Autogenous Bone Group Research Articles

Radiographic outcomes following lateral alveolar ridge augmentation using autogenous tooth roots

BackgroundTo assess and compare the radiographic outcomes following lateral alveolar ridge augmentation using autogenous tooth roots (TR) and autogenous bone (AB) blocks.MethodsIn a total of 30 patients, lateral ridge augmentation was conducted in parallel groups using either (1) healthy autogenous tooth roots (e.g., retained wisdom or impacted teeth) (n = 15) or (2) cortical autogenous bone blocks harvested from the retromolar area. Cone-beam computed tomographic (CBCT) scans taken at 26 weeks of submerged healing were analyzed for the basal graft integration (i.e., contact between the graft and the host bone in %) (BI26) and the cross-sectional grafted area (mm2) (SA26).ResultsBoth groups revealed a comparable clinical width of the alveolar ridge at baseline (CWb). Mean BI26 and SA26 values amounted to 69.26 ± 26.01% (median 72.44) and 22.07 ± 12.98 mm2 (median 18.83) in the TR group and 79.67 ± 15.66% (median 78.85) and 12.42 ± 10.11 mm2 (median 11.36) in the AB group, respectively. Between-group differences in mean SA26 values were statistically significant (p = 0.031). Linear regression analysis failed to reveal any significant correlations between BI26 and CWb/SA26 values in either group.ConclusionsTR grafts may be associated with improved SA26 values following lateral alveolar ridge augmentation.Trial registrationDRKS00009586. Registered 10 February 2016.

Design of a slideable pedicle screw-rod system and its efficacy in the treatment of lumbar spine fusion

Objective To investigate the efficacy and safety of a novel slideable pedicle screw-rod system in the treatment of lumbar degenerative diseases. Methods Analysed 71 patients (47 males and 24 females) with lumbar degenerative diseases underwent lumbar fusion using the novel slideable pedicle screw-rod system from June 2014 to June 2016, aged 30-73 years by average 57.6 years. All patients were divided into 2 groups according to different operative methods: autogenous bone group (34 patients, fusion with autogenous bone plus slideable pedicle screw-rod) and cage group (37 cases, fusion with cage and autogenous bone plus slideable pedicle screw-rod). The Japanese Orthopaedic Association score (JOA) and visual analogue scale (VAS) were used to assess the clinical effect postoperatively while X-ray and CT were used to evaluate the fusion situation and the height variation of fusion segment. Results The average operation time was (98.5±26.72) min in autogenous bone group, (110.4±23.41) min in cage group. All patients were followed up for 3-18 months and 5 cases were followed for more than 12 months. The height of fusion segment decreased postoperatively, however, there was no neurologic symptoms. The VAS score of low back pain and leg pain decreased by 4.7 and 6.8 points in autogenous bone group after 3 months postoperatively, it decreased by 5.1 and 6.3 points in cage group. JOA scores of 2 groups after 3 months after operation were increased by 20.8 and 19.9 points compared with preoperative scores. According to the criteria, the excellent and good rate was 91.5%. 1 case out of 5 cases followed more than 12 months can not be determined whether fusion was complete. Conclusion The novel slideable pedicle screw-rod system can provide a satisfactory outcome for the treatment of lumbar degenerative diseases and can promote the decompression segment fusion effectively. Key words: Spinal diseases; Spinal fusion; Internal fixators

Extracted tooth roots used for lateral alveolar ridge augmentation: a proof-of-concept study.

To assess the efficacy of tooth roots used as autografts for lateral ridge augmentation and two-stage early osseointegration of titanium implants. The maxillary premolars were randomly assigned to either endodontic therapy (PM-E) or were left untreated (PM-C). Retromolar cortical autogenous bone (AB) blocks served as controls. PM-E/PM-C and AB were used for ridge augmentation at chronic-type defects in both lower quadrants (n=8 foxhounds). At 12weeks, titanium implants were inserted and left to heal for another 3weeks. Histological analyses considered crestal ridge width (CW); augmented area (AA) and bone-to-implant contact (BIC). Both PM and AB grafts (exposures: AB=3; PM-C=4; PM-E=7) were gradually involved in the bone remodelling process and associated with a replacement resorption. Median CW (PM-C: 2.70 versus AB: 3.30mm; PM-E: 2.96 versus AB: 3.35mm), AA (PM-C: 7.55 versus AB: 8.56mm(2) ; PM-E: 11.20 versus AB: 6.60mm(2) ) and BIC (PM-C: 36.96mm versus AB: 64.10%; PM-E: 50.79 versus AB: 32.53%) values were comparable in both PM and AB groups (p>0.05, respectively). Extracted tooth roots revealed a structural and biological potential to serve as an alternative autograft to autogenous bone. A higher exposure rate may be expected when using endodontically treated teeth.

