Autogenous Tissue Research Articles

Reconstruction of deep and perforating corneal defects in dogs-A review (Part II/III): Biomaterials and keratoprosthesis.

The surgical reconstruction of severe corneal ulcers is a common and crucial component of the clinical practice of veterinary ophthalmology. Numerous surgical techniques are used in dogs for corneal reconstruction, and these techniques may be categorized by the material used to repair the corneal lesion. The first part of the present review described procedures that utilize autogenous ocular tissues, homologous donor tissues, and heterologous donor tissues. In this second part of the review, the categories of biomaterials and keratoprosthetics will be summarized. Biomaterials that are reported for use in dogs include amniotic membrane, porcine urinary bladder acellular matrix, porcine small intestinal submucosa, acellular porcine corneal stroma, and other miscellaneous soft tissue and cartilage grafts (e.g., preserved equine renal capsule, autologous omentum, autologous buccal mucosa membrane, bovine pericardium, and homologous peritoneum). Descriptions of keratoprosthesis surgery in dogs are currently limited, but the use of artificial corneal transplants hold promise for dogs with severe, vision-compromising corneal disease that is not amenable to other reconstruction techniques. This review describes the results of experimental studies evaluating these graft materials in dogs, and it will summarize the findings and outcomes of the clinical articles published in each material category. Reporting inconsistencies and areas where additional research is required will be highlighted to help guide future studies in this area. A major aim of this review is to help identify potential subjects that could be evaluated in future investigations and that might lead to refinements in clinical practice.

Reconstruction of deep and perforating corneal defects in dogs-A review (Part I/III): Autogenous ocular tissues, donor tissues, and corneal clarity scoring.

Corneal reconstruction is a key part of veterinary ophthalmic practice and numerous reconstructive techniques have been described for use in small animals in the peer-reviewed veterinary literature written in English. Despite the evidence accrued over the last six decades in over 40 clinical articles and numerous other publications on ocular surface health, several key areas require further study. The comparison between studies is difficult due to elements that go beyond common factors, such as the indication for surgery, the reconstructive technique preferred by the surgeon or the availability of reconstructive materials. However, the differences in reporting style adopted by different authors between similar studies and the lack of data found in retrospective studies add to this complexity. The present review is divided into three parts. One covers the use of autologous materials for reconstruction and corneal transplants, as well as corneal clarity. A second part focuses on biomaterials and keratoprosthetics, while the third part focuses on the use of corneal sutures and report of ocular discomfort/pain in the veterinary literature. The review focuses on the main findings of each reconstruction technique. It aims to identify areas where key information about common procedures is missing so that general guidelines may be provided for the planning of patient record keeping and future retrospective or prospective studies, while it also aims to highlight the presence of knowledge gaps that deserve further attention.

Reconstruction of deep and perforating corneal defects in dogs-A review (Part III/III): The use of corneal sutures and reporting of ocular discomfort.

The surgical reconstruction of severe corneal disease is a common and crucial component of the clinical practice of veterinary ophthalmology. The first part of the present review described procedures that utilize autogenous ocular tissues, homologous donor tissues, and heterologous donor tissues in dogs, while the second part reviewed the use of biomaterials and keratoprosthetics in this species. This third part is dedicated to the review of the use of corneal sutures including suture type and suture pattern in corneal reconstruction of small animals including dogs and cats. The review also focused on the way studies report postoperative ocular discomfort/pain and how this is treated. Lastly, the author briefly presents the simple but effective techniques available to bury corneal knots for corneal reconstructive surgery in small animal patients, such as the "tugging" and "deep-superficial-superficial-deep" methods for simple interrupted sutures, and the adaptation of the latter for simple continuous sutures.

Effect of suturing in root coverage via coronally advanced flaps: A systematic review.

