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Yang L, Wang Q, Wang X, Yang Z, Ning Y, Guo Z. Horizontal ridge augmentation in the maxillary aesthetic region using the autogenous circular cortical-lamina anchoring technique: A case series study. Clin Implant Dent Relat Res 2024; 26:518-531. [PMID: 38320956 DOI: 10.1111/cid.13311] [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: 09/16/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
AIM This case series aimed to evaluate the effectiveness of the autologous circular cortical lamina-anchoring (CCA) technique for horizontal bone augmentation in the maxillary aesthetic region. MATERIALS AND METHODS A total of 25 patients with 28 implants underwent horizontal bone augmentation using CCA followed by implant placement and crown delivery. The primary outcome measures were alveolar ridge width (ARW) and buccal bone thickness (BBT), whereas the secondary outcome measures included marginal bone loss (MBL), mid-facial mucosal margin loss (MML), clinical assessment of peri-implant and aesthetic parameters, patient-reported outcome measures (PROMs), and implant survival rates. RESULTS All 25 patients with 28 implants completed the treatment, no dropouts occurred. After CCA, the mean ARW at 1, 2, and 4 mm below the alveolar crest significantly increased from 2.38 ± 0.48, 2.85 ± 0.51, and 3.21 ± 0.53 mm to 6.80 ± 0.48, 6.99 ± 0.50, and 8.08 ± 0.52 mm, respectively. At the 3-year follow-up, the mean BBT0, BBT2, and BBT4 slightly decreased from 2.51 ± 0.26, 2.63 ± 0.31, and 2.75 ± 0.29 mm to 2.43 ± 0.27, 2.51 ± 0.30, and 2.64 ± 0.28 mm, respectively. Although the overall MBL was <0.15 mm, the results were statistically significant. The mean MML at the 3-year follow-up was 0.02 mm. All implant sites showed acceptable peri-implant and aesthetic outcomes. Incisions healed without complications, and no significant differences in PROMs observed at any time point. The 3-year follow-up showed a 100% implant survival rate. CONCLUSION The autologous CCA technique is a useful method for increasing ARW and maintaining BBT in the maxillary aesthetic region.
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Affiliation(s)
- Liqing Yang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Qing Wang
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Xinyi Wang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Zijing Yang
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Yingyuan Ning
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Zehong Guo
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
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Chen R, Xu J, Wang S, Duan S, Wang Z, Zhang X, Tang Y. Effectiveness of immediate implant placement into defective sockets in the esthetic zone: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00144-6. [PMID: 38493065 DOI: 10.1016/j.prosdent.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/18/2024]
Abstract
STATEMENT OF PROBLEM A defective socket is common after tooth extraction in the esthetic zone, but whether an implant can be immediately placed in a defective socket is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to summarize relevant studies within the last 20 years on implant survival and changes in soft and hard tissues after immediate implant placement in esthetic areas with socket defects. MATERIAL AND METHODS A search was conducted for the relevant studies in the PubMed/Medline, the Cochrane Library, Web of Science, and Embase databases from January 2000 to March 2022. The literature review, data retrieval, and judgment whether the included studies had a risk of bias were handled independently by 2 reviewers, and a single-arm meta-analysis was performed using a statistical software program. RESULTS A total of 23 studies evaluating the immediate implant placement of 630 implants (9 studies without a flap and 14 studies with a flap) were included. A 98.1% implant survival rate (95% confidence interval (CI): 96.2%, 100.0%) was determined. Marginal bone loss (MBL) at 6, 12, and ≥24 months were 1.03 mm (95%CI: 1.02, 1.03), 0.72 mm (0.72, 0.73), and 1.15 mm (1.14, 1.16). Gingival recession at 12 months was 0.25 mm (95%CI: 0.17, 0.33). The pink esthetic score (PES) were 12.34 (95%CI: 12.16, 12.52) at 12 months and 12.58 (12.39, 12.76) at ≥24 months. CONCLUSIONS Current evidence shows that immediate implant placement into defective sockets in esthetic areas is feasible. Immediate implant placement can have a relatively good therapeutic effect in terms of implant survival rate, MBL, gingival recession, and PES.
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Affiliation(s)
- Rui Chen
- Graduate student, Department of Stomatology, General Hospital of Northern Theater Command, China Medical University, Shenyang, PR China
| | - Jialin Xu
- Doctoral student, Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Shuang Wang
- Graduate student, Department of Stomatology, General Hospital of Northern Theater Command, China Medical University, Shenyang, PR China
| | - Siyi Duan
- Graduate student, Department of Stomatology, General Hospital of Northern Theater Command, Dalian Medical University, Dalian, PR China
| | - Zijian Wang
- Graduate student, Department of Stomatology, General Hospital of Northern Theater Command, Dalian Medical University, Dalian, PR China
| | - Xiaodong Zhang
- Professor, Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, PR China
| | - Yulong Tang
- Associate Professor, Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, PR China.
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Fernandes GVO, Castro F, Pereira RM, Teixeira W, Gehrke S, Joly JC, Blanco Carrion J, Fernandes JCH. Critical-size defects reconstruction with four different bone grafts associated with e-PTFE membrane: A histomorphometric experimental in vivo study. Clin Oral Implants Res 2024; 35:167-178. [PMID: 37987205 DOI: 10.1111/clr.14210] [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: 05/08/2023] [Revised: 10/20/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES The goal of this study was to assess the newly formed bone and the remnant biomaterial by comparing four different bone grafts used to treat critical-size defects, associated or not with the non-resorbable membrane. MATERIALS AND METHODS Two calvaria critical-size bone defects were created in 50 male Wistar rats. They were divided into blood (G1), autogenous (G2), bioglass (G3), hydroxyapatite (G4), and xenograft (G5) groups, associated or not with e-PTFE. The experimental periods were 15 and 45 days. Sections were prepared for histomorphometric assessment. All data were analyzed by the mixed-effects model with multiple comparisons (significance level, p < .05). RESULTS A similar level of new bone was observed for all groups, associated with a high level of vascularization. G1 and G2 ensured sovereignty over the greater quantity of new bone. A non-significant result was reported comparing groups with and without membranes. No significant result was found between the experimental synthetic biomaterials (G3 and G4). G5L achieved 22.0% of new bone after 45 days (p > .05). All groups had a stable volume of biomaterial kept in the short term (p > .05). G2 was the best material for new bone formation and final volume of biomaterial, followed by G4 < G5 < G3. Thus, it is possible that G4 had a better degradation profile among the experimental groups. CONCLUSIONS The best results were found in the autogenous group, with higher resorption and integration; non-significative new bone was found among the experimental groups; and the regeneration of critical bone defects using an e-PTFE barrier did not present significant results on new bone formation.
