Autogenous Periosteal Grafts Research Articles

A Comparative Analysis of Open Flap Debridement with and without Autogenous Periosteal Graft as a Barrier Membrane for the Treatment of Class II Furcation Involvement in Mandibular Molars: A Case-control Study

A Comparative Analysis of Open Flap Debridement with and without Autogenous Periosteal Graft as a Barrier Membrane for the Treatment of Class II Furcation Involvement in Mandibular Molars: A Case-control Study

Appraising and comparing the role of autogenous periosteal graft as a barrier membrane in the treatment of intrabony defects in chronic periodontitis cases: A systematic review and meta-analysis.

Periodontal regeneration refers to procedures aimed at restitution of lost supporting tissue around the periodontally compromised tooth. Regenerative procedures very often include the use of barrier materials to encourage the growth of key surrounding tissues. The current study aimed to evaluate the effectiveness of autogenous periosteal graft as a barrier membrane for the treatment of intrabony defects in chronic periodontitis patients. A total of four data bases MEDLINE (by PubMed), Cochrane database, EBSCO, and Google Scholar were explored to identify the studies in English up to December 2022. An additional hand search of relevant journals was also done. A team of three independent reviewers screened the retrieved articles using the inclusion criteria. Randomized control trials (RCTs) evaluating the effectiveness of autogenous periosteal grafts in the treatment of intrabony defects in chronic periodontitis cases were included in the study. A total of six relevant articles were recognized for data procurement. A total of 117 patients with 68 sites with an age range between 18 years and 55 years were selected. Outcome variables examined were pocket depth (PD), clinical attachment level (CAL), radiographic bone defect fill (BDF), gingival recession (GR), plaque index (PI), gingival index (GI) and bleeding on probing (BOP). Data were analyzed using Revman 5.3 software. The mean differences and 95% confidence interval were used to illustrate the estimate of effect size. There is an equal effect in both groups for the PI, GI, and BOP reduction. For PD reduction, the result was in the favor of periosteal graft with open flap debridement (OFD) group. For CAL gain, radiographic BDF and GR, results also favored the periosteal graft, but no statistically significant difference was found amongst the groups. Within the limitation of the study, it seems that the autogenous periosteal graft can be used successfully along with OFD to treat intrabony defects in chronic periodontitis patients.

Repair of a perforated sinus membrane with an autogenous periosteal graft: a study in 24 patients

We describe a technique for repairing a perforation of the sinus membrane with a periosteal graft. Of 117 patients who had augmentation of the sinus floor, the sinus membrane perforated in 24, and these were repaired with autogenous periosteal grafts. Patients were followed up daily for the first 10days and monthly for the next six months, and clinical and radiographic variables were recorded. Patients had to be free of complications such as wound dehiscence, sinus infections, exposure of the graft, local inflammation, or pain. The radiographs showed correct osseointegration of all implants. Periosteal grafts are an effective alternative for repair of a perforation of the sinus membrane.

Connective tissue graft as a biological barrier for guided tissue regeneration in intrabony defects: a histological study in dogs.

The use of the autogenous periosteal graft as biological barrier has been proposed for periodontal regeneration. The aim of this study was to evaluate the histometric findings of the subepithelial connective tissue graft as barrier in intrabony defects compared to a bioabsorbable membrane. Three-walled intrabony defects were created surgically in the mesial aspect of the right and left maxillary canines in five healthy mongrel dogs. The defects were chronified, and two types of barriers were randomly carried out for guided tissue regeneration in a split-mouth design: the test group with a subepithelial connective tissue graft and the control group with a bioabsorbable membrane. The specimens were processed for histometric analyses of the epithelium (E), connective tissue (CT), newly formed cementum (NC), new bone (NB), and total newly formed tissues (NFT). The test side showed smaller mean of NC (3.6 ± 1.2), NB (2.1 ± 0.7), and NFT (7.7 ± 0.8) than the control group (NC 7.3 ± 0.5; NB 5.3 ± 1.3; NFT 10.1 ± 2.2; P < 0.05). No statistically significant differences were verified for E (test 3.1 ± 2.0; control 2.8 ± 2.1; P > 0.05) and CT (test 2.5 ± 1.1; control 2.0 ± 0.5; P > 0.05) between groups. The bioabsorbable membrane was more effective in maintaining the space for periodontal regeneration than periosteal connective graft when used as barrier. The bioabsorbable membrane showed more favorable regenerative results in intrabony defects in dogs than the subepithelial connective tissue graft as biological barrier.