To analyze the evidence about the influence of the suturing technique and material in terms of the percentage of mean root coverage (%MRC) following root coverage therapy in teeth diagnosed with single/localized gingival recession defects (GRD) via a monolaminar coronally advanced flap. The protocol of this systematic review was registered in PROSPERO (CRD42024514043). A literature search was conducted to identify investigations that fulfilled the eligibility criteria. Variables of interest were extracted, subsequently categorized, and qualitatively analyzed. A total of 15 randomized clinical trials, including 301 localized GRD in non-molar sites classified as Miller class I-II/RT1, in 253 patients were included. The studies reporting the combination of sling and single interrupted sutures, or interrupted sutures alone showed an MRC of 70.2%±16.6%, and 74.1%±0.75%, respectively. The highest MRC was observed in the studies using polyglactin 910 with a pooled value of 76.6% ± 15.3%, and monofilament materials, with a pooled MRC of 74.8%±7.1%. When the suturing diameter was evaluated, the highest pooled MRC with values of 79.1%±9.8% was observed with the use of 5-0. For the treatment of single/localized GRD in non-molar sites via a monolaminar coronally advanced flap, the use of a combination of sling and single interrupted sutures, or single interrupted sutures, polyglactin 910 or monofilament materials, and material diameter of 5-0 showed a higher MRC as compared to the use of expanded polytetrafluoroethylene, and silk with/without dressing, and other suture diameters. There were no differences in the percentage of root coverage achieved between the use of sling and single interrupted, versus single interrupted sutures alone on the treatment of single/localized GRD in non-molar sites. Polyglactin 910 and monofilament sutures resulted in a higher percentage of root coverage achieved as compared to expanded polytetrafluoroethylene, and silk with/without dressing. The use of 5-0 material diameter showed the highest percentage of root coverage achieved. This study was primarily aimed at evaluating how different suturing techniques and materials could affect the percentage of root coverage in single/localized recession defects, without the use of soft tissue substitutes or autogenous soft tissue grafts. After the pooled analyses of 15 randomized clinical trials that fulfilled the inclusion criteria, we observed that the adequate selection of suturing techniques, materials, and size could lead to a higher percentage of root coverage. Specifically, the use of single interrupted with or without sling sutures at the most coronal portion, Polyglactin 910 or monofilament materials, and size of 5-0 showed a higher percentage of root coverage as compared to the use of expanded polytetrafluoroethylene, and silk with/without dressing, and other suture diameters.

Advancing Periodontal Care: Development of a Novel Collagen-Chitosan-Bioglass Scaffold as a Substitute for Autologous Soft Tissue Grafts.

Introduction Modern dentistry prioritizes aesthetic outcomes, making root coverage for gingival recession a key focus. Various approaches, including autologous grafts, address this issue, yet no substitute matches the properties of autogenous connective tissue grafts. The innovative collagen-chitosan-bioglass scaffold presents a promising solution, surpassing the limitations of the traditional methods. This scaffold blends the advantages of collagen with chitosan's antibacterial and regenerative properties, enhanced by bioglass, which promotes tissue healing through angiogenesis. It was evaluated for its physicochemical characteristics, as well as antioxidativeand anti-inflammatory properties, making it a promising solution for soft tissue management in dentistry. Materials and methods Chitosan, collagen, and bioglass were combined into a scaffold through the lyophilization process (freeze-drying). Chitosan was sourced from shrimp, collagen from bovine, and the bioglass 1% comprised 58% tetra-ethyl ortho silicate, 33% calcium silicate, and phosphorous pentoxide. After the scaffold was created, it was subjected to physicochemical characterization via scanning electron microscopic and infrared spectroscopic analysis. Its anti-inflammatory and antioxidantproperties were evaluated using DPPH (2,2-diphenyl -1-picrylhydrazyl) assay and by measuring the scaffold's radical scavenging activity. Results This study employed infrared spectroscopy and scanning electron microscopy techniques to analyze the sample components and their morphology. The infrared (attenuated total reflection) analysis revealed various elements confirming the presence of all the biomaterials required to fabricate the scaffold. Scanning electron microscope imaging displayed a folded-like morphology with a porous structure. The protein denaturation inhibition increased from 25% at 50 μg of scaffold weight to 45% at 200 μg of scaffold weight. Similarly, the antioxidant activity increased, with values rising from 23% at 50μg to 35% at 200μg of scaffold weight. Conclusion The fabricatedcollagen-chitosan-bioglass scaffolddemonstrates promising antioxidant andanti-inflammatory properties. These findings suggest that this scaffold holds significant potential as a viable substitute for soft tissue augmentation.

