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Philip-Alliez C, Fievet L, Serratrice N, Seiler M, Le Gall M, Charavet C, Catherine JH. Cone Beam-CT-Based Bone Volume Assessments of Alveolar Synthetic Bone Graft GlassBONE™ in Cleft Lip and Palate Patients: A Retrospective Study. J Maxillofac Oral Surg 2024; 23:342-352. [PMID: 38601220 PMCID: PMC11001803 DOI: 10.1007/s12663-023-02056-6] [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: 07/14/2023] [Accepted: 10/26/2023] [Indexed: 04/12/2024] Open
Abstract
Background Clefts of the lip and palate (CLP) are facial deformities that require multiple surgical procedures during childhood. One of these steps consists of filling the alveolar space with bone graft, traditionally removed from the iliac crest. However, this procedure could be invasive in children. Aim Here, we aimed to evaluate the outcomes of GlassBONE™ graft, a bioactive glass used as a bone substitute, as an alternative to the deleterious autologous bone graft in children. Materials & methods Retrospective monocentric study with 17 children aged 7.5 ± 2.2 yo [3.8-13.3 yo] carrying CLP. This technique has been established at La Timone Children hospital (Assistance Publique - Hôpitaux de Marseille) since 2011. Clinical (scar, graft rejection and periodontal status) and radiological (both panoramic radiographs and cone beam-CT) follow-up was conducted one year after the graft. The primary outcome was the reduction of the cleft volume, and secondary was the eruption of the adjacent tooth through the graft. Results GlassBONE™ permitted a significant reduction in the cleft volume by 42.4 ± 27.7% [0.6-81.1%] (p < 0.0001), corresponding to a filling of 57.6 ± 27.7% of the alveolar cleft. GlassBONE™ is well tolerated, ensuring satifactory clinical results (improvement in both scar and periodontal coverage), as well as the physiological evolution of the germs through the biomaterial. GlassBONE™ appears particularly suitable for small volumes, and we were able to determine a minimum volume of approximtely 0.259 + / - 0.155 cc required for a successful bone fusion. Conclusion The bioactive glass GlassBONE™ could be safely used in children with small CLP cases, providing satisfactory clinical and radiological results.
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Affiliation(s)
- C. Philip-Alliez
- Department of Orthodontics, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
- UMR-T24 Ifsttar Aix-Marseille Université/Université Gustave Eiffel, Marseille, France
| | - L. Fievet
- Department of Pediatric Surgery, CHU La Réunion, Saint-Denis, France
| | - N. Serratrice
- Department of Neurosurgery, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
| | - M. Seiler
- Department of Orthodontics, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
| | - M. Le Gall
- Department of Orthodontics, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
| | - C. Charavet
- Département d’Orthodontie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, Nice, France
- Unité d’Orthodontie, Institut de Médecine Bucco-Dentaire, CHU de Nice, Nice, France
- Laboratoire MICORALIS UPR 7354, Université Côte d’Azur, Nice, France
| | - J. H. Catherine
- Department of Oral Surgery, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
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Ho Nguyen CT, Bui MH, Lam PH. Residual calcified material volume of β-tricalcium phosphate with platelet-rich fibrin in unilateral alveolar bone graft. Maxillofac Plast Reconstr Surg 2024; 46:7. [PMID: 38427143 PMCID: PMC10907557 DOI: 10.1186/s40902-024-00420-1] [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: 01/02/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the effectiveness of β-tricalcium phosphate (β-TCP) and platelet-rich fibrin (PRF) in unilateral alveolar bone graft, involving the percentage of residual calcified material and the average labiopalatal thickness of the grafts on cone beam computed tomography at 6 months after surgery, comparing two age groups 12 years and under and over 12 years old. RESULTS The mean preoperative defect volume was 0.93 ± 0.20 cm3, with no significant difference between the two groups (p = 0.652). In the postoperative period, we did not record any abnormal bleeding and no infection was observed. Six months after surgery, the mean percentage of residual calcified material was 63.53 ± 16.48% with a significantly higher difference in the age group 12 and under (p < 0.001), and the mean average labiopalatal thickness of the grafted bone was 5.72 ± 1.09 mm with a significantly higher difference in the age group 12 and under (p = 0.011). CONCLUSION Using β-TCP and PRF in alveolar bone graft surgery has acceptable effectiveness clinically and on CBCT images, with significantly higher differences of the percentage of residual calcified material and the average labiopalatal thickness of the grafted bone in the group 12 years old and younger than in the older group.
