Autogenous Bone Graft Research Articles

Shell Technique with a Xenogeneic Cortical Bone Lamina and Particulate Bone Graft for Horizontal Ridge Augmentation: A Case Series

The aim of this prospective case series was to evaluate the efficacy and safety of a xenogeneic cortical bone lamina utilized as a "shell" on the buccal aspect of narrow alveolar ridges for horizontal bone augmentation. Fifteen patients requiring multiple implant restorations at sites with moderate to severe horizontal bone deficiency were consecutively enrolled. Horizontal bone augmentation was performed using a xenogeneic cortical bone lamina (XCBL), that was fixed on the buccal aspect of the ridge using titanium screws, and a mixture of particulate autogenous bone graft and porcine hydroxyapatite. Cone-beam computed tomography (CBCT) scans were taken at baseline and 6 months after bone augmentation. The healing was uneventful, with no intra- or post-operative complications. Twenty-seven dental implants were placed in the augmented sites. The calculated average horizontal bone gain from CBCT scans was 4.79 ± 1.64 mm, 5.59 ± 1.51 mm, and 5.79 ± 2.53 mm at 1-, 3- and 5-mm reference points apical to the buccal bone crest, respectively. The present case series demonstrated that the shell technique with the xenogeneic cortical bone lamina and particulate bone graft can be an effective approach for horizontal bone augmentation prior to implant placement.

MULTICYSTIC AMELOBLASTOMA: A CASE REPORT WITH A 14-YEAR FOLLOW-UP

Patient R.M.S., 38 years, was referred for treatment evaluation of a mandibular multicystic ameloblastoma performed in 1997 by another service. Clinically, no changes were detected in the region, and the patient reported no other comorbidities. Computed tomography revealed a mixed and multiloculated image, with bone destruction and expansion, located in the anterior region of the mandible at the apex of teeth 35 to 42. The lesion was asymptomatic and suggestive of tumor recurrence. An incisional biopsy confirmed the diagnostic hypothesis of multicystic ameloblastoma. The patient underwent a marginal resection of the lesion and extraction of the adjacent teeth. Peripheral ostectomy and application of Carnoy´s solution were also performed. Four years later, the patient was submitted to a mandibular reconstruction with autogenous bone graft from the iliac crest. After five months, the region was rehabilitated with an implant-supported dental prosthesis. No signs of recurrence were observed within a 14-year follow-up period. Patient R.M.S., 38 years, was referred for treatment evaluation of a mandibular multicystic ameloblastoma performed in 1997 by another service. Clinically, no changes were detected in the region, and the patient reported no other comorbidities. Computed tomography revealed a mixed and multiloculated image, with bone destruction and expansion, located in the anterior region of the mandible at the apex of teeth 35 to 42. The lesion was asymptomatic and suggestive of tumor recurrence. An incisional biopsy confirmed the diagnostic hypothesis of multicystic ameloblastoma. The patient underwent a marginal resection of the lesion and extraction of the adjacent teeth. Peripheral ostectomy and application of Carnoy´s solution were also performed. Four years later, the patient was submitted to a mandibular reconstruction with autogenous bone graft from the iliac crest. After five months, the region was rehabilitated with an implant-supported dental prosthesis. No signs of recurrence were observed within a 14-year follow-up period.

Vertical Ridge Augmentation Using Distraction Osteogenesis Versus Autogenous Bone Grafting: A Systematic Review and Meta-Analysis.

The aim of this systematic review was to systematically assess the papers comparing the surgical techniques of Alveolar Distraction Osteogenesis(ADO) and Autogenous Bone grafting (ABG) for Vertical Ridge Augmentation in terms of bone gain, bone resorption and incidences of complications. The review was registered on PROSPERO with the ID : CRD42021237671. A broad electronic survey was conducted in the PubMed, Scopus, Web of Science, Cochrane Library, and Virtual Health Library databases of all studies published till 08/03/2022. Four studies fulfilled the criteria to carry out a meta-analysis a in which a total of 58 patients underwent ADO and 43 patients for ABG. A total of 133 implants were placed in the ABG group and 124 in the ADO group. DerSimonian-Laird estimator of variance was used for Random effect meta-analysis. The estimates of an intervention were expressed as the odds ratio (OR) and standard mean difference (SMD) in millimeters. There was statistically significant difference in terms of bone height gain with SMD of - 0.78 (95% 0.04-1.55) in ABG. Bone resorption and complications were statistically insignificant with SMD of 0.52 (95% - 1.59 to 0.56) and OR 0.55 (95% 0.18-1.70), respectively.PROSPERO Registration ID: CRD42021237671.

