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Urban IA, Serroni M, Dias DR, Baráth Z, Forster A, Araújo TG, Saleh MHA, Cucchi A, Ravidà A. Impact of Collagen Membrane in Vertical Ridge Augmentation Using Ti-Reinforced PTFE Mesh: A Randomised Controlled Trial. J Clin Periodontol 2025; 52:575-588. [PMID: 39953742 PMCID: PMC11949596 DOI: 10.1111/jcpe.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 12/08/2024] [Accepted: 01/06/2025] [Indexed: 02/17/2025]
Abstract
AIMS This non-inferiority randomised clinical trial aimed to compare vertical bone gain (VBG), volumetric bone changes and incidence of complications after vertical ridge augmentation (VRA) using perforated titanium-reinforced dense-polytetrafluoroethylene (PTFE) mesh covered by a collagen membrane (CM) or used alone. MATERIALS AND METHODS Thirty patients with vertical bone defects were randomly assigned to receive VRA with either PTFE + CM or PTFE alone. Meshes were removed after 9 months. Clinical assessments included complication rates, pseudo-periosteum type and bone density. VBG, effective regeneration rate and the need for additional augmentation were evaluated using CBCT reconstructions. RESULTS Non-inferiority of PTFE alone compared with PTFE + CM was not demonstrated for absolute and relative VBG (4.5 ± 2.1 mm vs. 4.1 ± 2.7 mm, 79.2% ± 16.6% vs. 85.8% ± 10.6%, respectively), effective regeneration rates (69.3% ± 17.9% vs. 72.3% ± 16.4%, respectively) or complication rates (6.7% in both groups). A higher incidence of type 1 pseudo-periosteum was observed in the PTFE + CM group. CONCLUSION The non-inferiority of PTFE alone compared with PTFE + CM for absolute VBG was not established. However, both techniques led to comparable outcomes for VBG, complication rates and bone density. The higher incidence of type 1 pseudo-periosteum and lacking bone volume in the PTFE + CM group suggests that adding a collagen membrane may help prevent soft tissue ingrowth. TRIAL REGISTRATION Clinicaltrials.gov identification number: NCT04843488.
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Affiliation(s)
- Istvan A. Urban
- Graduate Implant Dentistry, Loma Linda UniversityLoma LindaCaliforniaUSA
- Department of Periodontics and Preventive DentistryUniversity of Pittsburgh School of Dental MedicinePittsburghPennsylvaniaUSA
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
- Department of Periodontology, Faculty of DentistryUniversity of SzegedSzegedHungary
- Urban Regeneration InstituteBudapestHungary
| | - Matteo Serroni
- Department of Periodontics and Preventive DentistryUniversity of Pittsburgh School of Dental MedicinePittsburghPennsylvaniaUSA
- Periodontology Unit, Department of Innovative Technologies in Medicine and DentistryG. D'Annunzio UniversityChieti‐PescaraItaly
| | - Debora R. Dias
- Department of Periodontics and Preventive DentistryUniversity of Pittsburgh School of Dental MedicinePittsburghPennsylvaniaUSA
- Department of DentistryState University of MaringáMaringáBrazil
| | - Zoltán Baráth
- Department of Periodontology, Faculty of DentistryUniversity of SzegedSzegedHungary
| | | | - Tiago G. Araújo
- Department of Periodontics and Preventive DentistryUniversity of Pittsburgh School of Dental MedicinePittsburghPennsylvaniaUSA
| | - Muhammad H. A. Saleh
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | | | - Andrea Ravidà
- Department of Periodontics and Preventive DentistryUniversity of Pittsburgh School of Dental MedicinePittsburghPennsylvaniaUSA
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Jung JY, Park SH, Kim KJ, Ko KA, Lee DW, Lee JS. Particulate Versus Cross-Linked Collagenated Bone Substitutes for Guided Bone Regeneration: A Randomized Controlled Trial. Clin Oral Implants Res 2025. [PMID: 40126197 DOI: 10.1111/clr.14433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 02/18/2025] [Accepted: 02/26/2025] [Indexed: 03/25/2025]
Abstract
AIM To compare the dimensional outcomes of horizontal augmentation with the retentive-flap technique using particulate and cross-linked collagenated bone substitutes. MATERIALS AND METHODS This two-centre, two-arm randomized clinical trial investigated 69 subjects: 34 in the particulate group and 35 in the collagenated group. Patients were randomly assigned to receive single implant placement with simultaneous guided bone regeneration (GBR) using either particulate deproteinized porcine bone material (DPBM) or cross-linked collagenated DPBM. Quantitative evaluations were conducted for horizontal width, augmented area, and augmented volume in both hard and soft tissue dimensions. RESULTS Immediately after surgery, the collagenated group exhibited higher hard tissue dimensions in terms of horizontal width and augmented area. After 4 months, the difference between the two groups decreased to a non-significant level, mainly attributable to the high shrinkage rate of the collagenated group (32.32 [20.79] %) compared to the particulate group (19.90 [14.33] %). No significant difference was observed regarding the soft tissue contour analyses between the two groups after 4 months. CONCLUSIONS There were no significant differences between cross-linked collagenated and particulated DPBMs regarding the dimensional outcomes of horizontal augmentation with the retentive-flap technique. The high resorption rate of the collagenated bone substitute negates its initial superiority in both radiographic and soft tissue dimensions (no. KCT0005348).
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Affiliation(s)
- Ji-Young Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Seung-Hyun Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Kwan-Jung Kim
- Department of Periodontology, Dental Hospital, Veterans Health Service Medical Center, Seoul, South Korea
| | - Kyung-A Ko
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Dong-Woon Lee
- Department of Periodontology, College of Dentistry, Wonkwang University, Iksan, South Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
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Galvez P, Ahmed Omar N, Siadous R, Durand M, Comperat L, Lafarge X, Gindraux F, Sentilhes L, Fricain JC, L'Heureux N, Fenelon M. In vitro and in vivo assessment of a new acellular human amnion/chorion membrane device for guided bone regeneration. Sci Rep 2025; 15:5483. [PMID: 39952961 PMCID: PMC11829051 DOI: 10.1038/s41598-025-88814-7] [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: 05/19/2024] [Accepted: 01/31/2025] [Indexed: 02/17/2025] Open
Abstract
Thanks to its unique biological properties, the human amniotic membrane (AM) has shown promising results for guided bone regeneration (GBR), but displays some limitations such as poor space-maintaining ability. This study thus aimed to develop a new amnion/chorion membrane (ACM), with better mechanical properties as well as comparable or improved biological properties for GBR. We first developed a new decellularization method of ACM (DL-ACM) which was validated by DNA staining and quantification, and its cytocompatibility was established in vitro. The thickness of DL-ACM was significantly increased over thirty-fivefold, and its tearing strength and compression strength significantly increased more than tenfold compared to the decellularized AM (DL-AM). In vivo, DL-ACM demonstrated its biocompatibility subcutaneously, and its osteogenic properties were compared to DL-AM and a gold standard membrane in a GBR defect model in rats. Micro-CT and histomorphometric analysis showed that DL-ACM significantly promoted early bone regeneration after 1 week and significantly increased bone regeneration compared to the empty defect and the gold standard membrane over time. In this study, we developed a simple and reproducible method to produce an acellular, non-cytotoxic, and biocompatible DL-ACM. This new membrane is as effective as AM to promote early bone regeneration while demonstrating better biomechanical properties.
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Affiliation(s)
- Paul Galvez
- Univ. Bordeaux, INSERM, BioTis, U1026, 146 rue Léo Saignat, 33000, Bordeaux, France.
- CHU Bordeaux, Service de Chirurgie Orale, Place Amélie Raba Léon, 33076, Bordeaux, France.
| | - Naïma Ahmed Omar
- Univ. Bordeaux, INSERM, BioTis, U1026, 146 rue Léo Saignat, 33000, Bordeaux, France
| | - Robin Siadous
- Univ. Bordeaux, INSERM, BioTis, U1026, 146 rue Léo Saignat, 33000, Bordeaux, France
| | - Marlène Durand
- Univ. Bordeaux, INSERM, BioTis, U1026, 146 rue Léo Saignat, 33000, Bordeaux, France
- CHU de Bordeaux, CIC 1401, Place Amélie Raba Léon, 33000, Bordeaux, France
- Univ. Bordeaux, INSERM, Institut Bergonié, CIC 1401, 146 rue Léo Saignat, 33000, Bordeaux, France
| | - Léo Comperat
- Univ. Bordeaux, INSERM, BioTis, U1026, 146 rue Léo Saignat, 33000, Bordeaux, France
| | - Xavier Lafarge
- Etablissement Français du Sang Nouvelle-Aquitaine, Laboratoire d'ingénierie Tissulaire et Cellulaire, Place Amélie Raba Léon, 33000, Bordeaux, France
- Univ. Bordeaux, INSERM, U1211, « Maladies Rares : Génétique et Métabolisme », 146 rue Léo Saignat, 33000, Bordeaux, France
| | - Florelle Gindraux
- CHU Besançon, Service de Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, 3 boulevard Alexandre Fleming, 25000, Besançon, France
- Univ. Marie & Louis Pasteur, SINERGIES, 16 route de Gray, 25000, Besançon, France
| | - Loïc Sentilhes
- CHU Bordeaux, Service de Gynécologie-Obstétrique, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Jean-Christophe Fricain
- Univ. Bordeaux, INSERM, BioTis, U1026, 146 rue Léo Saignat, 33000, Bordeaux, France
- CHU Bordeaux, Service de Chirurgie Orale, Place Amélie Raba Léon, 33076, Bordeaux, France
- CHU Bordeaux, Centre de Compétence des Maladies Rares Orales et Dentaires, O-RARES, Pôle d'odontologie et Santé Buccale, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Nicolas L'Heureux
- Univ. Bordeaux, INSERM, BioTis, U1026, 146 rue Léo Saignat, 33000, Bordeaux, France
| | - Mathilde Fenelon
- Univ. Bordeaux, INSERM, BioTis, U1026, 146 rue Léo Saignat, 33000, Bordeaux, France
- CHU Bordeaux, Service de Chirurgie Orale, Place Amélie Raba Léon, 33076, Bordeaux, France
- CHU Bordeaux, Centre de Compétence des Maladies Rares Orales et Dentaires, O-RARES, Pôle d'odontologie et Santé Buccale, Place Amélie Raba Léon, 33076, Bordeaux, France
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Chowdhary R, V M. Vertical Ridge Augmentation Using Deproteinized Bovine Bone Material Without Covering With a Membrane: A Tunnel Pouch Technique-4-Year Follow-up-A Pilot Clinical Study. J ORAL IMPLANTOL 2025; 51:27-35. [PMID: 39690915 DOI: 10.1563/aaid-joi-d-24-00131] [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] [Indexed: 12/19/2024]
Abstract
The present pilot clinical trial was planned to evaluate the effect of particulate deproteinized bovine bone graft mixed with blood used as a vertical ridge augmentation material without covering with any form of collagen membrane in a tunnel pouch technique, resulting in sufficient bone formation to allow placement of dental implants with maintenance of the newly formed bone after final restoration. Eight patients (3 males and 5 females) were selected for this procedure and treated between February 2016 and December 2017. All these patients had a deficient vertical height of the posterior mandibular alveolar bone above the inferior alveolar canal. The particulate deproteinized organic bovine bone graft (Bio-Oss) mixed with blood was placed through the tunnel in the defected area and compacted firmly to form a dense pack. The average gain of alveolar bone in the first implant site immediately postoperative was 13.51 ± 0.85 and in the second implant site was 13.84 ± 0.62. Histomorphometric analysis showed that about 70.31% of the area analyzed was occupied by the vital bone, the newly formed bone, whereas only 29.69% of the residual graft remained. In the present pilot study, the deproteinized bovine bone graft placed to enhance vertical and horizontal bone gain showed positive results in regaining the bone needed to place implants and maintaining the bone around restored implants for 4 years of follow-up.
