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1.
Int J Hyperthermia ; 41(1): 2345382, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38843894

RESUMO

PURPOSE: The objective was to describe the technique and clinical outcome of microwave thermal ablation (MWA) and perfusion combined with synthetic bone substitutes in treating unicameral bone cysts (UBCs) in adolescents. MATERIALS AND METHODS: A total of 14 consecutive patients were enrolled by percutaneous MWA and saline irrigation combined with synthetic bone substitutes. Clinical follow-up included the assessment of pain, swelling, and functional mobility. Radiological parameters included tumor volume, physis-cyst distance, cortical thickness of the thinnest cortical bone, and the Modified Neer classification system. RESULTS: The mean follow-up was 28.9 months (26-52 months). All UBCs were primary, and all patients underwent the MWA, saline perfusion, and reconstruction combined with a synthetic bone substitute session, except for one patient (7.1%) who required a second session. All patients had good clinical results at the final follow-up. Satisfactory cyst healing was achieved in 13 cases according to radiological parameters. Tumor volume decreased from a mean of 49.7 cm3 before surgery treatment to 13.9 cm3 at the final follow-up (p < 0.01). The physis-cyst distance increased from a mean of 3.17-4.83 cm at the final follow-up (p < 0.01). Cortical thickness improved from a mean of 1.1 mm to 2.0 mm at the final follow-up (p < 0.01). According to the proposed radiological criteria, our results were considered successful (Grading I and II) in 13 patients (92.9%) at the final follow-up. CONCLUSION: Percutaneous microwave ablation combined with a bone graft substitute is a minimally invasive, effective, safe, and cost-effective approach to treating primary bone cysts in the limbs of adolescents.


Assuntos
Cistos Ósseos , Substitutos Ósseos , Micro-Ondas , Humanos , Masculino , Feminino , Adolescente , Cistos Ósseos/cirurgia , Cistos Ósseos/diagnóstico por imagem , Substitutos Ósseos/uso terapêutico , Micro-Ondas/uso terapêutico , Seguimentos , Criança , Procedimentos de Cirurgia Plástica/métodos , Adulto Jovem , Técnicas de Ablação/métodos
2.
Clin Oral Investig ; 28(7): 375, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38878120

RESUMO

OBJECTIVE: To investigate the impact of mineralized dentin matrix (MDM) on the prognosis on bone regeneration and migration of retained roots after coronectomy. MATERIALS AND METHODS: Patients were divided into three groups based on the type of bone graft after coronectomy: Group C (n = 20, collagen), Group T (n = 20, tricalcium phosphate (TCP) + collagen), and Group D (n = 20, MDM + collagen). CBCT scans, conducted immediately and 6 months after surgery, were analyzed using digital software. Primary outcomes, including changes in bone defect depth and retained root migration distance, were evaluated 6 months after surgery. RESULTS: After 6 months, both Groups D and T exhibited greater reduction of the bone defect and lesser retained root migration than Group C (p < 0.001). Group D had greater regenerated bone volume in the distal 2 mm (73 mm3 vs. 57 mm3, p = 0.011) and lesser root migration (2.18 mm vs. 2.96 mm, p < 0.001) than Group T. The proportion of completely bone embedded retained roots was also greater in Group D than in Group C (70.0% vs. 42.1%, p = 0.003). CONCLUSIONS: MDM is an appropriate graft material for improving bone defect healing and reducing retained root migration after coronectomy. CLINICAL RELEVANCE: MDM is an autogenous material prepared chairside, which can significantly improve bone healing and reduce the risk of retained root re-eruption. MDM holds promise as a routine bone substitute material after M3M coronectomy.


Assuntos
Regeneração Óssea , Fosfatos de Cálcio , Colágeno , Tomografia Computadorizada de Feixe Cônico , Dentina , Humanos , Masculino , Feminino , Fosfatos de Cálcio/uso terapêutico , Prognóstico , Pessoa de Meia-Idade , Colágeno/uso terapêutico , Regeneração Óssea/efeitos dos fármacos , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/cirurgia , Adulto , Coroa do Dente/cirurgia , Resultado do Tratamento , Transplante Ósseo/métodos , Substitutos Ósseos/uso terapêutico
3.
Int J Periodontics Restorative Dent ; 44(3): 299-307, 2024 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-38787708

