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Rossana I, Chiara C, Marco N, Niccolò B, Filippo G, Antonio B. Maxillary sinus augmentation via the bone lid technique: A prospective, radiographic case series. Clin Adv Periodontics 2024. [PMID: 38646843 DOI: 10.1002/cap.10288] [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: 02/06/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Maxillary sinus augmentation is one of the most performed procedures to increase the bone quantity of the atrophic maxilla to allow implant placement. The aim of the present case series was to describe a surgical protocol to perform maxillary sinus augmentation with the "bone lid technique," and its outcomes in a cohort of patients eligible for the procedure. METHODS After the initial clinical evaluation, a cone-beam computed tomography (CBCT) examination was performed for preoperative assessment. Patients were then scheduled for surgical intervention. At 6-9 months follow-up, patients underwent a second CBCT scan to evaluate bone height following bone graft and to schedule implant placement. RESULTS A total of 11 patients were enrolled in the study with a total of 13 sinus lift procedures. Membrane perforation was registered in 4 cases (30.76%). Mean surgical time was 67.69 min (SD 6.51). Postoperative period was uneventful in all patients, in the absence of complications. The mean graft volume increase was 2.46 cm3 (SD 0.85), and the mean height increase was 14.27 mm (SD 3.18). Mean membrane thickness was 1.40 mm (SD 0.75). In all the 4 cases with sinus membrane perforation, the membrane had a thickness lower than 1 mm. CONCLUSIONS The present study highlights that the maxillary sinus augmentation with bone lid repositioning could provide repeatable results in terms of bone height increase. The technique appears reliable both in terms of bone gain and absence of complications. KEY POINTS The bone lid technique for maxillary sinus augmentation provides repeatable results in terms of bone height increase. The favorable clinical outcomes can be related to an enhancement of bone formation due to the unique osteoconductive and osteoinductive properties of autogenous bone, along with a reduction of soft tissue ingrowth. Complications were not observed in any of the patients following the surgical procedures. The risk of Schneiderian membrane perforation is inversely proportional to membrane thickness; the thinner the membrane is, the higher the risk to perforate it.
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Affiliation(s)
- Izzetti Rossana
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Cinquini Chiara
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Nisi Marco
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Baldi Niccolò
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Graziani Filippo
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Barone Antonio
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
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Shokri M, Dalili F, Kharaziha M, Baghaban Eslaminejad M, Ahmadi Tafti H. Strong and bioactive bioinspired biomaterials, next generation of bone adhesives. Adv Colloid Interface Sci 2022; 305:102706. [PMID: 35623113 DOI: 10.1016/j.cis.2022.102706] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/20/2022] [Accepted: 05/15/2022] [Indexed: 12/29/2022]
Abstract
The bone adhesive is a clinical requirement for complicated bone fractures always articulated by surgeons. Applying glue is a quick and easy way to fix broken bones. Adhesives, unlike conventional fixation methods such as wires and sutures, improve healing conditions and reduce postoperative pain by creating a complete connection at the fractured joint. Despite many efforts in the field of bone adhesives, the creation of a successful adhesive with robust adhesion and appropriate bioactivity for the treatment of bone fractures is still in its infancy. Because of the resemblance of the body's humid environment to the underwater environment, in the latest decades, researchers have pursued inspiration from nature to develop strong bioactive adhesives for bone tissue. The aim of this review article is to discuss the recent state of the art in bone adhesives with a specific focus on biomimetic adhesives, their action mechanisms, and upcoming perspective. Firstly, the adhesive biomaterials with specific affinity to bone tissue are introduced and their rational design is studied. Consequently, various types of synthetic and natural bioadhesives for bone tissue are comprehensively overviewed. Then, bioinspired-adhesives are described, highlighting relevant structures and examples of biomimetic adhesives mainly made of DOPA and the complex coacervates inspired by proteins secreted in mussel and sandcastle worms, respectively. Finally, this article overviews the challenges of the current bioadhesives and the future research for the improvement of the properties of biomimetic adhesives for use as bone adhesives.
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Affiliation(s)
- Mahshid Shokri
- Department of Materials Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran
| | - Faezeh Dalili
- School of Metallurgy & Materials Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Mahshid Kharaziha
- Department of Materials Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran.