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Affiliation(s)
| | - Midhula V
- Brånemark Osseointegration Center India, Vijaynagar, Bengaluru
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Raabe C, Cafferata EA, Couso‐Queiruga E, Chappuis V, Ramanauskaite A, Schwarz F. Impact of Two Flap Advancement Techniques and Periosteal Suturing on Graft Displacement During Guided Bone Regeneration. Clin Implant Dent Relat Res 2025; 27:e13434. [PMID: 39815673 PMCID: PMC11736094 DOI: 10.1111/cid.13434] [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: 10/06/2024] [Revised: 11/29/2024] [Accepted: 12/11/2024] [Indexed: 01/18/2025]
Abstract
OBJECTIVES This preclinical ex vivo porcine study aimed to evaluate the effects of two flap advancement techniques and periosteal suturing (PS) on graft material displacement during primary wound closure in guided bone regeneration (GBR). Secondary objectives included assessing flap advancement and the impact of soft tissue characteristics on graft displacement. MATERIALS AND METHODS Standardized two-walled horizontal bone defects were created in second premolar sites of pig hemimandibles. Sites were randomized to using either full-thickness flaps with modified periosteal releasing incisions (MPRI) or combination flaps using the mucosal detachment technique (MDT), both with and without PS. Cone-beam computed tomography was used to measure changes in graft material thickness (GMT) at seven incremental levels (L0-L6) relative to the implant platform, before and after primary wound closure. Keratinized mucosa width (KMW), flap thickness (FT), and flap advancement (FA) were also recorded. RESULTS Sixty-eight horizontal bone augmentation procedures were performed on 34 pig hemimandibles, divided into four groups (MDT+PS, MDT-PS, MPRI+PS, MPRI-PS). Mean overall change in GMT at L0 was -24.5% ± 14.0% for MPRI and - 23.0% ± 14.3% for MDT (p ≥ 0.085). PS reduced graft displacement (-14.2% ± 11.5%) compared with no PS (-33.2% ± 16.9%, p < 0.001). FA was 8.3 ± 1.1 mm (MPRI) and 8.3 ± 1.5 mm (MDT). The mean KMW was 6.8 ± 0.9 mm, and FT ranged from 0.8 to 1.6 mm. CONCLUSIONS PS significantly reduced graft material displacement during primary wound closure, while flap advancement techniques and soft tissue characteristics had no impact on graft stability. Both surgical techniques provided sufficient flap advancement for primary wound closure.
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Affiliation(s)
- Clemens Raabe
- Department of Oral Surgery and ImplantologyGoethe UniversityFrankfurt am MainGermany
- Department of Oral Surgery and Stomatology, School of Dental MedicineUniversity of BernBernSwitzerland
| | - Emilio A. Cafferata
- Department of Oral Surgery and ImplantologyGoethe UniversityFrankfurt am MainGermany
- Oral Peri‐Implant Research Group, School of DentistryUniversidad Científica del SurLimaPeru
| | - Emilio Couso‐Queiruga
- Department of Oral Surgery and Stomatology, School of Dental MedicineUniversity of BernBernSwitzerland
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental MedicineUniversity of BernBernSwitzerland
| | - Ausra Ramanauskaite
- Department of Oral Surgery and ImplantologyGoethe UniversityFrankfurt am MainGermany
| | - Frank Schwarz
- Department of Oral Surgery and ImplantologyGoethe UniversityFrankfurt am MainGermany
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Bane WE, Blyleven GM, Lincicum AR, Stancoven BW, Inouye KA, Johnson TM. The nasal spine suture: A novel approach for membrane stabilization. Clin Adv Periodontics 2024; 14:300-309. [PMID: 38487961 DOI: 10.1002/cap.10279] [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: 12/14/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/11/2025]
Abstract
BACKGROUND Current evidence acknowledges guided bone regeneration (GBR) as a predictable therapeutic modality in the augmentation of a deficient alveolar ridge. Such deficiencies often reveal inadequate bone volume to support implant placement in a position amenable to prosthetic reconstruction. Additionally, an evolving body of literature demonstrates that membrane fixation may lead to improved clinical bone gain through positively influencing blood clot formation, stability, and the eventual osteogenic potential of the defect. Alternative benefits to membrane fixation, such as reduced graft displacement and reduction in wound micromotion, have also been cited as mechanisms for an increased regenerative response. METHODS AND RESULTS The aim of this report was to present a case, including diagnosis, treatment, and follow-up for the reconstruction of a horizontal ridge deficiency. The patient's deficiency in ridge volume was found to be a developmental sequelae of lateral incisor agenesis, resulting in an underdeveloped midfacial region of the alveolar process subjacent to sites #7 and #10. The fixation protocol outlined in this report demonstrated adequate horizontal ridge augmentation to facilitate future prosthetic reconstruction with the use of implants. CONCLUSIONS Numerous protocols have been established in an attempt to achieve effective barrier membrane stabilization for bone augmentation procedures. However, some techniques are poorly suited for the anatomically challenging region of the anterior maxilla. A case report describing the utilization of the anterior nasal spine for anchorage of a membrane-stabilizing suture may present a novel, safe, and effective technique for stabilizing the intended region of augmentation, as well as preventing graft migration beyond the membrane-maxilla interface. Key points Regarding guided bone regeneration (GBR) procedures, micromotion of the membrane or of the underlying particulate graft may negatively influence the volume of the augmented site. The ability to adequately stabilize the graft-membrane interface is recognized as a necessary prerequisite to predictably achieve optimal surgical outcomes. To the authors' knowledge, there is no clinical or scientific evidence regarding the use of the anterior nasal spine for membrane anchorage in maxillary GBR procedures, and thus a novel approach to membrane stabilization is introduced.
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Affiliation(s)
- William E Bane
- Department of Periodontics, Army Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University, Fort Eisenhower, Georgia, USA
| | - Gary M Blyleven
- Department of Periodontics, Army Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University, Fort Eisenhower, Georgia, USA
| | - Adam R Lincicum
- Department of Periodontics, Army Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University, Fort Eisenhower, Georgia, USA
| | - Brian W Stancoven
- Department of Periodontics, Army Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University, Fort Eisenhower, Georgia, USA
| | - Kimberly A Inouye
- Department of Periodontics, Army Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University, Fort Eisenhower, Georgia, USA
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University, Fort Eisenhower, Georgia, USA
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Zhang S, Wang Y, Wang Q, Li J, Wang F, Li Z, Cui J, Zhang J. The impact of collagen membrane fixation protocols on volume stability in horizontal ridge augmentation in the aesthetic area: A retrospective study. Clin Implant Dent Relat Res 2024; 26:1354-1365. [PMID: 39350569 DOI: 10.1111/cid.13393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 08/26/2024] [Accepted: 08/27/2024] [Indexed: 12/21/2024]
Abstract
OBJECTIVES This study aimed to evaluate the impact of different collagen membran fixation protocols on the volume stability in horizontal ridge augmentation in the aesthetic area. METHODS A total of 48 patients with 65 augmented sites were included in this study. Implants were placed in the aesthetic region, and simultaneous guided bone regeneration (GBR) surgery was performed for horizontal ridge augmentation. Participants were divided into four groups, each comprising 12 patients, based on different absorbable collagen membrane fixation protocols. Group 1: without fixation; Group 2: fixation with absorbable sutures; Group 3: fixation with titanium pins; Group 4: fixation with titanium pins and absorbable sutures. Cone beam computed tomography (CBCT) was performed immediately after surgery and at 6 months post-surgery, respectively. The horizontal thickness of the augmented region was analyzed for volume stability at the implant shoulder (H0) and 1-5 mm apical to the implant shoulder (H1-H5). Changes in labial thickness during bone healing were calculated as absolute values (mm) and relative values (%). RESULTS After 6 months of bone healing, horizontal thickness was significantly reduced at all levels (H0-H5) in all groups compared to immediate post-surgery results (p < 0.05). At H1-H5, horizontal bone loss in group 1 was significantly higher than in the other three groups (p < 0.05). Group 4 exhibited significantly less horizontal bone loss compared to group 2 at H0-H2 (p < 0.05) and group 4 compared to group 3 at H0-H1 (p < 0.05). No significant difference in horizontal bone loss between groups 2 and 3 was detected at H0-H5 (p > 0.05). CONCLUSION Guided bone regeneration in the aesthetic area with additional membrane fixation demonstrated superior volume stability of the augmented region compared to cases without fixation. There was no significant difference in bone volume stability between membrane fixation with titanium pins and fixation with absorbable sutures. However, the combined use of pins and absorbable sutures yielded superior volume stability.
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Affiliation(s)
- Shuo Zhang
- Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
| | - Yanying Wang
- Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Qingfu Wang
- Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Jinmeng Li
- Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Feifan Wang
- Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Zhaoyang Li
- Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Jianlin Cui
- School of Medicine, Nankai University, Tianjin, China
| | - Jian Zhang
- Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
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Tironi F, Sofos S, Wong J, Leyva M, Contasti G, Nevins M, Vardar-Sengul S. Periodontal phenotype modification in surgically facilitated orthodontics: A case report. Clin Adv Periodontics 2024. [PMID: 39540554 DOI: 10.1002/cap.10321] [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: 05/15/2024] [Revised: 09/09/2024] [Accepted: 10/20/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND Orthodontic treatment in adults with thin periodontal phenotype presents challenges such as lengthy treatment time and increased risk for gingival recessions. In this case, surgically facilitated orthodontic treatment (SFOT) was proposed to accelerate orthodontic tooth movement while modifying the periodontal phenotype. METHODS An orthodontic patient was referred for periodontal evaluation of lower anterior teeth, which presented a thin gingival phenotype and bone dehiscence. SFOT was performed on the mandible using particulate allograft combined with platelet rich fibrin (PRF) and collagen membrane to augment soft and hard tissue, thereby preventing future recessions, while accelerating the treatment times. RESULTS Six-month and 3-year follow-ups confirmed radiographic bone fill, absence of gingival recession and thick band of keratinized gingiva. SFOT also resulted in a shorter treatment time where desired tooth movements were achieved within 6 months with periodontal stability. CONCLUSIONS SFOT provided clinical benefits by accelerating orthodontic movement, improving periodontal phenotype, preventing the displacement of teeth beyond the alveolar housing and minimizing the risk for development of dehiscences and gingival recessions. KEY POINTS Orthodontic movements can create recessions and dehiscence in thin periodontal phenotypes. SFOT can help prevent bone dehiscence and creates a thicker gingival phenotype while accelerating treatment time. PLAIN LANGUAGE SUMMARY Adults who face lengthy orthodontic treatments and have thin gums have risks of gum problems. Surgically facilitated orthodontic treatment (SFOT) can help by speeding up tooth movements and improving gum health and thickness. A patient with thin gums and lack of bone in the lower front teeth was evaluated. The SFOT procedure involved using a bone graft, healing factors, and a collagen membrane to strengthen the gums and bones. This approach aimed to prevent future gum problems and speed up orthodontic treatment. Follow-ups at 6 months and 3 years after treatment showed good healing of the gums and bones, with no signs of gum recession and healthier, thicker gums. The desired tooth movements were achieved within 6 months, resulting in a shorter treatment time. The patient's gums remained stable throughout this period. SFOT offered significant clinical benefits, including faster tooth movement and improved gum health. It also helped prevent teeth from moving out of place and minimized the risk of gum recession and bone issues. This approach can be a valuable option for adults with thin gums undergoing orthodontic treatment.
