A new method for oral cancer biomarkers detection with a non-invasive cyto-salivary sampling and rapid-highly sensitive ELISA immunoassay: a pilot study in humans.

Introduction: Oral squamous cell carcinoma (OSCC) accounts for approximately 90% of oral malignancies and has a 5-year mortality rate close to 50%. A consistent part (70%) of all oral cancers is diagnosed at an advanced stage since available screening techniques are ineffective. Therefore, it would be urgent to improve them. The diagnostic gold standard is tissue biopsy with histological and immunohistochemical assessment. This method presents some limitations. Biopsy is invasive and the histopathological evaluation is semi-quantitative, and the absolute abundance of the target cannot be reliably determined. In addition, tissue is highly processed and may lead to loss of information of the natural state. The search for classical and new clinical biomarkers on fragments of tissue/cells collected with a cytobrush is a highly hopeful technique for early detection and diagnosis of OSCC, because of its non-invasive sampling and easy collection method. Methods: Here we analyzed cytobrush biopsies samples collected from the oral cavity of 15 patients with already diagnosed OSCC by applying an innovative high-sensitivity ELISA technique, in order to verify if this approach may provide useful information for detection, diagnosis, and prognosis of OSCC. To this end, we selected six biomarkers, already used in clinical practice for the diagnosis of OSCC (EGFR, Ki67, p53) or selected based on recent scientific and clinical data which indicate their presence or over-expression in cells undergoing transformation and their role as possible molecular targets in immunecheckpoints blockade therapies (PD-L1, HLA-E, B7-H6). Results: The selected tumor biomarkers were highly expressed in the tumor core, while were virtually negative in healthy tissue collected from the same patients. These differences were highly statistically significant and consistent with those obtained using the gold standard test clearly indicating that the proposed approach, i.e. analysis of biomarkers by a custom ELISA technique, is strongly reliable. Discussion: These preliminary data suggest that this non-invasive rapid phenotyping technique could be useful as a screening tool for phenotyping oral lesions and support clinical practice by precise indications on the characteristics of the lesion, also with a view to the application of new anti-tumor treatments, such as immunotherapy, aimed at OSCC patients.

Emerging potential of phototherapy in management of symptomatic oral lichen planus: A systematic review of randomised controlled clinical trials.

Phototherapy incorporating photobiomodulation therapy and antimicrobial photodynamic therapy has been utilised as antioxidants in symptomatic oral lichen planus (OLP) management; however, its role of intervention remains controversial. The aim of this systematic review of CRD42021227788 PROSPERO (an international prospective register of systematic reviews in health and social care) registration number was to oversee and determine phototherapy efficacy in patients with symptomatic OLP, identifying and bridging the literature gaps by proposing recommendations for future studies. A search strategy was developed in consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Various electronic databases were exercised to search for randomised controlled clinical trials (RCTs). Several search engines were employed to analyse a total of 177 studies of which nine included. A wide range of utilised laser and light-emitted diode wavelengths between 630 and 808 nm and irradiance ranged between 10 and 13 mW/cm2 were noted. 67% of studies reported a high risk of bias and a high heterogeneity obtained from numerical data for quantitative analysis, therefore meta-analysis was impossible to conduct. Despite inconsistency and diversity in phototherapy parameters, treatment protocols, photosensitiser (type, concentration and method of application) and outcome assessment tools, the majority of the studies showed positive results compared with standard care treatments. Hence, a necessity to perform well-designed RCTs with robust methodology is warranted, after acknowledging the current drawbacks and addressing the suggested recommendations highlighted in our review. Moreover, advanced knowledge in understanding further phototherapy-antioxidants molecular mechanistic in symptomatic OLP is required.

Peri-implant Soft Tissue Management: Cairo Opinion Consensus Conference.

