-i-PRF after 3 and 7 and for CX-i-PRF after 10 days. For metabolic activity, the highest rate among non-i-PRF groups was seen for MO at day 3 and for CB at day 7 and 10. Here, i-PRF groups showed higher values than non-i-PRF groups (highest values: CB + i-PRF) at all time points. There was no difference in ALP-expression between groups. For OCN expression in non-i-PRF groups, CB showed the highest values after day 3, CX after day 7 and 10. Among i-PRF-groups, the highest values were seen for CX + i-PRF. At day 3, the highest BMP-2 expression was observed for CX. Here, for i-PRF groups, the highest increase was seen for CX + i-PRF at day 3. At day 7 and 10, there was no significant difference among groups. Conclusion XBSM sintered under high temperature showed increased HOB viability and metabolic activity through the whole period when compared to XBSM manufactured at lower temperatures. Overall, the combination of XBSM with i-PRF improved all cellular parameters, ALP and BMP-2 expression at earlier stages as well as OCN expression at later stages.
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Affiliation(s)
- Solomiya Kyyak
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Sebastian Blatt
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Diana Heimes
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Henning Staedt
- Private Practice, University Medical Center Rostock, Rostock, Germany.,Department of Prosthodontics and Materials Science, University Medical Center Rostock, Rostock, Germany
| | - Daniel G E Thiem
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
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15
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Pereira RDS, Bonardi JP, Ouverney FRF, Campos AB, Griza GL, Okamoto R, Hochuli-Vieira E. The new bone formation in human maxillary sinuses using two bone substitutes with different resorption types associated or not with autogenous bone graft: a comparative histomorphometric, immunohistochemical and randomized clinical study. J Appl Oral Sci 2020; 29:e20200568. [PMID: 33331393 PMCID: PMC7799149 DOI: 10.1590/1678-7757-2020-0568] [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: 07/08/2020] [Accepted: 09/07/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants. METHODOLOGY 40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1. RESULTS In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed. CONCLUSION This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.
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Affiliation(s)
| | | | | | | | | | - Roberta Okamoto
- Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP)
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16
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Vincent-Bugnas S, Charbit Y, Charbit M, Dard M, Pippenger B. Maxillary Sinus Floor Elevation Surgery With BioOss Mixed With Enamel Matrix Derivative: A Human Randomized Controlled Clinical and Histologic Study. J ORAL IMPLANTOL 2020; 46:507-513. [PMID: 32299097 DOI: 10.1563/aaid-joi-d-19-00119] [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] [Indexed: 11/22/2022]
Abstract
Xenograft bone substitutes are commonly used to increase bone volume and height in the deficient posterior maxilla. The addition of enamel matrix derivate (Emdogain) could increase the efficiency of the bone healing process. The aim of this prospective randomized, controlled split-mouth design study was to compare the percentage of newly formed bone in sinus floor augmentation with deproteinized bovine bone mineral with or without the addition of enamel matrix derivative after 6 months of healing. Sixteen bilateral sinus floor augmentation procedures were performed. Deproteinized bovine bone mineral combined with enamel matrix derivative (test) and deproteinized bovine bone mineral alone (control) groups were randomly allocated within each patient. Six months after augmentation and concurrent to implant placement, bone biopsies were taken for histomorphometric analysis. Additionally, implant survival and peri-implant bone levels were radiographically assessed at baseline and 24 months after functional loading. Histomorphometric analysis revealed a significantly higher amount of newly formed bone in the test group compared with the control group (22.6% and 15.5%, respectively; P = .033). No significant differences in the amount of remaining graft or connective tissue was found. Enamel matrix derivative added to deproteinized bovine bone mineral particles significantly increased new bone formation in sinus lift procedures in edentulous or partially edentulous patients with deficient bilateral posterior alveolar ridges requiring augmentation for implant placement.
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Affiliation(s)
- Séverine Vincent-Bugnas
- Département de parodontologie, Pôle odontologie, Centre Hospitalier Universitaire de Nice.,Laboratoire MICORALIS, Université Côte d'Azur
| | - Yves Charbit
- Département de parodontologie, Pôle odontologie, Centre Hospitalier Universitaire de Nice
| | - Mathieu Charbit
- Département de parodontologie, Pôle odontologie, Centre Hospitalier Universitaire de Nice.,Laboratoire MICORALIS, Université Côte d'Azur
| | - Michel Dard
- Section of Oral, Diagnosis and Rehabilitation Sciences, Columbia University, College of Dental Medicine, New York, New York.,Straumann Group, Basel, Switzerland
| | - Benjamin Pippenger
- Preclinical & Translational Research, Institut Straumann AG, Basel, Switzerland
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17
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Tenting effect of dental implant on maxillary sinus lift without grafting. J Dent Sci 2020; 15:278-285. [PMID: 32952885 PMCID: PMC7486502 DOI: 10.1016/j.jds.2020.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 05/12/2020] [Indexed: 12/02/2022] Open
Abstract
Background/purpose Maxillary sinus lift without grafting is an alternative procedure that is used to lower the risk of infection and facilitate the surgical procedure. The objective of this study was to evaluate the tenting effect of the dental implant by measuring the amount and morphology of bone formation around it. Material and methods 49 implants were placed in 26 patients by maxillary sinus lift without grafting. Radiographic images were taken preoperatively and at 6 months postoperatively and used to evaluate the height of the residual bone, the width of the maxillary sinus, the amount of bone formation, and the adjacent tooth. Results The most common type of bone formed around the implant, as seen in 23 cases, was the same height as the apex of the implant; in 11 cases, it was 0–2 mm above the apex of the implant, and in 7 cases, 2 mm or more. Meanwhile, 5 cases showed defects. The tent type of bone formation, which showed more bone formation at the implant apex than in the surrounding bone, was overwhelmingly the most common. (80.4%) The amount of bone formation increased in proportion to the difference between the residual bone height and the implant length. (P < .001). Conclusion The amount of bone formation in the sinus lift without grafting increased in proportion to the length of the implants in the maxillary sinus due to the tenting effect of the implant in the maxillary sinus membrane.
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18
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Liu Y, Wang J, Chen F, Feng Y, Xie C, Li D. A reduced healing protocol for sinus floor elevation in a staged approach with deproteinized bovine bone mineral alone: A randomized controlled clinical trial of a 5-month healing in comparison to the 8-month healing. Clin Implant Dent Relat Res 2020; 22:281-291. [PMID: 32267601 DOI: 10.1111/cid.12906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To investigate the feasibility of reducing the healing time of maxillary sinus floor elevation (MSFE) by a two-stage approach using deproteinized bovine bone mineral (DBBM) alone, based on clinical, histomorphometric, and microradiographic evaluations. MATERIALS AND METHODS Twenty consecutive cases with an atrophic posterior edentulous maxilla were randomly assigned to two groups at a ratio of 1:1. The lateral window approach to MSFE with DBBM alone was followed by an 8-month bone-healing period in the control group compared to 5 months in the test group. During implant placement, bone biopsies were harvested from implant osteotomy sites for micro-computed tomography (CT), histological, and histomorphometric evaluations. Cone beam CT (CBCT) scans were performed before and immediately after MSFE and after the bone-healing periods. The implant stability quotient (ISQ) was measured sequentially at implant placement and 1, 3, and 6 months thereafter. RESULTS The histomorphometric and microradiographic results showed no significant differences in new bone formation on the augmented sinus floor between the two groups (all Ps > .05), except that trabecular thickness was significantly reduced and trabecular separation significantly increased in the test group (both Ps < .05). The ISQs of both groups increased continuously after implant placement, but the difference was not significant between the groups at each time point. CBCT analyses showed that the extent of volumetric loss was comparable after bone healing for 5 and 8 months (P > .05). CONCLUSIONS Within the limitations of this study, the bone-healing time of MSFE with DBBM alone for staged implant placement could be reduced to 5 months instead of 8 or 9 months, based on the histomorphometric, microradiographic, and clinical outcomes; however, impact on long-term implant survival remains unknown and needs further investigation with long-term follow-ups.
