Autogenous Bone Transplantation Research Articles

Research progress on the application of magnesium phosphate bone cement in bone defect repair: A review.

Bone defects arising from diverse causes, such as traffic accidents, contemporary weapon usage, and bone-related disorders, present significant challenges in clinical treatment. Prolonged treatment cycles for bone defects can result in complications, impacting patients' overall quality of life. Efficient and timely repair of bone defects is thus a critical concern in clinical practice. This study aims to assess the scientific progress and achievements of magnesium phosphate bone cement (MPC) as an artificial bone substitute material. Additionally, the research seeks to explore the future development path and clinical potential of MPC bone cement in addressing challenges associated with bone defects. The study comprehensively reviews MPC's performance, encompassing e.g. mechanical properties, biocompatibility, porosity, adhesion and injectability. Various modifiers are also considered to broaden MPC's applications in bone tissue engineering, emphasizing drug-loading performance and antibacterial capabilities, which meet clinical diversification requirements. In comparison to alternatives such as autogenous bone transplantation, allograft, polymethyl methacrylate (PMMA), and calcium phosphate cement (CPC), MPC emerges as a promising solution for bone defects. It addresses limitations associated with these alternatives, such as immunological rejection and long-term harm to patients. MPC can control heat release during the curing process, exhibits superior mechanical strength, and has the capacity to stimulate new bone growth. MPC stands out as an artificial bone substitute with appropriate mechanical strength, rapid degradation, non-toxicity, and good biocompatibility, facilitating bone repair and regeneration. Modification agents can enhance its clinical versatility. Future research should delve into its mechanical properties and formulations, expanding clinical applications to create higher-performing and more medically valuable alternatives in bone defect repair.

Functionalized chitosan hydrogel promotes osseointegration at the interface of3D printed titanium alloy scaffolds

Autogenous bone transplantation is a prevalent clinical method for addressing bone defects. However, the limited availability of donor bone and the morbidity associated with bone harvesting have propelled the search for suitable bone substitutes. Bio-inspired scaffolds, particularly those fabricated using electron beam melting (EBM) deposition technology, have emerged as a significant advancement in this field. These 3D-printed titanium alloy scaffolds are celebrated for their outstanding biocompatibility and favorable elastic modulus. Thermosensitive chitosan hydrogel, which transitions from liquid to solid at body temperature, serves as a popular carrier in bone tissue engineering. Icariin (ICA), known for its efficacy in promoting osteoblast differentiation from bone marrow mesenchymal stem cells (BMSCs), plays a crucial role in this context. We developed a system combining a 3D-printed titanium alloy with a thermosensitive chitosan hydrogel, capable of local bone regeneration and integration through ICA delivery. Our in vitro findings reveal that this system can gradually release ICA, demonstrating excellent biocompatibility while fostering BMSC proliferation and osteogenic differentiation. Immunohistochemistry and Micro-CT analyses further confirm the effectiveness of the system in accelerating in vivo bone regeneration and enhancing osseointegration. This composite system lays a significant theoretical foundation for advancing local bone regeneration and integration.

Meta-analysis of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures

To explore clinical efficacy of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures by Meta analysis. Controlled clinical studies on autogenous bone transplantation and bone substitutes in treating tibial plateau fractures published on PubMed,Web of Science,CNKI,Wanfang and other databases from January 2005 to August 2022 were searched by computer. Literature screening and data extraction were performed according to randomized controlled trial(RCT),and the quality of RCT were evaluated by using intervention meta-analysis criteria in Cochrane manual. Meta-analysis of joint depression,secondary collapse rate of articular surface,blood loss,operative time and infection rate between two methods were performed by Rev Man 5.3 software. Seven RCT studies (424 patients) were included,296 patients in bone replacement group and 128 patients in autograft group. Operative time [MD=-16.79,95%CI(-25.72,-7.85),P=0.000 2] and blood loss[MD=-70.49,95%CI(-79.34,-61.65),P<0.000 01] between two groups had statistically differences,while joint depression[MD=-0.17,95%CI(-0.91,0.58),P=0.66],secondary collapse rate of joint surface[RR=-0.74, 95%CI(0.35,1.57),P=0.43],infection rate [RR=1.21,95%CI(0.31,4.70),P=0.78] between two groups had no differences. The effects of bone substitute and autograft for the treatment of tibial plateau fracture have similar effects in terms of joint depression,secondary articular surface collapse rate and infection rate. However,compared with autologous bone transplantation,bone replacement could reduce blood loss and shorten operation time.

