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Autogenous Bone Grafts (autogenous + bone_graft)
Selected AbstractsThe Use of Mandibular Tori as a Donor Site for Autogenous Bone GraftJOURNAL OF PROSTHODONTICS, Issue 3 2000Periklis Proussaefs DDS [source] Segmental osteotomy to reposition multiple osseointegrated dental implants in the anterior maxilla in a trauma patientDENTAL TRAUMATOLOGY, Issue 1 2007Shou-Yen Kao Abstract,,, A 16-year-old young man had severe loss of alveolar bone and lost four teeth in the anterior maxilla because of traumatic injury in a traffic accident. To overcome the surgically compromised condition for implant rehabilitation, the deficient ridge was augmented by autogenous bone graft from the mandibular symphysis. The augmented ridge had much improvement in width but less in vertical height. Four implants were placed to gain initial osseointegration. Segmental osteotomy was performed to occlusally reposition the implants and bone for 5-mm in the anterior maxilla. After 2 years of clinical follow-up, the rehabilitation outcome is satisfactory and stable. [source] Recombinant human bone morphogenetic protein-7 in maxillary sinus floor elevation surgery in 3 patients compared to autogenous bone graftsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2000A clinical pilot study Abstract Background/Aims: This pilot study was designed to determine the clinical bone formation ability of a human recombinant DNA bone morphogenetic protein-7, also referred to as Osteogenic Protein-1 [OP-1] combined with a collagen carrier, implanted in the maxillary sinus of 3 patients. The results were compared with a group of 3 patients treated with sinus floor elevation and autogenous bonegrafts. Methods: 6 consecutive patients, 4 female and 2 male, between 48 and 57 years of age were treated by means of sinus floor elevation for insufficient bone height in the posterior maxilla for implant surgery. 3 patients, 2 female and 1 male, were treated with OP-1 attached to a collagen device. In these patients, 4 maxillary sinus grafting procedures according to Tatum's method were carried out. 1 g of collagen carrier containing 2.5 mg rhOP-1 mixed with 3 ml of saline was placed between the bony floor and the elevated mucosal lining of the most caudal part of the maxillary sinus, in order to increase the vertical bone dimension to place dental implants of a sufficient length. The 3 other patients, also 2 female and 1 male, with a total of 5 sinus sites, were treated with sinus floor elevation and autogenous iliac crest bonegrafts. After 6 months, during dental implant preparation, bone cores were taken for histology. Thus, clinical, radiological and histological results of the 2 groups of 3 patients were compared. Results: 6 months after sinus grafting with OP-1, in 1 male, well-vascularized bonelike tissue of good quality was observed clinically. This could be confirmed by histology. In the second, female, patient no bone formation was observed at all. A cyst-like granular tissue mass, without purulent content, was removed. In the 3rd, female, patient, who received bilateral sinus grafts, some bonelike formation was seen, however it showed flexible tissue which led to the decision that at 6 months after the sinus grafting, the implant placement had to be postponed. In all 5 autogenous grafted sinuses a bone appearance similar to normal maxillary bone was observed clinically as well as histologically and dental implants could be placed six months after sinus floor elevation surgery. Conclusions: These findings indicate that the OP-1 device has the potential for initiating bone formation in the human maxillary sinus within 6 months after a sinus floor elevation operation. However, the various findings in these 3 patients indicate that the behaviour of the material is at this moment insufficiently predictable, in this indication area. Further investigation is indicated before OP-1 can be successfully used instead of the "gold standard" autogenous bone graft. [source] NS13P A PROSPECTIVE COMPARISON OF TWO CERVICAL INTERBODY FUSION CAGESANZ JOURNAL OF SURGERY, Issue 2007M. A. Hansen Purpose For some time the surgical management of chronic back pain has utilised interbody lumbar cages. Recently interbody cages for use in the cervical spine have been produced. Cervical cages provide initial stability during the fusion process. There is little literature comparing the performance of interbody cage systems due to their relative recent introduction. Methodology Patients with symptomatic cervical degeneration or traumatic lesions were treated with the dynamic ABC 2 Aesculap anterior cervical plating system and either the B-Braun Samarys or Zimmer cage systems. A single surgeon conducted all surgery. Pre- and post-operative radiological