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Affiliation(s)
- Yi Liu
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Jin Wang
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Fei Chen
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Yuan Feng
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Chao Xie
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Dehua Li
- Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China
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19
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Cinar IC, Gultekin BA, Saglanmak A, Yalcin S, Olgac V, Mijiritsky E. Histologic, Histomorphometric, and Clinical Analysis of the Effects of Growth Factors in a Fibrin Network Used in Maxillary Sinus Augmentation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061918. [PMID: 32183498 PMCID: PMC7142822 DOI: 10.3390/ijerph17061918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/15/2022]
Abstract
This randomized controlled clinical trial evaluated the effect of mineralized plasmatic matrix (MPM), comprised of synthetic graft and platelet concentrates, on new bone formation and volume stability over time in maxillary sinus lifting (MSL). Unilateral MSL was performed in 20 patients with either beta-tricalcium phosphate (β-TCP) or MPM grafts (10 sinuses each). Six months postsurgery, specimens were obtained with a trephine bur prior to implant placement in 39 cases. Volumetric changes in sinus augmentation were analyzed between 1 week (T-I) and 6 months (T-II) postsurgery. Histomorphometric and histological analyses of biopsy samples revealed mean new bone percentages of 35.40% ± 9.09% and 26.92% ± 7.26% and residual graft particle areas of 23.13% ± 6.16% and 32.25% ± 8.48% in the MPM and β-TCP groups, respectively (p < 0.05). The mean soft-tissue areas in the MPM and β-TCP groups were 41.48% ± 8.41% and 40.83% ± 8.86%, respectively (p > 0.05). Graft reductions between baseline and 6-months postprocedure in the β-TCP and MPM groups were 17.12% ± 13.55% and 14.41% ± 12.87%, respectively, with significant graft volume reduction observed in both groups (p < 0.05) while there is no significant difference between MPM and β-TCP groups (p > 0.05). Thus, MPM, representing growth factors in a fibrin network, increases new bone formation and has acceptable volume stability in MSL procedures
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Affiliation(s)
- Ihsan Caglar Cinar
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey; (I.C.C.); (A.S.); (S.Y.)
| | - Bahattin Alper Gultekin
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey; (I.C.C.); (A.S.); (S.Y.)
- Correspondence: ; Tel.: +90-5326757236; Fax: +90-212-5323254
| | - Alper Saglanmak
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey; (I.C.C.); (A.S.); (S.Y.)
| | - Serdar Yalcin
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey; (I.C.C.); (A.S.); (S.Y.)
| | - Vakur Olgac
- Pathology and Oncology Cytology Department of Institute of Oncology, Istanbul University, 34093 Fatih, Turkey;
| | - Eitan Mijiritsky
- Department of Otolaryngology, Head and Neck and Maxilllofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, 5219100 Ramat Aviv, Israel;
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20
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Raghoebar GM, Onclin P, Boven GC, Vissink A, Meijer HJA. Long-term effectiveness of maxillary sinus floor augmentation: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:307-318. [PMID: 30624789 DOI: 10.1111/jcpe.13055] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/28/2018] [Accepted: 12/12/2018] [Indexed: 12/27/2022]
Abstract
AIM To assess the long-term effectiveness (≥5 years) of maxillary sinus floor augmentation (MSFA) procedures applying the lateral window technique and to determine possible differences in outcome between simultaneous and delayed implant placement, partially and fully edentulous patients and grafting procedures. MATERIALS AND METHODS MEDLINE (1950-May 2018), EMBASE (1966-May 2018) and Cochrane Central Register of Controlled Trials (1800-May 2018) were searched. Inclusion criteria were prospective studies with follow-up ≥5 years and a residual bone height ≤6 mm. Outcome measures included implant loss, peri-implant bone level change, suprastructure survival, patient-reported outcome measures and overall complications. Data were pooled and analysed using a random effects model. RESULTS Out of 2,873 selected articles, 11 studies fulfilled all inclusion criteria. Meta-analysis revealed a weighted annual implant loss of 0.43% (95% CI: 0.37%-0.49%). Meta-regression analysis did not reveal significant differences in implant loss neither between edentulous and dentate patients nor implants placed simultaneously with or delayed after MSFA, nor implants placed in MSFA using solely autologous bone or bone substitutes. The results of the other outcome measures were favourable, and overall complications were low. CONCLUSION MSFA is a reliable procedure in the partially and fully edentulous maxilla for support of dental implants.
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Affiliation(s)
- Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Pieter Onclin
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - G Carina Boven
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Implant Dentistry, Dental School, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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21
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DOU X, WANG Y, HE J, XU X. R.T.R ® promotes bone marrow mesenchymal stem cells osteogenic differentiation by upregulating BMPs/SMAD induced cbfa1 expression. Dent Mater J 2019; 38:764-770. [DOI: 10.4012/dmj.2018-306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Xiaochen DOU
- School of Stomatology of Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province
| | - Yuanyin WANG
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province
| | - Jiacai HE
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province
| | - Xin XU
- School of Stomatology of Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration
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22
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Offner D, de Grado GF, Meisels I, Pijnenburg L, Fioretti F, Benkirane-Jessel N, Musset AM. Bone Grafts, Bone Substitutes and Regenerative Medicine Acceptance for the Management of Bone Defects Among French Population: Issues about Ethics, Religion or Fear? CELL MEDICINE 2019; 11:2155179019857661. [PMID: 32634194 PMCID: PMC6587382 DOI: 10.1177/2155179019857661] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/21/2019] [Indexed: 12/13/2022]
Abstract
Several techniques exist to manage bone defects in patients: bone grafts (autograft, allograft, xenograft), use of synthetic bone substitutes, or use of the products of bone regenerative medicine. Studies generally focus on their efficacy, but few focus on their acceptance. Our objectives were to assess their theoretical acceptance among the French general population, and to identify issues justifying refusals, by mean of an open e-questionnaire. The questionnaire was submitted to a general French population, and explained these techniques in an understandable way. Participants were asked to say whether they would accept or refuse these techniques, specifying why in case of refusal (fear of the technique, ethical reasons, religious reasons). In total, 562 persons participated. Autograft and use of the products of bone regenerative medicine were the most accepted techniques (93.4% and 94.1%, respectively). Xenograft was the least accepted technique (58.2%). Most refusals were due to fear such as failure, pain, infection (autograft 8%, allograft 14.9%, xenograft 25.3%, synthetic bone substitutes 14.6%, and products of bone regenerative medicine 6.8%). Ethical reasons were mostly mentioned for allograft (6.4%) and xenograft (18.3%). Religious reasons were scarcely mentioned, only for xenograft (1.2%). Thus, acceptance of techniques does not seem to be greatly linked to sociodemographic characteristics in France. However, other countries with their own cultural, religious, and population patterns may show different levels of acceptance. This study shows that bone regenerative medicine is a promising research direction, reaching biological and also humanist quality standards, expected to improve the health of patients. Information is still the cornerstone to defuse issues about fear.
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Affiliation(s)
- Damien Offner
- INSERM (French National Institute of Health and Medical Research), UMR1260, Regenerative Nanomedicine (RNM), FMTS.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg.,Hôpitaux Universitaires de Strasbourg, Strasbourg.,Both the authors contributed equally to this article
| | - Gabriel Fernandez de Grado
- INSERM (French National Institute of Health and Medical Research), UMR1260, Regenerative Nanomedicine (RNM), FMTS.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg.,Hôpitaux Universitaires de Strasbourg, Strasbourg.,Both the authors contributed equally to this article
| | - Inès Meisels
- Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg.,Hôpitaux Universitaires de Strasbourg, Strasbourg
| | - Luc Pijnenburg
- INSERM (French National Institute of Health and Medical Research), UMR1260, Regenerative Nanomedicine (RNM), FMTS.,Hôpitaux Universitaires de Strasbourg, Strasbourg.,Faculté de Médecine, Université de Strasbourg, Strasbourg
| | - Florence Fioretti
- INSERM (French National Institute of Health and Medical Research), UMR1260, Regenerative Nanomedicine (RNM), FMTS.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg.,Hôpitaux Universitaires de Strasbourg, Strasbourg
| | - Nadia Benkirane-Jessel
- INSERM (French National Institute of Health and Medical Research), UMR1260, Regenerative Nanomedicine (RNM), FMTS.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg.,Faculté de Médecine, Université de Strasbourg, Strasbourg
| | - Anne-Marie Musset
- INSERM (French National Institute of Health and Medical Research), UMR1260, Regenerative Nanomedicine (RNM), FMTS.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg.,Hôpitaux Universitaires de Strasbourg, Strasbourg
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Alayan J, Ivanovski S. Biological and technical outcomes of restored implants after maxillary sinus augmentation-Results at 1-year loading. Clin Oral Implants Res 2019; 30:849-860. [PMID: 31148293 DOI: 10.1111/clr.13489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 05/13/2019] [Accepted: 05/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report biological and technical outcomes of implant-supported restorations placed into previously maxillary sinus floor augmentation using the lateral wall approach (MSA) using anorganic bovine bone mineral (ABBM) + autogenous bone (AB) (control group) or collagen-stabilized ABBM (test group). MATERIALS AND METHODS Single implant was placed 6 months after MSA in 27 control and 26 test patients. Fixed restorations were delivered 12 weeks later and reviewed 12 months after function. Outcomes measured included implant survival, marginal bone levels (DIB), peri-implant parameters, and incidence of biological and technical complications. RESULTS Seven patients (three control, four test group) did not return for their 1-year review. No significant inter-group differences were noted for all parameters. At baseline (3 months after implant placement), a mean(SD) marginal bone loss of 0.66 mm (0.40) and 0.77 mm (0.48) from the implant shoulder was recorded in the control and test group, respectively. After 12 months of loading, a mean (SD) additional marginal bone loss of 0.32 mm (0.24) and 0.35 mm (0.23) was noted in the control and test group, respectively. Peri-implant mucositis (≥1 site BOP) was diagnosed in 62.9% of control and 69.23% of test patients. No peri-implantitis was diagnosed. Screw retention and single crowns predominated. Technical complications mostly comprised of ceramic veneer chipping and were noted in 7.4% of control and 11.54% of test patients. CONCLUSION Based on a short observation period, implant reconstruction of the partially edentulous posterior maxilla after MSA using ABBM + AB or collagen-stabilized ABBM led stable marginal bone levels, high prevalence of peri-implant mucositis, and low rates of technical complications.