Peri-implant soft tissues play a role of paramount importance, not only on the esthetic appearance, but also on the maintenance and long-term stability of implants. The present report presents the conclusions from the Consensus Conference of the South European North African Middle Eastern Implantology & Modern Dentistry Association (SENAME) (4-6 November 2016, Cairo, Egypt). The conference focused on the topic of the soft tissue around dental implants, and in particular, on the influence of implant configurations on the marginal soft tissues, soft tissue alterations after immediate, early or delayed implant placement and immediate loading, the long-term outcomes of soft tissue stability around dental implants, and soft tissue augmentation around dental implants. Thirty world experts in this field were invited to take part in this two-day event; however, only 29 experts were in the final consensus voting process.

Clinical osseointegration of bone level implants with conical shape and textured surface with low primary stability.

BACKGROUND: Evidence shows lower chance for osseointegration of implants without sufficient primary stability. The present retrospective study observed bone level conical screw implants with textured surface without primary stability. METHODS: Twenty-six Stark conical screw implants, with V-Blast (Vanish Blast) surface treatment were placed with low primary stability, (insertion torque lower than 10 N/cm and visible mobility at lateral load of 250 g). A soft diet was prescribed. osseointegration was assessed applying 30 Ncm of reverse torque 6 months after placement. RESULTS: The 26 implants that did not achieve primary stability still had a survival rate of 96% after the observation period and were classified as successful according with ICOI Pisa consensus conference success, survival, failure classification .96% of the implants showed clinical osteointegration and were successfully restored. After 12 months, all implants remained functional. CONCLUSIONS: It can be concluded that bone-level implants with V-Blast surface in absence of functional loading are able to achieve osteointegration, even with low primary stability.

Piezoelectric implant surgery and immediate loading in the aesthetic zone.

BACKGROUND: Replacement of missing teeth in the anterior aesthetic zone has challenged clinicians with fixed, removable or implant prosthodontics. Problems have been encountered could void aesthetic and functional results. The aim of this study was to present a clinical case report in which clinician challenged a very strong aesthetic case with an innovative surgical and prosthetic approach. METHODS: A patient who presented to the authors with a maxillary central incisor that had a hopeless prognosis secondary to acute localized severe periodontitis. The patient was treated by extracting the tooth and replacing it immediately with a platform switched implant using piezoelectric surgery. The implant was then restored with an immediate, non-occlusal loading provisional restoration. RESULTS: The implant became osseointegrated and was ultimately restored with a definitive abutment and crown restoration. CONCLUSIONS: Innovative approaches could represent a valid alternative to restore patients functionally and aesthetically.

Micro-Scale Surface Patterning of Titanium Dental Implants by Anodization in the Presence of Modifying Salts.

The bone-implant interface influences peri-implant bone healing and osseointegration. Among various nano-engineering techniques used for titanium surface modification, anodization is a simple, high-throughput and low-cost process, resulting in a nanoporous oxide coating which can promote osseointegration and impart antimicrobial and immunomodulatory properties. We anodized rounded tip dental implants of commercial grade titanium in aqueous phosphoric acid modified with calcium and potassium acetate, and characterized the resulting surface morphology and composition with scanning electron microscopy and energy dispersive spectrometry. The appearance of nanopores on these implants confirmed successful nanoscale morphology modification. Additionally, the metal cations of the used salts were incorporated into the porous coating together with phosphate, which can be convenient for osseointegration. The proposed method for surface nanostructuring of titanium alloy could allow for fabrication of dental implants with improved biocompatibility in the next stage of research.

Early postoperative reactions following lateral sinus floor elevation using piezosurgery: A radiographic study.