The Application of Biological Materials of Carpal Articular Cartilage in Athletic Injury

This paper investigated the effect of biological materials on rehabilitation carpal articular cartilage injury in athletic injury, which aimed at provides ideal biological materials for the injury repair and functional reconstruction of carpal articular cartilage injury. Arthroscopic micro fracture technique combined with hyaluronic acid gel can improve the thickness of cartilage regeneration, which is more close to the hyaline cartilage; Calcium polyphosphate fiber / gelatin composite scaffold can meet the needs of tissue engineering scaffold composite porosity; Auto-genous periosteal graft fixation of bone marrow mesenchymal stem cells can promote the repair, generation and self-adaptation of articular cartilage. the carpal articular cartilage injury is common in exercise and training due to wrist joint physiological structure and biomechanical characteristic, tissue engineering of cartilage repair implant the cells and scaffold composite into the damaged tissues or organs, so as to achieve the purpose of wound repair and functional reconstruction, which provides a effective way for wrist joint cartilage injury.

Regenerated Cartilage Produced by Autogenous Periosteal Grafts: A Histologic and Mechanical Study in Rabbits Under the Influence of Continuous Passive Motion

To evaluate the repaired tissues formed in full-thickness cartilage defects in a rabbit model implanted with autogenous periosteal grafts under the influence of continuous passive motion (CPM) establishing a correlation between histology, histomorphometry, and mechanical behavior. Autogenous periosteal grafts were used to resurface full-thickness defects produced in the trochlear groove in the right knees of 60 New Zealand rabbits. Four groups were formed according to the time to death and postoperative mobilization: group A--active intermittent motion, euthanized at 8 weeks; group B--CPM, euthanized at 8 weeks; group C--active intermittent motion, euthanized at 36 weeks; and group D, CPM, euthanized at 36 weeks. Repaired tissues were evaluated grossly, histologically, and mechanically, as well as by histomorphometry. The repair tissue was hyaline-like cartilage in 68.1% of the specimens in group A, 71.4% in group B, 0% in group C, and 20% in group D. The mean thickness of the regenerated tissue was 1.20 mm in group A, 1.23 mm in group B, 0.20 mm in group C, and 0.25 in group D. Elastic stiffness at 8 weeks was lower than that of the control cartilage and increased significantly at 36 weeks because of degenerative changes. Postoperative motion showed no influence on the results. Repaired tissue developed severe degenerative changes in time, and deterioration of the mechanical properties was observed without any protective effect of the CPM. Full-thickness cartilage defects treated with autologous periosteal grafts were repaired with hyaline-like cartilage tissue. Regenerated tissue showed viscoelastic behavior similar to normal cartilage 8 weeks after surgery. CPM did not improve histologic or mechanical results. Repaired tissue did not last over time. Free periosteal grafts should not be used clinically in the treatment of full-thickness cartilage defects because even though regenerated tissue seems initially to be hyaline-like cartilage, it is not capable of maintaining its histologic and mechanical properties over a long period of time.

Regeneration of the mandibular head from grafted periosteum.

Grafted periosteum has a rich potential to induce heterotopic bone formation. In the current study the authors investigate whether autogenous periosteal grafts can regenerate the mandibular head in a rabbit model. They removed the mandibular head of Japanese white rabbits and grafted tibial periosteum to the cut surface of the mandible. Grafted periosteum was observed histologically and radiographically at day 7, 14, 21, and 45 after surgery. At day 7 after grafting, grafted tissue showed remarkable cell proliferation. By 14 days these cells had differentiated into chondrocytes to form cartilage, and endochondral ossification took place after 21 days. At 45 days after surgery, soft X-ray findings showed a newly formed mandibular head, which was similar histologically to that of a normal mandibular head. The cut mandible without periosteal graft showed no regeneration. These findings indicate that grafted periosteum can regenerate the mandibular head without special procedures such as bone fixation in a rabbit model, and suggest that this technique may be useful clinically.