A preliminary investigation into the impact of soft tissue augmentation-based periodontal phenotype modification therapy for patients exhibiting class III decompensation

BackgroundPatients with skeletal angle Class III malocclusion usually have inadequate hard and soft tissue volume at the mandibular anterior teeth. The labial proclination at the teeth may lead to gingival recession. The purpose of this study was to explore whether periodontal phenotype modification therapy with soft tissue augmentation (PhMT-s) can prevent gingival recession in these patients.MethodsFour patients with skeletal Class III malocclusion and a thin periodontal phenotype underwent surgical-orthodontic treatment. Prior to tooth movement, they underwent a minimally invasive vestibular incision with subperiosteal tunnel access combined with autogenous connective tissue grafts for periodontal phenotype modification with soft tissue augmentation (PhMT-s). The labial gingival thickness of the anterior mandibular teeth was measured at three distinct levels: at the cementoenamel junction (GT0), 3 mm apical to the CEJ (GT3), and 6 mm apical to the CEJ (GT6). These measurements were taken at baseline, three months following PhMT-s, and after tooth decompensation. Additionally, a biopsy sample was obtained from the PhMT-s site of one patient. All sections were subsequently stained using hematoxylin and eosin, Masson trichrome, Sirius Red, and immunohistochemistry.ResultsThe thickness of the labial gingiva was increased about 0.42 to 2.00 mm after PhMT-s. At the end of pre-orthognathic surgical orthodontic treatment, the thickness of the labial gingiva was increased about − 0.14 to 1.32 mm compared to the baseline and no gingival recession occurred after the pre-orthognathic surgical orthodontic treatment. The histologic results demonstrated that the grafts obtained from the PhMT-s site exhibited increased deposition of collagen fibers. Moreover, the proportion of type III collagen increased and the grafts displayed significantly reduced positive expression of CD31 and OCN.ConclusionsPhMT-s increased the thickness of the soft tissue, stabilizing the gingival margin for teeth exhibiting a thin periodontal phenotype and undergoing labial movement. This is attributed to the increased deposition of collagen fibers.

The distally anchored connective tissue graft platform for papilla enhancement: A case report

AbstractBackgroundAs the need for using dental implants to replace single missing teeth grows, so does the demand for greater esthetic results. However, achieving complete interproximal papillae fill in single‐tooth implant restorations remains a challenge. The distally anchored connective tissue platform is a novel soft tissue augmentation technique that consists of harvesting an autogenous connective tissue graft from the palate, folding it, and positioning it at the level of the distal occlusal and buccal surfaces with the help of a distal sling suture to the adjacent distal tooth.MethodsThis case report describes how a maxillary central incisor with compromised hard and soft tissues were replaced using a comprehensive treatment plan.ResultsThe clinical outcomes showed stable mucosal margin levels and complete papillae fill. The patient expressed satisfaction with the achieved results.ConclusionsThe distally anchored connective tissue graft platform performed at the time of implant placement emerges as a viable and effective soft tissue augmentation technique that yields highly esthetic results.Key pointsWhy is this case new information? To the best of our knowledge, this is the first case report in the literature using the distally anchored connective tissue platform. What are the keys to successful management of this case? Adequate diagnosis and decision‐making, resulting in a treatment plan focused on reconstructing both soft and hard tissues in a single‐tooth implant within the esthetic area, yield favorable clinical, radiological, and patient‐reported outcomes. What are the primary limitations to success in this case? The primary limitation of this study is its reliance on a single case report.

Betulin Stimulates Osteogenic Differentiation of Human Osteoblasts-Loaded Alginate-Gelatin Microbeads.

