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Kim K, Su Y, Kucine AJ, Cheng K, Zhu D. Guided Bone Regeneration Using Barrier Membrane in Dental Applications. ACS Biomater Sci Eng 2023; 9:5457-5478. [PMID: 37650638 DOI: 10.1021/acsbiomaterials.3c00690] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Guided bone regeneration (GBR) is a widely used technique in preclinical and clinical studies due to its predictability. Its main purpose is to prevent the migration of soft tissue into the osseous wound space, while allowing osseous cells to migrate to the site. GBR is classified into two main categories: resorbable and non-resorbable membranes. Resorbable membranes do not require a second surgery but tend to have a short resorption period. Conversely, non-resorbable membranes maintain their mechanical strength and prevent collapse. However, they require removal and are susceptible to membrane exposure. GBR is often used with bone substitute graft materials to fill the defect space and protect the bone graft. The membrane can also undergo various modifications, such as surface modification and biological factor loading, to improve barrier functions and bone regeneration. In addition, bone regeneration is largely related to osteoimmunology, a new field that focuses on the interactions between bone and the immune system. Understanding these interactions can help in developing new treatments for bone diseases and injuries. Overall, GBR has the potential to be a powerful tool in promoting bone regeneration. Further research in this area could lead to advancements in the field of bone healing. This review will highlight resorbable and non-resorbable membranes with cellular responses during bone regeneration, provide insights into immunological response during bone remodeling, and discuss antibacterial features.
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Affiliation(s)
- Kakyung Kim
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
| | - Yingchao Su
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
| | - Allan J Kucine
- Department of Oral and Maxillofacial Surgery, Stony Brook University, Stony Brook, New York 11794, United States
| | - Ke Cheng
- Department of Biomedical Engineering, Columbia University, New York City, New York 10027, United States
| | - Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
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McKenna GJ, Gjengedal H, Harkin J, Holland N, Moore C, Srinivasan M. EFFECT OF AUTOGENOUS BONE GRAFT SITE ON DENTAL IMPLANT SURVIVAL AND DONOR SITE COMPLICATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2022; 22:101731. [PMID: 36162883 DOI: 10.1016/j.jebdp.2022.101731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/10/2022] [Accepted: 03/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis was undertaken to answer the following focus questions: Is the implant survival in augmented bone utilizing iliac crest bone grafts the same as while using intraoral autologous bone grafts? Is the incidence of postoperative donor site complications the same when using iliac crest bone grafts as opposed to intraoral grafts? METHODS Systematic searches of electronic databases (PubMed, Embase, CENTRAL) were performed to identify studies which reported on implant survival and postoperative complications for dental implants placed in grafted partially/completely edentulous human jaws. Studies were included if: they reported on 2-piece micro-rough surface root form dental implants placed in bone-augmented completely or partially edentulous human jaws, and the jaws must have been augmented with autologous bone graft materials. Time and nature of postoperative complications must have been reported. Two investigators performed data extraction and a Cohen's unweighted kappa was calculated for inter-investigator reliability. A meta-analysis was performed for the extracted data on implant survival rate in both iliac crest grafts and intra-oral grafts. A qualitative analysis was performed on the information extracted on graft donor site complications. Quality assessment of the included studies were done using the Cochrane collaboration tool and the Newcastle-Ottawa scales. RESULTS A total of 23 studies were included in the final analysis. The calculated kappa ranged between 0.77-0.89 for the literature search and identification process. Fourteen studies were included with data on implant survival including five randomized controlled clinical trials. The meta-analysis of included studies revealed that the implant survival rate of dental implants placed in jaws augmented with iliac crest grafts was lower than those placed in jaws augmented with intra-oral bone grafts at 6-months [ICG = 95.8% IOG = 98.4%; P < .001], 12-months [ICG = 97.0%, IOG = 98.4%; P < .001], 24-months [ICG = 85.9%, IOG = 98.2%; P < .001], 60-months [ICG = 90.0%, IOG = 91.5%; P < .001], and at 120-months [ICG = 88.8%, IOG = 95.2%; P < .001] follow-up periods. Iliac crest grafts were also frequently associated with donor site complications including pain / discomfort, gait disturbance, and sensory disturbance. CONCLUSIONS This systematic review and meta-analysis demonstrates that implant survival is consistently higher in bone harvested from intraoral sites compared to iliac crest grafts. Donor site complications seemed to be a frequent finding with iliac crest grafts and mental grafts. FUNDING None. REGISTRATION The review protocol was registered with PROSPERO: International prospective register of systematic reviews (CRD42021283738).
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Affiliation(s)
- Gerald J McKenna
- Clinical Reader / Consultant in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Harald Gjengedal
- Institute of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Jennifer Harkin
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Nicola Holland
- Specialty Registrar in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Ciaran Moore
- Specialty Registrar in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Murali Srinivasan
- Clinic of General-, Special care and Geriatric Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Borgia GS, Pebé P, Barbot R, Haas AN. Immediate implants with buccal defects filled with bone from the tuberosity or a xenograft: 1-year randomized trial. Braz Oral Res 2022; 36:e102. [PMID: 35830145 DOI: 10.1590/1807-3107bor-2022.vol36.0102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to compare the use of autologous bone from tuberosity (TUBER) and deproteinized bovine bone mineral (DBBM) in immediate implants with buccal bone defects. A total of 31 patients with one single tooth in the upper anterior region indicated for extraction presenting tomographic buccal bone defect were analyzed. Immediate implantation was conducted for all patients. In one group, DBBM and a collagen membrane were inserted into the buccal defect; in the other group, a small block of bone from tuberosity was used. The primary outcome was facial-palatal ridge thickness (FPT) measured in casts 1 year after function. The implant success rate was 100% in both groups. FPT changes were <0.5 mm and did not differ significantly between groups. FPT reductions in the DBBM and TUBER groups were 1% and 0.6%, respectively, at the gingival margin and 5% and 2%, respectively, at 6 mm apical of the gingival margin (p > 0.05). No significant differences were observed between groups for patient's esthetic, satisfaction, pain and quality of life. Pink esthetic scores for the DBBM and TUBER were 11.5±1.7 and 10.8±1.9, respectively (p=0.37). It can be concluded that DBBM and TUBER did not differ in terms of ridge alterations, peri-implant clinical parameters and patient-reported outcomes.