Neochondrogenesis in repair of full-thickness articular cartilage defects using free autogenous periosteal grafts in the rabbit. A follow-up in six months

Objective To analyse the repair of lesions of articular cartilage with periosteum-free implants and follow-up at 6 months.Design Thirty-six New Zealand rabbits, 4–6 weeks old, were used. Full-thickness articular cartilage defects in the medial femoral condyle were created. Spontaneous evolution occurred in 18 animals; the other 18 animals were treated with a free autogenous periosteal tibial implant fixed with Tissucol®. Animals were killed in groups of six at 8, 12 and 24 weeks. Macroscopic, histologic and histochemical results were evaluated and analysed statistically using the Mann-Whitney U-test.Results The spontaneous evolution of the lesion did not lead to complete repair in any case. The periosteum-free implant provided complete repair of the lesion and statistically significant restoration of the articular surface.Conclusions In the rabbit, this study confirms the incomplete spontaneous repair of articular cartilage and the chondrogenic potential of tibial periosteum-free implants, with long-term maintenance of the macroscopic, histologic and histochemical characteristics of neo-cartilage. This raises the possibility of its use as an alternative method in the repair of circumscribed osteochondral lesions in young patients.

The Use of Autogenous Periosteal Grafts for the Periodontal Regeneration in Mandibular Class II Furcation Defects in the Dog

The Use of Autogenous Periosteal Grafts for the Periodontal Regeneration in Mandibular Class II Furcation Defects in the Dog

Experimental study of bone formation from autogenous periosteal graft following insulin-like growth factor I administration

The present study evaluates the effect of insulin-like growth factor I (IGF-I) administration on bone formation following grafted periosteum. Twenty-four Japanese white rabbits were randomly assigned into one IGF-I administered group (1 mg for 14 days) and a second control group. Grafted periosteum taken from the tibia was placed under the submandibular muscles. At 14, 21, and 28 days following the operation, the grafted periosteum was extirpated and examined. Throughout all stages of the experiment, active bone formation was confirmed histologically and radiographically in both control and experimental groups. In addition, a micro-CT scan was used to observe three-dimensional micro structures in newly formed bone and to measure the trabecular bone thickness as a marker of bone development. As a result, a significant increase in bone formation in the IGF-I group was observed when compared with the findings in the control group. Trabecular bone thickness in the IGF-I group was significantly greater when compared with the control group at 14 days and 21 days following grafting (P<0.01). At 28 days following grafting, there were no significant differences, suggesting that administration of IGF-I may play an important role in inducing bone formation from grafted periosteum in the early stages.

Transplantation of autogenous perichondrial or periosteal grafts for treatment of deep hyalin-cartilage lesions

The problem in the treatment of deep hyalin cartilage defects is due to the minimal regeneration potential of this specific tissue. Several attempts were made to solve this difficulties experimentally and clinically. The proliferative potential of autogenous perichondrium/periost is well-known for decades.

An Experimental Study about the Effects of TGF - 1 and Autogenous Periosteal Graft on Healing of Osteochondral Defect in Rabbit

An Experimental Study about the Effects of TGF - 1 and Autogenous Periosteal Graft on Healing of Osteochondral Defect in Rabbit

Periocular Autografts in Socket Reconstruction

Current enucleation and socket reconstruction techniques often require reinforcement of an orbital implant or wound by the use of a tissue graft. Commonly, allograft tissue (cadaveric sclera, fascia, etc.) is used. Disadvantages of allografts include possible inflammatory reaction, unpredictable vascularization rate, variable resorption, antigenicity, and cost. Another alternative to implant reinforcement is autogenous tissue which usually is harvested from a remote site (fascia lata, split dermis, temporalis fascia, pericranium, etc.). An overlooked source of readily available autogenous grafts is the connective tissue in the periorbital region and the enucleated eye itself. These sources include autogenous lamellar sclera, the corneoscleral button, capsular tissue from a migrated implant, and orbital rim periosteum. The authors used periocular autografts in primary and secondary socket reconstructions in 24 patients, with excellent success over a 2-year period. Seven autogenous corneoscleral buttons and two autogenous scleral grafts were used to cover biointegrated implant spheres. Ten implant capsules from migrated nonintegrated spheres were used to cover and reinforce secondary implants. In five patients, an autogenous periosteal graft was taken from the supraorbital rim and used to cover an exposed implant. Complications included one pyogenic granuloma, one conjunctival inclusion cyst, and one recurrent exposure after a periosteal graft, which necessitated explanation and a dermis fat graft. Postoperative motility was judged to be good to excellent in 21 patients. These techniques are presented as a new alternative to using human bank tissue or remote incision autografts for reconstruction of the anophthalmic socket.