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Affiliation(s)
- Gustavo Vicentis Oliveira Fernandes
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- A. T. Still University, St. Louis, Missouri, USA
| | - Filipe Castro
- FP-I3ID, FCS, Universidade Fernando Pessoa, Porto, Portugal
| | - Rafael Martins Pereira
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Wendel Teixeira
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Sérgio Gehrke
- Department of Research, Bioface/PgO/UCAM, Montevideo, Uruguay
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Calciolari E, Corbella S, Gkranias N, Viganó M, Sculean A, Donos N. Efficacy of biomaterials for lateral bone augmentation performed with guided bone regeneration. A network meta-analysis. Periodontol 2000 2023; 93:77-106. [PMID: 37752820 DOI: 10.1111/prd.12531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023]
Abstract
Bone regeneration is often required concomitant with implant placement to treat a bone fenestration, a dehiscence, and for contouring. This systematic review assessed the impact of different biomaterials employed for guided bone regeneration (GBR) simultaneous to implant placement on the stability of radiographic peri-implant bone levels at ≥12 months of follow-up (focused question 1), as well as on bone defect dimension (width/height) changes at re-assessment after ≥4 months (focused question 2). Only randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared different biomaterials for GBR were considered. A Bayesian network meta-analysis (NMA) was performed using a random-effects model. A ranking probability between treatments was obtained, as well as an estimation of the surface under the cumulative ranking value (SUCRA). Overall, whenever the biological principle of GBR was followed, regeneration occurred in a predictable way, irrespective of the type of biomaterial used. A lower efficacy of GBR treatments was suggested for initially large defects, despite the trend did not reach statistical significance. Regardless of the biomaterial employed, a certain resorption of the augmented bone was observed overtime. While GBR was shown to be a safe and predictable treatment, several complications (including exposure, infection, and soft tissue dehiscence) were reported, which tend to be higher when using cross-linked collagen membranes.
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Affiliation(s)
- Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Dental School, Department of Medicine and Dentistry, Università di Parma, Parma, Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS, Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Nikolaos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Marco Viganó
- Medacta International SA, Castel San Pietro, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol 2000 2023; 93:26-55. [PMID: 37615306 DOI: 10.1111/prd.12518] [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: 02/10/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune-inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non-invasive imaging and with patient-reported outcome measures. We also envisage that the integration of multi-omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Ninad Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Dentistry, Dental School, University of Parma, Parma, Italy
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Song YW, Bienz SP, Benic GI, Cha JK, Hämmerle CHF, Jung UW, Jung RE. Soft-tissue dimensional change following guided bone regeneration on peri-implant defects using soft-type block or particulate bone substitutes: 1-year outcomes of a randomized controlled clinical trial. J Clin Periodontol 2023; 50:147-157. [PMID: 36330670 DOI: 10.1111/jcpe.13738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/19/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
AIM To compare the peri-implant soft-tissue dimensional changes following guided bone regeneration between particulate (particle group) and collagenated soft-block-type (block group) biphasic calcium phosphate (BCP). MATERIALS AND METHODS This study investigated 35 subjects: 18 in the particle group and 17 in the block group. Cone-beam computed tomography obtained at 6 months post surgery and optical impressions taken periodically (before surgery, 6 months post surgery, and 1 year post surgery) were superimposed. The ridge contour changes over time and the peri-implant mucosal thicknesses were measured diagonally and horizontally, and analysed statistically. RESULTS The increases in diagonal (1.12 ± 0.78 mm) and horizontal (2.79 ± 1.90 mm) ridge contour of the block group were significantly higher than those in the particle group during the first 6 months (p < .05); however, the contour hardly changed thereafter (diagonal: 0.07 ± 0.75 mm; horizontal: -0.34 ± 1.26 mm), resulting in the 1-year contour changes similar between the two groups. Regardless of the type of BCP, the ridge contour increased significantly over 1 year when the dehiscence defect had a contained configuration (p < .05). CONCLUSIONS The increase in soft-tissue dimensions for 1 year was similar between the two groups. The mucosal contour increase was larger when the surgery was conducted in a more contained defect, and this was not influenced by the type of BCP.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Stefan P Bienz
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Goran I Benic
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland.,Institute for Research and Education in Dental Medicine, Lugano, Switzerland
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
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Kusirisin T, Suwanprateeb J, Buranawat B. Polycaprolactone versus collagen membrane and 1‐year clinical outcomes: A randomized controlled trial. Clin Implant Dent Relat Res 2022; 25:330-342. [PMID: 36519395 DOI: 10.1111/cid.13166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Polycaprolactone (PCL) is a synthetic aliphatic polyester widely used in biomedical applications with biodegradability in the body and promotes cell proliferation and differentiation. A newly developed bilayered PCL membrane was developed for possibly being used as a membrane in guided bone regeneration (GBR). PURPOSE To compare the clinical efficacy between a newly developed bilayered PCL membrane with a Cytoplast™ RTM collagen membrane for GBR with simultaneous implant placement. MATERIALS AND METHODS Twenty-four patients were randomized to PCL or RTM group, and a total of 24 dental implants were placed. Primary outcomes were patient mean buccal bone thickness (BBT) immediately postimplantation and at 6 months using cone-beam CT and soft tissue surface dimensional changes (STC) at crown insertion, 6 months, and 1 year after loading using intraoral scanner. Secondary outcomes included success rate, clinical parameters, healing index, implant stability, pink esthetic score, and marginal bone levels. RESULTS The percentage of reduced BBT at 6 months was 32.38%, 25.94%, and 23.96% in the test group and 34.42%, 14.75%, and 6.34% in the control group at the corresponding levels. The mean difference of changed BBT associated with PCL membrane, when compared to collagen membrane, at 6 months was -0.02 ± 0.18 mm (95% confidence interval [CI]: -0.40 to 0.35), 0.29 ± 0.28 mm (95% CI: -0.29 to 0.87), and 0.62 ± 0.38 mm (95% CI: -0.17 to 1.42) at 0, 2, and 4 mm from implant shoulder. Minimal loss of STC was observed in both groups up to 1 year of loading. The mean difference loss of surface dimensional change associated with PCL membrane, when compared to collagen membrane, at 1 year of loading was 0.31 ± 0.19 mm (95% CI: -0.07 to 0.70), 0.22 ± 0.26 mm (95% CI: -0.33 to 0.76), and 0.17 ± 0.30 mm (95% CI: -0.45 to 0.78) at 0, 2, and 4 mm from implant shoulder. None of these differences were statistically significant (unpaired t-test, degrees of freedom [df] = 22; p > 0.05). CONCLUSION Within the limits of this trial, both barrier membranes resulted in comparable outcomes for GBR with implant placement after 1 year in function. Further research is necessary with a larger sample size.
