The shape of a bone scraper: an in vitro pilot study using porcine bone chips.

Bone scrapers are commonly used to harvest autologous bone in oral and implant surgery. The angle of the cutting blade is a variable that distinguishes bone scrapers. In the present study, the impact of the angle of the cutting blade on the in vitro characteristics of harvested bone was determined. Bone scrapers with blade angles of 15°, 25°, 35°, 45°, and 55° were used to harvest porcine cortical mandibular bone. The number and characteristics of the cells that grew out from the bone chips were examined. The data showed that, independent of the angle of the cutting blade, viable cells were barely detectable in fresh bone grafts. However, cells with a fibroblastic morphology appeared within 1 week in the culture dishes. After 21 days, the number of cells did not differ significantly between the five preparations. Moreover, cells responded to incubation with bone morphogenetic protein 7 (BMP-7) with an increased alkaline phosphatase activity, irrespective of the preparation. The data suggest that bone scrapers with different cutting angles produce bone chips with comparable in vitro characteristics.

Long-term stability of early implant placement with contour augmentation.

In this prospective case series study, 20 patients with an implant-borne single crown following early implant placement with simultaneous contour augmentation were followed for 6 years. Clinical, radiologic, and esthetic parameters were assessed. In addition, cone beam computed tomography (CBCT) was used at 6 years to examine the facial bone wall. During the study period, all 20 implants were successfully integrated, and the clinical parameters remained stable over time. Pleasing esthetic outcomes were noted, as assessed by the pink esthetic scores. None of the implants developed mucosal recession of 1 mm or more. The periapical radiographs yielded stable peri-implant bone levels, with a mean DIB of 0.44 mm at 6 years. The CBCT scans showed that all 20 implants had a detectable facial bone wall at 6 years, with a mean thickness of around 1.9 mm. In summary, this prospective case series study demonstrated stable peri-implant hard and soft tissues for all 20 implants, and pleasing esthetic outcomes overall. The follow-up of 6 years confirmed that the risk for mucosal recession is low with early implant placement. In addition, contour augmentation with guided bone regeneration (GBR) was able to establish and maintain a facial bone wall in all 20 patients.

Short-term teriparatide delivery and osseointegration: a clinical feasibility study.

Teriparatide is an anabolic osteoporosis therapeutic agent that can improve healing after fractures and periodontal surgeries. Clinical studies investigating the effects of teriparatide on the osseointegration of titanium implants have not been performed. We conducted an open-label randomized controlled feasibility study and included 24 individuals with edentulous lower jaws. The participants received 2 study implants in the mandible during interforaminal dental implant surgery. They were randomly assigned to receive either 20 µg of teriparatide once daily for 28 days or no treatment. Study implants were retrieved from 23 participants after 9 weeks and were subjected to histomorphometric analyses. Endpoints were new bone-volume-per-tissue-volume (NBV/TV) and new bone-to-implant-contact (NBIC). We report here that median values of NBV/TV in the control and the teriparatide groups were 15.4% vs. 17.6% in the periosteal compartment, 11.3% vs. 16.5% in the cortical compartment, and 7.3% vs. 12.0% in the medullary compartment, respectively. NBIC median values in the control and the teriparatide groups were 3.3% vs. 4.1% in the periosteal compartment, 5.0% vs. 4.4% in the cortical compartment, and 0.3% vs. 1.4% in the medullary compartment, respectively. The results provide the first histological data on the osseointegration of titanium study implants in individuals treated with teriparatide. ClinicalTrials.gov number, NCT00089674.