Osteoporosis, a terminal illness, has emerged as a global public health problem in recent years. The long-term use of bone anabolic drugs to treat osteoporosis causes multi-morbidity in elderly patients. Alternative therapies, such as allogenic and autogenic tissue grafts, face important issues, such as a limited source of allogenic grafts and tissue rejection in autogenic grafts. However, stem cell therapy has been shown to increase bone regeneration and decrease osteoporotic bone formation. Stem cell therapy combined with betulin (BET) supplementation might be adequate for bone remodeling and new bone tissue generation. In this study, the effect of BET on the viability and osteogenic differentiation of hFOB 1.19 cells was investigated. The cells were encapsulated in alginate-gelatin (AlGel) microbeads. In vitro tests were conducted during the 12 d of incubation. While BET showed cytotoxic activity (>1 µM) toward non-encapsulated hFOB 1.19 cells, encapsulated cells retained their functionality for up to 12 days, even at 5 µM BET. Moreover, the expression of osteogenic markers indicates an enhanced osteo-inductive effect of betulin on encapsulated hFOB 1.19, compared to the non-encapsulated cell culture. The 3D micro-environment of the AlGel microcapsules successfully protects the hFOB 1.19 cells against BET cytotoxicity, allowing BET to improve the mineralization and differentiation of osteoblast cells.

Comparison of Resorption in Autogenous Dorsal Onlay Cartilage Grafts: An Experimental Study.

The present study was designed to compare the graft resorption characteristics of autogenous cartilage from the septum, auricle, and costal in the superficial muscular aponeurotic system of the nasal dorsum of the rabbit model. Equal-sized perichondrium-free septal, auricular, and costal cartilage grafts were collected from fifteen New Zealand white rabbits. Cartilage grafts were taken at the scale of two grafts from each animal's ear, two from its costal part, and one from its septum. Costal cartilage grafts that were shaped with a micro-motor device and monopolar electrocautery, elastic cartilage grafts that were shaped with a micro-motor device and monopolar electrocautery, and septal cartilage grafts that were shaped with a scalpel were all implanted into the dorsum of rabbit's noses to create five groups. All autogenous cartilage tissues were removed 3months later. Cartilages were evaluated for histological features, graft mass, and chondrocyte density resorption. The elastic cartilage group, where electrocautery was used to shape the cartilage, had a higher resorption score than the other groups. The costal cartilage graft shaped with a micro-motor was also observed to have the best cartilage regeneration score. We observed that the resorption of costal cartilage was lower than that of ear and septum cartilage. It was determined that micro-motor application for the shaping process caused less resorption and stimulated more regeneration than cautery application. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Surgeon preferences in the treatment of thumb carpometacarpal osteoarthritis.

Primary thumb carpometacarpal (CMC) osteoarthritis is one of the most common conditions encountered by hand surgeons. Of the vast number of operations that have been proposed, none have demonstrated results significantly superior to trapeziectomy alone. The purpose of our study was to determine why surgeons opt for their technique in treating CMC arthritis. A cross-sectional survey of active members of the American Society for Surgery of the Hand was conducted to evaluate the reasons behind their preferred technique in the treatment of isolated thumb CMC arthritis. Surgeons were contacted by e-mail once and provided with a link to a de-identified survey consisting of 5 treatment questions and 5 demographic questions. Of 950 responses were received. 40.5% of surgeons preferred trapeziectomy + ligament reconstruction tendon interposition (LRTI), followed by trapeziectomy + suspensionplasty (28.2%), suture button suspension (5.9 %), trapeziectomy alone (4.6%), prosthetic arthroplasty (3.2%), arthrodesis (1.1%), and other (6.6%). Proponents of trapeziectomy + LRTI cited familiarity (73.2%), exposure during fellowship (48.8%) and less proximal migration (60%) to be the main reasons affecting their decision. Surgeons who preferred trapeziectomy + suspensionplasty most reported simplicity (74.9%), fewer complications (45.3%), less proximal migration (43.8%), and avoidance of autogenous tissue harvest (42.7%). Advocates of suture button suspension cited avoidance of autogenous tissue harvest (80.4%), shorter immobilization (76.8%), and quicker recovery (73.2%) with their technique. Advocates of trapeziectomy alone cited simplicity (97.7%), fewer complications (86.4%), and avoidance of autogenous tissue harvest (59.1%). In their comments, 45% of surgeons choosing trapeziectomy alone cited evidence as an additional rationale. Advocates of prosthetic arthroplasty cited improved pinch strength (83.3%) and improved range of motion (63.3%), while those preferring arthrodesis cited better pinch strength (90%) and frequently in their comments, durability. Of the surgeons who preferred a technique other than LRTI, 41.8% reported they had tried LRTI in the past, citing complexity of the procedure, flexor carpi radialis harvest, and longer operative time as reasons for moving on. Our study provides an update on current treatment trends and offers new insight into the reasons behind surgeons' decision making in the management of thumb carpometacarpal osteoarthritis. Despite strong Level 1 evidence supporting the use of trapeziectomy alone, our findings demonstrate that most surgeons continue to supplement trapeziectomy with other techniques such as LRTI or suspensionplasty. Several factors including familiarity, personal experience (Level 4 evidence), and comfort may be more influential than Level 1 evidence in determining the techniques in a surgeon's armamentarium. Further prospective studies are needed to determine the optimal technique for surgical management of Eaton stages II-IV CMC arthritis and how these studies will affect surgeons' choice.