Research Hotspots and Trends of Bone Xenograft in Clinical Procedures: A Bibliometric and Visual Analysis of the Past Decade.

Bone defect therapy is a common clinical challenge for orthopedic and clinical physicians worldwide, and the therapeutic effect affects the physiological function and healthy life quality of millions of patients. Compared with traditional autogenous bone transplants, bone xenografts are attracting attention due to their advantages of unlimited availability and avoidance of secondary damage. However, there is currently a lack of bibliometric analysis on bone xenograft. This study aimed to use bibliometric methods to analyze the literature on bone xenograft from 2013 to 2023, to explore the current status, hotspots, and future trends of research in this field, and to promote its development and progress. Using the Web of Science Core Collection database, we retrieved and collected publication data related to xenogeneic bone grafting materials worldwide from January 2013 to March 2023. Origin (2021), CiteSpace (6.2.R2 standard), and an online bibliometric platform were used for bibliometric analysis and data visualization. A total of 3395 documents were retrieved, and 686 eligible papers were selected. The country and institutions with the highest number of publications and centrality were the United States (125 papers, centrality = 0.44) and the University of Zurich (29 papers, centrality = 0.28), respectively. The most cited author was Araujo MG (163 times), and the author with the most significant centrality was Froum SJ (centrality = 0.09). The main keyword clusters were "tissue engineering", "sinus floor elevation", "dental implants", "tooth extraction", and "bone substitutes". The most significant bursting keywords in the last three years were "platelet rich fibrin". Research on bone xenograft is steadily growing and will continue to rise. Currently, research hotspots and directions are mainly focused on dental implants related to bone-augmentation techniques and bone tissue engineering. In the future, research hotspots and directions may focus on decellularization technology and investigations involving platelet-rich fibrin.

Immediate Autogenous Bone Transplantation Using a Novel Kinetic Bioactive Screw 3D Design as a Dental Implant

The restoration of osseous defects is accomplished by bone grafts and bone substitutes, which are also called biomaterials. Autogenous grafts, which are derived from the same individual, can retain the viability of cells, mainly the osteoblasts and osteoprogenitor stem cells, and they do not lead to an immunologic response, which is known as the gold standard for bone grafts. There are both different techniques and devices that can be used to obtain bone grafts according to the needs of the patients, the location, and the size of the bone defect. Here, an innovative technique is presented in which the patient’s own bone is removed from the trigone retromolar region of the mandible and is inserted into a dental alveolus after the extraction and immediate insertion of an innovative dental implant, the BKS. The first step of the technique creates the surgical alveolus; the second step perforates the BKS in the retromolar region, and shortly after, the BKS containing the bone to be grafted is removed; the third step screws the BKS bone that collects in the created surgical alveolus. Experimental studies have shown the feasibility and practicality of this new technique and the new dental implant model for autogenous transplants.

Regeneration of Horizontal Bone Defect in Edentulous Maxilla Using the Allogenic Bone-Plate Shell Technique and a Composite Bone Graft—A Case Report