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Affiliation(s)
- Francesco Tironi
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Stavros Sofos
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Jason Wong
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Megan Leyva
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Gisella Contasti
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Myron Nevins
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard University, School of Dental Medicine, Boston, Massachusetts, USA
| | - Saynur Vardar-Sengul
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
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Dong C, Zheng S, Xia Z, Chen R, Zheng Y, Yang F, Wang L. Demineralized, Freeze-Dried Allogeneic Bone Blocks With Suture Fixation Technique for Reconstruction of Maxillary Alveolar Bone Deficiency: A Case Series. J ORAL IMPLANTOL 2024; 50:499-506. [PMID: 38967002 DOI: 10.1563/aaid-joi-d-24-00072] [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] [Indexed: 07/06/2024]
Abstract
This study aims to evaluate the clinical outcomes of using demineralized, freeze-dried allogeneic bone blocks (DFDABB) combined with the periosteal vertical mattress suture (PVMS) technique for the reconstruction of severe horizontal alveolar bone deficiencies in the maxilla. In continuous horizontal maxillary defects cases, bone augmentation was performed using DFDABB and deproteinized bovine bone matrix (DBBM) filling the interstice. Subsequently, a resorbable collagen membrane was carefully placed over the graft surface, and both the membrane and bone graft were firmly secured using the PVMS technique. Linear changes were assessed through superimposed cone-beam computerized tomography scans obtained before the operation and after a healing period of 6-10 months. A total of 7 female patients with 10 bone blocks and 13 implants were included in this study. One of the wounds was slightly ruptured postoperatively without infection, and all implants showed successful osseointegration. The average alveolar ridge width at a point 5 mm below the crest was 4.52 ± 2.03 mm before bone graft and 9.79 ± 1.57 mm after implantation with an average increase of 5.26 ± 1.97 mm. Similarly, at a point 10 mm below the crest, the pregraft alveolar ridge width measured 7.23 ± 3.60 mm, and postimplantation, it expanded to 11.81 ± 2.90 mm, showing an average gain of 4.58 ± 2.01 mm. This case series demonstrates the successful application of DFDABB combined with the PVMS technique to achieve adequate bone width for implantation at severe continuous horizontal bone deficiency of the maxilla. DFDABB with the PVMS technique resulted in superior horizontal bone gain during maxillary bone augmentation with horizontal continuity deficiency. However, further studies are necessary to validate these findings.
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Affiliation(s)
- Chengzhi Dong
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Simin Zheng
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhuoheng Xia
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Runzhi Chen
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yuxin Zheng
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Fan Yang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang China
| | - Linhong Wang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang China
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10
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Abedi M, Shafiee M, Afshari F, Mohammadi H, Ghasemi Y. Collagen-Based Medical Devices for Regenerative Medicine and Tissue Engineering. Appl Biochem Biotechnol 2024; 196:5563-5603. [PMID: 38133881 DOI: 10.1007/s12010-023-04793-3] [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] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Assisted reproductive technologies are key to solving the problems of aging and organ defects. Collagen is compatible with living tissues and has many different chemical properties; it has great potential for use in reproductive medicine and the engineering of reproductive tissues. It is a natural substance that has been used a lot in science and medicine. Collagen is a substance that can be obtained from many different animals. It can be made naturally or created using scientific methods. Using pure collagen has some drawbacks regarding its physical and chemical characteristics. Because of this, when collagen is processed in various ways, it can better meet the specific needs as a material for repairing tissues. In simpler terms, collagen can be used to help regenerate bones, cartilage, and skin. It can also be used in cardiovascular repair and other areas. There are different ways to process collagen, such as cross-linking it, making it more structured, adding minerals to it, or using it as a carrier for other substances. All of these methods help advance the field of tissue engineering. This review summarizes and discusses the current progress of collagen-based materials for reproductive medicine.
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Affiliation(s)
- Mehdi Abedi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran.
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran.
| | - Mina Shafiee
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Farideh Afshari
- Department of Tissue Engineering and Applied Cell Science, School of Advanced Medical Sciences and Technology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Mohammadi
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Younes Ghasemi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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11
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Jeong S, Lee WH, Hong KJ, Strauss FJ, Lee JS. The distance of insertion points from wound margins in interrupted and vertical mattress sutures influences the tensile load capacity: An in vitro experimental study. Clin Oral Implants Res 2024; 35:739-746. [PMID: 38647359 DOI: 10.1111/clr.14273] [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: 05/01/2023] [Revised: 01/24/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
AIM To determine the tensile load capacity (TLC) and the tearing characteristics for interrupted and vertical mattress sutures with different insertion points from the wound margin, and the effect of the bite size when using vertical mattress sutures. MATERIALS AND METHODS A total of 120 gingiva and lining mucosa samples obtained from pig jaws were divided into groups according to the suturing technique (interrupted and vertical mattress sutures), distance of the insertion points from the wound margin (margin, 1, 3, and 5 mm) and bite size (1, 3, and 5 mm). The TLC of the suture and the tearing characteristics were evaluated using a tensile tester device. RESULTS The TLC was significantly higher for vertical mattress sutures than for interrupted sutures regardless of the distance of the insertion points from the wound margin (intergroup p < .001). This distance significantly influenced the TLC for vertical mattress sutures (p < .05) but not for interrupted sutures (p > .05). Testing the tearing characteristics revealed that no tissue tearing occurred in groups when the insertion points were more than 3 mm from the wound margin. CONCLUSION The TLC is higher for vertical mattress sutures than for interrupted sutures, and it increases when the insertion points are farther from the wound margin.
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Affiliation(s)
- Seungho Jeong
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Won-Ho Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Kyu-Jin Hong
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Franz Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
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12
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Blasi G, Abrahamian L, Blasi A. The distally anchored connective tissue graft platform for papilla enhancement: A case report. Clin Adv Periodontics 2024. [PMID: 38853678 DOI: 10.1002/cap.10299] [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: 03/09/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND As the need for using dental implants to replace single missing teeth grows, so does the demand for greater esthetic results. However, achieving complete interproximal papillae fill in single-tooth implant restorations remains a challenge. The distally anchored connective tissue platform is a novel soft tissue augmentation technique that consists of harvesting an autogenous connective tissue graft from the palate, folding it, and positioning it at the level of the distal occlusal and buccal surfaces with the help of a distal sling suture to the adjacent distal tooth. METHODS This case report describes how a maxillary central incisor with compromised hard and soft tissues were replaced using a comprehensive treatment plan. RESULTS The clinical outcomes showed stable mucosal margin levels and complete papillae fill. The patient expressed satisfaction with the achieved results. CONCLUSIONS The distally anchored connective tissue graft platform performed at the time of implant placement emerges as a viable and effective soft tissue augmentation technique that yields highly esthetic results. KEY POINTS Why is this case new information? To the best of our knowledge, this is the first case report in the literature using the distally anchored connective tissue platform. What are the keys to successful management of this case? Adequate diagnosis and decision-making, resulting in a treatment plan focused on reconstructing both soft and hard tissues in a single-tooth implant within the esthetic area, yield favorable clinical, radiological, and patient-reported outcomes. What are the primary limitations to success in this case? The primary limitation of this study is its reliance on a single case report.
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Affiliation(s)
- Gonzalo Blasi
- Department of Periodontology, School of Dentistry, International University of Catalonia, Barcelona, Spain
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore School of Dentistry, Baltimore, Maryland, USA
| | - Lory Abrahamian
- Department of Periodontology, School of Dentistry, International University of Catalonia, Barcelona, Spain
| | - Alvaro Blasi
- Department of Restorative Dentistry, School of Dentistry, International University of Catalonia, Barcelona, Spain
- Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, Georgia, USA
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13
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Minniti A, Caroprese M, Zarantonello M, De Santis D, Caliendo G, Gelpi F. High-Density Dermal Matrix for Soft Tissue Augmentation Using a Matrix Tissue Graft Technique-A Comprehensive Multicenter Analysis of 20 Implants: A 1-Year Follow-Up Retrospective Study. J Clin Med 2024; 13:2954. [PMID: 38792495 PMCID: PMC11122547 DOI: 10.3390/jcm13102954] [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: 02/27/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Background: In this multicenter case series analysis, the authors present successful instances of 20 single-screw-retained and implant-supported prosthetic rehabilitation samples. Methods: A high-density heterologous dermal matrix (Derma® Osteobiol by Tecnoss, Torino, Italy) was employed with a specific technique named the matrix tissue graft (MTG) in all these cases characterized by an inadequate initial supra-crestal tissue height (thin if 1 mm or medium if 2 mm) to enhance the peri-implant soft tissues both vertically and horizontally. Results: The implants were deemed successful in all cases, yielding a success proportion of 100% (one-sided 97.5% confidence interval = 83.2-100%). The buccal and lingual gains were, respectively, 2.2 ± 0.38 mm (range 1.7-3.22 mm) and 0.83 ± 0.33 mm (range 0.1-1.5 mm). These measurements were calculated as the maximum distance between two superimposed .stl file models (derived from two different IOS devices) scanned before implant placement and 1 year after dermal matrix healing. Conclusions: An outstanding vertical and horizontal gain was obtained using this heterologous derma matrix placed above the bone crest and surrounding the dental implants.
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Affiliation(s)
| | - Marino Caroprese
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Morris Zarantonello
- Head and Neck Department, Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37129 Verona, Italy; (M.Z.); (D.D.S.)
| | - Daniele De Santis
- Head and Neck Department, Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37129 Verona, Italy; (M.Z.); (D.D.S.)
| | - Gialfonso Caliendo
- Department of Diagnostics & Public Health, Specialization School in Health Statistics and Biometry, University of Verona, 37129 Verona, Italy;
| | - Federico Gelpi
- Head and Neck Department, Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37129 Verona, Italy; (M.Z.); (D.D.S.)
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14
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Sohn DS, Lui A, Choi H. Utilization of Tenting Pole Abutments for the Reconstruction of Severely Resorbed Alveolar Bone: Technical Considerations and Case Series Reports. J Clin Med 2024; 13:1156. [PMID: 38398468 PMCID: PMC10889334 DOI: 10.3390/jcm13041156] [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: 12/15/2023] [Revised: 01/18/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION Although various surgical techniques have been utilized in the reconstruction of severely resorbed alveolar bone, its regeneration is still regarded as a major challenge. Most of the surgical techniques used in advanced ridge augmentation have the disadvantages of prolonging the patient's edentulous healing and increasing the need for surgical revisits because simultaneous implant placement is not allowed. This report presents a new and simplified method for advanced ridge augmentation, which utilizes a vertical tenting device. CASE PRESENTATION The first case presented the reconstruction of the mandibular posterior region with severely resorbed alveolar bone due to peri-implantitis using tenting pole abutment for ridge augmentation. The second and third cases presented three-dimensional ridge augmentations in severely resorbed ridges due to periodontitis. The last case presented horizontal ridge augmentation using a vertical tenting device. All cases were performed under local anesthesia. Implants were simultaneously placed in the bone defect area. A vertical tensioning device was then connected to the implant platform to minimize the collapse of the bone graft during the bone regeneration period due to the contraction of the soft tissue matrix. A sticky bone graft was transplanted onto the exposed surface of the implant and on top of the vertical tensioning device. After covering with an absorbable barrier membrane, the soft tissues were sutured without tension. CONCLUSIONS In all cases, prosthetic restorations were provided to patients after a bone grafting period of 5-6 months, leading to a rapid restoration of masticatory function. Results tracked for up to 6 years revealed observed stable reconstruction of the alveolar bone. The use of a vertical tenting device can prevent the collapse of biomaterials in the augmented ridge during the healing period, leading to predictable outcomes when achieving three-dimensional ridge augmentation.