| | - Mohamadreza Baghaban Eslaminejad
- Department of Stem Cells and Developmental Biology, Cell Sciences Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
| | - Hossein Ahmadi Tafti
- Tehran Heart Hospital Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Villanova Junior JA, Magalhães MAB, Cereja de Souza TD, Battisti MKB, Engracia Filho JR, Pimpão CT, Müeller MO, Arruda PD, Capriglione LGA. Polypropylene mesh inhibits post-laminectomy compressive scar formation in rabbits: Histopathological and computational morphometric evaluation. Neurosci Lett 2021; 760:135973. [PMID: 34023408 DOI: 10.1016/j.neulet.2021.135973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/14/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022]
Abstract
We evaluated the effect of polypropylene mesh placement on post-laminectomy compressive scar formation in rabbits. Twenty-two white male New Zealand rabbits were distributed into two groups (n = 11). In the control group, the animals underwent lumbosacral laminectomy, whereas in the mesh group, the rabbits were submitted to lumbosacral laminectomy followed by the attachment of a polypropylene mesh to the vertebrae by the application of N-butyl cyanoacrylate. After eight weeks, the rabbits were euthanized, and the laminectomy area was collected for macro- and microscopic analyses. Macroscopically, we evaluated the (1) vertebral canal height; (2) laminectomy width and (3) length; and (4) fibrosis width, (5) height, and (6) length. Microscopically, we evaluated (7) fibroblasts; (8) the thickness of the dura-mater; and (9) the distance between the dura-mater and the laminectomy area. Macroscopically, there were no differences between the groups regarding vertebral canal height; width and length of the laminectomy; and fibrosis width. However, the height, and length of fibrosis were smaller in the mesh group. Microscopically, there were no differences in dura mater thickness and the distance between the dura mater and laminectomy area, but fewer fibroblasts were observed in the mesh group. This indicated that the polypropylene mesh improved tissue repair, with greater tissue organization. The results demonstrate that the use of a polypropylene mesh in the treatment of post-laminectomy wounds in rabbits reduces the severity of compressive fibrous scar formation. Polypropylene mesh is presented as a good alternative to reduce complications associated with laminectomy surgeries.
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Affiliation(s)
| | - Maria Angélica B Magalhães
- Graduate Program in Animal Science at Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, Brazil
| | - Tainah D Cereja de Souza
- Graduate Program in Animal Science at Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, Brazil
| | | | - Jair Rodini Engracia Filho
- Graduate Program in Animal Science at Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, Brazil
| | - Cláudia T Pimpão
- Graduate Program in Animal Science at Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, Brazil
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Albanese M, Zotti F, Lanaro L, Trojan D, Paolin A, Montagner G, Iannielli A, Rodella LF, Nocini PF. Fresh-frozen homologous bone in sinus lifting: histological and radiological analysis. ACTA ACUST UNITED AC 2019; 68:226-235. [PMID: 31822046 DOI: 10.23736/s0026-4970.19.04192-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The aim of this study was to evaluate radiological and histological characteristics of fresh-frozen homologous bone as grafting material for maxillary sinus floor augmentation. Radiological, histological and clinical evaluations were made. METHODS Twenty-three patients with a 2 mm to 6 mm alveolar ridge height in the posterior maxilla have been enrolled. Unilateral or bilateral sinus floor augmentations were performed with fresh frozen morcelized homologous bone. Together with implant placement, 7 months after surgery, a bone core was harvested for histological analysis. Radiological measurements were obtained by superimposition of CT scans carried out at the surgery time and six months later. A total of 93 implants were positioned. RESULTS A mean (±SD) increase in mineralized tissue height of 10.74±2.82 mm was noticed by comparing the CT scans. Histological analysis revealed the presence of newly formed bone in the grafted sites. The follow up period after the prosthetic load ranged from 8 to 31 months. One implant failure occurred. CONCLUSIONS Fresh frozen homologous bone seems to have a good healing pattern and to be a successful and steady grafting material for the treatment of maxillary ridge atrophy. It might be considered a valid alternative to autologous bone in sinus floor augmentation procedures.
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Affiliation(s)
- Massimo Albanese
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
| | - Francesca Zotti
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy -
| | - Luca Lanaro
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
| | | | | | | | | | - Luigi F Rodella
- Section of Anatomy and Pathophysiology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Pier F Nocini
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
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Oral Applications of Cyanoacrylate Adhesives: A Literature Review. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8217602. [PMID: 31008113 PMCID: PMC6441539 DOI: 10.1155/2019/8217602] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/03/2019] [Indexed: 02/08/2023]
Abstract
Cyanoacrylate adhesives have been used in medicine and dentistry with some controversial opinions. The aim of this review was to summarize the relevant literature regarding the use of cyanoacrylate adhesives for oral wounds during dental and surgical procedures, with focus on the applications, indications, advantages, and disadvantages. In conclusion, in vivo and clinical studies have demonstrated in the last few years convincing results regarding the safety, efficacy, ease of application, and feasibility of all types of cyanoacrylate adhesives used in intra- and extraoral procedures.