examinations were compared. Changes in disc height at affected and adjacent levels, lordosis and evidence of fusion were recorded. Patient outcome was measured with questionnaires. The modified Oswestry neck pain disability and Copenhagen neck disability scale scores were utilised to allow comparison between patients. Results A total of 43 patients were involved in the study (30 with the Zimmer cage system and 13 with the Samarys cage). Patient follow-up has been up to 12 months. Improvement in disability scores was shown in 90% of patients. Follow up imaging did not demonstrate subsidence of the cage or adjacent instability in either group. There was no statistical difference in complication rate between the two groups. Discussion Initial stability was provided by both interbody cervical spine cage system. Rates of fusion and symptomatic relief compared favourably to fusion involving autogenous bone graft without associated morbidity. Longer follow up is necessary to determine whether there is evidence of adjacent level instability or vertebral end-plate subsidence. [source] A New Technique for Reconstruction of the Atrophied Narrow Alveolar Crest in the Maxilla Using Morselized Impacted Bone Allograft and Later Placement of Dental ImplantsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2008Per Holmquist DDS ABSTRACT Background: In cases when the alveolar crest is too narrow to host an implant, lateral augmentation is required. The use of autogenous bone blocks harvested from the iliac crest is often demanded. One disadvantage is the associated patient morbidity. Purpose: The purpose of this study was to clinically and histologically evaluate the use of morselized impacted bone allograft, a novel technique for reconstruction of the narrow alveolar crest. Materials and Methods: Two patients with completely edentulous maxillae and one partially edentulous, with a mean age of 77 years (range 76,79 years) were included in the study. The alveolar crest width was <3 mm without possibility to place any implant. Bone grafts were taken from a bone bank in Gävle Hospital. Bone from the neck of femur heads was milled to produce bone chips. The milled bone was partially defatted by rinsing in 37°C saline solution. After compression of the graft pieces with a size of 15 mm (height), 30 mm (length), and 6 mm (width), they were then fit to adapt to the buccal surface of the atrophied alveolar crest. One piece was placed to the right and one to the left side of the midline. On both sides fibrin glue was used (Tisseel®, Baxter AG, Vienna, Austria) to stabilize the graft. After 6 months of graft healing, dental implants were placed, simultaneously biopsies were harvested and in one patient two oxidized microimplants were placed. At the time of abutment connection, microimplants were retrieved with surrounding bone for histology. Fixed screw-retained bridges were fabricated in mean of 7 months after implant surgery. Radiographs were taken before and after implant surgery and after 1 year of loading. Results: Sixteen implants with an oxidized surface were placed (TiUnite®, Nobel Biocare AB, Göteborg, Sweden). After 1 year of functional loading, all implants were clinically stable. The marginal bone loss was 1.4 mm (SD 0.3) after 1 year of loading. The histological examination showed resorption and subsequent bone formation on the allograft particles. There were no signs of inflammatory cell infiltration in conjunction with the allograft. The two microimplants showed bone formation directly on the implant surface. Conclusions: This study shows that morselized impacted bone allograft can be used to increase the width of the atrophied narrow alveolar crest as a good alternative to autogenous bone grafts in elderly patients. The histological examination of biopsies revealed a normal incorporation process and no signs of an immunological reaction. Further studies with larger samples are of important to be able to conclude if equal results can be obtained using morselized impacted bone allograft as for autogenous bone graft. [source] Bone Reformation and Implant Integration following Maxillary Sinus Membrane Elevation: An Experimental Study in PrimatesCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006Vinicius C Palma DDS ABSTRACT Background:, Recent clinical studies have described maxillary sinus floor augmentation by simply elevating the maxillary sinus membrane without the use of adjunctive grafting materials. Purpose:, This experimental study aimed at comparing the histologic outcomes of sinus membrane elevation and simultaneous placement of implants with and without adjunctive autogenous bone grafts. The purpose was also to investigate the role played by the implant surface in osseointegration under such circumstances. Materials and