The Use of Autogenous Periosteal Grafts as Barriers for the Treatment of Class II Furcation Involvements in Lower Molars

This study clinically analyzed the efficacy of a connective tissue graft including the periosteum used as a barrier to enhance new attachment and osseous regeneration. Fifteen patients, with no systemic diseases, and adult periodontitis including 2 Class II furcation involvements in lower molars comprised the study group. After completion of the initial phase of therapy, all patients were treated with full-thickness periodontal flaps, using sulcular incisions, and thorough scaling and root planing. One furca, selected at random, had a connective tissue graft, obtained from the palate and including the periosteum, placed over the furca with the flap sutured over the top of this graft. Control furcas received no graft and the flap was sutured in its original position. Both molars were treated in the same session. The following presurgical measurements were made: probing pocket depth, attachment level, gingival recession, sulcular bleeding index, and plaque index. The horizontal and vertical dimensions of the osseous defects were recorded after flap elevation and debridement. Six months later all clinical parameters were again measured and reentry flaps were performed to measure the bony defects. No statistically significant differences were found preoperatively between control and experimental molars with respect to soft tissue and osseous measurements. Six months after surgery, the experimental molars showed, in comparison to the controls, significant reduction in pocket depth and gain in attachment level as well as in vertical and horizontal measurements of the inter-radicular osseous defect.

Autogenous osteoperiosteal grafts in the reconstruction of full-thickness joint surface defects

Free, autogenous periosteal grafts from the medial metaphysis of the proximal tibia have been used to reconstruct full thickness cartilage defects of the articular surfaces of the knee joint. If there was a bone defect, it was initially filled with cancellous bone graft. The method is illustrated by six patients, three with acute traumatic patellar defects and three with local sclerotic osteochondritis of the medial femoral condyle. The latter had loose fragments unsuitable for fixation and single excision would have left a large and deep defect. The grafts have given satisfactory results, 14 to 59 months after the procedures. Clinical grading of the defects has been monitored by radiographs with arthroscopy of two knees and CT scan of one knee.

Durability of regenerated articular cartilage produced by free autogenous periosteal grafts in major full-thickness defects in joint surfaces under the influence of continuous passive motion. A follow-up report at one year.

An autogenous graft of tibial periosteum was sutured (with its cambium layer facing into the joint) to the base of a five by ten-millimeter full-thickness defect in the patellar groove of each of forty-five adolescent rabbits. The rabbits were randomly treated postoperatively by either four weeks of immobilization in a cast, intermittent active motion in a cage, or two weeks of continuous passive motion. One year postoperatively, the regenerated tissue from each rabbit was analyzed macroscopically, histologically, histochemically, and biochemically. Gross degenerative changes were seen in 57 per cent of the rabbits that had been immobilized in a cast, in 73 per cent of the rabbits that had been allowed intermittent active motion, and in 22 per cent of the rabbits that had been subjected to continuous passive motion (p less than 0.05). Out of a possible score of 7.0 points for the nature of the regenerated tissue, the scores for the three groups were: immobilization in a cast, 4.1 points; intermittent active motion, 4.0 points; and continuous passive motion, 5.9 points (p greater than 0.05). Out of a possible perfect combined score of 10.0 points for the structural characteristics of the regenerated tissue, the cast-immobilization group scored 3.8 points; the intermittent active-motion group, 2.5 points; and the continuous passive-motion group, 6.4 points (p less than 0.001). The total scores for freedom from cellular changes of degeneration, a perfect score being 5.0 points, were: immobilization in a cast, 2.4 points; intermittent active motion, 2.3 points; and continuous passive motion, 3.9 points (p less than 0.01). Degenerative changes in the adjacent cartilage, which were noted in 42 and 46 per cent of the knees in the immobilization and intermittent active-motion groups, respectively, were not found in the knees that had been subjected to continuous passive motion (p less than 0.05). The total indices, which were derived by combining the scores for all categories (maximum, 24.0 points), revealed that the index for the continuous passive-motion group was significantly better than the index for either of the other two groups: immobilization in a cast, 12.9 points; intermittent active motion, 11.2 points; and continuous passive motion, 19.2 points (p less than 0.0005).(ABSTRACT TRUNCATED AT 400 WORDS)