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Affiliation(s)
- Jamil Alayan
- School of Dentistry and Oral Health, Centre for Medicine and Oral Health, Griffith University, Southport, Queensland, Australia
| | - Saso Ivanovski
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
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24
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Donos N, Dereka X, Calciolari E. The use of bioactive factors to enhance bone regeneration: A narrative review. J Clin Periodontol 2019; 46 Suppl 21:124-161. [DOI: 10.1111/jcpe.13048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| | - Xanthippi Dereka
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
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Efficacy of Recombinant Human BMP2 and PDGF-BB in Orofacial Bone Regeneration: A Systematic Review and Meta-analysis. Sci Rep 2019; 9:8073. [PMID: 31147568 PMCID: PMC6542831 DOI: 10.1038/s41598-019-44368-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/28/2019] [Indexed: 02/05/2023] Open
Abstract
With the rapid development of tissue engineering therapies, there is a growing interest in the application of recombinant human growth factors (rhGFs) to regenerate human orofacial bones. However, despite reports of their ability to promote orofacial bone regeneration in animal experiments, their benefits in human clinical treatments remain unclear. Furthermore, the appropriate concentrations or indications of a specific rhGF remain ambiguous. Therefore it is essential to collect data from diverse clinical trials to evaluate their effects more precisely. Here we reviewed randomized clinical trials (RCT) that focused on the utilization of rhGFs in orofacial bone regeneration. Data from included studies were extracted, pooled and then quantitatively analyzed according to a pre-established protocol. Our results indicate that all current concentrations of rhBMP-2 produces insufficient effect on promoting either tooth extraction socket healing, sinus augmentation or reconstruction of alveolar clefts. However, 0.3 mg/ml rhPDGF-BB promotes the healing of tooth extraction sockets, though the effect does not reach a level of statistical significance. Summarily, we recommend concentrations of 0.3 mg/ml rhPDGF-BB only for the healing of tooth extraction sockets.
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Pereira RS, Pavelski MD, Griza GL, Boos FBJD, Hochuli-Vieira E. Prospective evaluation of morbidity in patients who underwent autogenous bone-graft harvesting from the mandibular symphysis and retromolar regions. Clin Implant Dent Relat Res 2019; 21:753-757. [PMID: 31094060 DOI: 10.1111/cid.12789] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/04/2019] [Accepted: 04/15/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autogenous bone grafts are the most favorable and predictable types of bone graft due to their osteogenic, osteoinductive, and osteoconductive properties. The advantages of harvesting from mandibular bone are that it requires only local anesthesia, is less invasive, has less morbidity, and avoids harvesting from distant sites, thus making it the best choice for maxillary bone reconstruction. PURPOSE The aim of this study was to evaluate inferior alveolar nerve (IAN) neurosensory disturbances after autogenous bone graft harvesting from the mandibular symphysis and retromolar region to reconstruct maxillary sinus height for posterior dental implant placement and the effect of these disturbances on patient satisfaction. MATERIALS AND METHODS Fifty-four patients were invited to participate in this study. Autogenous bone graft was harvested from the mandibular symphysis and retromolar regions. After the procedure, the patients were evaluated by means of an adapted questionnaire to determine if they had complaints of neurosensory disturbances at the following time intervals: immediately, 1, 2-5, 6, 7-11, and 12 months postsurgery. RESULTS Immediately after surgery, 28 patients described sensory changes and 25 reported paresthesia of inferior lip. Only three patients reported pain, and one patient experienced dental hypersensitivity after the surgical procedure. During the evaluation period, the patients reported a decrease in paresthesia and a return of sensation to areas innervated by the IAN. After 12 months, five patients still reported paresthesia of areas innervated by the IAN. Beside this, patients reported significant clinical improvement from the beginning of the evaluation, as 49 patients were satisfied with their treatment outcomes. CONCLUSION Harvesting bone grafts from the mandibular symphysis results in greater postoperative morbidity upon immediate evaluation compared with bone graft harvesting from the retromolar region. Nevertheless, during clinical follow-up, the results of both treatments showed that sensation was eventually recovered, depending on the healing period.
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Affiliation(s)
- Rodrigo Santos Pereira
- Department of Surgery and Clinic Integraded, Universidade Estadual Paulista - UNESP, São Paulo, Brazil
| | - Maicon D Pavelski
- Department of Oral Surgery, Universidade Estadual do Oeste do Paraná - UNIOESTE, Paraná, Brazil
| | - Geraldo L Griza
- Department of Oral Surgery, Universidade Estadual do Oeste do Paraná - UNIOESTE, Paraná, Brazil
| | - Fernanda B J D Boos
- Department of Surgery and Clinic Integraded, Universidade Estadual Paulista - UNESP, São Paulo, Brazil
| | - Eduardo Hochuli-Vieira
- Department of Surgery and Clinic Integraded, Universidade Estadual Paulista - UNESP, São Paulo, Brazil
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Effectiveness of Platelet-Rich Fibrin as an Adjunctive Material to Bone Graft in Maxillary Sinus Augmentation: A Meta-Analysis of Randomized Controlled Trails. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7267062. [PMID: 31008111 PMCID: PMC6441530 DOI: 10.1155/2019/7267062] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/08/2019] [Accepted: 02/25/2019] [Indexed: 12/11/2022]
Abstract
Purpose To date, it remains unknown whether the addition of platelet-rich fibrin (PRF) to bone grafts actually improves the effectiveness of maxillary sinus augmentation. This study aimed to perform a meta-analysis to evaluate the efficacy of PRF in sinus lift. Materials and Methods PubMed, Embase, and the Cochrane Library were searched. Randomized controlled studies were identified. The risk of bias was evaluated using the Cochrane Collaboration tool. Results Five RCTs were included in our meta-analysis. Clinical, radiographic, and histomorphometric outcomes were considered. No implant failure or graft failure was detected in all included studies within the follow-up period. The percentage of contact length between newly formed bone substitute and bone in the PRF group was lower but lacked statistical significance (3.90%, 95% CI, -2.91% to 10.71%). The percentages of new bone formation (-1.59%, 95% CI, -5.36% to 2.18%) and soft-tissue area (-3.73%, 95% CI, -10.11% to 2.66%) were higher in the PRF group but were not significantly different. The percentage of residual bone graft was not significant in either group (4.57%, 95% CI, 0% to 9.14%). Conclusions Within the limitations of this review, it was concluded that there were no statistical differences in survival rate, new bone formation, contact between newly formed bone and bone substitute, percentage of residual bone graft (BSV/TV), and soft-tissue area between the non-PRF and PRF groups. Current evidence supporting the necessity of adding PRF to bone graft in sinus augmentation is limited.