The biopolymer sugarcane as filling material of critical defects in rats.

To evaluate the effects of particulate (granule-shaped) SCB on bone repair relating it to its biocompatibility and bone neoformation. Thirty Wistar rats were submitted to a one 7-mm-diameter defect and divided equally into three experimental groups, with two different postoperative times of evaluation, 90 and 120 days. Each calvaria defect was filled up with clot (control group), particulated autogenous bone or granulated SCB. Five animals of each group were assessed at 90 and 120 days after surgery. In these two periods, histological and histometric analysis were obtained. The clot group showed a bone resorption trend while the autogenous bone group a bone repair trend. However in the SCB group, the critical defect filled up only with fibrous connective tissue and presented none bone neoformation. The sugarcane biopolymer when used in critical size defects was a biocompatible material and proved to be a good material to fill bone cavities, keeping them as uniform areas filled with soft tissue and avoiding the tissue shrinkage.

Use of autogenous bone and beta-tricalcium phosphate in maxillary sinus lifting: a prospective, randomized, volumetric computed tomography study

The correction of bone defects can be performed using autogenous or alloplastic materials, such as beta-tricalcium phosphate (β-TCP). This study compared the changes in bone volume (CBV) after maxillary sinus lifting using autogenous bone (n=12), autogenous bone associated with β-TCP 1:1 (ChronOS; DePuy Synthes, Paoli, CA, USA) (n=9), and β-TCP alone (n=11) as grafting material, by means of cone beam computed tomography (CBCT). CBV was evaluated by comparing CBCT scans obtained in the immediate postoperative period (5–7 days) and at 6 months postoperative in each group using OsiriX software (OsiriX Foundation, Geneva, Switzerland). The results showed an average resorption of 45.7±18.6% for the autogenous bone group, 43.8±18.4% for the autogenous bone+β-TCP group, and 38.3±16.6% for the β-TCP group. All bone substitute materials tested in this study presented satisfactory results for maxillary sinus lifting procedures regarding the maintenance of graft volume during the healing phase before the insertion of implants, as assessed by means of CBCT.

Platelet-rich plasma and autogenous bone graft combined with guided tissue regeneration in periodontal fenestration defects in dogs.

The aim of this study was to evaluate the effects of platelet-rich plasma (PRP), autogenous bone (AB), and guided tissue regeneration (GTR) combination therapy compared to GTR therapy alone on healing of bone and cementum in fenestration-type periodontal defects in dogs. Six dogs were included in this study. Fenestration-type defects were created, and the following treatment groups were established: a control group treated with GTR alone and experimental groups treated with a combination of GTR + PRP, GTR + AB, and GTR + AB + PRP. The defects were evaluated by stereologic method and histomorphometric analysis, which were performed 4, 8, and 12 weeks postoperatively. The results showed a significant increase in trabecular bone area in the GTR + PRP group as compared with the control at 4 and 8 weeks (P < .05). The GTR + AB + PRP group showed significantly more trabecular bone area than both GTR and GTR + PRP groups at all time intervals (P < .05). The 8- and 12-week results in terms of cementum area revealed a significant difference between the GTR + AB + PRP group and the control in favor of the former (P < .05). Cementum area in the GTR + AB group was significantly greater than that in the GTR group at all time intervals (P < .05). Within the limitations of this study, PRP and AB, when used under barrier membrane, resulted in significant improvement in bone and cementum formation compared to GTR alone in periodontal fenestration defects; AB, rather than PRP, was responsible for this outcome.

Immunoexpression of PPAR-γ and osteocalcin proteins for bone repair of critical-size defects treated with fragmented autogenous abdominal adipose tissue graft.