Allotendoplasty in Treatment of Habitual Patella Dislocation in Adults

Background. Habitual dislocation of patella is a congenital disease that manifests in early childhood or adolescent age and requires surgical treatment. In case this condition has not been rectified timely, the congenial patellar luxation develops the properties of a habitual dislocation accompanied by pain syndrome and osteoarthrosis development in the patellofemoral and knee joints. In most cases reconstructive surgery is used for this disease treatment; it is aimed at the strengthening of the knee joint interval compartment, with the formation of a fibrous graſt or a vertical strip of it, which are moved to the knee joint outside compartment and fixed to adjacent tissues with sutures. However, such surgery is possible only in case of preserved anatomic structures of the knee medial compartment. In adult patients, aſter multiple patellar dislocations, the interval joint capsule and medial aponeurosis lose their normal structure, become weakened, strained, and loose. That is why the patient’s own tissues from that area cannot be used for reconstructive surgery.The purpose of the study is to develop the new low-traumatic method of treatment for habitual dislocation of kneecap in adult patients to ensure its reliable stabilization as related to the joint surface on distal femoral epimetaphys, and to prevent patella dislocation relapse.Material and methods. Surgery technique consists of the lateral release of knee joint, mobilization of patellar ligament and its excision together with the fragment of tibial tuberosity osseous. On 1.5–2.0 cm medially from the area of own patellar ligament harvesting in tibia epimetaphys, the new bed with the similar form and shape is formed, and the excised tibial tuberosity fragment with patellar ligament is introduced there and fixed with a Cancellous screw.The area of own patellar ligament harvestingis filled up with autogenous osseous tissue taken from the medial part of tibia epimetaphys when forming the new bed for the excised tibial tuberosity fragment. Transversal tunnelis formedin the quadriceps tendon above the patella; allotendonis pulledvia this tunnel. The allotendon ends are sutured together, thus forming the duplication, analogous to the ligament, and fixit, stretched to “pes anserinus” of the shin onits anterior-interior surface.Conclusion. The new technology of allotendoplasty for the treatment of habitual kneecap dislocation in adult patients facilitates the surgical technique, additionally strengthens medial compartment tissues of the knee, reliably stabilizes the patella as related to its joint surface on distal femoral epimetaphys, eliminates patella dislocation relapse, normalizes the knee and patellofemoral joints functioning by preventing osteoarthrosis progression in them.