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Affiliation(s)
- Chon T Ho Nguyen
- Department of Maxillofacial Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam.
| | - Minh H Bui
- Department of Maxillofacial Surgery, National Hospital of Odonto-Stomatology Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
| | - Phuong H Lam
- My Thien Odonto-Stomatology Hospital, Ho Chi Minh City, 700000, Vietnam
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Natsir Kalla DS, Alkaabi S, Fauzi A, Tajrin A, Nurrahma R, Müller WEG, Schröder HC, Wang X, Forouzanfar T, Helder MN, Ruslin M. Microfragmented Fat and Biphasic Calcium Phosphates for Alveolar Cleft Repair: Protocol for a Prospective, Nonblinded, First-in-Human Clinical Study. JMIR Res Protoc 2024; 13:e42371. [PMID: 38224475 PMCID: PMC10825761 DOI: 10.2196/42371] [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: 09/02/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Biphasic calcium phosphates (BCP) may serve as off-the-shelf alternatives for iliac crest-derived autologous bone in alveolar cleft reconstructions. To add osteoinductivity to the osteoconductive BCPs to achieve similar regenerative capacity as autologous bone, a locally harvested buccal fat pad will be mechanically fractionated to generate microfragmented fat (MFAT), which has been shown to have high regenerative capacity due to high pericyte and mesenchymal stem cell content and a preserved perivascular niche. OBJECTIVE Our primary objectives will be to assess the feasibility and safety of the BCP-MFAT combination. The secondary objective will be efficacy, which will be evaluated using radiographic imaging and histological and histomorphometric evaluation of biopsies taken 6 months postoperatively, concomitant with dental implant placement. METHODS Eight patients with alveolar cleft (≥15 years) will be included in this prospective, nonblinded, first-in-human clinical study. MFAT will be prepared intraoperatively from the patient's own buccal fat pad. Regular blood tests and physical examinations will be conducted, and any adverse events (AEs) or serious EAs (SAEs) will be meticulously recorded. Radiographic imaging will be performed prior to surgery and at regular intervals after reconstruction of the alveolar cleft with the BCP-MFAT combination. Biopsies obtained after 6 months with a trephine drill used to prepare the implantation site will be assessed with histological and histomorphometric analyses after methylmethacrylate embedding and sectioning. RESULTS The primary outcome parameter will be safety after 6 months' follow-up, as monitored closely using possible occurrences of SAEs based on radiographic imaging, blood tests, and physical examinations. For efficacy, radiographic imaging will be used for clinical grading of the bone construct using the Bergland scale. In addition, bone parameters such as bone volume, osteoid volume, graft volume, and number of osteoclasts will be histomorphometrically quantified. Recruitment started in November 2019, and the trial is currently in the follow-up stage. This protocol's current version is 1.0, dated September 15, 2019. CONCLUSIONS In this first-in-human study, not only safety but also the histologically and radiographically assessed regenerative potential of the BCP-MFAT combination will be evaluated in an alveolar cleft model. When an SAE occurs, it will be concluded that the BCP-MFAT combination is not yet safe in the current setting. Regarding AEs, if they do not occur at a higher frequency than that in patients treated with standard care (autologous bone) or can be resolved by noninvasive conventional methods (eg, with analgesics or antibiotics), the BCP-MFAT combination will be considered safe. In all other cases, the BCP-MFAT combination will not yet be considered safe. TRIAL REGISTRATION Indonesia Clinical Trial Registry INA-EW74C1N; https://tinyurl.com/28tnrr64. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42371.