Immunoexpression of PPAR-γ and osteocalcin proteins was evaluated for bone repair of critical-size defects (CSDs), created in rat calvaria (n=42) and treated with fragmented abdominal autogenous adipose tissue graft. Three groups (n=14) were formed: C (control - blood clot), AB (autogenous bone) and AT (fragmented adipose tissue). The groups were divided into subgroups (n=7) for euthanasia at 30 and 90 days. Histological and immunohistochemical analyses were performed. Data were subjected to descriptive statistics (mode). A complete bone closure was observed in Group AB 90 days after surgery. In Group C, repair was achieved by the formation of collagen fiber bundles oriented parallel to the wound surface at both post-surgery periods. In Group AT the type of healing was characterized by dense connective tissue containing collagen fiber bundles arranged amidst the remaining adipose tissue, with rare heterotopic bone formation associated with fibrosis and different types of tissue necrosis. Immunostaining of PPAR-γ was not observed in any specimen from Groups C and AB. In Group AT, the immunostaining of PPAR-γ was more evident 30 days after surgery. Immunostaining of osteocalcin was present in all groups and at both postoperative periods. The fragmented autogenous abdominal adipose tissue graft did not favor the repair of critical-size bone defects created surgically in rat calvaria as evidenced by the positive immunostaining of PPAR-γ protein and the negative immunostaining of osteocalcin in the osteoblast-like cells and bone matrix.

Maxillary sinus floor elevation with a tissue-engineered bone composite of deciduous tooth stem cells and calcium phosphate cement in goats

The study aimed to assess the effect of maxillary sinus floor elevation with tissue-engineered bone constructed from deciduous tooth stem cells (DTSCs) and calcium phosphate cement (CPC). The stem cells from goat deciduous teeth (SGDs) were isolated and transfected by means of the adenovirus with an enhanced green fluorescent protein gene (AdEGFP). As many as 18 bilateral maxillary sinuses of nine goats were randomly allocated into three groups (n = 6/group): group A (SGDs-CPC compound), group B (CPC alone) and group C (autogenous bone obtained from an iliac crest). All the samples were evaluated by computed tomography (CT), histology and histomorphometric analysis. Furthermore, the fate of implanted SGDs was traced using an immunohistochemical staining method in the decalcified samples. SGDs might be differentiated into osteoblasts in an osteogenic medium. In the present study, three-dimensional CT analysis showed that the volume of newly formed bone in group A was greater than that in the other two groups. After a healing period of 3 months, sequential analyses of triad-colour fluorescence labelling, histology and histomorphology indicated that the SGDs-CPC compound primarily promoted bone formation and mineralization at 2 and 3 months after the operation. Moreover, the areas of new bone formation in elevated sinuses were 41.82 ± 6.24% in the SGDs-CPC group, which was significantly higher than the 30.11 ± 8.05% in the CPC-alone group or the 23.07 ± 10.21% in the autogenous bone group. Immunohistochemical staining revealed that GFP and OCN were both expressed in the new bone tissue for the samples with eGFP, which suggested that the implanted SGDs might have contributed to new bone formation on the elevated sinus floor. SGDs can promote new bone formation and maturation in the goat maxillary sinus, and the tissue-engineered bone composite of SGDs and CPC might be a potential substitute for existing maxillary sinus floor elevation methods. Copyright © 2014 John Wiley & Sons, Ltd.

Fresh Frozen versus Autogenous Iliac Bone for the Rehabilitation of the Extremely Atrophic Maxilla with Onlay Grafts and Endosseous Implants: Preliminary Results of a Prospective Comparative Study

The purpose of this study was to compare (1) the clinical outcome of the reconstruction of extremely atrophic edentulous maxillae with fresh frozen allogeneic bone (FFB) (group A) and autogenous bone (AB) (group B) iliac blocks; and (2) the peri-implant bone resorption and the survival rate of implants in the two groups. In a 1-year period, eight patients were treated with FFB and seven with AB iliac grafts. Five to seven months afterward, 108 implants were inserted (59 in group A and 49 in group B). Four to five months afterward, patients were rehabilitated with implant-supported prostheses. The mean follow-up was 24 months. Prior to implant placement, graft exposure occurred in two patients in group A and in one patient in group B. The mean graft resorption prior to implant placement was 0.78 mm and 0.54 mm in group A and B, respectively. After implant placement, bone graft exposures with partial loss of the graft occurred in six out of eight patients in group A and in none of the group B patients. The survival rate of implants was 90.1% and 100% in group A and B, respectively. The mean values of peri-implant bone resorption at the end of the follow-up period were 1.64 mm and 0.92 mm in group A and B, respectively. Results of this study seem to demonstrate that FFB does not represent a reliable alternative to AB blocks because of the higher rate of bone exposure and partial loss of the grafts, the lower implant survival, and the higher peri-implant bone resorption in FFB patients.