An insufficient volume of the alveolar bone may prevent implants from being placed in the prosthetically optimal position. Complex restoration of bony structures is required to achieve long-term peri-implant bone stability and represents an adequate prosthetic solution. Background and Objectives: The shell technique has become a widespread and important method for guided bone regeneration in dentistry. Allogeneic bone materials appear to be the most similar substitution for autogenous bone transplants. However, there are few studies using cortical bone allografts in combination with a mix of autogenous and xenograft materials for the augmentation of horizontal ridge defects. This combination offers the advantage of reduced patient morbidity while adding adequate volume and contour to the alveolar ridge. Case report: The present case study aimed to clinically and radiographically evaluate the efficacy of allogenic cortical bone lamina combined with a composite bone graft in the augmentation of a horizontal bone defect in the edentulous maxilla during a 6-year follow-up period. Three CB CT scans taken before treatment, 6 months after the augmentation period/before implant placement, and after a 6-year follow-up period, were analyzed using stable referent points. After the 6 -year follow-up period, the average resorption rate was 21.65% on the augmented buccal side, with no implant exposure being observed. Conclusions: The bone shell technique used in conjunction with allogenic bone plates combined with autogenous bone, xenografts, and collagen membranes is an effective technique to manage horizontal ridge defects.

A comparative study of bone union and nonunion during distraction osteogenesis

BackgroundThe clinical characteristics of bone nonunion during distraction osteogenesis (DO) were rarely discussed. This study was employed to specify the difference between bone union and nonunion during DO.MethodsThe patients with bone lengthening were recruited in our study. The bone union cases indicated the ones that remove the external fixator successfully, whereas the bone nonunion represented the bridging callus did not appear even after 9 months (an absence of bridging callus for at least three out of four cortices on plain radiographs) that needs autogenous bone transplantation. The differences in the pixel value ratio (PVR) growth of regenerated callus, lengthening index (LI), healing index (HI), external fixation index (EFI) and blood biochemical indexes between bone union and nonunion were analyzed.ResultsA total of 8 bone nonunion and 27 bone union subjects were included in this study. The PVR growth in bone nonunion was significantly lower than that in bone union (0.19 ± 0.06 vs. 0.32 ± 0.16, P = 0.048). Interestingly, the HI and EFI in bone nonunion was significantly higher than that in bone union (62.0 ± 31.4 vs. 37.0 ± 27.4, P = 0.036; 75.0 ± 30.9 vs. 49.9 ± 16.1, P = 0.006). However, no significant difference with regard to LI was identified (0.76 ± 0.52 vs. 0.77 ± 0.32, P = 0.976). Moreover, the circulating level of urea and lymphocyte count in bone union was significantly lower than that in bone nonunion (4.31 ± 1.05 vs. 5.17 ± 1.06, P = 0.049; 2.08 ± 0.67 vs. 2.73 ± 0.54, P = 0.018). On the contrary, the circulating level of magnesium in bone union was significantly higher than that in bone nonunion (0.87 ± 0.07 vs. 0.80 ± 0.07, P = 0.014).ConclusionCompared to the bone union, the PVR growth was significantly lower, whereas the HI and EFI was significantly higher in the bone nonunion. Moreover, the circulating level of urea, magnesium and lymphocyte count was also different between these two. Therefore, the PVR, HI and EFI seems to be reliable and sensitive indicators to reflect the bone nonunion during DO, which might be considered in bone lengthening. Further prospective studies are still needed to elaborate the concerned issues.

Locally Applied Repositioned Hormones for Oral Bone and Periodontal Tissue Engineering: A Narrative Review.

Bone and periodontium are tissues that have a unique capacity to repair from harm. However, replacing or regrowing missing tissues is not always effective, and it becomes more difficult as the defect grows larger. Because of aging and the increased prevalence of debilitating disorders such as diabetes, there is a considerable increase in demand for orthopedic and periodontal surgical operations, and successful techniques for tissue regeneration are still required. Even with significant limitations, such as quantity and the need for a donor area, autogenous bone grafts remain the best solution. Topical administration methods integrate osteoconductive biomaterial and osteoinductive chemicals as hormones as alternative options. This is a promising method for removing the need for autogenous bone transplantation. Furthermore, despite enormous investigation, there is currently no single approach that can reproduce all the physiologic activities of autogenous bone transplants. The localized bioengineering technique uses biomaterials to administer different hormones to capitalize on the host’s regeneration capacity and capability, as well as resemble intrinsic therapy. The current study adds to the comprehension of the principle of hormone redirection and its local administration in both bone and periodontal tissue engineering.