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Affiliation(s)
- Diandra Sabrina Natsir Kalla
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Salem Alkaabi
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Department of Oral and Maxillofacial Surgery, Fujairah Hospital, Ministry of Health, Fujairah, United Arab Emirates
| | - Abul Fauzi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Andi Tajrin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Rifaat Nurrahma
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Department of Prosthodontics, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Werner E G Müller
- ERC Advanced Investigator Grant Research Group at the Institute for Physiological Chemistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Heinz C Schröder
- ERC Advanced Investigator Grant Research Group at the Institute for Physiological Chemistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Xiaohong Wang
- ERC Advanced Investigator Grant Research Group at the Institute for Physiological Chemistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, Netherlands
| | - Marco N Helder
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
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Sedaghat F, Mahamed P, Sultani AS, Bagherian M, Biglari M, Mohammadzadeh A, Ghasemzadeh S, Barati G, Saburi E. Revisiting Recent Tissue Engineering Technologies in Alveolar Cleft Reconstruction. Curr Stem Cell Res Ther 2024; 19:840-851. [PMID: 37461350 DOI: 10.2174/1574888x18666230717152556] [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: 01/15/2023] [Revised: 05/06/2023] [Accepted: 06/05/2023] [Indexed: 05/15/2024]
Abstract
Tissue engineering and regenerative medicine have received significant attention in treating degenerative disorders and presented unique opportunities for researchers. The latest research on tissue engineering and regenerative medicine to reconstruct the alveolar cleft has been reviewed in this study. Three approaches have been used to reconstruct alveolar cleft: Studies that used only stem cells or biomaterials and studies that reconstructed alveolar defects by tissue engineering using a combination of stem cells and biomaterials. Stem cells, biomaterials, and tissue-engineered constructs have shown promising results in the reconstruction of alveolar defects. However, some contrary issues, including stem cell durability and scaffold stability, were also observed. It seems that more prospective and comprehensive studies should be conducted to fully clarify the exact dimensions of the stem cells and tissue engineering reconstruction method in the therapy of alveolar cleft.
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Affiliation(s)
- Faraz Sedaghat
- School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Parham Mahamed
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Mobina Bagherian
- School of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Biglari
- Faculty of Dentistry, Iran University of Medical Sciences, Tehran, Iran
| | - Anisa Mohammadzadeh
- Faculty of Dentistry, Babol University of Medical Sciences, Mazandaran, Iran
| | | | | | - Ehsan Saburi
- Medical Genetics Research center, Mashhad University of medical Sciences, Mashhad, Iran
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Nugraha AP, Yang H, Chen J, Yang K, Kraisintu P, Zaww K, Ma A, Wang R, Alhadi NEAM, Vanegas Sáenz JR, Hong G. β-Tricalcium Phosphate as Alveolar Bone Grafting in Cleft Lip/Palate: A Systematic Review. Dent J (Basel) 2023; 11:234. [PMID: 37886919 PMCID: PMC10606107 DOI: 10.3390/dj11100234] [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: 07/19/2023] [Revised: 08/27/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
The aim of this systematic review is to describe and identify the prospects of β-Tricalcium Phosphate (β-TCP) as an alveolar bone grafting (ABG) material in cleft lip/palate (CL/P) or alveolar bone cleft defects. A systematic review protocol based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) was drafted. The literature search was conducted using MEDLINE/PubMed, Web of Science/ISI Web of Knowledge, Scopus, and the Cochrane Library, with English as the inclusion criterion and no publication year limits. The keywords yielded a total of 5824 publications. After removing duplicates and non-English articles, there were 3196 suitable articles available for evaluation. Subsequently, 1315 studies remained after reviewing titles and abstracts. Furthermore, 85 full articles were assessed for eligibility. After reading the complete texts of those papers, 20 were eventually selected that matched the inclusion requirements. Thirteen out of the twenty studies included in this systematic review were deemed to have a low risk of bias; one had a high risk of bias; and six had a moderate risk of bias due to not reporting randomization. β-TCP, when used as an ABG material, is biocompatible, visible, practical, offers a less invasive procedure, and does not interfere with orthodontic treatment. Synthetic β-TCP for ABG can be an alternative to autologous bone grafts under certain terms and conditions. The efficacy of β-TCP for ABG in CL/P or alveolar bone cleft defects can be enhanced through a tissue engineering approach that combines β-TCP with growth factors, mesenchymal stem cells, or other graft materials, along with modifications to β-TCP's physical properties.