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Affiliation(s)
- Gonzalo Stagnaro Borgia
- Universidad de la Republica del Uruguay, Faculty of Dentistry, Department of Oral and Maxillofacial Prosthesis, Montevideo, Uruguay
| | - Pablo Pebé
- Universidad de la Republica del Uruguay, Faculty of Dentistry, Department of Oral and Maxillofacial Prosthesis, Montevideo, Uruguay
| | - Roberto Barbot
- Universidad de la Republica del Uruguay, Faculty of Dentistry, Department of Oral and Maxillofacial Prosthesis, Montevideo, Uruguay
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Periodontology and Implantology, Porto Alegre, RS, Brazil
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Kim YK, Ku JK. Sinus membrane elevation and implant placement. J Korean Assoc Oral Maxillofac Surg 2020; 46:292-298. [PMID: 32855378 PMCID: PMC7469962 DOI: 10.5125/jkaoms.2020.46.4.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022] Open
Abstract
Sinus Schneiderian membrane elevation surgery is widely performed for dental implant placement in the maxillary posterior region. With regard to sinus elevation surgery, various complications can occur and lead to implant failure. For successful implants in the maxillary posterior region, the clinician must be well acquainted with sinus anatomy and pathology, a variety of bone graft materials, the principles of sinus elevation surgery, and prevention and management of complications.
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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, Seongnam, Korea.,Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Seongnam, 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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Three-Layered Closure of Persistent Oroantral Fistula Using Chin Graft, Buccal Fat Pad, and Buccal Advancement Flap: A Case Report with Review of Literature. Case Rep Dent 2019; 2019:8450749. [PMID: 31485358 PMCID: PMC6710802 DOI: 10.1155/2019/8450749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/20/2019] [Accepted: 07/30/2019] [Indexed: 11/30/2022] Open
Abstract
Various techniques have been used for the repair of oroantral fistula (OAF) but majority of them have focused on the soft tissue closure alone, and most of the time, the osseous floor of the sinus was ignored. Existing literature supports that bone grafts supported by Buccal Fat Pad (BFP) heal well without undergoing significant resorption and necrosis. Through this case report, we wish to elaborate on the clinical success of using BFP and autogenous chin graft for simultaneous reconstruction of a large long-standing oroantral fistula with underlying osseous defect. The combination technique can prove beneficial for osseous regeneration of sinus floor and improve chances for future implant prosthetic rehabilitation.
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Bone Regeneration Effect of Hyperbaric Oxygen Therapy Duration on Calvarial Defects in Irradiated Rats. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9051713. [PMID: 31061829 PMCID: PMC6466916 DOI: 10.1155/2019/9051713] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/13/2019] [Indexed: 11/18/2022]
Abstract
Objective In this study, we evaluated changes in bone remodeling in an irradiated rat calvarial defect model according to duration of hyperbaric oxygen therapy. Materials and Methods The 28 rats were divided into four groups. Radiation of 12 Gy was applied to the skull, and 5-mm critical size defects were formed on both sides of the skull. Bone grafts were applied to one side of formed defects. From the day after surgery, HBO was applied for 0, 1, and 3 weeks. At 6 weeks after bone graft, experimental sites were removed and analyzed for radiography, histology, and histomorphometry. Results Micro-CT analysis showed a significant increase in new bone volume in the HBO-3 group, with or without bone graft. When bone grafting was performed, BV, BS, and BS/TV all significantly increased. Histomorphometric analysis showed significant increases in %NBA and %BVN in the HBO-1 and HBO-3 groups, regardless of bone graft. Conclusion Hyperbaric oxygen therapy was effective for bone regeneration with only 1 week of treatment.
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Park KM, Hu KS, Choi H, Oh SE, Kim HI, Park W, Kim S. Synergistic effect of hyperbaric oxygen therapy with PTH [1-34] on calvarial bone graft in irradiated rat. Oral Dis 2019; 25:822-830. [PMID: 30633848 DOI: 10.1111/odi.13037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/13/2018] [Accepted: 09/07/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To determine the synergistic effect of parathyroid hormone (PTH) [1-34] in combination with hyperbaric oxygen (HBO) on bone graft in a rat calvarial bone defect model under impaired osteogenic conditions. MATERIALS AND METHODS Twenty-four rats were divided into three groups. Localized radiation with a single 12 Gy dose was administered to the calvaria. Four weeks after radiation, calvarial circular defects were created in the parietal bones. All defects were filled with biphasic calcium phosphate. After the bone graft, PTH [1-34] was injected subcutaneously, and HBO was administered. At 6 weeks after the bone graft, the rats were sacrificed, and specimens were harvested. RESULTS Histomorphometric evaluation showed that the percentage of new bone area was higher in the PTH and PTH/HBO groups than in the control group. The percent residual material area was decreased in the PTH/HBO group compared with the control group. The percentage blood vessel number was highest in the PTH group. Micro-CT evaluation showed that the new bone volume was highest in the PTH/HBO group. The residual material volume was lowest in the PTH/HBO group. CONCLUSION Within the limitations of this study, our data indicate that PTH combined with HBO may reverse radiation-induced impairment of bone healing.