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Younes F, Cosyn J, De Bruyckere T, Cleymaet R, Eghbali A. A 2-year prospective case series on volumetric changes, PROMs, and clinical outcomes following sinus floor elevation using deproteinized bovine bone mineral as filling material. Clin Implant Dent Relat Res 2019; 21:301-309. [PMID: 30740863 DOI: 10.1111/cid.12730] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND A sinus floor augmentation may be indicated when a lack of hard tissue impedes implant placement. Although clinically successful, evidence supporting the long-term three-dimensional stability of the grafted volume is scarce. Second, evidence on the patient's acceptance of this type of treatment is limited. PURPOSE First is to evaluate the changes in graft volume after lateral wall sinus lifting based on superimposed cone beam computed tomography (CBCT) images and then to assess patient-reported outcome measures (PROMs) and clinical outcomes. MATERIALS AND METHODS Partially edentulous patients in need of a sinus lift and fixed reconstruction on at least two neighboring implants were selected for a prospective case series. Lateral wall sinus augmentation was performed using deproteinized bovine bone mineral (DBBM) as the only filling material. Volumetric changes were quantified on the basis of a preoperative CBCT and three postoperative CBCTs (at 2 weeks, 3 months, and 2 years). PROMs and clinical parameters were registered. RESULTS Twenty-two patients (7 males, 15 females; mean age 59 years) participated of which three patients dropped out during the follow up. Graft volumes amounted to 1418.26 mm3 at 2 weeks, 1201.21 mm3 at 3 months, and 1130.13 mm3 at 2 years postoperative pointing to a relative graft volume stability of 79.7%. Swelling was the leading symptom during the first week. A peak in visual analogue scale scores was observed for pain, swelling, and hematoma the day of surgery and 1 day postoperation with a statistically significant decline between days 3 and 7. Hemorrhage and nose bleeding occurred in 18.2% and 27.3% of the subjects, respectively. About 95.5% of the subjects would undergo the treatment again. All implants integrated successfully and demonstrated healthy clinical conditions. CONCLUSION Lateral wall sinus augmentation using DBBM as the only filling material is a viable treatment concept given limited graft resorption, good patients' tolerance, and clinical outcomes.
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Affiliation(s)
- Faris Younes
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
| | - Thomas De Bruyckere
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
| | - Robbert Cleymaet
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Aryan Eghbali
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
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Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Four or six implants in the maxillary posterior region to support an overdenture: 5-year results from a randomized controlled trial. Clin Oral Implants Res 2019; 30:169-177. [PMID: 30636064 DOI: 10.1111/clr.13403] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 11/23/2018] [Accepted: 12/23/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare clinical and patient-reported outcomes when providing maxillary overdentures on four bar- and six bar-connected implants placed in the posterior region during a 5-year follow-up period. MATERIALS AND METHODS Sixty-six fully edentulous patients with functional maxillary denture complaints and insufficient bone volume to allow implant placement were scheduled for a maxillary sinus floor elevation procedure with bone from the anterior iliac crest and randomized to receive either four or six implants in the posterior maxilla and four implants in the mandible. After 3 months of osseointegration, a bar-supported overdenture was constructed. Maxillary implant survival, overdenture survival, clinical scores, peri-implant bone height changes and patient satisfaction were assessed. RESULTS Sixty patients completed the 5-year follow-up. Implant survival was 100% in the four-implant group and 99.5% in the six-implant group. No new overdentures had to be made in the four-implant group, and three new overdentures were made in the six-implant group due to excessive wear of the denture base and teeth (90.9% overdenture survival). Clinical parameters did not differ significantly between groups. Mean marginal bone loss compared to baseline was 0.58 ± 0.51 mm in the four-implant group and 0.60 ± 0.58 mm in the six-implant group, respectively. Overall, patient satisfaction improved significantly, but did not differ between groups. CONCLUSION Following a bilateral maxillary sinus floor elevation procedure, a bar-supported overdenture on four implants in the posterior maxillary region is not inferior to an overdenture supported by six implants after a 5-year evaluation period in patients with functional maxillary denture complaints and marked posterior resorption (Clinical trial registration number: NTR2969).
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Affiliation(s)
- Wim Slot
- Department of Fixed and Removable Prosthodontics and Biomaterials, Dental School, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Marco S Cune
- Department of Fixed and Removable Prosthodontics and Biomaterials, Dental School, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Henny J A Meijer
- Department of Fixed and Removable Prosthodontics and Biomaterials, Dental School, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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30
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Minetti E, Palermo A, Contessi M, Gambardella U, Schmitz J, Giacometti E, Celko M, Trisi P. Autologous tooth graft for maxillary sinus augmentation: A multicenter clinical study. ACTA ACUST UNITED AC 2019. [DOI: 10.4103/gfsc.gfsc_13_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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31
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Kudoh K, Fukuda N, Kasugai S, Tachikawa N, Koyano K, Matsushita Y, Ogino Y, Ishikawa K, Miyamoto Y. Maxillary Sinus Floor Augmentation Using Low-Crystalline Carbonate Apatite Granules With Simultaneous Implant Installation: First-in-Human Clinical Trial. J Oral Maxillofac Surg 2018; 77:985.e1-985.e11. [PMID: 30597134 DOI: 10.1016/j.joms.2018.11.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/22/2018] [Accepted: 11/24/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Carbonate apatite (CO3Ap), an inorganic component of human bone, can be fabricated in chemically pure form from calcium carbonate block via a dissolution-precipitation reaction. A first-in-human clinical trial was conducted in which low-crystalline CO3Ap granules were evaluated for safety and efficacy in sinus floor augmentation and simultaneous implant installation. MATERIALS AND METHODS Procedures were performed in 8 patients (9 implants) with 2 granule sizes: small (300 to 600 μm) and medium (600 to 1,000 μm). Panoramic radiographic assessment was performed immediately after augmentation, 7 ± 2 months after augmentation, 6 ± 2 months after prosthetic loading, and 12 ± 2 months after prosthetic loading. RESULTS Postoperative healing was uniformly uneventful, with no abnormal bleeding, pain, or swelling, and all implants achieved successful osseointegration. The mean residual maxillary molar bone height was 5.2 ± 0.8 mm preoperatively and increased to 14.0 ± 1.9 mm after augmentation. Implants 9.0 to 11.5 mm in length were placed. The post-augmentation height decreased to 12.4 ± 1.3 mm at 7 ± 2 months; after prosthetic loading, it decreased to 11.9 ± 0.8 mm at 6 ± 2 months and 11.7 ± 0.6 mm at 12 ± 2 months. No abnormal bone resorption of the augmented areas was observed, and bone height supporting the implants was maintained. The overall implant survival rate was 100%, with no implant failures or complications during the first year. CONCLUSIONS Low-crystalline CO3Ap granules were useful and safe for sinus floor augmentation and simultaneous implant installation, providing a promising bone substitute for dental implant surgery.
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Affiliation(s)
- Keiko Kudoh
- Assistant Professor, Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
| | - Naoyuki Fukuda
- Assistant Professor, Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shohei Kasugai
- Professor, Dental Implant Clinic, Dental Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Tachikawa
- Associate Professor, Dental Implant Clinic, Dental Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiyoshi Koyano
- Professor, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yasuyuki Matsushita
- Associate Professor, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yoichiro Ogino
- Associate Professor, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kunio Ishikawa
- Professor, Department of Biomaterials, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Youji Miyamoto
- Professor, Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Hosni A, El-Beialy WR, Ezz M. Modified lateral sinus lift using disc-form silica calcium-phosphate NanoComposite and consequent implant placement. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.fdj.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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de Melo Pereira D, Habibovic P. Biomineralization-Inspired Material Design for Bone Regeneration. Adv Healthc Mater 2018; 7:e1800700. [PMID: 30240157 DOI: 10.1002/adhm.201800700] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/23/2018] [Indexed: 12/22/2022]
Abstract
Synthetic substitutes of bone grafts, such as calcium phosphate-based ceramics, have shown some good clinical successes in the regeneration of large bone defects and are currently extensively used. In the past decade, the field of biomineralization has delivered important new fundamental knowledge and techniques to better understand this fascinating phenomenon. This knowledge is also applied in the field of biomaterials, with the aim of bringing the composition and structure, and hence the performance, of synthetic bone graft substitutes even closer to those of the extracellular matrix of bone. The purpose of this progress report is to critically review advances in mimicking the extracellular matrix of bone as a strategy for development of new materials for bone regeneration. Lab-made biomimicking or bioinspired materials are discussed against the background of the natural extracellular matrix, starting from basic organic and inorganic components, and progressing into the building block of bone, the mineralized collagen fibril, and finally larger, 2D and 3D constructs. Moreover, bioactivity studies on state-of-the-art biomimicking materials are discussed. By addressing these different topics, an overview is given of how far the field has advanced toward a true bone-mimicking material, and some suggestions are offered for bridging current knowledge and technical gaps.
