scholarly journals Allogeneic Demineralized Dentin Matrix Graft for Guided Bone Regeneration in Dental Implants

2020 ◽  
Vol 10 (13) ◽  
pp. 4661
Author(s):  
In-Woong Um ◽  
Jeong-Kui Ku ◽  
Yu-Mi Kim ◽  
Pil-Young Yun ◽  
Na-Hee Chang ◽  
...  

Autogenous and allogeneic demineralized dentin matrices (Auto-DDM and Allo-DDM, respectively) are currently used for guided bone regeneration (GBR). Buccal marginal bone (BMB) resorption is critical for successful implant integration. This study analyzed BMB resorption around dental implants for GBR between the control group (Auto-DDM graft) and experimental group (Allo-DDM graft). From 2014 to 2019, we enrolled 96 patients (59 males, 37 females, average 57.13 years) who received GBR (52 and 44 using Allo-DDM and Auto-DDM, respectively,) without a barrier membrane and a simultaneous single dental implantation (54 in the maxilla and 42 in the mandible). BMB height was measured immediately after GBR, at prosthetic loading, and 12 months after loading. BMB resorption was classified as initial resorption (between GBR and prosthetic loading) and functional resorption (during 12 months after prosthetic loading). The differences in the BMB levels of Auto-DDM and Allo-DDM were analyzed between the initial and functional resorption stages by independent sample t-test. Auto-DDM and Allo-DDM showed similar BMB changes in initial resorption (0.73 ± 0.97 and 0.72 ± 0.77 mm, respectively) and functional resorption (0.69 ± 0.81 and 0.48 ± 0.58 mm, respectively) without a significant difference between the maxilla and mandible. For GBR, Allo-DDM is comparable to Auto-DDM in terms of BMB resorption.

Materials ◽  
2021 ◽  
Vol 14 (9) ◽  
pp. 2166
Author(s):  
Jeong-Kui Ku ◽  
In-Woong Um ◽  
Mi-Kyoung Jun ◽  
Il-hyung Kim

An autogenous, demineralized, dentin matrix is a well-known osteo-inductive bone substitute that is mostly composed of type I collagen and is widely used in implant dentistry. This single case report describes a successful outcome in guided bone regeneration and dental implantation with a novel human-derived collagen membrane. The authors fabricated a dentin-derived-barrier membrane from a block-type autogenous demineralized dentin matrix to overcome the mechanical instability of the collagen membrane. The dentin-derived-barrier acted as an osteo-inductive collagen membrane with mechanical and clot stabilities, and it replaced the osteo-genetic function of the periosteum. Further research involving large numbers of patients should be conducted to evaluate bone forming capacity in comparison with other collagen membranes.


2021 ◽  
Vol 5 (4) ◽  
pp. 251-255
Author(s):  
Hui Wang ◽  
Ting Tang ◽  
Min Jin ◽  
Lili Fang ◽  
Aihua Ou

Objective: To analyze and evaluate the clinical efficacy of different treatment options for patients with peri-implant infection. Methods: The study period was from June 2019 to June 2020. Seventy-six patients with peri-implant infection that were treated in Stomatological Hospital of Hefei were selected as study samples. The patients were divided into a research group and a control group by random number table method in which the sample size of each group was n=38. Patients in the control group were treated with drugs combined with ultrasonic cleaning while patients in the research group were treated with guided bone regeneration combined with flap curettage. The indicators of the two groups were compared and analyzed. Results: The plaque index (PLI), probing depth (PD), and sulcus bleeding index (SBI) of the two groups after treatment were lower than those before treatment (P < 0.05). There was no significant difference between the groups (P > 0.05). However, the height of the implant marginal bone of the study group after treatment was higher than that of the control group (P < 0.05). Conclusion: The use of guided bone regeneration combined with flap curettage for patients with infection around dental implants promotes the fusion of bone and implants. The clinical effect was significant and this should be comprehensively promoted in medical institutions at all levels.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qingjie Lin ◽  
Yong Zhang ◽  
Yanguo Liu