Methods:, Four tufted capuchin primates had all upper premolars and the first molar extracted bilaterally. Four months later, the animals underwent maxillary sinus membrane elevation surgery using a replaceable bone window technique. The schneiderian membrane was kept elevated by insertion of two implants (turned and oxidized, Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) in both sinuses. The right sinus was left with no additional treatment, whereas the left sinus was filled with autogenous bone graft. Implant stability was assessed through resonance frequency analysis (OsstellTM, Integration Diagnostics AB, Göteborg, Sweden) at installation and at sacrifice. The pattern of bone formation in the experimental sites and related to the different implant surfaces was investigated using fluorochromes. The animals were sacrificed 6 months after the maxillary sinus floor augmentation procedure for histology and histomorphometry (bone-implant contact, bone area in threads, and bone area in rectangle). Results:, The results showed no differences between membrane-elevated and grafted sites regarding implant stability, bone-implant contacts, and bone area within and outside implant threads. The oxidized implants exhibited improved integration compared with turned ones as higher values of bone-implant contact and bone area within threads were observed. Conclusions:, The amount of augmented bone tissue in the maxillary sinus after sinus membrane elevation with or without adjunctive autogenous bone grafts does not differ after 6 months of healing. New bone is frequently deposited in contact with the schneiderian membrane in coagulum-alone sites, indicating the osteoinductive potential of the membrane. Oxidized implants show a stronger bone tissue response than turned implants in sinus floor augmentation procedures. [source] Histologic Analysis of Clinical Biopsies Taken 6 Months and 3 Years after Maxillary Sinus Floor Augmentation with 80% Bovine Hydroxyapatite and 20% Autogenous Bone Mixed with Fibrin GlueCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2001Mats Hallman DDS Abstract: Background: Bovine hydroxyapatite (Bio-Oss®, Geistlich Pharmaceutical, Wollhausen, Switzerland) has been suggested to be used in maxillary sinus floor augmentation procedures prior to or in conjunction with implant placement. However, the long-term histologic fate of this material is not well understood. Purpose: The aim with this study was to histologically evaluate the tissue response in patients to a mixture of bovine hydroxyapatite (BH), autogenous bone, and fibrin glue 6 months and 3 years after a maxillary sinus floor augmentation procedure. Materials and Method: Biopsies were taken from a group of 20 consecutive patients 6 months (n = 16) and 3 years (n = 12) after maxillary sinus floor augmentation with a mixture of BH (80%), autogenous bone (20%), and fibrin glue and prepared for histologic analysis. Results: Light microscopy and morphometry from biopsies taken after 6 months showed various amounts of mineralized bone tissue. The specimen area was occupied by 54.1 ± 12.6% nonmineralized tissue, followed by 21.2 ± 24.5% lamellar bone, 14.5 ± 10.3% BH particles, and 10.2 ± 13.4% woven bone. The nonmineralized tissue seen in bone-forming areas consisted of a loose connective tissue, rich with vessels and cells. There were no signs of resorption of the BH particles. The lamellar bone appeared to have originated from the recipient site and was seldom in contact with the BH particles. After 3 years, the nonmineralized tissue area had decreased to 36.0 ± 19.0% (p > .05) and consisted mainly of bone marrow tissue. The surface area of lamellar bone had increased to 50.7 ± 22.8% (p > .05), and there was almost no immature bone. The mean specimen area occupied by BH particles, was 12.4 ± 8.7% and had not changed from 6 months (not significant). Moreover, the sizes of the particles were similar after 6 months and 3 years. The degree of BH particle,bone contact had increased from 28.8%± 19.9% after 6 months to 54.5 ± 28.8% after 3 years (p > .05). Conclusion: Histology of specimens from maxillary sinuses augmented with 80% BH particles, 20% autogenous bone, and fibrin glue showed a positive bone tissue response after 6 months and 3 years after augmentation of the maxillary sinus floor prior to implant placement in a group fo 20 patients. The bone surrounding and in contact with the BH particles after 6 months was mainly immature woven bone, which with time was replaced by mature lamellar bone filling the interparticle space as observed in the 3-year specimens. Moreover, bone-integrated BH particles seem to be resistant to resorption. The results indicate that the procedure may be considered when only small amounts of intraoral autogenous bone graft are