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Affiliation(s)
- Daniel de Melo Pereira
- MERLN Institute for Technology-Inspired Regenerative Medicine; Maastricht University; P.O. Box 616 6200 MD Maastricht The Netherlands
| | - Pamela Habibovic
- MERLN Institute for Technology-Inspired Regenerative Medicine; Maastricht University; P.O. Box 616 6200 MD Maastricht The Netherlands
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Effects of boric acid on bone formation after maxillary sinus floor augmentation in rabbits. Oral Maxillofac Surg 2018; 22:443-450. [PMID: 30345483 DOI: 10.1007/s10006-018-0729-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/09/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Augmentation of the maxillary sinus floor with bone grafting is commonly used for successful treatment of edentulous posterior maxilla with dental implants, and it is essential to maintain good bone volume and quality for long-term success of dental implants. The aim of this experimental study was to investigate the local and systemic effects of boric acid on new bone formation after maxillary sinus floor augmentation (MSFA). MATERIALS AND METHODS Twenty-four male, New Zealand rabbits were randomly divided into three groups with eight rabbits each, and bilateral MSFA was performed in each animal. An autogenous bone/xenograft mixture was used to augment the maxillary sinuses in each group. Group 1 was determined as control with no additional materials, whereas 3 mg/kg boric acid (BA) was added to the mixture in group 2, and 3 mg/kg boric acid solution added to drinking water daily in group 3. RESULTS The animals were sacrificed and also histologic, histomorphometric, and immunnohistochemical analyses were performed at weeks 4 and 8. At week 4, bone regeneration was better in the local BA group than in the control and systemic BA groups (p < 0.05). However, no significant difference was found among the groups in terms of bone regeneration at the end of week 8 (p > 0.05). CONCLUSION Significant higher new bone formation was revealed by BA at early healing especially with local application. BA may be a therapeutic option for improving the bone regeneration.
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Long-Term Effects of Bone Morphogenetic Protein-2-Loaded Calcium Phosphate on Maxillary Sinus Lift Surgery for Delayed and Simultaneous Dental Implantation. J Craniofac Surg 2018; 29:e58-e61. [PMID: 29040148 DOI: 10.1097/scs.0000000000004039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Maxillary sinus lift surgery (MSLS) is considered to be a useful treatment method for patients with atrophic alveolar bone. Choosing a suitable surgical procedure to simultaneously decrease graft absorption and obtain long-term survival of dental implants is still a challenge. In this study, 20 patients received MSLS with graft of bone morphogenetic protein 2 (BMP2)-loaded calcium phosphate. Dental implants were placed simultaneously in 10 patients receiving MSLS (1-stage group), and in 10 patients receiving dental implants with a 3 to 6 months delay (2-stage group). The effects were evaluated based on clinical and radiographic examination during a 4 to 5 years follow-up. The results showed that only 1 perforation of the maxillary sinus mucosa was observed in 1-stage group, and was patched with a collagen membrane. An average bone gain of 6.8 mm was observed, and all implants exhibited no looseness, peri-implantitis, or fracture, all of which were stable during the follow-up and exhibited nice dental function during a 4 to 5 years follow-up. The loss of peri-implant bone height was 1.12 ± 0.47 and 1.10 ± 0.39 mm, the probing depth of periodontal pocket was 1.79 ± 0.62 and 1.81 ± 0.71 mm, the sulcular bleeding index was 1.63 ± 0.47 and 1.72 ± 0.54 in 1-stage group and 2-stage group, respectively, and no significant differences existed between these 2 groups. These findings implied that BMP2-loaded calcium phosphate may be a suitable material for MSLS, especially for patients with minimal bone height. Clinicians can use the 1- or 2-stage technique based on clinical condition, patients' choice and clinicians' experience. In patients where implants cannot be stabilized for patients with minimal bone height, 2-stage surgery may be more suitable.
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Abstract
Systematic reviews of literature over the period between 2008 and 2017 are discussed regarding clinical evidence for the factors affecting survival and failure of dental implants. The factors addressed include publication bias, tooth location, insertion torque, collar design, implant-abutment connection design, implant length, implant width, bone augmentation, platform switching, surface roughness, implant coatings, and the use of ceramic materials in the implant body and abutment.
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Affiliation(s)
- Jason A Griggs
- Biomedical Materials Science, The University of Mississippi Medical Center School of Dentistry, 2500 North State Street, Room D528, Jackson, MS 39216-4505, USA.
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Menezes JD, Pereira RDS, Bonardi JP, Griza GL, Okamoto R, Hochuli-Vieira E. Bioactive glass added to autogenous bone graft in maxillary sinus augmentation: a prospective histomorphometric, immunohistochemical, and bone graft resorption assessment. J Appl Oral Sci 2018; 26:e20170296. [PMID: 29898173 PMCID: PMC6007965 DOI: 10.1590/1678-7757-2017-0296] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 01/05/2018] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to compare the bone resorption rate, histomorphometry and immunohistochemical findings of bioactive glass (Biogran; Biomet, Warsaw, IN, USA) mixed with autogenous bone grafts (1:1) and autogenous bone graft isolate in maxillary sinus elevation surgery. Material and Methods A total of 9 maxillary sinuses were grafted with Biogran with autogenous bone graft (group 1) and 12 were mixed with autogenous bone graft (group 2). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T1), and 6 months later, another CBCT scan was performed to evaluate the final graft volume (T2) and determine the graft resorption rate. The resorption outcomes were 37.9%±18.9% in group 1 and 45.7%±18.5% in group 2 (P=0.82). After 6 months, biopsies were obtained concurrent with the placement of dental implants; these implants were subjected to histomorphometric analysis and immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). Results The average bone formation in group 1 was 36.6%±12.9 in the pristine bone region, 33.2%±13.3 in the intermediate region, and 45.8%±13.8 in the apical region; in group 2, the values were 34.4%±14.4, 35.0%±13.9, and 42.0%±16.6 of new bone formation in the pristine bone, intermediate, and apical regions, respectively. Immunostaining for TRAP showed poor clastic activity in both groups, which can indicate that those were in the remodeling phase. Conclusions The similarity between the groups in the formation and maintenance of the graft volume after 6 months suggests that the bioactive glass mixed with autogenous bone (1:1) can be used safely as a bone substitute for the maxillary sinus lift.
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Affiliation(s)
- Juliana Dreyer Menezes
- Univ. Estadual Paulista , Faculdade de Odontologia de Araraquara , Araraquara , São Paulo , Brasil
| | | | - João Paulo Bonardi
- Univ. Estadual Paulista , Faculdade de Odontologia de Araçatuba , Araçatuba , São Paulo , Brasil
| | - Geraldo Luiz Griza
- Univ. Estadual Paulista , Faculdade de Odontologia de Araçatuba , Araçatuba , São Paulo , Brasil
| | - Roberta Okamoto
- Univ. Estadual Paulista , Faculdade de Odontologia de Araçatuba , Departamento de Ciências Básicas , Araçatuba , São Paulo , Brasil
| | - Eduardo Hochuli-Vieira
- Univ. Estadual Paulista , Faculdade de Odontologia de Araraquara , Departamento de Cirurgia e Diagnóstico , Araraquara , São Paulo , Brasil
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Maxillary Sinus Augmentation for Dental Implant Rehabilitation of the Edentulous Ridge: A Comprehensive Overview of Systematic Reviews. IMPLANT DENT 2018; 26:438-464. [PMID: 28520572 DOI: 10.1097/id.0000000000000606] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The objective of this systemic review was to perform a comprehensive overview of systematic reviews and meta-analyses of the maxillary sinus augmentation procedure for implant rehabilitation in humans. The following were evaluated in this overview: (1) anatomic variables affecting sinus augmentation, (2) histomorphometric analysis of the grafted sinus, (3) volumetric changes after sinus grafting, and (4) implant survival beyond 1 year. MATERIAL AND METHODS Electronic databases were searched for systematic reviews and meta-analyses of implant-related sinus augmentation published from 1976 to September 2015. The studies selected must identify itself as a systemic review or meta-analysis in the title or abstract and must pertain to sinus augmentation. RESULTS Thirty-three publications fulfilled the review criteria. The AMSTAR ratings for the 33 chosen reviews scored greater than 3 of 11, with 8 reviews scoring greater or equal to 8 of 11. CONCLUSION The outcome of this overview suggested that the following will increase the success of sinus augmentation and survival of implants placed in the grafted sinus: (1) the use of barrier membranes over the lateral window when using a lateral approach to graft the sinus, (2) the use of particulate autogenous bone with or without other substitute graft materials, (3) sinus augmentation without the use of grafting materials may be considered provided that the space between the sinus membrane and floor can be maintained, (4) the use of rough-surfaced implants, (5) simultaneous implant placement with residual bone height greater than 4 mm, and (6) the cessation of smoking.