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Omori Y, Ricardo Silva E, Botticelli D, Apaza Alccayhuaman KA, Lang NP, Xavier SP. Reposition of the bone plate over the antrostomy in maxillary sinus augmentation: A histomorphometric study in rabbits. Clin Oral Implants Res 2018; 29:821-834. [PMID: 29876969 DOI: 10.1111/clr.13292] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/15/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To test if repositioning the bony plate secured with a cyanoacrylate over the antrostomy in maxillary sinus augmentation was superior to covering the antrostomy with a collagen membrane in terms of the bone augmentation area and the bone density. MATERIAL AND METHODS After the exposure of the nasal bone in eighteen rabbits, a rectangular access window was prepared with a sonic instrument, and the bony plate was removed. A bilateral sinus mucosa elevation was performed, and the space was filled with a resorbable xenograft. On the test side, the bone plate was repositioned over the antrostomy and fixed with a cyanoacrylate. On the control side, a collagen membrane was placed over the opening. Per group, six animals were sacrificed after 2, 4, and 8 weeks of healing, respectively. Histological ground sections were prepared. RESULTS The augmented area after elevation decreased between 2 and 8 weeks from 9.4 ± 1.8 to 4.8 ± 2.8 mm2 at the test and from 9.5 ± 2.6 and 5.1 ± 1.6 mm2 at the control sites. Small amounts of new bone were seen after 2 weeks in both groups (~1.6%-2.5%) forming from the bony sinus walls. New bone density increased over time in both groups reaching ~ 10%-11% and ~ 23%-25% after 4 and 8 weeks, respectively. No statistically significant differences were found. Small residual defects were present both at the test sites in the margin of the bone plate, and at the control sites in the center of the antrostomy. CONCLUSIONS The bone healing in the elevated sinus space was similar irrespective of the coverage of the antrostomy. After 8 weeks, the bone plate repositioned on the antrostomy was incorporated while at the control sites the healing was still incomplete. Residual defects were still present in both groups.
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Affiliation(s)
- Yuki Omori
- Department of Oral Implantology, Osaka Dental University, Osaka, Japan.,ARDEC Academy, Ariminum Odontologica, Rimini, Italy
| | - Erick Ricardo Silva
- Depto CTBMF e Periodontia FORP-USP- Faculty of Ribeirão Preto (SP), Ribeirão Preto, Brazil
| | - Daniele Botticelli
- ARDEC Academy, Rimini, Italy.,POI-Programa Odontológico Internacional, Cartagena de Indias, Colombia
| | | | - Niklaus P Lang
- Center for Dental Medicine, University of Zurich, Zurich, Switzerland.,University of Bern, Bern, Switzerland
| | - Samuel P Xavier
- Depto CTBMF e Periodontia FORP-USP- Faculty of Ribeirão Preto (SP), Ribeirão Preto, Brazil
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Linderman SW, Golman M, Gardner TR, Birman V, Levine WN, Genin GM, Thomopoulos S. Enhanced tendon-to-bone repair through adhesive films. Acta Biomater 2018; 70:165-176. [PMID: 29427745 DOI: 10.1016/j.actbio.2018.01.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 01/04/2018] [Accepted: 01/23/2018] [Indexed: 12/16/2022]
Abstract
Tendon-to-bone surgical repairs have unacceptably high failure rates, possibly due to their inability to recreate the load transfer mechanisms of the native enthesis. Instead of distributing load across a wide attachment footprint area, surgical repairs concentrate shear stress on a small number of suture anchor points. This motivates development of technologies that distribute shear stresses away from suture anchors and across the enthesis footprint. Here, we present predictions and proof-of-concept experiments showing that mechanically-optimized adhesive films can mimic the natural load transfer mechanisms of the healthy attachment and increase the load tolerance of a repair. Mechanical optimization, based upon a shear lag model corroborated by a finite element analysis, revealed that adhesives with relatively high strength and low stiffness can, theoretically, strengthen tendon-to-bone repairs by over 10-fold. Lap shear testing using tendon and bone planks validated the mechanical models for a range of adhesive stiffnesses and strengths. Ex vivo human supraspinatus repairs of cadaveric tissues using multipartite adhesives showed substantial increase in strength. Results suggest that adhesive-enhanced repair can improve repair strength, and motivate a search for optimal adhesives. STATEMENT OF SIGNIFICANCE Current surgical techniques for tendon-to-bone repair have unacceptably high failure rates, indicating that the initial repair strength is insufficient to prevent gapping or rupture. In the rotator cuff, repair techniques apply compression over the repair interface to achieve contact healing between tendon and bone, but transfer almost all force in shear across only a few points where sutures puncture the tendon. Therefore, we evaluated the ability of an adhesive film, implanted between tendon and bone, to enhance repair strength and minimize the likelihood of rupture. Mechanical models demonstrated that optimally designed adhesives would improve repair strength by over 10-fold. Experiments using idealized and clinically-relevant repairs validated these models. This work demonstrates an opportunity to dramatically improve tendon-to-bone repair strength using adhesive films with appropriate material properties.
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