Alloplastic Bone Research Articles

Conventional Manufacturing by Pouring Versus Additive Manufacturing Technology of β-Tricalcium Phosphate Bone Substitute Implants.

The aim of the study was to compare conventional sintering with additive manufacturing techniques for β-TCP bioceramics, focusing on mechanical properties and biocompatibility. A "critical" bone defect requires surgical intervention beyond simple stabilization. Autologous bone grafting is the gold standard treatment for such defects, but it has its limitations. Alloplastic bone grafting with synthetic materials is becoming increasingly popular. The use of bone graft substitutes has increased significantly, and current research has focused on optimizing these substitutes, whereas this study compares two existing manufacturing techniques and the resulting β-TCP implants. The 3D printed β-TCP hybrid structure implant was fabricated from two components, a column structure and a freeze foam, which were sintered together. The conventionally fabricated ceramics were fabricated by casting. Both scaffolds were characterized for porosity, mechanical properties, and biocompatibility. The hybrid structure had an overall porosity of 74.4 ± 0.5%. The microporous β-TCP implants had a porosity of 43.5 ± 2.4%, while the macroporous β-TCP implants had a porosity of 61.81%. Mechanical testing revealed that the hybrid structure had a compressive strength of 10.4 ± 6 MPa, which was significantly lower than the microporous β-TCP implants with 32.9 ± 8.7 MPa. Biocompatibility evaluations showed a steady increase in cell proliferation over time for all the β-TCP implants, with minimal cytotoxicity. This study provides a valuable insight into the potential of additive manufacturing for β-TCP bioceramics in the treatment of bone defects.

Developments in Alloplastic Bone Grafts and Barrier Membrane Biomaterials for Periodontal Guided Tissue and Bone Regeneration Therapy.

Periodontitis is a serious form of oral gum inflammation with recession of gingival soft tissue, destruction of the periodontal ligament, and absorption of alveolar bone. Management of periodontal tissue and bone destruction, along with the restoration of functionality and structural integrity, is not possible with conventional clinical therapy alone. Guided bone and tissue regeneration therapy employs an occlusive biodegradable barrier membrane and graft biomaterials to guide the formation of alveolar bone and tissues for periodontal restoration and regeneration. Amongst several grafting approaches, alloplastic grafts/biomaterials, either derived from natural sources, synthesization, or a combination of both, offer a wide variety of resources tailored to multiple needs. Examining several pertinent scientific databases (Web of Science, Scopus, PubMed, MEDLINE, and Cochrane Library) provided the foundation to cover the literature on synthetic graft materials and membranes, devoted to achieving periodontal tissue and bone regeneration. This discussion proceeds by highlighting potential grafting and barrier biomaterials, their characteristics, efficiency, regenerative ability, therapy outcomes, and advancements in periodontal guided regeneration therapy. Marketed and standardized quality products made of grafts and membrane biomaterials have been documented in this work. Conclusively, this paper illustrates the challenges, risk factors, and combination of biomaterials and drug delivery systems with which to reconstruct the hierarchical periodontium.

Comparative Evaluation of the Differentiation and Proliferation Potential of Dental Pulp Stem Cells on Hydroxyapatite/Beta-Tricalcium Bone Graft and Bovine Bone Graft: An In Vitro Study.

Stem cells of mesenchymal origin have good proliferative capacity when compared to other stem cell types. Dental pulp stem cells (DPSCs) are a variety of mesenchymal cells obtained from the pulpal tissue of teeth and are abundantly available and easy to obtain. DPSCs facilitate and improve the formation of new bone using different bone graft scaffolds. This present study aims to evaluate and compare the osteogenic potential of DPSCs on alloplastic and xenogeneic bone grafts. Hydroxyapatite and beta-tricalcium bone graft and bovine bone graft were used in a triplicate manner in the laboratory. DPSCs were obtained from the pulpal tissue of extracted third molars in the laboratory. The cytotoxicity, osteogenic potential, and difference in the rate of proliferation of mesenchymal cells on the biomaterials were assessed. Darker purple staining was seen in the case of hydroxyapatite/beta-tricalcium bone graft on MTT colorimetric assay stating that there was an increase in cell viability in hydroxyapatite/beta-tricalcium bone graft as compared to the bovine bone graft. Hydroxyapatite/beta-tricalcium bone graft showed more osteogenic potential as compared to the bovine bone graft as a higher degree of red staining was seen in Alizarin staining. Higher cell viability and higher osteogenic proliferation and differentiation were seen on the hydroxyapatite/beta-tricalcium bone graft compared to the bovine bone scaffold.