Cellular Origin and Evolution of Neochondrogenesis in Major Full-Thickness Defects of a Joint Surface Treated by Free Autogenous Periosteal Grafts and Subjected to Continuous Passive Motion in Rabbits

A graft of periosteum from the tibia of 27 rabbits was incubated in vitro with tritiated thymidine for 24 hours and then transplanted into a full-thickness defect in the patellar groove. The rabbits were managed after the operation on continuous passive motion (CPM), and the joints excised at intervals of two to 21 days. After one week the cells had begun to synthesize glycosaminoglycan and by two weeks the tissue resembled immature hyaline cartilage. Thymidine-labeled cells were seen throughout the entire regenerated tissue. The cellular origin of the hyaline-like tissue that filled the defects was the progenitor cells of the periosteal graft.

The chondrogenic potential of free autogenous periosteal grafts for biological resurfacing of major full-thickness defects in joint surfaces under the influence of continuous passive motion. An experimental investigation in the rabbit.

A rectangular graft of autogenous tibial periosteum was sutured (with its cambium layer facing into the joint) onto the base of a five by ten-millimeter full-thickness defect in the patellar groove of each of 143 adolescent and adult rabbits. The rabbits were managed postoperatively by either immobilization, intermittent active motion, continuous passive motion for two weeks, or continuous passive motion for four weeks. When the animals were killed four weeks postoperatively, the contour of the patellar groove had been restored in all of the rabbits in the group that had had four weeks of continuous passive motion, and the newly formed tissue in all of the defects in this group had the gross, histological, and histochemical appearance of smooth, intact hyaline articular cartilage. Histologically, the nature of the tissue that had formed, as well as its surface regularity, structural integrity, and bonding to the adjacent cartilage, were significantly better in the group that had had four weeks of continuous passive motion than in any of the other groups. The results were significantly worse when the orientation of the periosteal graft was reversed (that is, when it had been sutured into the defect with the cambium layer of the graft facing the subchondral bone rather than into the joint) or when no periosteal graft was used. Biochemical analyses revealed that, in the group that had had four weeks of continuous passive motion, the total hexosamine content, the levels of chondroitin sulphate and keratan sulphate, and the ratio of galactosamine to glucosamine were all comparable with the values for normal articular cartilage. In contrast, in the groups that were treated by immobilization, intermittent active motion, or two weeks of continuous passive motion, as well as in the adult rabbits, the content of the first three of these substances was significantly less than normal. In the groups that were treated by immobilization, intermittent active motion, or two weeks of continuous passive motion, 32 to 47 per cent of the total collagen was type II, while in the group that had had four weeks of continuous passive motion, 93 per cent of the total collagen was type II. These results demonstrate that, under the influence of continuous passive motion, free autogenous periosteal grafts can repair a large full-thickness defect in a joint surface by producing tissue that resembles articular cartilage grossly, histologically, and biochemically, and that contains predominantly type-II collagen.

Resurfacing Canine Femoral Trochleoplasties with Free Autogenous Periosteal Grafts

Femoral trochleoplasties resurfaced with autogenous free periosteal grafts in six dogs were compared to femoral trochleoplasties performed without grafts in six dogs. The grafts produced cartilage as early as 4 weeks after surgery; however, it was fibrocartilage rather than normal hyaline articular cartilage. The trochleoplasties not resurfaced with periosteum also healed with fibrocartilage but not until 40 weeks postoperatively. The grafted stifles had less patellar cartilage damage when compared to trochleoplasties left to heal without resurfacing.

The treatment of necrotizing scleritis with an autogenous periosteal graft: by S. Koenig and H.E. Kaufman. Ophthalmic Surg 14:1029–1032, 1983

The treatment of necrotizing scleritis with an autogenous periosteal graft: by S. Koenig and H.E. Kaufman. Ophthalmic Surg 14:1029–1032, 1983