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Affiliation(s)
- Kyeong-Mee Park
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyung-Seok Hu
- Division of Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyunmin Choi
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Seo-Eun Oh
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Hyeong-Il Kim
- Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, Buffalo, New York
| | - Wonse Park
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
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Lie N, Merten HA, Yamauchi K, Wiltfang J, Kessler P. Pre-implantological bone formation in the floor of the maxillary sinus in a self-supporting space. J Craniomaxillofac Surg 2019; 47:454-460. [PMID: 30683623 DOI: 10.1016/j.jcms.2019.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/06/2018] [Accepted: 01/04/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION In edentulous patients the form and size of the maxillary sinus vary greatly. Therefore sinus floor augmentation is a standard procedure for implantological purposes. As the sinus membrane cannot be characterized as periosteum, various augmentation materials are used. HYPOTHESIS an artificially generated space underneath the sinus membrane in the floor of the sinus will lead to spontaneous callus forming and a stable bony consolidation without augmentation material. METHODS Ten edentulous patients with highly atrophic maxillae were selected. Augmentation of the sinus floor was carried out in a split-mouth study design: On one side a combination of autogenous and xenogenous bone was used, and on the contralateral side a sinus membrane elevation was performed without using any substitutes. After a 6-month interval bone specimens from the test regions were harvested during implant placement. RESULTS Clear histological evidence of new bone formation was found in all human bone specimens. An active de-novo bone formation process could be proven by the presence of Haversian systems (osteons) displaying osteoblastic and osteoclastic activity. CONCLUSION In the maxillary sinus of edentulous patients a spontaneous callus-derived de-novo bone formation is possible by elevating the sinus membrane without using augmentation materials.
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Affiliation(s)
- Nynke Lie
- Department of Cranio-Maxillofacial Surgery, (Head: Prof. Dr. P.A.W.H. Kessler), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
| | - Hans-Albert Merten
- Department of Orthodontics Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Kensuke Yamauchi
- Department of Oral-Maxillofacial Surgery, Tohoku University, Sendai, Japan
| | - Jörg Wiltfang
- Department of Oral-Maxillofacial Surgery, University of Kiel, Arnold-Heller-Straße, D-24105, Kiel, Germany
| | - Peter Kessler
- Department of Cranio-Maxillofacial Surgery, (Head: Prof. Dr. P.A.W.H. Kessler), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands
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Vieira WA, McCusker CD. Regenerative Models for the Integration and Regeneration of Head Skeletal Tissues. Int J Mol Sci 2018; 19:E3752. [PMID: 30486286 PMCID: PMC6321600 DOI: 10.3390/ijms19123752] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/17/2018] [Accepted: 11/20/2018] [Indexed: 12/19/2022] Open
Abstract
Disease of, or trauma to, the human jaw account for thousands of reconstructive surgeries performed every year. One of the most popular and successful treatment options in this context involves the transplantation of bone tissue from a different anatomical region into the affected jaw. Although, this method has been largely successful, the integration of the new bone into the existing bone is often imperfect, and the integration of the host soft tissues with the transplanted bone can be inconsistent, resulting in impaired function. Unlike humans, several vertebrate species, including fish and amphibians, demonstrate remarkable regenerative capabilities in response to jaw injury. Therefore, with the objective of identifying biological targets to promote and engineer improved outcomes in the context of jaw reconstructive surgery, we explore, compare and contrast the natural mechanisms of endogenous jaw and limb repair and regeneration in regenerative model organisms. We focus on the role of different cell types as they contribute to the regenerating structure; how mature cells acquire plasticity in vivo; the role of positional information in pattern formation and tissue integration, and limitations to endogenous regenerative and repair mechanisms.
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Affiliation(s)
- Warren A Vieira
- Department of Biology, University of Massachusetts Boston, Boston, MA 02125, USA.
| | - Catherine D McCusker
- Department of Biology, University of Massachusetts Boston, Boston, MA 02125, USA.
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A description of the sequence of long-term behavior of autogenous boneblock in maxillary sinus augmentation in sheep: Additional morphologic and histomorphometric evidence. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:6-13. [PMID: 29150321 DOI: 10.1016/j.oooo.2017.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/16/2017] [Accepted: 09/14/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To document the behavior of autogenous bone block in sinus lift and surgical consequences. STUDY DESIGN Twelve sinus lifts with autogenous hip bone blocks and simultaneous insertion of two implants in 6 adult female sheep. Polychrome sequential labelling and histologic and histomorphometric evaluation after 6, 16, and 26 weeks. RESULTS Augmentation material in the apical third was almost fully resorbed after 26 weeks (P = .00388). Percentage of bone tissue increased 0.5-1.0 mm from the implant in crestal region (15.3 ± 7.5% to 16.2 ± 10.1%), whereas it vanished in the apical region from 16 to 26 weeks (4.2 ± 10.4% to 0%) (P = .363). CONCLUSIONS Autogenous bone block leaves an apical thin but functionally crucial layer covering implants in a form follows function way. Denial of animal-originated biomaterials and prion diseases remain a rarely discussed issue. The use of an implant length-adapted autogenous transplant with osseoinductive advantages should be taken into consideration.
