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PubMed1994

Use of Zircalloy to induce bone regeneration. A 2-year follow-up study.

In a previous study we analyzed the behaviour of Zircalloy 4 particles employed in patients with significant loss of periodontal bone support which threatened the permanence in situ of the tooth. We herein present the results obtained after regular examination over a 2-year period of 6 patients submitted to this treatment. Our results reveal that all patients exhibited excellent gingivo-periodontal health with an increase in clinical insertion of 7 mm +/- 1 and a marked reduction in motility from 3 to 1. None of the cases featured added inflammation or expulsion of the implant material. In one of the cases it was possible to study the histology of the area by punch biopsy with a disposable needle (Sherwood-Medical). Analysis of the sample revealed the presence of bone tissue in intimate contact with implanted metallic particles of Zircalloy 4, producing osseointegration. This osseointegration would lead to filling of the periodontal bone defect. Macrophages loaded with metallic particles were found in the vicinity of particles which were not osseointegrated. These features may correspond to superficial areas related with soft tissue as observed in our study on alveolar filling in rats with the same type of particles.

Adult↗
PubMed2006

Histomorphometric evaluation of guided bone regeneration around implants with SLA surface: an experimental study in beagle dogs.

The aim of this study was to evaluate the efficacy of collagen membranes, either alone or combined with a human demineralized freeze-dried bone allograft (DFDBA) or natural bovine bone graft, in bone defects around dental implants with an SLA (sand-blasted, large grit, acid-etched) surface. The experiments were carried out in three beagle dogs using a split-mouth design. On one side of the jaw, three implants were placed and intra-bony defects were created and covered with a collagen membrane, randomly combined in two of the defects with human DFDBA or inorganic bovine bone graft. A control implant, without membrane covering or defect filling, was also placed. On the other side of the jaw, three implants were placed and the bone defects were treated in a similar fashion, but without membrane covering. The studied variables were the percentage of bone-to-implant contact within the limits of the initial bony defect and percentage of the original bony defect occupied by bone tissue. Although no statistically significant differences were found in this study between the membrane and nonmembrane groups, bone defects augmented with anorganic bovine bone and membranes showed the most promising results from a histological and histomorphometric perspective.

Animals↗
PubMedDate not supplied

Enhanced bone regeneration using porcine small intestinal submucosa.

Small intestinal submucosa (SIS) is an easily produced material that has been used experimentally for tissue engineering. To evaluate the ability of SIS to facilitate bone growth within a long-bone defect, a segment of the radius was surgically removed in adult, female Sprague-Dawley rats. The defect was either left unfilled or implanted with SIS, demineralized cortical bone (DMCB), or ovalbumin. The defect was evaluated radiographically and histologically after 3, 6, 12, and 24 weeks. Tissue remodeling within the defect was evident by week 3 in SIS- and DMCB-treated rats. Filling was characterized initially by infiltration of mononuclear cells and extracellular material in SIS-implanted rats and multifocal remodeling bone particles and cartilage formation in DMCB-implanted rats. Cartilage was observed as early as 3 weeks and bone as early as 6 weeks in SIS-implanted rats. Filling of the defect arose from multiple foci in DMCB-implanted rats, but was contiguous with and parallel to the ulnar shaft in SIS-implanted rats, suggesting that defect repair by SIS may be conductive rather than inductive. Rats in which the defect was left unfilled demonstrated slow but progressive filling of the defect, characterized by mononuclear cell infiltrates and fibrous extracellular material. In summary, SIS facilitated rapid filling of a long-bone defect. These results suggest that SIS may be useful as a bone repair material.

Animals↗
PubMed1997

Bone regeneration around an osseointegrated implant. A simultaneous approach in a fenestrated defect: a case report.

The use of a barrier membrane, with or without osseous allograft, has been shown to establish regeneration of osseous tissue around dental implants. Following three episodes of persistent symptomatic failed apicoectomy and subsequent tooth extraction, an osseointegrated implant was placed in a wide fenestrated defect. Demineralized freeze-dried bone allograft was covered by an occlusive expanded polytetrafluorethylene membrane. The reentry procedure revealed complete bone fill that followed the texture of the augmentation material beyond the previous buccal bony envelope.

Adult↗
PubMed1996

Bone repair by regeneration.

Bone repair by regeneration as we know it continues to undergo changes, with advances approaching that may change our treatment of patients with craniofacial deformities and skeletal defects. Perhaps by the turn of the century, patients born with asymmetric deformities due to lack of growth will be treated early in life by skeletal stretching, and then later in life by skeletal distraction that is followed by use of accelerating factors to assist the healing processes. All of these available modalities are part of the regeneration of new bone formation. The future of such changes is very interesting, and our ability to help our patients will be maximized. We may even look back 25 years from now at bone grafting and find it to be obsolete and crude. It is hoped that with the new modalities being developed, we will not deviate from the use of a bone grafting procedure, which is the workhorse of the craniofacial surgeon. Bone grafting is used by all surgeons working on the craniofacial skeleton despite the problems of unpredictability of healing and an inability to calculate what percentage of the original graft will survive. The transplantation issue will be solved. The problems with donor site morbidity will continue. The use of inorganic bone substitutes will continue to have its limitation, particularly in type II wounds, which we as plastic surgeons see in the craniofacial region. As we redefine our approach to skeletal repair, we may look back and find solutions to some of the major problems we have had. The rapid stretch of soft tissue after facial advancement or structural alteration that is accompanied by a relapse due to the elastic recoil of the soft tissue could be eliminated by gradual distraction. The bone will undergo better functional adaptation when it has a gradual change in structure based on adjustment and molding in a gradual fashion. The problem of donor site morbidity and a prediction formula for bone could be resolved with new bone formation in situ by mineralization of the area under repair. Bone healing enhancers are here to stay and their clinical application will produce a far-reaching better final outcome (Fig. 11).