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Affiliation(s)
- Dong-Seok Sohn
- Department of Dentistry and Oral and Maxillofacial Surgery, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea
| | - Albert Lui
- Private Practice, Calgary, AB T2P 2Y3, Canada;
| | - Hyunsuk Choi
- Department of Dentistry and Prosthodontics, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea;
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15
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Happe A, Blender SM, Luthardt RG, Rudolph H, Kuhn K. Digital Evaluation of Vertical Ridge Augmentation with the Modified Shell Technique Using a Xenogeneic Bone Lamina: A Case Series. J Clin Med 2023; 12:7013. [PMID: 38002627 PMCID: PMC10671913 DOI: 10.3390/jcm12227013] [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: 10/02/2023] [Revised: 10/18/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Vertical ridge augmentation is a demanding and technique-sensitive surgical procedure. In the present case series, cone beam CT (CBCT) scans from the clinical routine of patients treated using a novel approach for vertical bone augmentation were assessed. All patients showed a single-tooth class 5 defect and were treated using a modification of the original shell technique. Cortical bone plates were replaced with a lamina composed of a partially demineralized porcine xenograft. CBCT scans of six consecutive patients were treated with the lamina and particulate bone from the mandibular ramus prior to a single tooth implant in the anterior maxilla were included. Pre- and postsurgical CBCT data sets were superimposed and analyzed digitally using surface matching and Boolean subtraction. The volume of the grafted area was calculated with and without the xenograft. The vertical gain of the ridge height measured in this case series varied from 7 to 11.3 mm. The mean vertical gain was 8.97 mm. The mean volume including the xenograft was 382.59 mm3 (SD 73.39) and 250.84 mm3 (SD 53.67) without the lamina. The modified shell technique used in this case series for the vertical augmentation of single-tooth class 5 defects provided sufficient bone for single implant restorations.
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Affiliation(s)
- Arndt Happe
- Department of Prosthetic Dentistry, Center of Dentistry University of Ulm, 89081 Ulm, Germany; (S.M.B.); (R.G.L.); (H.R.); (K.K.)
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16
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Alavi SE, Gholami M, Shahmabadi HE, Reher P. Resorbable GBR Scaffolds in Oral and Maxillofacial Tissue Engineering: Design, Fabrication, and Applications. J Clin Med 2023; 12:6962. [PMID: 38002577 PMCID: PMC10672220 DOI: 10.3390/jcm12226962] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023] Open
Abstract
Guided bone regeneration (GBR) is a promising technique in bone tissue engineering that aims to replace lost or injured bone using resorbable scaffolds. The promotion of osteoblast adhesion, migration, and proliferation is greatly aided by GBR materials, and surface changes are critical in imitating the natural bone structure to improve cellular responses. Moreover, the interactions between bioresponsive scaffolds, growth factors (GFs), immune cells, and stromal progenitor cells are essential in promoting bone regeneration. This literature review comprehensively discusses various aspects of resorbable scaffolds in bone tissue engineering, encompassing scaffold design, materials, fabrication techniques, and advanced manufacturing methods, including three-dimensional printing. In addition, this review explores surface modifications to replicate native bone structures and their impact on cellular responses. Moreover, the mechanisms of bone regeneration are described, providing information on how immune cells, GFs, and bioresponsive scaffolds orchestrate tissue healing. Practical applications in clinical settings are presented to underscore the importance of these principles in promoting tissue integration, healing, and regeneration. Furthermore, this literature review delves into emerging areas of metamaterials and artificial intelligence applications in tissue engineering and regenerative medicine. These interdisciplinary approaches hold immense promise for furthering bone tissue engineering and improving therapeutic outcomes, leading to enhanced patient well-being. The potential of combining material science, advanced manufacturing, and cellular biology is showcased as a pathway to advance bone tissue engineering, addressing a variety of clinical needs and challenges. By providing this comprehensive narrative, a detailed, up-to-date account of resorbable scaffolds' role in bone tissue engineering and their transformative potential is offered.
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Affiliation(s)
- Seyed Ebrahim Alavi
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia; (S.E.A.); (M.G.)
| | - Max Gholami
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia; (S.E.A.); (M.G.)
| | - Hasan Ebrahimi Shahmabadi
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan 7717933777, Iran;
| | - Peter Reher
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia; (S.E.A.); (M.G.)
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17
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Roccuzzo M, Roccuzzo A, Marruganti C, Fickl S. The importance of soft tissue condition in bone regenerative procedures to ensure long-term peri-implant health. Periodontol 2000 2023; 93:129-138. [PMID: 37277923 DOI: 10.1111/prd.12496] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/13/2023] [Accepted: 04/26/2023] [Indexed: 06/07/2023]
Abstract
Bone regenerative procedures have been widely proved to be a reliable treatment option to re-create the ideal pre-implant clinical conditions. Nevertheless, these techniques are not free from post-operative complications which might result in implant failure. Consequently, as demonstrated by the increasing recently published evidence, a careful pre- and intra-operative flap evaluation to ensure an ideal and hermetic tension-free wound closure is of paramount importance to successfully treat bony defects. In this respect, several surgical interventions mainly aimed to increase the amount of keratinized mucosa either to allow an optimal healing after a reconstructive procedure or to establish an optimal peri-implant soft tissue seal have been proposed. The present review summarizes the level of evidence on the surgical clinical aspects which have an impact on the soft tissue handling associated with bone reconstructive procedures and on the importance of soft tissue conditions to enhance and maintain peri-implant health in the long-term.
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Affiliation(s)
- Mario Roccuzzo
- Private Practice, Torino, Italy
- Division of Maxillo-Facial Surgery, University of Torino, Torino, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral and Maxillo-Facial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- Department of Restorative, Pediatric and Preventive Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Crystal Marruganti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Stefan Fickl
- Private Practice, Fürth, Germany
- Department of Periodontology, Julius-Maximilians-University Würzburg, Würzburg, Germany
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18
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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: 19] [Impact Index Per Article: 9.5] [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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19
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Shi X, Li X, Tian Y, Qu X, Zhai S, Liu Y, Jia W, Cui Y, Chu S. Physical, mechanical, and biological properties of collagen membranes for guided bone regeneration: a comparative in vitro study. BMC Oral Health 2023; 23:510. [PMID: 37481548 PMCID: PMC10362553 DOI: 10.1186/s12903-023-03223-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/11/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND To provide a reference for clinical selection of collagen membranes by analyzing the properties of three kinds of collagen membranes widely used in clinics: Bio-Gide membrane from porcine dermis (PD), Heal-All membrane from bovine dermis (BD), and Lyoplant membrane from bovine pericardium (BP). METHODS The barrier function of three kinds of collagen membranes were evaluated by testing the surface morphology, mechanical properties, hydrophilicity, and degradation rate of collagen membranes in collagenase and artificial saliva. In addition, the bioactivity of each collagen membrane as well as the proliferation and osteogenesis of MC3T3-E1 cells were evaluated. Mass spectrometry was also used to analyze the degradation products. RESULTS The BP membrane had the highest tensile strength and Young's modulus as well as the largest water contact angle. The PD membrane exhibited the highest elongation at break, the smallest water contact angle, and the lowest degradation weight loss. The BD membrane had the highest degradation weight loss, the highest number of proteins in its degradation product, the strongest effect on the proliferation of MC3T3-E1 cells, and the highest expression level of osteogenic genes. CONCLUSIONS The PD membrane is the best choice for shaping and maintenance time, while the BD membrane is good for osteogenesis, and the BP membrane is suitable for spatial maintenance. To meet the clinical requirements of guided bone regeneration, using two different kinds of collagen membranes concurrently to exert their respective advantages is an option worth considering.
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Affiliation(s)
- Xiaolu Shi
- Department of Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Xianjing Li
- Department of Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Ye Tian
- Department of Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Xinyao Qu
- Department of Drug Clinical Trial, the Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Shaobo Zhai
- Department of Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Yang Liu
- Department of Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Wei Jia
- Yongchang Community Health Service Center of Chaoyang District, Changchun, China
| | - Yan Cui
- Department of Dermatology and Venereology, First Hospital of Jilin University, Jilin University, Changchun, China.
| | - Shunli Chu
- Department of Implantology, Hospital of Stomatology, Jilin University, Changchun, China.
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20
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Wang J, Qi X, Zhou Y, Wang G, Yang Y, Jiang T, Yu L, Wang S, Zhang W. Stabilization of Bio-Oss ® particulates using photocurable hydrogel to enhance bone regeneration by regulating macrophage polarization. Front Bioeng Biotechnol 2023; 11:1183594. [PMID: 37351475 PMCID: PMC10282947 DOI: 10.3389/fbioe.2023.1183594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/23/2023] [Indexed: 06/24/2023] Open
Abstract
Bone substitutes are widely used in maxillofacial and oral surgeries. However, in clinical practice, bone substitutes with various forms, including separated particulates, powders, and blocks, have exhibited poor handling properties and space maintenance characteristics, resulting in long surgery procedures and unstable volume of the newly formed bone. Movable separated particulates with high stiffness have induced local inflammatory responses that hinder bone regeneration. The present study aimed to develop a new method to enhance the stability and operability of bone substitutes commonly used in dentistry by premixing with photocurable hydrogel GelMA. The GelMA-encapsulated particulate had a strong capacity to aggregate separated particulates and firmly attach to the host bone defect after photocuring compared to particulates alone. Additionally, macrophages at the surface of the GelMA-stabilized particulates tended to present a more M2-like phenotype than those at the surface of Bio-Oss®, leading to more MMR+ multinucleated giant cell formation and the induction of blood vessel invasion and new bone formation. In conclusion, this hydrogel-coated bone substitute strategy facilitates bone regeneration with increased operability, a stable volume of osteogenic space, and a favorable osteogenic microenvironment, indicating its potential value in the field of maxillofacial and oral surgeries when bone substitutes are needed.