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Kang YH, Kim HM, Byun JH, Kim UK, Sung IY, Cho YC, Park BW. Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone. BMC Oral Health 2015; 15:172. [PMID: 26714451 PMCID: PMC4696287 DOI: 10.1186/s12903-015-0156-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 12/17/2015] [Indexed: 11/10/2022] Open
Abstract
Background Jaw bone and iliac bone are the most frequently used autologous bone sources for dental implant placement in patients with atrophic alveolar ridges. However, the comparative long-term stability of these two autologous bone grafts have not yet been investigated. The aim of this study was to compare the stability of simultaneously placed dental implants with autologous bone grafts harvested from either the iliac crest or the intraoral jaw bone for severely atrophic alveolar ridges. Methods In total, 36 patients (21 men and 15 women) were selected and a retrospective medical record review was performed. We compared the residual increased bone height of the grafted bone, peri-implantitis incidence, radiological density in newly generated bones (HU values), and implant stability using resonance frequency analysis (ISQ values) between the two autologous bone graft groups. Results Both autologous bone graft groups (iliac bone and jaw bone) showed favorable clinical results, with similar long-term implant stability and overall implant survival rates. However, the grafted iliac bone exhibited more prompt vertical loss than the jaw bone, in particular, the largest vertical bone reduction was observed within 6 months after the bone graft. In contrast, the jaw bone graft group exhibited a slower vertical bone resorption rate and a lower incidence of peri-implantitis during long-term follow-up than the iliac bone graft group. Conclusions These findings demonstrate that simultaneous dental implantation with the autologous intraoral jaw bone graft method may be reliable for the reconstruction of edentulous atrophic alveolar ridges.
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Affiliation(s)
- Young-Hoon Kang
- Department of Oral and Maxillofacial Surgery, Gyeongsang National University School of Medicine, Institute of Health Science, Jinju, 660-702, Republic of Korea
| | - Hyun-Min Kim
- Department of Oral and Maxillofacial Surgery, Gyeongsang National University School of Medicine, Institute of Health Science, Jinju, 660-702, Republic of Korea
| | - June-Ho Byun
- Department of Oral and Maxillofacial Surgery, Gyeongsang National University School of Medicine, Institute of Health Science, Jinju, 660-702, Republic of Korea
| | - Uk-Kyu Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Busan, Republic of Korea
| | - Iel-Yong Sung
- Department of Oral and Maxillofacial Surgery, College of Medicine, Ulsan University, Ulsan, Republic of Korea
| | - Yeong-Cheol Cho
- Department of Oral and Maxillofacial Surgery, College of Medicine, Ulsan University, Ulsan, Republic of Korea
| | - Bong-Wook Park
- Department of Oral and Maxillofacial Surgery, Gyeongsang National University School of Medicine, Institute of Health Science, Jinju, 660-702, Republic of Korea.
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Lie N, Merten HA, Meyns J, Lethaus B, Wiltfang J, Kessler P. Elevation of the maxillary sinus membrane for de-novo bone formation: First results of a prospective study in humans. J Craniomaxillofac Surg 2015; 43:1670-7. [PMID: 26293185 DOI: 10.1016/j.jcms.2015.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 07/14/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Sinus floor elevation via the lateral window approach represents a reliable technique for bone augmentation in the atrophic posterior maxilla. It is known that sinus membrane elevation leads to new bone formation. This prospective clinical study compared a specific technique in sinus membrane elevation with a conventional sinus floor augmentation (xenogenous/autogenous bone) in a human split mouth model. METHODS Five edentulous patients with highly atrophic posterior maxillae were included in this study. On one maxillary side a degradable PDLLA-membrane was placed to create a space underneath the sinus membrane. Contralateral a mixture of autogenous and xenogenous bone was used for sinus floor augmentation. A two-stage procedure was carried out. The following variables were assessed: bone regeneration on cone-beam computed tomography (cone-beam CT), implant success, prosthetic comfort and patient satisfaction. Bone biopsies were taken with simultaneous implant placement. The samples were histologically analyzed. RESULTS Cone-beam CTs revealed new bone formation on both sides. Thirty implants were placed, 15 in the augmented region and 15 in the non-augmented side. Thirty bone biopsies were taken and evaluated. Vital new bone was detected on the experimental side (osteoinductivity). On the conventional side a mixture of autogenous and residual bone substitute material was seen (osteoconductivity). Implant survival was 100% so far. Patient's satisfaction was high and prosthetic complications were not encountered. CONCLUSION As it provides the highest rate of bone formation, autogenous bone in combination with bone substitute material can be considered as a very reliable standard procedure in sinus floor augmentation. The specific sinus membrane elevation technique as presented here showed satisfying results and might be a suitable alternative for maxillary sinus augmentation.
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Affiliation(s)
- Nynke Lie
- Department of Cranio-Maxillofacial Surgery (Head: Prof. P. Kessler), Maastricht Univesity Medical Center, Maastricht, The Netherlands.
| | | | - Joeri Meyns
- Department of Cranio-Maxillofacial Surgery (Head: Prof. P. Kessler), Maastricht Univesity Medical Center, Maastricht, The Netherlands
| | - Bernd Lethaus
- Department of Oral-Maxillofacial Surgery, University of Aachen, Aachen, Germany
| | - Jörg Wiltfang
- Department of Oral-Maxillofacial Surgery (Head: Prof. J. Wiltfang), University of Kiel, Kiel, Germany
| | - Peter Kessler
- Department of Cranio-Maxillofacial Surgery (Head: Prof. P. Kessler), Maastricht Univesity Medical Center, Maastricht, The Netherlands
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Bacci C, Lucchiari N, Berengo M, Paulon G, Stellini E. Semplicità ed efficacia d’impiego di due dispositivi per il prelievo di osso particolato: strumento piezoelettrico e scraper osseo. DENTAL CADMOS 2015. [DOI: 10.1016/s0011-8524(15)70271-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Moest T, Koehler F, Prechtl C, Schmitt C, Watzek G, Schlegel KA. Bone formation in peri-implant defects grafted with microparticles: a pilot animal experimental study. J Clin Periodontol 2014; 41:990-8. [PMID: 25131387 DOI: 10.1111/jcpe.12295] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2014] [Indexed: 01/01/2023]
Abstract
AIM This study aimed to evaluate the healing of peri-implant defects grafted with microparticles (MPs). MATERIAL AND METHODS Six domestic pigs received nine standardized defects at the calvaria, and an implant was inserted in the middle of each defect. The space between the implant and lateral bone portion was filled with MP pellets (n = 18) or MP supernatant (n = 18) or left unfilled (n = 18). After 14 and 28 days, three animals were sacrificed and specimens removed for further processing. Samples were microradiographically and histologically analysed. In addition, we immunohistochemically stained for anti-vWF as a marker of angiogenesis. RESULTS In the case of bone regeneration and vessel formation, the null hypothesis can be partially rejected. After 14 and 28 days, no significant difference was observed within groups regarding de novo bone formation, bone density and osseointegration. However, superior vessel formation was found at both time points. CONCLUSION Microparticles represent a promising treatment option to accelerate peri-implant vessel formation. Further studies are needed to investigate the regenerative properties of MPs more precisely.
