Abstract
BackgroundThe aim of this study was to compare new bone formation, resorbed bone matrix, and fibrous enclosed residual bone substitute material in laterally augmented alveolar bone defects using allogeneic, pre-treated and cleaned human bone blocks (tested in dogs, therefore considered to be xenogeneic), and pre-treated and cleaned bovine cancellous bone blocks, both with and without a collagen membrane in order to evaluate their augmentative potential.MethodsThirty-two critical size horizontal defects were prepared in the mandible of 4 adult foxhound dogs (8 per dog, 4 on each side). After 3 months of healing, the defects were laterally augmented in a split-mouth-design with either human (HXB) or bovine solvent-preserved bone blocks (BXB). Afterwards, defects were randomly covered with a bovine collagenous membrane (HXB + M, BXB + M). After a healing interval of 6 months, percentages of new bone formation, resorbed bone matrix, and fibrous enclosed residual bone substitute material were compared.ResultsResults showed little new bone formation of up to 3.7 % in human bone blocks (HXB 3.7 % ± 10.2, HXB + M 0.3 %± 0.4, BXB, 0.1 % ± 0.8, BXB + M 2.6 % ± 3.2, p = > 0.05). Percentages of fibrous encapsulation were higher in human bone blocks than in bovine bone blocks (HXB 71.2 % ± 8.6, HXB + M 73.71 % ± 10.6, BXB, 60.5 % ± 27.4, BXB + M 52.5 % ± 28.4, p = > 0.05). Resorption rates differed from 44.8 % in bovine bone blocks covered with a membrane to 17.4 % in human bone blocks (HXB 17.4 % ± 7.4, HXB + M 25.9 % ± 10.7, BXB, 38.4 % ± 27.2, BXB + M 44.8 % ± 29.6, p = > 0.05). The use of additional membranes did not significantly affect results.ConclusionsWithin its limitations, results of this study suggest that solvent-preserved xenogenic human and bovine bone blocks are not suitable for lateral bone augmentation in dogs. Furthermore, defect coverage with a membrane does not positively affect the outcome.
Highlights
The aim of this study was to compare new bone formation, resorbed bone matrix, and fibrous enclosed residual bone substitute material in laterally augmented alveolar bone defects using allogeneic, pretreated and cleaned human bone blocks, and pre-treated and cleaned bovine cancellous bone blocks, both with and without a collagen membrane in order to evaluate their augmentative potential
In human bone blocks covered with a collagenous membrane (HXB + M) cancellous new bone was mainly found directly at the borders of residual and augmented bone
In bovine bone blocks covered with a membrane (BXB + M) a thick cortical layer without bone re-organization was found on the outline of the graft
Summary
The aim of this study was to compare new bone formation, resorbed bone matrix, and fibrous enclosed residual bone substitute material in laterally augmented alveolar bone defects using allogeneic, pretreated and cleaned human bone blocks (tested in dogs, considered to be xenogeneic), and pre-treated and cleaned bovine cancellous bone blocks, both with and without a collagen membrane in order to evaluate their augmentative potential. Tooth loss due to extraction or trauma often results in a vertical and horizontal loss of bone height due to remodeling processes [1]. During this remodeling process, more horizonal bone than vertical bone (29.63 % to 11– 22) is lost [2]. Horizontal single-walled defects are usually difficult for reconstruction and augmentation. Applied methods for reconstruction and augmentation of horizontal bone defects vary according to expertise and preferences of patients and therapists. These, require a primary horizontal width of at least 3–4 mm and without any other augmentative treatment underlie similar resorption rates to those after tooth extraction. Disadvantages are long treatment duration, high relapse rates, and possible post-operative complications, such as early, delayed or absent bone consolidation, nerve injury, and infection [3]
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