Oral repair membrane guided oral bone regeneration, particularly in dental implants, is a guided regeneration technology for bone tissue. The principle is based on the characteristics of rapid migration of epithelial cells and fibroblasts and slower migration of osteoblasts. Materials are placed in the bone defect, creating a relatively closed environment which is conducive to the growth of bone tissue. In this paper, we have evaluated clinical effects of Hai’ao oral repair membrane as a barrier membrane to guide bone regeneration in implants. For this purpose, certain treatment data are collected through data mining and patient’s names with bone defects in the implantation area are selected. According to the randomness principles, these patients are divided into experimental and control groups and preoperative examinations along with basic periodontal treatments are performed on the selected cases. Furthermore, we have analyzed different effects by comparing treatment conditions. Experimental results, as a technical shielding film, verify that Hai’ao oral repair membrane meets requirements of safety and no immune rejection. It plays a role in promoting bone formation around the implant. Mid-to-long-term follow-up is satisfactory with no related complications. At the same time, it has the advantages of simple operation, reduced patient suffering, convenient transportation and storage, and longer validity period. Compared with the control group in terms of safety evaluation of postoperative vital signs, laboratory examinations, and incision healing, Hai’ao oral repair membrane has no significant difference. Postoperative osteogenesis effect is equivalent to that of the control group and meets requirements of superiority. Hai’ao oral repair membrane is used as a shielding membrane material in implant surgery technology to guide bone regeneration.


2021 ◽  
Vol 10 (17) ◽  
pp. 3953
Author(s):  
Horia Mihail Barbu ◽  
Stefania Andrada Iancu ◽  
Antonio Rapani ◽  
Claudio Stacchi

Background: The purpose of this study was to compare clinical results of two different horizontal ridge augmentation techniques: guided bone regeneration with sticky bone (SB) and the bone-shell technique (BS). Methods: Records of patients who underwent horizontal ridge augmentation with SB (test) and BS (control) were screened for inclusion. Pre-operative and 6-month post-operative ridge widths were measured on cone beam computer tomography (CBCT) and compared. Post-operative complications and implant survival rate were recorded. Results: Eighty consecutive patients were included in the present study. Post-operative complications (flap dehiscence, and graft infection) occurred in ten patients, who dropped out from the study (12.5% complication rate). Stepwise multivariate logistic regression analysis showed a significant inverse correlation between the occurrence of post-operative complications and ridge width (p = 0.025). Seventy patients (35 test; 35 control) with a total of 127 implants were included in the final analysis. Mean ridge width gain was 3.7 ± 1.2 mm in the test and 3.7 ± 1.1 mm in the control group, with no significant difference between the two groups. No implant failure was recorded, with a mean follow-up of 42.7 ± 16.0 months after functional loading. Conclusions: SB and BS showed comparable clinical outcomes in horizontal ridge augmentation, resulting in sufficient crestal width increase to allow implant placement in an adequate bone envelope.


