Ridge Thickness Research Articles

In Situ Measurement of Oil Reservoir and Oil Layers by Fluorescence Technique in a Ball-on-Disc Test Rig

Abstract The major oil supply for the ball-on-disc contact is provided by the lubricating oil reservoir and the oil ridges; however, the regularity of their changes has not been thoroughly investigated. In this study, the laser-induced fluorescence technique was adopted to determine the film distribution of the oil reservoir and the layer thickness of the oil ridges on the free surface. It clearly depicts the changes in the oil reservoir and reveals the mechanism of the oil reflow surrounding the contact region under various driving actions. The results may give a new perspective and a fuller understanding of the lubricating oil supply by revealing additional information about the oil supply surrounding the contact region.

Associations of the left atrial epicardial fat thickness with the thrombosis prevalence and left atrial appendage flow velocity in patients with persistent non-valvular atrial fibrillation

Aim. To study the associations of the left atrial epicardial fat (LAEF) thickness with the thrombosis prevalence and left atrial appendage (LAA) flow velocity in patients with persistent non-valvular atrial fibrillation (AF).Material and methods. Transesophageal echocardiography in 475 patients with persistent non-valvular AF (men 58,9%, age 64,0 (58,3-70,0) years) assessed LAA flow velocity, interatrial septum and left lateral ridge thickness. Their average thickness was used to estimate the LAEF volume.Results. LAA thrombus was detected in 42 (8,8%) patients. LAA flow velocity without thrombus was 32,0 (26,0-39,0) cm/s, with thrombus — 20,0 (14,0-25,8) cm/s (p<0,0001). Depending on the LAEF thickness, patients were divided into 3 tertile groups: group 1 (n=168) — 5,6-7,4 mm, group 2 (n=154) — 7,45-8,2 mm, group 3 (n=153) — 8,25-10,9 mm. In group 1, no thrombus was detected, in group 2, thrombus was detected in 2 (1,3%) patients, in group 3 — in 40 (26,0%) patients (p<0,0001). In the absence of LAA thrombus, flow velocity in the selected groups did not differ (32,0 (26,0-39,0) cm/s, 31,0 (26,0-7,8) cm/s and 31,5 (25,0-40,0) cm/s, (p=0,9514)).Conclusion. EFL thickness, calculated as the average of interatrial septum and left lateral ridge thickness, can be used to study the relationship between epicardial obesity and LAA thrombosis in patients with AF. In patients with persistent non-valvular AF with a LAEF thickness >8,2 mm, LAA thrombosis occurs more than 40 times more often than in patients with a lower LAEF thickness. The influence of LAEF thickness on LAA flow velocity was not revealed in the pre­sent study.

Impact of different cephalometric skeletal configurations on anatomic midface parameters in adults

ObjectivesSkull morphology and growth patterns are essential for orthodontic treatment, impacting clinical decision making. We aimed to determine the association of different cephalometric skeletal configurations on midface parameters as measured in 3D CT datasets.Materials and methodsAfter sample size calculation, a total of 240 fully dentulous patients between 20 and 79 years of age (mean age: 42 ± 15), who had received a CT of the skull within the scope of trauma diagnosis or intracranial bleeding, were retrospectively selected. On the basis of cephalometric analysis, using MPR reconstructions, patients were subdivided into three different vertical skull configurations (brachyfacial, mesofacial, dolichofacial) and the respective skeletal Class I, II, and III relationships. Anatomic parameters were measured using a three-dimensional post-processing console: the thickness of the maxillary and palatine bones as well as the alveolar crest, maxillary body and sutural length, width and height of the hard palate, maxillary facial wall thickness, and masseter muscle thickness and length.ResultsIndividuals with brachyfacial configurations had a significantly increased palatal and alveolar ridge thicknesses compared to those with dolichofacial- or mesofacial configurations. Brachyfacial configurations presented a significantly increased length and thickness of the masseter muscle (4.599 cm; 1.526 cm) than mesofacial (4.431 cm; 1.466 cm) and dolichofacial configurations (4.405 cm; 1.397 cm) (p < 0.001). Individuals with a skeletal Class III had a significantly shorter palatal length (5.313 cm) than those with Class I (5.406 cm) and Class II (5.404 cm) (p < 0.01). Sutural length was also significantly shorter in Class III (p < 0.05).ConclusionsSkeletal configurations have an impact on parameters of the bony skull. Also, measurable adaptations of the muscular phenotype could result.Clinical relevanceThe association between viscerocranial morphology and midface anatomy might be beneficial for tailoring orthodontic appliances to individual anatomy and planning cortically anchored orthodontic appliances.