available. [source] Immunoexpression of Cbfa-1/Runx2 and VEGF in sinus lift procedures using bone substitutes in rabbitsCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2010Leandro Soeiro De Souza Nunes Abstract Objectives: To analyze and compare the expression of core binding factor-1 (Cbfa-1)/Runx2 and vascular endothelium growth factor (VEGF) in sinus lift procedures using bovine hydroxyapatite (HA) and ,-tricalcium phosphate (,-TCP). Material and Methods: Twenty-four male rabbits that had undergone bilateral sinus lift procedures were divided into three groups, according to the sinus filling material: Group 1: autogenous bone graft; Group 2: bovine HA; and Group 3: ,-TCP. All groups were sacrificed after 7, 14, 30 and 60 days, for microscopic, histomorphometry and immunohistochemistry analysis. Results: Microscopic analysis showed a similar bone repair pattern between the tested groups. New bone formation, soft and medular tissue, remaining material or particulate bone graft area were obtained by histomorphometric analysis. After 14 days, statistically significant differences in new bone formation were found between Group 1 (27.76±7.8) and Groups 2 (14.22±3.2) and 3 (11.1±7.7). After 30 days, statistically significant differences (P<0.05) were detected in bone formation between Groups 1 (31.39±36.5) and 2 (14.13±3.2). The last period showed improved bone formation in Group 2. Also, Group 2 showed higher Cbfa-1/Runx2 immunoexpression when compared with Group 3. No remarkable differences were observed in VEGF immunoexpression among groups. Conclusion: Taken together, both biomaterials allowed bone tissue growth in a conductive pattern and did not interfere with bone remodeling in the late period, with a slight improvement in bone tissue formation when using HA, confirmed by marked expression of Cbfa-1 at initial periods. To cite this article: Nunes LSS, De Oliveira RV, Holgado LA, Nary Filho H, Ribeiro DA, Matsumoto MA. Immunoexpression of Cbfa-1/Runx2 in sinus lift procedures using bone substitutes in rabbits. Clin. Oral Impl. Res. 21, 2010; 584,590. doi: 10.1111/j.1600-0501.2009.01858.x [source] Bone replacement following dental trauma prior to implant surgery , present statusDENTAL TRAUMATOLOGY, Issue 1 2009Mats Hallman Although autogenous bone grafts is considered the ,gold standard', this may be associated with patient morbidity and graft resorption. Consequently, the use of bone substitutes has increased. Today, a substantial number of biomaterials are available on the market, but only a few are well documented. The user should be aware that these biomaterials have different properties: resorbable or non-resorbable, time of resorption and resorption mechanism. The purpose of this review is to describe the function of various bone substitutes and indications for their use in reconstructive implant surgery and to give an overview of the current situation. [source] Effects of maxillary sinus floor elevation surgery on maxillary sinus physiologyEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 3 2003Nicolaas M. Timmenga In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac crest bone grafts. All patients were subjected to unilateral endoscopic examination of the maxillary sinus, taking of a biopsy specimen from the sinus floor mucosa, and collection of a sinus lavage-fluid aspirate. This triad of evaluations was performed immediately preceding the elevation procedure, and 3 months (at implant insertion) and 9 months (at uncovering of implants) postoperatively. All procedures were performed under general anesthesia. Preoperatively, three out of 17 patients showed pre-existing mucosal pathology endoscopically, while the 3- and 9-month results revealed the presence of mucosal pathology in four and two patients, respectively. The 3-month microbiological evaluation showed a significant increase in cultures with bacterial growth, while the 9-month culture results were comparable to the preoperative status of the maxillary sinus. Morphologically, neither fibrosis nor an altered inflammatory response or thickening of the epithelium and lamina propria was observed postoperatively. The number of goblet cells in the epithelial layer was increased. From this study it is concluded that the effect of maxillary sinus floor elevation surgery with autogenous bone grafts does not appear to have clinical consequences in patients without signs of pre-existing maxillary sinusitis. [source] Recombinant human bone morphogenetic protein-7 in maxillary sinus floor elevation surgery in 3 patients compared to autogenous bone graftsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2000A clinical pilot study Abstract Background/Aims: This pilot study was designed to determine the clinical bone formation ability of a human recombinant DNA bone morphogenetic protein-7, also referred to as Osteogenic Protein-1 [OP-1] combined with a collagen carrier, implanted in the maxillary sinus of 3 patients. The results were compared with a group of 3 patients treated with sinus floor elevation and autogenous bonegrafts. Methods: 6 consecutive patients, 4 female and 2 male, between 48 and 57 years of age were treated by means of sinus floor elevation for insufficient bone height in the posterior maxilla for implant surgery. 