Particulate autogenous bone graft in treatment of infected non‐union mandible fracture: A case report

Oral SurgeryAccepted Articles LETTER TO THE EDITOR Particulate autogenous bone graft in treatment of infected non-union mandible fracture: A case report Rodrigo dos Santos Pereira, Corresponding Author Rodrigo dos Santos Pereira [email protected] orcid.org/0000-0003-2509-8633 University of Grande Rio-UNIGRANRIO, Rio de Janeiro, Brazil General Hospital of Nova Iguacu in Rio de Janeiro, Brazil Correspondence Email: [email protected]Search for more papers by this authorGustavo Lima Latini, Gustavo Lima Latini General Hospital of Nova Iguacu in Rio de Janeiro, BrazilSearch for more papers by this authorIzabela Lopes Pessanha, Izabela Lopes Pessanha University of Grande Rio-UNIGRANRIO, Rio de Janeiro, BrazilSearch for more papers by this authorRodrigo Santos Batista Martins, Rodrigo Santos Batista Martins University of Grande Rio-UNIGRANRIO, Rio de Janeiro, BrazilSearch for more papers by this authorAdam Lowenstein, Adam Lowenstein Tufts University School of Dental Medicine, Division of Dental Research, Administration, Department of Periodontology, Boston, MA, USASearch for more papers by this authorCarlos F. Mourão, Carlos F. Mourão Tufts University School of Dental Medicine, Division of Dental Research, Administration, Department of Periodontology, Boston, MA, USASearch for more papers by this author Rodrigo dos Santos Pereira, Corresponding Author Rodrigo dos Santos Pereira [email protected] orcid.org/0000-0003-2509-8633 University of Grande Rio-UNIGRANRIO, Rio de Janeiro, Brazil General Hospital of Nova Iguacu in Rio de Janeiro, Brazil Correspondence Email: [email protected]Search for more papers by this authorGustavo Lima Latini, Gustavo Lima Latini General Hospital of Nova Iguacu in Rio de Janeiro, BrazilSearch for more papers by this authorIzabela Lopes Pessanha, Izabela Lopes Pessanha University of Grande Rio-UNIGRANRIO, Rio de Janeiro, BrazilSearch for more papers by this authorRodrigo Santos Batista Martins, Rodrigo Santos Batista Martins University of Grande Rio-UNIGRANRIO, Rio de Janeiro, BrazilSearch for more papers by this authorAdam Lowenstein, Adam Lowenstein Tufts University School of Dental Medicine, Division of Dental Research, Administration, Department of Periodontology, Boston, MA, USASearch for more papers by this authorCarlos F. Mourão, Carlos F. Mourão Tufts University School of Dental Medicine, Division of Dental Research, Administration, Department of Periodontology, Boston, MA, USASearch for more papers by this author First published: 27 May 2023 https://doi.org/10.1111/ors.12823 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/ors.12823. AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Accepted ArticlesAccepted, unedited articles published online and citable. The final edited and typeset version of record will appear in the future. RelatedInformation

TORUS PALATINUS AND TORUS MANDIBULARIS: A LITERATURE REVIEW UPDATE

Torus palatinus and torus mandibularis are common localised bony overgrowths of cortical bone, which are non-pathological. As tori have been widely discovered for ages, there are some new findings in the 21st century. This review aims to summarise the aspect of aetiology, sociodemographic features, clinical features, treatments and functions of tori. A search was performed in PubMed and Google Scholar databases from 1950 until 2022. From the total of 4,150 studies evaluated, 61 articles were included in this review. The aetiology of tori has shown that Y chromosomes and some signal factors (Notch3, SMAD9, LRP5 V171) may affect its occurrence. The prevalence among people of East Asian is higher than among West African heritage, and the age range is 20-50 years old. Clinical features of tori are represented by size, shape and location, and sometimes by symptoms. Patients who need the removal of tori are treated by surgical removal using burs/bone chisel and mallet/peeling it with Er:YAG laser/piezoelectric surgery, plus postoperative anti-inflammatory drugs, which give a good healing effect. In addition, tori can be used as an autogenous bone graft to repair periodontitis bone defects in maxillary sinus lift cases and to increase bone thickness for dental implants. Tori can also be a marker for hyperparathyroidism and bioarcheological investigation. In conclusion, updates on these aspects have been found. However, complex aetiology needs to be further confirmed. Moreover, treatment is worth tracking, and its function as autologous bone deserves to be studied in other body parts.