Comprehensive Evaluation of Cryopreserved Bone‐Derived Osteoblasts for the Repair of Segmental Mandibular Defects in Canines

The repair of segmental mandibular defects remains challenging in the clinic. Previous studies have shown that cryopreserved bone-derived osteoblasts (CBOs) have good proliferation and osteogenicity. However, whether these cells can be used in the repair of segmental mandibular defects is largely unknown. In this study, we applied CBOs combined with beta-tricalcium phosphate (β-TCP) to repair a segmental mandibular defect in canines and thus established the feasibility of using this type of tissue-bank cell for the repair of large bone defects in the future. Sixteen segmental mandibular defects in 16 animals were made on the right side. Sequential radiographs, computer tomography, polychrome fluorescent labeling, immunohistochemical staining, and histological analysis were used to evaluate the effects of tissue-engineered bone for segmental mandibular defects. Our results demonstrated that CBOs combined with β-TCP promoted bone mineralization and deposition at the early stage, and bony union was achieved in the CBO and fresh bone-derived osteoblast (FBO) groups. However, nonunion and minimal callus were present in the β-TCP group. Furthermore, there was a large amount of newly formed bone in the CBO and FBO groups and in the autogenous bone group. Additionally, osteocalcin immunohistochemistry showed intensive osteocalcin immunoreactivity in the bone matrix of the CBO and FBO groups. These data indicate that CBOs implanted in a scaffold can promote new bone formation, and this tissue-engineered bone can repair critically sized segmental mandibular defects in canines. The use of CBOs combined with β-TCP may be an effective approach for the reconstruction of segmental mandibular defects in the clinic.

Anterior Operation for Unstable Thoracolumbar and Lumbar Burst Fractures

We retrospectively compared 25 cases that used the autogenous iliac bone grafting with 18 cases that used a titanium mesh cage for reconstruction of the vertebral body. To analyze clinical and radiographic results of the autogenous iliac bone and a titanium mesh cage used to reconstruct the vertebral body. Grafting of the autogenous iliac bone as a strut bone has been traditionally applied for reconstruction of the spine using anterior approach. Although grafting the autogenous iliac bone as a strut bone achieves a high bone fusion rate, it has reported complications in the donor site. For this reason, bone fusion with a mesh cage has been introduced. Between March 2000 and December 2010, 43 cases that underwent decompression and instrumented fusion for unstable burst fractures using the anterior approach were enrolled. Levels of injury were T12 in 8 cases, L1 in 19 cases, L2 in 11 cases, and L3 in 5 cases. The mean follow-up period was 64.5 months (range, 14-129 mo). The local kyphotic angle in the group that used the tricortical autogenous iliac bone (group A) was measured 24.81±2.27 degrees preoperatively and 4.95±0.61 degrees at the last follow-up. The angle in the group that used a titanium mesh cage (group B) was 25.21±1.55 degrees preoperatively and 3.9±0.43 degrees at the last follow-up. Both groups obtained bone fusion of grade I and II by Bridwell fusion criteria. The operation site visual analog scale and Korean Oswestry disability index did not differ significantly between 2 groups. Donor site visual analog scale and the operation time was significantly in favor of group B (P<0.05). Titanium mesh cage filled with the autogenous cancellous bone shortened operation time and reduced the risk of complications in the donor site compared with the group that used the tricortical iliac bone.