RESUMO

This study aimed to investigate the dimensional stability and quality of the alveolar ridge augmented using a synthetic bone block (SBB) at damaged extraction sockets. Four participants were included, and socket augmentation was performed using SBB and a collagen membrane. Intraoral and CBCT scans were performed before extraction (baseline), immediately postoperative (IP), and at 6 months postoperative (6M). At 6M, a trephine biopsy sample was obtained during implant placement, and the sample was observed using synchrotron. Soft tissue profile changes were assessed using profilometric analysis of the intraoral scan data, while dimensional changes in hard tissue were evaluated based on CBCT measurements. Bone quality was analyzed using synchrotron imaging. There were minimal changes in the soft tissue profile between baseline and IP, baseline and 6M, and IP and 6M (0.11 ± 1.08 mm3, 0.02 ± 0.8 mm3, and -0.65 ± 0.82 mm3, respectively). Horizontal bone width was measured at 1-mm increments from the augmented bone crest to 5 mm apically and revealed only a slight reduction (< 1 mm) at all levels between IP and 6M. The augmented bone height was well maintained from IP until 6M (-0.21 ± 0.53 mm). Synchrotron analysis revealed low to moderate bone quality after 6M (percentage of new bone: 16.49% ± 4.91%). Socket augmentation using SBB appears to be a viable technique for regenerating damaged extraction sockets, with the augmented ridge dimensions maintained up to 6M. Further long-term randomized clinical trials are needed.


Assuntos
Aumento do Rebordo Alveolar , Tomografia Computadorizada de Feixe Cônico , Síncrotrons , Alvéolo Dental , Humanos , Alvéolo Dental/cirurgia , Alvéolo Dental/diagnóstico por imagem , Projetos Piloto , Aumento do Rebordo Alveolar/métodos , Pessoa de Meia-Idade , Masculino , Feminino , Extração Dentária , Implantação Dentária Endóssea/métodos , Adulto , Substitutos Ósseos/uso terapêutico , Idoso , Colágeno/uso terapêutico
4.
Int J Periodontics Restorative Dent ; 44(3): 257-266, 2024 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-38787711

RESUMO

Bone graft materials are often used in implant treatment to optimize functional and esthetic outcomes. The requirements for bone grafting materials are the ability to maintain space for bone regeneration to occur and the capability of being resorbed by osteoclasts and replaced with new bone tissue occurring in passive chemolysis and bone remodeling. Carbonate apatite (CO3Ap) granules (Cytrans Granules, GC) are a chemically synthetic bone graft material similar to autogenous bone minerals and more biocompatible than allografts and xenografts. The aim of this report is to evaluate the efficacy of CO3Ap granules in implant treatments when used alone or in combination with autogenous bone. The clinical findings and the radiographic and histologic assessments in three cases of immediate implant placement and lateral and vertical guided bone regeneration are reported. Despite the short-term follow-ups, histologic findings showed that CO3Ap granules were efficiently resorbed and replaced bone in clinical use. Furthermore, the clinical findings showed that CO3Ap granules maintained their morphology around the implant. This limited short-term case report suggests that this bone substitute is effective. However, further clinical studies and long-term reports of this new biomaterial are needed.


Assuntos
Apatitas , Substitutos Ósseos , Humanos , Apatitas/química , Substitutos Ósseos/uso terapêutico , Feminino , Masculino , Pessoa de Meia-Idade , Regeneração Óssea/efeitos dos fármacos , Adulto , Regeneração Tecidual Guiada Periodontal/métodos , Carga Imediata em Implante Dentário/métodos , Transplante Ósseo/métodos
5.
Int J Implant Dent ; 10(1): 26, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38801622