CBCT Evaluation of the maxillary palatine process as a donor site for the regeneration of periodontal defects.

Background The maxillary palatine process (MPP) is an excellent source of autogenous bone transplants for anterior maxillary reconstruction. This research aimed to determine the quantity and quality of accessible MPP as a donor location. Methods Cone-beam computed tomography (CBCT) scans of patients referred to the School of Dentistry were evaluated by a certified examiner. The harvestable MPP was defined as the space between the distal surfaces of maxillary first premolars. OnDemand 3D Imaging software was used to determine bone properties. SPSS software was used to investigate the following variables: Bone characteristics are correlated with age and gender, accessible volume, and palatal width and height. P<0.05 was defined as the level of statistical significance. Results This study was performed on CBCT scans of 81 subjects (41 females and 40 males). MPP volume and palatal heights were 1.33±0.53 cm3 and 20.86±5.51 mm, respectively. Maximum bone density was observed around lateral incisors. Palatal width was 33.81±2.42 mm between canines and 41.81±2.66 mm between premolars. The MPP volume was significantly greater in males (P<0.001). Additionally, there was a positive correlation between the volume and palatal width (P<0.05).Conclusion Within the constraints of this research, there is a limited supply of MMP accessible for use as a graft source, and it is best suited for treating localized bone lesions. The favorable link between palatal breadth and harvestable volume aids the surgeon in estimating the quantity of bone accessible during the first evaluation.

Comparison of Clinical Effects of the Modified Masquelet Technique and Kirschner Wire External Fixation-Assisted Autogenous Bone Transplantation in the Treatment of Segmental Metacarpophalangeal Bone Defects.

ObjectiveThe present study aims to explore the (1) clinical effects of the modified Masquelet technique, whose improved Masquelet technique innovates the in vitro plasticity of the bone cement module and prefabricated hollow design, and the Kirschner wire external fixation-assisted autologous bone transplantation technique in the treatment of segmental metacarpophalangeal bone defects and (2) the differences between the two techniques.MethodsThe clinical data of 32 patients with segmental metacarpophalangeal bone defects (15 patients treated with the modified Masquelet technique and 17 patients treated with the self-made Kirschner wire external fixation technique) admitted to our department between January 2012 and January 2020 were retrospectively analyzed. The postoperative bone healing time, hand function, and complications were compared between the two groups.ResultsThe two groups were comparable; there were no significant differences in age, sex, length of bone defect, and time from injury to operation between the two groups (P > 0.05). All patients were followed up with for 6–24 months (average = 13.7 months), and all patients with segmental metacarpophalangeal bone defects achieved fracture healing. The postoperative hospital stay, fracture healing time, functionary scores of the affected limb, and incidence of severe complications were better in the modified group than in the external fixation group (P < 0.05).ConclusionCompared with the Kirschner wire external fixation stent assisted autologous bone transplantation, the improved Masquelet technique has the advantages of simple operation, fast healing, accurate effect, wide indications, and less complications, making it more worthy of clinical promotion.

Application of Graphene-Based Nanomaterials Combined with Early Exercise Rehabilitation Training in the Treatment of Patients with Infectious Bone Defects

Methods of treating bone defects include autogenous bone and allogeneic bone transplantation, tissue engineering technology, gene therapy, growth factor and adjuvant therapy of physical therapy, etc. However, most treatment schemes have obvious disadvantages. The purpose of this paper is to study the application of graphene-based nanomaterials combined with early exercise rehabilitation training in the treatment of patients with infectious bone defects. The biomedical properties and biomedical applications of graphene are briefly introduced through literature research and investigation, and bone defect diseases and commonly used treatment methods are analyzed. Graphene is used in many biomedical fields, such as disease diagnosis, biosensing, antibacterial and antiviral materials, cancer targeting, photothermal therapy, drug delivery, cell electrical stimulation, tissue engineering, stem cell technology, DNA sequencing and fluorescent (FL) tracking molecular probes. The effects of graphene-based nanomaterials and rehabilitation exercise on the treatment of infectious bone defects were compared through controlled experiments. The results show that although the repair effect of graphene-based nano-materials is not as good as that of autogenous bone, the difference is not significant, and it is better than calcium phosphate cement. After rehabilitation exercise, the curative effect of graphene experimental group was improved. In the 12th week, the tensile strength reached 5.78 N, and the torsional strength reached 0.93 N m, which exceeded the group of autogenous bone without rehabilitation exercise. This paper discusses the strength-related repair effect, but the in vivo toxicity of graphene needs further study.

