Graft Stability Research Articles

GraftFast Surface Engineering to Improve MOF Nanoparticles Furtiveness.

Controlling the outer surface of nanometric metal-organic frameworks (nanoMOFs) and further understanding the in vivo effect of the coated material are crucial for the convenient biomedical applications of MOFs. However, in most studies, the surface modification protocol is often associated with significant toxicity and/or lack of selectivity. As an alternative, how the highly selective and general grafting GraftFast method leads, through a green and simple process, to the successful attachment of multifunctional biopolymers (polyethylene glycol (PEG) and hyaluronic acid) on the external surface of nanoMOFs is reported. In particular, effectively PEGylated iron trimesate MIL-100(Fe) nanoparticles (NPs) exhibit suitable grafting stability and superior chemical and colloidal stability in different biofluids, while conserving full porosity and allowing the adsorption of bioactive molecules (cosmetic and antitumor agents). Furthermore, the nature of the MOF-PEG interaction is deeply investigated using high-resolution soft X-ray spectroscopy. Finally, a cell penetration study using the radio-labeled antitumor agent gemcitabine monophosphate (3 H-GMP)-loaded MIL-100(Fe)@PEG NPs shows reduced macrophage phagocytosis, confirming a significant in vitro PEG furtiveness.

Segmental bone replacement via patient-specific, three-dimensional printed bioresorbable graft substitutes and their use as templates for the culture of mesenchymal stem cells under mechanical stimulation at various frequencies.

The treatment of large segmental bone defects remains a challenge as infection, delayed union, and nonunion are common postoperative complications. A three-dimensional printed bioresorbable and physiologically load-sustaining graft substitute was developed to mimic native bone tissue for segmental bone repair. Fabricated from polylactic acid, this graft substitute is novel as it is readily customizable to accommodate the particular size and location of the segmental bone of the patient to be replaced. Inspired by the structure of the native bone tissue, the graft substitute exhibits a gradient in porosity and pore size in the radial direction and exhibit mechanical properties similar to those of the native bone tissue. The graft substitute can serve as a template for tissue constructs via seeding with stem cells. The biocompatibility of such templates was tested under in vitro conditions using a dynamic culture of human mesenchymal stem cells. The effects of the mechanical loading of cell-seeded templates under in vitro conditions were assessed via subjecting the tissue constructs to 28 days of daily mechanical stimulation. The frequency of loading was found to have a significant effect on the rate of mineralization, as the alkaline phosphatase activity and calcium deposition were determined to be particularly high at the typical walking frequency of 2 Hz, suggesting that mechanical stimulation plays a significant role in facilitating the healing process of bone defects. Utilization of such patient-specific and biocompatible graft substitutes, coupled with patient's bone marrow cells seeded and exposed to mechanical stimulation of 2 Hz have the potential of reducing significant volumes of cadaveric tissue required, improving long-term graft stability and incorporation, and alleviating financial burdens associated with delayed or failed fusions of long bone defects.

Randomized interventional trial comparing conjunctival autograft secured with Sutures versus fibrin glue in primary pterygium excision

Background: An ideal pterygium surgery should achieve three principal goals: a low recurrence rate, absence of complications, and satisfactory cosmesis. Natural substances, such as fibrin, have significant advantage in achieving these goals. Aim: To compare the primary & secondary outcomes following primary pterygium excision with conjunctival auto graft using fibrin glue versus sutures. Methodology: A prospective interventional study was conducted at Department of Ophthalmology, Annapoorana medical college& Hospital, Salem, India, for a period of one year from June 2016 to May 2017. A total of 87 patients were included in the study. They were randomized into two groups. Group I received conjunctival auto graft secured with glue and Group II received conjunctival auto graft secured with suture. Postoperatively the patients were followed for a period of 6 months for measuring the primary and secondary outcomes.  Results: The mean rank score for graft inflammation, and patients discomfort was less in fibrin glue group when compared to suture group during the follow-up period from 15th to 90th postoperative day and the difference was found to be statistically significant, whereas the mean rank for graft stability was lower in the suture group when compared to the fibrin glue group with a statistical significant difference between the two group. Conclusion: The use of fibrin glue removes the need for the tedious suturing process, the learning curve can be shortened, and better results may be more consistently achieved despite differences in surgical expertise.

Current trends in the management of degenerative lumbar spondylolisthesis.