RESUMO

PURPOSE: Particulate bovine bone substitutes (BS) are commonly used in oral regeneration. However, more literature is needed focusing on comparative analyses among various particulate bovine BS. This study evaluates pre-clinical and clinical data of different particulate bovine BS in oral regeneration. METHODS: A narrative review was conducted by screening the PubMed database Included in the review were pre-clinical and clinical studies until 2024 comparing a minimum of two distinct particulate bovine BS. In addition to examining general data concerning manufacturing and treatment processes, biological safety, physical and chemical characteristics, and graft resorption, particular emphasis was placed on assessing pre-clinical and clinical data related to ridge preservation, sinus floor elevation, peri-implant defects, and various forms of alveolar ridge augmentation utilizing particulate bovine BS. RESULTS: Various treatment temperatures ranging from 300 to 1,250 °C and the employment of chemical cleaning steps were identified for the manufacturing process of particulate bovine BS deemed to possess biosecurity. A notable heterogeneity was observed in the physical and chemical characteristics of particulate bovine BS, with minimal or negligible graft resorption. Variations were evident in particle and pore sizes and the porosity of particulate bovine BS. Pre-clinical assessments noted a marginal inclination towards favorable outcomes for particulate bovine BS subjected to higher treatment temperatures. However, clinical data are insufficient. No distinctions were observed regarding ridge preservation, while slight advantages were noted for high-temperature treated particulate bovine BS in sinus floor elevation. CONCLUSIONS: Subtle variances in both pre-clinical and clinical outcomes were observed in across various particulate bovine BS. Due to inadequate data, numerous considerations related to diverse particulate bovine BS, including peri-implant defects, must be more conclusive. Additional clinical studies are imperative to address these knowledge gaps effectively.


Assuntos
Substitutos Ósseos , Bovinos , Animais , Substitutos Ósseos/uso terapêutico , Humanos , Aumento do Rebordo Alveolar/métodos , Regeneração Óssea/fisiologia
6.
Biomater Adv ; 161: 213900, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38772132

RESUMO

This study investigates the safety and efficacy of 3D-printed polycaprolactone/hydroxyapatite (PCL/HA) scaffolds for patient-specific cranioplasty surgeries, employing liquid deposition modeling (LDM) technology. This research is pioneering as it explores the impact of gamma radiation on PCL/HA scaffolds and utilizes printing ink with the highest content of HA known in the composite. The mechanical, morphological, and macromolecular stability of the gamma-sterilized scaffolds were verified before implantation. Subsequent research involving animal subjects was conducted to explore the effects of sterilized implants. Eventually, three clinical cases were selected for the implantation studies as part of a phase 1 non-randomized open-label clinical trial. It was shown that a 25 kGy gamma-ray dose for sterilizing the printed implants did not alter the required geometrical precision of the printed implants. The implants exhibited well-distributed HA and strength comparable to cancellous bone. Gamma radiation reduced hydrophobicity and water uptake capacity without inducing pyrogenic or inflammatory responses. Personalized PCL/HA substitutes successfully treated various craniomaxillofacial defects, including trauma-induced facial asymmetry and congenital deformities. HA nanoparticles in the ink stimulated significant osteoconductive responses within three months of implantation. Moreover, the results revealed that while larger implants may exhibit a slower bone formation response in comparison to smaller implants, they generally had an acceptable rate and volume of bone formation. This clinical trial suggests the application of a sterilized PCL/HA composite for craniomaxillofacial surgery is safe and could be considered as a substitute for autologous bone.


Assuntos
Durapatita , Raios gama , Poliésteres , Impressão Tridimensional , Durapatita/química , Durapatita/uso terapêutico , Humanos , Poliésteres/química , Animais , Esterilização/métodos , Masculino , Feminino , Alicerces Teciduais/química , Próteses e Implantes , Adulto , Substitutos Ósseos/química , Substitutos Ósseos/uso terapêutico
7.
Acta Cir Bras ; 39: e392424, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38808817

RESUMO

PURPOSE: To evaluate the inductive capacity of F18 bioglass putty on the induced membrane technique in a segmental bone defect of the rabbit's radius. METHODS: Ten female Norfolk at 24 months of age were used. The animals were randomly separated based on postoperative time points: five rabbits at 21 and four at 42 days. A 1-cm segmental bone defect was created in both radii. The bone defects were filled with an F18 bioglass putty. RESULTS: Immediate postoperative radiographic examination revealed the biomaterial occupying the segmental bone defect as a well-defined radiopaque structure with a density close to bone tissue. At 21 and 42 days after surgery, a reduction in radiopacity and volume of the biomaterial was observed, with particle dispersion in the bone defect region. Histologically, the induced membrane was verified in all animals, predominantly composed of fibrocollagenous tissue. In addition, chondroid and osteoid matrices undergoing regeneration, a densely vascularized tissue, and a foreign body type reaction composed of macrophages and multinucleated giant cells were seen. CONCLUSIONS: the F18 bioglass putty caused a foreign body-type inflammatory response with the development of an induced membrane without expansion capacity to perform the second stage of the Masquelet technique.