Epicardial fat and left atrial mechanical dispersion in patients with hypertension with persistent atrial fibrillation and without cardiac arrhythmia

Aim. To study the relationship between the amount of epicardial left atrial fat and left atrial mechanical dispersion (LAMD) in hypertensive patients with persistent atrial fibrillation (AF) and without cardiac arrhythmias.Material and methods. The main group included 100 hypertensive patients with persistent AF, who underwent transesophageal echo cardiography (TEE) before the elective cardioversion, and transthoracic echocardiography (TTE) after cardioversion and disappearance of atrial stunning. The control group included 24 hypertensive patients without cardiac arrhythmias, who underwent TEE for other indication. The thickness of atrial septum and left lateral ridge was measured by TEE. The average thickness of these structures was designated as left atrial fat. The time to peak of longitudinal myocardial strain in 6 left atrium segments was determined by speckle-tracking echocardiography. LAMD was calculated as a percentage of the standard deviation of the obtained values to cardiac cycle duration.Results. The median left atrial fat thickness in the main and control groups was 8,03 [6,78; 8,95] and 5,23 [4,48; 5,80] mm (p&lt;0,0001), median LAMD — 2,68 [2,41; 2,83] and 0,95 [0,62; 1,11]% (p&lt;0,0001). There was a positive correlation between left atrial fat thickness and LAMD in the main group (r=0,556; p&lt;0,0001). This relationship did not reach the level of statistical significance in the control group, (r=0,358; p=0,0860). There was no independent relationship between body mass index and left atrial fat thickness in the patients (r=0,027; p=0,7651).Conclusion. In hypertensive patients with persistent AF, compared with patients without rhythm disturbances, the average values of left atrial fat thickness and LAMD are significantly higher. The increase in left atrial fat thickness is associated with the increase in LAMD in hypertensive patients with AF. There was no correlation between left atrial fat thickness and LAMD in hypertensive patients without rhythm disturbances. There was no effect of body mass index on left atrial fat thickness in the present study.

Three-dimensional analysis of the alveolar ridge profiles of maxillary central incisors in children for autotransplantation

BackgroundSufficient alveolar housing is fundamental to ensure the favorable prognosis of autotransplanted teeth. However, little is known about the alveolar ridge profiles of the anterior maxilla in children. Therefore, this study aimed to investigate the alveolar ridge profiles of the anterior maxilla in growing children. MethodsA total of 169 Korean children aged 10–13 years old were included in this retrospective study. Demographic data and cone-beam computed tomography scans of 244 maxillary central incisors were collected. For each tooth, the alveolar ridge thickness was determined at 1-, 3-, and 5-mm levels below the cemento-enamel junction. The alveolar process height and labial concavity were also evaluated. Statistical analyses were performed to evaluate differences according to age and sex. ResultsThe alveolar ridge thickness did not differ according to age. The alveolar ridge thickness in males was significantly greater than that in females among those aged 10 and 11 years. The average alveolar process height was 17.43 ± 2.22 mm. The alveolar process height hardly changed with age from 10–13 years, whereas the alveolar process height of males was significantly greater compared with that of females among those aged 10 years. The labial concavity was approximately 150˚, with no significant differences between age and sex. ConclusionsWithin the limits of this study, the anatomy of the alveolar ridge in the maxillary central incisors showed sufficient capacity as a recipient site for autotransplantation using mandibular premolars, especially in males. These findings serve as a valuable resource for facilitating autotransplantation in children.