Immediate orthodontic treatment after regeneration of periodontal intrabony defects: A long-term retrospective study

Background/purposeOrthodontic movement is often necessary for periodontally compromised patients to enhance esthetics, function, and long-term occlusal stability. However, the impact of orthodontic treatment immediately following the regeneration of intrabony defects on periodontal healing remains a topic of debate. The objective of this long-term case series study was to test the hypothesis that orthodontic treatment performed immediately after regenerative procedures for periodontal intrabony defects did not adversely affect periodontal healing. Materials and methodsThis case series study involved nine periodontally compromised subjects with a total of 17 intra-bony defects. Orthodontic brackets were applied immediately before surgery. Flaps were raised, and diseased roots were debrided. All intra-bony defects were filled with alloplastic bone grafts and covered with resorbable membranes, except for one defect treated with Emdogain. All patients initiated orthodontic treatment immediately after periodontal regenerative surgery. Clinical parameters, including probing depth, attachment level, and bone fill, were assessed at baseline and during final maintenance therapy. ResultsThe mean follow-up duration was 12.8 years. None of the 17 surgically regenerated teeth were lost. The mean reduction in probing depth was 3.94 mm (95% confidence level, 3.19–4.68; P < 0.001), with a mean clinical attachment gain of 3.47 mm (95% confidence level, 2.90–4.03; P < 0.001). The mean radiographic bone fill was 4.89 mm (P < 0.001). ConclusionBased on the findings of this long-term case study, it can be concluded that immediate orthodontic treatment does not adversely affect the maturation process of periodontal regeneration outcomes and can be maintained for more than ten years.

Implant stability and clinical outcome between implant placement using internal sinus floor elevation with alloplastic bone material grafting and without grafting: A 1-year randomized clinical trial.

To compare implant stability and clinical outcome in implant placement between osteotome sinus floor elevation (OSFE) with biphasic calcium phosphate (BCP) which consisted of 30% of hydroxyapatite (HA) and 70% of beta-tricalcium phosphate (β -TCP) grafting material and OSFE without using bone grafting material. The research questions is whether the BCP provides any benefit in OSFE or not. Thirty patients (30 implants) with a single edentulous area of upper premolar or molar were randomly separated into OSFE with BCP (n = 15) and OSFE without grafting (n = 15). The patients were reevaluated 3, 6, 9, and 12months after implant loading. The clinical assessments (implant stability quotient (ISQ), implant survival-failure rate, and surgical complication) were analyzed. Together with radiographic assessments in 2D (endo-sinus bone gain (ESBG), mean marginal bone change (MMBC)) and 3D (endo-sinus bone gain in CBCT (ESBG-CT)) were evaluated, with a mean follow-up time of at least 12months of functional loading and prosthetic complication. 20 remaining implants (OSFE with BCP, n = 10; OSFE without grafting, n = 10) were analyzed. Mean ISQ was 79.18 3.43 in 1-year follow-up (ISQ; OSFE with BCP = 78.72 3.46, OSFE without grafting = 79.65 3.52). ISQ in both groups increased steadily without significant differences in each follow-up. (p = 0.56). In radiographic evaluation, at 6-, 9-, and 12-month, OSFE without grafting group showed statistically significant lower MMBC (p < 0.05). The 1-year clinical results showed that 2 implants failed in OSFE with BCP, and 1 implant failed in OSFE without grafting. Graft material "BCP" (HA30:TCP70) coupled with OSFE presents no extraordinary benefit in implant stability, clinical and radiographic outcome in 1-year follow-up. Clinically, OSFE with grafting materials provides no additional benefit. TCTR20210517008 (date of registration: May 17, 2021).