Assuntos
Materiais Biocompatíveis , Regeneração Óssea , Substitutos Ósseos , Cerâmica , Rádio (Anatomia) , Animais , Coelhos , Feminino , Regeneração Óssea/efeitos dos fármacos , Rádio (Anatomia)/diagnóstico por imagem , Rádio (Anatomia)/cirurgia , Substitutos Ósseos/uso terapêutico , Reprodutibilidade dos Testes , Fatores de Tempo , Distribuição Aleatória , Membranas Artificiais
8.
Clin Oral Investig ; 28(6): 342, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38801474

RESUMO

OBJECTIVE: To compare implant stability and clinical outcome in implant placement between osteotome sinus floor elevation (OSFE) with biphasic calcium phosphate (BCP) which consisted of 30% of hydroxyapatite (HA) and 70% of beta-tricalcium phosphate (ß -TCP) grafting material and OSFE without using bone grafting material. The research questions is whether the BCP provides any benefit in OSFE or not. MATERIALS AND METHODS: Thirty patients (30 implants) with a single edentulous area of upper premolar or molar were randomly separated into OSFE with BCP (n = 15) and OSFE without grafting (n = 15). The patients were reevaluated 3, 6, 9, and 12 months after implant loading. The clinical assessments (implant stability quotient (ISQ), implant survival-failure rate, and surgical complication) were analyzed. Together with radiographic assessments in 2D (endo-sinus bone gain (ESBG), mean marginal bone change (MMBC)) and 3D (endo-sinus bone gain in CBCT (ESBG-CT)) were evaluated, with a mean follow-up time of at least 12 months of functional loading and prosthetic complication. RESULTS: 20 remaining implants (OSFE with BCP, n = 10; OSFE without grafting, n = 10) were analyzed. Mean ISQ was 79.18 ± 3.43 in 1-year follow-up (ISQ; OSFE with BCP = 78.72 ± 3.46, OSFE without grafting = 79.65 ± 3.52). ISQ in both groups increased steadily without significant differences in each follow-up. (p = 0.56). In radiographic evaluation, at 6-, 9-, and 12-month, OSFE without grafting group showed statistically significant lower MMBC (p < 0.05). The 1-year clinical results showed that 2 implants failed in OSFE with BCP, and 1 implant failed in OSFE without grafting. CONCLUSIONS: Graft material "BCP" (HA30:TCP70) coupled with OSFE presents no extraordinary benefit in implant stability, clinical and radiographic outcome in 1-year follow-up. CLINICAL RELEVANCE: Clinically, OSFE with grafting materials provides no additional benefit. CLINICAL TRIAL REGISTRATION NUMBER: TCTR20210517008 (date of registration: May 17, 2021).


Assuntos
Substitutos Ósseos , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endóssea , Hidroxiapatitas , Levantamento do Assoalho do Seio Maxilar , Humanos , Levantamento do Assoalho do Seio Maxilar/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Resultado do Tratamento , Hidroxiapatitas/uso terapêutico , Implantação Dentária Endóssea/métodos , Adulto , Substitutos Ósseos/uso terapêutico , Transplante Ósseo/métodos , Idoso , Osteotomia/métodos
9.
Int J Periodontics Restorative Dent ; 44(3): 309-319, 2024 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-38787714

RESUMO

Sinus floor augmentation is one of the most common approaches to obtain sufficient bone availability for placing implants in cases with severe bone atrophy in the posterior maxilla. Several bone substitutes are indicated for sinus augmentation, but they may achieve different clinical outcomes. This study aims to compare bovine bone mineral (BBM) with freeze-dried bone allograft (FDBA) in a two-stage lateral window sinus grafting approach. Twenty patients received a lateral window sinus elevation with either FDBA or BBM. Postoperative graft height was measured with CBCT. Implants were placed 6 months later, at which time biopsy samples were taken for histologic analysis and new CBCT scans were performed to measure graft height. The mean height reduction at 6 months was 20.27% ± 4.94% for FDBA samples and 5.36% ± 2.41% for BBM samples. The histologic analysis revealed a mean ratio of newly formed bone of 43.70% ± 5.29% for the FDBA group and 38.11% ± 4.03% for the BBM group. The FDBA group also showed a higher amount of residual biomaterial (17.25% ± 10.10%) and connective tissue (14.63% ± 4.38%) compared to the BBM group (15.53% ± 5.42% and 13.11% ± 4.42%, respectively). The differences between groups were statistically significant for the height reduction and newly formed bone (P ≤ .05) but not for the amounts of residual biomaterial and nonmineralized connective tissue (P ≥ .05). Six months after performing a lateral window sinus elevation, the percentage of newly formed bone was significantly higher when using FDBA than when using BBM, although the graft height reduction was also significantly higher for the FDBA group.