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Affiliation(s)
- Thun Kusirisin
- Department of Implantology, Faculty of Dentistry Thammasat University Pathum Thani Thailand
| | - Jintamai Suwanprateeb
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center National Science and Technology Development Agency Pathum Thani Thailand
| | - Borvornwut Buranawat
- Department of Implantology, Faculty of Dentistry Thammasat University Pathum Thani Thailand
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Hamdy A, Ghalwash DM. Flipped autograft: A novel approach for management of wound dehiscence in implant dentistry. A case report. Int J Surg Case Rep 2022; 98:107559. [PMID: 36041333 PMCID: PMC9433679 DOI: 10.1016/j.ijscr.2022.107559] [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: 07/20/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction and importance This case report describes a novel technique for management of peri-implant wound dehiscence that involves using auto graft from the same surgical site to seal the dehiscence defect. Case presentation A 21-year-old female was referred for extraction of a non-restorable lower left first molar and replacement by immediate dental implant. Following attachment of the cover screw bone graft biomaterial and collagen membrane was secured over the biomaterial and buccal flap was coronally positioned and sutured. Patient was seen 1 week after surgery for follow up where a minor wound dehiscence was discovered with some biomaterial particles exposed. Patient was advised to continue strict oral hygiene control and to wait for another week. After 2 weeks of the implant placement surgery patient came back for dehiscence management visit where an innovative flipped autograft technique was performed to seal the dehiscence defect. Clinical discussion Healing by primary intention was achieved that led to uneventful healing and hence a successful well-functioning restoration with clinically healthy soft tissue and optimal aesthetic outcome. Conclusions Peri-implant wound dehiscence can be successfully treated by the novel flipped autograft technique that yielded great aesthetic and functional results. This report is the first to demonstrate the management of wound dehiscence using flipped autograft technique Visibility and access, Primary closure with delicate manipulation and patient home care are the keys to successful management of this case. The primary limitations to success in this case are poor blood supply associated with thin thickness soft tissue flap and Failure to achieve primary closure
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Affiliation(s)
- Ahmed Hamdy
- Faculty of Dentistry, The British University in Egypt (BUE), Cairo, Egypt.
| | - Dalia M Ghalwash
- Faculty of Dentistry, The British University in Egypt (BUE), Cairo, Egypt
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Clinical Efficacy and Safety of Different Dental Prosthetic Membranes in Guided Bone Regeneration during Dental Implants: A Meta-Analysis. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:3245014. [PMID: 35958742 PMCID: PMC9357784 DOI: 10.1155/2022/3245014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022]
Abstract
Objective. To evaluate clinical efficacy and safety of absorbable and non-absorbable dental restorative membranes in guided bone regeneration (GBR). Articles concerning absorbable and non-absorbable prosthetic membrane-related studies of GBR were screened from multiple databases. In the end, 526 postoperative patients who met eligibility criteria were screened for the study from eight trials. The results showed that the repair success rate of the experimental group (absorbable dental restorative membrane) was higher than that of the control group (non-absorbable dental restorative membrane) (RR = 1.18, 95% CI [1.11,1.26], and the total physical therapy effect was P < 0.0001, I2 = 0%), and the height of bone graft in the experimental group was higher than that in the control group (MD = 0.67, 95% CI [0.11, 1.23]). The thickness of bone graft in the experimental group was higher than that in the control group (MD = 0.43, 95% CI [0.30,0.56], P < 0.00001, I2 = 61%), and the adverse events in the experimental group were less than those in the control group (RR = 0.31, 95% CI [0.18, 0.51], P < 0.00001, I2 = 13%). Absorbable prosthetic membrane is superior to non-absorbable prosthetic membrane in clinical efficacy and safety.
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Naenni N. [Influencing Hard and Soft Tissue Changes Following Tooth Extraction]. PRAXIS 2022; 111:163-167. [PMID: 35232257 DOI: 10.1024/1661-8157/a003798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Influencing Hard and Soft Tissue Changes Following Tooth Extraction Abstract. Influencing Hard and Soft Tissue Changes Following Tooth Extraction The loss of a tooth leads to the initiation of resorption processes and thus to the remodeling of the tissues of the alveolar process. At the hard tissue level, this resorption mainly affects the bundle bone at the buccal side of the extracted tooth and occurs most rapidly in the first weeks and months after extraction. Tissue changes occur not only at the level of the hard tissue (bone), but also at the level of the soft tissue. These changes lead to a significant loss of volume, especially at the buccal area of the alveolar ridge. They are responsible for a volume loss of the alveolar ridge contour of up to 50 %.
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Affiliation(s)
- Nadja Naenni
- Zentrum für Zahnmedizin, Klinik für Rekonstruktive Zahnmedizin, Zürich
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11
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Bienz SP, Payer M, Hjerppe J, Hüsler J, Jakse N, Schmidlin PR, Hämmerle CHF, Jung RE, Thoma DS. Primary bone augmentation leads to equally stable marginal tissue conditions comparing the use of xenograft blocks infused with BMP-2 and autogenous bone blocks: A 3D analysis after 3 years. Clin Oral Implants Res 2021; 32:1433-1443. [PMID: 34543475 PMCID: PMC9293361 DOI: 10.1111/clr.13843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 05/26/2021] [Accepted: 07/07/2021] [Indexed: 11/28/2022]
Abstract
Objectives To test whether or not primary bone augmentation using xenograft blocks infused with BMP‐2 or autogenous bone blocks lead to similar results regarding the implant survival and 3D marginal soft tissue contours. Methods Twenty‐four patients with an insufficient ridge width for implant placement in need of primary augmentation were randomly assigned to either a block of deproteinized bovine bone mineral infused with rhBMP‐2 (BMP) or an intraorally harvested block of autogenous bone (ABB). At 4 months, 1–4 dental implants were placed in the regenerated area. After crown insertion and at 3 years, peri‐implant tissue parameters, two‐ and three‐dimensional radiographic parameters, and soft tissue contour changes were evaluated. Explorative mixed model analyses were performed. The level of significance was set at 5%. Results At the 3‐year follow‐up, 23 patients with 40 implants were evaluated. The implant survival rate was 100% in both groups. At baseline, the marginal hard tissue levels amounted to −0.4 ± 0.8 mm (mean ± standard deviation) in the BMP group and −0.7 ± 1.0 mm in the ABB group. At 3 years, these values were −0.2 ± 0.4 mm (BMP) and −0.6 ± 1.0 mm (ABB). At baseline, the thickness of the buccal hard tissue at the level of the implant shoulder measured 1.1 ± 1.1 mm (BMP) and 1.4 ± 1.0 mm (ABB). At 3 years, it measured 0.9 ± 0.9 mm (BMP) and 0.7 ± 0.6 mm (ABB). Conclusions The present study demonstrated excellent implant survival rates and stable marginal hard tissue levels in both augmentation groups, 3 years after crown insertion. In addition, the clinical stability of soft and hard tissues was demonstrated in both groups.
