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Apaza-Bedoya K, Magrin GL, Romandini M, Blanco-Carrión J, Benfatti CAM. Efficacy of alveolar ridge preservation with xenografts and resorbable socket sealing materials in the esthetic region: A systematic review with meta-analyses. Clin Implant Dent Relat Res 2024; 26:4-14. [PMID: 37674334 DOI: 10.1111/cid.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/02/2023] [Accepted: 07/18/2023] [Indexed: 09/08/2023]
Abstract
AIM The present systematic review aimed to identify and summarize the clinical, radiographic, and histological outcomes of alveolar ridge preservation using bone xenografts and absorbable sealing materials compared with spontaneous healing in the esthetic zone. MATERIALS AND METHODS Randomized clinical trials (RCTs) fulfilling specific eligibility criteria were included. Two review authors independently searched for eligible studies, extracted data from the published reports and performed the risk of bias assessment (RoB 2 tool). Study results were summarized using random effects meta-analyses. RESULTS Thirteen articles concerning 10 RCTs were included, involving a total of 357 participants. Most of studies were considered as "low" risk of bias. Meta-analyses indicated less horizontal (difference in means-MD = 1.88 mm; p < 0.001), vertical mid-buccal (MD = 1.84 mm; p < 0.001) and vertical mid-lingual (MD = 2.27 mm; p < 0.001) bone resorption in alveolar ridge preservation compared to spontaneous healing as assessed clinically. Bone changes assessed radiographically showed consistent results in terms of horizontal (at 1 mm: MD = 1.84 mm, p < 0.001), vertical mid-buccal (MD = 0.95 mm; p < 0.001) and mid-lingual (MD = 0.62 mm; p = 0.05) resorption. Part of the bone resorption in the spontaneous healing group was compensated by soft-tissues, since the observed differences between groups in linear ridge reduction evaluated through cast models superimposition were smaller (MD = 0.52 mm; p < 0.001). CONCLUSIONS Alveolar ridge preservation with xenogeneic bone substitutes and non-autogenous resorbable socket sealing materials is efficacious in reducing post-extraction bone and ridge changes in the esthetic region.
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Affiliation(s)
- Karin Apaza-Bedoya
- Centre for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Gabriel Leonardo Magrin
- Centre for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
- Department of Surgery and Medical-Surgical Specialties (Dentistry - Unit of Periodontology), Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Mario Romandini
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Juan Blanco-Carrión
- Department of Surgery and Medical-Surgical Specialties (Dentistry - Unit of Periodontology), Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Cesar Augusto Magalhães Benfatti
- Centre for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
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Quality Assessment of Randomized Controlled Trials Published In Journal of Maxillofacial and Oral Surgery (MAOS) From 2009–2021 Using RoB-2.0 Tool. J Maxillofac Oral Surg 2022. [DOI: 10.1007/s12663-022-01795-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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3
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Tomographic evaluation of the effect of simvastatin topical use on alveolar bone microarchitecture, pain and swelling after mandibular third molar extraction: a randomized controlled trial. Clin Oral Investig 2022; 26:3533-3545. [DOI: 10.1007/s00784-021-04322-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/24/2021] [Indexed: 11/03/2022]
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Aribau-Gumà C, Jorba-García A, Sánchez-Torres A, Sànchez-Garcés MÀ. Alveolar ridge preservation: an overview of systematic reviews. Int J Oral Maxillofac Surg 2021; 51:234-242. [PMID: 34272149 DOI: 10.1016/j.ijom.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/29/2021] [Accepted: 06/04/2021] [Indexed: 01/08/2023]
Abstract
The aim of this overview was to assess the methodological quality of systematic reviews of randomized clinical trials on alveolar ridge preservation after a tooth extraction. During March 2020, two independent reviewers performed an electronic search of the PubMed (MEDLINE), Scopus, Web of Science, and Cochrane Library databases to identify all relevant systematic reviews including randomized clinical trials on alveolar ridge preservation. A manual search of articles in renowned journals was also conducted. The methodological quality of the included reviews was determined using the AMSTAR-2 tool. From the 53 initially retrieved studies, 11 were finally included: three systematic reviews and eight systematic reviews with meta-analyses. The methodological quality of the included reviews was low or critically low. Higher quality clinical studies should be conducted prior to performing further reviews and these should meet the methodological requirements that are fundamental to this type of research.