Coronal-splitting Reduction Genioplasty Combined with Bilateral Osteotomies of the Mandibular Inferior Border for Macrogenia

Summary: There are various types of chin deformities, and the least established surgical method for deformity correction may be reduction for anteroposterior macrogenia. Anteroposterior macrogenia is commonly corrected by either setback genioplasty or burring reduction, but these approaches are less likely to produce aesthetically pleasing results. Both procedures have poor reduction effects because of the low response rate of soft tissues to skeletal alterations. There is a high likelihood of chin ptosis and flattening. Setback genioplasty can also yield step deformities at the inferior mandibular border. To overcome these drawbacks of conventional methods, I developed a novel technique of coronal-splitting reduction genioplasty. I have performed more than 83 procedures with a high success rate over the past 10 years. Alloplastic chin implant-shaped bone fragments were resected from the prominent bony chin, in which the average thickness of resected bone was 8.2 mm. Sufficient sagittal reduction effects were then achieved in most cases, although the soft tissue response rate remains 25%–50%, as reported in the literature. The no-degloving technique with cephalic suspension of the mentalis muscle prevents chin ptosis. Combined bilateral oblique osteotomies of the inferior mandibular border contribute to minimizing obvious postoperative chin flattening. Moreover, macrogenia can be large in multiple planes, including anteroposterior, vertical, transverse, or their combinations. This new technique can handle all three planes by combining both bilateral oblique osteotomies of the inferior mandibular border and burr ostectomy. Overall, these findings suggest that the coronal-splitting genioplasty method may replace conventional methods for correcting macrogenia.

Customized three-dimensional printed ceramic bone grafts for osseous defects: a prospective randomized study

Ridge resorption can result in insufficient bone volume for implant surgery, necessitating bone substitutes to restore the resorption area. Recent advances in computer-aided design and manufacturing enable the use of alloplastic bone graft materials with customizable compositions or shapes. This randomized study evaluated the clinical effectiveness of a customized three-dimensional (3D) printed alloplastic bone material. Sixty patients requiring guided bone regeneration for implant installation following tooth extraction due to alveolar bone resorption were recruited at two institutions. The participants were randomly allocated to either a group that received 3D-printed patient-customized bone graft material or a group that received conventional block bone graft material. Implant installation with bone harvesting was performed approximately 5 months after bone grafting. Histological and radiological assessments of the harvested bone area were performed. The experimental group had a significantly higher percent bone volume and a smaller tissue surface than the control group. Bone volume, bone surface, bone surface/volume ratio, bone surface density (bone surface/total volume), and bone mineral density did not differ significantly between groups. Patient-customized bone graft materials offer convenience and reduce patient discomfort. The findings suggest 3D-printed patient-customized bone graft materials could be used as an alternative for simpler bone grafting procedures.

Bone Regeneration Using an Alloplastic Graft Material that Combines β Tricalcium Phosphate and Calcium Sulphate: A Case Series Report with Histology

This retrospective case series reports on the use of an established alloplastic bone product composed of a 65:35 ratio of β Tricalcium Phosphate and Calcium Sulphate to facilitate host bone regeneration in a variety of intra-oral sites and clinical indications. The study involved seven patients treated by seven different clinicians operating at five geographical sites. All cases included trephined bone cores harvested at 12 and 33 weeks. These cores were subject to histological analysis using standardized protocols at six separate laboratories. The primary measured outcome was the percentage of residual graft, new bone, and connective tissue at the measured time points. The results of this case series suggest that the alloplastic bone product is 50% resorbed and replaced by new host bone at 12 weeks, with further consistent resorption to 85% at 33 weeks. These results suggest that this alloplastic product can be successfully used in a wide variety of intra-oral bone grafting protocols leading to consistent resorption of the material and its replacement with new host bone, independent of clinician and established histological analytical protocol used.

A meta-analysis of alveolar bone grafting using bone substitutes in cleft lip and palate patients.