Degenerative spondylolisthesis (DS) is a common disease of the degenerative spine, often associated with lumbar canal stenosis. However, the choice between the different medical or surgical treatments remains under debate.Preference for surgical strategy is based on the functional symptoms, and when surgical treatment is selected, several questions should be posed and the surgical strategy adapted accordingly.One of the main goals of surgery is to improve neurological symptoms. Therefore, radicular decompression may be necessary. Radicular decompression can be performed indirectly through interbody fusion or interspinous spacer. However, indirect decompression has some limits, and the most frequent technique is a posterior decompression with fusion.Indeed, in cases of DS, associated fusion or dynamic stabilization are recommended to improve functional outcomes and prevent future destabilization. Risk factors for destabilization, such as anteroposterior and angular mobility, and significant disc height, have been discussed in the literature. When fusion is performed, osteosynthesis is often associated. It is essential to choose the length and position of the fusion according to the pelvic incidence and global alignment of the patient. It is possible to add interbody fusion to the posterolateral arthrodesis to improve graft area and stability, increase local lordosis and open foramina.The most common surgical treatment for DS is posterior decompression with instrumented fusion. Nevertheless, some cases are more complicated and it is crucial to consider the patient’s general health status, symptoms and alignment when selecting the surgical strategy.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170050

A bigger suture diameter for anterior cruciate ligament all-inside graft link preparation leads to better graft stability: An anatomical specimen study

BackgroundIn anterior cruciate ligament reconstruction, different suture types are used for graft link preparation. Thus the aim of this study was to determine whether differences in the diameter of the suture used influence biomechanical stability of the prepared graft. We hypothesized that the use of a greater suture diameter leads to a higher load to failure rate in tested graft links. MethodsIn an anatomic specimen study, ligament preparation was enrolled in 15 cadaveric knees. The material used was the semitendinosus/gracilis tendon, which was fresh frozen (−80°) after harvesting for four weeks. The grafts were then defrosted, randomized into two groups and prepared with the same technique: 12 with a suture; FiberWire No. 2 and 12 with a FiberWire No. 0. ResultsOverall, the group using FiberWire No. 2 presented with a mean load to failure rate of 730.67N, mean overall final elongation of the graft was 5.98mm. In the FiberWire No. 0 group mean load to failure was with a mean overall elongation of the graft of 6.96mm. Significant differences (P=0.006) between the two groups with regard to the load to failure rate were found, with FiberWire No. 2 withstanding forces better. There was no difference in elongation of the grafts or mode to failure between the two groups. ConclusionsGraft preparation with a bigger suture type is recommended to gain better load to failure rates, also in smaller-diameter grafts. Regarding the elongation rate, different suture types did not influence the outcome. Level of evidenceAnatomical specimen study, Level III.

ACL graft compression: a method to allow reduced tunnel sizes in ACL reconstruction.

A common problem during ACL reconstruction is asymmetry of proximal-distal graft diameter leading to tunnel upsizing and graft-tunnel mismatch. Compression downsizing provides a graft of uniform size, allowing easy passage into a smaller tunnel. The purpose of this study was to quantify the graft compression technique and its effects on graft biomechanics and stability. It was hypothesised that compression downsizing would significantly reduce cross-sectional area (CSA); that no significant changes in graft biomechanics would occur; graft fixation stability would be improved. Sixty-eight non-irradiated peroneus longus (PL) tendons were investigated. Twenty were halved and paired into ten four-strand grafts, 20 strands were compressed by 0.5-1mm diameter and changes in CSA recorded using an alginate mould technique. The following properties were compared with 20 control strands: cyclic strain when loaded 70-220N for 1000 cycles; stiffness; ultimate tensile load and stress; Young's modulus. 24 PL tendons were quadrupled into grafts, 12 were compressed and all 24 were submerged in Ringer's solution at 37°C and the CSA recorded over 12h. Twelve compressed and 12 control quadrupled grafts were mounted in porcine femurs, placed in Ringer's solution for 12h at 37°C and graft displacement at the bone tunnel aperture recorded under cyclic loading. Mean decreases in CSA of 31% under a stress of 471kPa and 21% under a stress of 447kPa were observed for doubled and quadrupled grafts, respectively. Compressed grafts re-expanded by 19% over 12h compared to 2% for controls. No significant differences were observed between compressed and control grafts in the biomechanical properties and graft stability; mean cyclic displacements were 0.3mm for both groups. No detrimental biomechanical effects of graft compression on allograft PL tendons were observed. Following compression, the grafts significantly increased in size during in vitro joint simulation. No significant difference was observed in graft stability between groups. Graft compression did not cause adverse mechanical effects in vitro. Smaller tunnels for compressed grafts reduce bone loss and ease anatomical placement.