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Affiliation(s)
- Alexander Patera Nugraha
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
- Department of Orthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Hui Yang
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
| | - Junduo Chen
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
| | - Kunhua Yang
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
| | - Ploypim Kraisintu
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
| | - Kyaw Zaww
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
| | - Aobo Ma
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
| | - Ruixian Wang
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
| | - Nada Emad Alshafei Mohamed Alhadi
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
| | - Juan Ramón Vanegas Sáenz
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
| | - Guang Hong
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai 9830865, Japan (G.H.)
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van Dijk LA, Janssen NG, Nurmohamed SJ, Muradin MSM, Longoni A, Bakker RC, de Groot FG, de Bruijn JD, Gawlitta D, Rosenberg AJWP. Osteoinductive calcium phosphate with submicron topography as bone graft substitute for maxillary sinus floor augmentation: A translational study. Clin Oral Implants Res 2023; 34:177-195. [PMID: 36645164 DOI: 10.1111/clr.14028] [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: 02/08/2022] [Revised: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The aim of this study was the preclinical and clinical evaluation of osteoinductive calcium phosphate with submicron surface topography as a bone graft substitute for maxillary sinus floor augmentation (MSFA). MATERIAL AND METHODS A preclinical sheep model of MSFA was used to compare a calcium phosphate with submicron needle-shaped topography (BCPN , MagnetOs Granules, Kuros Biosciences BV) to a calcium phosphate with submicron grain-shaped topography (BCPG ) and autologous bone graft (ABG) as controls. Secondly, a 10-patient, prospective, randomized, controlled trial was performed to compare BCPN to ABG in MSFA with two-stage implant placement. RESULTS The pre-clinical study demonstrated that both BCPN and BCPG were highly biocompatible, supported bony ingrowth with direct bone apposition against the material, and exhibited bone formation as early as 3 weeks post-implantation. However, BCPN demonstrated significantly more bone formation than BCPG at the study endpoint of 12 weeks. Only BCPN reached an equivalent amount of bone formation in the available space and a greater proportion of calcified material (bone + graft material) in the maxillary sinus compared to the "gold standard" ABG after 12 weeks. These results were validated in a small prospective clinical study, in which BCPN was found comparable to ABG in implant stability, bone height, new bone formation in trephine core biopsies, and overall clinical outcome. CONCLUSION This translational work demonstrates that osteoinductive calcium phosphates are promising bone graft substitutes for MSFA, whereas their bone-forming potential depends on the design of their surface features. Netherlands Trial Register, NL6436.
