Semi-customized three-dimensional ultra-fine titanium meshes in guided bone regeneration for implant therapy in severe alveolar bone defect: a case report.

This case report provides a detailed description of a simple and fast bone regeneration procedure using a semi-customized three-dimensional ultra-fine titanium mesh. A 50-year-old male with a severe vertical and horizontal bone defect in the anterior mandible underwent implant treatment in a staged approach. The autologous bone was combined with a xenograft, and the mixture was grafted to augment the bone defect and covered with semi-customized ultra-fine titanium meshes, which were selected among its various types according to size and configuration of the bone defect, directly connected and immobilized on the tenting screws with minimal shaping. In a postoperative 6 months re-entry surgery, the performed titanium meshes were removed, implants were placed, and a bone core biopsy was obtained that demonstrated satisfactory new bone formation. Finally, two months later, the definitive prosthesis was installed. This semi-customized ultra-fine titanium mesh could help an implant clinician obtain more predictable results in the guided bone regeneration (GBR).

A hyaluronate-atelocollagen/beta-tricalcium phosphate-hydroxyapatite biphasic scaffold for the repair of osteochondral defects: a porcine study.

The authors had devised a novel biphasic scaffold combining hyaluronic acid and atelocallagen for the chondral phase and combining hydroxyapatite and beta-tricalcium phosphate for the osseous phase. Sixty-four osteochondral defects were created in the knee joints of 16 minipigs to evaluate the effectiveness of this scaffold for repairing cartilage in a large animal model. The defects were divided into five groups according to their treatment: filling with a cell/biphasic scaffold composite (Group I, 16 defects); implanting only the biphasic scaffold (Group II, 16 defects); placing the removed osteochondral fragments back into the defect (Group IIIa, 8 defects); autologous chondrocyte implantation (Group IIIb, 8 defects); leaving the defects empty (Group IV, the negative control). After 5 months, the International Cartilage Repair Society Macroscopic Score was similar in Group I (9.0), Group II (9.1), and Group IIIa (9.1), followed by Group IIIb (7.4) and Group IV (6.2). Except for three defects noted in Group IV, all the defects were filled with cartilaginous or fibrous tissue depending on the groups. The junction to the adjacent native cartilage was detectable in all the groups of minipigs. Microscopically, Group II had the highest score from the International Cartilage Repair Society Visual Histological Assessment Scale. The indentation study showed that the maximum loads and time constant of Group I, II, and IIIa defects were comparable to that of native cartilage, whereas the equilibrium loads of these groups were slightly greater than that of native cartilage. In conclusion, our results suggest that a biphasic osteochondral scaffold with a chondral phase, consisting of hyaluronate and atelocollagen, and an osseous phase, consisting of hydroxyapatite and beta-tricalcium phosphate, is effective for repairing osteochondral defects in a large animal model.

Novel hyaluronate-atelocollagen/beta-TCP-hydroxyapatite biphasic scaffold for the repair of osteochondral defects in rabbits.

The authors devised a novel biphasic scaffold combining hyaluronic acid and atelocollagen for the chondral phase and combining hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP) for the osseous phase. The biphasic scaffold was fabricated by placing the freeze-dried chondral phase over the HA/beta-TCP scaffold prewetted with hyaluronate/atelocollagen solution. Chondrocytes were isolated in 28 rabbits, expanded, injected inside the chondral phase of the biphasic scaffold, and then cultured in chondrogenic medium. After 2 weeks of in vitro culture, chondrocytes had evenly infiltrated inside the chondral phase and produced extracellular matrix. For in vivo study, a large osteochondral defect was made on the patellar groove of the right distal femur and managed using one of the following methods: filling with cell-biphasic scaffold composite (group I); implanting only biphasic scaffold (group II); placing the removed osteochondral fragments back into the defect (group III, positive control); leaving empty (group IV, negative control). Seven rabbits were allocated to each group. After 12 weeks, the International Cartilage Repair Society Macroscopic Score was highest in group III, followed by group I, group II, and lastly group IV. Depression of the defect was greatest in group IV. There were three rabbits (two in group I and one in group II) that were completely denuded of the chondral phase. The junction to adjacent native cartilage was distinct in rabbits of all groups. The International Cartilage Repair Society Visual Histological Score was highest in group III, followed by groups II and I, and lastly group IV. In conclusion, our results suggest that a biphasic osteochondral composite using a chondral phase consisting of hyaluronate and atelocollagen and an osseous phase consisting of HA and beta-TCP holds the promise for repair of osteochondral defects.