In individuals with cleft lip and palate (CLP), an alveolar bone graft (ABG) is carried out for alveolar cleft closure. Several sources for ABG include autologous bone, xenologous bone, and alloplastic substitutes. Autologous bone has been the preferred source for ABG. Alloplastic substitutes might serve as an alternative. This study aimed to compare the outcomes between autologous and alloplastic as sources for ABG. This study made use of eight web databases. Randomized control trials (RCTs) and non-RCTs were included. CLP patients with alveolar cleft with imaging studies, computed tomography (CT scan) and/or cone beam CT scan, and bone graft volume within 6-12 months postintervention were selected. Bone graft volume within 6-12 months postintervention was assessed. Three studies met the inclusion criteria. After 6-12 months of follow-up, there were no statistically significant differences in bone graft volume between autologous and alloplastic bone grafts (fixed-effect model estimate value = 0.21; confidence interval - 0.301-0.730; P = 0.414). The limitations include small research sample sizes, a high likelihood of bias among included studies, and different alloplastic materials from each included study. Autologous and alloplastic bone grafts showed similar effectiveness in alveolar bone grafting. Further clinical trial studies with bigger sample sizes and similar interventions are needed as evidence for future reviews.

Interdisciplinary management of horizontal root fracture in middle third with osseous bone defect – A clinical report

Dental trauma are the main cause of emergencies in dental practice. Amongst these, root fractures are relatively uncommon but comprises about 0.5 to 7% of all injuries affecting permanent dentition. Most commonly, root fracture occurs from a horizontal impact mostly in oblique direction. The incidence is more common at the mid-third of the root rather at the apical and cervical thirds. Such hideous injury must be restored to normal as early as possible to retain the dental health and appearance. This report records the case of horizontal root fracture of upper anterior tooth, treated with Mineral Trioxide Aggregate (MTA) and fractured root fragments were unified with the aid of a stainless steel reamer after an endodontic treatment. Alloplastic bone graft and GTR membrane were used for osseous bone defect. Mineral trioxide aggregate (MTA) has several impending &amp; forthcomin clinical applications owing to its grander sealing property and biocompatibility. A 12 months follow-up revealed a well stabilized assembly of the root fragments and periodontal healing.

Comparison between platelet rich fibrin as space filling material versus xenograft and alloplastic bone grafting materials in immediate implant placement: a randomized clinical trial

BackgroundThis study aimed to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla.Materials and methodsThirty-six implants were inserted in patients seeking for replacement of non-restorable maxillary anterior and premolar teeth (esthetic zone) by immediate implant. Patients were randomly distributed into three equal groups, twelve implants in each group. Group 1 received Platelet Rich Fibrin (PRF) into the jumping distance, Group 2 received Xenograft into the jumping distance and Group 3 received Alloplastic bone grafting material into the jumping distance. Implant stability by measuring the changes in Resonance Frequency Analysis (RFA), peri-implant pocket depth, marginal bone loss and changes in buccal bone thickness were evaluated during follow up periods. All the clinical and radiographic data were subjected to statistical analysis by One Way ANOVA test and the Post Hoc Tukey test.ResultsThis study involved 19 female patients and 17 male patients who received 36 dental implants. There was no significant difference between the study groups regarding implant stability, peri-implant pocket depth and palatal bone loss, while there was a significant difference between PRF Group (Group 1) and the other Groups regarding buccal bone loss and changes in buccal bone thickness.ConclusionPRF can be used as a gap filling material in conjunction with immediate implant placement, but other bone grafting materials give superior result regarding buccal bone loss and changes in buccal bone thickness.Trial registrationThe study was listed on www.clinicaltrials.gov with registration number (NCT05878392) on 26/05/2023. The Institutional Review Board (IRB) of the Faculty of Dentistry, Mansoura University, Mansoura, Egypt, approved the current study in compliance with the seventh revision of the Helsinki Declaration in 2013 (A0103023OS).

Consequence of Synthetic Bone Substitute Used for Alveolar Cleft Graft Reconstruction (Preliminary Clinical Study).