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Affiliation(s)
- C Aribau-Gumà
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - A Jorba-García
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - A Sánchez-Torres
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; IDIBELL Institute, Barcelona, Spain.
| | - M À Sànchez-Garcés
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; IDIBELL Institute, Barcelona, Spain
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Pickert FN, Spalthoff S, Gellrich NC, Blaya Tárraga JA. Cone-beam computed tomographic evaluation of dimensional hard tissue changes following alveolar ridge preservation techniques of different bone substitutes: a systematic review and meta-analysis. J Periodontal Implant Sci 2021; 52:3-27. [PMID: 35187870 PMCID: PMC8860760 DOI: 10.5051/jpis.2007100355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 06/15/2021] [Accepted: 07/04/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Finn Niclas Pickert
- Universidad Europea de Valencia, Valencia, Spain
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Simon Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
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Couso-Queiruga E, Stuhr S, Tattan M, Chambrone L, Avila-Ortiz G. Post-extraction dimensional changes: A systematic review and meta-analysis. J Clin Periodontol 2020; 48:126-144. [PMID: 33067890 DOI: 10.1111/jcpe.13390] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 12/16/2022]
Abstract
AIM To analyse the evidence pertaining to post-extraction dimensional changes in the alveolar ridge after unassisted socket healing. MATERIALS AND METHODS The protocol of this PRISMA-compliant systematic review (SRs) was registered in PROSPERO (CRD42020178857). A literature search to identify studies that fulfilled the eligibility criteria was conducted. Data of interest were extracted. Qualitative and random-effects meta-analyses were performed if at least two studies with comparable features and variables reported the same outcome of interest. RESULTS Twenty-eight articles were selected, of which 20 could be utilized for the conduction of quantitative analyses by method of assessment (i.e. clinical vs radiographic measurements) and location (i.e. non-molar vs molar sites). Pooled estimates revealed that mean horizontal, vertical mid-facial and mid-lingual ridge reduction assessed clinically in non-molar sites was 2.73 mm (95% CI: 2.36-3.11), 1.71 mm (95% CI: 1.30-2.12) and 1.44 mm (95% CI: 0.78-2.10), respectively. Mean horizontal, vertical mid-facial and mid-lingual ridge reduction assessed radiographically in non-molar sites was 2.54 mm (95% CI: 1.97-3.11), 1.65 mm (95% CI: 0.42-2.88) and 0.87 mm (95% CI: 0.36-1.38), respectively. Mean horizontal, vertical mid-facial and mid-lingual ridge reduction assessed radiographically in molar sites was 3.61 mm (95% CI: 3.24-3.98), 1.46 mm (95% CI: 0.73-2.20) and 1.20 mm (95% CI: 0.56-1.83), respectively. CONCLUSION A variable amount of alveolar bone resorption occurs after unassisted socket healing depending on tooth type.
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Affiliation(s)
- Emilio Couso-Queiruga
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Sandra Stuhr
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Mustafa Tattan
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Leandro Chambrone
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA.,Graduate Dentistry Program, Ibirapuera University, São Paulo, Brazil.,Unit of Basic Oral Investigations, School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
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7
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Troiano G, Zhurakivska K, Lo Muzio L, Laino L, Cicciù M, Lo Russo L. Combination of bone graft and resorbable membrane for alveolar ridge preservation: A systematic review, meta-analysis, and trial sequential analysis. J Periodontol 2019; 89:46-57. [PMID: 28895779 DOI: 10.1902/jop.2017.170241] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 08/15/2017] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Alveolar ridge preservation (ARP) techniques aim to reduce resorption after tooth extraction. The combination of a graft material covered with a resorbable membrane represents one of the most common strategies performed in the clinical practice. The aim of this systematic review is to analyze evidence regarding potential benefits of ARP procedures performed with allogenic/xenogenic grafts in combination with a resorbable membrane coverage in comparison with spontaneous healing. METHODS Electronic databases were screened independently to select studies suitable for inclusion in this review. Horizontal ridge width reduction (HRWR) and vertical ridge height reduction (VRHR) were investigated as primary outcomes and volume changes (VC) as a secondary outcome. Meta-analysis was performed using the inverse of variance test with a random effect model. Adjustment for Type I and II errors and analysis of the power of evidence was performed with trial sequential analysis (TSA). RESULTS Seven studies met the inclusion criteria and were included in the quantitative synthesis. Meta-analysis revealed that the combination therapy resulted in a lower rate of resorption for both HRWR (-2.19 mm, 95% confidence interval [CI]: -2.67 to -1.71 mm) and VRHR (-1.72 mm, 95% CI: -2.14 to -1.30 mm). For VC no meta-analysis was performed due to insufficient data. Analysis of the power of the evidence performed with TSA showed that the number of both studies and sockets analyzed is sufficient to validate such findings, despite the high rate of heterogeneity. CONCLUSIONS Use of bone graft covered by a resorbable membrane can decrease the rate of alveolar ridge horizontal and vertical resorption after tooth extraction. The power and reliability of the evidence is strong enough to confirm the above-mentioned findings, despite the high rate of heterogeneity of included studies.