3 patients, 2 female and 1 male, were treated with OP-1 attached to a collagen device. In these patients, 4 maxillary sinus grafting procedures according to Tatum's method were carried out. 1 g of collagen carrier containing 2.5 mg rhOP-1 mixed with 3 ml of saline was placed between the bony floor and the elevated mucosal lining of the most caudal part of the maxillary sinus, in order to increase the vertical bone dimension to place dental implants of a sufficient length. The 3 other patients, also 2 female and 1 male, with a total of 5 sinus sites, were treated with sinus floor elevation and autogenous iliac crest bonegrafts. After 6 months, during dental implant preparation, bone cores were taken for histology. Thus, clinical, radiological and histological results of the 2 groups of 3 patients were compared. Results: 6 months after sinus grafting with OP-1, in 1 male, well-vascularized bonelike tissue of good quality was observed clinically. This could be confirmed by histology. In the second, female, patient no bone formation was observed at all. A cyst-like granular tissue mass, without purulent content, was removed. In the 3rd, female, patient, who received bilateral sinus grafts, some bonelike formation was seen, however it showed flexible tissue which led to the decision that at 6 months after the sinus grafting, the implant placement had to be postponed. In all 5 autogenous grafted sinuses a bone appearance similar to normal maxillary bone was observed clinically as well as histologically and dental implants could be placed six months after sinus floor elevation surgery. Conclusions: These findings indicate that the OP-1 device has the potential for initiating bone formation in the human maxillary sinus within 6 months after a sinus floor elevation operation. However, the various findings in these 3 patients indicate that the behaviour of the material is at this moment insufficiently predictable, in this indication area. Further investigation is indicated before OP-1 can be successfully used instead of the "gold standard" autogenous bone graft. [source] A New Technique for Reconstruction of the Atrophied Narrow Alveolar Crest in the Maxilla Using Morselized Impacted Bone Allograft and Later Placement of Dental ImplantsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2008Per Holmquist DDS ABSTRACT Background: In cases when the alveolar crest is too narrow to host an implant, lateral augmentation is required. The use of autogenous bone blocks harvested from the iliac crest is often demanded. One disadvantage is the associated patient morbidity. Purpose: The purpose of this study was to clinically and histologically evaluate the use of morselized impacted bone allograft, a novel technique for reconstruction of the narrow alveolar crest. Materials and Methods: Two patients with completely edentulous maxillae and one partially edentulous, with a mean age of 77 years (range 76,79 years) were included in the study. The alveolar crest width was <3 mm without possibility to place any implant. Bone grafts were taken from a bone bank in Gävle Hospital. Bone from the neck of femur heads was milled to produce bone chips. The milled bone was partially defatted by rinsing in 37°C saline solution. After compression of the graft pieces with a size of 15 mm (height), 30 mm (length), and 6 mm (width), they were then fit to adapt to the buccal surface of the atrophied alveolar crest. One piece was placed to the right and one to the left side of the midline. On both sides fibrin glue was used (Tisseel®, Baxter AG, Vienna, Austria) to stabilize the graft. After 6 months of graft healing, dental implants were placed, simultaneously biopsies were harvested and in one patient two oxidized microimplants were placed. At the time of abutment connection, microimplants were retrieved with surrounding bone for histology. Fixed screw-retained bridges were fabricated in mean of 7 months after implant surgery. Radiographs were taken before and after implant surgery and after 1 year of loading. Results: Sixteen implants with an oxidized surface were placed (TiUnite®, Nobel Biocare AB, Göteborg, Sweden). After 1 year of functional loading, all implants were clinically stable. The marginal bone loss was 1.4 mm (SD 0.3) after 1 year of loading. The histological examination showed