Predictable Rehabilitation of Bone Deficiencies: Hygiene, Functional and Aesthetic Perspectives.

The aim of this article is to describe a method for correcting bone deficiencies which may compromise aesthetic, functional or oral hygiene maintenance of implant supported restorations. The generic causes of these deficiencies are mentioned. The use of autogenous block bone grafts is described alongside methods for managing the hard and soft tissues at both the recipient and donor sites. The biomechanical advantage conferred with the use of grafts in reducing the crown:implant ratio is emphasised. The sources of intraoral bone grafts are identified and the risks of damage to adjacent anatomical structures and their avoidance are addressed.The principles of healing are briefly described with an emphasis on the increasing predictability of contact healing, as opposed to gap healing.The impact and inherent risks associated with the supplementary use of membranes for containment is also addressed.Clinical cases have been used to illustrate procedures and outcomes. Previously published data is referenced.

Comparison of Marginal Bone Loss in Simultaneous Versus Delayed Implant Placement Following Horizontal Ridge Augmentation with Autogenous Lateral Ramus Bone Block.

Alveolar ridge resorption after tooth extraction may interfere with optimal dental implant placement. This study aimed to compare the marginal bone loss (MBL) and thickness of the buccal aspect of the augmented site in simultaneous versus delayed implant placement following lateral ramus horizontal ridge augmentation in the posterior mandible. This prospective cohort study was conducted on patients who required horizontal bone augmentation of the posterior mandible using lateral ramus autogenous bone graft. Patients were divided into two groups of simultaneous implant placement (group 1) and delayed implant placement (group 2). Cone-beam computed tomography (CBCT) images were obtained before augmentation, at the time of implant placement, and 10 months later (6 months after implant loading). MBL and thickness of the buccal aspect were evaluated over time. There were 18 patients in the group 1 and 16 patients in the group 2. Analysis of the CBCT scans demonstrated that the mean MBL was 1.21±0.35mm in the group 1 and 1.08±0.19mm in the group 2, with no significant difference between the two groups (p= 0.19). Thickness of the buccal aspect of the augmented site at the time of implant placement was 1.85±0.20mm in the group 1 and 2.16±0.29 mm in the group 2, with a significant difference (p< 0.001). However, data analysis regarding changes in the buccal plate thickness showed no significant difference between the two groups (p= 0.36). According to the results of this study, there was no significant difference in M-BL and post-operative changes in the thickness of the buccal aspect of the augmented sites with onlay lateral ramus bone blocks between simultaneous and delayed implant placement.

Determination of Osteoblast Cell Viability and Histological Changes of Samples Obtained from Different Implant Drills during Osteotomy.

The bone particles collected during osteotomy could be used as autogenous bone graft materials for dental implant surgery. Different factors such as drill design may influence its clinical viability. This study examined the effect of drill design on the osteoblast viability and histopathology parameters of bone collected during the preparation of dental implant site. In this experimental study, 90 samples were obtained from three different bone drilling systems including Bego, Implantium, and Dio during fixture installation in patients requiring treatment at the Department of Periodontology, Dentistry University Hamedan. The MTT (3-4,5-Dimethylthiazol2,5-diphenyltetrazolium bromide) was used to determine percentage of cell viability. Samples were fixed in 10% formaldehyde for histological evaluation. Then, they were kept in 10% EDTA solution for 4 weeks for decalcification. The provided slides were evaluated regarding bone structure and osteocytes counts for assessment of viability. Tukey test and SPPS 21 software were used for statistical analysis. The result showed the viability of osteoblast obtained by Dio (0.45±0.04) was significantly better than Bego (0.37±0.05) and Implantium (0.37±0.04) systems. In histopathological evaluation, the grafting material obtained by Dio presented the best osteoblast morphology. It might be concluded that drill geometry has significantly influenced the viability of bone particles collected during the preparation of implant sites .Moreover, characteristic geometry alone cannot represent the performance of a particular drill, and several geometric features should be concerned. The results of this study showed that the geometry of the Dio drill was the best considering the viability and histopathological evaluations.