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Patient-Reported Outcomes After Lateral Wall Sinus Floor Elevation: A Systematic Review. IMPLANT DENT 2018; 27:236-245. [PMID: 29319545 DOI: 10.1097/id.0000000000000717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this systematic review is to assess patient-reported outcome measures (PROMs) after a sinus lift elevation by means of a lateral approach. MATERIAL AND METHODS An electronic search was performed to search for eligible publications reporting PROMs after a lateral wall sinus lift procedure. Selected articles were further scrutinized and underwent a quality check before inclusion in a final study pool. RESULTS The electronic search provided us with 2444 articles of which 98 were further examined through a full-text analysis. Of these 98 studies, 11 were selected based on our inclusion and exclusion criteria. Results on a different number of PROMs were examined and compared: pain, edema, ability to eat, ability to work, phonetics, daily activities, bleeding, bruising, ability to sleep, bad breath, patient preference, and Oral Health Impact Profile-14 (OHIP-14). Methods of evaluation were 3- to 5-point scales, visual analog scale scores, and OHIP-14 questionnaires. Evaluation time points differed between 1 single evaluation time to a daily registration during 1 week. CONCLUSIONS A general peak in discomfort could be noticed on day 1 postoperatively with a general decline thereafter. Severe morbidity or discomfort occurred but not in most patients.
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Márton K, Tamás SB, Orsolya N, Béla C, Ferenc D, Péter N, Csaba DN, Lajos C, Zsombor L, Eitan M, György S. Microarchitecture of the Augmented Bone Following Sinus Elevation with an Albumin Impregnated Demineralized Freeze-Dried Bone Allograft (BoneAlbumin) versus Anorganic Bovine Bone Mineral: A Randomized Prospective Clinical, Histomorphometric, and Micro-Computed Tomography Study. MATERIALS 2018; 11:ma11020202. [PMID: 29382095 PMCID: PMC5848899 DOI: 10.3390/ma11020202] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 12/15/2022]
Abstract
Serum albumin has been identified as an endogenous protein that is integral to early bone regeneration. We hypothesized that albumin addition to allografts may result in better bone remodeling than what can be achieved with anorganic xenografts. Sinus elevations were performed at 32 sites of 18 patients with the lateral window technique. Sites either received filling with an anorganic bovine bone mineral (ABBM, BioOss, Geistlich, CH) or albumin impregnated allograft (BoneAlbumin, OrthoSera, AT). After 6-months patients received dental implants and 16 bone core biopsy samples were obtained from the ABBM filled, and 16 from the BoneAlbumin augmented sites. The biopsies were examined by histomorphometry and µCT. Percentage of the residual graft in the BoneAlbumin group was 0–12.7%, median 5.4% vs. ABBM 6.3–35.9%, median 16.9%, p < 0.05. Results of the µCT analysis showed that the microarchitecture of the augmented bone in the BoneAlbumin group resembles that of the native maxilla in morphometric parameters Trabecular Pattern Factor and Connectivity. Our data show that while ABBM successfully integrates into the newly formed bone tissue as persisting particles, BoneAlbumin is underway towards complete remodeling with new bone closely resembling that of the intact maxilla.
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Affiliation(s)
- Kivovics Márton
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40, 1088 Budapest, Hungary; (N.O.); (C.B.)
- Correspondence: ; Tel.: +36-20-360-1909
| | - Szabó Bence Tamás
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi utca 47, 1088 Budapest, Hungary; (S.B.T.); (D.-N.C.)
| | - Németh Orsolya
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40, 1088 Budapest, Hungary; (N.O.); (C.B.)
| | - Czinkóczky Béla
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40, 1088 Budapest, Hungary; (N.O.); (C.B.)
| | - Dőri Ferenc
- Department of Periodontology, Semmelweis University, Szentkirályi utca 47, 1088 Budapest, Hungary;
| | - Nagy Péter
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary;
| | - Dobó-Nagy Csaba
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi utca 47, 1088 Budapest, Hungary; (S.B.T.); (D.-N.C.)
| | - Csönge Lajos
- Petz Aladár County Hospital, West Hungarian Regional Tissue Bank, Vasvári Pál u. 2–4, 9024 Győr, Hungary;
| | - Lacza Zsombor
- Institute of Clinical Experimental Research, Semmelweis University, Tűzoltó u. 37–47, 1094 Budapest, Hungary;
| | - Mijiritsky Eitan
- Department of Oral Rehabilitation, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel;
| | - Szabó György
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52, 1085 Budapest, Hungary;
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Fernandez de Grado G, Keller L, Idoux-Gillet Y, Wagner Q, Musset AM, Benkirane-Jessel N, Bornert F, Offner D. Bone substitutes: a review of their characteristics, clinical use, and perspectives for large bone defects management. J Tissue Eng 2018; 9:2041731418776819. [PMID: 29899969 PMCID: PMC5990883 DOI: 10.1177/2041731418776819] [Citation(s) in RCA: 356] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 04/24/2018] [Indexed: 12/13/2022] Open
Abstract
Bone replacement might have been practiced for centuries with various materials of natural origin, but had rarely met success until the late 19th century. Nowadays, many different bone substitutes can be used. They can be either derived from biological products such as demineralized bone matrix, platelet-rich plasma, hydroxyapatite, adjunction of growth factors (like bone morphogenetic protein) or synthetic such as calcium sulfate, tri-calcium phosphate ceramics, bioactive glasses, or polymer-based substitutes. All these substitutes are not suitable for every clinical use, and they have to be chosen selectively depending on their purpose. Thus, this review aims to highlight the principal characteristics of the most commonly used bone substitutes and to give some directions concerning their clinical use, as spine fusion, open-wedge tibial osteotomy, long bone fracture, oral and maxillofacial surgery, or periodontal treatments. However, the main limitations to bone substitutes use remain the management of large defects and the lack of vascularization in their central part, which is likely to appear following their utilization. In the field of bone tissue engineering, developing porous synthetic substitutes able to support a faster and a wider vascularization within their structure seems to be a promising way of research.
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Affiliation(s)
- Gabriel Fernandez de Grado
- INSERM (French National Institute of Health and Medical Research), “Regenerative Nanomedicine” laboratory, http://www.regmed.fr, UMR 1260, Faculté de Médecine, FMTS, F-67085 Strasbourg Cedex
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Ste Elisabeth, F-67000 Strasbourg
- Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, F-67000 Strasbourg
| | - Laetitia Keller
- INSERM (French National Institute of Health and Medical Research), “Regenerative Nanomedicine” laboratory, http://www.regmed.fr, UMR 1260, Faculté de Médecine, FMTS, F-67085 Strasbourg Cedex
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Ste Elisabeth, F-67000 Strasbourg
| | - Ysia Idoux-Gillet
- INSERM (French National Institute of Health and Medical Research), “Regenerative Nanomedicine” laboratory, http://www.regmed.fr, UMR 1260, Faculté de Médecine, FMTS, F-67085 Strasbourg Cedex
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Ste Elisabeth, F-67000 Strasbourg
| | - Quentin Wagner
- INSERM (French National Institute of Health and Medical Research), “Regenerative Nanomedicine” laboratory, http://www.regmed.fr, UMR 1260, Faculté de Médecine, FMTS, F-67085 Strasbourg Cedex
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Ste Elisabeth, F-67000 Strasbourg
| | - Anne-Marie Musset
- INSERM (French National Institute of Health and Medical Research), “Regenerative Nanomedicine” laboratory, http://www.regmed.fr, UMR 1260, Faculté de Médecine, FMTS, F-67085 Strasbourg Cedex
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Ste Elisabeth, F-67000 Strasbourg
- Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, F-67000 Strasbourg
| | - Nadia Benkirane-Jessel
- INSERM (French National Institute of Health and Medical Research), “Regenerative Nanomedicine” laboratory, http://www.regmed.fr, UMR 1260, Faculté de Médecine, FMTS, F-67085 Strasbourg Cedex
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Ste Elisabeth, F-67000 Strasbourg
| | - Fabien Bornert
- INSERM (French National Institute of Health and Medical Research), “Regenerative Nanomedicine” laboratory, http://www.regmed.fr, UMR 1260, Faculté de Médecine, FMTS, F-67085 Strasbourg Cedex
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Ste Elisabeth, F-67000 Strasbourg
- Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, F-67000 Strasbourg
| | - Damien Offner
- INSERM (French National Institute of Health and Medical Research), “Regenerative Nanomedicine” laboratory, http://www.regmed.fr, UMR 1260, Faculté de Médecine, FMTS, F-67085 Strasbourg Cedex
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Ste Elisabeth, F-67000 Strasbourg
- Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, F-67000 Strasbourg
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Maxillary Sinus Floor Augmentation Using an Equine-Derived Graft Material: Preliminary Results in 17 Patients. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9164156. [PMID: 29209631 PMCID: PMC5676360 DOI: 10.1155/2017/9164156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 10/04/2017] [Indexed: 02/03/2023]
Abstract
Objective Sinus floor elevation with lateral approach is probably the most frequently performed reconstructive procedure to rehabilitate posterior maxilla when a bone deficiency is present. Different graft materials have been proposed and tested, often with high clinical performances and predictable results. Histological analysis is required when evaluating new materials. We investigated human biopsies retrieved after sinus floor elevation procedure by histomorphometric evaluation to test the performance of an equine-derived bone grafting material. Study Design Seventeen consecutive patients were enrolled and sinus lift surgeries were performed using an equine bone graft. Six months after surgery, at implant placement, bone samples were collected. Histomorphometry analysis was carried out on decalcified samples. Results All surgeries were uneventful and no additional grafting was required prior to implant insertion. Forty percent of new bone formation was detected, which represented the most abundant tissue retrieved, followed by the residual graft material (33%) and fibrous tissue (27%). A significant reduction in particles size demonstrates a remodeling activity of the graft material. Conclusion Within the limitations of this study, this equine-derived bone graft proved to be an effective material to induce new bone formation in the sinus floor elevation procedure.