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Affiliation(s)
- Tobias Moest
- Oral and Maxillofacial Surgery, University Hospital Erlangen, Erlangen, Germany
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Schmitt CM, Moest T, Lutz R, Neukam FW, Schlegel KA. Anorganic bovine bone (ABB) vs. autologous bone (AB) plus ABB in maxillary sinus grafting. A prospective non-randomized clinical and histomorphometrical trial. Clin Oral Implants Res 2014; 26:1043-50. [PMID: 24730602 DOI: 10.1111/clr.12396] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This investigation focused on histological characteristics and 5-year implant survival after sinus floor augmentation with anorganic bovine bone (ABB, Bio-Oss) and ABB plus autologous bone (AB) with a ratio of 1/1. MATERIAL AND METHODS Nineteen consecutive patients with bony atrophy of the posterior edentulous maxilla and a vertical bone height ≤4 mm were prospectively included in this study. In the first surgical stage, the maxillary sinus was non-randomized either augmented with ABB alone (n = 12) or a 1/1 mixture of ABB and AB (n = 7). After a mean healing period of 167 days, biopsies were harvested in the region of the grafted sinus with a trephine burr and implants were placed simultaneously, ABB n = 18 and ABB + AB n = 12. The samples were microradiographically and histomorphometrically analyzed judging the newly formed bone (bone volume, BV), residual bone substitute material volume (BSMV), and intertrabecular volume (soft tissue volume, ITV) in the region of the augmented maxillary sinus. Implant survival was retrospectively evaluated from patient's records. RESULTS No significant difference in residual bone substitute material (BSMV) in the ABB group (31.21 ± 7.74%) and the group with the mixture of ABB and AB (28.41 ± 8.43%) was histomorphologically determined. Concerning the de novo bone formation, also both groups showed statistically insignificant outcomes; ABB 26.02 ± 5.23% and ABB + AB 27.50 ± 6.31%. In all cases, implants were installed in the augmented sites with sufficient primary stability. After a mean time in function of 5 years and 2 months, implant survival was 93.75% in the ABB and 92.86% in the ABB + AB group with no statistically significant differences. CONCLUSION The usage of ABB plus AB to a 1/1 ratio leads to an amount of newly formed bone comparable with the solitary use of ABB after grafting of the maxillary sinus. Considering that ABB is a non-resorbable bone substitute, it can be hypothesized that this leads to stable bone over time and long-term implant success. Importantly, in the sole use of ABB, bone grafting and therefore donor site morbidities can be avoided.
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Affiliation(s)
- Christian M Schmitt
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Tobias Moest
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Friedrich W Neukam
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Lutz R, Berger-Fink S, Stockmann P, Neukam FW, Schlegel KA. Sinus floor augmentation with autogenous bone vs. a bovine-derived xenograft - a 5-year retrospective study. Clin Oral Implants Res 2014; 26:644-8. [DOI: 10.1111/clr.12352] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Rainer Lutz
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Susanne Berger-Fink
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Philipp Stockmann
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Friedrich Wilhelm Neukam
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen Germany
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17
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Choi H, Park NJ, Jamiyandorj O, Hong MH, Oh S, Park YB, Kim S. Improvement of osteogenic potential of biphasic calcium phosphate bone substitute coated with synthetic cell binding peptide sequences. J Periodontal Implant Sci 2012. [PMID: 23185697 PMCID: PMC3498301 DOI: 10.5051/jpis.2012.42.5.166] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose The aim of this study was to evaluate the improvement of osteogenic potential of biphasic calcium phosphate (BCP) bone substitute coated with synthetic cell-binding peptide sequences in a standardized rabbit sinus model. Methods Standardized 6-mm diameter defects were created bilaterally on the maxillary sinus of ten male New Zealand white rabbits, receiving BCP bone substitute coated with synthetic cell binding peptide sequences on one side (experimental group) and BCP bone substitute without coating (control group) on the other side. Histologic and histomorphometric analysis of bone formation was carried out after a healing period of 4 or 8 weeks. Results Histological analysis revealed signs of new bone formation in both experimental groups (4- and 8-week healing groups) with a statistically significant increase in bone formation in the 4-week healing group compared to the control group. However, no statistically significant difference in bone formation was found between the 8-week healing group and the control group. Conclusions This study found that BCP bone substitute coated with synthetic cell-binding peptide sequences enhanced osteoinductive potential in a standardized rabbit sinus model and its effectiveness was greater in the 4-week healing group than in the 8-week healing group.