EXPERIMENTAL SUBSTANTIATION OF THE USE OF XENOGENIC CEREBROSPINAL FLUID IN HERNIOLOGY TO REDUCE THE PERIPROSTHETIC REACTION

The aim of this study was to experimentally validate the possibility and advisability of the treatment of polypropylene mesh implants with xenogenic cerebrospinal fluid in order to reduce a local acute inflammatory response. An experimental evaluation of the effectiveness of the proprietary method of polypropylene mesh implant processing during their implantation in the tissues of the anterior abdominal wall (Patent of Ukraine No. 146637) is presented. It has been proven that the use of the proposed new technology for the treatment of polypropylene mesh implants with a biocompatible component is a simple, safe and effective method that optimizes the reparative processes in the peri-implant zone without affecting the mechanical properties of mesh implants. All of the treatment effects were found to increase the biocompatibility and improve the survival rate of mesh implants. The thickness of the inflammatory ridge around the elements of mesh implants significantly decreased on average by 35.3% when xenogenic cerebrospinal fluid was used.

Socket regeneration after immediate loading implants with tissue and bone graft

Evaluation of ridge alteration after 1 year follow up after immediate loading implant placement. Methods: Ten patients were included in the study, in whom the ridge volume, height, and thickness were evaluated from region of interest (ROI) of tomographic images of the operated areas (test group) and compared to the opposite tooth (control group). Results: After one year, there was no implant loss and all patients were satisfied with the treatment. In the test group there was a statistically significant increase in ridge height (2.89±1.05 mm) when compared to the control group. No significant difference in relation to ridge volume and thickness was observed. In the intragroup evaluation, a significant gain in ridge height (2.65±3.08 mm) was observed when compared to baseline. Conclusion: The placement of an immediate implant, temporary crown, and tissue regeneration in sockets with buccal defects promotes the regeneration of the buccal wall while preventing the reduction of bone volume and thickness.

The bone shielding versus dual-zone concept in treating thin-walled fresh extraction sockets with immediate implant placement: Soft and hard tissue changes. A randomized clinical trial.

To evaluate the ridge alterations and esthetic outcome 1 year after immediate implant placement using the dual-zone (DZ) technique versus the bone shielding concept in patients with intact thin-walled sockets in the esthetic zone. This randomized clinical trial included 26 patients with nonrestorable maxillary teeth in the esthetic zone who were randomly assigned to two groups (n = 13 each) to receive immediate implants using either the bone shielding concept or DZ. Definitive restorations were delivered after 2 months. Pink esthetic scores (PESs), vertical soft tissue alterations, and bucco-palatal ridge dimensional changes were measured and assessed using intra-oral digital scans at baseline and 1 year post-procedure. Labial bone thickness was measured using cone beam computed tomography scans at baseline and after 1 year. The bone shielding group provided bucco-palatal ridge thickness stability after 1 year (9.43 mm) compared to baseline values (9.82 mm), while DZ showed a significant loss in the bucco-palatal ridge thickness after 1 year (7.83) compared to baseline values (9.49). No significant difference was reported in the baseline bucco-palatal ridge thickness between the two groups (p = 0.6). After 1 year, the bone shielding group demonstrated 0.38 mm ridge shrinkage which was statistically significant (p = 0.0002) compared to 1.67 mm ridge shrinkage in the DZ group. In addition, the average total PES in the bone shielding group was 12.04 versus 10.28 in the DZ group. No significant difference was reported in the mesial papilla length between the DZ and the bone shielding group after 1 year (p > 0.05). However, the midfacial gingival margin (p = 0.026) and distal papilla were significantly higher in the DZ group (p = 0.0025). There was no significant difference in the mean ± SD mm bone gain at the apical level between the two studied groups after 1 year (p = 0.06) showing 0.85 ± 0.23 and 0.64 ± 0.32 mm, respectively. However, the bone shielding concept showed a statistically significant more bone gain mm (p < 0.001) at the (0.56 ± 0.43) and crestal (0.03 ± 0.8) levels after 1 year compared to DZ which revealed 0.18 ± 0.5 and 0.38 ± 0.29 mm bone loss, respectively. The bone shielding concept might offer a reliable alternative for restoring thin-walled sockets by minimizing postextraction ridge dimensional alterations effect following immediate implant placement in the esthetic zone. Nevertheless, the study suffers from confounding bias since there are two systematic differences between the groups, the barrier membrane type, and the level of bone filling. "This clinical trial was not registered prior to participant recruitment and randomization." NCT05381467.