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Affiliation(s)
- Jiajia Wang
- Shanghai Key Laboratory of Stomatology, Department of Oral Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xuanyu Qi
- Shanghai Key Laboratory of Stomatology, Department of Prosthodontics, Shanghai Ninth People’s Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuqi Zhou
- School of Stomatology, Weifang Medical University, Weifang, China
| | - Guifang Wang
- Shanghai Key Laboratory of Stomatology, Department of Prosthodontics, Shanghai Ninth People’s Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuanmeng Yang
- Shanghai Key Laboratory of Stomatology, Department of Preventive Dentistry, Shanghai Ninth People’s Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ting Jiang
- Shanghai Key Laboratory of Stomatology, Department of Orthodontics, Shanghai Ninth People’s Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Yu
- School of Stomatology, Weifang Medical University, Weifang, China
| | - Shaoyi Wang
- Shanghai Key Laboratory of Stomatology, Department of Oral Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjie Zhang
- Shanghai Key Laboratory of Stomatology, Department of Prosthodontics, Shanghai Ninth People’s Hospital, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Li Q, He W, Li W, Luo S, Zhou M, Wu D, Li Y, Wu S. Band-Aid-Like Self-Fixed Barrier Membranes Enable Superior Bone Augmentation. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2206981. [PMID: 37029705 PMCID: PMC10238180 DOI: 10.1002/advs.202206981] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/10/2023] [Indexed: 06/04/2023]
Abstract
In guided bone regeneration surgery, a barrier membrane is usually used to inhibit soft tissue from interfering with osteogenesis. However, current barrier membranes usually fail to resist the impact of external forces on bone-augmented region, thus causing severe displacement of membranes and their underlying bone graft materials, eventually leading to unsatisfied bone augmentation. Herein, a new class of local double-layered adhesive barrier membranes (ABMs) is developed to successfully immobilize bone graft materials. The air-dried adhesive hydrogel layers with suction-adhesion properties enable ABMs to firmly adhere to the wet bone surface through a "stick-and-use" band-aid-like strategy and effectively prevent the displacement of membranes and the leakage of bone grafts in uncontained bone defect treatment. Furthermore, the strategy is versatile for preparing diverse adhesive barrier membranes and immobilizing different bone graft materials for various surgical regions. By establishing such a continuous barrier for the bone graft material, this strategy may open a novel avenue for designing the next-generation barrier membranes.
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Affiliation(s)
- Qianqian Li
- Hospital of StomatologyGuanghua School of StomatologyGuangdong Provincial Key Laboratory of StomatologySun Yat‐sen UniversityGuangzhou510055P. R. China
| | - Wenyi He
- PCFM LabSchool of ChemistrySun Yat‐sen UniversityGuangzhou510006P. R. China
| | - Weiran Li
- Hospital of StomatologyGuanghua School of StomatologyGuangdong Provincial Key Laboratory of StomatologySun Yat‐sen UniversityGuangzhou510055P. R. China
| | - Shulu Luo
- Hospital of StomatologyGuanghua School of StomatologyGuangdong Provincial Key Laboratory of StomatologySun Yat‐sen UniversityGuangzhou510055P. R. China
| | - Minghong Zhou
- Medical Research InstituteGuangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou510080P. R. China
| | - Dingcai Wu
- PCFM LabSchool of ChemistrySun Yat‐sen UniversityGuangzhou510006P. R. China
| | - Yan Li
- Hospital of StomatologyGuanghua School of StomatologyGuangdong Provincial Key Laboratory of StomatologySun Yat‐sen UniversityGuangzhou510055P. R. China
| | - Shuyi Wu
- Hospital of StomatologyGuanghua School of StomatologyGuangdong Provincial Key Laboratory of StomatologySun Yat‐sen UniversityGuangzhou510055P. R. China
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22
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Vaquette C, Carluccio D, Batstone M, Ivanovski S. Workflow for Fabricating 3D-Printed Resorbable Personalized Porous Scaffolds for Orofacial Bone Regeneration. Methods Mol Biol 2023; 2588:485-492. [PMID: 36418706 DOI: 10.1007/978-1-0716-2780-8_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Resorption of alveolar bone following tooth extraction is a physiological process that can often prevent the placement of dental implants due to the limited bone remaining. In severe cases, vertical bone augmentation, which aims to restore bone in an extraskeletal dimension (outside of the skeletal envelope), is required prior to implant placement. While current treatment strategies rely on autologous grafts, or "Guided Bone Regeneration" involving the placement of particulate bone grafting biomaterials under a protective membrane, the field is shifting to patient-matched solutions. Herein, we describe the various steps required for modeling the patient data, creating the patient-matched scaffold geometry and 3D-printing using the biodegradable polymer polycaprolactone for application in the oro-dental and craniofacial areas.
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Affiliation(s)
- Cedryck Vaquette
- School of Dentistry, Centre for Oral Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Herston, QLD, Australia.,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Danilo Carluccio
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Martin Batstone
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Sašo Ivanovski
- School of Dentistry, Centre for Oral Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Herston, QLD, Australia. .,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia.
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23
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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: 0.3] [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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24
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Funato A, Ishikura C, Naito K, Hasuike A. Resorbable Membrane Pouch Technique for Single-Implant Placement in the Esthetic Zone: A Preliminary Technical Case Report. Bioengineering (Basel) 2022; 9:bioengineering9110649. [PMID: 36354560 PMCID: PMC9687625 DOI: 10.3390/bioengineering9110649] [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: 10/09/2022] [Revised: 10/20/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
Abstract
The conventional protocol for lateral guided bone regeneration (GBR) in esthetic areas requires the securing of resorbable collagen membranes using titanium cortical bone pins to immobilize bone grafts. These procedures are highly invasive and can increase patient morbidity and discomfort. Herein, we introduce a minimally invasive novel resorbable membrane pouch technique, wherein collagen membranes can be immobilized by securing them to the periosteum without the need of titanium pins. We describe 11 cases of single-immediate- or delayed-implant placement in the atrophic maxilla esthetic zone. All implants were successful and functional without pain or inflammation and with optimal soft-tissue health and esthetics. Radiographic evaluation with cone-beam computed tomography (CBCT) and esthetic assessment using the pink esthetic score (PES) were performed. At the time of implant placement, the average augmented bone width was 2.8 ± 0.6 mm on CBCT analysis. In all cases, resorption of the augmented bone was confirmed with an average of −1.3 ± 0.8 mm. Soft-tissue outcomes were scored 1 year after permanent restoration. The PES score 1 year after treatment was 11.9 ± 1.4. The resorbable membrane pouch technique with immediate or delayed implant placement for buccal dehiscence in the esthetic area can be predictable and is minimally invasive.
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Affiliation(s)
| | | | - Koji Naito
- DIABUILDING Dental Clinic, Tokyo 104-0033, Japan
| | - Akira Hasuike
- Department of Periodontology, Nihon University School of Dentistry, Tokyo 101-8310, Japan
- Dental Research Center, Nihon University School of Dentistry, Tokyo 101-8310, Japan
- Correspondence:
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25
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Wang LH, Ruan Y, Zhao WY, Chen JP, Yang F. Modified membrane fixation technique in a severe continuous horizontal bone defect: A case report. World J Clin Cases 2022; 10:5789-5797. [PMID: 35979105 PMCID: PMC9258389 DOI: 10.12998/wjcc.v10.i17.5789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/26/2022] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Continuous severe horizontal bone defect is common in the aesthetic maxillary anterior area, and presents a major challenge in implant dentistry and requires predictable bone augmentation to increase the width of the alveolar bone.
CASE SUMMARY A 24-year-old man, with a history of well-controlled IgA nephropathy, presented to the Dentistry Department of our hospital complaining of missing his right maxillary anterior teeth 1 mo ago. Severe horizontal alveolar bone defects at sites of teeth 12, 13 and 14 were diagnosed. A modified guided bone regeneration surgical approach stabilizing the absorbable collagen membrane and particulate graft materials by periosteal diagonal mattress suture (PDMS) combined with four corner pins was used for this severe continuous horizontal bone defect. The outcome revealed that the newly formed alveolar ridge dimension increased from 0.72 mm to 11.55 mm horizontally 10 mo postoperatively, with no adverse events. The implant surgery was successfully performed.
CONCLUSION This case highlights that PDMS combined with four corner pins is feasible to maintain the space and stabilize the graft and membranes in severe continuous horizontal bone defect.
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Affiliation(s)
- Lin-Hong Wang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
| | - Yan Ruan
- Graduate Department, Bengbu Medical College, Bengbu 233030, Anhui Province, China
| | - Wen-Yan Zhao
- Department of Stomatology, The First People's Hospital of Hangzhou Lin'an District, Hangzhou 311399, Zhejiang Province, China
| | - Jian-Ping Chen
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
| | - Fan Yang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
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26
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Biodegradation of a Magnesium Alloy Fixation Screw Used in a Guided Bone Regeneration Model in Beagle Dogs. MATERIALS 2022; 15:ma15124111. [PMID: 35744169 PMCID: PMC9229971 DOI: 10.3390/ma15124111] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 02/06/2023]
Abstract
Nowadays, the most commonly used fixation systems are non-resorbable, but new resorbable magnesium alloy fixation screws have been introduced recently. Therefore, the aim of this study was to compare the magnesium fixation screw and the commonly used non-resorbable titanium screw in an animal model. Four 3-wall defect sites were covered with collagen membranes in the mandible of twenty beagle dogs (two sites on the left and two on the right). Each membrane was fixed with either four magnesium screws or four titanium screws. Post-operative follow-up revealed the expected observations such as transient inflammation and pain. Both groups showed a good healing response, with no differences between groups. Micro-CT analysis showed no significant difference between groups in terms of BV/TV or soft tissue volume. The void volume in the magnesium fixation screw group continued to decrease on average between the different timepoints, but not significantly. Furthermore, a gradual progression of the degradation process of the magnesium screws was observed in the same group. Magnesium screws and titanium screws showed equal performance in tissue regeneration according to GBR principles. An additional advantage of magnesium screws is their resorbable nature, which eliminates the need for a second surgical step to remove the screws.
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27
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Wang J, Luo Y, Qu Y, Man Y. Horizontal ridge augmentation in the anterior maxilla with in situ onlay bone grafting: a retrospective cohort study. Clin Oral Investig 2022; 26:5893-5908. [PMID: 35583662 DOI: 10.1007/s00784-022-04547-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/08/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aimed to introduce a digitally guided in situ autogenous onlay grafting technique and compare its effectiveness with the conventional (ex situ) onlay technique in augmenting horizontal bone defects of the anterior maxilla. MATERIALS AND METHODS This retrospective cohort study included 24 patients who had received autogenous onlay bone grafts combined with guided bone regeneration (GBR) in the anterior maxilla. Fourteen patients were recruited into the in situ onlay grafting group (EG), and 10 were recruited into the ex situ onlay group (CG), defined by the donor sites. The clinical parameters, radiographic changes, micro-CT, and histological processes were evaluated after a mean follow-up period of 1.7 years. RESULTS The horizontal bone width reflected significant bone modeling over time (p < 0.001) in the first 6 months. Multivariable analysis showed that the treatment modality (grouping) was a critical factor positively associated with vertical bone height alteration. However, neither the alteration rate of horizontal bone width nor the bone volume was associated with the treatment modality. The number of periosteal screws per graft positively affected horizontal contour maintenance (p < 0.05). No significant differences were observed between the groups in the clinical parameters (complications, success rate, and peri-implant parameters). The micro-CT and histological outcomes were similar between the groups. CONCLUSION Despite the limitations of this study, in situ onlay grafting combined with GBR was an effective and reliable approach for horizontal bone augmentation in the anterior maxilla and appeared to demonstrate better stability in vertical bone remodeling. CLINICAL RELEVANCE This study introduces a modified and minimally invasive technique of onlay grafting for horizontal bone augmentation. This in situ onlay grafting demonstrates superior stability in vertical bone remodeling. The trial registration number is ChiCTR2100054683.