Assuntos
Aloenxertos , Transplante Ósseo , Tomografia Computadorizada de Feixe Cônico , Levantamento do Assoalho do Seio Maxilar , Humanos , Levantamento do Assoalho do Seio Maxilar/métodos , Animais , Bovinos , Feminino , Masculino , Pessoa de Meia-Idade , Transplante Ósseo/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Xenoenxertos/transplante , Adulto , Substitutos Ósseos/uso terapêutico , Maxila/cirurgia , Maxila/diagnóstico por imagem
10.
Int J Periodontics Restorative Dent ; 44(3): 339-346, 2024 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-38787715

RESUMO

This study assessed the effects of buccal contour augmentation for periodontally compromised teeth with horizontal bone loss. A total of 30 subjects were divided into Group A or Group B (n = 15 subjects per group). Group A received open-flap debridement (OFD) with buccal contour augmentation using deproteinized bovine bone mineral (DBBM), jointly referred to as contour augmentation for periodontal defects (CAPD; test group). Group B received only OFD (control group). Bleeding on probing (BOP), clinical attachment level (CAL), probing depth (PD), gingival recession (GR), keratinized mucosa width (WKM), keratinized mucosa thickness (TKM), and labial cortical plate thickness were compared at baseline and 1 year. BOP, CAL, PD, and GR did not show significant differences. TKM increased by 1.76 mm for Group A but decreased by 1 mm for Group B. WKM increased from 2.86 ± 0.4 mm to 3.6 ± 0.71 mm (P < .001) and from 2.93 ± 0.32 mm to 3 ± 0.7 mm (P = 0.5) for Groups A and B, respectively, which showed statistical significance. Labial cortical plate thickness increased from 0.94 ± 0.3 mm to 1.95 ± 0.54 mm (P < .001) for Group A but decreased from 0.87 ± 0.45 mm to 0.68 ± 0.31 mm for Group B. Visual analog scale scores for pain perception showed no difference between the two groups. CAPD for periodontally compromised teeth improves WKM and TKM. Long-term analyses are needed to determine its benefits in daily clinical practice.


Assuntos
Perda do Osso Alveolar , Humanos , Estudos Prospectivos , Feminino , Perda do Osso Alveolar/cirurgia , Pessoa de Meia-Idade , Masculino , Adulto , Índice Periodontal , Substitutos Ósseos/uso terapêutico , Retração Gengival/cirurgia , Resultado do Tratamento , Retalhos Cirúrgicos
11.
ACS Biomater Sci Eng ; 10(6): 3514-3527, 2024 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-38723173

RESUMO

The field of bone regeneration has always been a hot and difficult research area, and there is no perfect strategy at present. As a new type of biodegradable material, magnesium alloys have excellent mechanical properties and bone promoting ability. Compared with other inert metals, magnesium alloys have significant advantages and broad application prospects in the field of bone regeneration. By searching the official Web sites and databases of various funds, this paper summarizes the research status of magnesium composites in the field of bone regeneration and introduces the latest scientific research achievements and clinical transformations of scholars in various countries and regions, such as improving the corrosion resistance of magnesium alloys by adding coatings. Finally, this paper points out the current problems and challenges, aiming to provide ideas and help for the development of new strategies for the treatment of bone defects and fractures.