Bony bridge resorption after secondary alveolar grafting and correlation with success of orthodontic treatment: A prospective volumetric cone beam computed tomography (CBCT) study

BackgroundCleft lip/palate is the second most observed congenital defect which constitutes a serious dental–medical–social problem. Successful uptake and stability of alveolar graft is required to achieve closure of the oro-nasal fistula and continuity of the dental arches. Resorption of bone graft may compromise the results achieved. This study determined the bony bridge volume required for successful repair of alveolar cleft, evaluated the resorption after 3 months of grafting and correlated the success of orthodontic treatment. Methods30 patients with unilateral cleft lip and palate requiring secondary alveolar bone grafting and orthodontic correction were included in the study. After arch expansion and before alveolar grafting using cone beam computed tomography (CBCT) of maxilla was recorded and was repeated after 3 months of alveolar bone grafting to estimate the volume of grafted bone in the cleft. ResultsThe bridge bone volume resorption after 3 months post-operative ranged from 14% to 100% with a mean of 36.46%. The percentage of resorption of alveolar bone graft after 3 months of surgery was statistically significant. Success of orthodontic treatment was statistically significant when correlated with percentage of resorption. ConclusionThe accurate localization and estimation of the size and extent of alveolar cleft area is important for treatment planning. Post-operative it is important to analyze the outcome of transplanted bone as early as possible. Early evaluation can help to predict the outcome of transplanted bone and may guide to re-grafting of the site immediate or to restart any interrupted orthodontic procedure, if necessary.

Anterosuperior anchoring myringoplasty using cyanoacrylate glue can prevent packing gelfoam in the middle ear cavity

ObjectivesAlthough a number of methods have been attempted to improve securing the graft, packing gelfoam in the middle ear cavity cannot be avoided, which could obstruct the tympanic ostium of the Eustachian tube and affect inner ear function. Myringoplasty using tissue adhesive has gained traction because tissue adhesives can effectively stabilise the graft and act as scaffolding to improve the graft uptake. The aim of this prospective study was to explore myringoplasty using cyanoacrylate glue with no packing in the middle ear cavity for the repair of subtotal tympanic membrane (TM) perforations. MethodsBetween March 2014 and November 2015, 71 patients with subtotal TM perforations were randomly and prospectively divided into a glue group and a control group. Two securing techniques were performed using only cyanoacrylate glue or using only filling gelfoam in the middle ear cavity, respectively, during an anterosuperior anchoring myringoplasty operated by a single surgeon. ResultsAt a 6-month follow-up, the graft uptake rate was 87% in the glue group and 89% in the control group. A significant hearing improvement was found in both groups postoperatively when compared to the preoperative values (P<0.05 for both). There was no significant difference in the graft uptake rate and hearing improvement between the 2 groups (P>0.05). Similar complications were found in each group. ConclusionCyanoacrylate glue is a helpful material for graft stabilisation and can substitute for filling gelfoam in the middle ear cavity during anterosuperior anchoring myringoplasty for subtotal TM perforation.

Impact of surgical management in cases of intraoperative membrane perforation during a sinus lift procedure: a follow-up on bone graft stability and implant success

BackgroundUntil now, sinus floor elevation represents the gold standard procedure in the atrophic maxilla in order to facilitate dental implant insertion. Although the procedure remains highly predictive, the perforation of the Schneiderian membrane might compromise the stability of the augmented bone and implant success due to chronic sinus infection. The aim of this retrospective cohort study was to show that a membrane tear, if detected and surgically properly addressed, has no influence on the survival of dental implants and bone resorption in the augmented area.MethodsThirty-one patients with 39 perforations could be included in this evaluation, and a control group of 32 patients with 40 sinus lift procedures without complications were compared regarding the radiographically determined development of bone level, peri-implant infection, and implant loss.ResultsImplant survival was 98.9% in the perforation group over an observation period of 2.7 (± 2.03) years compared to 100% in the control group after 1.8 (± 1.57) years. The residual bone level was significantly lower in the perforation group (p = 0.05) but showed no difference direct postoperatively (p = 0.7851) or in the follow-up assessment (p = 0.2338). Bone resorption remained not different between both groups (p = 0.945). A two-stage procedure was more frequent in the perforation group (p = 0.0003) as well as peri-implantitis (p = 0.0004).ConclusionsWithin the limits of our study, the perforation of the Schneiderian membrane did not have a negative impact on long-term graft stability or the overall implant survival.