Comparison between Autogenous Bone Graft and Allogenous Cancellous Bone Graft in Medial Open Wedge High Tibial Osteotomy with 2-Year Follow-up

PurposeTo compare the radiographic and clinical results of medial open wedge high tibial osteotomy (OWHTO) using autogenous bone graft and allogenous cancellous bone graft for medial compartment osteoarthritis of the knee with two-year follow-up.Materials and MethodsFifty-one patients (52 knees) who underwent medial OWHTO from October 2007 to April. 2010 were included in the study. The patients were divided into group I (n=29) that received an autogenous tricortical bone graft and group II (n=23) that received an allogenous cancellous bone chip graft. The radiographic parameters (preoperative anatomical and mechanical femorotibial angles, modified tibial bone varus angle, and posterior tibial slope), clinical parameters, bone union period, and complications were evaluated from medical records.ResultsThe radiographic and clinical outcomes did not show significant difference between two groups. The average bone union period was 11.7 weeks in group I and 12.1 weeks in group II. The visual analog scale score on the first postoperative day was significantly higher in group I than group II.ConclusionsMedial OWHTO using allogenous cancellous bone graft for medial compartment osteoarthritis of the knee can be considered as an alternative treatment method that provides equivalent radiographic and clinical results of OWHTO using autogenous bone graft and causes less immediate postoperative pain.

The effect of low‐level laser on bone healing in critical size defects treated with or without autogenous bone graft: an experimental study in rat calvaria

The objective of this study was to evaluate the effect of low-level laser (LLL) on bone healing process in surgically created critical size defects in rat calvaria treated with or without autogenous bone graft (AB). The study was conducted on 40 male rats (Rattusnorvegicus, albinus, Wistar), weighing 250-300 g. For accomplishment of the experimental procedures, the rats were anesthetized with an intramuscular injection of xylazine (0.02 ml/kg) and ketamine hydrochloride (0.4 ml/kg). Acritical size defect with 5-mm diameter was created. The animals were divided into four groups: Group C (Control- filled with blood clot), Group LLL, Group AB (autogenous bone graft), Group AB + LLL (autogenous bone graft and LLL). The animals treated with LLL received applications of LLL at the infrared spectrum wavelength (λ = 810 nm) and energy density of 6 J/cm(2) per point, 60 s per point, adding up to five points on the entire created defect. The animals were euthanized at 30 days postoperatively. After decalcification, each specimen was longitudinally divided into two blocks, exactly along the center of the original surgical defect, processed and embedded in paraffin. Longitudinal serial sections with 6-μm thickness were made, initiating from the center of the original surgical defect. The sections were stained with hematoxylin and eosin (HE) for light microscopy analysis for histomorphometric analysis. Group C presented smaller quantity of new bone formation than Groups LLL (P < 0.01), AB (P < 0.01), and AB + LLL (P < 0.01). Utilization of LLL favored the healing process in rat calvaria. The quantity of new bone formation with use of the LLL was similar to the autogenous bone graft.

A Comparison of the Healing Capabilities of Various Grafting Materials in Critical-Size Defects in Guinea Pig Calvaria

To estimate the efficacy of various bone grafting materials in the healing of 8-mm-diameter critical-size defects (CSD) in guinea pig calvaria. In this randomized trial study, critical-size defects were created in the calvaria of 36 guinea pigs 6 months of age. Animals were assigned into three groups and each received one of three experimental protocols. In protocol A, the right-side defect was filled with macroporous biphasic calcium phosphate (MBCP Gel) and the left side was left empty as a control. In protocol B, the right-side defect was filled with demineralized freeze-dried bone allograft (DFDBA) and the left side was filled with Stypro. In protocol C, the right-side defect was filled with Bio-Oss and the left side was filled with autogenous bone. The percentage of new bone formation was evaluated histomorphometrically after 8 weeks. The mean bone formation was 68.19% for autogenous bone, 66.96% for MBCP Gel, 57.28% for Bio-Oss, 50.19% for DFDBA, 18.79% for Stypro, and 10.61% for the empty control. Except for the MBCP Gel and autogenous bone groups (P = .6), the differences between the other groups were statistically significant (P < .05). The results of this study indicated that all the testing materials had different capacities to produce new bone in CSD of guinea pig calvaria. MBCP Gel showed promising results in producing new bone proportionate to the autogenous bone graft group.