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Affiliation(s)
- Stefan P Bienz
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Michael Payer
- Department of Oral Surgery and Radiology, School of Dentistry, Medical University Graz, Graz, Austria
| | - Jenni Hjerppe
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Norbert Jakse
- Department of Oral Surgery and Radiology, School of Dentistry, Medical University Graz, Graz, Austria
| | - Patrick R Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Zurich, Switzerland
| | | | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, College of Dentistry, Research Institute for Periodontal Regeneration, Yonsei University, Seoul, Korea
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Naenni N, Stucki L, Hüsler J, Schneider D, Hämmerle CHF, Jung RE, Thoma DS. Implants sites with concomitant bone regeneration using a resorbable or non-resorbable membrane result in stable marginal bone levels and similar profilometric outcomes over 5 years. Clin Oral Implants Res 2021; 32:893-904. [PMID: 33977571 DOI: 10.1111/clr.13764] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/25/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess clinical and radiographic outcomes as well as the profilometric contour alterations of peri-implant hard and soft tissues around single implants treated with simultaneous guided bone regeneration (GBR) at 5 years. MATERIALS AND METHODS Twenty-seven patients presenting with a single tooth gap in the esthetic zone received a two-piece implant. GBR was randomly performed using a resorbable (RES) or a non-resorbable membrane (N-RES) combined with a bone substitute material. Follow-up examinations were performed at baseline (BL = crown insertion), 1 year (FU-1), 3 years (FU-3), and at 5 years (FU-5) including clinical and radiographic parameters as well as profilometric changes. Statistics were performed by means of parametric and nonparametric tests. RESULTS At 5 years, 20 out of 27 patients (9 RES, 11 N-RES) were re-examined. Median values for probing depth changed insignificantly between BL and FU-5 in both groups. The median marginal bone levels were located 0.23 mm (0.06; 0.46; RES) and 0.17 mm (0.13;0.28; N-RES) below the implant shoulder at FU-5 (changes over time p < .05). The calculated median profilometric change between BL and FU-5 was -0.28 mm (-0.53;-0.20; RES; p = .016) and -0.24 mm (-0.43;0.08; N-RES; p = .102; intergroup p = .380). The horizontal bone thickness decreased significantly between re-entry and FU-5 for group RES at all measured levels (p < .05) measuring 0.87 mm (0.0; 2.05) at the implant shoulder, whereas the decrease for group N-RES was insignificant (p = .031) with 0 mm (0; 0.84) at the implant shoulder at 5 years. CONCLUSIONS Implants sites with concomitant GBR using a resorbable or non-resorbable membrane revealed stable marginal bone levels and clinical outcomes. Profilometric changes were clinically negligible over 5 years. The observed change in hard tissue thickness was partially compensated by an increase in soft tissue thickness.
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Affiliation(s)
- Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Lukas Stucki
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - David Schneider
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
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13
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Guided bone regeneration simultaneous with implant placement using bovine-derived xenograft with and without liquid platelet-rich fibrin: a randomized controlled clinical trial. Clin Oral Investig 2021; 25:5563-5575. [PMID: 34047835 DOI: 10.1007/s00784-021-03987-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess augmentation success after guided bone regeneration (GBR) carried out simultaneously with implant placement using bovine-derived xenograft alone and in combination with liquid platelet-rich fibrin (liquid-PRF). METHODS This randomized controlled clinical trial was conducted on patients with horizontal bone deficiency in the posterior regions of the mandible. After implant placement, GBR procedures were randomly performed using liquid-PRF-enriched bovine-derived xenograft (for the test group) and with bovine-derived xenograft alone (for the control group). To assess the change in augmentation thickness, the primary outcome of the study, cone beam computed tomography was carried out at the implant sites on completion and 6 months after surgery. The secondary outcomes were marginal bone level and implant survival rate at prosthetic delivery and at 6 months, 1 year, and 2 years follow-up after loading. The significance level was set at p<0.05 for all analysis. RESULTS Twenty patients with 50 implants were analyzed for the test group and 20 patients with 48 implants for the control group. At 6 months postoperatively, the mean values of augmentation thickness were 1.63 ± 0.21 mm, 2.59 ± 0.34 mm, and 3.11 ± 0.36 mm for the test group and 1.34 ± 0.14 mm, 2.49 ± 0.24 mm, and 2.97 ± 0.24 mm for the control group at 2 mm, 4 mm, and 6 mm below to the implant shoulder (p < 0.001, p = 0.007, and p = 0.036, respectively). The mean marginal bone loss was found to be less than 1 mm for both study groups during the 2 years of follow-up after prosthetic loading. Implant survival rate was 100% for both study groups. CONCLUSION Bovine-derived xenograft alone and in combination with liquid-PRF are both successful in achieving bone augmentation around the implants and produce a small change in marginal bone level and a high implant survival rate after loading. CLINICAL RELEVANCE There is a lack of evidence in the literature regarding the augmentation success of liquid-PRF used in combination with bone graft substitutes. This study indicates that liquid-PRF could be used as a supportive material with bovine-derived xenograft in GBR procedures carried out simultaneously with implant placement.
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14
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Balbinot GDS, Bahlis EADC, Visioli F, Leitune VCB, Soares RMD, Collares FM. Polybutylene-adipate-terephthalate and niobium-containing bioactive glasses composites: Development of barrier membranes with adjusted properties for guided bone regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 125:112115. [PMID: 33965098 DOI: 10.1016/j.msec.2021.112115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/29/2021] [Accepted: 04/13/2021] [Indexed: 02/08/2023]
Abstract
This study aimed to develop bioactive guided bone regeneration (GBR) membranes by manufacturing PBAT/BAGNb composites as casting films. Composites were produced by melt-extrusion, and BAGNb was added at 10 wt%, 20 wt%, and 30 wt% concentration. Pure PBAT membranes were used as a control (0wt%BAGNb). FTIR and thermogravimetric analysis characterized the composites. Barrier membranes were produced by solvent casting, and their mechanical and surface properties were assessed by tensile strength test and contact angle analysis, respectively. The ion release and cell behavior were evaluated by pH, cell proliferation, and mineralization. Composites were successfully produced, and the chemical structure showed no interference of BAGNb in the PBAT structure. The addition of BAGNb increased the stiffness of the membranes and reduced the contact angle, increasing the roughness in one side of the membrane. Sustained pH increment was observed for BAGNb-containing membranes with increased proliferation and mineralization as the concentration of BAGNb increases. The incorporation of up to 30 wt% of BAGNb into PBAT barrier membranes was able to maintain adequate chemical-mechanical properties leading to the production of materials with tailored surface properties and bioactivity. Finally, this biomaterial class showed outstanding potential and may contribute to bone formation in GBR procedures.