Bone augmentation followed by implant surgery in the edentulous mandible: A systematic review.

Long-standing loss of natural teeth in the mandible can lead to severe jaw atrophy and even mandibular fracture. There is no consensus on the best pre-prosthetic surgical treatment to reconstruct the atrophic edentulous mandible. The purpose of this review was to provide an overview of the existing literature and to give an evidence-based recommendation for bone grafting and future research. This systematic review was conducted according to the PRISMA statement. A literature search was performed in online databases Pubmed and Cochrane library for articles published between January 1980 and September 2017. The search was conducted using Medical Subject Heading terms: alveolar ridge augmentation; mouth, edentulous and mandible. Eligible articles were included according to in- and exclusion criteria and assessed on quality. Dental implant survival and bone stability were the primary outcomes. Secondary outcomes were complications. Twenty-four text articles matched the criteria and were included. Eleven articles were assessed to be of adequate quality for analysis. Graft stability seems to be higher in vertical distraction and tent-pole grafting, but as the dental implant survival is high (91.7% or higher) regardless of the procedure used for bone augmentation, this is of no clinical relevance. The survival rate of dental implants is high, regardless of the bone augmentation procedure used. High-quality clinical trials are needed to support the current evidence and guidelines on pre-implant bone grafting. Reporting of future research should include proper baseline characteristics and treatment description, as well as uniform outcome rendering.

Effect of COX-2 inhibition on tendon-to-bone healing and PGE2 concentration after anterior cruciate ligament reconstruction

BackgroundNon-steroidal anti-inflammatory drugs are commonly used to reduce pain and inflammation in orthopaedic patients. Selective cyclooxygenase-2 (COX-2) inhibitors have been developed to minimize drug-specific side effects. However, they are suspected to impair both bone and tendon healing. The objective of this study is to evaluate the effect of COX-2 inhibitor administration on tendon-to-bone healing and prostaglandin E (PGE2) concentration.MethodsThirty-two New Zealand white rabbits underwent reconstructions of the anterior cruciate ligaments and were randomized into four groups: Two groups postoperatively received a selective COX-2 inhibitor (Celecoxib) on a daily basis for 3 weeks, the two other groups received no postoperative COX-2 inhibitors at all and were examined after three or 6 weeks. The PGE2 concentration of the synovial fluid, the osseous integration of the tendon graft at tunnel aperture and midtunnel section, as well as the stability of the tendon graft were examined via biomechanic testing.ResultsAfter 3 weeks, the PGE2 content of the synovial fluid in the COX-2 inhibitor recipients was significantly lower than that of the control group (p = 0.018). At the same time, the COX-2 inhibitor recipients had a significantly lower bone density and lower amount of new bone formation than the control group (p = 0.020; p = 0.028) in the tunnel aperture. At the 6-week examination, there was a significant increase in the PGE2 content within synovial fluid of the COX-2 inhibitor recipients (p = 0.022), whose treatment with COX-2 inhibitors had ended 3 weeks earlier; in contrast, the transplant stability decreased and was reduced by 37% compared to the controls.ConclusionsSelective COX-2 inhibitors cause impaired tendon-to-bone healing, weaken mechanical stability and decrease PGE2 content of the synovial fluid. The present study suggests a reluctant use of COX-2 inhibitors when tendon-to-bone healing is intended.

Simultaneous and delayed direct sinus lift versus conventional implants: Retrospective study with 5-years minimum follow-up