Background The outcome of alveolar grafting with synthetic bone substitute (Osteon III) in various bone defect volumes is highlighted. Methods A prospective study was accomplished on 55 patients (6-13 years of age) with unilateral alveolar bone cleft. Osteon III, consisting of hydroxyapatite and tricalcium phosphate, is used to reconstruct the defect. Alveolus defect diameter was calculated before surgery (V1), after 3 months (V2), and finally after 6 months (V3) postsurgery. In the t -test, a significant difference and correlation between V1, V2, and V3 are stated. A p- value of 0.01 is considered a significant difference between parameters. Results The degree of cleft is divided into three categories: small (9 cases), medium (20 patients), and large (26 cases).The bone volume of the clefted site is divided into three steps: volume 1: (mean 18.1091 mm 3 ); step 2: after 3 months, volume 2 resembles the amount of unhealed defect (mean 0.5109 mm 3 ); and the final bone volume assessment is made after 6 months (22.5455 mm 3 ). Both show statistically significant differences in bone volume formation. Conclusion An alloplastic bone substitute can also be used as a graft material because of its unlimited bone retrieval. Osteon III can be used to reconstruct the alveolar cleft smoothly and effectively.

Aesthetic Reconstruction of an Old Burr Hole Defect Using a Cancellous Bone Chip and a Porous Polyethylene Implant.

Burr hole trephination is a minimally invasive procedure but can leave a depressed scar at the surgical site. Various materials have been studied to fill such defects; however, to the best of our knowledge, there are no reports of reconstructing old, depressed scars from burr hole surgery. This report presents a patient with depressed scarring near the anterior hairline of the frontal bone on both sides due to burr hole trephination for a subdural hematoma 27 years prior. Computed tomography scans revealed bony defects under the scar. Reconstruction of the bony defect was performed by debriding the bony bed, filling it with hydrated alloplastic cancellous bone, and covering it with a porous SynPOR polyethylene titanium-reinforced implant. During 1 year of follow-up, the reconstruction was maintained without complications. The patient was satisfied with the esthetic outcome. Thus, old bony defects can be repaired using the appropriate materials and techniques.

Clinical outcomes of periodontal regenerative therapy with carbonate apatite granules for treatments of intrabony defects, Class II and Class III furcation involvements: A 9-month prospective pilot clinical study

IntroductionCarbonated apatite (CO3Ap) has unique properties as an alloplastic bone substitute and has been reported the safety and efficacy for bone regeneration. However, no previous studies reported the clinical application of CO3Ap for periodontal regeneration therapy. The aim of this study was to evaluate the safety and efficacy of periodontal regeneration with CO3Ap in treating intrabony defects, Class II and Class III furcation involvement (FI). MethodsA single-arm and single-center prospective pilot clinical study was performed to verify the safety and efficacy of CO3Ap in patients with periodontitis. A total of four patients with seven teeth, including three deep intrabony defects, two Class II FI, and two Class III FI, were treated with CO3Ap. The clinical parameters, including probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), tooth mobility (Mo), Plaque index (PI), and Gingival index (GI) were evaluated at baseline, 6 months, and 9 months after the surgery. Radiographic analysis was conducted on images of dental X-ray and cone beam computed tomography (CBCT) at baseline and 9 months post-surgery. ResultsThe postoperative healing in all cases was uneventful, with no abnormal bleeding, pain, or swelling. The mean PPD reduction and CAL gain were 5.0 ± 1.0 mm, 4.5 ± 0.7 mm, 1.5 ± 0.7 mm, and 4.7 ± 1.2 mm, 4.5 ± 0.7 mm, 0.0 mm for intrabony defect, Class II and Class III FI, respectively. According to radiographic analysis, linear bone height in intrabony defects and vertical subclassification of FI in Class II FI were improved. ConclusionsThe clinical application of CO3Ap for the treatment of intrabony defects and Class II FI could be effective for periodontal regeneration, although its efficacy in treating Class III FI might be limited. Despite the limitations of this study, the findings in this study suggested that CO3Ap has the potential to be a promising bone graft substitute for periodontal regeneration.

Evaluation of in vitro biocompatibility of human pulp stem cells with allogeneic, alloplastic, and xenogeneic grafts under the influence of extracellular vesicles