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Affiliation(s)
- Jing Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yilin Luo
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China.,Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Man
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China. .,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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28
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Lee JS, Park JY, Chung HM, Song YW, Strauss FJ. Vertical ridge augmentation feasibility using unfixed collagen membranes and particulate bone substitutes: A 1- to 7-year retrospective single-cohort observational study. Clin Implant Dent Relat Res 2022; 24:372-381. [PMID: 35324059 PMCID: PMC9314959 DOI: 10.1111/cid.13084] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/15/2022] [Accepted: 03/07/2022] [Indexed: 12/28/2022]
Abstract
Aim To determine whether vertical ridge augmentation (VRA) can be obtained through guided bone regeneration (GBR) using exclusively resorbable collagen membranes and particulate bone substitutes without additional stabilization. Materials and Methods This study retrospectively examined 22 participants who underwent VRA with staged or simultaneous implant placement. The vertical defects of all participants were filled with particulate bone substitutes and covered with resorbable collagen membranes. The augmented sites were stabilized with unfixed collagen membranes and the flap without any additional fixation. The augmented tissue height was assessed using cone‐beam computed tomography at baseline, immediately after surgery, and at annual follow‐ups. Results The vertical bone gain of the 22 augmented sites amounted to 6.48 ± 2.19 mm (mean ± SD) immediately after surgery and 5.78 ± 1.72 mm at 1‐ to 7‐year follow‐up. Of the 22 augmented sites, 18 exhibited changes of less than 1 mm, while the other 4 showed changes of greater than 1 mm. Histological observation of three representative cases revealed new bone apposition on the remaining material. Conclusion The present findings indicate that GBR procedures using exclusively collagen membranes and particulate biomaterials without any additional fixation are feasible options for VRA.
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Affiliation(s)
- Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Republic of Korea.,Department of Oral Biology, Medical University of Vienna, Vienna, Austria
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Republic of Korea
| | - Hye-Min Chung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Republic of Korea.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Franz-Josef Strauss
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria.,Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.,Clinic of Reconstructive Dentistry, University of Zurich, Zürich, Switzerland
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29
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An YZ, Strauss FJ, Park JY, Shen YQ, Thoma DS, Lee JS. Membrane fixation enhances guided bone regeneration in standardized calvarial defects: A pre-clinical study. J Clin Periodontol 2022; 49:177-187. [PMID: 34866208 DOI: 10.1111/jcpe.13583] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/09/2021] [Accepted: 11/23/2021] [Indexed: 12/21/2022]
Abstract
AIM To determine whether collagen membrane (CM) fixation enhances guided bone regeneration in standardized defects. MATERIALS AND METHODS Four 8-mm-diameter defects were surgically made in eight rabbit calvaria, and randomly allocated into four groups: control (empty), unfixed-CM, fixed-CM, and unfixed-CM with bone graft (BG + CM) (positive control). After 1- and 4-week healing periods, the animals were sacrificed and quantitative reverse transcription polymerase chain reaction, micro-computed tomography, and histological outcomes were assessed. RESULTS At week 1, the expression levels of BMP-2, FGF-2, VEGF, and osteocalcin were significantly higher in the fixed-CM group than in the unfixed-CM and control groups (p < .05). Conversely, cathepsin-K was significantly expressed in the unfixed-CM group. No significant differences in expression markers were observed between the fixed-CM and BG + CM groups (p > .05). At week 4, new bone formation was significantly higher in the fixed-CM group than the unfixed-CM and control groups (p < .05), but similar to the BG + CM group (p > .05). CONCLUSIONS CM fixation enhances the expression of osteogenic factors similar to BG + CM, leading to significantly more new bone formation. This suggests that the osteogenic potential is greater when membranes are fixed, thereby limiting the necessity of membrane-supporting materials to enhance bone formation.
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Affiliation(s)
- Yin-Zhe An
- Department of Periodontology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Yu Qin Shen
- Department of Periodontology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Daniel Stefan Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Jung-Seok Lee
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Republic of Korea
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30
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Azhar I, Ayulita D, Laksono H, Margaretha T. The efficiency of PRF, PTFE, and titanium mesh with collagen membranes for vertical alveolar bone addition in dental implant therapy: A narrative review. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_7_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Hard tissue stability after guided bone regeneration: a comparison between digital titanium mesh and resorbable membrane. Int J Oral Sci 2021; 13:37. [PMID: 34782595 PMCID: PMC8594427 DOI: 10.1038/s41368-021-00143-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/28/2021] [Accepted: 10/27/2021] [Indexed: 02/05/2023] Open
Abstract
Guided bone regeneration (GBR) uses resorbable and non-resorbable membranes as biological barriers. This study compared the differences in hard tissue stability between GBR using evidence-based digital titanium mesh and resorbable collagen membranes during implant placement. A total of 40 patients (65 implant sites) were enrolled and divided into two groups: resorbable membrane and digital titanium mesh groups. The alveolar bone was analyzed at two- and three-dimensional levels using cone-beam computed tomography and by reconstructing and superimposing the hard tissues at four time points: preoperatively, postoperatively, before second-stage surgery, and 1 year after loading. The use of digital titanium mesh showed less alveolar bone resorption in vertical and horizontal directions two-dimensionally before the second-stage surgery and 1 year after loading. Regarding volumetric stability, the percentage of resorption after 6 months of healing with resorbable membrane coverage reached 37.5%. However, it was only 23.4% with titanium mesh. Although postoperative bone volume was greater at all labial sites with resorbable membrane than with digital titanium mesh, after substantial bone resorption within 1 year of loading, the labial bone thickness at the upper part of implants was thinner with resorbable membrane than with digital titanium mesh. Furthermore, digital titanium meshes made according to ideal bone arch contour reduced soft tissue irritation, and the exposure rate was only 10%. Therefore, although both resorbable membrane and digital titanium mesh in GBR were able to successfully reconstruct the bone defect, digital titanium meshes were better at maintaining the hard tissue volume in the osteogenic space.
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Lee JH, Jung EH, Jeong SN. Augmentation Stability of Guided Bone Regeneration for Peri-Implant Dehiscence Defects with L-shaped Porcine-Derived Block Bone Substitute. MATERIALS 2021; 14:ma14216580. [PMID: 34772106 PMCID: PMC8585415 DOI: 10.3390/ma14216580] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 12/13/2022]
Abstract
Block bone substitutes have better augmentation stability for guided bone regeneration (GBR) than particulate bone substitutes. This study sought to determine whether GBR with an L-shaped porcine block bone (DPBM-C) differs from GBR with an L-shaped bovine block bone (DBBM-C) based on clinical, radiographic, and volumetric outcomes for peri-implant dehiscence defects. A total of 42 peri-implant defects were grafted with 20 L-shaped DPBM-C and 22 DBBM-C groups. The horizontal and vertical thicknesses of the augmented hard tissue were measured using sagittal cone-beam computed tomography, and the volumetric tissue change was evaluated by stereolithography image superimposition. Postoperative discomfort, early wound healing outcomes, and implant stability were also assessed. Among the clinical (subjective pain and swelling, wound dehiscence, membrane exposure, and periotest values), radiographic (changes in horizontal and vertical hard tissue thickness), and volumetric parameters of the L-shaped DPBM-C and DBBM-C groups during the healing period, only the periotest values showed a statistically significant difference (0.67 ± 1.19, p = 0.042). Within the limitations of this study, an L-shaped DPBM-C is not inferior to an L-shaped DBBM-C based on their clinical, radiographic, and volumetric outcomes for GBR of peri-implant dehiscence defects.
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Affiliation(s)
- Jae-Hong Lee
- Correspondence: ; Tel.: +82-42-366-1114; Fax: +82-42-366-1115
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Puisys A, Auzbikaviciute V, Vindasiute‐Narbute E, Zukauskas S, Deikuviene J, Razukevicius D. Decompression technique - A modified approach for lateral alveolar ridge augmentation: A case report. Clin Case Rep 2021; 9:1253-1260. [PMID: 33768821 PMCID: PMC7981741 DOI: 10.1002/ccr3.3746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/02/2020] [Accepted: 10/19/2020] [Indexed: 11/18/2022] Open
Abstract
A particular technique can increase the mucosal and peri-implant bone thickness, prevent compression around implant neck, and obtain proper space for the following prosthetic treatment with an adequate emergence profile.
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Affiliation(s)
- Algirdas Puisys
- Vilnius Implantology CenterVilniusLithuania
- Vilnius Research GroupVilniusLithuania
| | | | - Egle Vindasiute‐Narbute
- Vilnius Implantology CenterVilniusLithuania
- Vilnius Research GroupVilniusLithuania
- Vilnius UniversityVilniusLithuania
| | - Saulius Zukauskas
- Vilnius Implantology CenterVilniusLithuania
- Vilnius Research GroupVilniusLithuania
- Vilnius UniversityVilniusLithuania
| | - Justina Deikuviene
- Vilnius Implantology CenterVilniusLithuania
- Vilnius Research GroupVilniusLithuania
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34
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Lee WH, Kuchler U, Cha JK, Stavropoulos A, Lee JS. Distance of insertion points in a mattress suture from the wound margin for ideal primary closure in alveolar mucosa: an in vitro experimental study. J Periodontal Implant Sci 2021; 51:189-198. [PMID: 34114382 PMCID: PMC8200382 DOI: 10.5051/jpis.2100680034] [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: 01/22/2021] [Revised: 03/15/2021] [Accepted: 04/29/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose This study was conducted to determine how the distance of the near insertion points in a vertical mattress suture from the wound margin influences the pattern of primary closure in an in vitro experimental model. Methods Pairs of 180 porcine gingival and alveolar mucosa samples were harvested from 90 pig jaws and fixed to a specially designed model. A vertical mattress suture was performed with the near insertion point at 3 different distances from the wound margin (1-, 3-, and 5-mm) on both the gingival and mucosal samples (6 groups; n=30 for each group). The margin discrepancy and the presence of epithelium between the wound margins were measured on histologic slides. Results The margin discrepancy decreased significantly as the near insertion point became closer to the wound margin both in mucosal tissue (0.241±0.169 mm, 0.945±0.497 mm, and 1.306±0.773 mm for the 1-, 3-, and 5-mm groups, respectively) and in gingival tissue (0.373±0.304 mm, 0.698±0.431 mm, and 0.713±0.691 mm, respectively). The frequency of complications of wound margin adaptation reduced as the distance of the near insertion point from the wound margin decreased both in the mucosal and gingival tissues. Conclusions Placing the near insertion point close to the wound margin enhances the precision of wound margin approximation/adaptation using a vertical mattress suture.
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Affiliation(s)
- Won Ho Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ulrike Kuchler
- Department of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Jae Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine CUMD, University of Geneva, Geneva, Switzerland
| | - Jung Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
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Abdelfadil E, Aboelmaaty W. Mineralized Plasmatic Matrix for Horizontal Ridge Augmentation in Anterior Maxilla with and without a Covering Collagen Membrane. Open Dent J 2020. [DOI: 10.2174/1874210602014010743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background:
Mineralized Plasmatic Matrix [MPM] is a unique form of platelet rich fibrin that contains mineralized bone graft particles within a fibrin network.
Aim:
This study was conducted to evaluate horizontal ridge augmentation using MPM with and without a coverage membrane.
Materials and Methods:
Sixteen edentulous spaces were randomly divided into 2 equal groups. MPM was used for horizontal ridge augmentation with and without a covering collagen membrane (group 1 and 2, respectively). Cone Beam CT images were obtained preoperatively as well as 1 week and 4 months postoperatively to evaluate alveolar ridge and the resorption of the grafting material at 3 predetermined points along with the site where the future dental implant will be placed.
Student’s t-test (Unpaired) was used for comparing two different groups with quantitative parametric data and student’s t-test (Paired) was used for comparing two related groups with quantitative parametric data while repeated measures ANOVA (Analysis of variance) followed by post-hoc Bonferroni was used for comparing more than two related groups with quantitative parametric data.