Effects of Photobiomodulation Using Low-Level Laser Therapy on Alveolar Bone Repair

Alveolar bone repair is a complex and extremely important process, so that functions such as the mastication, occlusion and osseointegration of implants can be properly reestablished. Therefore, in order to optimize this process, many procedures have been used, such as grafting with biomaterials and the application of platelet-rich fibrin (PRF). Another method that has been studied is the use of photobiomodulation (PBM) with the use of low-level laser therapy (LLLT), which, through the absorption of photons by the tissue, triggers photochemical mechanisms in the cells so that they start to act in the search for homeostasis of the affected region. Therefore, the objective of this review was to analyze the use of LLLT as a possible auxiliary tool in the alveolar bone repair process. A search was carried out in scientific databases (PubMed/MEDLINE, Web of Science, Scopus and Cochrane) regarding the following descriptors: “low-level laser therapy AND alveolar bone repair” and “photobiomodulation AND alveolar bone repair”. Eighteen studies were selected for detailed analysis, after excluding duplicates and articles that did not meet predetermined inclusion or non-inclusion criteria. According to the studies, it has been seen that LLLT promotes the acceleration of alveolar repair due to the stimulation of ATP production, activation of transcription and growth factors, attenuation of the inflammatory process and induction of angiogenesis. These factors depend on the laser application protocol, and the Gallium Aluminum Arsenide—GaAlAs laser, with a wavelength of 830 nm, was the most used and, when applications of different energy densities were compared, the highest dosages showed themselves to be more efficient. Thus, it was possible to conclude that PBM with LLLT has beneficial effects on the alveolar bone repair process due to its ability to reduce pain, the inflammatory process, induce vascular sprouting and, consequently, accelerate the formation of a new bone matrix, favoring the maintenance or increase in height and/or thickness of the alveolar bone ridge.

Alveolar Ridge Splitting with Simultaneous Implant Placement in Narrow Atrophic Ridges: A Case Series

&lt;p&gt;Objectives: Implant placement in atrophic ridges with severe horizontal bone deficiency without adequate bony housing around the defects remains a significant clinical challenge. The aim of this case series is to evaluate the effectiveness of alveolar ridge splitting (ARS) with simultaneous implant placement. Materials and Methods: Four patients with severe horizontal bone deficiency in atrophic ridges received ARS with simultaneous implant placement. The stability of the widened ridges was evaluated by superimposition of initial and postoperative CBCT images. The ridge thickness at baseline (RT0) and at least 6-month postoperation (RT1), as well as horizontal bone gain (HBG), were measured with the reference of implant platform. Results: All 7 implant sites healed uneventfully without complications. The mean RT0 was 3.84 &amp;plusmn; 0.56 mm at baseline; the mean RT1 was 7.61 &amp;plusmn; 0.96 mm at least 6-month postoperatively, with the mean HBG of 3.77 &amp;plusmn; 0.80 mm. The results demonstrated significant HBG and sufficient bone thickness around implants after ARS with simultaneous implant placement in all cases. Conclusion: The ARS technique with simultaneous implant placement is an effective and predictable treatment modality to augment ridge width significantly for narrow atrophic ridges without adequate bony housing.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Radiological Evaluation of Marginal Bone Loss Around Sandblasted and Acid-etched (SLA) and Modified Surface (SLActive) Tissue-level Implants Surfaces: A Retrospective 5-year Follow-up Study