Assuntos
Regeneração Óssea , Magnésio , Regeneração Óssea/efeitos dos fármacos , Magnésio/uso terapêutico , Magnésio/farmacologia , Magnésio/química , Humanos , Ligas/química , Ligas/uso terapêutico , Materiais Biocompatíveis/uso terapêutico , Materiais Biocompatíveis/farmacologia , Materiais Biocompatíveis/química , Animais , Substitutos Ósseos/uso terapêutico , Substitutos Ósseos/química , Substitutos Ósseos/farmacologia , Corrosão
12.
Biomed Mater Eng ; 35(3): 265-278, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38728179

RESUMO

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


Assuntos
Cimentos Ósseos , Substitutos Ósseos , Compostos de Magnésio , Fosfatos , Cimentos Ósseos/química , Cimentos Ósseos/uso terapêutico , Humanos , Fosfatos/química , Compostos de Magnésio/química , Compostos de Magnésio/uso terapêutico , Substitutos Ósseos/uso terapêutico , Substitutos Ósseos/química , Animais , Regeneração Óssea/efeitos dos fármacos , Porosidade , Teste de Materiais , Osso e Ossos/efeitos dos fármacos
13.
Artigo em Inglês | MEDLINE | ID: mdl-38704857

RESUMO

Graft materials available to supplement hindfoot and ankle arthrodesis procedures include autologous (autograft) or allogeneic bone graft (allograft) but also bone graft substitutes such as demineralized bone matrix, calcium sulfate, calcium phosphate, and tricalcium phosphate/hydroxyapatite. In addition, biologic agents, such as recombinant human bone morphogenetic protein-2 or recombinant human platelet derived growth factor-BB (rhPDGF-BB), and preparations, including platelet-rich plasma or concentrated bone marrow aspirate, have been used to facilitate bone healing in ankle or hindfoot arthrodesis. The purpose of this review was to summarize the available clinical evidence surrounding the utilization and efficacy of the above materials and biological agents in ankle or hindfoot arthrodesis procedures, with emphasis on the quality of the existing evidence to facilitate clinical decision making.


Assuntos
Artrodese , Transplante Ósseo , Humanos , Artrodese/métodos , Transplante Ósseo/métodos , Substitutos Ósseos/uso terapêutico , Articulação do Tornozelo/cirurgia , Fosfatos de Cálcio/uso terapêutico
14.
J Orthop Surg (Hong Kong) ; 32(2): 10225536241254200, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38733211

RESUMO

PURPOSE: The primary objective of this study was to determine time to full weight-bearing after the use of a calcium-sulfate-calcium phosphate bone substitute (CaSO4/CaPO4) as a bone void filler in the treatment of primary benign bone tumours following intralesional curettage. The secondary objectives were to determine surgical complications and recurrence rates. METHODS: Retrospective review of patients identified from a surgeon-specific orthopaedic oncology database, who underwent curettage of benign bone tumours and subsequent bone void filling with CaSO4/CaPO4. RESULTS: A total of 39 patients (20 males, 19 females) met inclusion criteria with an average age of 31 years (range: 13 to 62 years), a median follow-up of 3.7 years, and a maximum follow-up of 11 years. The most common tumour diagnosis was giant cell tumour of bone (GCT) (n = 19), and the most common location was the proximal tibia (n = 9). The mean volume of tumour excised was 74.1 cm3 including extraosseous bone expansion due to tumour growth, with a mean of volume of 21.4 mL of CaSO4/CaPO4 used to fill the intraosseous cavitary defects to restore normal bone anatomy. None of the lesions required additional internal fixation. The primary outcome measure, average time to full weight-bearing/full range of motion, was 11 weeks and 6 weeks for upper and lower extremity lesions, respectively. Secondary outcomes included tumour recurrence requiring reoperation in five patients and infection requiring reoperation in two patients. CONCLUSION: This study demonstrates that CaSO4/CaPO4 is a viable option as a bone void filler in the reconstruction of cavitary defects following removal of primary benign bone tumours. CaSO4/CaPO4 provides sufficient bone regeneration early in the post-operative period to allow progression to full weight-bearing within weeks without the need for internal fixation. There were no graft-specific complications noted.