Student’s t-test (Unpaired) was used for comparing two different groups with quantitative parametric data and student’s t-test (Paired) was used for comparing two related groups with quantitative parametric data while repeated measures ANOVA (Analysis of variance) followed by post-hoc Bonferroni was used for comparing more than two related groups with quantitative parametric data.
Results:
There was no statistically significant difference between the gained bone width in both groups. More but not statistically significant resorption was recorded in group 2.
Conclusion:
MPM can be successfully used for horizontal ridge augmentation without a barrier membrane.
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Kamat SM, Khandeparker RV, Akkara F, Dhupar V, Mysore A. SauFRa Technique for the Fixation of Resorbable Membranes in Horizontal Guided Bone Regeneration: A Technical Report. J ORAL IMPLANTOL 2020; 46:609-613. [PMID: 32315438 DOI: 10.1563/aaid-joi-d-19-00265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Saurabh Mohandas Kamat
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Calapor, India
| | - Rakshit V Khandeparker
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Calapor, India
| | - Francis Akkara
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Calapor, India
| | - Vikas Dhupar
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Calapor, India
| | - Ashwin Mysore
- Department of Prosthodontics, Goa Dental College and Hospital, Calapor, India
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Deeb JG, Reichert A, Carrico CK, Laskin DM, Deeb GR. Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study. Clin Exp Dent Res 2020; 7:147-155. [PMID: 33150685 PMCID: PMC8019766 DOI: 10.1002/cre2.343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/06/2020] [Accepted: 06/11/2020] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate if the addition of biologic agents to a particulate bone graft enhances horizontal ridge augmentation outcomes in terms of bone dimensions, bone density, and successful implant placement. MATERIALS AND METHODS A retrospective chart review was done to assess the clinical and radiographic outcomes in 52 horizontal ridge augmentation sites in 43 patients. Information was gathered regarding surgical technique, type of graft material, biologic agents used (PRP or rhPDGF-BB), method of space maintenance, and achieved alveolar ridge width and bone density changes as quantified on CBCT scans. RESULTS The use of tenting screws, a resorbable membrane, and a combination of particulate allogenic and xenogenic bone graft material provided an average horizontal bone gain of 3.6 mm in the 52 augmented sites. There was no statistically significant difference observed in the amount of horizontal bone gain between sites treated with the addition of biologic agents (n = 21), or with a particulate bone graft alone (n = 31). A marginally statistically significant difference was found in the density of the grafted bone with the addition of biologics (p value = .0653). CONCLUSION The addition of biologic agents to the graft materials did not have a significant effect on the amount of horizontal bone gain or successful implant placement; however, it marginally enhanced the bone density of the grafted area.
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Affiliation(s)
- Janina Golob Deeb
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Amy Reichert
- Cardinal Dental Specialists, Harrisonburg, Virginia, USA
| | - Caroline K Carrico
- Dental Public Health and Policy, Oral Health Research Core, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Daniel M Laskin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - George R Deeb
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
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Fenelon M, Etchebarne M, Siadous R, Grémare A, Durand M, Sentilhes L, Torres Y, Catros S, Gindraux F, L'Heureux N, Fricain JC. Assessment of fresh and preserved amniotic membrane for guided bone regeneration in mice. J Biomed Mater Res A 2020; 108:2044-2056. [PMID: 32319212 DOI: 10.1002/jbm.a.36964] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 03/23/2020] [Accepted: 03/28/2020] [Indexed: 12/13/2022]
Abstract
Thanks to its biological properties, the human amniotic membrane (HAM) can be used as a barrier membrane for guided bone regeneration (GBR). However, no study has assessed the influence of the preservation method of HAM for this application. This study aimed to establish the most suitable preservation method of HAM for GBR. Fresh (F), cryopreserved (C) lyophilized (L), and decellularized and lyophilized (DL) HAM were compared. The impact of preservation methods on collagen and glycosaminoglycans (GAG) content was evaluated using Masson's trichrome and alcian blue staining. Their suture retention strengths were assessed. In vitro, the osteogenic potential of human bone marrow mesenchymal stromal cells (hBMSCs) cultured on the four HAMs was evaluated using alkaline phosphatase staining and alizarin red quantification assay. In vivo, the effectiveness of fresh and preserved HAMs for GBR was assessed in a mice diaphyseal bone defect after 1 week or 1 month healing. Micro-CT and histomorphometric analysis were performed. The major structural components of HAM (collagen and GAG) were preserved whatever the preservation method used. The tearing strength of DL-HAM was significantly higher. In vitro, hBMSCs seeded on DL-HAM displayed a stronger ALP staining, and alizarin red staining quantification was significantly higher at Day 14. In vivo, L-HAM and DL-HAM significantly enhanced early bone regeneration. One month after the surgery, only DL-HAM slightly promoted bone regeneration. Several preserving methods of HAM have been studied for bone regeneration. Here, we have demonstrated that DL-HAM achieved the most promising results for GBR.
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Affiliation(s)
- Mathilde Fenelon
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Oral Surgery, CHU Bordeaux, Bordeaux, France
| | - Marion Etchebarne
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Maxillofacial Surgery, CHU Bordeaux, Bordeaux, France
| | - Robin Siadous
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France
| | - Agathe Grémare
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Odontology and Oral Health, CHU Bordeaux, Bordeaux, France
| | - Marlène Durand
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,CHU Bordeaux, CIC 1401, Bordeaux, France.,INSERM, CIC 1401, Bordeaux, France
| | - Loic Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France
| | - Yoann Torres
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France
| | - Sylvain Catros
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Oral Surgery, CHU Bordeaux, Bordeaux, France
| | - Florelle Gindraux
- Department of Orthopedic, Traumatology & Plastic Surgery, University Hospital of Besançon, Besançon, France.,Nanomedicine Lab, Imagery and Therapeutics (EA 4662), SFR FED 4234, University of Franche-Comté, Besançon, France
| | - Nicolas L'Heureux
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France
| | - Jean-Christophe Fricain
- INSERM, Laboratory BioTis, UMR 1026, University of Bordeaux, Bordeaux, France.,Department of Oral Surgery, CHU Bordeaux, Bordeaux, France
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Sbricoli L, Guazzo R, Annunziata M, Gobbato L, Bressan E, Nastri L. Selection of Collagen Membranes for Bone Regeneration: A Literature Review. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E786. [PMID: 32050433 PMCID: PMC7040903 DOI: 10.3390/ma13030786] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/23/2020] [Accepted: 02/05/2020] [Indexed: 12/22/2022]
Abstract
Several treatment modalities have been proposed to regenerate bone, including guided bone regeneration (GBR) where barrier membranes play an important role by isolating soft tissue and allowing bone to grow. Not all membranes biologically behave the same way, as they differ from their origin and structure, with reflections on their mechanical properties and on their clinical performance. Collagen membranes have been widely used in medicine and dentistry, because of their high biocompatibility and capability of promoting wound healing. Recently, collagen membranes have been applied in guided bone regeneration with comparable outcomes to non-resorbable membranes. Aim of this work is to provide a review on the main features, application, outcomes, and clinical employment of the different types of collagen membranes. Comparisons with non-resorbable membranes are clarified, characteristics of cross-linked collagen versus native collagen, use of different grafting materials and need for membrane fixation are explored in order to gain awareness of the indications and limits and to be able to choose the right membrane required by the clinical condition.
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Affiliation(s)
- Luca Sbricoli
- Department of Neurosciences, School of Dentistry, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; (R.G.); (L.G.); (E.B.)
| | - Riccardo Guazzo
- Department of Neurosciences, School of Dentistry, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; (R.G.); (L.G.); (E.B.)
| | - Marco Annunziata
- Multidisciplinary Department of Medical Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (M.A.); (L.N.)
| | - Luca Gobbato
- Department of Neurosciences, School of Dentistry, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; (R.G.); (L.G.); (E.B.)
| | - Eriberto Bressan
- Department of Neurosciences, School of Dentistry, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; (R.G.); (L.G.); (E.B.)
| | - Livia Nastri
- Multidisciplinary Department of Medical Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (M.A.); (L.N.)
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40
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Liu X, Fan B, Abdelrehem A, Ma Z, Yang C. Membrane fixation for osseous graft stabilization in periodontally accelerated osteogenic orthodontics: a comparative study. BMC Oral Health 2020; 20:22. [PMID: 31992277 PMCID: PMC6988277 DOI: 10.1186/s12903-019-0964-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 11/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Periodontally accelerated osteogenic orthodontics (PAOO) is a treatment for bone defects associated with a lack of bone graft stability, especially in coronal locations. This study aimed to compare a modified technique of membrane fixation that utilizes periosteal sutures (using a pouch design) with the traditional approach, which does not use membrane fixation. METHODS Twenty-eight patients with a total of 168 teeth treated were divided into two groups: 1-A, in which patients were treated using the modified technique (with membrane fixation), and group 2-B, in which patients were treated using the traditional technique (without membrane fixation). The postoperative bone thickness was evaluated via radiographic examination. RESULTS Postoperative improvements in bone augmentation were detected in both groups. At 12 months, the values of the CHBT (measured from the midpoint of the coronal third to the labial cortical surface, 0.84 ± 0.33 mm) and the values of VBL (measured from the alveolar crest to the cemento-enamel junction, - 2.35 ± 0.80 mm)were significantly greater in the modified technique group than those in the traditional technique group (CHBT:0.12 ± 0.21 mm and VBL:-1.39 ± 0.99 mm; P = 0.00 and P = 0.01). CONCLUSIONS This study shows that compared to the traditional technique, the modified PAOO technique with membrane fixation using periosteal sutures provides improved graft stabilization, superior coronal augmentation and satisfactory vertical volume.
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Affiliation(s)
- Xiaohan Liu
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. National Clinical Research Center of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Baoting Fan
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. National Clinical Research Center of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Ahmed Abdelrehem
- Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Zhigui Ma
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. National Clinical Research Center of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Chi Yang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. National Clinical Research Center of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China.
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41
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McGary RT, Johnson TM, Berridge JP, Wilson JP, Baron D. The Tissue-Supported Sling Suture: Technique and Clinical Applications. Clin Adv Periodontics 2019; 10:107-117. [PMID: 31613057 DOI: 10.1002/cap.10081] [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: 06/08/2019] [Accepted: 07/14/2019] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Continuous and interrupted sling sutures (ISSs) are used around teeth in contemporary periodontics. However, conventional ISSs depend upon favorable tooth morphology for stability through the early healing period. The purpose of this report is to present a variation of the classic ISS that does not rely on favorable tooth morphology. CASE SERIES Tissue-supported sling sutures (TSSs) were used for six patients undergoing root coverage, gingival augmentation, or pontic site development (guided bone regeneration) procedures. CONCLUSIONS Although techniques such as vertical mattress suturing may support greater coronal flap advancement, the TSS technique does maintain coronal flap position while minimizing trauma to papillae. TSS stability is independent of tooth morphology and may offer clinicians flexibility in achieving reliable closure over hard and soft tissue implants. Like mattress sutures, TSSs reduce tension at the crestal incision line in tissue grafting procedures.