Application of the method of frequency-resonance analysis of implants installed after autogenous bone transplantation

Background: Purpose of study determine the timing of prosthtic rehabilitation of patients after autograft and dental implantation of the jaw bone using resonance-frequency method (RFA).

Application of degradable new nano-biomaterials in bone defect repair and its impact on sports health

In addition to good biocompatibility, degradable new biomaterials should also have suitable hydrophilic and hydrophobic properties and mechanical strength, and have a degradation rate that matches the tissue growth rate. From the perspective of bionics, a new biodegradable biomaterial was synthesised to fill bone defects in rats, and compared with the autogenous bone transplantation group, blank control group, and polymeric biomaterials to compare the repair effect of bone defects in rats. This study aimed to explore the effect of new biodegradable materials on the repair of bone defects in rats, evaluate the biocompatibility, degradability, bone conduction capacity, osteoinductive capacity and other properties of the material, provide theoretical basis and reference materials for further research and development of the material, and provide new options and ideas for the development of bone defect repair materials. Sixty rat knee joints were used to establish a full-thickness articular cartilage defect model and were randomly divided into three groups. Group A underwent CPM for 8 h each day; group B underwent CPM for 2 h each day. Both groups underwent CPM for 4 weeks, and then caged. Group C were free to move only in the cage. The repair effect of full-thickness articular cartilage defect in group A was better than that in group B and group C. Interventions given to bone defect repair can significantly promote tissue repair, and at the same time promote the recovery of type II collagen and proteoglycans.

Impact of bone defect morphology on the outcome of reconstructive treatment of peri-implantitis

ObjectivesTo assess if (I) the alveolar bone defect configuration at dental implants diagnosed with peri-implantitis is related to clinical parameters at the time of surgical intervention and if (II) the outcome of surgical intervention of peri-implantitis is dependent on defect configuration at the time of treatment.Materials and methodsIn a prospective study, 45 individuals and 74 dental implants with ≥ 2 bone wall defects were treated with either an autogenous bone transplant or an exogenous bone augmentation material. Defect fill was assessed at 1 year.ResultsAt baseline, no significant study group differences were identified. Most study implants (70.7%, n = 53) had been placed in the maxilla. Few implants were placed in molar regions. The mesial and distal crestal width at surgery was greater at 4-wall defects than at 2-wall defects (p = 0.001). Probing depths were also greater at 4-wall defects than at 2-wall defects (p = 0.01). Defect fill was correlated to initial defect depth (p < 0.001). Defect fill at 4-wall defects was significant (p < 0.05).Conclusions(I) The buccal-lingual width of the alveolar bone crest was explanatory to defect configuration, (II) 4-wall defects demonstrated more defect fill, and (III) deeper defects resulted in more defect fill.

Study of PLGA microspheres loaded with pOsx/PEI nanoparticles for repairing bone defects in vivo and in vitro.