BackgroundTo compare the radiological parameters and success of posterior maxillary direct sinus lift with simultaneous or delayed implant placement, or implant placement in native bone, after a minimum follow-up period of 5 years.Material and MethodsA retrospective cohort study was carried out in a university clinic, selecting patients subjected to implant treatment in the posterior maxilla between the years 2005 and 2011. The patients were divided into three groups: 1) implants placed in native bone; 2) direct sinus lift with simultaneous implant placement; and 3) direct sinus lift with delayed implant placement. Bone crest level, bone loss, vertical bone gain, and implant success and survival after a minimum follow-up period of 5 years after prosthetic loading were analyzed.ResultsA total of 163 patients and 329 implants were included in the study. The mean duration of follow-up was 7.0 ± 1.9 years. Bone loss and implant success and survival were very similar in all three groups, with no significant differences among them. Graft reabsorption was greatest during the first 12 months, though graft stabilization was confirmed after 5 years of follow-up.ConclusionsBone loss and percentage success and survival proved very similar for the implants placed in native bone and for sinus lift with simultaneous or delayed implant placement. The height of the graft material decreased mainly in the first 12 months, and continued until stabilization after 5 years, with no significant variations thereafter. Key words:Sinus lift, pristine bone, native bone, dental implants, marginal bone loss, radiological study, implant survival, implant success.

Arthroscopic Delivery of Injectable Bone Graft for Staged Revision Anterior Cruciate Ligament Reconstruction

Bone defects caused by femoral and tibial tunnel enlargement can pose a significant technical challenge when planning to perform revision anterior cruciate ligament reconstruction. A number of options have been described for managing osseous deficiencies, including the use of large autograft or allograft bone dowels to provide sufficient tunnel fill and subsequent structural support for revision surgery. These techniques can be time-consuming and technically demanding to ensure proper tunnel fill and press-fit stability of the bone graft. We describe our preferred technique for arthroscopic bone grafting using a mixture of demineralized cortical bone graft augmented with platelet-rich plasma delivered through a simple delivery system.

Polyurethane Foam Wound Dressing Technique for Areola Skin Graft Stabilization and Nipple Protection After Nipple-Areola Reconstruction.

We describe a new wound management technique using a soft dressing material to stabilize the areola skin graft and protect the nipple after nipple-areola reconstruction at the final stage of breast reconstruction. We introduced a center-fenestrated multilayered hydrocellular polyurethane foam dressing material that provides adequate pressure and retains a moist environment for a smooth skin graft "take." Moreover, the reconstructed nipple can be monitored at any time through the fenestrated window for adequate blood circulation. Altogether, this simple and inexpensive wound dressing technique improves the clinical outcome. Level of Evidence IV 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 Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Bone grafts used for arthroscopic glenoid reconstruction restore the native glenoid anatomy.

Recurrent anterior instability of the glenohumeral joint is a demanding condition, especially in cases of glenoid bone loss. Various treatment options have been described, such as arthroscopic grafting techniques and the Latarjet procedure. In this study, the degree to which an arthroscopically applied iliac crest graft restores the glenoid anatomy was evalutated. Nine patients (three women and six men) with an average age of 31 ± 9years (21-46years) who were treated with an arthroscopic iliac crest graft technique were included in this study. After a mean follow up of 34 ± 10months (19-50months) after the procedure, MRI scans of both shoulders were performed and the glenoid width, Glenoid Index (GI), Pixel Signal intensity (PSI), thickness of the tissue covering the articular aspect of the graft, inclination, version, concavity and balance stability angle were measured. All scans showed the cultivation of tissue on the graft, which visually resembled the cartilage of the native ipsilateral glenoid. Additionally, reshaping of the graft to repair the glenoid configuration could be observed. Glenoid width (p = 0.022) and GI (p < 0.001) increased significantly through surgery. The tissue examined on the graft showed a significant pixel intensity gap (p = 0.017) but comparable thickness (n.s.) in relation to native cartilage. The remaining parameters did not differ significantly between both shoulders. In the cohort presented, iliac crest grafts were able to restore the glenoid configuration, and the glenoid was re-shaped to its native contour. Additionally, cartilage-like scar tissue with similar thickness as healthy cartilage was formed on the articular side of the graft. These results suggest that glenoid reconstruction is not only important for prevention of recurrence, but also for restoration of the native glenoid anatomy. Level III-retrospective cohort study.