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Affiliation(s)
- Gabriela de Souza Balbinot
- Dental Materials Laboratory, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | - Fernanda Visioli
- Patology Laboratory, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | | | - Fabricio Mezzomo Collares
- Dental Materials Laboratory, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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15
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Di Raimondo R, Sanz-Esporrin J, Martin IS, Vignoletti F, Nuñez J, Muñoz F, Haugen HJ, Sanz M. Hard tissue volumetric and soft tissue contour linear changes at implants with different surface characteristics after experimentally induced peri-implantitis: an experimental in vivo investigation. Clin Oral Investig 2021; 25:3905-3918. [PMID: 33415377 DOI: 10.1007/s00784-020-03720-8] [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: 09/24/2020] [Accepted: 11/27/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the hard tissue volumetric and soft tissue contour linear changes in implants with two different implant surface characteristics after a ligature-induced peri-implantitis. MATERIAL AND METHODS In eight beagle dogs, implants with the same size and diameter but distinct surface characteristics were placed in the healed mandibular sites. Test implants had an external monolayer of multi-phosphonate molecules (B+), while control implants were identical but without the phosphonate-rich surface. Once the implants were osseointegrated, oral hygiene was interrupted and peri-implantitis was induced by placing subgingival ligatures. After 16 weeks, the ligatures were removed and peri-implantitis progressed spontaneously. Bone to implant contact (BIC) and bone loss (BL) were assessed three-dimensionally with Micro-Ct (μCT). Dental casts were optically scanned and the obtained digitalized standard tessellation language (STL) images were used to assess the soft tissue vertical and horizontal contour linear changes. RESULTS Reduction of the three-dimensional BIC percentage during the induction and progression phases of the experimental peri-implantitis was similar for both the experimental and control implants, without statistically significant differences between them. Soft tissue analysis revealed for both implant groups an increase in horizontal dimension after the induction of peri-implantitis, followed by a decrease after the spontaneous progression period. In the vertical dimension, a soft tissue dehiscence was observed in both groups, being more pronounced at the buccal aspect. CONCLUSIONS The added phosphonate-rich surface did not provide a more resistant environment against experimental peri-implantitis, when assessed by the changes in bone volume and soft tissue contours. CLINICAL RELEVANCE Ligature-induced peri-implantitis is a validated model to study the tissue changes occurring during peri-implantitis. It was hypothesized that a stronger osseointegration mediated by the chemical bond of a phosphonate-rich implant surface would develop an environment more resistant to the inflammatory changes occurring after experimental peri-implantitis. These results, however, indicate that the hard and soft tissue destructive changes occurring at both the induction and progression phases of experimental peri-implantitis were not influenced by the quality of osseointegration.
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Affiliation(s)
- R Di Raimondo
- Graduate Clinic of Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Javier Sanz-Esporrin
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain.
- Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n (Ciudad Universitaria), 28040, Madrid, Spain.
| | - I Sanz Martin
- Graduate Clinic of Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - F Vignoletti
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - J Nuñez
- Graduate Clinic of Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - F Muñoz
- Department of Veterinary Clinical Sciences, University of Santiago de Compostela, Lugo, Spain
| | - H J Haugen
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, Oslo, Norway
| | - M Sanz
- Graduate Clinic of Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
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Li L, Wang C, Li X, Fu G, Chen D, Huang Y. Research on the dimensional accuracy of customized bone augmentation combined with 3D-printing individualized titanium mesh: A retrospective case series study. Clin Implant Dent Relat Res 2020; 23:5-18. [PMID: 33336492 DOI: 10.1111/cid.12966] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Few studies have focused on the dimensional accuracy of customized bone grafting by means of guided bone regeneration (GBR) with 3D-Printed Individual Titanium Mesh (3D-PITM). PURPOSE Digital technologies were applied to evaluate the dimensional accuracy of customized bone augmentation with 3D-PITM with a two-stage technique. MATERIALS AND METHODS Sixteen patients were included in this study. The CBCT data of post-GBR (immediate post-GBR) and post-implantation (immediate post-implant placement) were 3D reconstructed and compared with the pre-surgical planned bone augmentation. The dimensional differences were evaluated by superimposition using the Materialize 3-matic software. RESULTS The superimposition analysis showed that the maximum deviations of contour between were 3.4 mm, and the average differences of the augmentation contour were 0.5 ± 0.4 and 0.6 ± 0.5 mm respectively. The planned volume of bone regeneration was approximately equal to the amount of regenerated bone present 6 to 9 months after the surgical procedure. On average, the vertical gain in bone height was about 0.5 mm less than planned. And, the horizontal bone gain on the straight buccal of the dental implants and 2 to 4 mm apical of the platform fell also about a 0.5 mm short on average. Statistically significant differences were observed between the augmented volume of virtual and post-GBR, and the horizontal bone gain of post-implantation on the level of 4 mm apical to the implant platform (P < .05). CONCLUSIONS The dimensional accuracy of customized bone augmentation with the 3D-PITM approach needs further improvement and compared to other surgical approaches of bone augmentation.
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Affiliation(s)
- Linzhi Li
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - Xian Li
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Gang Fu
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Dan Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yuanding Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Tay JRH, Lu XJ, Lai WMC, Fu JH. Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management. Int J Implant Dent 2020; 6:76. [PMID: 33241468 PMCID: PMC7688776 DOI: 10.1186/s40729-020-00274-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
It is not uncommon to encounter post-surgical complications after horizontal guided bone regeneration (GBR). The primary aim of this review was to evaluate the incidence and types of complications that occur after horizontal GBR and propose management strategies to deal with these clinical situations. A secondary aim was to conduct a histomorphometric review of the wound healing process at sites that experienced post-surgical complications after GBR. A keyword search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published in English from January 2015 to January 2020 was conducted for the primary aim and 23 studies were selected. A second search addressing the secondary aim was conducted, and five studies were included. Site-level analysis showed that the weighted mean incidence proportion of minor wound dehiscence and minor infections occurring at the augmented site was 9.9% [95% CI 6.4, 13.9, P < 0.01] and 1.5% [95% CI 0.4, 3.1, P = 0.21) respectively. Patient-level analysis showed minor and major complications occurring at a weighted mean incidence proportion of 16.1% [95% CI 11.9, 20.8, P = 0.01] and 1.6% [95% CI 0.0, 4.7, P < 0.01] respectively, while neurosensory alterations at the donor site was 7.0% [95% CI 1.3, 15.5, P < 0.01]. Subgroup analysis also revealed that the use of block grafts increased the incidence proportion of minor post-surgical complications, whereas a staged GBR procedure increased the incidence proportion of both minor and major post-surgical complications. Although exposure of the barrier membrane is often associated with less bone regeneration and graft resorption, the type of membrane used (resorbable or non-resorbable) had no statistically significant influence on any post-surgical complication. Histologically, a layer of fibrous connective tissue instead of bone is commonly observed at the interface between the native bone at the recipient site and the regenerated bone in cases with membrane exposure after GBR procedure. Minor wound dehiscence was the highest incidence proportion of post-surgical complications. Methods ranging from daily application of antiseptics, use of systemic antimicrobials, regular reviews, and total removal of the non-integrated biomaterials are commonly prescribed to manage these post-surgical complications in attempt to minimise the loss of tissue at the surgical site.
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Affiliation(s)
- John Rong Hao Tay
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.,Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, Singapore, 168938, Singapore
| | - Xiaotong Jacinta Lu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Wei Ming Clement Lai
- Statistics Unit, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Jia-Hui Fu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.