Therapies using dental pulp stem cells (DPSCs) or stem cell-derived extracellular vesicles (EVs) have shown promising applications for bone tissue engineering. This in vitro experiment evaluated the joint osteogenic capability of DPSCs and EVs on alloplastic (maxresorp), allogeneic (maxgraft), and xenogeneic (cerabone) bone grafts. We hypothesize that osteogenic differentiation and the proliferation of human DPSCs vary between bone grafts and are favorable under the influence of EVs. DPSCs were obtained from human wisdom teeth, and EVs derived from DPSCs were isolated from cell culture medium. DPSCs were seeded on alloplastic, allogeneic, and xenogeneic bone graft substitutes for control, and the same scaffolds were administered with EVs in further groups. The cellular uptake of EVs into DPSC cells was assessed by confocal laser scanning microscopy. Cell vitality staining and calcein acetoxymethyl ester staining were used to evaluate cell attachment and proliferation. Cell morphology was determined using scanning electron microscopy, and osteogenic differentiation was explored by alkaline phosphatase and Alizarin red staining. Within the limitations of an in vitro study without pathologies, the results suggest that especially the use of xenogeneic bone graft substitutes with DPSCS and EVs may represent a promising treatment approach for alveolar bone defects.

Comparison of Xenograft and Alloplast Bone Grafts for Infrabony Bone Defect: Literature Review

Restoring supporting tissues to a healthy state is a critical area that provides a much more appealing beside prevention, initial therapy, and corrective procedure. Infrabony defects can be found in the interalveolar and marginal bone caused by periodontal disease as a result of local factors. Nowadays, various surgical therapies are available for treating infrabony defects such as bone graft. However, many considerations in selecting the best option of bone graft materials. To compare the effectiveness of Xenograft and Alloplast bonegraft in infrabony defect therapy. The allograft presented a significantly higher amount of newly formed bone than the xenograft. There were no differences in the percentage of newly formed bone between the allograft and the alloplastic graft, and between the alloplastic graft and the xenograft. Between the three types of grafts, there were no discernible changes in the percentage of remaining particles. All bone substitute materials shown favorable properties for use in bone regeneration treatments. Local factors such as oral hygiene and controlled chronic disease are the main point of successful bone graft therapy. The present study concludes that both Alloplast and Xenograft have equal potential in infrabony bone defect therapy.

Treatment of Human Intraosseous Periodontal Defects Using Recombinant Human Bone Morphogenetic Protein-2: A Randomized Controlled Clinical Trial.

Aim The purpose of this research was to assess the clinical and radiographic outcomes of recombinant human bone morphogenetic protein-2 (rhBMP-2) for the treatment of intraosseous abnormalities after periodontal flap surgery. Material and methods Patients aged 35-55 years who had undergone periodontal treatment at Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, and had a total of 14 intraosseous abnormalities were included in the research. Those in the control group had open flap debridement with alloplast, whereas those in the experimental group underwent the same procedure with the addition of rhBMP-2. Clinical indicators, such as plaque index (PI), gingival index, probing pocket depth (PPD), clinical attachment level, and radiographic defect fill, were collected at baseline at three months, six months, and nine months. Results The findings demonstrated that following periodontal treatment, both sets of patients had considerable improvements in their PI, gingival index, and PPD. The degree of relative connection improved significantly in both groups. When comparing the two groups radiographically, we saw that the test group had significantly better defect fill than the control group. Conclusion According to this research, there was a statistically significant decrease in PI, gingival index, PPD, clinical attachment level, and radiographic bone fill in patients who received rhBMP-2. Open flap debridement with rhBMP-2 and alloplastic bone grafts showed better reduction than open flap debridement with alloplastic bone grafts group in the radiographic defect fill.

3D-Printed PLA Scaffold with Fibronectin Enhances In Vitro Osteogenesis.

Tricalcium phosphate (TCP, Molecular formula: Ca3(PO4)2) is a hydrophilic bone graft biomaterial extensively used for guided bone regeneration (GBR). However, few studies have investigated 3D-printed polylactic acid (PLA) combined with the osteo-inductive molecule fibronectin (FN) for enhanced osteoblast performance in vitro, and specialized bone defect treatments. This study evaluated PLA properties and efficacy following glow discharge plasma (GDP) treatment and FN sputtering for fused deposition modeling (FDM) 3D printed PLA alloplastic bone grafts. 3D trabecular bone scaffolds (8 × 1 mm) were printed by the 3D printer (XYZ printing, Inc. 3D printer da Vinci Jr. 1.0 3-in-1). After printing PLA scaffolds, additional groups for FN grafting were continually prepared with GDP treatment. Material characterization and biocompatibility evaluations were investigated at 1, 3 and 5 days. SEM images showed the human bone mimicking patterns, and EDS illustrated the increased C and O after fibronectin grafting, XPS and FTIR results together confirmed the presence of FN within PLA material. Degradation increased after 150 days due to FN presence. 3D immunofluorescence at 24 h demonstrated better cell spreading, and MTT assay results showed the highest proliferation with PLA and FN (p < 0.001). Cells cultured on the materials exhibited similar alkaline phosphatase (ALP) production. Relative quantitative polymerase chain reaction (qPCR) at 1 and 5 days revealed a mixed osteoblast gene expression pattern. In vitro observations over a period of five days, it was clear that PLA/FN 3D-printed alloplastic bone graft was more favorable for osteogenesis than PLA alone, thereby demonstrating great potential for applications in customized bone regeneration.