Introduction of temporomandibular joint and skull base combined reconstruction by autogenous bone graft.

This study introduces the application of autogenous bone graft for the reconstruction of temporomandibular joint (TMJ) and skull base combined defects. Patients treated with autogenous bone grafts for reconstruction of the TMJ and skull base were reviewed. All patients underwent virtual surgical design to confirm the osteotomies of the combined lesion and the selections of autogenous bone graft, fabrication of surgical templates to transfer the plan to actual operation, and reconstruction of autogenous bone graft for the TMJ and/or skull base. Surgical outcomes were assessed by clinical examinations and radiological data. Twenty-two patients were involved in this study. Ten patients underwent reconstruction of the skull base by a free iliac or temporal bone graft and preservation of the TMJ. Twelve patients underwent skull base reconstruction by the same methods and total reconstruction of the TMJ by half sternoclavicular joint flap or costochondral bone graft. No severe complications occurred after surgery. The occlusion relationship was stable and similar to that of the preoperative state. The pain and maximal interincisal opening were significantly improved by the 101.2-month follow-up. Autogenous bone graft is a good alternative for repairing the TMJ and the skull base structure and function. The study introduced the application of autogenous bone graft for the reconstruction of temporomandibular joint and skull base combined defect, which is a good way to repair the defect and restore the function.

Comparison of Radiological and Clinical Outcomes between Expandable and Non-expandable Cages Following Cervical Corpectomy: A Systematic Review and Meta-analysis.

Anterior cervical corpectomy and fusion is considered the mainstay of surgical treatment in cervical pathology. Expandable and nonexpandable cages are preferred over autogenous bone graft because of donor-related morbidity. However, the choice of the cage type remains a debatable topic as studies report conflicting results. Thus, we evaluated the outcomes of expandable and non-expandable cages following cervical corpectomy. Studies were searched in various electronic databases (MEDLINE, PubMed, EMBASE, CINAHL, Scopus, and Cochrane) between 2011 and 2021. Forest plot was made to compare the radiological and clinical outcomes between expandable and non-expandable cages following cervical corpectomy. Altogether, 26 studies (1,170 patients) were included in the metaanalysis. The mean change in segmental angle was significantly greater in the expandable cage group than in the non-expandable cage group (6.7° vs. 3.0°, p <0.001). The mean subsidence rate was lower in the expandable cage group (6% vs. 41%, p <0.001). The mean fusion rate was lower (93% vs. 98%, p =0.06) and the mean displacement rate was significantly higher in the expandable cage group (29% vs. 5%, p <0.05). The mean reoperation rate was higher in the expandable cage group (16% vs. 2%, p >0.05). The improvement in segmental angle is better with expandable cages. Higher subsidence is a major problem with non-expandable cages, but it seems to be beneficial as evidenced by the high fusion rate and minimal effect on clinical outcome in patients with this cage.

Effectiveness of arthroscopic autologous iliac bone grafting with double-row elastic fixation for recurrent anterior shoulder dislocation with massive glenoid bone defect

To investigate the effectiveness of arthroscopic autologous iliac bone grafting with double-row elastic fixation in treatment of recurrent anterior shoulder dislocation combined with massive glenoid bone defects. Between January 2018 and December 2021, 16 male patients with recurrent anterior shoulder dislocation combined with massive glenoid bone defects were treated with arthroscopic autogenous iliac bone grafting and double-row elastic fixation. The patients were 14-29 years old at the time of the first dislocation, with an average age of 18.4 years. The causes of the first dislocation included falling injury in 5 cases and sports injury in 11 cases. The shoulders dislocated 4-15 times, with an average of 8.3 times. The patients were 17-37 years old at the time of admission, with an average age of 25.1 years. There were 5 left shoulders and 11 right shoulders. The preoperative instability severity index (ISIS) score of the shoulder joint was 5.8±2.1, and the Beighton score was 4.3±2.6. The University of California Los Angeles (UCLA) score, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and Rowe score were used to evaluate shoulder function, and the degree of the glenoid bone defect repair was observed based on CT after operation. All incisions healed by first intention, and no complication such as incision infection or neurovascular injury occurred. The patients were followed up 12 months. At 12 months after operation, UCLA score, Constant score, ASES score, and Rowe score all significantly improved when compared with the scores before operation ( P<0.05). CT imaging showed the degree of glenoid bone defect was significantly smaller at immediate, 6 and 12 months after operation when compared with that before operation ( P<0.05), and the bone blocks healed with the scapula, and bone fusion had occurred at 12 months. Arthroscopic autologous iliac bone grafting with double-row elastic fixation is a safe treatment for recurrent anterior shoulder dislocation combined with massive glenoid bone defects, with good short-term effectiveness.

