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A volumetric study of guided bone regeneration around titanium implants in the New Zealand white rabbit.

Previous studies have shown the ability for bone to grow under occlusive membranes. This study was undertaken to determine the time required for bone to form in the space created under the membrane and to determine the amount of bone that may be grown under the membrane. Thirty-two New Zealand white rabbits were divided into three groups. A Brånemark implant, having a diameter of 3.75 mm with a length of 7 mm, was placed in each tibia and Gore-Tex membrane was draped over the implant on the experimental side and tethered to the wound margin. Sixteen rabbits were sacrificed at six weeks, eight at twelve weeks, and eight at eighteen weeks. At six weeks the available space under the membrane was filled to 68 per cent, at twelve weeks it was 45 per cent, and at eighteen weeks 54 per cent. A comparison of bone height measurements on test and control sides showed a significant difference (p = 0.0001) at the three time intervals. A comparison of grown bone volumes (test vs control) was also statistically significant (p = 0.0001). The ability to grow bone under an occlusive membrane was confirmed but the long-term survival rate and ability to support load needs to be investigated.

Analysis of Variance↗

Enhancement of bone regeneration using resorbable ceramics and a polymer-ceramic composite material.

The aim of this experimental study was to evaluate the use of resorbable implants for the repair of nonloaded skeletal defects. Porous ceramic implants of alpha-TCP, of glass-ceramic, and of solid composite implants of glass-ceramic/polylactic acid 8 mm in diameter and 2 mm in thickness were fabricated and implanted pressfit into biparietal, full-thickness defects of the calvaria of 60 adult rats. Twenty rats received unfilled defects and served as controls. Fluorochrome labeling of bone formation was performed during the observation period. Five animals from each group were evaluated after 6, 13, 26, and 52 weeks. The control defects showed incomplete regeneration, with bone formation extending 1.66 mm, on average, into the defect after 52 weeks. In the group of alpha-TCP implants, histologic evaluation indicated that the bone formed during initial stages had undergone resorption later on, so that bone repair after 52 weeks was not significantly enhanced, with an average depth of 1.83 mm of bone ingrowth. The glass-ceramic implants exhibited extensive bone formation and nearly complete repair of the calvarial defect, with 3.90 mm of bone ingrowth into the implant pores. Degradation of the ceramic was nearly complete, with a few remaining particles surrounded by soft tissue. The composite implants showed a negligible bone ingrowth of 0.63 mm, on average. Soft tissue had invaded the polylactic acid implant body, but no bone formation had taken place at the surface of the embedded ceramic particles. Degradation of the polymer was not complete after 52 weeks. It is concluded that the balance between degradation and bone formation is delicate and that chemical events and cellular reaction during degradation may counteract complementary bone ingrowth.

Absorbable Implants↗

Mesenchymal stem cells combined with biphasic calcium phosphate ceramics promote bone regeneration.

The reconstruction and repair of large bone defects, resulting from trauma, cancer or metabolic disorders, is a major clinical challenge in orthopaedics. Clinically available biological and synthetic grafts have clear limitations that necessitate the development of new graft materials and/or strategies. Human mesenchymal stem cells (MSCs), obtained from the adult bone marrow, are multipotent cells capable of differentiating into various mesenchymal tissues. Of particular interest is the ability of these cells to differentiate into osteoblasts, or bone-forming cells. At Osiris, we have extensively characterized MSCs and have demonstrated MSCs can induce bone repair when implanted in vivo in combination with a biphasic calcium phosphate, specifically hydroxyapatite/tricalcium phosphate. This article reviews previous and current studies utilizing mesenchymal stem cells and biphasic calcium phosphates in bone repair.

Journal Article↗

The immediate implant: bone preservation and bone regeneration.

This paper demonstrates that an intact extraction socket is not necessary for the successful integration of a titanium implant fixture. Several case reports are used to describe the immediate placement of fixtures into compromised sockets, some in conjunction with bone grafting and/or guided tissue regeneration techniques to enhance the surgical result. Advantages of immediate implant placement are threefold: (1) treatment time is significantly reduced; (2) ridge contour can be preserved; and (3) it is possible to place the fixture in a more ideal axial position, thus enhancing fabrication, esthetics, and biomechanics of the subsequent restoration.

Alveolar Bone Loss↗

Bone regeneration in 2 stages for retention of dental implant. A case report.

This case report describes the successful rebuilding of jaw bone for t he anchorage of an endosseous implant by applying the principle of "guided tissue regeneration". The extremely reduced bone volume required reconstructive surgery in 2 stages, the 1st surgical procedure being carried out before the installation of the implant and the 2nd simultaneously with the placement of the implant. The biological prerequisites as well as technical demands for this treatment modality are discussed.

Alveolar Bone Loss↗