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Parra M, Olate S, Cantín M. Clinical and biological analysis in graftless maxillary sinus lift. J Korean Assoc Oral Maxillofac Surg 2017; 43:214-220. [PMID: 28875135 PMCID: PMC5583195 DOI: 10.5125/jkaoms.2017.43.4.214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/05/2016] [Accepted: 08/26/2016] [Indexed: 11/07/2022] Open
Abstract
Maxillary sinus lift for dental implant installation is a well-known and versatile technique; new techniques are presented based on the physiology of intrasinus bone repair. The aim of this review was to determine the status of graftless maxillary sinus lift and analyze its foundations and results. A search was conducted of the literature between 1995 and 2015 in the Medline, ScienceDirect, and SciELO databases using the keywords "maxillary sinus lift," "blood clot," "graftless maxillary sinus augmentation," and "dental implant placement." Ten articles were selected for our analysis of this technique and its results. Despite the limited information, cases that were followed for at least six months and up to four years had a 90% success rate. Published techniques included a lateral window, elevation of the sinus membrane, drilling and dental implant installation, descent of the membrane with variations in the installation of the lateral wall access and suturing. The physiology behind this new bone formation response and the results of the present research were also discussed. We concluded that this is a promising and viable technique under certain inclusion criteria.
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Affiliation(s)
- Marcelo Parra
- Master in Dental Science Program, Universidad de La Frontera, Temuco, Chile
| | - Sergio Olate
- Department of Oral and Maxillofacial Surgery, Universidad de La Frontera, Temuco, Chile.,Center of Excellence in Surgical and Morphological Studies (CEMYQ), Universidad de La Frontera, Temuco, Chile.,Center for Biomedical Research, Universidad Autónoma de Chile, Temuco, Chile
| | - Mario Cantín
- Center of Excellence in Surgical and Morphological Studies (CEMYQ), Universidad de La Frontera, Temuco, Chile.,Center for Biomedical Research, Universidad Autónoma de Chile, Temuco, Chile
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Nizam N, Eren G, Akcalı A, Donos N. Maxillary sinus augmentation with leukocyte and platelet-rich fibrin and deproteinized bovine bone mineral: A split-mouth histological and histomorphometric study. Clin Oral Implants Res 2017; 29:67-75. [PMID: 28786494 DOI: 10.1111/clr.13044] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the effect of leukocyte and platelet-rich fibrin (L-PRF) in combination with deproteinized bovine bone mineral (DBBM) on bone regeneration in maxillary sinus augmentation. MATERIAL AND METHODS Thirteen patients (nine males and four females, mean age ± SD; 49.92 ± 10.37) were enrolled to the study. 26 maxillary sinus augmentation procedures were randomly performed using DBBM and L-PRF mixture (test) or DBBM alone (control) in a split-mouth design. The same surgical procedures were performed in both groups, and bone biopsies were harvested from the implant sites 6 months postoperatively for histological and histomorphometric evaluations as the primary outcome of the study. Implants were placed and then loaded in the augmented sites after 6 months. The secondary outcomes included clinical and radiographic data and were obtained pre- and postoperatively. RESULTS There was no qualitative difference in histological analyses among the groups. In all samples, a newly formed bone was in direct contact with the residual material. The percentages of newly formed bone (test; 21.38 ± 8.78% and control; 21.25 ± 5.59%), residual bone graft (test; 25.95 ± 9.54% and control; 32.79 ± 5.89%), bone graft in contact with the newly formed bone (test; 47.33 ± 12.33% and control; 54.04 ± 8.36%), and soft tissue (test; 52.67 ± 12.53% and control; 45.96 ± 8.36%) were similar among the groups (p < .05). Similar radiographic bone height in the augmented area was observed, and implant survival rate was 100% for both groups. CONCLUSIONS Both techniques were effective for maxillary sinus augmentation, and after 6 months of healing, the addition of L-PRF in DBBM did not improve the amount of regenerated bone or the amount of the graft integrated into the newly formed bone under histological and histomorphometric evaluation.
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Affiliation(s)
- Nejat Nizam
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Gülnihal Eren
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Aliye Akcalı
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.,Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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Histologic and Histomorphometric Comparison between Sintered Nanohydroxyapatite and Anorganic Bovine Xenograft in Maxillary Sinus Grafting: A Split-Mouth Randomized Controlled Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9489825. [PMID: 28845435 PMCID: PMC5563399 DOI: 10.1155/2017/9489825] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/25/2017] [Indexed: 12/30/2022]
Abstract
The presence of vital bone after maxillary sinus augmentation is crucial to enhance the quality of bone-implant interface, ensuring predictable long-term results. The aims of this RCT with split-mouth design were the histologic and histomorphometric comparison of two different biomaterials in sinus elevation after 6 months of healing and the evaluation of the clinical outcomes of implants inserted in the augmented areas after 12 months of prosthetic loading. Twenty-eight patients (10 females, 18 males) were treated with bilateral sinus floor elevation with lateral approach. Pure sintered nanohydroxyapatite (NHA) and anorganic bovine bone (ABB) were used as test and active control, respectively. After six months, 52 bone biopsies were harvested from 26 patients, and 107 implants were inserted in the augmented areas. Histomorphometry showed that, in the two groups, vital bone percentages were 34.9 ± 15% (NHA) and 38.5 ± 17% (ABB) (p = 0.428), marrow spaces percentages were 44.5 ± 18% (NHA) and 43.5 ± 23% (ABB) (p = 0.866), and residual graft percentages were 20.6 ± 13% (NHA) and 22.3 ± 12% (ABB) (p = 0.638). After 6 months of healing, no statistically significant difference was present in histomorphometric outcomes between NHA and ABB groups. Implant survival rate in NHA group after 12 months of loading was 96.4%, showing no statistically significant differences with ABB group.
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Yilmaz S, Ozden B, Bas B, Altun G, Altunkaynak BZ. Could Calcified Triglyceride Bone Cement Be an Alternative Graft Material in Maxillary Sinus Augmentation? J Craniofac Surg 2017; 28:97-103. [PMID: 27977491 DOI: 10.1097/scs.0000000000003236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The ideal graft material for maxillary sinus augmentation is still a matter of controversy and the search for a more appropriate bone substitute for use continues. The aim of this study was to evaluate bone formation as a sign of the regeneration following maxillary sinus augmentation in rabbits using 3 different biomaterials, one of which is a newly developed graft material; calcified triglyceride bone cement (CTBC).Twenty-one New Zealand rabbits were used and randomly divided into 3 groups. Bilateral maxillary sinus augmentation was carried out and autogenous bone (AB), bovine hydroxyapatite (BHA), and CTBC were administered. Maxillary sinuses were dissected after fourth and eighth weeks of the operation. The bone formation was evaluated by stereological and histopathological analysis and the data were analyzed statistically.When the volume of primary bone is compared, statistically significant differences were found among all groups at both of the fourth and eighth weeks. The highest value was obtained from AB applied group. In BHA and CTBC applied groups, active bone formation, osseointegration of graft materials were observed at both fourth and eighth weeks. In CTBC applied group, primary bone formation was only seen as linked to the continuation of parent sinus bony wall.The efficiency of primary bone formation of CTBC was found less than AB and BHA. Of the 3 graft materials tested, BHA is the strongest alternative to AB graft for maxillary sinus augmentation.