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18
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Tavelli L, Barootchi S, Majzoub J, Siqueira R, Mendonça G, Wang HL. Volumetric changes at implant sites: A systematic appraisal of traditional methods and optical scanning-based digital technologies. J Clin Periodontol 2020; 48:315-334. [PMID: 33151586 DOI: 10.1111/jcpe.13401] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/06/2020] [Accepted: 10/28/2020] [Indexed: 12/13/2022]
Abstract
AIM To evaluate techniques for assessing soft tissue alterations at implant sites and compare the traditionally utilized methods to the newer three-dimensional technologies emerging in the literature. MATERIALS AND METHODS A comprehensive search was performed to identify interventional studies reporting on volumetric changes at implant sites following different treatments. RESULTS Seventy-five articles were included the following: 30 used transgingival piercing alone, one utilized calliper, six with ultrasonography, six on cone-beam computed tomography, and 32 utilized optical scanning and digital technologies. Optical scanning-based digital technologies were the only approach that provided 'volumetric changes,' reported as volumetric variation in mm3 , or the mean distance between the surfaces/mean thickness of the reconstructed volume. High variability in the digital analysis and definition of the region of interest was observed. All the other methods reported volume variation as linear dimensional changes at different apico-coronal levels. No studies compared volumetric changes with different approaches. CONCLUSIONS Despite the emergence of optical scanning-based digital technologies for evaluating volumetric changes, a high degree of variation exists in the executed workflow, which renders the comparison of study results not feasible. Establishment of universal guidelines could allow for volumetric comparisons among different studies and treatments.
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Affiliation(s)
- Lorenzo Tavelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Shayan Barootchi
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Jad Majzoub
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Rafael Siqueira
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Gustavo Mendonça
- Department of Biologic and Materials Sciences, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Kim YK, Ku JK. Guided bone regeneration. J Korean Assoc Oral Maxillofac Surg 2020; 46:361-366. [PMID: 33122463 PMCID: PMC7609932 DOI: 10.5125/jkaoms.2020.46.5.361] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 12/15/2022] Open
Abstract
Guided bone regeneration (GBR) is a surgical procedure that utilizes bone grafts with barrier membranes to reconstruct small defects around dental implants. This procedure is commonly deployed on dehiscence or fenestration defects ≥2 mm, and mixing with autogenous bone is recommended on larger defects. Tension-free primary closure is a critical factor to prevent wound dehiscence, which is critical cause of GBR failure. A barrier membrane should be rigidly fixed without mobility. If the barrier is exposed, closed monitoring should be utilized to prevent secondary infection.
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Affiliation(s)
- Young-Kyun Kim
- Editor-in-Chief of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea.,Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jeong-Kui Ku
- Section Editor of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea.,Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Hospital, Armed Forces Medical Command, Seongnam, Korea
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20
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Contour changes of peri-implant tissues are minimal and similar for a one- and a two-piece implant system over 12 years. Clin Oral Investig 2020; 25:719-727. [PMID: 33063219 PMCID: PMC7819926 DOI: 10.1007/s00784-020-03638-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/07/2020] [Indexed: 01/23/2023]
Abstract
Objectives To assess contour changes of peri-implant tissues comparing a one- and a two-piece dental implant system over 12 years. Materials and methods Patients seeking implant therapy were enrolled and randomly allocated to receive implants (a one-piece (STM) or a two-piece (BRA) system). Impressions were taken at the time of insertion of the final reconstruction (BL), after 1 year (FU-1), 5 years (FU-5), and at 12 years (FU-12). Thirty patients were included in the analysis (STM, 16; BRA, 14). Digital scans of casts were superimposed and analyzed in an image analysis program. Measurements included changes of the crown height, contour changes on the buccal side of the implants and the contralateral teeth (control). Results Contour changes at implant sites revealed a loss of − 0.29 mm (STM) and − 0.46 mm (BRA) during an observation period of 12 years. Contour changes at the corresponding tooth sites amounted to − 0.06 mm (STM) and − 0.12 mm (BRA) during the same time period. The implant crown gained 0.25 mm (STM) and 0.08 mm (BRA) in height due to recession of the marginal mucosa. The corresponding gain in crown height at the contralateral tooth sites amounted to 0.36 mm (STM) and 0.10 mm (BRA). Interproximal marginal bone level changes measured − 0.28 mm (STM) and − 1.11 mm (BRA). The mean BOP amounted to 38.8% (STM) and 48.7% (BRA) at the 12-year follow-up (FU-12). Conclusion Minimal changes of the peri-implant soft tissue contour were observed at implant sites over the period of 12 years irrespective of the use of a one- or a two-piece implant system. The differences between the implant sites and corresponding teeth were clinically negligible. Clinical relevance Peri-implant soft tissue stability is of high clinical relevance when monitoring dental implant sites on the long run. Clinical data on the extent of soft tissue changes around different implant systems are scarce. The present RCTs demonstrate minimal changes of the peri-implant soft tissue contour 12 years after implant insertion independent of the use of a one- or a two-piece implant system.
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Di Raimondo R, Sanz-Esporrín J, Sanz-Martin I, Plá R, Luengo F, Vignoletti F, Nuñez J, Sanz M. Hard and soft tissue changes after guided bone regeneration using two different barrier membranes: an experimental in vivo investigation. Clin Oral Investig 2020; 25:2213-2227. [PMID: 32851532 DOI: 10.1007/s00784-020-03537-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the contour and volumetric changes of hard and soft tissues after guided bone regeneration (GBR) using two types of barrier membranes together with a xenogeneic bone substitute in dehiscence-type defects around dental implants. MATERIAL AND METHODS In 8 Beagle dogs, after tooth extraction, two-wall chronified bone defects were developed. Then, implants were placed with a buccal dehiscence defect that was treated with GBR using randomly: (i) deproteinized bovine bone mineral (DBBM) covered by a synthetic polylactic membrane (test group), (ii) DBBM plus a porcine natural collagen membrane (positive control) and (iii) defect only covered by the synthetic membrane (negative control group). Outcomes were evaluated at 4 and 12 weeks. Micro-CT was used to evaluate the hard tissue volumetric changes and STL files from digitized cast models were used to measure the soft tissues contour linear changes. RESULTS Test and positive control groups were superior in terms of volume gain and contour changes when compared with the negative control. Soft tissue changes showed at 4 weeks statistically significant superiority for test and positive control groups compared with negative control. After 12 weeks, the results were superior for test and positive control groups but not statistically significant, although, with a lesser magnitude, the negative control group exhibited gains in both, soft and hard tissues. CONCLUSIONS Both types of membranes (collagen and synthetic) attained similar outcomes, in terms of hard tissue volume gain and soft tissue contours when used in combination with DBBM CLINICAL RELEVANCE: Synthetic membranes were a valid alternative to the "gold standard" natural collagen membrane for treating dehiscence-type defects around dental implants when used with a xenogeneic bone substitute scaffold.
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Affiliation(s)
- Riccardo Di Raimondo
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Javier Sanz-Esporrín
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Ignacio Sanz-Martin
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Rafael Plá
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Fernando Luengo
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Fabio Vignoletti
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Javier Nuñez
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain. .,ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.