Albumin-capped gold nanocluster-integrated human albumin scaffolds: A traceable, xeno-free and customizable template for autogenic tissue engineering applications

Albumin has attracted interest in the field of tissue engineering for fabricating three-dimensional scaffolds due to its stability, unique ligand-binding property, biocompatibility, high solubility and low cost. This study aimed to develop a versatile fluorescent scaffold using human serum albumin (HSA), HSA-capped gold nanoclusters (HSA@AuNCs) and oxidized dextran. The morphological, structural, mechanical and physical properties of the constructs were evaluated using FTIR, SEM, thermogravimetric analysis, swelling, compression, in vitro biocompatibility and degradation tests. Traceability was demonstrated by fluorescence imaging, while Au release from scaffolds was determined by inductively coupled plasma-optical emission spectroscopy. Cell adhesion and proliferation on scaffolds were evaluated using mesenchymal stem cells (MSCs), cellular metabolic activity was assessed by alamarBlue assay for 10 days. The alkaline phosphatase activity of MSCs was followed for up to 21 days. The findings revealed that the HSA/AuNC scaffolds are fluorescent, biodegradable and exhibit good in vitro biocompatibility. In addition, the nanocomposite scaffolds provide a suitable environment for MSCs to adhere, proliferate and maintain their metabolic activities. This work is expected to pave the way for the design of albumin-based scaffolds with different bioactive agents that can be conjugated to the albumin backbone.

IS SYNTHETIC MESHPLASTY THE ONLY METHODFOR INGUINAL HERNIA REPAIR OR ARE THERE OTHER RESOURCEFUL ALTERNATIVES?

There aremultifactorial causes for development ofinguinal hernia.Weakness in the fascia transversalisplays a major role in causing a inguinal hernia. There are different techniques of repair of the inguinal hernia that are currently being practiced. Traditionally, inguinal hernia repair included usage of autogenous tissue (Shouldice, Bassini, Coopers). But the use of synthetic mesh for the repair of inguinal hernia had decreased the recurrence rate. Gradually, the complications associated with the use of synthetic mesh like infections, adhesions, granulomas, fistulae, migrations, etcbecame challenging to deal with. To avoid such complications and to overcome these challenges, we will be using autologous biological tissue i.e, an expanded sac for the repair of inguinal herniain this study.

Salvage treatment of acute respiratory failure after autogenous tissue flap transplantation for chronic empyema with chest wall sinus: a case report and literature review

BackgroundChronic empyema with chest wall sinus is a difficult and complex disease caused by multiple causative factors. It is difficult to control local infection due to its possible combination of bronchopleural fistula (BPF) and residual bone.The relevant literature emphasizes some risk factors for empyema progression after pneumonectomy, while the correlation between empyema and BPF after pneumonectomy increases mortality by infecting the remaining lungs. After pneumonectomy, the lung function of the contralateral side is particularly important.Case presentationThis paper reports a 62-year-old male patient who underwent right pneumonectomy for squamous cell carcinoma of the lung 12 years ago and began to develop empyema with anterior chest wall sinus 3 years ago. After admission, chest computed tomography (CT) showed right pleural effusion and formation of chest wall sinus. According to his clinical symptoms and imaging examination, he was diagnosed as chronic empyema with chest wall sinus.Due to the huge residual cavity of the patient,the clinical effect of using free vastus lateralis myocutaneous flap combined with pedicled pectoralis major muscle flap to fill the abscess cavity was satisfactory,but acute respiratory failure occurred due to left lung aspiration pneumonia after operation.ConclusionsAfter a series of treatment measures such as tracheal cannula, tracheotomy, anti-infection, maintenance of circulatory stability, and rehabilitation training, the patient was ultimately rescued and cured. Postoperative follow-up showed that the muscle flaps survived and empyema was eliminated.

Therapeutic effectiveness of keratinized mucosa augmentation for functioning dental implants: A systematic review and meta-analysis.

This study aimed to provide the latest updates on the therapeutic effectiveness of keratinized mucosa (KM) augmentation using autogenous soft tissue grafts for dental implants retaining prostheses. A systematic search of electronic databases was conducted on autogenous soft tissue grafts to create and/or augment KM for functioning dental implants. Two investigators independently extracted data from the selected 11 clinical studies, including 290 participants, from the initially retrieved 573 publications. A lack of KM surrounding dental implants was associated with greater mucosal inflammation. A free gingival graft (FGG) was used to increase the KM width, and a connective tissue graft (CTG) was used to manage peri-implant mucosal recession (MR). The weighted mean gain in KM was 2.6 mm from the selected FGG studies, with a significant reduction in mucosal inflammation and no changes in crestal bone levels for up to 4 years. The weighted mean reduction in MR was 2 mm in selected CTG studies. A lack of KM negatively affects soft tissue health around dental implants. FGG was effective in increasing KM and reducing mucosal inflammation, whereas CTG was effective in decreasing MR.