Effect of Platelet-rich Plasma on the Clinical Success of Alveolar Grafts in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis.

This study assessed the effect of platelet-rich plasma (PRP) on the clinical success of alveolar grafts in patients with cleft lip and palate. In this meta-analysis, a search of the literature was conducted in Medline, Scopus, ISI Web of Science, and Cochrane Central Register of Controlled Trials for randomized clinical trials using PRP or platelet-rich fibrin (PRF) along with autogenous bone for alveolar ridge grafts in patients with cleft lip and palate. The methodological quality of the studies was analyzed using Cochrane's risk of the bias assessment tool. The extracted data underwent meta-analysis using the random-effects model. Of a total of 2256 articles retrieved, 12 met the eligibility criteria and were enrolled; out of which 6 did not undergo meta-analysis due to heterogeneous data. The percentage of defects filled by bone graft was 0.648% (95% confidence interval: -0.15 to 1.45), which was not statistically significant ( P =0.115). Subgroup analysis showed no significant difference based on the use of PRF or PRP ( P =0.28), type of cleft (unilateral/bilateral; P =0.56), or type of radiographic modality (3D/2D; P =0.190). Meta-regression analysis showed that the duration of follow-up and the difference in the mean age of patients did not have a significant effect on the results (R=0, I2: high). The application of PRP/PRF in combination with autogenous bone graft did not have a significant effect on the percentage of alveolar cleft filled by a bone graft. Future clinical studies are required to further elucidate the effect of PRP in the regeneration of alveolar clefts.

Comparison of demineralized bone matrix with different cycling crushing times in posterolateral fusion model of athymic rats.

Decalcified bone matrix (DBM) is a widely used alternative material for bone transplantation. In the DBM production process, an effective particle size and the highest utilization rate of raw materials can be achieved only through multiple high-speed circulating comminution. The rat posterolateral lumbar fusion model (PLF) is the most mature small animal model for the initial evaluation of the efficacy of graft materials for bone regeneration and spinal fusion. To evaluate the differences in the in vivo osteogenic effects of DBM pulverization through 1, 5, 9, and 14 high-speed cycles, sixty athymic rats were divided into six groups: single cycling crushing (CC1), 5 cycles of crushing (CC5), 9 cycles of crushing (CC9), 13 cycles of crushing (CC13), autogenous bone graft (ABG) and negative control (NC). Posterolateral lumbar fusion was performed. Six weeks after surgery, the bilateral lumbar fusion of athymic rats was evaluated through manual palpation, X-ray, micro-CT and histological sections. Rank data were tested by the rank-sum test, and nonparametric data were tested by the Kruskal‒Wallis H test. The manual palpation and X-ray results showed that the fusion rate did not significantly differ between the CC1, CC5, CC9, CC13 and ABG groups. However, cavities appeared in CC9 and CC13 on the micro-CT image. The bone mass (BV/TV) of CC1, CC5, CC9 and CC13 was better than that of the ABG group, while almost no osteogenesis was observed in the NC group. Histologically, there was no obvious difference between the four groups except that the CC9 group and CC13 group had more fibrous tissues in the new bone. In conclusion, DMB with different cycling crushing times has no obvious difference in fusion rate of PLF, but it is slightly better than the ABG group.