&lt;p&gt;Objectives: Implant placement in atrophic ridges with severe horizontal bone deficiency without adequate bony housing around the defects remains a significant clinical challenge. The aim of this case series is to evaluate the effectiveness of alveolar ridge splitting (ARS) with simultaneous implant placement. Materials and Methods: Four patients with severe horizontal bone deficiency in atrophic ridges received ARS with simultaneous implant placement. The stability of the widened ridges was evaluated by superimposition of initial and postoperative CBCT images. The ridge thickness at baseline (RT0) and at least 6-month postoperation (RT1), as well as horizontal bone gain (HBG), were measured with the reference of implant platform. Results: All 7 implant sites healed uneventfully without complications. The mean RT0 was 3.84 &amp;plusmn; 0.56 mm at baseline; the mean RT1 was 7.61 &amp;plusmn; 0.96 mm at least 6-month postoperatively, with the mean HBG of 3.77 &amp;plusmn; 0.80 mm. The results demonstrated significant HBG and sufficient bone thickness around implants after ARS with simultaneous implant placement in all cases. Conclusion: The ARS technique with simultaneous implant placement is an effective and predictable treatment modality to augment ridge width significantly for narrow atrophic ridges without adequate bony housing.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Horizontal bone augmentation using a mixture of cortico-cancellous allograft and bovine bone mineral with a collagen membrane: a retrospective study

Aim: The study aimed to evaluate the clinical outcomes of bone augmentation with a mixture of cortico-cancellous allograft and xenograft with a collagen membrane in horizontal augmentation of knife-edge alveolar crests.&#x0D; Material and Method: Patients with a ridge thickness of less than 4 mm by preoperative tomography were included in the study. Twelve patients (10 Female, 2 Male) were treated with a mixture of Cortico-Cancellous Allograft and Bovine Bone Mineral with a collagen membrane.&#x0D; Results: Thirty-nine implants were placed in twelve patients. The initial bone thickness is between 1 and 4 cm (mean: 3±0.89440). Nine months after horizontal augmentation, bone thickness varies between 4.53 and 9.15 cm (mean: 4.62±1.16782). The gained bone thickness varies between 1.27 and 7.72 cm (mean 3.66±1.21041).&#x0D; Conclusion: Augmentation of alveolar bones knife-edge crestal margins with a mixture of Cortico-Cancellous Allograft and Bovine Bone Mineral with a collagen membrane is simple, successful, and feasible.

Zoledronate/Anti-VEGF Neutralizing Antibody Combination Administration Increases Osteal Macrophages in a Murine Model of MRONJ Stage 0-like Lesions

The pathophysiology, pathogenesis, histopathology, and immunopathology of medication-related osteonecrosis of the jaw (MRONJ) Stage 0 remain unclear, although 50% of MRONJ Stage 0 cases could progress to higher stages. The aim of this study was to investigate the effects of zoledronate (Zol) and anti-vascular endothelial cell growth factor A (VEGFA) neutralizing antibody (Vab) administration on polarization shifting of macrophage subsets in tooth extraction sockets by creating a murine model of MRONJ Stage 0-like lesions. Eight-week-old, female C57BL/6J mice were randomly divided into 4 groups: Zol, Vab, Zol/Vab combination, and vehicle control (VC). Subcutaneous Zol and intraperitoneal Vab administration were performed for 5 weeks with extraction of both maxillary first molars 3 weeks after drug administration. Euthanasia was conducted 2 weeks after tooth extraction. Maxillae, tibiae, femora, tongues, and sera were collected. Structural, histological, immunohistochemical, and biochemical analyses were comprehensively performed. Tooth extraction sites appeared to be completely healed in all groups. However, osseous healing and soft tissue healing of tooth extraction sites were quite different. The Zol/Vab combination significantly induced abnormal epithelial healing, and delayed connective tissue healing due to decreased rete ridge length and thickness of the stratum granulosum and due to decreased collagen production, respectively. Moreover, Zol/Vab significantly increased necrotic bone area with increased numbers of empty lacunae compared with Vab and VC. Most interestingly, Zol/Vab significantly increased the number of CD169+ osteal macrophages (osteomacs) in the bone marrow and decreased F4/80+ macrophages, with a slightly increased ratio of F4/80+CD38+ M1 macrophages compared to VC. These findings are the first to provide new evidence of the involvement of osteal macrophages in the immunopathology of MRONJ Stage 0-like lesions.

Evaluation of extra-narrow diameter implants in the oral rehabilitation of young patients after oral trauma: Aprospective study.