Porcine study on the efficacy of autogenous tooth bone in the maxillary sinus

ObjectivesThis study sought to elucidate the effect of autogenous tooth bone material by experimenting on minipig's maxillary sinus and performing histological and histomorphometric analyses.Materials and MethodsFive 18-24 month-old male minipigs were selected, and right maxillary sinuses were grafted with bone graft material made of their respective autogenous teeth extracted eight weeks earlier. The left sides were grafted with synthetic hydroxyapatite as control groups. All minipigs were sacrificed at 12 weeks after bone graft, which was known to be 1 sigma (σ) period for pigs. Specimens were evaluated histologically under a light microscope after haematoxylin-eosin staining followed by semi-quantitative study via histomorphometric analysis. The ratio of new bone to total area was evaluated using digital software for calculation of area.ResultsAll specimens were available, except one on the right side (experimental group), which was missing during specimen preparation. This study demonstrated new bone at the periphery of the existing bone in both groups, showing evidence of bone remodeling, however, encroachment of new bone on the central part of the graft at the 1 σ period was observed only in the autogenous tooth bone group (experimental group). Histomorphometric analysis showed more new bone formation in the experimental group compared to the control group. Although the difference was not statistically significant (P>0.05), the mean percentage area for new bone for the experimental and control groups were 57.19%±11.16% and 34.07%±13.09%, respectively.ConclusionThe novel bone graft material using autogenous tooth is a good alternative to autogenous bone, comparable to autogenous bone, and outperforming synthetic hydroxyapatite bone graft materials in terms of bone regeneration capacity. Augmentation with autogenous tooth bone materials will reduce donor site morbidity without hampering the safety of the autogenous bone graft.

Resonance Frequency Analysis Assessment of Implants Placed with a Simultaneous or a Delayed Approach in Grafted and Nongrafted Sinus Sites: A 12‐Month Clinical Study

Implant stability is one of the key factors for a successful osseointegration. At present, several techniques are available to regenerate bone tissue, but it is not clear whether implants placed in grafted bone are as stable as implants in native bone over time. The aim of the present study was to compare, by means of resonance frequency analysis (RFA), the stability of implants placed in sinus-grafted and -nongrafted sites during 12-month follow-up. Twenty-five patients received a total of 38 implants. Nineteen implants were placed in maxillary native bone (group A) and 19 implants following maxillary sinus floor augmentation using anorganic bovine bone and autogenous bone (group B) in a 50:50 ratio. Group B was divided into groups B1 and B2 depending on the timing of implant insertion, that is, B1 simultaneously and B2 6 months after sinus lift. The implants were inserted according to a two-stage procedure. RFA values were collected at baseline, 6 and 12 months after implant placement. Between the tested groups, no statistically significant difference was found in RFA values of implants placed in sinus-grafted and -nongrafted sites after the surgery as well as at 6 and 12 months, while a significant difference was recorded in group B1 (p = .0297) when RFA values were compared over time. The results of the present study suggest that regenerated bone can offer good stability for dental implants.

Healing patterns of critical size bony defects in rats after grafting with bone substitutes soaked in recombinant human bone morphogenetic protein-2: histological and histometric evaluation

The aim of the study was to evaluate the effect of different bone substitutes soaked in recombinant human bone morphogenetic protein-2 (rhBMP-2) on the healing of critical size defects in calvarial bone. Defects were created in 24 Sprague Dawley rats. The rhBMP-2 was diluted to obtain a final concentration of 0.2mg/ml. Rats were divided into four groups and treated as follows: in the first group the defect was filled with anorganic bovine bone mineral (ABBM) and rhBMP-2, the second group was treated with freeze-dried bone allograft (FDBA) and rhBMP-2, and the third group was treated with autogenous bone (AUTO). In the control group the defects were left untreated. Animals were killed after 8weeks and calcified histological sections prepared. Histometric measurements showed that mean (SD) bone formation was 4.00 (1.69)mm2 in the ABBM group, 2.56 (1.06)mm2 in the FDBA group, and 2.30 (0.34)mm2 in the AUTO group. The difference between the ABBM group and the other 3 groups was significant (p<0.0001) with a mean bone formation of 0.82 (0.25)mm2 in the control group. There was no significant difference between the FDBA and the AUTO groups (p=0.96). Within the limits of this study we concluded that the addition of rhBMP-2 to bone substitutes was efficacious in regenerating bone in critical size bone defects in calveria in rats.