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Affiliation(s)
- Giuseppe Troiano
- Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy
| | | | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Marco Cicciù
- Department of Human Pathology, School of Dentistry, University of Messina, Messina, Italy
| | - Lucio Lo Russo
- Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy
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Saletta JM, Garcia JJ, Caramês JMM, Schliephake H, da Silva Marques DN. Quality assessment of systematic reviews on vertical bone regeneration. Int J Oral Maxillofac Surg 2018; 48:364-372. [PMID: 30139710 DOI: 10.1016/j.ijom.2018.07.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 06/08/2018] [Accepted: 07/25/2018] [Indexed: 12/14/2022]
Abstract
The aim of this study was to evaluate and compare the quality of systematic reviews of vertical bone regeneration techniques, using two quality-assessment tools (AMSTAR and ROBIS). An electronic literature search was conducted to identify systematic reviews or meta-analyses that would evaluate at least one of the following outcomes: implant survival, success rates, complications or bone gain after vertical ridge augmentation. Methodological quality assessment was performed by two independent evaluators. Results were compared between reviewers, and reliability measures were calculated using the Holsti's method® and Cohen's kappa. Seventeen systematic reviews were included, of which seven presented meta-analysis. Mean ±95% confidence interval AMSTAR score was 6.35 [4.74;7.97], with higher scores being correlated with a smaller risk of bias (Pearson's correlation coefficient=-0.84; P<0.01). Cohen's inter-examiner kappa showed substantial agreement for both checklists. From the available evidence, we ascertained that, regardless of the technique used, it is possible to obtain vertical bone gains. Implant success in regenerated areas was similar to implants placed in pristine bone with results equating between 61.5% and 100% with guided bone regeneration being considered the most predictable technique regarding bone stability, while distraction osteogenesis achieved the biggest bone gains with the highest risk of possible complications.
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Affiliation(s)
- J M Saletta
- Implant Department, Universidad Europea de Madrid, Madrid, Spain
| | - J J Garcia
- Implant Department, Universidad Europea de Madrid, Madrid, Spain; CIRO, Madrid, Spain
| | - J M M Caramês
- Oral Surgery and Implant Department, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Implantology Institute, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - H Schliephake
- Department of Oral and Maxillofacial Surgery, University Medicine, George-Augusta-University, Göttingen, Germany
| | - D N da Silva Marques
- Implantology Institute, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Centro de Estudos de Medicina Dentária Baseada na Evidência, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
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9
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Lee DW, Shin IS. Critical quality evaluation of network meta-analyses in dental care. J Dent 2018; 75:7-11. [DOI: 10.1016/j.jdent.2018.05.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/27/2018] [Accepted: 05/17/2018] [Indexed: 02/04/2023] Open
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10
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Mandarino D, Luz D, Moraschini V, Rodrigues DM, Barboza ESP. Alveolar ridge preservation using a non-resorbable membrane: randomized clinical trial with biomolecular analysis. Int J Oral Maxillofac Surg 2018; 47:1465-1473. [PMID: 30954146 DOI: 10.1016/j.ijom.2018.06.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 06/25/2018] [Indexed: 11/26/2022]
Abstract
The aim of this randomized clinical trial was to evaluate the newly formed tissues in post-extraction sockets and to compare ridge dimensional changes with and without the use of a dense polytetrafluoroethylene membrane (d-PTFE). Twenty human extraction sockets (lower molars and premolars) received either an intentionally exposed d-PTFE membrane (test group) or no biomaterial (control group). After 4 months, during preparation for implant placement, bone and gingival tissues were collected for histological and biomolecular analysis. Clinically, the test and control groups showed mean gains of keratinized gingiva of 4.30±1.20mm and 2.50±2.20mm, respectively. A reduction in ridge width was observed in the control (2.90±2.70mm) and test (3.30±2.00mm) groups. The bone height alteration ranged from a reduction of 0.12±1.60mm to a gain of 0.60±3.60mm on average for both groups. Analysis of gene expression (OPG/RANKL) in gingival fibroblasts and osteoblasts revealed no difference between the two groups. Ridge preservation using the d-PTFE membrane increased the formation of keratinized tissue. A reduction in width and mild reduction/gain in height of the alveolar ridge was observed in both groups. The membrane had no influence on the healing process.