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Affiliation(s)
- Ryan T McGary
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA, USA
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA, USA
| | - Joshua P Berridge
- Department of Periodontics, United States Army Dental Health Activity, Fort Bragg, NC, USA
| | - James P Wilson
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA, USA
| | - Dmitry Baron
- Department of Periodontics, United States Army Dental Health Activity, Stuttgart, Germany
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Urban IA, Wessing B, Alández N, Meloni S, González-Martin O, Polizzi G, Sanz-Sanchez I, Montero E, Zechner W. A multicenter randomized controlled trial using a novel collagen membrane for guided bone regeneration at dehisced single implant sites: Outcome at prosthetic delivery and at 1-year follow-up. Clin Oral Implants Res 2019; 30:487-497. [PMID: 30927498 DOI: 10.1111/clr.13426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 02/22/2019] [Accepted: 03/05/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To compare clinical performance of a novel resorbable non-cross-linked collagen membrane (CXP) with a reference membrane (non-cross-linked resorbable membrane; BG) for simultaneous implant placement and guided bone regeneration (GBR) at dehisced single implant sites. MATERIALS AND METHODS Preliminary data from this randomized controlled trial were reported previously; this is the 12-month report. The primary outcome measure was defected height at 6 months post-GBR. Secondary outcomes included implant cumulative survival rate (CSR) and success rate since placement; bone level changes, pink esthetic score (PES), and patient satisfaction since definitive prosthesis delivery; patient quality of life since pretreatment; and the 1-year bleeding index. Non-parametric statistical analyses were performed. RESULTS Among patients, 24 were treated with CXP and 25 with BG. The 1-year implant CSR and success rate were 100% (n = 42). Bone level change between definitive prosthetic delivery and 1 year was not significantly different between the CXP and BG groups (BG + 0.42 mm, CXP + 0.01 mm). The PES increased from 7.55 to 8.10 for the CXP group and from 6.48 to 7.48 for the BG group; 1-year bleeding indices were 0 (16 CXP, 18 BG) and 1 (4 CXP, 2 BG). Patient quality of life changed from an OHIP-14 score of 6.5 at pretreatment to 1.9 at 1 year. Overall satisfaction (visual analogue score) with function and esthetics was 9.9 and 9.7, respectively. Inter-group differences were not significant for assessed outcomes. No device-related adverse events were reported. CONCLUSIONS The use of CXP and BG for simultaneous implant placement and GBR at dehisced implant sites similarly reduced defect height and improved secondary measures, indicating non-inferiority.
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Affiliation(s)
- Istvan A Urban
- Department of Periodontics and Oral Medicine School of Dentistry, University of Michigan, Ann Arbor, Michigan.,Graduate Implant Dentistry, Loma Linda University, Loma Linda, California.,Urban Regeneration Institute, Budapest, Hungary
| | | | | | - Silvio Meloni
- Department of Surgical, Microsurgical, and Medical Sciences, Dentistry Unit, University Hospital of Sassari, Sassari, Italy
| | | | | | - Igancio Sanz-Sanchez
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Eduardo Montero
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Werner Zechner
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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Mertens C, Braun S, Krisam J, Hoffmann J. The influence of wound closure on graft stability: An in vitro comparison of different bone grafting techniques for the treatment of one-wall horizontal bone defects. Clin Implant Dent Relat Res 2019; 21:284-291. [PMID: 30741470 DOI: 10.1111/cid.12728] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 09/25/2018] [Accepted: 01/08/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The aim of this preclinical study was to analyze and compare different grafting techniques with respect to volume stability after wound closure. MATERIALS AND METHODS Four different grafting techniques were evaluated in vitro for volume stability in a one-wall horizontal defect configuration. Group 1: guided bone regeneration (GBR) with collagen membrane, particulated xenograft; group 2: GBR with collagen membrane, particulated xenograft, pins; group 3: GBR with titanium-reinforced membrane, particulated xenograft, pins; group 4: autogenous block graft, particulated xenograft, collagen membrane. Cone beam computed tomography scans were performed before and after wound closure, and the horizontal bone dimensions were analyzed for stability at 0-5 mm apical to the implant shoulder (H0-H5). RESULTS At H0-H2, wound closure induced a statistically significant change in bone dimensions in groups 1 and 2. In group 3, only the change in H0 was significant, and for group 4, only H2 was significant. CONCLUSION Wound closure has a significant impact on graft stability in a one-wall horizontal defect configuration. GBR with additional membrane fixation showed better results than without. Titanium-reinforced membranes and autogenous blocks showed significantly greater volume stability than GBR with collagen membrane, especially in the coronal portion.
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Affiliation(s)
- Christian Mertens
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Sebastian Braun
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Johannes Krisam
- Institute of Medical Biometry and Informatics, University Heidelberg, Heidelberg, Germany
| | - Jürgen Hoffmann
- Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
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44
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Golob Deeb J, McCormack D, Laskin DM, Deeb GR. Use of Transalveolar Sutures for Anchorage of a Resorbable Membrane During Horizontal Ridge Augmentation. Clin Adv Periodontics 2018. [DOI: 10.1002/cap.10032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Janina Golob Deeb
- Department of Periodontics; School of Dentistry; Virginia Commonwealth University; Richmond VA
| | | | - Daniel M. Laskin
- Department of Oral and Maxillofacial Surgery; School of Dentistry; Virginia Commonwealth University
| | - George R. Deeb
- Department of Oral and Maxillofacial Surgery; School of Dentistry; Virginia Commonwealth University
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45
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Bone Regeneration of Peri-Implant Defects Using a Collagen Membrane as a Carrier for Recombinant Human Bone Morphogenetic Protein-2. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5437361. [PMID: 30046599 PMCID: PMC6036850 DOI: 10.1155/2018/5437361] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/19/2018] [Indexed: 11/17/2022]
Abstract
This study is designed to determine the effect of collagen membrane (CM) soaked with bone morphogenetic protein-2 (rhBMP-2) for the treatment of peri-implant dehiscence defects. Material and Methods. Three treatment groups were allocated at each defect in 5 dogs: (i) collagenated synthetic bone (OC) and CM soaked with rhBMP-2 (BMP group), (ii) OC and CM soaked with saline (nonBMP group), and (iii) no further treatment (control group). Titanium pins were used to stabilize the membranes in two dogs. Radiographic and histomorphometric analyses were performed 4 weeks later. Results. The median augmented volumes were 4.27 mm3, 6.24 mm3, and 2.75 mm3 in the BMP, nonBMP, and control groups, respectively; the corresponding median first bone-to-implant contact (fBIC) distances were 3.25 mm, 3.08 mm, and 2.56 mm (P > 0.05). The placement of pins (with the BMP and nonBMP groups pooled) significantly improved bone regeneration: the augmented volumes were 17.60 mm3 with pins and 3.68 mm3 without pins (P = 0.024), with corresponding fBIC distances of 2.25 mm and 3.31 mm, respectively (P < 0.001). Conclusions. The addition of rhBMP-2 to CM failed to improve bone regeneration of peri-implant dehiscence defects compared to using an unsoaked CM after 4 weeks. However, the stabilization of CMs using pins positively influenced the outcomes.
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Beitlitum I, Sebaoun A, Nemcovsky CE, Slutzkey S. Lateral bone augmentation in narrow posterior mandibles, description of a novel approach, and analysis of results. Clin Implant Dent Relat Res 2018; 20:96-101. [DOI: 10.1111/cid.12580] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 12/19/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Ilan Beitlitum
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel-Aviv University; Tel-Aviv Israel
| | - Alon Sebaoun
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel-Aviv University; Tel-Aviv Israel
| | - Carlos E. Nemcovsky
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel-Aviv University; Tel-Aviv Israel
| | - Shimshon Slutzkey
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel-Aviv University; Tel-Aviv Israel
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Shalev TH, Kurtzman GM, Shalev AH, Johnson DK, Kersten MEM. Continuous Periosteal Strapping Sutures for Stabilization of Osseous Grafts With Resorbable Membranes for Buccal Ridge Augmentation: A Technique Report. J ORAL IMPLANTOL 2017. [DOI: 10.1563/aaid-joi-d-17-00060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Alveolar bone loss occurs after extraction with loss of a premolar or anterior tooth; the residual supporting alveolar bone loss averages 1.53 mm of crestal bone height and 3.87 mm of buccolingual width, with most of the bone loss occurring at the facial plate. Socket preservation does not completely preserve the original ridge contours but can be an effective means of reducing bone loss following extraction. Attempts to rebuild the alveolar ridge structure after tooth loss often employ the concept of guided bone regeneration, a technique-sensitive procedure that routinely involves placement of particulate bone with or without fixation screws and either a resorbable or a nonresorbable membrane. We present a novel technique for stabilizing a resorbable membrane and underlying particulate graft allowing for predictable bone grafting across multiple edentulous sites.
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Affiliation(s)
- Tamir H Shalev
- Department of Developmental and Surgical Sciences, University of Minnesota, Minneapolis, Minn
| | | | - Alon H Shalev
- Department of Developmental and Surgical Sciences, University of Minnesota, Minneapolis, Minn
| | - Deborah K Johnson
- Department of Developmental and Surgical Sciences, University of Minnesota, Minneapolis, Minn
| | - Mark Elias M Kersten
- Department of Developmental and Surgical Sciences, University of Minnesota, Minneapolis, Minn
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Wessing B, Urban I, Montero E, Zechner W, Hof M, Alández Chamorro J, Alández Martin N, Polizzi G, Meloni S, Sanz M. A multicenter randomized controlled clinical trial using a new resorbable non-cross-linked collagen membrane for guided bone regeneration at dehisced single implant sites: interim results of a bone augmentation procedure. Clin Oral Implants Res 2016; 28:e218-e226. [PMID: 27990692 PMCID: PMC5697637 DOI: 10.1111/clr.12995] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2016] [Indexed: 12/02/2022]
Abstract
Objective To compare clinical performance of a new resorbable non‐cross‐linked collagen membrane, creos xenoprotect (CXP), with a reference membrane (BG) for guided bone regeneration at dehisced implant sites. Materials and methods This randomized controlled clinical trial enrolled patients with expected dehiscence defects following implant placement to restore single teeth in the maxillary and mandibular esthetic zone and premolar area. Implants were placed using a two‐stage surgical protocol with delayed loading. Bone augmentation material placed at the implant surface was immobilized with CXP or BG membrane. Soft tissue health was followed during the healing period, and the defect size was measured at reentry and 6 months after implant placement. Results Of the 49 included patients, 24 were treated with CXP and 25 with BG. Patient characteristics did not differ between the two arms. In the CXP arm, the defect height at implant insertion was (mean ± SD) 5.1 ± 2.1 mm (n = 24) and reduced at reentry by 81% to 1.0 ± 1.3 mm (n = 23). In the BG arm, the defect height at implant insertion was 4.9 ± 1.9 mm (n = 25) and reduced at reentry by 62% to 1.7 ± 2.1 mm (n = 24). Assuming a margin of non‐inferiority of 1 mm, CXP was non‐inferior to BG. Membrane exposure rate was highest at week 3 in both arms, reaching 16.7% for BG and 8.7% for CXP. Conclusions The new resorbable non‐cross‐linked collagen membrane facilitates bone gain to support implant placement in expected dehiscence defects. The observed trend toward higher mean bone gain and lower exposure rate with CXP compared to BG should be further investigated.
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Affiliation(s)
| | - Istvan Urban
- Graduate Implant Dentistry, Loma Linda, CA, USA.,Urban Regeneration Institute, Budapest, Hungary
| | - Eduardo Montero
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Werner Zechner
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Markus Hof
- Division of Dental Student Training and Patient Care, Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Silvio Meloni
- Dentistry Unit, Department of Surgical, Microsurgical, and Medical Sciences, University Hospital of Sassari, Sassari, Italy
| | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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