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Affiliation(s)
- Lukas A van Dijk
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Regenerative Medicine Center Utrecht, Utrecht, the Netherlands
- Kuros Biosciences BV, Bilthoven, the Netherlands
| | - Nard G Janssen
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Silke J Nurmohamed
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marvick S M Muradin
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alessia Longoni
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Regenerative Medicine Center Utrecht, Utrecht, the Netherlands
| | - Robbert C Bakker
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Joost D de Bruijn
- Kuros Biosciences BV, Bilthoven, the Netherlands
- School of Materials Science and Engineering, Queen Mary University of London, London, UK
| | - Debby Gawlitta
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Regenerative Medicine Center Utrecht, Utrecht, the Netherlands
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
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Yan LB, Zhou YC, Wang Y, Li LX. Orthodontic treatment combined with 3D printing guide plate implant restoration for edentulism and its influence on mastication and phonic function. World J Clin Cases 2022; 10:5297-5305. [PMID: 35812655 PMCID: PMC9210907 DOI: 10.12998/wjcc.v10.i16.5297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/20/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Dentition defect, a common clinical oral disease developed in humans, not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the intestinal tract. Restorative treatment is the primary option for this disease. However, traditional restorations have many drawbacks, such as mismatch with the body, low reliability, and incomplete occlusal function recovery.
AIM to analyze the efficacy of orthodontics combined with 3D printing guide plate implant restoration in treating patients with dentition defects and its influence on masticatory and phonic functions.
METHODS A prospective study was carried out in 86 patients with dentition defects who received implant prosthesis after orthodontic treatment in our hospital between January 2018 and January 2019. Those patients were divided into a control group and an intervention group with 43 patients in each group using a random number table. The control group received traditional implant restoration, whereas the intervention group received 3D printing guide plate implant restoration. Treatment outcomes, cosmetic appearance, dental function, implant deviation, and quality of life were compared between the two groups.
RESULTS The overall response rate in the intervention group was significantly higher than that in the control group (95.35% vs 81.40%, χ2 = 4.071, P = 0.044). The number of cases with neatly trimmed cosmetic appearance (χ2 = 4.497, P = 0.034), complete coverage (χ2 = 4.170, P = 0.041), and normal occlusion (χ2 = 5.512, P = 0.019) in the intervention group was higher than that in the control group. After treatment, mastication, swallowing, and articulation were significantly improved in both groups. Masticatory (t = 2.980, P = 0.004), swallowing (t = 2.199, P = 0.031), and phonic functions (t = 3.950, P = 0.004) were better in the intervention group than those in the control group. The deviation value and the deviation angle (t = 5.440, P = 0.000) at the top (t = 6.320, P = 0.000) and middle parts of the implants (t = 22.295, P = 0.000) in the intervention group were lower than those in the control group after treatment. Functional limitations, psychosocial and physical pain and discomfort, and total scores decreased in both groups. The functional limitation (t = 2.379, P = 0.020), psychosocial (t = 2.420, P = 0.000), physical pain and discomfort (t = 6.581, P = 0.000), and total scores (t = 2.140, P = 0.035) were lower in the intervention group than those in the control group.
CONCLUSION Orthodontic treatment combined with 3D printing guide plate implant restoration can significantly improve the masticatory and phonic functions, quality of life, and psychological health of patients with dentition defects. Therefore, it is highly recommended in clinic application.
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Affiliation(s)
- Li-Bo Yan
- The Outpatient Department, Lintong Rehabilitation and Convalescent Center, Xi’an 710000, Shaanxi Province, China
| | - Yu-Chao Zhou
- The Outpatient Department, Lintong Rehabilitation and Convalescent Center, Xi’an 710000, Shaanxi Province, China
| | - Yang Wang
- The Outpatient Department, Lintong Rehabilitation and Convalescent Center, Xi’an 710000, Shaanxi Province, China
| | - Li-Xin Li
- Department of Administration, Lintong Rehabilitation and Convalescent Center, Xi’an 710000, Shaanxi Province, China
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Stoop CC, Janssen NG, Ten Harkel TC, Rosenberg AJWP. A Novel and Practical Protocol for Three-Dimensional Assessment of Alveolar Cleft Grafting Procedures. Cleft Palate Craniofac J 2022; 60:601-607. [PMID: 35234078 PMCID: PMC10108332 DOI: 10.1177/10556656221074210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the reproducibility and accuracy of a new, easy-to-use volumetric assessment of the alveolar cleft. DESIGN Twelve cone-beam computed tomography (CBCT) datasets of patients with a unilateral cleft lip, alveolus, and palate were evaluated by two investigators. Residual alveolar cleft calcified volume one year after surgery was analyzed by using standardized landmarks to determine the borders of the cleft defect and semi-automatically segment the alveolar cleft defect. RESULTS The Dice-coefficient between observers for the segmented preoperative alveolar cleft defect was 0.81. Average percentage of residual alveolar cleft calcified material was 66.7% one year postoperatively. CONCLUSIONS This study demonstrates a reliable and practical semi-automatic three-dimensional volumetric assessment method for unilateral clefts using CBCT.