resorption and subsequent bone formation on the allograft particles. There were no signs of inflammatory cell infiltration in conjunction with the allograft. The two microimplants showed bone formation directly on the implant surface. Conclusions: This study shows that morselized impacted bone allograft can be used to increase the width of the atrophied narrow alveolar crest as a good alternative to autogenous bone grafts in elderly patients. The histological examination of biopsies revealed a normal incorporation process and no signs of an immunological reaction. Further studies with larger samples are of important to be able to conclude if equal results can be obtained using morselized impacted bone allograft as for autogenous bone graft. [source] Bone Reformation and Implant Integration following Maxillary Sinus Membrane Elevation: An Experimental Study in PrimatesCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006Vinicius C Palma DDS ABSTRACT Background:, Recent clinical studies have described maxillary sinus floor augmentation by simply elevating the maxillary sinus membrane without the use of adjunctive grafting materials. Purpose:, This experimental study aimed at comparing the histologic outcomes of sinus membrane elevation and simultaneous placement of implants with and without adjunctive autogenous bone grafts. The purpose was also to investigate the role played by the implant surface in osseointegration under such circumstances. Materials and Methods:, Four tufted capuchin primates had all upper premolars and the first molar extracted bilaterally. Four months later, the animals underwent maxillary sinus membrane elevation surgery using a replaceable bone window technique. The schneiderian membrane was kept elevated by insertion of two implants (turned and oxidized, Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) in both sinuses. The right sinus was left with no additional treatment, whereas the left sinus was filled with autogenous bone graft. Implant stability was assessed through resonance frequency analysis (OsstellTM, Integration Diagnostics AB, Göteborg, Sweden) at installation and at sacrifice. The pattern of bone formation in the experimental sites and related to the different implant surfaces was investigated using fluorochromes. The animals were sacrificed 6 months after the maxillary sinus floor augmentation procedure for histology and histomorphometry (bone-implant contact, bone area in threads, and bone area in rectangle). Results:, The results showed no differences between membrane-elevated and grafted sites regarding implant stability, bone-implant contacts, and bone area within and outside implant threads. The oxidized implants exhibited improved integration compared with turned ones as higher values of bone-implant contact and bone area within threads were observed. Conclusions:, The amount of augmented bone tissue in the maxillary sinus after sinus membrane elevation with or without adjunctive autogenous bone grafts does not differ after 6 months of healing. New bone is frequently deposited in contact with the schneiderian membrane in coagulum-alone sites, indicating the osteoinductive potential of the membrane. Oxidized implants show a stronger bone tissue response than turned implants in sinus floor augmentation procedures. [source] Ramus or Chin Grafts for Maxillary Sinus Inlay and Local Onlay Augmentation: Comparison of Donor Site Morbidity and ComplicationsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2003Jaime Clavero DDS ABSTRACT Background: The placement of endosseous implants in edentulous areas is frequently limited by inadequate bone volume of the residual ridge. Local bone grafts from the mandible are a convenient source of autogenous bone for alveolar reconstruction prior to implant placement. Purpose: The aim of the present study was to document and compare the morbidity and the frequency of complications occurring at two intraoral donor sites: the mandibular symphysis and the mandibular ramus. Material and Methods: This study reviewed 53 consecutively treated patients:29 with autogenous bone grafts from the mandibular symphysis and 24 with mandibular ramus bone grafts. Each patient received a questionnaire 18 months after surgery regarding problems that may have occurred during the postoperative period. Results: In the patients in whom bone was harvested from the mandibular ramus, there were fewer postoperative symptoms immediately after the operation than with mandibular symphysis harvesting. Twenty-two of the 29 patients with symphysis grafts experienced decreased sensitivity in the skin innervated by the mental nerve 1 month after the operation. Five of the 24 patients with ramus grafts experienced decreased sensitivity in the vestibular mucosa corresponding to the