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Affiliation(s)
- D Mandarino
- Department of Periodontology, Fluminense Federal University School of Dentistry, Niterói, Rio de Janeiro, Brazil
| | - D Luz
- Department of Periodontology, Fluminense Federal University School of Dentistry, Niterói, Rio de Janeiro, Brazil
| | - V Moraschini
- Department of Periodontology, Fluminense Federal University School of Dentistry, Niterói, Rio de Janeiro, Brazil
| | - D M Rodrigues
- Department of Periodontology, Fluminense Federal University School of Dentistry, Niterói, Rio de Janeiro, Brazil
| | - E S P Barboza
- Department of Periodontology, Fluminense Federal University School of Dentistry, Niterói, Rio de Janeiro, Brazil.
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Nagendrababu V, Pulikkotil SJ, Sultan OS, Jayaraman J, Peters OA. Methodological and Reporting Quality of Systematic Reviews and Meta-analyses in Endodontics. J Endod 2018; 44:903-913. [PMID: 29602531 DOI: 10.1016/j.joen.2018.02.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/07/2017] [Accepted: 02/10/2018] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The aim of this systematic review (SR) was to evaluate the quality of SRs and meta-analyses (MAs) in endodontics. METHODS A comprehensive literature search was conducted to identify relevant articles in the electronic databases from January 2000 to June 2017. Two reviewers independently assessed the articles for eligibility and data extraction. SRs and MAs on interventional studies with a minimum of 2 therapeutic strategies in endodontics were included in this SR. Methodologic and reporting quality were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), respectively. The interobserver reliability was calculated using the Cohen kappa statistic. Statistical analysis with the level of significance at P < .05 was performed using Kruskal-Wallis tests and simple linear regression analysis. RESULTS A total of 30 articles were selected for the current SR. Using AMSTAR, the item related to the scientific quality of studies used in conclusion was adhered by less than 40% of studies. Using PRISMA, 3 items were reported by less than 40% of studies, which were on objectives, protocol registration, and funding. No association was evident comparing the number of authors and country with quality. Statistical significance was observed when quality was compared among journals, with studies published as Cochrane reviews superior to those published in other journals. AMSTAR and PRISMA scores were significantly related. CONCLUSIONS SRs in endodontics showed variability in both methodologic and reporting quality.