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Affiliation(s)
- Hyunmin Choi
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
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18
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Schmitt C, Karasholi T, Lutz R, Wiltfang J, Neukam FW, Schlegel KA. Long-term changes in graft height after maxillary sinus augmentation, onlay bone grafting, and combination of both techniques: a long-term retrospective cohort study. Clin Oral Implants Res 2012; 25:e38-46. [DOI: 10.1111/clr.12045] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Christian Schmitt
- Department of Oral and Maxillofacial Surgery; University of Erlangen- Nuremberg; Erlangen Germany
- Faculty of Dentistry; University of Toronto; Toronto ON Canada
| | | | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery; University of Erlangen- Nuremberg; Erlangen Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery; University of Kiel; Kiel Germany
| | - Friedrich-Wilhelm Neukam
- Department of Oral and Maxillofacial Surgery; University of Erlangen- Nuremberg; Erlangen Germany
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery; University of Erlangen- Nuremberg; Erlangen Germany
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19
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Huang HL, Hsu JT, Chen MYC, Liu C, Chang CH, Li YF, Chen KT. Microcomputed tomography analysis of particular autogenous bone graft in sinus augmentation at 5 months: differences on bone mineral density and 3D trabecular structure. Clin Oral Investig 2012; 17:535-42. [PMID: 22526892 DOI: 10.1007/s00784-012-0725-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 04/03/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study investigated the effects of gender on the three-dimensional (3D) bone mineral density (BMD) and micromorphology of the trabeculae of matured autogenous bone grafts after sinus floor augmentation, and compared them to those of adjacent native bone. MATERIALS AND METHODS Ten bone biopsy samples were removed from the implant placement areas of patients who had received second-stage sinus floor augmentation, and analyzed by microcomputed tomography. BMD phantoms with two calcium hydroxyapatite densities (0.25 and 0.75 g/cm(3)) were used to determine the BMD of the grafted and native bone samples. The 3D structural parameters of the trabeculae, including percentage of bone volume (bone volume/tissue volume, BV/TV), trabecular thickness (Tb.Th), trabecular number, trabecular separation, trabecular pattern factor (Tb.Pf), and structure model index, were analyzed between males and females and between grafted bone and native bone. RESULTS No significant gender-specific differences in BMD and 3D trabecular structure of either native or grafted bone were found (P > 0.05). Compared to the adjacent native bone, the autogenous grafted bone exhibited lower BV/TV and Tb.Th as well as a higher Tb.Pf (P < 0.05). Additionally, there was a weak positive correlation between the Tb.Th values of grafted and native bone (R (2) = 0.58). CONCLUSIONS In the maxillary sinus, autogenous grafted bone exhibited lower BV/TV, Tb.Th, and trabecular connectivity than the adjacent native bone. No significant gender-specific differences were found for either the BMD or 3D trabecular structure of grafted bone. CLINICAL RELEVANCE After bone remodeling, autogenous grafted bone revealed different 3D trabecular structure as compared to native bone.
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Affiliation(s)
- Heng-Li Huang
- School of Dentistry, China Medical University, 91 Hsueh-Shih Road, 40402, Taichung, Taiwan.
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20
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Schmitt CM, Doering H, Schmidt T, Lutz R, Neukam FW, Schlegel KA. Histological results after maxillary sinus augmentation with Straumann® BoneCeramic, Bio-Oss®, Puros®, and autologous bone. A randomized controlled clinical trial. Clin Oral Implants Res 2012; 24:576-85. [PMID: 22324456 DOI: 10.1111/j.1600-0501.2012.02431.x] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This investigation focused on a comparison of clinical and histological characteristics after sinus floor augmentation with biphasic calcium phosphate (BCP, Straumann BoneCeramic(®) ), anorganic bovine bone (ABB, Geistlich Bio-Oss(®) ), mineralized cancellous bone allograft (MCBA, Zimmer Puros(®) ), or autologous bone (AB). MATERIALS AND METHODS Thirty consecutive patients with a posterior edentulous maxillary situation and a vertical bone height less than or equal to 4 mm were included in this study. A two-stage procedure was carried out. After augmentation of the maxillary sinus with ABB, BCP, MCBA, or AB followed by a healing period of 5 months, biopsies were taken with simultaneous implant placement. The samples were analyzed using microradiography and histology. RESULTS Ninety-four implants were placed in the augmented positions and 53 bone biopsies were taken and evaluated. The bone volume fraction of newly formed bone was measured as 30.28 ± 2.16% for BCP, 24.9 ± 5.67% for ABB, 41.74 ± 2.1% for AB, and 35.41 ± 2.78% for MCBA with significant increases in bone volume of AB vs. BCP and ABB, and MCBA vs. ABB samples. Significantly different residual bone substitute material was measured as 15.8 ± 2.1% in the BCP group and 21.36 ± 4.83% in the ABB group. CONCLUSION As it provides the highest rate of de novo bone formation, AB can be considered to remain the gold standard in sinus floor augmentation. All tested control materials showed comparable results and are suitable for maxillary sinus augmentation.