Assuntos
Neoplasias Ósseas , Substitutos Ósseos , Fosfatos de Cálcio , Sulfato de Cálcio , Curetagem , Suporte de Carga , Humanos , Masculino , Feminino , Adulto , Estudos Retrospectivos , Neoplasias Ósseas/cirurgia , Fosfatos de Cálcio/uso terapêutico , Pessoa de Meia-Idade , Adolescente , Substitutos Ósseos/uso terapêutico , Adulto Jovem , Fatores de Tempo
15.
Quintessence Int ; 55(5): 348-357, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38619257

RESUMO

OBJECTIVES: To evaluate the clinical effectiveness of regenerative treatment of intrabony defects in combination with consecutive orthodontic therapy with clear aligners in stage IV (type 2) periodontitis. METHOD AND MATERIALS: Ten patients with a total of 103 intrabony defects were analyzed after regenerative surgery using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic therapy with clear aligners. Changes in radiographic bone level and probing pocket depths were evaluated after 1 year (T1) and at final splinting (T2) after orthodontic tooth movement. RESULTS: Mean radiographic bone level gain was significant, with 2.13 ± 1.64 mm at T1 and 3.02 ± 2.00 mm at T2. Mean probing pocket depth was significantly reduced from 5.40 ± 1.80 mm at baseline to 3.78 ± 1.73 mm at T1, and remained stable with 3.73 ± 1.70 mm at T2. Pocket closure (≤ 4 mm probing pocket depth) was accomplished in 76% of all defects. Tooth loss amounted to 2.9%. CONCLUSION: Within the limitations of the retrospective study design, the findings suggest that the interdisciplinary treatment of periodontitis stage IV by regenerative periodontal surgery and consecutive orthodontic therapy with clear aligners can lead to favorable results.


Assuntos
Regeneração Tecidual Guiada Periodontal , Técnicas de Movimentação Dentária , Humanos , Masculino , Feminino , Técnicas de Movimentação Dentária/métodos , Estudos Retrospectivos , Regeneração Tecidual Guiada Periodontal/métodos , Resultado do Tratamento , Adulto , Pessoa de Meia-Idade , Periodontite/cirurgia , Periodontite/terapia , Perda do Osso Alveolar/cirurgia , Perda do Osso Alveolar/diagnóstico por imagem , Colágeno/uso terapêutico , Animais , Substitutos Ósseos/uso terapêutico , Bovinos , Bolsa Periodontal/cirurgia
16.
J Oral Implantol ; 50(3): 238-244, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38624039

RESUMO

The objective of this paper was to assess the outcome of bone graft material at alveolar bone augmentation sites combined with dental implants in postmenopausal women with compromised bone health by evaluating cone beam computerized tomography (CBCT) scans at multiple time points.CBCT scans were analyzed on 55 postmenopausal women with compromised bone health status to determine the fate of alveolar bone augmentation. CBCT scans were taken immediately after surgery and 9 and 24 months postoperatively. The patient's medication regimens and durations were recorded, and the pixel intensity value (PIV) was measured and standardized using scoring criteria and visual assessment. Statistical analyses included 2-sample t tests for continuous variables and Fisher's exact tests for categorical variables.Among the normal patients, 73% received a grade 2 visual score, and 27% received a grade 1 visual score. After 24 months, 45% of patients received a grade 2 score, and 27% received a grade 3 score. In the osteoporotic group receiving medication, 77% of participants received a grade 1 visual score at the 9-month postoperative evaluation, while 23% received a grade 2 score. At the 24-month assessment, 55% of patients received a grade 1 score, 41% received a grade 2 score, and only 5% received a grade 3 score. Notably, although the graft material did not remodel into native bone, it was a scaffold for implants in controlled osteoporotic patients. The study's results show that the pixel intensity values of particulate graft materials are similar across the three different time points, suggesting that the graft material's pixel intensity value remains constant in postmenopausal women with osteoporosis. The study's limitations include a small sample size and a restricted 24-month follow-up period. This limited time frame may need to capture long-term changes or variations in graft materials adequately. Future research should include a larger sample size and have a longer follow-up duration to provide a more comprehensive understanding of the change in graft materials between patients with normal and compromised bone health.