Autogenous or allogenic bone transplantation is the main treatment for bone defects and nonunions. However, the shortcomings of autogenous or allogenic bone transplantation limit its wide application in clinical use. This study investigated the effect of poly(lactic-co-glycolic acid) (PLGA) microspheres loaded with pOsterix (pOsx)/polyethylenimine (PEI) nanoparticles in repairing bone defects and explored its mechanism. Poly(lactic-co-glycolic acid) microspheres loaded with pOsx/PEI nanoparticles were constructed. The Osx transfection effect was detected by fluorescence quantitative PCR and western blotting methods. 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-diphenytetrazoliumromide (MTT) and flow cytometry methods were used to detect cell proliferation. The collagen I (Col-1), osteopontin (OPN) and osteocalcin (OC) expression levels were detected using real-time polymerase chain reaction (RT-PCR) and western blotting methods. Bone defect model was constructed. Bone repair was detected using X-ray, hematoxylin and eosin (H&E) staining, and Mason staining methods. PLGA@pOsx/PEI has transfection effect both in vitro and in vivo, does not affect cell proliferation and is safe for cells. PLGA@pOsx/PEI could promote the expression of Col-1, OPN and OC in vitro and in vivo. PLGA@pOsx/PEI could promote osteogenesis in vivo. PLGA@pOsx/PEI with high Osx expression could promote the expression of OC, OPN, and COL-I. PLGA@pOsx/PEI can be used as a material for repairing bone defects and can promote bone formation. These results provide a theoretical and practical basis for its further clinical application.

Repair of lateral calcaneal wound with the lateral supramalleolar flap pedicled with the end perforator of peroneal artery

Objective To explore the method and effect of repairing the soft tissue defect of the lateral heel with the retrograde lateral supramalleolar flap pedicled with the end perforator of peroneal artery. Methods From May, 2015 to February, 2018, 16 cases of lateral calcaneal soft tissue defect were repaired with the retrograde lateral supramalleolar flap pedicled with the end perforator of peroneal artery. All wounds were treated with one-stage dilatation and VSD to control infection. In cases of chronic calcaneal bone infection, the bone defect formed after extensive resection of infected bone was temporarily filled with antibiotic bone cement. The area of soft tissue defect on the lateral heel was 3.0 cm×2.0 cm-8.0 cm×5.0 cm, and the area of flaps was 3.5 cm×2.5 cm-8.5 cm×5.5 cm. The small donor area of the flap was sutured directly, and the larger area was repaired by skin grafting. Patients with chronic calcaneal bone infection underwent bone cement removal and autogenous bone transplantation after inducing membrane formation 6 to 8 weeks after flap transplantation. All cases were followed-up, including 7 cases outpatient follow-up and 9 telephone follow-up. Results All the 16 flaps survived smoothly. The donor and recipient areas of the flaps healed primarily. All cases were followed-up for 3 to 13 months. The flaps had good shape, no swelling, similar color to heel skin and no pigmentation. Ankle flexion and extension were not restricted. Four cases with chronic osteomyelitis of calcaneus healed well after second-stage bone grafting, with an average healing time of 8.5 months. Conclusion The retrograde lateral supramalleolar flap with the end perforator of peroneal artery is an ideal method for repairing the soft tissue defect on the lateral heel with simple operation and reliable blood supply. Key words: Lateral supramalleolar flap; Perforator of peroneal artery; Repair; Heel wound; Microsurgical technique

Discussion on hot topics of skeletal sternal reconstruction

Sternum is an important constituent of the thoracic cage, and a pivotal part of the anterior chest wall. When a considerable portion of the sternum needs to be resected, in order to protect the vital organs beneath, restore the anatomical structure and physiological function, reconstruction is unavoidable. Sternal reconstruction consists of two related parts: skeletal and soft tissue reconstruction. Skeletal reconstruction uses materials such as autograft or allograft of bones, metallic plates, sandwich patch, non-rigid patches, bio-synthetic patches and three-dimensional printing prosthesis. Each has its advantages and disadvantages. For example, autogenous bone transplantation is limited by the source of donor bones and surgical trauma; allograft bone transplantation demands cryopreservation and is susceptible to infection; titanium plate cannot be placed overlapped; "sandwich" patch is susceptible to local fluid accumulation and infection; non-rigid patches cannot provide enough mechanical support; the design and manufacture of three-dimensional printing prosthesis is complicated, time consuming and expensive, and cannot be adjusted due to change of extent of resection during operation. The modularized prosthesis system is a promising new technique developed on the basis of titanium plate. It is divided into standard components of different sizes that can be selected according to operational requirement and easily assembled. Until now, no perfect method or material has been found to imitate the autogenous sternum. Soft tissue reconstruction is a prerequisite to the success of large scale skeletal reconstruction of the sternum.