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Affiliation(s)
- Venkateshbabu Nagendrababu
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Shaju Jacob Pulikkotil
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Omer Sheriff Sultan
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Jayakumar Jayaraman
- Division of Community and Children Oral Health, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Ove A Peters
- Department of Endodontics, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, California; The University of Queensland Dental School, UQ Oral Health Centre, Herston, Queensland, Australia
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Carmo ABXD, Sartoretto SC, Alves ATNN, Granjeiro JM, Miguel FB, Calasans-Maia J, Calasans-Maia MD. Alveolar bone repair with strontium- containing nanostructured carbonated hydroxyapatite. J Appl Oral Sci 2018; 26:e20170084. [PMID: 29364342 PMCID: PMC5777423 DOI: 10.1590/1678-7757-2017-0084] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 06/22/2017] [Indexed: 01/21/2023] Open
Abstract
Objective This study aimed to evaluate bone repair in rat dental sockets after implanting nanostructured carbonated hydroxyapatite/sodium alginate (CHA) and nanostructured carbonated hydroxyapatite/sodium alginate containing 5% strontium microspheres (SrCHA) as bone substitute materials. Methods Twenty male Wistar rats were randomly divided into two experimental groups: CHA and SrCHA (n=5/period/group). After one and 6 weeks of extraction of the right maxillary central incisor and biomaterial implantation, 5 μm bone blocks were obtained for histomorphometric evaluation. The parameters evaluated were remaining biomaterial, loose connective tissue and newly formed bone in a standard area. Statistical analysis was performed by Mann-Withney and and Wilcoxon tests at 95% level of significance. Results The histomorphometric results showed that the microspheres showed similar fragmentation and bio-absorbation (p>0.05). We observed the formation of new bones in both groups during the same experimental periods; however, the new bone formation differed significantly between the weeks 1 and 6 (p=0.0039) in both groups. Conclusion The CHA and SrCHA biomaterials were biocompatible, osteoconductive and bioabsorbable, indicating their great potential for clinical use as bone substitutes.
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Affiliation(s)
- André Boziki Xavier do Carmo
- Universidade Federal Fluminense, Faculdade de Odontologia, Laboratório Associado de Pesquisa Clínica em Odontologia, Niterói, RJ, Brasil
| | - Suelen Cristina Sartoretto
- Universidade Federal Fluminense, Faculdade de Odontologia, Laboratório Associado de Pesquisa Clínica em Odontologia, Niterói, RJ, Brasil
| | | | - José Mauro Granjeiro
- Instituto Nacional de Metrologia, Qualidade e Tecnologia, Programa de Bioengenharia, Duque de Caxias, RJ, Brasil
| | - Fúlvio Borges Miguel
- Universidade Federal do Recôncavo da Bahia, Centro de Ciências da Saúde, Santo Antônio de Jesus, BA, Brasil
| | - Jose Calasans-Maia
- Universidade Federal Fluminense, Faculdade de Odontologia, Laboratório Associado de Pesquisa Clínica em Odontologia, Niterói, RJ, Brasil
| | - Monica Diuana Calasans-Maia
- Universidade Federal Fluminense, Faculdade de Odontologia, Laboratório Associado de Pesquisa Clínica em Odontologia, Niterói, RJ, Brasil
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13
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Miron RJ, Zucchelli G, Pikos MA, Salama M, Lee S, Guillemette V, Fujioka-Kobayashi M, Bishara M, Zhang Y, Wang HL, Chandad F, Nacopoulos C, Simonpieri A, Aalam AA, Felice P, Sammartino G, Ghanaati S, Hernandez MA, Choukroun J. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Investig 2017; 21:1913-1927. [PMID: 28551729 DOI: 10.1007/s00784-017-2133-z] [Citation(s) in RCA: 230] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 05/15/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Research across many fields of medicine now points towards the clinical advantages of combining regenerative procedures with platelet-rich fibrin (PRF). This systematic review aimed to gather the extensive number of articles published to date on PRF in the dental field to better understand the clinical procedures where PRF may be utilized to enhance tissue/bone formation. MATERIALS AND METHODS Manuscripts were searched systematically until May 2016 and separated into the following categories: intrabony and furcation defect regeneration, extraction socket management, sinus lifting procedures, gingival recession treatment, and guided bone regeneration (GBR) including horizontal/vertical bone augmentation procedures. Only human randomized clinical trials were included for assessment. RESULTS In total, 35 articles were selected and divided accordingly (kappa = 0.94). Overall, the use of PRF has been most investigated in periodontology for the treatment of periodontal intrabony defects and gingival recessions where the majority of studies have demonstrated favorable results in soft tissue management and repair. Little to no randomized clinical trials were found for extraction socket management although PRF has been shown to significantly decrease by tenfold dry sockets of third molars. Very little to no data was available directly investigating the effects of PRF on new bone formation in GBR, horizontal/vertical bone augmentation procedures, treatment of peri-implantitis, and sinus lifting procedures. CONCLUSIONS Much investigation now supports the use of PRF for periodontal and soft tissue repair. Despite this, there remains a lack of well-conducted studies demonstrating convincingly the role of PRF during hard tissue bone regeneration. Future human randomized clinical studies evaluating the use of PRF on bone formation thus remain necessary. CLINICAL RELEVANCE PRF was shown to improve soft tissue generation and limit dimensional changes post-extraction, with little available data to date supporting its use in GBR.