Bacterial cellulose matrix and acellular dermal matrix seeded with fibroblasts grown in platelet-rich plasma supplemented medium, compared to free gingival grafts: a randomized animal study.

Mucogingival defects (MGDs), such as dental root recessions, decreased vestibular depth, and absence of keratinized tissues, are commonly seen in dental clinics. MGDs may result in functional, aesthetic, and hygienic concerns. In these situations, autogenous soft tissue grafts are considered the gold-standard treatment. This study compares the healing process of free gingival grafts (FGGs) to bacterial cellulose matrix (BCM) and human acellular dermal matrix (ADM) seeded with fibroblasts from culture supplemented with platelet-rich plasma in a rat model. Surgical defects were made in rats, which received the following treatments in a randomized manner: group I, negative control (defect creation only); group II, positive control (FGG); group III, BCM; group IV, BCM + fibroblasts; group V, ADM; and group VI, ADM + fibroblasts. Clinical, histological, and immunological analyses were performed 15 days after grafting. Clinical examinations recorded epithelium regularity and the presence of ulcers, erythema, and/or edema. The histological analysis revealed the degree of reepithelization, width, regularity, and presence of keratin. The Fisher exact statistical test was applied to the results (P<0.05). No groups showed ulcers except for group I. All groups had regular epithelium without erythema and without edema. Histologically, all groups exhibited regular epithelium with keratinization, and myofibroblasts were present in the connective tissue. The groups that received engineered grafts showed similar clinical and histological results to the FGG group. Within the limitations of this study, it was concluded that BCM and ADM can be used as cell scaffolds, with ADM yielding the best results. This study supports the use of this technical protocol in humans.

The Use of Autogenous Teeth Tissues Grafts for Alveolar Bone Reconstruction: a Systematic Review.

Enough bone around the implant is an important factor in ensuring the stability and longevity of the implant. Therefore, alveolar bone regeneration procedures are often required. A relatively new bone substitute is made from autogenous teeth. There are more and more studies in the scientific literature that perform regenerative alveolar bone procedures using autogenous tissues substitutes made from extracted teeth. The objective of this systematic literature review is to systematize information and present conclusions about the effectiveness of this regenerative material. Scientific articles were selected using the PRISMA recommendations. Publications have been carried out since January 1, 2012 to January 1, 2022. The review includes articles in English, clinical studies in humans who underwent bone augmentation prior to or during dental implantation using an autogenous teeth tissues substitute. A total of 7 publications were included in this systematic literature review. Summarizing the data of the publications, 258 patients participated in the studies, 240 subjects were included in the results for various reasons, and a total of 298 implants were inserted. No statistically significant results were found in the five studies. Two studies comparing autogenous tooth graft with xenogeneic bone graft and autogenous teeth tissues showed statistically significant positive results in autogenous tooth group. Within the limitations of this study, autogenous tissues graft derived from teeth are an effective material and can be used as an alternative to other bone grafts existing on the market. Further studies with a longer follow-up period are needed to validate these findings.