BACKGROUND AND PURPOSE: Early postoperative reactions occur following lateral sinus floor elevation (LSFE). This article radiographically describes, quantifies, and measures these early postoperative changes inside grafted maxillary sinus area. MATERIALS AND METHODS: In 24 patients, 31 maxillary sinuses were performed using piezosurgery and grafted by bioceramic materials. Cone beam computed tomography was done preoperatively and then postoperatively, randomly, at either day 1 (n = 6), 2 (n = 11), 3 (n = 8), or 7 (n = 6) and at 6 months for all patients. Membrane thickening and subsequent swelling ratio, submucosal edema, and air bubbles inside grafted area were noted and measured. Inflammation was classified as mild, moderate, or severe. RESULTS: Preoperative mean membrane thickness was 0.75 mm then following LSFE it significantly increased at days 1, 2, 3, and 7 and was respectively 2.36, 4.14, 6.05, and 6.63 mm. Mean swelling ratio significantly increased over time and was 11.37, 13.73, 16.34 and 35.78 at days 1, 2, 3, and 7, respectively. Submucosal edema height was noted in 24 cases. It had a mean value of 3.35 mm and increased significantly with time. Inflammation inside grafted area was mild in 7, moderate in 15, and severe in 9 of the cases. It significantly increased with time. Apical air bubble was present in 19 cases and had mean dimensions of 6.6 × 4.6 mm. No inflammatory signs were noted at 6 months. CONCLUSIONS: Inflammatory reactions are always noted following LSFE and tend to increase with time reaching peak values at 7 days. All inflammatory changes significantly subsided at 6 months.

Osteointegration of Tissue-Level Implants With Very Low Insertion Torque in Soft Bone: A Clinical Study on SLA Surface Treatment.

INTRODUCTION: Evidence shows lower percentage of osteointegration when implants are placed without sufficient primary stability. The present work tested the hypothesis that implants unstable at insertion could achieve osteointegration with proper implant surface treatment. MATERIALS AND METHODS: Eleven Straumann tissue-level implants with sandblasted, large-grit, acid-etched (SLA) surface treatment were placed in soft bone unfavorable to primary stability, as indicated by insertion torque lower than 10 N/cm and slight mobility on the application of a lateral load of 250 g. After 4 to 6 months of healing, a reverse torque of 35 Ncm was applied to assess osteointegration. RESULTS: All implants appeared to be clinically osseointegrated and were successfully restored and loaded with fixed partial dentures or single crowns. After 28.5 months, all implants remained functional. CONCLUSIONS: Within the limitations of the low number of implants analyzed, it can be concluded that tissue-level implants with sand-blasted and acid-etched surface treatment can achieve osteointegration, even in the absence of primary stability.

Using MicroCT to Assess Periodontal Regeneration Outcomes-Comparison of Image-Based and Histologic Results: A Case Report.

The purpose of this study was to compare microcomputed tomography (microCT) and histologic analysis outcomes of a periodontal regeneration of a human defect treated with a polylactic- and polyglycolic-acid copolymer. At 11 months following the grafting procedure, the root with the surrounding periodontal tissues was removed and analyzed using microCT and histologic techniques. The results suggest that microCT three-dimensional analysis may be used in synergy with two-dimensional histologic sections to provide additional information for studying the regeneration outcomes normally reported by histologic biopsies in humans. Additional data is needed to validate these findings.

Standard Drilling Versus Ultrasonic Implant Site Preparation: A Clinical Study at 4 Weeks After Insertion of Conical Implants.

OBJECTIVE: Clinically evaluate implants placed after ultrasonic implant site preparation (UISP) and standard drilling (SD). MATERIALS AND METHODS: Ten patients received 21 implants placed using UISP (n = 11) or SD (n = 10). Bone quality was hand assessed and final insertion torque (IT), resonance frequency analysis (ISQ) at baseline and ISQ, and removal torque values (RTV) at 4 weeks were recorded and compared. RESULTS: Mean IT values were 70.91 and 72.40 N/cm in UISP and SD groups, respectively, and were not statistically different. IT significantly correlated to bone quality. Mean ISQ values at baseline and 4 weeks were not significantly different and were 74.72 and 74.73 for UISP and 76.70 and 73.20 for SD, respectively. Mean ISQ at baseline significantly correlated to IT values and bone quality in both groups. Mean RTV values in both UISP (51.32 N/cm) and SD (53.1 N/cm) were not significantly different but significantly correlated to IT values. All implants achieved osseointegration and were restored. CONCLUSION: Implant placement after ultrasonic preparation can be considered a predictable technique leading to clinical and biological responses similar to SD 4 weeks after insertion.