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22
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Zhou Y, Lian H, Liu K, Wang D, Xiu X, Sun Z. Puerarin improves graft bone defect through microRNA‑155‑3p‑mediated p53/TNF‑α/STAT1 signaling pathway. Int J Mol Med 2020; 46:239-251. [PMID: 32377717 PMCID: PMC7255454 DOI: 10.3892/ijmm.2020.4595] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 01/23/2020] [Indexed: 02/07/2023] Open
Abstract
Bone graft defects may lead to dysfunction of bone regeneration and metabolic disorders of bone mesenchymal stem cells (BMSCs). Puerarin has demonstrated pharmacological activities in the treatment of human metabolic diseases. The purpose of the present study was to investigate the role of puerarin and to explore its possible protective mechanism of action in rats with bone grafts. A bone graft rat model was established using bone grafting surgery and the rats received puerarin or PBS. Reverse transcription-quantitative PCR, western blot, TUNEL, immunofluorescence and immunohistochemistry assays were used to analyze the beneficial effects of puerarin on bone repair. The results demonstrated that puer-arin effectively ameliorated pathological graft bone defects, decreased bone loss and apoptosis of BMSCs, promoted BMSC proliferation and differentiation, and increased bone mass and the parameters of bone formation in rats with bone grafts. Puerarin decreased the levels of pro-inflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-17A, IL-6 and transforming growth factor (TGF)-β1] and increased the levels of anti-inflammatory cytokines (IL-2 and IL-10) in the serum compared with the PBS group. Puerarin treatment was associated with lower serum alanine transaminase, glutamic oxaloacetic transaminase, γ-glutamyl transferase, alkaline phosphatase, direct bilirubin and total bilirubin levels compared with those in the PBS group in experimental rats. The expression of microRNA-155-3p (miR-155-3p) was upregulated, whereas that of p53, TNF-α and signal transducer and activator of transcription (STAT)1 was downregulated in BMSC cultures of puerarin-treated rats. In vitro assay demonstrated that knockdown of miR-155-3p increased p53, TNF-α and STAT1 expression in BMSCs, and blocked puerarin-regulated p53/TNF-α/STAT1 signaling. Most importantly, miR-155-3p knockdown inhibited puer-arin-regulated apoptosis, proliferation and differentiation of BMSCs. Moreover, the results demonstrated that puerarin regulated vascular endothelial growth factor expression via the miR-155-3p signaling pathway. In conclusion, the results of the present study demonstrated that the upregulation of miR-155-3p induced by puerarin promoted BMSC differentiation and bone formation and increased bone mass in rats with bone grafts, thereby supporting the potential application of puerarin in the prevention of bone graft defects.
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Affiliation(s)
- Yang Zhou
- Department of Stomatology, Mudanjiang Medical University, Affiliated Hongqi Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
| | - Hongyu Lian
- Second Department of Orthopedics Surgery, Mudanjiang Medical University, Affiliated Hongqi Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
| | - Kexin Liu
- Second Department of Orthopedics Surgery, Mudanjiang Medical University, Affiliated Hongqi Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
| | - Deli Wang
- Department of Stomatology, Mudanjiang Medical University, Mudanjiang, Heilongjiang 157000, P.R. China
| | - Xuelian Xiu
- Department of Stomatology, Mudanjiang Medical University, Affiliated Hongqi Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
| | - Zhang Sun
- Department of Stomatology, Mudanjiang Medical University, Affiliated Hongqi Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
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Barbeck M, Kühnel L, Witte F, Pissarek J, Precht C, Xiong X, Krastev R, Wegner N, Walther F, Jung O. Degradation, Bone Regeneration and Tissue Response of an Innovative Volume Stable Magnesium-Supported GBR/GTR Barrier Membrane. Int J Mol Sci 2020; 21:ijms21093098. [PMID: 32353983 PMCID: PMC7247710 DOI: 10.3390/ijms21093098] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction: Bioresorbable collagenous barrier membranes are used to prevent premature soft tissue ingrowth and to allow bone regeneration. For volume stable indications, only non-absorbable synthetic materials are available. This study investigates a new bioresorbable hydrofluoric acid (HF)-treated magnesium (Mg) mesh in a native collagen membrane for volume stable situations. Materials and Methods: HF-treated and untreated Mg were compared in direct and indirect cytocompatibility assays. In vivo, 18 New Zealand White Rabbits received each four 8 mm calvarial defects and were divided into four groups: (a) HF-treated Mg mesh/collagen membrane, (b) untreated Mg mesh/collagen membrane (c) collagen membrane and (d) sham operation. After 6, 12 and 18 weeks, Mg degradation and bone regeneration was measured using radiological and histological methods. Results: In vitro, HF-treated Mg showed higher cytocompatibility. Histopathologically, HF-Mg prevented gas cavities and was degraded by mononuclear cells via phagocytosis up to 12 weeks. Untreated Mg showed partially significant more gas cavities and a fibrous tissue reaction. Bone regeneration was not significantly different between all groups. Discussion and Conclusions: HF-Mg meshes embedded in native collagen membranes represent a volume stable and biocompatible alternative to the non-absorbable synthetic materials. HF-Mg shows less corrosion and is degraded by phagocytosis. However, the application of membranes did not result in higher bone regeneration.
