Evaluation of the Regenerative Capacity of Demineralized Bone Matrix vs Fat Graft in Alveolar Cleft Model in Albino Rats.

AIM: This study was performed to evaluate the regenerative capacity of demineralized bone matrix vs fat graft, both guided by pericardium membrane in alveolar cleft model in albino rats. MATERIALS AND METHODS: A total of 72 rats were required in this study. A surgical bone defect with a 7 mm length × 4 mm width × 3 mm depth was created as a model of an alveolar cleft, then the rats were divided randomly into four equal groups each group contained 18 rats: control group (defect only), the membrane group (the defect was covered by the pericardium membrane), the demineralized bone matrix (DBM) group (the defect was filled with DBM guided by pericardium membrane) and fat group (the defect was filled with a fat graft guided by the pericardium membrane). Around 6 rats from each group were euthanized after 2, 4, and 8 weeks. Skulls were scanned with cone beam computed tomography (CBCT) and harvested for histological evaluation with routine H&E immunohistochemical stains (Anti-osteocalcin and Anti-Wnt5a). The data was recorded and statistically analyzed by a two-way ANOVA. RESULTS: The study showed a notable formation of new bone, and expression of OCN and Wnt5a were notably increased by time in the fat group. However, the density of bone grafts and OCN and Wnt5a expression decreased with time in the DBM group. Control and membrane groups showed negative OCN and Wnt5a immune-reactivity in the cleft site. CONCLUSION: Fat graft results were superior to DBM results with regard to mucosal closure and accelerated bone regeneration, and may represent an effective treatment for alveolar cleft reconstruction. CLINICAL SIGNIFICANCE: Finding an inexpensive, accessible, biocompatible and easily manipulated treatment for craniofacial reconstruction and fat graft fulfilled the desired aims. Further investigations with prolonged evaluation periods are needed. How to cite this article: Abdel Raouf E, Elsherbini AM, Abdel Salam Yousef Y, et al. Evaluation of the Regenerative Capacity of Demineralized Bone Matrix vs Fat Graft in Alveolar Cleft Model in Albino Rats. J Contemp Dent Pract 2024;25(6):554-562.

The Effect of Topical Application of Hyaluronic Acid on the Stability of Immediate Loaded Dental Implants in the Posterior Maxilla: Clinical and Animal Study.

Objective: To assess the effect of topically applied hyaluronic acid (HA) on the stability of immediately loaded implants in the posterior maxilla. Materials and Methods: For the clinical study, a total of 20 implants were placed in 14 patients seeking the replacement of missing single or multiple posterior maxillary teeth. The patients were randomly divided into two groups. In the clinical control group (CC group), 10 implants were placed and immediately loaded, while in the clinical study group (CS group), 10 implants were coated with HA immediately before placement and immediately loaded. All patients had implant stability clinically evaluated at implant placement time (T0) and 1 (T1), 3 (T3), and 6 (T6) months after loading. Peri-implant pocket depth and modified sulcus bleeding index were evaluated clinically at 6 months in all patients. Bone density was evaluated radiographically after 3 months. All the clinical and radiographic data were subjected to statistical analysis. For the animal study, a total of 12 implants were placed in the tibiae of six rabbits. For each rabbit, 1 implant without any applied HA was placed in the left tibia (AC group), and 1 implant coated with HA was placed in the right tibia (AS group). The rabbits were euthanized at 21 and 45 days after implant insertion. Results: There were no significant statistical differences between the two groups regarding implant stability, peri-implant pocket depth, modified sulcus bleeding index, or bone density from the palatal and apical aspects. However, there was a significant statistical difference in the bone density from the buccal aspect in favor of the study group. The animal study showed that the newly formed bone in the right tibiae showed improved quantity and quality of bone, as it had denser bone trabeculae and smaller marrow spaces compared to the left tibiae. Conclusion: In the clinical study, the application of hyaluronic acid had a superior effect on the buccal bone density around immediately loaded implants. In the animal study, hyaluronic acid had a synergistic effect on the quality and quantity of bone formation around dental implants.

Evaluation of Two Computerized Methods for Presurgical Volumetric Analysis in Secondary Alveolar Cleft Bone Grafting: A Prospective Study.

AIM: The purpose of this study is to evaluate presurgical computerized volumetric analysis in secondary alveolar cleft bone grafting (SABG) and the time taken for calculation using cone-beam computed tomography (CBCT) via two different software programs. MATERIALS AND METHODS: Twelve patients with unilateral alveolar clefts were investigated using CBCT. Two independent investigators did presurgical volumetric analysis for each patient's CBCT data using two different methods. Method A involved On-Demand 3D software (Cybermed Inc., Korea), while method B involved InVesalius 3 software (CTI, Brazil). The volume outcomes and time spent for measurements were compared between both software programs. Interobserver reliability and descriptive and t-test statistics were computed, and statistical significance was considered when p ≤ 0.05. RESULTS: There was not a statistically significant difference between clefts' volumetric measurements by the two methods via both investigators (p = 0.186 and 0.069). However, the difference in time taken for these measurements between the two methods was statistically significant (p < 0.001). Intraclass correlation coefficient (ICC) values indicated excellent interobserver reliability for measurements by method A (ICC ~ 0.998), and moderate reliability for method B (ICC ~ 0.626). CONCLUSIONS: Both software programs used in this study had comparable volumetric computation. Method B took much less calculating time than method A. The interobserver reliability was high for both methods. CLINICAL SIGNIFICANCE: These both investigated software programs may show a clinical implication for presurgical alveolar cleft volume measurement, thus reducing the surgical operating time and adequately selecting a donor site with a congruent sufficient amount of bone grafts.