Evaluation of the Safety and Efficacy of Soft Tissue Augmentation With a Compressive-Resistant Collagen Matrix in a Nonhuman Primate Model.

PURPOSE: The purpose of the present study was to evaluate the safety and efficacy of the compression-resistant collagen-based cross-linked matrix for augmentation of maxillary and mandibular soft tissue defects in an animal model. MATERIALS AND METHODS: Six rhesus macaque monkeys were subjected to soft tissue grafting in 4 sites intraorally; the anterior maxilla was subjected to hard and soft tissue grafting with implant placement. Each site was randomly assigned 1 of 3 treatments: a compressive-resistant collagen matrix membrane (CM), a subepithelial connective tissue autograft (SCTG), or sham treatment, in which a partial-thickness flap was elevated and then sutured closed with no further treatment (control). The following methods were used for data collection: in vivo evaluation by periodontal probing, ultrasound, shear modulus elasticity, polyether impressions for volumetric analysis, and in vitro analysis by histologic biopsy examinations. In vitro analysis provided by histologic measurements and evaluations was performed on nondecalcified sections. The follow-up period was 6 months. RESULTS: The SCTG and CM showed favorable tissue integration. No adverse reaction to or deviation from the normal healing processes was detected. The CM integrated well in all sites, with a variable range of soft tissue volume increases. Volumetric discrepancies were appreciated in the histologic analyses and differences were found when the CM and SCTG were applied in the anterior maxilla in combination with hard tissue grafting and implant placement. Histologic evaluation showed favorable integration, no immunogenic response to the CM, and stable volumetric retention in autograft and CM sites during the experimental period. CONCLUSION: The compressive-resistant CM could be a safe and efficacious alternative for soft tissue augmentation by obviating a donor site and the consequent morbidity. Although a similar performance between the CM and SCTG was observed, further studies will be necessary to estimate the clinical potentiality and describe the limits of the technique.

Does Bone Grafting Improve Outcomes in Coronectomy Surgery? Long-Term (5- to 9-Year) Clinical and Radiographic Follow-Up of 78 Adult Patients.

PURPOSE: To report the long-term outcomes of 78 adult patients who underwent coronectomy with bone grafting (CWG) of the bony crypt. MATERIALS AND METHODS: Seventy-eight patients with follow-up of at least 5 to 9 years underwent CWG. Preoperative imaging and probing depths were recorded, as were yearly follow-up radiographs or cone-beam computed tomograms and yearly postoperative probing depths. RESULTS: Periodontal probing depths and bone levels on the distal surfaces of adjacent mandibular molars showed marked improvement compared with preoperative probing depths and bone levels. All retained roots maintained their immediate postoperative positions with no migrations and no reoperations required. CONCLUSION: CWG is a predictable procedure that should be considered for patients at risk for developing sensory disturbances or for those with deeper (>4 mm) preoperative probing depths on the distal surfaces of the adjacent molars. Adding bone graft appears to aid in preventing root migration and decreasing probing depths on the distal surfaces of adjacent molars.

Complex bone augmentation in alveolar ridge defects.

The current gold standard for bone grafting is autogenous bone, due to its biocompatibility, lack of antigenicity, osteoconductive, and osteoinducive properties. Radiography using cone-beam computed tomography for complex defects is useful in determining the amount of bone available and what bone augmentation technique will be needed. Many options for treatment of alveolar ridge defects are available, including varying surgical techniques as well as bone graft options.

Intraosseous inflammatory myofibroblastic tumor in the mandible: a rare pathologic case report.

Inflammatory myofibroblastic tumor (IMT) is an extremely rare lesion found in the maxillofacial region. Its frequency diminishes further when found in the bone. Although classification has varied throughout its history, the histologic features are often diagnostic, particularly with its strong association with anaplastic lymphoma kinase-1 (ALK-1) staining. The current mode of treatment for such a lesion is surgical removal with careful followup. In this rare case report, we describe the diagnosis and treatment in a 16-year-old male. Although this rare pathology can present as-and at times mimic-more serious pathologies, it is important for the attending surgeon to initially manage the pathology conservatively.