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Affiliation(s)
- Richard J Miron
- College of Dental Medicine, Department of Periodontology, Nova Southeastern University, Fort Lauderdale, FL, USA. .,Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA.
| | - Giovanni Zucchelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Maurice Salama
- College of Dental Medicine, Department of Periodontology, Nova Southeastern University, Fort Lauderdale, FL, USA.,Department of Periodontology, Georgia University, Athens, GA, USA.,Goldstein Garber & Salama, Atlanta, GA, USA
| | - Samuel Lee
- International Academy of Dental Implantology, San Diego, CA, USA
| | | | - Masako Fujioka-Kobayashi
- College of Dental Medicine, Department of Periodontology, Nova Southeastern University, Fort Lauderdale, FL, USA.,Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Oral Surgery, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Mark Bishara
- West Bowmanville Dental, Bowmanville, Ontario, Canada
| | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Fatiha Chandad
- Department of Periodontology, Laval University, Quebec City, Canada
| | - Cleopatra Nacopoulos
- Laboratory for Research of the Musculoskeletal System, KAT Hospital, School of Medicine, National and Kapodistrian, University of Athens, Athens, Greece
| | - Alain Simonpieri
- Oral Surgery Department, University Federico II Naples, Naples, Italy.,Periodontology and Implantology, Beausoleil, France.,Periodontology and Implantology, Marseille, France
| | - Alexandre Amir Aalam
- Department of Advanced Periodontics, USC School of Dentistry, Los Angeles, CA, USA
| | - Pietro Felice
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Gilberto Sammartino
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Shahram Ghanaati
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Maria A Hernandez
- College of Dental Medicine, Department of Periodontology, Nova Southeastern University, Fort Lauderdale, FL, USA
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Fujioka‐Kobayashi M, Schaller B, Saulacic N, Pippenger BE, Zhang Y, Miron RJ. Absorbable collagen sponges loaded with recombinant bone morphogenetic protein 9 induces greater osteoblast differentiation when compared to bone morphogenetic protein 2. Clin Exp Dent Res 2017; 3:32-40. [PMID: 29744176 PMCID: PMC5839213 DOI: 10.1002/cre2.55] [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: 10/06/2016] [Revised: 11/27/2016] [Accepted: 12/07/2016] [Indexed: 12/29/2022] Open
Abstract
The use of growth factors for the regeneration of soft and hard tissues has been utilized extensively in dental medicine over the past decade. Recently our group found that recombinant human bone morphogenetic protein 9 (rhBMP9) was more osteopromotive than recombinant human bone morphogenetic protein 2 (rhBMP2) when combined with a deprotenized bovine bone mineral bone grafting material. The aim of the present in vitro study was to evaluate the regenerative potential of an absorbable collagen sponge(ACS) specifically designed for extraction socket healing loaded with rhBMP9 when compared to rhBMP2. The adsorption and release kinetics of rhBMP2 and rhBMP9 were first investigated by enzyme-linked immunosorbent assay quantification. Then, the cellular effects of stromal cell line (ST2) preosteoblasts were investigated utilizing four groups including rhBMP2 and rhBMP9 at both low(10 ng/ml) and high(100 ng/ml) concentrations loaded onto ACS. Cellular attachment(8 hours) and proliferation(1, 3, and 5 days) as well as osteoblast differentiation were investigated by real-time polymerase chain reaction (PCR) at 3 and 14 days, alkaline phosphatase (ALP) activity at 7 days, and alizarin red staining at 14 days. ACS fully adsorbed both rhBMP2 and rhBMP9 that were slowly released up to 10 days. Although neither rhBMP2 nor rhBMP9 had any effects on cell attachment or proliferation, pronounced effects were observed on osteoblast differentiation. ALP activity was increased seven-fold with rhBMP2-high, whereas a marked 10-fold and 20-fold increase was observed with rhBMP9-low and high loaded to ACS, respectively. Furthermore, mRNA levels of collagen1, ALP, bone sialoprotein, and osteocalcin were all significantly higher for rhBMP9 when compared to control or rhBMP2 groups. Alizarin red staining further confirmed that rhBMP9-low and high demonstrated marked increases in mineralization potential when compared to rhBMP2-high. The results demonstrate the marked effect of rhBMP9 on osteoblast differentiation when combined with ACS in comparison to rhBMP2 at doses as much as 10 times lower. Further in vivo studies are necessary to investigate whether the regenerative potential is equally as potent.