Management of failed autogenous tissues temporomandibular joint reconstruction: case series and literature review

Management of failed autogenous tissues temporomandibular joint reconstruction: case series and literature review

Comparative analysis of xenogeneic collagen matrix and autogenous subepithelial connective tissue graft to increase soft tissue volume around dental implants: a systematic review and meta-analysis

ObjectiveThe gold standard for a soft tissue augmentation around implants is a subepithelial connective tissue graft (CTG), but the xenogeneic collagen matrices (XCM) started to be used as an alternative. This systematic review aimed to assess the effectiveness XCM in comparison to CTG for the increasing the thickness of the soft tissue around implants.DataAll studies included at least two parallel groups comparing the use of CTG and XCM with a minimum follow-up of 3 months. As the primary outcome, the amount of soft tissue thickness gain after soft tissue augmentation with XCM or CTG was assessed. Secondary outcomes were clinical and patient-related outcomes; evaluation of aesthetic outcomes, patient-reported outcomes measures (PROMs) and complications. Eligible studies were selected based on the inclusion criteria. Meta-analysis was applied whenever possible. The quality of the evidence of studies including in meta-analysis was assessed using the GRADE approach.SourceA systematic literature search up to January 2022 was conducted using the following electronic databases: PubMed (MEDLINE), Scopus, Cochrane Library, LILACS, eLIBRARY.RU. Unpublished researches, the gray literature, nonprofit reports, government studies and other materials were reviewed electronically using an EASY search. An additional manual search was carried out in November 2022.Study selectionOf the 1376 articles from the initial search, 8 randomized controlled trials (RCTs) (306 patients and 325 implants) were included in this systematic review, and 7 studies were part of the meta-analysis. Meta-analysis revealed that XCM is less effective than the CTG in increasing soft tissue thickness around dental implants. However, XCM also provides soft tissue thickness gain and can be recommended for use in various clinical situations.Clinical significancePrevious systematic reviews and meta-analyses have shown that autologous grafts are more effective than collagen matrices in increasing soft tissue thickness, however, the latter can be used as an alternative. Studies included in previous systematic reviews varied in design, which could lead to limitations. The present systematic review and meta-analysis includes for the first time only randomized controlled clinical trials with collagen matrix of xenogeneic origin in the test group. Tight eligibility criteria were established, and the main parameter studied was soft tissue thickness. It was found that xenogeneic collagen matrix is effective for increasing soft tissue thickness around dental implants, however, the results obtained using an autogenous connective tissue graft are superior.

Revision Anterior Cruciate Ligament Reconstruction: Current Approaches to Preoperative Planning (Systematic Review)

Background. The number of primary anterior cruciate ligament (ACL) reconstructions increases every year, which causes an increase in revision interventions due to ACL graft failure. When studying the literature, we identify many factors that together influence the outcome of revision ACL reconstruction, but are not always taken into account by surgeons.&#x0D; Aim of the review — is to perform a systematic review of studies that evaluated the outcomes of revision anterior cruciate ligament reconstructions and to identify optimal solutions to the most common problems encountered in preoperative planning.&#x0D; Methods. Information search was performed in the eLIBRARY, PubMed, and Scopus databases for the period from 2013 to 2022. Studies describing the main aspects of revision ACL reconstruction were selected for analysis. Inclusion criteria were the following: mean patient follow-up period of no less than 12 months, number of observations of no less than 10 cases. After evaluation of 898 articles, 22 articles were included in the systematic review.&#x0D; Results. Five main factors that should be taken into account in preoperative planning of revision ACL reconstruction have been identified: choice of the graft, necessity of reconstruction of the anterolateral complex, correction of tibial plateau deformity in the sagittal plane, determination of indications for one- or two-stage intervention, method of bone defect replacement in two-stage surgical treatment.&#x0D; Conclusion. The patient’s autogenous tissues should be preferred when choosing a graft. Correction of excessive anteroposterior tibial plateau inclination angle is performed only at the second revision intervention if the inclination angle exceeds 12º. Reconstruction of the anterolateral complex should be performed in young, active patients who are involved in pivot sports and in case of severe anterior instability. When determining the possibility of performing revision ACL reconstruction in one or two stages, the canal diameter is not a crucial parameter, as it is necessary to take into account the possibility of fusion of the canals from the previous surgery with the newly created ones. If the canals have correct entry points, one-stage revision reconstruction can be performed with the canal width not exceeding 10 mm and depending on the expected diameter and type of the prepared tendon graft. Bone grafting of the secondary dilated canals in two-stage intervention can be carried out using any material, but allogenous bone or synthetic grafts have certain advantages.