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Affiliation(s)
- Celine C Stoop
- 8124Utrecht University Medical Center, Utrecht, the Netherlands
| | - Nard G Janssen
- 8124Utrecht University Medical Center, Utrecht, the Netherlands
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Alkaabi SA, Natsir Kalla DS, Alsabri GA, Fauzi A, Tajrin A, Müller WEG, Schröder HC, Wang XG, Forouzanfar T, Helder MN, Ruslin M. Polyphosphate (PolyP) for alveolar cleft repair: study protocol for a pilot randomized controlled trial. Trials 2021; 22:393. [PMID: 34127045 PMCID: PMC8201927 DOI: 10.1186/s13063-021-05325-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/12/2021] [Indexed: 01/17/2023] Open
Abstract
Objective Bone grafting is an important surgical procedure to restore missing bone in patients with alveolar cleft lip/palate, aiming to stabilize either sides of the maxillary segments by inducing new bone formation, and in bilateral cleft cases also to stabilize the pre-maxilla. Polyphosphate (PolyP), a physiological polymer composed of orthophosphate units linked together with high-energy phosphate bonds, is a naturally existing compound in platelets which, when complexed with calcium as Ca-polyP microparticles (Ca-polyP MPs), was proven to have osteoinductive properties in preclinical studies. Aim To evaluate the feasibility, safety, and osteoinductivity of Ca-polyP MPs as a bone-inducing graft material in humans. Methods This prospective non-blinded first-in-man clinical pilot study shall consist of 8 alveolar cleft patients of 13 years or older to evaluate the feasibility and safety of Ca-PolyP MPs as a bone-inducing graft material. Patients will receive Ca-polyP graft material only or Ca-polyP in combination with biphasic calcium phosphate (BCP) as a bone substitute carrier. During the trial, the participants will be investigated closely for safety parameters using radiographic imaging, regular blood tests, and physical examinations. After 6 months, a hollow drill will be used to prepare the implantation site to obtain a biopsy. The radiographic imaging will be used for clinical evaluation; the biopsy will be processed for histological/histomorphometric evaluation of bone formation. Discussion This is the first-in-man study evaluating the safety and feasibility of the polyP as well as the potential regenerative capacity of polyP using an alveolar cleft model. Trial registration Indonesian Trial Registry INA-EW74C1N. Registered on 12 June 2020
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Affiliation(s)
- S A Alkaabi
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Al Kuwait Hospital, Ministry of Health, Dubai, United Arab Emirates
| | - D S Natsir Kalla
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - G A Alsabri
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A Fauzi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, 90425, Indonesia
| | - A Tajrin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, 90425, Indonesia
| | - W E G Müller
- Institut für Physiologische Chemie, Angewandte Molekularbiologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Germany.,NanotecMARIN GmbH, Mainz, Germany
| | - H C Schröder
- Institut für Physiologische Chemie, Angewandte Molekularbiologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Germany.,NanotecMARIN GmbH, Mainz, Germany
| | - X G Wang
- Institut für Physiologische Chemie, Angewandte Molekularbiologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, 90425, Indonesia
| | - M N Helder
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, 90425, Indonesia
| | - M Ruslin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, 90425, Indonesia.