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Affiliation(s)
- Seda Yilmaz
- *Department of Oral and Maxillofacial Surgery, Private Dental Clinic, Istanbul †Department of Oral and Maxillofacial Surgery, Faculty of Dentistry ‡Department of Histology and Embryology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Pereira RDS, Menezes JD, Bonardi JP, Griza GL, Okamoto R, Hochuli-Vieira E. Histomorphometric and immunohistochemical assessment of RUNX2 and VEGF of Biogran™ and autogenous bone graft in human maxillary sinus bone augmentation: A prospective and randomized study. Clin Implant Dent Relat Res 2017; 19:867-875. [PMID: 28608398 DOI: 10.1111/cid.12507] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Few studies have been conducted to assess new bone formation using Biogran, a bioactive glass, in maxillary sinus bone augmentation through a prospective and randomized evaluation. Moreover, there are no studies that evaluate cellular behavior by immunohistochemical assessment for osteoblastic and vascular activity during bone repair. PURPOSE The aim of this study is to compare new bone formation and cellular behavior with Biogran alone, a 1:1 combination of Biogran and autogenous bone graft, and autogenous bone graft alone in human maxillary sinuses. MATERIALS AND METHODS Ten maxillary sinuses were grafted with Biogran (Group 1), 10 grafted with Biogran added to autogenous bone graft in a 1:1 ratio (Group 2), and 10 grafted with autogenous bone graft alone (Group 3). After 6 months of bone healing, samples were obtained concurrent to the dental implants' placement to be evaluated by histomorphometric and immunohistochemical assessment for RUNX2 and vascular endothelial growth factor (VEGF). RESULTS The amount of new bone formation in Group 1 was 42.0 ± 7.3% in the pristine bone region, 40.7 ± 14.0% in the intermediate region, and 45.6 ± 13.5% in apical region. In Group 2, for pristine bone, intermediate, and apical regions, new bone formation was 36.6 ± 12.9%, 33.2 ± 13.3%, and 45.8 ± 13.9%, respectively. Group 3 showed new bone formation of 37.3 ± 11.6%, 35.3 ± 14.7%, and 39.9 ± 15.8% in pristine bone, intermediate, and apical regions, respectively. The immunolabeling for RUNX2 showed low cellular activity in osteoblasts for all groups, and the VEGF assessment demonstrated moderate cellular activity in Groups 1 and 2; however, Group 3 presented with low activity in the pristine bone region, followed by moderate activity in the intermediate and apical region. CONCLUSION This study demonstrates that Biogran and its combination with autogenous bone graft 1:1 are good bone substitutes due to their similarity to autogenous bone graft.
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Affiliation(s)
| | - Juliana Dreyer Menezes
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
| | - João Paulo Bonardi
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
| | - Geraldo Luiz Griza
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
| | - Roberta Okamoto
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
| | - Eduardo Hochuli-Vieira
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
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Maxillary Sinus Floor Augmentation Using Biphasic Calcium Phosphate and a Hydrogel Polyethylene Glycol Covering Membrane: An Histological and Histomorphometric Evaluation. IMPLANT DENT 2017; 25:599-605. [PMID: 27548109 DOI: 10.1097/id.0000000000000435] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Maxillary sinus floor augmentation with a lateral approach is usually performed using a bone substitute covered with standard collagen or a synthetic barrier membrane to prevent soft tissue ingrowth within the bone graft. The purpose of this case series was to evaluate a polyethylene glycol (PEG) membrane with a hydrogel consistency, used to protect the lateral sinus anstrotomy, by analyzing the histological quality and histomorphometric quantity of newly formed bone (NB) in a maxillary sinus graft using biphasic calcium phosphate (BCP). MATERIALS AND METHODS Fifteen sinuses were grafted from 12 patients. Six months after the maxillary sinus floor augmentation, bone biopsies were harvested from 7 patients during the implant placement second-step surgery. RESULTS The histomorphometric evaluation of the 7 grafted sinuses showed mean values of 27.4 ± 4.6% for NB, 26.9 ± 5.4% for remaining BCP particles, and 45.7 ± 6.0% for connective tissue/bone marrow. No implant failure was observed in the 14- to 45-month follow-up period after maxillary sinus floor augmentation procedure and in the 8- to 39-month follow-up period after implant loading. CONCLUSION The use of a hydrogel PEG membrane to protect BCP proved to be a valuable grafting procedure to enhance the vital bone formation in the maxillary sinus floor augmentation procedure.
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Zamuner A, Brun P, Scorzeto M, Sica G, Castagliuolo I, Dettin M. Smart biomaterials: Surfaces functionalized with proteolytically stable osteoblast-adhesive peptides. Bioact Mater 2017; 2:121-130. [PMID: 29744421 PMCID: PMC5935176 DOI: 10.1016/j.bioactmat.2017.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/09/2017] [Accepted: 05/09/2017] [Indexed: 02/07/2023] Open
Abstract
Engineered scaffolds for bone tissue regeneration are designed to promote cell adhesion, growth, proliferation and differentiation. Recently, covalent and selective functionalization of glass and titanium surfaces with an adhesive peptide (HVP) mapped on [351-359] sequence of human Vitronectin allowed to selectively increase osteoblast attachment and adhesion strength in in vitro assays, and to promote osseointegration in in vivo studies. For the first time to our knowledge, in this study we investigated the resistance of adhesion sequences to proteolytic digestion: HVP was completely cleaved after 5 h. In order to overcome the enzymatic degradation of the native peptide under physiological conditions we synthetized three analogues of HVP sequence. A retro-inverted peptide D-2HVP, composed of D amino acids, was completely stable in serum-containing medium. In addition, glass surfaces functionalized with D-2HVP increased human osteoblast adhesion as compared to the native peptide and maintained deposition of calcium. Interestingly, D-2HVP increased expression of IBSP, VTN and SPP1 genes as compared to HVP functionalized surfaces. Total internal reflection fluorescence microscope analysis showed cells with numerous filopodia spread on D-2HVP-functionalized surfaces. Therefore, the D-2HVP sequence is proposed as new osteoblast adhesive peptide with increased bioactivity and high proteolytic resistance.
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Affiliation(s)
- Annj Zamuner
- Department of Industrial Engineering, University of Padova, Via F. Marzolo 9, 35131, Padova, Italy
| | - Paola Brun
- Department of Molecular Medicine, University of Padova, Via A. Gabelli 63, 35121, Padova, Italy
| | - Michele Scorzeto
- Department of Biomedical Sciences, University of Padova, Via U. Bassi 58/B, 35131, Padova, Italy
| | - Giuseppe Sica
- Department of Industrial Engineering, University of Padova, Via F. Marzolo 9, 35131, Padova, Italy
| | - Ignazio Castagliuolo
- Department of Molecular Medicine, University of Padova, Via A. Gabelli 63, 35121, Padova, Italy
| | - Monica Dettin
- Department of Industrial Engineering, University of Padova, Via F. Marzolo 9, 35131, Padova, Italy
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50
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Kim CH, Ju MH, Kim BJ. Comparison of recombinant human bone morphogenetic protein-2-infused absorbable collagen sponge, recombinant human bone morphogenetic protein-2-coated tricalcium phosphate, and platelet-rich fibrin-mixed tricalcium phosphate for sinus augmentation in rabbits. J Dent Sci 2017; 12:205-212. [PMID: 30895052 PMCID: PMC6400000 DOI: 10.1016/j.jds.2017.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/02/2022] Open
Abstract
Background/purpose Numerous grafting materials have been used in the bone regeneration of maxillary sinus to obtain a sufficient amount of new bone in implant dentistry. The objective of this study was to compare the potentials of Type I absorbable collagen sponge (ACS) impregnated with recombinant human bone morphogenetic protein (rhBMP)-2, rhBMP-2-coated tricalcium phosphate (TCP), platelet-rich fibrin-mixed TCP for enhancing bone regeneration in sinus augmentation in rabbits. Materials and methods The sinus defects were grafted with rhBMP-2+ACS (Group A), rhBMP-2-coated TCP (Group B), and platelet-rich fibrin-mixed TCP (Group C). The specimens underwent decalcification, and were stained for histomorphometric analysis. Results There were no significant differences in inflammatory features among the groups 1-week postoperation. In a histomorphometric analysis, the new bone formation ratio showed significant differences between groups at 2 weeks. rhBMP-2+ACS showed a larger and more rapid bone formation area at 2 weeks than those of Groups B and C. Conclusion Our histological evaluation demonstrates that Type I ACS can be used as a carrier of rhBMP-2, and rhBMP-2+ACS showed rapid bone formation, remodeling, and calcification at Week 2 in rabbit.
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Affiliation(s)
- Chul-Hun Kim
- Department of Oral and Maxillofacial Surgery, Assistant Professor, Dong-a Univ. College of Medicine, Busan, South Korea
| | - Mi-Ha Ju
- Department of Pathology, Faculty of Pathology, Dong-a University College of Medicine, Busan, South Korea
| | - Bok-Joo Kim
- Department of Oral and Maxillofacial Surgery, Assistant Professor, Dong-a Univ. College of Medicine, Busan, South Korea
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