In Vitro Biocompatibility Assessment and In Vivo Behavior of a New Osteoconductive ßTCP Bone Substitute.

OBJECTIVE: Beta-tricalcium phosphate (ßTCP) granules (OsproLife) exhibit a pure crystalline phase and a rough microporous surface for promoting cell adhesion and microsized intragranule porosity for improving wettability and resorption necessary for bone regeneration. OsproLife is a fully resorbable, space-maintaining, and osteoconductive synthetic material for the filling of bone defects. To asses OsproLife properties, a similar synthetic biomaterial, already on the market, has been chosen as reference: Cerasorb has the same chemical composition, but different crystal structure, surface morphology, and granule size. The aim of this study is to compare the properties of OsproLife and Cerasorb. METHODS: Chemical purity, composition and physical properties, in vitro cytotoxicity, and in vivo bone performance in a rabbit model were analyzed. ßTCP OsproLife granules (test) were compared with Cerasorb (control). Histological and µCT analyses were performed at 6, 12, and 56 weeks after implantation. RESULTS: ßTCP OsproLife and Cerasorb granules result to be both biocompatible and characterized by the same osteoconductivity and resorption rate. CONCLUSION: ßTCP OsproLife granules are a promising bone substitute for dental and orthopedic applications.

Piezosurgical treatment of crestal bone: quantitative comparison of post-extractive socket outcomes with those of traditional treatment.

OBJECTIVE: The study aimed to quantitatively compare, for the first time, the clinical outcomes of crestal bone volume resorption in sockets undergoing traditional extraction technique (TET) or piezosurgical extraction technique (PET), also considering the influence of buccal plate thickness. MATERIAL AND METHODS: In this prospective study, 19 sockets were randomly treated with TET, and 18 sockets were randomly treated with PET. Furthermore, patients were split into subgroup A, with buccal bone plate thickness (BPT) ≤1 mm, and subgroup B, with BPT>1 mm. Buccal (BCH) and palatal (PCH) cortex height, bucco-palatal ridge (BPR) width were monitored at tooth extraction and after the 4-month post-extractive period of natural healing. RESULTS: After 4 months, BCH, PCH and BPR width decreased more in the TET than in the PET group, but only the BPR decrease was statistically significant (P = 0.034) after ANOVA test. In both TET and PET groups, all B subgroup patients showed a lower decrease than A subgroup patients for both BCH, PCH and BPR, statistically significant for PCH (P = 0.019) and BPR (P < 0.001) of TET group, and BPR (P = 0.002) of PET group, after ANOVA. Both A and B subgroups of PET showed a statistically significant lower decrease than the corresponding subgroups of TET, comparing A (P = 0.005) and B (P = 0.037) subgroups for BPR, after ANOVA. CONCLUSIONS: With both thin and thick buccal plates, the piezosurgical extraction technique of teeth significantly decreases the horizontal resorption of the hard tissue ridge, but not the vertical resorption. Moreover, buccal plate thickness seems to be a key factor in post-extractive bone resorption: the thinner the buccal plate the greater the horizontal crestal bone loss.

Changes in Sinus Membrane Thickness After Lateral Sinus Floor Elevation: A Radiographic Study.