Volumetric graft stability at bone guided regeneration sites with simultaneous implants placement. a control randomized clinical study with results up to 2 years

Volumetric graft stability at bone guided regeneration sites with simultaneous implants placement. a control randomized clinical study with results up to 2 years

A pilot study to evaluate the efficacy of fibrin glue in attaching full thickness skin graft in repair of cicatricial ectropion

Background: Traditionally, sutures are used to attach skin graft. Periocular skin reconstruction is peculiar in respect of constant movement of the graft bed due to lid movements. This study was aimed at evaluating the use of fibrin glue in skin graft for cicatricial ectropion.Methods: This was prospective, non-randomized, interventional study. Total 10 patients with cicatricial ectropion were recruited. After dissection of scar, skin defect was covered with full thickness post auricular graft. Fibrin glue used to attach the graft over host bed. Bolster tied and bandage applied. Patients were evaluated for graft stability, opposition of graft host junction and graft uptake.Results: The mean age was 30.9 years. Patients were divided into three groups i.e. 20-30 years, 30-40 years and 40-50 years. There were 05 patients (50%) in first group, 03 patients (30%) in second group and 02 patients (20%) in third group. Majority (90%) were male. Following injury 70% patients reported between 1-3 years. Grade 3 ectropion was most common (60%). Average duration of surgery was 79.3 min (standard deviation of 14.15 min). Horizontal dimensions of graft, 32 mm maximum and 26 mm minimum (average 29 mm). Vertical dimensions of graft, 18 mm maximum and 12 mm minimum (average 15 mm). Graft uptake was complete in all cases. No cases of graft infection or necrosis. However, 03 patients had residual ectropion.Conclusions: Use of fibrin glue in attaching full thickness skin graft is an effective and safe technique with good uptake and stable graft host junction.

Femoral Nonunion With Iliac Crest Bone Graft

Fracture nonunion is a common problem for today's orthopaedic surgeon. However, many techniques are currently available for the treatment of long-bone nonunion. This video demonstrates the use of iliac crest bone graft and plate stabilization in the setting of a hypertrophic femoral nonunion. Treatment of femoral nonunion after intramedullary nail fixation using compression plating and bone grafting is a reliable technique for reducing pain, improving function, and achieving radiographic union. Furthermore, the use of autologous bone graft, in particular iliac crest bone graft, has provided reliable clinical results. In this video, we present the case of a hypertrophic femoral nonunion treated with supplemental bone grafting in addition to plate and screw fixation. Although femoral nonunions are a relatively rare occurrence, they can be reasonably treated using stabilization and supplemental bone grafting. Iliac crest bone graft provides for excellent results when used for treatment of a fracture nonunion.

The rate and stability of mandibular block bone graft in recent 5\xa0years

BackgroundThe purposes of the present study were to compare implant stabilities of mandibular block bone graft and bovine bone graft and to evaluate influencing factors for implant stability in mandibular block bone (MBB) graft.MethodsThis retrospective study investigated 1224 cases and 389 patients treated by one surgeon in the Department of Oral and Maxillofacial Surgery of Pusan National University Dental Hospital (Yangsan, Korea) between January 2010 and December 2014. Proportions that MBB graft cases constitute in all implant restoration cases and in all bone graft cases were measured. Implant stability quotient (ISQ) values were achieved by the same surgeon before loading. The average ISQ values of the experimental groups were compared. In addition, ISQ values of influencing factors, such as age, sex, implant size, and implant placement site, were compared within the MBB group using OsstellTM Mentor (Osstell®, Göteborg, Sweden). Paired t test and ANOVA were conducted for statistical analysis with a significance level of 0.05.ResultsFifty-five percent of all implant restoration cases performed bone graft while MBB cases constituted 34% of all implant restoration cases and 61% of all bone graft cases. Comparing ISQ values according to bone graft materials, the MBB group manifested sufficient implant stability by presenting comparable ISQ value to that of the experimental group without bone graft. Among the reviewed factors, females, mandibular molar regions, and implants in larger diameter displayed greater implant stabilities.ConclusionsSatisfactory implant stability was accomplished upon administration of MBB graft. Within the limitation of this study, gender, implant site, and implant diameter were speculated to influence on implant stability in MBB graft.

Postoperative Clinical Evolution of Edentulous Patients Treated by Guided Bone Regeneration Using Xenograft Bone Substitute and Collagen Membrane

This paper aims to assess the postoperative evolution of edentulous patients treated by guided bone regeneration technique using a xenograft bone substitute (Cerabone) and collagen membrane. A group of 40 patients, programmed for guided bone regeneration, randomly divided between laser-assisted technique and scalpel technique, were investigated to compare the postoperative evolution, healing time and prevalence of new bone formation, graft stability and inflammatory reactions. The guided bone regeneration technique associated with laser or scalpel technique offers reliable and predictable treatment results in the implant-prosthetic treatments. The accelerated healing time recommends the laser technique in the surgical procedures used for the alveolar augmentation.