2017 ◽  
Vol 8 (3) ◽  
pp. 177-182
Author(s):  
Umesh P Verma

ABSTRACT Aim The present study was primarily designed to evaluate the outcome of guided bone graft regeneration in peri-implant defects by combining recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and granules of beta-tricalcium phosphate (B-TCP) mounted by resorbable biomesh membrane. Secondary objective was to determine the value of resorbable barrier membrane to improve the efficacy of the growth factormediated regeneration. Materials and methods A randomized controlled study comprised 14 participants (8 males and 6 females, mean age 37 years, range 19—55 years), in which a total of 15 implants (10 in maxilla and 5 in the mandible) were placed. Fifteen implant sites were randomly divided by picking a code into three groups: Test group I (n = 5) ß-TCP + rhPDGF (0.3 mg/mL) + biomesh, test group II (n = 5) ß-TCP + rhPDGF, and control (n = 5) ß-TCP + biomesh. The experimental site was examined clinically for the gingival status and radiographically for the bone status. Results Statistically significant difference in preoperative and postoperative measurements was observed for test groups I and II in all the parameters except width; in contrast, there was no significant difference observed for the control group from baseline to 5 months postoperatively. On intergroup comparison, statistically significant difference was observed between test group I vs control group and test group II vs control group, but it was not significant between test groups I and II, which was further confirmed using global performance scale score. Conclusion It concluded that rhPDGF-BB and ß-TCP mounted by resorbable biomesh membrane played a synergistic role in the management of peri-implant defects. Clinical significance Bone regenerated using ß-TCP with rhPDGF-BB in the reversal of peri-implant defects. How to cite this article Arora R, Verma UP, Dixit J, Lal N. Synergistic Effects of Growth Factor, Bone Graft, and Resorbable Barrier Membrane in Management of Dehiscence and Fenestration of Dental Implants. World J Dent 2017;8(3):177-182.


Membranes ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 185
Author(s):  
Eleni Kapogianni ◽  
Said Alkildani ◽  
Milena Radenkovic ◽  
Xin Xiong ◽  
Rumen Krastev ◽  
...  

Collagen-based barrier membranes are an essential component in Guided Bone Regeneration (GBR) procedures. They act as cell-occlusive devices that should maintain a micromilieu where bone tissue can grow, which in turn provides a stable bed for prosthetic implantation. However, the standing time of collagen membranes has been a challenging area, as native membranes are often prematurely resorbed. Therefore, consolidation techniques, such as chemical cross-linking, have been used to enhance the structural integrity of the membranes, and by consequence, their standing time. However, these techniques have cytotoxic tendencies and can cause exaggerated inflammation and in turn, premature resorption, and material failures. However, tissues from different extraction sites and animals are variably cross-linked. For the present in vivo study, a new collagen membrane based on bovine dermis was extracted and compared to a commercially available porcine-sourced collagen membrane extracted from the pericardium. The membranes were implanted in Wistar rats for up to 60 days. The analyses included well-established histopathological and histomorphometrical methods, including histochemical and immunohistochemical staining procedures, to detect M1- and M2-macrophages as well as blood vessels. Initially, the results showed that both membranes remained intact up to day 30, while the bovine membrane was fragmented at day 60 with granulation tissue infiltrating the implantation beds. In contrast, the porcine membrane remained stable without signs of material-dependent inflammatory processes. Therefore, the bovine membrane showed a special integration pattern as the fragments were found to be overlapping, providing secondary porosity in combination with a transmembraneous vascularization. Altogether, the bovine membrane showed comparable results to the porcine control group in terms of biocompatibility and standing time. Moreover, blood vessels were found within the bovine membranes, which can potentially serve as an additional functionality of barrier membranes that conventional barrier membranes do not provide.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
John Rong Hao Tay ◽  
Xiaotong Jacinta Lu ◽  
Wei Ming Clement Lai ◽  
Jia-Hui Fu