PURPOSE: To radiographically monitor sinus membrane swelling after lateral sinus floor elevation surgery at short and long healing periods. MATERIALS AND METHODS: For 26 patients seeking posterior maxillary implant-supported reconstruction, 32 lateral sinus floor elevations were performed using Piezosurgery. Sinus membranes were grafted using synthetic calcium phosphate bone substitutes, and graft volume was measured in cubic centimeters for each case. Cone beam computed tomography (CBCT) examination was conducted preoperatively in all patients and for each grafted sinus at 1 day (n = 8), 2 days (n = 9), 3 days (n = 8), or 7 days (n = 7) after surgery. Control CBCT was then performed for all patients at 3, 6, and 12 months after surgery. Sinus membrane thickness was measured on cross-sectional CBCT images at nine standardized points per sinus, before lateral sinus floor elevation and at all postoperative examinations. RESULTS: Mean sinus membrane thickness was 0.73 mm before surgery, and 5 mm, 4.1 mm, 5.9 mm, and 7 mm, respectively, at 1, 2, 3, and 7 days after surgery. First week combined postoperative CBCT measurements of membrane thickness was 5.4 mm, then 1.3, 0.68, and 0.39 mm at 3, 6, and 12 months, respectively, after surgery. Membrane thickness significantly increased the first week after surgery and gradually decreased significantly at 3, 6, and 12 months in all groups (P < .001). First-week postoperative measurements showed a significant increase in membrane thickness at 3 days compared with the 1- and 2-day results (P < .001) and at 7 days compared with all other time points (P < .001). Membrane thickness at 2 days did not change significantly compared with 1-day measurements. Larger graft volume was positively correlated with an increase in membrane thickness after surgery at all time points (n = 32; r = 0.527; P < .001). CONCLUSION: After lateral sinus floor elevation surgery, transient swelling of sinus membrane is observed. It reaches a peak value 7 days after surgery and completely resolves over months. This swelling is correlated to the extent of sinus floor elevation.

Electrochemical coating of dental implants with anodic porous titania for enhanced osteointegration.

Clinical long-term osteointegration of titanium-based biomedical devices is the main goal for both dental and orthopedical implants. Both the surface morphology and the possible functionalization of the implant surface are important points. In the last decade, following the success of nanostructured anodic porous alumina, anodic porous titania has also attracted the interest of academic researchers. This material, investigated mainly for its photocatalytic properties and for applications in solar cells, is usually obtained from the anodization of ultrapure titanium. We anodized dental implants made of commercial grade titanium under different experimental conditions and characterized the resulting surface morphology with scanning electron microscopy equipped with an energy dispersive spectrometer. The appearance of nanopores on these implants confirm that anodic porous titania can be obtained not only on ultrapure and flat titanium but also as a conformal coating on curved surfaces of real objects made of industrial titanium alloys. Raman spectroscopy showed that the titania phase obtained is anatase. Furthermore, it was demonstrated that by carrying out the anodization in the presence of electrolyte additives such as magnesium, these can be incorporated into the porous coating. The proposed method for the surface nanostructuring of biomedical implants should allow for integration of conventional microscale treatments such as sandblasting with additive nanoscale patterning. Additional advantages are provided by this material when considering the possible loading of bioactive drugs in the porous cavities.

Stage Characterization and Marginal Bone Loss Evaluation Up to 96 Months of Crestal Sinus Augmentation With Sequential Drills: A Retrospective Study.

INTRODUCTION: The 2-stage crestal approach to augment the maxillary sinus is a little-used technique. The aim of this retrospective study was to assess events characterizing stages of this technique after implant placement in the posterior maxilla with residual bone height less than 4 mm and evaluate the marginal bone loss (MBL) changes over time. MATERIAL AND METHODS: Thirty-three patients underwent unilateral sinus augmentations using the trancrestal technique with mineralized allograft. Six-months (6 m) after first surgery, if skeletal subsidence prevented insertion of a 10-mm-length implant, additional grafting was performed during implant (n = 33) insertion. Radiographs were taken before grafting (baseline), immediately after and at 6 months; immediately after and 6 months after implant placement; and at follow-up (24-96 m). RESULTS: One implant was lost (ISR = 96.97%). Of the remaining 32 patients, 14 (A group) underwent standard implant placement, whereas 18 (B group) underwent additional grafting immediately before implant placement. Given that B-group patients initially obtained lower crestal bone height after first surgery, additional grafting procedures provided greater crestal height in the B group. A significant relationship between ending (eMBL) and 6mMBL was found in both groups, with greater values in the B group. However, in both groups, eMBL was always greater if 6mMBL was greater than 0.44 mm. DISCUSSION: Results suggest a high and low skeletal-reactivity patient categorization. In both patient categories, MBL greatly depends upon 6-month values. Investigations are necessary to relate sinus size with results obtained by this 2-stage crestal approach. CONCLUSIONS: The 2-stage crestal sinus lift procedure not only provides predictable results, but also allows low skeletal-reactivity patient recovery.