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10
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Secondary Care of Cleft Lip and Palate: Analysis of Dentofacial Orthopedic and Orthognathic Treatments. J Craniofac Surg 2021; 32:1346-1353. [PMID: 33645955 DOI: 10.1097/scs.0000000000007398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Orthodontic and orthognathic management of cleft lip and/or palate (CLP) is a highly controversial subject. We present herein a retrospective study of 214 secondary cases followed over 22 years in order to assess the factors of successful management. MATERIAL AND METHODS The study focuses on the results of gingivoperiosteoplasty, and occlusal stability. Nine subgroups were identified, taking into account the age of the patients, the history of surgery on the alveolar region, and the presence or absence of skeletal discrepancy. RESULTS Results clearly demonstrate a higher rate of poor outcomes and failures in the multioperated population. The success rate of the graft is 80.82% in the multioperated population versus 100% non-multioperated population. Periodontitis problem or orthodontic difficulties affect 19.17% of the patient in the multioperated groups versus 12% in the other groups. Relapse, particularly the transversal dimension, is also found mostly in the multi-operated population: 17.8% versus 6% in the non-multioperated population. DISCUSSION Several factors are involved in the success of orthodontics, dentofacial orthopedics, and orthognathic surgery of CLP patients. Our study shows that previous surgeries, especially when they are multiple with repeated failures, jeopardize the chances of success of secondary treatments. This is explained by the secondary fibrosis of the tissues around the cleft. Finally, major palatal surgeries performed early, have adverse effects on maxillary growth. Many other factors play an important role in the stability of the success that are linked with orofacial functions. These data must be taken into account in the treatment of CLP patients.
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Oliver JD, Jia S, Halpern LR, Graham EM, Turner EC, Colombo JS, Grainger DW, D'Souza RN. Innovative Molecular and Cellular Therapeutics in Cleft Palate Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2020; 27:215-237. [PMID: 32873216 DOI: 10.1089/ten.teb.2020.0181] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Clefts of the lip and/or palate are the most prevalent orofacial birth defects occurring in about 1:700 live human births worldwide. Early postnatal surgical interventions are extensive and staged to bring about optimal growth and fusion of palatal shelves. Severe cleft defects pose a challenge to correct with surgery alone, resulting in complications and sequelae requiring life-long, multidisciplinary care. Advances made in materials science innovation, including scaffold-based delivery systems for precision tissue engineering, now offer new avenues for stimulating bone formation at the site of surgical correction for palatal clefts. In this study, we review the present scientific literature on key developmental events that can go awry in palate development and the common surgical practices and challenges faced in correcting cleft defects. How key osteoinductive pathways implicated in palatogenesis inform the design and optimization of constructs for cleft palate correction is discussed within the context of translation to humans. Finally, we highlight new osteogenic agents and innovative delivery systems with the potential to be adopted in engineering-based therapeutic approaches for the correction of palatal defects. Impact statement Tissue-engineered scaffolds supplemented with osteogenic growth factors have attractive, largely unexplored possibilities to modulate molecular signaling networks relevant to driving palatogenesis in the context of congenital anomalies (e.g., cleft palate). Constructs that address this need may obviate current use of autologous bone grafts, thereby avoiding donor-site morbidity and other regenerative challenges in patients afflicted with palatal clefts. Combinations of biomaterials and drug delivery of diverse regenerative cues and biologics are currently transforming strategies exploited by engineers, scientists, and clinicians for palatal cleft repair.
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Affiliation(s)
- Jeremie D Oliver
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Shihai Jia
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Leslie R Halpern
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emily M Graham
- School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emma C Turner
- University of Western Australia Dental School, Perth, Western Australia
| | - John S Colombo
- University of Las Vegas at Nevada School of Dental Medicine, Las Vegas, Nevada, USA
| | - David W Grainger
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Rena N D'Souza
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
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