Radiographic evaluation of the tenting screw technique in horizontal alveolar bone augmentation: A retrospective study

To radiographically analyze the effects of tenting screw technique (TS) and onlay bone grafts (OG) in horizontal bone augmentation. Patients receiving horizontal bone augmentation by TS or OG were selected. The clinical outcomes and cone beam computed tomography (CBCT) data were documented pre-grafting, immediately post-grafting, before and after implantation. The survival rates, clinical complications, alveolar bone width, and volumetric bone augmentation were evaluated and statistically analyzed. A total of 25 patients and 41 implants were involved in this study, with no grafting failures observed in either the TS group (n = 20) or the onlay group (n = 21). Volumetric bone resorption rate in the TS group (21.34%) was significantly lower than that of the OG group (29.38%). In addition, significant horizontal bone gain was achieved in both groups (TS: 6.15 ± 2.12 mm; OG: 4.86 ± 1.40 mm) during the recovery period, with higher gain in the TS group. No apparent statistical difference in terms of volumetric bone gain was observed between the TS (748.53 mm3 , 607.47 mm3 ) and OG group (811.77 mm3 , 508.49 mm3 ) immediately post-grafting or after the recovery period. Both TS and OG achieved satisfactory bone augmentation effects, yet TS resulted in more bone augmentation and better stability than OG, with a reduced use of autogenous bone. Overall, the tenting screw technique can serve as an effective alternative to autogenous bone grafts.

A ramus cortical bone harvesting technique without bone marrow invasion

Autogenous bone grafts from the mandibular ramus are a known source of inadequate bone volume scenarios of the residual alveolar ridge. However, the conventional block-type harvesting technique cannot prevent bone marrow invasion, which can cause postoperative complications such as pain, swelling, and inferior alveolar nerve injury. This study aims to suggest a complication-free harvesting technique and present the results of bone grafting and donor sites. One patient received two dental implants with a complication-free harvesting technique that involves creation of ditching holes with a 1 mm round bur. Sagittal, coronal, and axial osteotomies produced grid-type cortical squares using a micro-saw and a round bur to confirm the cortical thickness. The grid-type cortical bone was harvested from the occlusal aspect, and the harvesting was extended through an additional osteotomy on the exposed and remaining cortical bone to prevent bone marrow invasion. The patient did not suffer postoperative severe pain, swelling, or numbness. After 15 months, the harvested site exhibited new cortical bone lining, and the grafted area had healed to a cortico-cancellous complex with functional loading of the implants. Our technique, grid-type cortical bone harvesting without bone marrow invasion, allowed application of autogenous bone without bone marrow invasion to achieve acceptable bone healing of the dental implants and to regenerate the harvested cortical bone.

Blade Plate With Autogenous Bone Grafting to Salvage Peri Ankle Nonunions.

Salvage surgery for a nonunion around the ankle is challenging. Poor bone stock, stiffness, scarring, previous (or persistent) infection, and a compromised soft tissue envelope are common in these patients. We describe 15 cases that underwent blade plate fixation as salvage for a nonunion around the ankle, including patient/nonunion characteristics, Nonunion Scoring System (NUSS), surgical technique, healing rate, complications, and long-term follow-up with 2 patient-reported outcome measures. This is a retrospective case series from a level 1 trauma referral center. We included all patients that underwent blade plate fixation for a long-standing nonunion of the distal tibia, talus, or failed subtalar fusion. All patients had autogenous bone grafting, including 14 with posterior iliac crest grafts and 2 with femoral reamer irrigator aspirator grafting. Median follow-up was 24.4 months (interquartile range [IQR], 7.7-40). Main outcome measures were (time to) union, and functional outcomes using the 36-item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary (MCS), and the Foot and Ankle Outcome Score (FAOS). We included 15 adults with a median age of 58 years (IQR, 54-62). The median NUSS score at the time of index surgery was 46 (IQR, 34-54). Union was achieved after the index procedure in 11 of 15 patients. Additional surgery was performed in 4 of 15 patients. Union was achieved in all patients at a median of 4.2 months (IQR, 2.9-11). The median score for the PCS was 38 (IQR, 34-48, range 17-58, P = .009), for the MCS 52 (IQR, 45-60, range 33-62, P = .701), and for the FAOS 73 (IQR, 48-83). In this series, our use of blade plate fixation with autogenous grafting was an effective method for managing a nonunion around the ankle allowing for alignment correction, stable compression and fixation, union, and fair patient-reported outcome scores. Level IV, therapeutic.