Surface microstructure of dental implants before and after insertion: an in vitro study by means of scanning probe microscopy.

INTRODUCTION: The surface microstructure of dental implants affects osseointegration, which makes their accurate topographic characterization important. We defined a procedure for evaluation of implant topography before (pre-) and after (post-) in vitro implantation test in bovine bone. MATERIALS AND METHODS: The apical morphology of ten implants was analyzed in pre- and post-conditions using atomic force microscopy or 3D profilometry. We extracted four topographical parameters (two amplitude, 1 spatial, and 1 hybrid) and assessed the differences by analysis of variance. RESULTS AND DISCUSSION: The implant with coating (Spline Twist MP-1 HA) was damaged. The two implants with highest pre-amplitude parameters (Pitt Easy VTPS, TLR3815) maintained their character on testing. Pitt Easy PURETEX and OT-F1 were the only nondamaged implants whose amplitude parameters increased. The surface area underwent minor changes even when the texture changed (Tri-Vent, Pitt Easy PURETEX, Exp #1). The implants that ranked the lowest in all parameters before implantation were DT4013TI, Tri-Vent, OT-F1, and Exp #2. On testing, DT4013TI showed the highest decrease in values, whereas Tri-Vent showed the highest increase in surface area. All the experimental implants showed similar topographic properties both pre- and post-test. CONCLUSION: For most implants, no major changes occurred in surface topography on implantation. The procedure applied seems promising to evaluate the degradation of implant surface on insertion.

Microstructure of titanium-cement-lithium disilicate interface in CAD-CAM dental implant crowns: a three-dimensional profilometric analysis.

BACKGROUND: Peri-implantitis is an infection of the implant surface caused by adhesion of bacteria that generate bone resorption and sometimes even consequent implant loss. Both screw-retained and cemented fixed implants are affected. PURPOSE: The purpose of this study is to investigate the morphological defects at the cemented interface between titanium abutment and ceramic crown, comparing different adhesive cements used to fill the marginal gap. MATERIALS AND METHODS: Twelve computer-aided design-computer-aided manufacturing dental crowns were cemented to titanium abutments using three different resin composite cements. Sealed margins were polished using grommets with descending diamond particle size. Three groups of four crowns each were made according to the cement used, namely RelyX Unicem (3 M ESPE), Panavia F 2.0 (Kuraray), and NX3 (Nexus Kerr). Samples were analyzed using optical inspection, three-dimensional profilometry, and image analysis, including analysis of variance. RESULTS: Although RelyX showed significantly lower root mean square surface roughness (4.4 ± 1.5 µm) than that of NX3 (7.0 ± 2.9 µm), it showed no significant difference with Panavia (3.7 ± 1.5 µm). The marginal gap was significantly wider in Panavia (149 ± 108 µm) as compared with NX3 (71 ± 45 µm) and Relyx (64 ± 34 µm). For all groups, homogeneous heights of both metal-cement and ceramic-cement gaps were observed. Moreover, all samples showed homogeneity of the margins and absence of instrumental bias, thus validating both procedure and materials. CONCLUSIONS: When using the chosen polishing method, RelyX Unicem showed both low roughness and marginal width, and thus the smoothest and more continuous abutment-crown interlayer, promising a low probability of occurrence of peri-implantitis.