Revision surgery for malar reduction: causes and treatment strategies

Objective To discuss the correlation between initial malar reduction procedures and the method of revision procedures and the personalized treatment strategies for the second deformity of postoperative prominent malar complex. Methods From January 2003 to December 2017, 27 patients underwent personalized revision surgery of malar reduction according to the different second deformity of malar complex. The surgical technique included the double support malar reduction technique, orthotopic malar osteotomy technique, malar bone grinding surgery, and autogenous bone transplantation. Results A total of 27 patients subjected to revision surgery for malar reduction between November 2006 and December 2017 were retrospectively reviewed. 22 patients were satisfied with aesthetic outcomes after the first revision procedure, while 5 patients were satisfied after 2 or 3 procedures follow-up for 10 to 12 months. Conclusions The incidence of complications after malar reduction is related to the first surgical method. According to the unsatisfactory results, it can be repaired individually to obtain a better clinical repair effect. Key words: Malar reduction; Complications; Revision surgery; Double support

Immunohistochemial study on the expression of von Willebrand factor (vWF) after onlay autogenous iliac grafts for lateral alveolar ridge augmentation.

IntroductionThe main problems of autogenous bone transplants are their unpredictable atrophy and their loss of structure. One key factor lies in the poor revascularization of simple onlay grafts. The the aim of this study was to evaluate the revascularization processes in autogenous bone grafts from the iliac crest to the alveolar ridge.MethodsIn a sheep model, autogenous bone grafts were harvested from the iliac crest. A combination of a resorbable collagen membrane (CM) and deproteinized bovine bone material (DBBM) was used to modify the bone graft (experiment 2). This was compared with a simple onlay bone graft (control group, experiment 1). The amount of vessels in bone and connective tissue (CT), and the amount of CT were analyzed. The expression of von Willebrand factor (vWF) was compared between the two experimental groups using immunohistochemical analysis.ResultsThe ratio of the amount of vessels in bone and CT changed over time, and more vessels could be detected in bone at 12–16 weeks of graft healing. The number of vessels were significantly higher in experiment 2 than in experiment 1. More CT was found in experiment 1, whereas the amount of CT in both experiments decreased over time.ConclusionThis study shows a more intensive and extensive revascularization in experiment 2, as significantly more vessels were detected. The decreased amount of CT in experiment 2 clarifies its clinical superiority.

Tissue-engineered bone grafts for osteoplasty in patients with cleft alveolus

Alveolar bone grafting is an integral part of the treatment concept in cleft palate patients. As an alternative to autogenous bone, tissue-engineered grafts have found some clinical application. The aim of the present study has been to compare ossification in the cleft area using tissue-engineered grafts in a case series of patients with ossification after transplantation of autogenous spongious bone as the gold standard in alveoloplasty. Eight children with complete cleft lips and cleft palates were included in the study. In four children (group A), the cleft defect was filled with tissue-engineered bone (autogenous osteoblasts cultured on demineralized bone matrix Osteovit(®)); as control in another 4 children (group B), the alveoloplasty was performed using spongious iliac bone. Preoperative and 6 months postoperative cone-beam computed tomography was performed, and volumes of the remaining cleft defects were calculated using 3D navigation software. Wound healing was uneventful in both groups. Six months postoperatively the mean volume of the cleft was 0.55±0.24cm(3) after grafting of tissue-engineered bone (group A) and 0.59±0.23cm(3) after transplantation of autogenous spongiosa. In group A, 40.9% of the cleft defect was ossified; in the control group (group B), 36.6%. Tissue-engineered bone is a promising alternative in alveolar bone grafting and no disadvantages were observed in comparison to the gold standard.