innervation of the buccal nerve. Eighteen months after the surgery, 15 of the 29 patients in the symphysis group still had some decreased sensitivity and presented with permanent altered sensation. Only one of the patients grafted from the mandibular ramus presented with permanent altered sensation in the posterior vestibular area. No major complication occurred in the donor sites in any of the 53 patients. Conclusion: The results of this study favored the use of the ascending mandibular ramus as an intraoral donor site for bone grafting. [source] What influence do anticoagulants have on oral implant therapy?CLINICAL ORAL IMPLANTS RESEARCH, Issue 2009A systematic review Abstract Objectives: This systematic review aims to assess the risks (both thromboembolic and bleeding) of an oral anticoagulation therapy (OAT) patient undergoing implant therapy and to provide a management protocol to patients under OAT undergoing implant therapy. Material and methods: Medline, Cochrane Data Base of Systematic Reviews, the Cochrane Central Register of Controlled Trials and EMBASE (from 1980 to December 2008) were searched for English-language articles published between 1966 and 2008. This search was completed by a hand research accessing the references cited in all identified publications. Results: Nineteen studies were identified reporting outcomes after oral surgery procedures (mostly dental extractions in patients on OAT following different management protocols and haemostatic therapies). Five studies were randomized-controlled trials (RCTs), 11 were controlled clinical trials (CCTs) and three were prospective case series. The OAT management strategies as well as the protocols during and after surgery were different. This heterogeneity prevented any possible data aggregation and synthesis. The results from these studies are very homogeneous, reporting minor bleeding in very few patients, without a significant difference between the OAT patients who continue with the vitamin K antagonists vs. the patients who stopped this medication before surgery. These post-operative bleeding events were controlled only with local haemostatic measures: tranexamic acid mouthwashes, gelatine sponges and cellulose gauzes's application were effective. Post-operative bleeding did not correlate with the international normalised ratio (INR) status. In none of the studies was a thromboembolic event reported. Conclusions: OAT patients (INR 2,4) who do not discontinue the AC medication do not have a significantly higher risk of post-operative bleeding than non-OAT patients and they also do not have a higher risk of post-operative bleeding than OAT patients who discontinue the medication. In patients with OAT (INR 2,4) without discontinuation, topical haemostatic agents were effective in preventing post-operative bleeding. OAT discontinuation is not recommended for minor oral surgery, such as single tooth extraction or implant placement, provided that this does not involve autogenous bone grafts, extensive flaps or osteotomy preparations extending outside the bony envelope. Evidence does not support that dental implant placement in patients on OAT is contraindicated. [source] Morphometric evaluation of the repair of critical-size defects using demineralized bovine bone and autogenous bone grafts in rat calvariaCLINICAL ORAL IMPLANTS RESEARCH, Issue 8 2008Rodrigo Cardoso de Oliveira Abstract Objective: To evaluate the repair of critical-size bone defects in rats treated with demineralized bovine bone (DBB) compared with autogenous bone (AB). Material and method: A bone defect of 8 mm in diameter was created in the calvaria of 50 Rattus norvegicus, treated either with DBB or AB. Sub-groups of five rats of each group were killed at 7, 14, 21, 30 and 90 days post-operatively, and the skulls were removed and processed histologically. Histological sections were stained with hematoxylin and eosin. Result: Histological analysis showed complete closure of the defects with new bone at 90 days in group AB, and substitution of the biomaterial by fibrotic connective tissue in the DBB group at 21 days. Morphometric analysis showed that DBB was rapidly absorbed at 14 days, with its volume density decreasing from 47%±0.8% at 7 days to 1.2%±0.41% at 14 days. Subsequently, volume densities of the connective tissue and neoformed bone increased from 51.1%±11.17% to 86.8%±7.92% and from 1.9%±1.13% to 12%±8.02%, respectively, for the same time interval. The volume density of AB particles did not change throughout the experimental periods, but the amount of new bone increased markedly between 7 and 90 days, from 4.5%±1.57% to 53.5%±6.42% (P<0.05). Conclusion: DBB did not provide complete repair of the defects, with significantly less new bone formation than in the AB group. [source] | ||||||||||