Ultrasonic implant site preparation using piezosurgery: a multicenter case series study analyzing 3,579 implants with a 1- to 3-year follow-up.

This multicenter case series introduces an innovative ultrasonic implant site preparation (UISP) technique as an alternative to the use of traditional rotary instruments. A total of 3,579 implants were inserted in 1,885 subjects, and the sites were prepared using a specific ultrasonic device with a 1- to 3-year follow-up. No surgical complications related to the UISP protocol were reported for any of the implant sites. Seventy-eight implants (59 maxillary, 19 mandibular) failed within 5 months of insertion, for an overall osseointegration percentage of 97.82% (97.14% maxilla, 98.75% mandible). Three maxillary implants failed after 3 years of loading, with an overall implant survival rate of 97.74% (96.99% maxilla, 98.75% mandible).

Expanded vs. dense polytetrafluoroethylene membranes in vertical ridge augmentation around dental implants: a prospective randomized controlled clinical trial.

OBJECTIVE: This prospective randomized controlled trial was designed to test the performance of titanium-reinforced dense polytetrafluoroethylene (d-PTFE) membrane vs. titanium-reinforced expanded polytetrafluoroethylene (e-PTFE) membrane in achieving vertical bone regeneration, both associated with a composite grafting material. MATERIAL AND METHODS: The study enrolled 23 patients requiring bone augmentation with guided bone regeneration (GBR) procedures for placing implants in atrophic posterior mandibles (available bone height <7 mm). Implants were inserted and left to protrude from the bone level to achieve the programmed amount of vertical regeneration. Defects were filled with a composite bone graft (50% autologous bone and 50% mineralized bone allograft) and randomly covered with either an e-PTFE membrane (control) or a d-PTFE membrane (test). Membrane removal was performed after 6 months, and changes in bone height were recorded. RESULTS: Seventy-eight implants were inserted in 26 mandibular sites contextually to vertical ridge augmentation procedures. The healing period was uneventful in all sites, and the vertical defects were satisfactorily filled with a newly formed hard tissue. Mean defect fill after 6 months was 5.49 mm (SD ± 1.58) at test sites and 4.91 mm (SD ± 1.78) at control sites. The normalized data (percentage changes against baseline) did not show any statistically significant difference between test and control groups (P = NS). CONCLUSIONS: Based on the data from this study, both d-PTFE and e-PTFE membranes showed identical clinical results in the treatment of vertical bone defects around implants, using the GBR technique. The membrane removal procedure was easier to perform in the d-PTFE group than in the e-PTFE group.

A new HA/TTCP material for bone augmentation: an in vivo histological pilot study in primates sinus grafting.

OBJECTIVE: Synthetic calcium phosphate bone substitutes are widely used in sinus graft procedures due to their osteoconductive and biocompatible properties. Hydroxyapatite (HA), beta-tricalcium phosphate (ß-TCP), and HA/ß-TCP composite are the most applied materials. The aim of this study was to propose a new mineralogical formulation, HA/tetracalcium phosphate (TTCP), as biomaterial for bone regeneration in the maxillary sinus. METHODS: Sinus grafts were performed by using granules of a HA/TTCP blend and a collagen membrane. Bone response at time points of 14 and 17 weeks was histologically evaluated. RESULTS: After 14 weeks of healing, histomorphometric analysis showed the formation of new bone trabeculae among HA/TTCP granules. After 17 weeks, the bone trabeculae were thicker and HA/TTCP granules were still present. Histomorphometric analysis revealed a bone graft contact (BGC) of 64%. CONCLUSIONS: After 17 weeks from implantation, HA/TTCP synthetic bone graft performed very well as osteoconductive material: BGC was found very high, and bone volume and vital bone showed an ideal bone density for implant placement. HA/TTCP granules are accounted for to accelerate new bone formation and to reduce the time needed for the graft healing, thus achieving high quantity of the new bone formed.