AbstractIt is not uncommon to encounter post-surgical complications after horizontal guided bone regeneration (GBR). The primary aim of this review was to evaluate the incidence and types of complications that occur after horizontal GBR and propose management strategies to deal with these clinical situations. A secondary aim was to conduct a histomorphometric review of the wound healing process at sites that experienced post-surgical complications after GBR. A keyword search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published in English from January 2015 to January 2020 was conducted for the primary aim and 23 studies were selected. A second search addressing the secondary aim was conducted, and five studies were included. Site-level analysis showed that the weighted mean incidence proportion of minor wound dehiscence and minor infections occurring at the augmented site was 9.9% [95% CI 6.4, 13.9, P < 0.01] and 1.5% [95% CI 0.4, 3.1, P = 0.21) respectively. Patient-level analysis showed minor and major complications occurring at a weighted mean incidence proportion of 16.1% [95% CI 11.9, 20.8, P = 0.01] and 1.6% [95% CI 0.0, 4.7, P < 0.01] respectively, while neurosensory alterations at the donor site was 7.0% [95% CI 1.3, 15.5, P < 0.01]. Subgroup analysis also revealed that the use of block grafts increased the incidence proportion of minor post-surgical complications, whereas a staged GBR procedure increased the incidence proportion of both minor and major post-surgical complications. Although exposure of the barrier membrane is often associated with less bone regeneration and graft resorption, the type of membrane used (resorbable or non-resorbable) had no statistically significant influence on any post-surgical complication. Histologically, a layer of fibrous connective tissue instead of bone is commonly observed at the interface between the native bone at the recipient site and the regenerated bone in cases with membrane exposure after GBR procedure. Minor wound dehiscence was the highest incidence proportion of post-surgical complications. Methods ranging from daily application of antiseptics, use of systemic antimicrobials, regular reviews, and total removal of the non-integrated biomaterials are commonly prescribed to manage these post-surgical complications in attempt to minimise the loss of tissue at the surgical site.


2015 ◽  
Vol 21 (6) ◽  
pp. 705-715 ◽  
Author(s):  
M. Fantini ◽  
F. De Crescenzio ◽  
L. Ciocca ◽  
F. Persiani

Purpose – The purpose of this paper is to describe two different approaches for manufacturing pre-formed titanium meshes to assist prosthetically guided bone regeneration of atrophic maxillary arches. Both methods are based on the use of additive manufacturing (AM) technologies and aim to limit at the minimal intervention the bone reconstructive surgery by virtual planning the surgical intervention for dental implants placement. Design/methodology/approach – Two patients with atrophic maxillary arches were scheduled for bone augmentation using pre-formed titanium mesh with particulate autogenous bone graft and alloplastic material. The complete workflow consists of four steps: three-dimensional (3D) acquisition of medical images and virtual planning, 3D modelling and design of the bone augmentation volume, manufacturing of biomodels and pre-formed meshes, clinical procedure and follow up. For what concerns the AM, fused deposition modelling (FDM) and direct metal laser sintering (DMLS) were used. Findings – For both patients, a post-operative control CT examination was scheduled to evaluate the progression of the regenerative process and verify the availability of an adequate amount of bone before the surgical intervention for dental implants placement. In both cases, the regenerated bone was sufficient to fix the implants in the planned position, improving the intervention quality and reducing the intervention time during surgery. Originality/value – A comparison between two novel methods, involving AM technologies are presented as viable and reproducible methods to assist the correct bone augmentation of atrophic patients, prior to implant placement for the final implant supported prosthetic rehabilitation.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Antonio Scarano ◽  
Ezio Crocetta ◽  
Alessandro Quaranta ◽  
Felice Lorusso

Background. Pure titanium continues to be the first choice for dental implants and represents the gold standard for their biocompatibility and physical and mechanical characteristics, while the titanium alloy (Ti6Al4V) has good mechanical properties. The surface structure of the titanium oxide layer formation on the surface influences and improves the bone response around dental implants. Purpose. The purpose of this study is to evaluate the influence of a thermal treatment of Ti6Al4V implant surfaces and the bone healing response in a rabbit model. Methods. Altogether sixteen implants with same design were inserted into the distal femoral metaphysis. A screw (13 mm long, 4 mm in diameter) was inserted in an implant bed. Each rabbit received two implants, one in the left femur and one in the right femur. The samples were histologically and histomorphometrically evaluated at 8 weeks. Results. A statistically significant difference (p = 0.000034) was present histologically in the percentages of bone-implant contact (BIC) between the test group (BIC = 69.25±4.49%.) and control group (BIC = 56.25 ± 4.8%) by one-way analysis of variance (ANOVA). Significance was set at p ≤ 0.05. Conclusions. The outcome of the present study indicates a novel approach to improving bone healing around titanium implants.


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