Adult↗
PubMed2005

Bone regeneration at implants with turned or rough surfaces in self-contained defects. An experimental study in the dog.

BACKGROUND: Marginal hard tissue defects present at implants with a rough surface can heal with a high degree of bone fill and osseointegration. The healing of similar defects adjacent to implants with a smooth surface appears to be less predictable. OBJECTIVE: The aim was to compare bone healing at implants with turned or rough surface topographies placed in self-contained defects using either a submerged or non-submerged installation technique. MATERIAL AND METHODS: Six dogs were used. Three months after tooth extraction four experimental sites were prepared for implant installation in both sides of the mandible. The marginal 5 mm of the canal prepared for the implant was widened. Thus, following implant placement a circumferential gap occurred between the bone tissue and the implant surface that was between 1 and 1.25 mm wide. In each side of the mandible two implants with a turned surface and two implants with a rough surface were installed. The implants in the right side were fully submerged, while a non-submerged technique was applied in the left side. The animals were sacrificed 4 months later, block biopsies of each implant site were dissected and ground as well as paraffin sections were prepared. RESULTS: The marginal defects around rough surface implants exhibited after 4 months of healing substantial bone fill and a high degree of osseointegration following either the submerged or the non-submerged installation technique. Healing at turned implants was characterized by incomplete bone fill and the presence of a connective tissue zone between the implant and the newly formed bone. The distance between the implant margin (M) and the most coronal level of bone-to-implant contact (B) at implants with a rough surface was 0.84+/-0.37 mm at submerged and 0.90+/-0.39 mm at non-submerged sites. The distance M-B at implants with a turned surface was 3.39+/-0.52 mm at submerged and 3.23+/-0.68 mm at non-submerged sites. The differences between the rough and turned implants regarding the length of distance M-B were statistically significant (paired t-test). CONCLUSION: Osseointegration at implants placed in sites with marginal defects is influenced by the surface characteristics of the implant.

Alveolar Bone Loss↗
PubMed1989

Detection of BrdU in the regenerating bone marrow cells of a patient with AML.

A patient with acute myeloid leukemia received bromodeoxyuridine (BrdU) prior to remission induction therapy. Prior to therapy only leukemic blast cells were found to be labeled. The marrow was aplastic by day 17 with the marrow cavity being devoid of BrdU labeled cells. In contrast rare BrdU containing cells were noted in the paratrabecular and endosteal regions. As the marrow recovered, many regenerating cells contained BrdU, implying that normal stem cells must have been in S-phase at the time of BrdU infusion, and repopulation of marrow may be accounted for by the activity of only a few clones in remission.

Bone Marrow↗
PubMed2005

Guided bone regeneration around non-submerged implants in narrow alveolar ridges: a prospective long-term clinical study.

OBJECTIVES: This prospective clinical study investigates long-term survival and clinical parameters of non-submerged implants with large buccal dehiscences treated with a deproteinized bovine bone mineral xenograft and a non-resorbable membrane in a one-stage approach. MATERIAL AND METHODS: Sixteen consecutive non-submerged implants (ITI Straumann) were installed in narrow alveolar ridges in 13 patients (age range: 25-61 years). All patients were non-smokers. On the buccal site the bone dehiscence ranged between 3 and 9 mm. Primary stability was achieved in all but one implant. The exposed threads were covered with a xenograft (Bio-Oss) and a non-resorbable expanded polytetrafluoroethylene membrane. The flap was sutured leaving the implant head non-submerged. The membrane was removed when (1) the membrane became exposed or (2) after a maximum of 24 weeks. All implants received singular cemented crowns. The implants were followed for a period ranging from 12 to 114 months. Whole-mouth plaque index (Pl), the % of bleeding on probing (BOP), probing depth and signs of peri-implantitis were recorded. Every year periapical radiographs were taken using a long cone technique. RESULTS: All but one implant integrated successfully. At the time of membrane removal, all previously exposed threads were completely covered with richly vascularized tissue except for two implants where the coverage reached 63% and 87%, respectively. The whole-mouth plaque score and BOP remained low in all patients during the observation period. None of the implants had plaque and, except for one implant BOP never occurred. All implants were stable and in function. Swelling, redness or purulence was never observed. On the periapical radiographs no bone resorption was observed on the mesial and distal site except for one implant in one patient with a mesial and distal bone resorption of 2 and 3 mm. Probing depth was never higher than 3 mm except for one patient where the implant was placed deeply subgingival for esthetical reasons. CONCLUSION: This prospective long-term study shows that with the use of non-submerged transmucosal implants, large bony dehiscences can be treated in a one-stage approach using a stiff non-resorbable membrane combined with a xenograft.

Adult↗
PubMed2005

Effect of granulocyte colony-stimulating factor on kinetics of hemopoietic precursors in regenerating bone marrow.

We studied processes of proliferation and differentiation of hemopoietic precursor cells in mice treated with granulocyte CSF under conditions of cytostatic myelodepression. It was found that the hemostimulating effect of original granulocyte CSF preparation consists in accelerated maturation of hemopoietic precursors and increased content of DNA-synthesizing CFU-GM in the bone marrow.

Animals↗