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Affiliation(s)
- Masako Fujioka‐Kobayashi
- Department of Periodontology, College of Dental MedicineNova Southeastern UniversityFloridaUSA
- Department of Cranio‐Maxillofacial Surgery, Bern University HospitalInselspitalSwitzerland
- Department of Oral Surgery, Clinical Dentistry, Institute of Biomedical SciencesTokushima University Graduate SchoolJapan
| | - Benoit Schaller
- Department of Cranio‐Maxillofacial Surgery, Bern University HospitalInselspitalSwitzerland
| | - Nikola Saulacic
- Department of Cranio‐Maxillofacial Surgery, Bern University HospitalInselspitalSwitzerland
| | | | - Yufeng Zhang
- Department of Oral ImplantologyUniversity of WuhanChina
| | - Richard J. Miron
- Department of Periodontology, College of Dental MedicineNova Southeastern UniversityFloridaUSA
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryMichiganUSA
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Miron RJ, Fujioka-Kobayashi M, Zhang Y, Sculean A, Pippenger B, Shirakata Y, Kandalam U, Hernandez M. Osteogain® loaded onto an absorbable collagen sponge induces attachment and osteoblast differentiation of ST2 cells in vitro. Clin Oral Investig 2016; 21:2265-2272. [PMID: 27909893 DOI: 10.1007/s00784-016-2019-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/23/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Dimensional changes of the alveolar bone following tooth extraction are a major challenge in daily dental practice. To limit bone loss, a variety of biomaterials including bone grafts, barrier membranes, and growth factors have been utilized either alone or in combination therapies to increase the speed and quality of new bone formation. The aim of the present in vitro study was to investigate the regenerative potential of Osteogain®, a new liquid carrier system of enamel matrix derivative (EMD) in combination with an absorbable collagen sponge (ACS) specifically designed for extraction socket healing. MATERIALS AND METHODS The potential of ACS was first investigated using ELISA to quantify total amelogenin adsorption and release from 0 to 10 days. Thereafter, the cellular effects of ST2 pre-osteoblasts were investigated for cellular attachment at 8 h and cell proliferation at 1, 3, and 5 days as well as osteoblast differentiation by real-time PCR and alizarin red staining for cells seeded on (1) tissue culture plastic, (2) ACS alone, and (3) ACS + Osteogain®. RESULTS ACS efficiently loaded nearly 100% of the amelogenin proteins found in Osteogain® which were gradually released up to a 10-day period. Osteogain® also significantly induced a 1.5-fold increase in cell attachment and resulted in a 2-6-fold increase in mRNA levels of osteoblast differentiation markers including runt-related transcription factor 2 (Runx2), collagen1a2, alkaline phosphatase, and bone sialoprotein as well as induced alizarin red staining when combined with ACS. CONCLUSIONS In summary, these findings suggest that Osteogain® is capable of inducing osteoblast attachment and differentiation when combined with ACS. Future animal studies and randomized human clinical trials are necessary to further support these findings. CLINICAL RELEVANCE The use of Osteogain® in combination with ACS may provide a valuable means to limit dimensional changes following tooth extraction.
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Affiliation(s)
- Richard J Miron
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA. .,Cell Therapy Institute, Center for Collaborative Research, Nova Southeastern University, Fort Lauderdale, FL, USA. .,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
| | - Masako Fujioka-Kobayashi
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.,Department of Cranio-Maxillofacial Surgery, Bern University Hospital, Inselspital, Bern, Switzerland.,Department of Oral Surgery, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | - Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Umadevi Kandalam
- Department of Pediatric Dentistry, Nova Southeastern University, Fort Lauderdale, USA
| | - Maria Hernandez
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
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