EFFECT OF DIFFERENT GRAFTING MATERIALS ON ALVEOLAR RIDGE PRESERVATION

Objectives: The purpose of this systematic review was to assess the effect of several grafting materials on alveolar bone resorption after teeth extraction. Materials &amp; methods: Electronic literature searches in MEDLINE (PubMed) and Cochrane (CENTRAL) were performed, in addition to a manual search through all periodontics and implantology-related journals, for publications in the period from January 1st, 2009, to February 1st, 2021. The primary focus was related to studies comparing alveolar ridge preservation reporting quantitative outcomes of hard tissue changes. Results: In total,18 randomized controlled studies were included. Mean difference values were calculated with the use of quantitative statistical analysis (RevMan) for split-mouth and parallel study designs. The pooled magnitude of bone resorption was calculated for different dimensions of the alveolar bone process after teeth extraction: for horizontal dimension. Meta-analyses were performed for the use of any graft without membranes compared to empty sockets or specifically for different kinds of grafts (with or without membranes) again compared to empty sockets. Further, a direct comparison was available from studies comparing xenografts either with allografts or alloplasts. Conclusion: Within the limitation of this systematic review, there is a decrease in alveolar bone resorption after teeth extraction as an impact of bone substitute use, with minimal variations between bone graft materials. Overall, in several outcome parameters, it was noticed that the xenograft materials had the highest amount of bone preservation, and the least magnitude for the alveolar bone reservation was accompanied with the use of alloplastic bone substitutes with a recommendation to make searches about combinations of alloplastic bone substitutes, but confidence intervals were strongly overlapping. Hence, final judgment on any superior graft material cannot be reached from actual available clinical evidence.

CLINICO-RADIOGRAPHIC EVALUATION OF GUIDED TISSUE REGENERATION USING COLLAGEN MEMBRANE AND BIPHASIC CALCIUM PHOSPHATE IN TREATMENT OF INTRABONY PERIODONTAL DEFECTS

Background: The ideal result of successful periodontal therapy is periodontal regeneration. Guided tissue regeneration is considered currently as gold standard for periodontal regeneration. Poor mechanical properties, biomaterials instability and lack of biocompatibility of regenerative membrane alone led to direct use of bioactive materials in defect area. So, this study was intended towards evaluation of effectiveness of resorbable membrane with bioactive molecule containing biphasic calcium phosphate determined by amount of bone fill both clinically and radiographically. Methods: A total of 20 intrabony defects from sixteen patients were selected. The study designed was Quasi experiment, a quantitative non randomized experimental trial. The clinical parameters like Plaque index, Gingival index, Pocket probing depth, Amount of Gingival recession and relative attachment level were recorded at baseline and after 6 months by using acrylic surgical stent following periodontal access flap surgery along with use of collagen membrane and alloplast bone graft. Radiographic parameters were taken using Orthopantomograph for measuring the radiographic bone fill at baseline and after 6 months. Data were analyzed using paired t-test and Wilcoxon sign rank test. Results: All the parameters post operatively were statistically significant. Clinically, gain in attachment was 2.1±1.25mm and pocket reduction was 3.35±1.39mm whereas linear radiographic bone fill was found to be 2.81±1.43mm. However, gingival recession was found to be increased post-operatively. Conclusions: The current study showed combination of bone alloplast and regenerative membrane yields promising results in treatment of human intrabony periodontal defects.