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Affiliation(s)
- Christian Martin Schmitt
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
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21
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Lee J, Susin C, Rodriguez NA, de Stefano J, Prasad HS, Buxton AN, Wikesjö UME. Sinus augmentation using rhBMP-2/ACS in a mini-pig model: relative efficacy of autogenous fresh particulate iliac bone grafts. Clin Oral Implants Res 2012; 24:497-504. [DOI: 10.1111/j.1600-0501.2011.02419.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2011] [Indexed: 11/29/2022]
Affiliation(s)
- Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
| | - Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
| | - Nancy A. Rodriguez
- Laboratory Animal Services; Georgia Health Sciences University; Augusta; GA; USA
| | - Jamie de Stefano
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
| | - Hari S. Prasad
- Hard Tissue Research Laboratory; Division of Oral and Maxillofacial Pathology; University of Minnesota School of Dentistry; Minneapolis; MN; USA
| | | | - Ulf M. E. Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
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Human Maxillary Sinuses Augmented With Mineralized, Solvent-Dehydrated Bone Allograft: A Longitudinal Case Series. IMPLANT DENT 2011; 20:445-54. [DOI: 10.1097/id.0b013e31823420a4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Huang HL, Chen MYC, Hsu JT, Li YF, Chang CH, Chen KT. Three-dimensional bone structure and bone mineral density evaluations of autogenous bone graft after sinus augmentation: a microcomputed tomography analysis. Clin Oral Implants Res 2011; 23:1098-103. [PMID: 22092756 DOI: 10.1111/j.1600-0501.2011.02273.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the relationships and differences in three-dimensional (3D) bone mineral density (BMD) and microtrabecular structures between autogenous bone grafts and their adjacent native bone after a healing period following maxillary sinus augmentation. MATERIALS AND METHODS Nine rod-shaped human bone biopsy samples were taken from patients receiving two-stage sinus augmentation therapy in implantation areas and analyzed using microcomputed tomography (micro-CT). Before micro-CT scanning, two BMD phantoms were placed near to the bone biopsy samples for executing BMD calculations of the grafted and native bone samples. In addition, 3D structural parameters of the trabeculae were analyzed for both the grafted and native bone, including percentage of bone volume [bone volume (BV)/tissue volume (TV)], bone-specific surface [bone surface (BS)/BV], trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular separation (Tb.Sp), trabecular pattern factor (Tb.Pf), and structure model index (SMI). RESULTS No significant correlations with regard to BMD and trabecular-structure parameters were found between native bone and grafted bone; however, BS/BV and Tb.Pf were higher and Tb.Th and Tb.Sp were 37.35% and 12.74% lower in grafted bone than in native bone. For grafted bone, there were significant correlations (P < 0.05) between BMD and BV/TV, and Tb.N. CONCLUSIONS When using autogenous bone as a graft material, BMD and micromorphological conditions of grafted bone were not influenced by the condition of the native bone in the maxilla. Differences were found in surface complexity, trabecular thickness, trabecular separation, and the connectivity of trabeculae between grafted and native bone. The BMD in grafted bone was affected by the quantity of the trabeculae.
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Affiliation(s)
- Heng-Li Huang
- School of Dentistry, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan.
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Camargo Filho GPD, Corrêa L, Costa C, Pannuti CM, Schmelzeisen R, Luz JGDC. Comparative study of two autogenous graft techniques using piezosurgery for sinus lifting. Acta Cir Bras 2011; 25:485-9. [PMID: 21120278 DOI: 10.1590/s0102-86502010000600005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Accepted: 06/21/2010] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Maxillary sinus lifting is a technique, in which, a possible complication is sinus membrane perforation. The aim of this study was to compare two techniques using ultrasound surgery to perform autogenous graft for maxillary sinus lifting. METHODS Ten rabbits were used in the study, one of them did not undergo surgery. The other nine rabbits had their maxillary sinuses filled with autogenous bone grafts collected from the external skull diploe in particulate form on the right side, and shaved on the left side, both with ultrasonic device. Data on bone density in left and right maxillary sinus, obtained by computed tomography in transverse and longitudinal sections, recorded 90 days after the grafts, were statistically compared. RESULTS There were no statistically significant differences between the two techniques that used shaved and particulate bone collected by means of ultrasonic device from rabbit skulls. CONCLUSION Assessment of operative procedures led to the conclusion that piezoelectric ultrasound was shown to be a safe tool in the surgical approach to the maxillary sinus of rabbits, allowing sinus membrane integrity to be maintained during surgical procedures.
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25
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Klijn RJ, Meijer GJ, Bronkhorst EM, Jansen JA. A meta-analysis of histomorphometric results and graft healing time of various biomaterials compared to autologous bone used as sinus floor augmentation material in humans. TISSUE ENGINEERING PART B-REVIEWS 2011; 16:493-507. [PMID: 20334505 DOI: 10.1089/ten.teb.2010.0035] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To date, no studies have been published in which histomorphometric data from a large group of patients comparing various biomaterials for sinus floor augmentation procedures were evaluated. MATERIALS AND METHODS A meta-analysis of the English literature from January 1993 till April 2009 was carried out. Out of 147 titles, according to our criteria, 64 articles were selected for analysis describing the use of autologous bone and their alternatives, such as allogenic, xenogenic, and alloplastic materials. RESULTS On the basis of autologous bone grafting, a reference value for total bone volume (TBV) of 63% was found. Particulation of the bone graft resulted in a general reduction of −18% in TBV. Delayed implant placement reduced the TBV with −7%. Overall TBV was 8% or 6% higher if a biopsy was, respectively, taken before 4.5 months or after 9.0 months after initial sinus augmentation surgery. Allogenic, xenogenic, alloplastic, or combinations of graft materials all resulted in a significant lower amount of TBV compared to autologous bone grafting ranging from −7% to −26%. Inventorying the effect of "biopsy time" for autologous bone, the TBV was significantly higher before 4.5 and after 9.0 months of healing time compared to period in between. Surprisingly, no significant differences in TBV with respect to "biopsy time" for bone substitutes were found. CONCLUSIONS On the basis of the aspect of TBV autologous bone still has to be considered to be the gold standard in sinus augmentation surgery. However, the consequence of the TBV for implant survival is still unraveled yet.