Oral trauma is a common event in young patients and can lead to tooth loss, especially after avulsion of a tooth. The aim of this study was to evaluate the survival, esthetic outcomes, ridge preservation, and patient satisfaction of extra-narrow diameter implants (NDIs) as a temporary rehabilitation treatment for young patients who had lost permanent maxillary incisors after an avulsion. This study comprised a prospective clinical and experimental study on a case series of 13 patients (age: 10-14 years) with a history of avulsion of one or more maxillary incisors. The patients received 19 mini-drive locks implants (Intralock) with acrylic resin crowns, divided into two evaluation arms: immediate implant placement (n=10) and delayed implant placement (n=9). The cases were followed up every 3months with an initial tomography (T0) before implant placement and after 1year (T1). The clinical stability of the implant in the bone and the retention of the provisional implant crown were evaluated, and the esthetic index was calculated at each follow-up. Intragroup and intergroup differences in alveolar ridge height and thickness were compared at T0 and T1, and a questionnaire was administered to assess the patient's perception of the treatment. The implant survival rate after 1year was 78.9%. Alveolar ridge height and thickness increased in all cases at T1 (p < .05). Patients who received immediate implants had greater initial and final alveolar ridge thickness. The esthetic index progressively increased over the investigated time period (p=.001). Only one female patient presented with crown infraocclusion after 1year. The patients' esthetic perceptions of their smiles significantly improved after treatment (p=.001). Extra-NDI had good survival rates, were effective at maintaining alveolar bone, and promoted aesthetic recovery and patient satisfaction with treatment during the period studied.

Catheter ablation in combined procedures is associated with residual leaks.

To compare patients with atrial fibrillation (AF) undergoing left atrial appendage closure (LAAC) with catheter ablation (CA) and those without CA. The CA of AF may cause ridge edema, which may affect the safety of LAAC. Patients with AF (N = 98) who underwent LAAC (combined CA + LAAC procedure group; N = 51) or alone (LAAC group; N = 47) received pre-procedural, intra-procedural, and 6 week post-procedural transesophageal echocardiography (TEE). The depth and ostial diameter of LAA, device compression, residual leak, and ridge thickness were evaluated in the patients who had undergone combined and alone procedures, as well as images of LAA and primary clinical characteristics. A residual leak was identified in 27 patients at 6 weeks after implantation by TEE (19 in the combined procedures group and eight in the alone group; p = 0.04). The combined procedure group had a significantly higher rate of a new residual leak than the alone group (25.5 vs. 8.5%; p = 0.03). Meanwhile, compared with at the time of implant, a smaller amount of device compression ratio was significant after 6 weeks (22.44 ± 3.90 vs. 19.59 ± 5.39; p = 0.03). There was no significant difference between both groups in all-cause mortality, cardiovascular mortality, and TIA/stroke/system embolism. The combined procedures of CA and LAAC for AF are feasible and safe; however, during the follow-up period, we found that the resolution of ridge edema caused by CA might cause an increased residual leak and a smaller device compression ratio.

Association of Optical Coherence Tomography–Measured Fibrovascular Ridge Thickness and Clinical Disease Stage in Retinopathy of Prematurity

Accurate diagnosis of retinopathy of prematurity (ROP) is essential to provide timely treatment and reduce the risk of blindness. However, the components of an ROP examination are subjective and qualitative. To evaluate whether optical coherence tomography (OCT)-derived retinal thickness measurements at the vascular-avascular junction are associated with clinical diagnosis of ROP stage. This cross-sectional longitudinal study compared OCT-based ridge thickness calculated from OCT B-scans by a masked examiner to the clinical diagnosis of 2 masked examiners using both traditional stage classifications and a more granular continuous scale at the neonatal intensive care unit (NICU) of Oregon Health & Science University (OHSU) Hospital. Infants who met ROP screening criteria in the OHSU NICU between June 2021 and April 2022 and had guardian consent were included. One OCT volume and en face image per patient per eye showing at least 1 to 2 clock hours of ridge were included in the final analysis. Comparison of OCT-derived ridge thickness to the clinical diagnosis of ROP stage using an ordinal and continuous scale. Repeatability was assessed using 20 repeated examinations from the same visit and compared using intraclass correlation coefficient (ICC) and coefficient of variation (CV). Comparison of ridge thickness with ordinal categories was performed using generalized estimating equations and with continuous stage using Spearman correlation. A total of 128 separate OCT eye examinations from 50 eyes of 25 patients were analyzed. The ICC was 0.87 with a CV of 7.0%. Higher ordinal disease classification was associated with higher axial ridge thickness on OCT, with mean (SD) thickness measurements of 264.2 (11.2) μm (P < .001), 334.2 (11.4) μm (P < .001), and 495.0 (32.2) μm (P < .001) for stages 1, 2, and 3, respectively and with continuous stage labels (ρ = 0.739, P < .001). These results suggest that OCT-based quantification of peripheral stage in ROP may be an objective and quantitative biomarker that may be useful for clinical diagnosis and longitudinal monitoring and may have implications for disease classification in the future.