Assuntos
Aumento do Rebordo Alveolar , Tomografia Computadorizada de Feixe Cônico , Implantes Dentários , Humanos , Feminino , Pessoa de Meia-Idade , Aumento do Rebordo Alveolar/métodos , Idoso , Transplante Ósseo/métodos , Resultado do Tratamento , Substitutos Ósseos/uso terapêutico , Osteoporose Pós-Menopausa , Implantação Dentária Endóssea , Seguimentos , Pós-Menopausa
17.
Clin Oral Implants Res ; 35(6): 652-667, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38563550

RESUMO

OBJECTIVE: The objective was to assess the one year implant treatment outcome and patient-related outcome measures (PROMs) following maxillary sinus floor augmentation (MSFA) with autogenous bone graft (ABG) from the zygomatic buttress (control) compared with 1:1 mixture of ABG and anorganic porcine bone mineral (APBM) (Test I) or biphasic bone graft material (BBGM) (Test II). MATERIALS AND METHODS: Sixty healthy patients (34 females, 26 males) were randomly allocated to either control or test groups. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of peri-implant tissue, peri-implant marginal bone loss, frequency of complications, and PROMs using Oral Health Impact Profile-14 combined with questionnaire assessing patient perception of peri-implant soft tissue, prosthetic solution, implant function, and implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was .05. RESULTS: All suprastructures and implants were well-functioning after one year of functional implant loading. There was no significant difference between control and test groups in any of the applied outcome measures. The implant stability significantly increased from implant placement to abutment connection within all groups (p < .001). High patient satisfaction and significant improvement in oral health-related quality of life was also reported within all groups. CONCLUSION: This study demonstrates that MSFA with composite grafts containing minimal amounts of ABG reveals comparable implant treatment outcomes as compared with ABG alone, after one year of functional implant loading. Extensive ABG harvesting in conjunction with MSFA therefore seems not to be needed.


Assuntos
Transplante Ósseo , Levantamento do Assoalho do Seio Maxilar , Humanos , Feminino , Masculino , Levantamento do Assoalho do Seio Maxilar/métodos , Transplante Ósseo/métodos , Pessoa de Meia-Idade , Método Simples-Cego , Adulto , Resultado do Tratamento , Implantação Dentária Endóssea/métodos , Substitutos Ósseos/uso terapêutico , Idoso
19.
Zhongguo Gu Shang ; 37(3): 300-5, 2024 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-38515419

RESUMO

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


Assuntos
Substitutos Ósseos , Fraturas da Tíbia , Fraturas do Planalto Tibial , Humanos , Substitutos Ósseos/uso terapêutico , Transplante Ósseo/métodos , Fraturas da Tíbia/cirurgia , Resultado do Tratamento , Fixação Interna de Fraturas/métodos
20.
Clin Oral Investig ; 28(4): 213, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38480533

RESUMO

OBJECTIVE: The limitations of spontaneous bone healing underscore the necessity for exploring alternative strategies to enhance bone regeneration in maxillary radicular cyst cases. This retrospective study aimed to assess the impact of a bone substitute material (i.e., Bio-Oss) on bone volume regeneration following maxillary radicular cyst enucleation using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Seventy-three patients with maxillary radicular cysts were divided into two groups: one undergoing guided bone regeneration (GBR) with Bio-Oss and absorbable collagen membrane (n = 35), and the other receiving cyst excision alone (n = 38). Volumetric measurements using Amira software on CBCT scans evaluated bone regeneration, with cystic lesion shrinkage rates calculated. Intergroup comparisons utilized independent sample t-tests (P < 0.05), and linear regression analysis assessed the influence of preoperative cyst volume and group on bone healing. RESULTS: Both groups showed similar success rates in bone formation at the 12-month follow-up, with no significant differences between them (mean (SD), control: 75.16 (19.17) vs. GBR: 82 (20.22), P > 0.05). Linear regression analysis revealed a negative correlation between preoperative cyst volume and bone regeneration in both groups (P < 0.05). CONCLUSION: Bio-Oss may not significantly enhance bone augmentation in maxillary radicular cysts. In addition, preoperative cyst volume negatively affected the shrinkage rate of cystic lesions. CLINICAL RELEVANCE: Clinicians should consider patient-specific factors such as anatomy and lesion size when determining the need for bone substitute materials. Future research could focus on optimizing treatment protocols and alternative regenerative strategies to improve patient outcomes in maxillary cyst cases.


Assuntos
Substitutos Ósseos , Minerais , Cisto Radicular , Humanos , Transplante Ósseo/métodos , Estudos Retrospectivos , Cisto Radicular/cirurgia , Substitutos Ósseos/uso terapêutico , Regeneração Óssea
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