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Affiliation(s)
- Reinoud J Klijn
- Department of Periodontology and Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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26
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Lambert F, Léonard A, Drion P, Sourice S, Layrolle P, Rompen E. Influence of space-filling materials in subantral bone augmentation: blood clot vs. autogenous bone chips vs. bovine hydroxyapatite. Clin Oral Implants Res 2010; 22:538-45. [DOI: 10.1111/j.1600-0501.2010.02069.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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von See C, Rücker M, Kampmann A, Kokemüller H, Bormann KH, Gellrich NC. Comparison of different harvesting methods from the flat and long bones of rats. Br J Oral Maxillofac Surg 2010; 48:607-12. [DOI: 10.1016/j.bjoms.2009.09.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2009] [Accepted: 09/30/2009] [Indexed: 12/01/2022]
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28
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Bacci C, Lucchiari N, Valente M, Della Barbera M, Frigo AC, Berengo M. Intra-oral bone harvesting: two methods compared using histological and histomorphometric assessments. Clin Oral Implants Res 2010; 22:600-5. [PMID: 21070379 DOI: 10.1111/j.1600-0501.2010.02022.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM This study used morphometric analyses to compare two methods for the intra-oral harvesting of particulate bone: Mectron Piezosurgery® and the Meta Micross®. MATERIALS AND METHODS Twenty patients requiring bilateral germectomy of the lower third molars for orthodontic reasons were selected and a sample was harvested from each patient from a standardised donor site (the cortical bone in the area of the retromolar triangle). Ten samples were obtained for each method. The particulate collected were subjected to a histological examination and the samples were analysed considering the following parameters: the mean surface area of fragments, the mean surface area considered vital and the mean surface area considered non-vital, the mean percentage of area considered vital and the mean percentage of area considered non-vital, the mean number of normal osteocytes and the mean number of osteocytes with morphological changes identified per unit area (600,000 μm(2)). The results were analysed, calculating the mean and the corresponding standard deviations, and testing their significance using Student's t-test, and plotted in graphs. RESULTS Mectron Piezosurgery® produced significantly larger particles (P<0.05) than the Meta Micross®, with a larger mean surface area considered vital and a significantly larger (P<0.05) surface area considered non-vital. Mectron Piezosurgery® also produced a smaller mean percentage of area considered vital (64.83%) and a larger mean percentage of area considered non-vital (35.17%) by comparison with the Meta Micross® (75.34% and 24.66%, respectively). The data also showed that the two methods produce a similar quantity of empty lacunae, and that the Mectron Piezosurgery® produces a larger quantity of osteocytes. CONCLUSIONS The analyses conducted demonstrated that the particulate collected with the Meta Micross® had a smaller mean surface area of the fragments and a smaller surface area of bone considered non-vital than in the particulate collected using Mectron Piezosurgery®.
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Affiliation(s)
- Christian Bacci
- Department of Surgical and Medical Specialities, Oral Surgery-Section of Dentistry, University of Padova, Padova, Italy.
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29
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Klijn RJ, Meijer GJ, Bronkhorst EM, Jansen JA. Sinus floor augmentation surgery using autologous bone grafts from various donor sites: a meta-analysis of the total bone volume. TISSUE ENGINEERING PART B-REVIEWS 2010; 16:295-303. [PMID: 19958168 DOI: 10.1089/ten.teb.2009.0558] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND To date, no studies have been published that evaluated histomorphometric data from a large number of patients while comparing different sites and methods of autologous bone grafting in sinus floor augmentation procedures. A meta-analysis of the English literature from January 1995 till April 2009 was carried out. MATERIALS AND METHODS PubMed search engine and the following journals were explored: Clinical Oral Implant Research, International Journal of Oral and Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, and the Journal of Periodontology. RESULTS Out of 147 titles, according to our criteria, 25 articles were left for analysis. The majority were prospective controlled studies (21) and 2 randomized clinical trials, 1 pilot study and 1 case series. A reference value of 47% for total bone volume (TBV) was found while using iliac bone grafting as a standard. Use of intraoral bone grafts increases the TBV, with 11% for chin bone and 14% for bone grafted from other intraoral sites. Particulation of the bone graft has a negative effect on the TBV of 18%. Surprisingly, no correlation between TBV and the time of graft healing was found. Histological section thickness seemed to be a significant variable, as every micron increase of section thickness leads to an increase of 0.4% of TBV. CONCLUSIONS Bone grafting from the iliac crest resulted in a significantly lower TBV compared with intraoral bone grafting. However, due to the limited availability of intraoral bone to be harvested, iliac grafts still have to be considered the gold standard in augmenting the severely atrophic maxilla.
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Affiliation(s)
- Reinoud J Klijn
- Department of Periodontology and Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Vitral RWF, da Silva Campos MJ, de Andrade Vitral JC, Santiago RC, Fraga MR. Orthodontic distalization with rigid plate fixation for anchorage after bone grafting and maxillary sinus lifting. Am J Orthod Dentofacial Orthop 2009; 136:109-14. [PMID: 19577157 DOI: 10.1016/j.ajodo.2007.07.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Revised: 07/13/2007] [Accepted: 07/13/2007] [Indexed: 11/17/2022]
Abstract
A 68-year-old woman was treated with an autogenous particulated bone graft from the anterior part of the mandible to elevate the right maxillary sinus floor, which was next to the alveolar ridge of an edentulous area, to facilitate dental implant placement. A rigid plate for anchorage was placed into the zygomatic bone. The maxillary right canine and the premolars were moved distally 6 months after the implant was placed and osteointegration of the bone graft had occurred. The Class II relationship was corrected. After tooth movement, the patient underwent multislice computed tomography to determine the mineral density of the bone graft and compare it with the opposite side of the maxilla. The mineral density showed values above normal for the posterior segment of the maxilla. Although the patient was taking bisphosphonate for treatment of osteoporosis, no related complications were noted during treatment.
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