Custom Bone Regeneration (CBR): An Alternative Method of Bone Augmentation-A Case Series Study.

We performed this clinical study in order to evaluate the reliability of the Guided Bone Regeneration (GBR) surgical technique through the use of customized CAD CAM titanium meshes (Yxoss CBR® Reoss) in order to show an alternative method of bone augmentation. Materials and methods: Nine patients presenting 10 bone defects were referred to solve oral dysfunction due to edentulous atrophic ridges. Guided bone regeneration was performed with titanium meshes combined with autogenous bone grafting and heterologous bovine bone mineral grafting, and exclusively a “poncho technique” soft tissue approach for all the cases. After a mean 9 months of graft healing (range 6–12 months), titanium meshes were removed, and implant surgery was subsequently performed. The results we obtained were positive in terms of volumetric increases in height, length and thickness of the atrophic ridges without biological complications detectable before implant surgery. Results: Out of nine, one site met titanium mesh exposure: however, in all 10 sites a three-dimensional volumetric bone implementation was obtained. The statistical results were estimated by uploading and superimposing cbct scans before and after CBR surgery for each patient, so it was possible evaluate the maximum linear vertical and horizontal bone gain through dedicated Cad Cam software (Exocad GmbH®). The average horizontal gain was 6.37 ± 2.17 mm (range 2.78–9.12 mm) and vertical gain was 5.95 ± 2.06 mm (range 2.68–9.02 mm). A total of 18 implants were placed into the grafted sites with a 100% survival rate (clearly they are relative percentages to be compared to the short time elapsed). Conclusions: The results we obtained in this study suggest that this CBR procedure (Yxoss® by Reoss) is reliable and safe for bone regeneration to allow implant-prosthetic restoration in horizontal, vertical and combined bone defects. The soft tissue management is diriment: all the cases were managed with a “poncho” flap approach to decrease exposure complication.

Effect of osseodensification on the increase in ridge thickness and the prevention of buccal peri-implant defects: an in vitro randomized split mouth pilot study

BackgroundImplant installation with conventional drilling can create buccal bone defects in areas of limited ridge thickness. Implant installation with osseodensification may aid in preventing buccal bone defects in these situations. This in vitro pilot study evaluated the impact of osseodensification on the increase in alveolar ridge thickness and the prevention of buccal peri-implant defects.MethodsTen fresh pig mandibles with limited bone thickness were selected for use in an experimental randomized split mouth pilot study. Two site-preparation protocols were used: conventional drilling with cutting burs (CTL, n = 10) and osseodensification with Densah® burs (OD, n = 10). After implant bed preparation, 20 implants (4.5 × 10 mm) were placed in the prepared sites and the insertion torque was recorded. Clinical and photographic analysis evaluated ridge thickness and the extent (height, width, and area) of bone defects in the buccal and lingual bone walls following implant placement. Three-dimensional measurements were performed using STL files to analyze the increase in buccal ridge thickness following site preparation and implant placement. The height of the buccal bone defect was considered as the primary outcome of this study. Defect width, area, implant insertion torque, and linear buccal ridge increase after implant site preparation and installation were also assessed. Non-parametric evaluations were carried out with the Mann–Whitney test to verify intergroup differences.ResultsThere was no statistically significant difference between groups in the baseline ridge thickness. OD presented a significantly higher insertion torque, associated with reduced buccal and lingual bone defect width, in comparison to CTL.ConclusionsThe increase in buccal ridge thickness after site preparation and implant placement was significantly higher in OD compared to CTL. Osseodensification increased the ridge thickness through expansion and reduced buccal bone defects after implant installation.