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Affiliation(s)
- Mike Barbeck
- Department of Oral Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, Study Group: Biomaterials/Surfaces, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- BerlinAnalytix GmbH, 12109 Berlin, Germany
- Correspondence: ; Tel.: +49-(0)-176-81022467
| | - Lennart Kühnel
- Department of Oral Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, Study Group: Biomaterials/Surfaces, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Frank Witte
- Biotrics Bioimplants GmbH, 12109 Berlin, Germany
| | | | - Clarissa Precht
- Department of Oral Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, Study Group: Biomaterials/Surfaces, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Xin Xiong
- NMI Natural and Medical Sciences Institute, University of Tübingen, 72770 Reutlingen, Germany
| | - Rumen Krastev
- NMI Natural and Medical Sciences Institute, University of Tübingen, 72770 Reutlingen, Germany
- Faculty of Applied Chemistry, Reutlingen University, 72762 Reutlingen, Germany
| | - Nils Wegner
- Department of Materials Test Engineering (WPT), TU Dortmund University, 44227 Dortmund, Germany
| | - Frank Walther
- Department of Materials Test Engineering (WPT), TU Dortmund University, 44227 Dortmund, Germany
| | - Ole Jung
- Department of Oral Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, Study Group: Biomaterials/Surfaces, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
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24
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Thoma DS, Bienz SP, Figuero E, Jung RE, Sanz-Martín I. Efficacy of lateral bone augmentation performed simultaneously with dental implant placement: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:257-276. [PMID: 30675733 DOI: 10.1111/jcpe.13050] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/16/2018] [Accepted: 10/26/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To analyse the evidence regarding the efficacy of lateral bone augmentation procedures in terms of defect resolution in cases of horizontal ridge deficiencies after implant placement. MATERIALS AND METHODS Included studies met the following inclusion criteria: randomized controlled trials (RCTs) or controlled clinical trials (CCTs), re-entry procedure to assess defect resolution, minimum of 10 patients (5 per group). Meta-analyses were performed whenever possible, including subgroup analysis based on membranes and grafting materials. RESULTS Twenty-eight publications (20 short-term, 8 follow-up studies) were included. The most often used type of intervention was a xenogeneic particulated grafting material (XE) and a resorbable collagen membrane (CM). The mean defect height at baseline amounted to 5.1 mm (range 2.4-7.8) and decreased to a mean of 0.9 mm (range 0.2-2.2) at re-entry, and the mean defect resolution was 81.3% (range 56.4%-97.1%). Defect height reduction was not significantly different using CM+XE as control treatment compared to the combined data of the respective test groups [n = 11; weighted mean difference (WMD) = -0.006 mm; 95% CI, -0.61, 0.60; p = 0.985]. The absence of any lateral bone augmentation was less favourable than the conjunction of a membrane and a bone grafting material (n = 1; MD = -1.96 mm; 95% CI, -3.48, -0.44; p = 0.011). The lack of a grafting material was less favourable than the conjunction of grafting material and membrane (n = 1; MD = -2.44 mm; 95% CI, -4.53, -0.35; p = 0.022), and the addition of a membrane compared to a grafting material alone was more favourable (n = 3; WMD = 0.97 mm; 95% CI, 0.31, 1.64; p = 0.004). CONCLUSIONS Lateral bone augmentation is a successful treatment modality. For optimal defect height reduction, a barrier membrane and a grafting material should be combined.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Elena Figuero
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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25
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Fenbo M, Xingyu X, Bin T. Strontium chondroitin sulfate/silk fibroin blend membrane containing microporous structure modulates macrophage responses for guided bone regeneration. Carbohydr Polym 2019; 213:266-275. [DOI: 10.1016/j.carbpol.2019.02.068] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/14/2019] [Accepted: 02/17/2019] [Indexed: 12/19/2022]
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26
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Comparison of Different Bone Filling Materials and Resorbable Membranes by Means of Micro-Tomography. A Preliminary Study in Rabbits. MATERIALS 2019; 12:ma12081197. [PMID: 31013766 PMCID: PMC6514859 DOI: 10.3390/ma12081197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/07/2019] [Accepted: 04/09/2019] [Indexed: 11/16/2022]
Abstract
The purpose of this work was to evaluate the behavior of different membranes and bone filling materials used to fill critical defects in rabbit calvaria. Four defects were prepared in the cranial calvaria of female rabbits. They were randomly divided into three subgroups according to the type of barrier membrane to be used. Four animals carried cross-linked bovine collagen membranes (Mem-Lok, Bio-Horizons, Birmingham, AL, USA)), four human fascia lata membranes (Tissue, Inbiomed SA, Córdoba, Argentina) and four human chorioamniotic membranes (Tissue. Inbiomed SA, Córdoba, Argentina). The defects were filled with the deproteinized bovine bone particulate BioOss® (GeistlichPharma AG, Wolhusen, Switzerland), with particulate human hydroxyapatite MinerOss® (Bio-Horizons, Birmingham, AL, USA), with particulate dental material (Tissue Bank Foundation, Inbiomed S.A., Córdoba, Argentina), and the last one was left without the addition of filler material. In the first group of four specimens, a resorbable cross-linked bovine collagen membrane was placed over the skull and defects, without additional fixing. In the second group, a human fascia lata membrane was placed, without additional fixing. In the third group, a human chorioamniotic membrane was placed, without additional fixing. The animals were sacrificed at 4 and 8 weeks. The highest percentages of relative radiological density (average) were recorded considering the amnio-chorionic membranes (83.63%) followed by collagen (81.44%) and finally the fascia lata membranes (80.63%), but the differences were not statistically significant (p > 0.05). The sites grafted with a decellularized tooth (96.83%) and BioOss (88.42%), recorded the highest percentages of radiological density but did not differ significantly from each other (subset 2). The three membranes used did not show statistical differences between them, in any of the two time periods used. There were statistical differences between the filling materials evidencing the presence of a large quantity of calcified material in the defects treated with particulate tooth and deproteinized bovine bone and while smaller amounts of calcified material were registered in the case of defects treated with human hydroxyapatite and those that were not treated.
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27
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Yang S, Guo Y, Zhang W, Zhang J, Zhang Y, Xu P. Effect of FGF-21 on implant bone defects through hepatocyte growth factor (HGF)-mediated PI3K/AKT signaling pathway. Biomed Pharmacother 2018; 109:1259-1267. [PMID: 30551376 DOI: 10.1016/j.biopha.2018.10.150] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 10/22/2018] [Accepted: 10/25/2018] [Indexed: 11/28/2022] Open
Abstract
Implant bone defects are the most common phenomenon in the processes of bone transplantation. Evidences have identified that fibroblast growth factor-21 (FGF-21) encourages osteogenesis for patients with implant bone defects. The purpose of this study was to investigate the role of FGF-21 and its potential mechanism in bone mesenchymal stem cells (BMSCs). RT-PCR, Western blotting, flow cytometry, immunofluorescence and immunohistochemistry assays were performed to analyze the role of FGF-21 and intracellular signaling pathways involved in BMSCs. It was shown that FGF-21 increased viability of BMSCs. Treatment with FGF-21 decreased the apoptosis of BMSCs by decreasing pro-apoptosis protein Caspase-3. Results indicated that FGF-21 (2 mg/kg) treatment up-regulated HGF, PI3K and AKT expression in BMSCs. In addition, the protective effects of FGF-21 on BMSCs were canceled by PI3K/AKT inhibitor in BMSCs. Results found that knockdown of HGF abolished FGF-21-decreased PI3K/AKT signal pathway. Furthermore, results demonstrated that FGF-21 presented beneficial effects for implant bone defects in rat model. In conclusion, these results indicate that FGF-21 can improve implant bone defects through HGF-mediated PI3K/AKT signaling pathway in BMSCs.
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Affiliation(s)
- Shimao Yang
- Department of Oral and Maxillofacial Surgery, Jinan Stomatology Hospital, Jinan City, Shandong Province, China
| | - Yanwei Guo
- Department of Oral and Maxillofacial Surgery, Jining Stomatology Hospital, Jining City, Shandong Province, China
| | - Wenmei Zhang
- Department of Oral and Maxillofacial Surgery, Jinan Stomatology Hospital, Jinan City, Shandong Province, China
| | - Jin Zhang
- Department of Oral and Maxillofacial Surgery, Jinan Stomatology Hospital, Jinan City, Shandong Province, China
| | - Yujie Zhang
- Department of Oral and Maxillofacial Surgery, Jinan Stomatology Hospital, Jinan City, Shandong Province, China
| | - Peng Xu
- Department of Dental Implant, Stomatological Hospital of Chongqing Medical University, Chongqing, 400015, China.
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