The use of autogenous tooth bone graft is an efficient method of alveolar ridge preservation – meta-analysis and systematic review

BackgroundRidge resorption following tooth extraction may be reduced by alveolar ridge preservation (ARP). Previous randomized clinical trials and systematic reviews have suggested that autogenous tooth bone graft (ATB) can be an effective alternative material for ARP. However, the results are heterogeneous. Therefore, our research aimed to evaluate the efficacy of ATB in ARP.MethodsA systematic search was conducted in Cochrane Library, Embase, MEDLINE and Scopus for studies published from inception to 31 November 2021. We searched searched for randomized, non-randomized controlled trials and case series reporting on ATB use for ARP. The primary outcome was the ridge width difference pre- and post-surgery, measured in millimetres (mm) measured on CBCT (cone beam computed tomography). The secondary outcomes were the histological results. We followed the PRISMA2020 recommendations for reporting our systematic review and meta-analysis.ResultsThe analysis included eight studies for the primary and six for the secondary outcomes. The meta-analysis revealed a positive ridge preservation effect with a pooled mean difference ridge width change of -0.72 mm. The pooled mean residual graft proportion was 11.61%, and the newly formed bone proportion was 40.23%. The pooled mean of newly formed bone proportion was higher in the group where ATB originated from both the root and crown of the tooth.ConclusionsATB is an effective particulate graft material in ARP. Complete demineralization of the ATB tends to decrease the proportion of newly formed bone. ATB can be an attractive option for ARP.Trial registrationThe study protocol was registered on PROSPERO (CRD42021287890).

Tooth Graft: An Umbrella Overview.

This umbrella review aims to evaluate systematic/meta-analysis studies containing clinical evidence on tooth grafts as bone substitutes in the oral and maxillofacial regions. Using language restrictions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic database search of PubMed, MEDLINE, Embase, Cochrane library, and Google Scholar was conducted, featuring published studies up until August 2022. All systematic/meta-analysis review articles relating to tooth graft materials were matched against the inclusion criteria. Two qualified researchers independently assessed the studies' inclusion or exclusion criteria and risk of bias, and a third investigator assisted in resolving ambiguities. A total of 81 systematic/meta-analysis studies, comprising 21 animal-controlled trials, 23 randomized controlled human trials, 23 prospective studies, and 14 retrospective studies, were selected for this study. A small risk of bias was observed in systematic studies/meta-analyses. In addition, the clinical evidence from the analysis of these studies revealed a low incidence of side effects. According to the current review, two systematic reviews indicated that autogenous bone grafting of prepared teeth might be as effective as other bone grafting materials. Four studies also mentioned autologous grafts as potential alternatives to autologous grafts, autogenous demineralized dentin (ADDM), engineered grafts, root blocks, and dental matrix. On the other hand, three systematic studies stated that more long-term research is needed to confirm their findings. Finally, given the importance of standardization and homogeneity of studies for clinical cases, it is advised to be used cautiously due to the risks of transplant rejection.

Bone Grafting Outcomes in Smokers Undergoing High Tibial Osteotomy: A Systematic Review.

This systematic review summarises the findings in the literature available to show outcomes of high tibial osteotomy (HTO) withbone grafting in smokers. It also studies the trend of complications, outcome measures used and overall outcomes like union, non-union or the need to perform revision surgeries. The aim is to find out if HTO done with bone graftingimproves outcomes in smokers. Articles were shortlisted using Population, Intervention, Control, and Outcomes (PICO) search design and quality assessment was completed using Jadad, STROBE (Strengthening the Reporting of Observational studies in Epidemiology), Delphi, and Critical Appraisal Skills Program (CASP) followed by data extraction by two independent authors. There was union in 97.6% of smokers who received HTO with bone grafting. A case of non-union was treated with removal of metalwork and distraction osteogenesis. Three cases of unknown demographics had arthroplasty in the time frame from HTO with bone grafting to follow up. The commonest complication post surgery was metalwork causing soft tissue irritation and lateral proximal tibial cortex fracture. Following this review we can conclude that HTO with bone grafting could be considered as an optionto achieve better outcomes in smokers. Bone grafting helps healing across osteotomy sites in smokers whose healing potential is poor. Autogenous Iliac crest bone grafting is ideal due to its osteoinductive and osteoconductive properties, but has the disadvantage of donor site morbidity.

Osteogenic Potential of Tooth as Autogenous Bone Graft in Dental Extraction Sites: A Split-mouth Randomized controlled Human Trial

Osteogenic Potential of Tooth as Autogenous Bone Graft in Dental Extraction Sites: A Split-mouth Randomized controlled Human Trial