Intraoperative Intradermal Application of Stromal Vascular Fraction into the Abdominal Suture Line: Histological Analysis of Abdominal Scar Tissue.

Stem cell therapy is a promising new approach to wound healing. Stromal vascular fraction is a heterogeneous collection of cells, including adipose-derived stem cells, which are traditionally isolated using a manual collagenase-based technique. To our knowledge, this is the first human study that histologically assesses the potential of intraoperative intradermal injection of stromal vascular fraction on skin regeneration. In this controlled study, 20 patients undergoing deep inferior epigastric perforator flap breast reconstruction and bilateral flank liposuction were included. Stromal vascular fraction was injected intradermally into one side of the abdominal suture line, while the other side served as a control. Outcome measures included analysis of stromal vascular fraction by flow cytometry, histological analysis of scar tissue, and scar photography. Cell yield for application and cell viability were 55.9 ± 28.5 × 106 and 75.1% ± 14.5%, respectively. Age and body mass index were positively correlated with the number of cells for application and adipose-derived stem cells. Mean vascular density, elastic fiber content, collagen maturity (scar index), epidermal thickness, and number of rete ridges all showed higher values on the treated side. Furthermore, the injected number of adipose-derived stem cells and pericytes positively correlated with vascular density. It is safe to speculate that intradermal stromal vascular fraction injection at the beginning of the healing process increases vascular density, collagen maturity and organization, elastic fiber content, epidermal thickness, epidermal-dermal anchoring of the scarring skin and is therefore responsible for improved skin regeneration. It is a viable and safe method that can be used as an adjunctive treatment in plastic surgery procedures where suboptimal wound healing is anticipated. 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 .

Individual and Combined Anatomic Risk Factors for the Development of an Anterior Cruciate Ligament Rupture in Men: A Multiple Factor Analysis Case-Control Study

Background: No comparative studies have evaluated anatomic risk factors in a large cohort including both patients with anterior cruciate ligament (ACL) ruptures and healthy participants. Purpose: To determine which anatomic parameters are independently associated with an ACL rupture and the diagnostic values of the individual and combined anatomic parameters. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 352 male patients who underwent arthroscopic ACL reconstruction because of a primary ACL rupture and 350 age-, sex-, body mass index–, and side dominance–matched healthy participants were included. Measurements of 32 previously determined parameters and 7 calculations were performed. Between-group differences were calculated. Univariate and multivariate logistic regression models and receiver operating characteristic curve analysis were conducted for the individual and combined independently associated factors. Results: The mean age and body mass index of all participants were 29.9 ± 7.7 years and 27.2 ± 3.1, respectively. There were significant differences between the groups regarding the notch width (NW), notch shape index, anterior tibial slope, notch width index, NW–eminence width (NW:EW) ratio, notch height, axial lateral wall angle, medial intercondylar ridge thickness, alpha angle, medial tibial depth (MTD), lateral tibial slope (LTS), coronal tibial plateau width, eminence width index, tibial proximal anteroposterior distance (TPAP), lateral condylar anteroposterior distance (LCAP)/TPAP, ACL cross-sectional area, ACL volume, medial and lateral meniscal cartilage height, medial and lateral meniscal cartilage angle (MCA), and medial and lateral meniscal cartilage bone height. The NW:EW ratio (odds ratio [OR], 4.419; P = .017), MTD (OR, 8.617; P = .001), LTS (OR, 2.254; P = .011), LCAP/TPAP (OR, 2.782; P = .037), and medial MCA (OR, 1.318; P = .010) were independently associated with the development of an ACL rupture. Combining the independently associated factors revealed a sensitivity of 93% and a specificity of 94% (area under the curve, 0.968). Conclusion: Patients with ACL ruptures could be distinguished from uninjured controls with high sensitivity and specificity via the combined use of the NW:EW ratio, MTD, LTS, LCAP/TPAP, and medial MCA. In clinical practice, these findings may contribute to the development of preventive strategies for ACL ruptures.