Nonprocessed Adipose Tissue Graft in the Treatment of Dehiscence Bone Defects in Rabbit Tibiae

To evaluate the bone repair of surgically created dehiscence-type defects (3 × 5 mm) around dental implants in rabbit tibia using nonprocessed adipose tissue graft or autogenous bone graft. The bone defects were randomly assigned to 3 groups: blood clot (C), autogenous bone (AB), and nonprocessed adipose tissue (AT). After 3 months, the animals were euthanized. Histomorphometric analyses were performed, and the results were analyzed with analysis of variance and Tukey tests (P ≤ 0.05). Statistics were performed for the percentage of the bone-to-implant contact (BIC) and bone area (BA) within the limits of the threads. The results for BIC in the AT (37.75% ± 28.03%) and C (40.57 ± 13.71%) groups were statistically similar, whereas the AB group had the greatest percentage of BIC (83.37% ± 11.85%). For all groups, the BA percentage was similar (61.48% ± 30.89% in AT; 72.90% ± 14.10% in C; 84.23% ± 11.96% in AB), with no statistically significant differences. Nonprocessed adipose tissue is not a comparable substitute for autogenous bone in the treatment of dehiscence bone defects around titanium dental implants.

Engineering of Bone Using Porous Calcium Phosphate Cement and Bone Marrow Stromal Cells for Maxillary Sinus Augmentation with Simultaneous Implant Placement in Goats

The aim of this study was to explore the effects of maxillary sinus floor elevation and simultaneous dental implantation with a tissue-engineered bone complex of calcium phosphate cement (CPC) scaffolds combined with bone marrow stromal cells (BMSCs). A large animal goat model is used with the tissue engineering method. Eighteen bilateral maxillary sinus of nine goats were randomly allocated into three groups; the CPC/BMSC complex (n=6) was used to elevate maxillary sinus floor with a simultaneous implant placement; the effects were compared with those treated with CPC alone (n=6) or autogenous bone (n=6). After a healing period of 3 months, sequential triad-color fluorescence labeling, micro-CT, as well as histological and histomorphometric analyses indicated that the tissue-engineered BMSC/CPC complex could promote earlier bone formation and mineralization, and maximally maintain the volume and height of the augmented maxillary sinus. By comparison, CPC-alone or autogenous bone achieved less bone formation and later mineralization. Besides, the average bone-implant contact value reflecting the osseointegration was 35.63%±9.42% in the BMSCs/CPC group, significantly higher than 22.47%±4.28% in the CPC-alone group or 28.26%±8.03% in the autogenous bone group. In conclusion, CPC serves as a potential substrate for BMSCs for the maxillary sinus floor augmentation and simultaneous implantation. The tissue-engineered bone might enhance the stability of implants and thus be of great significance to achieve improved quality to restore the oral function in clinic.

Rabbit maxillary sinus augmentation model with simultaneous implant placement: differential responses to the graft materials

PurposeThis study was performed to establish an experimental rabbit model for single-stage maxillary sinus augmentation with simultaneous implant placement.MethodsTwelve mature New Zealand white rabbits were used for the experiments. The rabbit maxillary sinuses were divided into 3 groups according to sinus augmentation materials: blood clot (BC), autogenous bone (AB), and bovine-derived hydroxyapatite (BHA). Small titanium implants were simultaneously placed in the animals during the sinus augmentation procedure. The rabbits were sacrificed 4 and 8 weeks after surgery and were observed histologically. Histomorphometric analyses using image analysis software were also performed to evaluate the parameters related to bone regeneration and implant-bone integration.ResultsThe BC group showed an evident collapse of the sinus membrane and limited new bone formation around the original sinus floor at 4 and 8 weeks. In the AB group, the sinus membrane was well retained above the implant apex, and new bone formation was significant at both examination periods. The BHA group also showed retention of the elevated sinus membrane above the screw apex and evident new bone formation at both points in time. The total area of the mineral component (TMA) in the area of interest and the bone-to-implant contact did not show any significant differences among all the groups. In the AB group, the TMA had significantly decreased from 4 to 8 weeks.ConclusionsWithin the limits of this study, the rabbit sinus model showed satisfactory results in the comparison of different grafting conditions in single-stage sinus floor elevation with simultaneous implant placement. We found that the rabbit model was useful for maxillary sinus augmentation with simultaneous implant placement.