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Sample records for autogenous bone grafts

  1. Reconstruction of mandibular defects with autogenous bone grafts: a review of 30 cases

    International Nuclear Information System (INIS)

    Multitudes of options are available for reconstruction of functional and cosmetic defects of the mandible, caused by various ailments. At the present time, autogenous bone grafting is the gold standard by which all other techniques of reconstruction of the mandible can be judged. The purpose of this study was to evaluate the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstruction. Methods: This Interventional study was conducted at Department of Oral and Maxillofacial Surgery, King Edward Medical University/Mayo Hospital Lahore, from January 2008 to July 2009 including one year follow-up. The study was carried out on thirty patients having bony mandibular defects. They were reconstructed with the autogenous bone grafts from different graft donor sites. On post-operative visits they were evaluated for outcome variables. Results: Success rate of autogenous bone grafts in this study was 90%. Only 10% of the cases showed poor results regarding infection, resorption and graft failure. Conclusion: Autogenous bone grafts, non-vascularized or vascularized, are a reliable treatment modality for the reconstruction of the bony mandibular defects with predictable functional and aesthetic outcome. (author)

  2. Bone formation by autogenous grafting of cultured bone/porous ceramic constructs in a dog

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    Iida, J.; Ueda, Y.; Ohgushi, H.; Takakura, Y. [Nara Medical Univ., Kashihara (Japan). Dept. of Orthopedic Surgery; Yoshikawa, T. [Nara Medical Univ., Kashihara (Japan). Dept. of Orthopedic Surgery; Nara Medical Univ., Kashihara (Japan). Dept. of Phathology; Uemura, T.; Tateishi, T. [National Inst. for Advanced Interdisciplinary Research (NAIR), Ibaraki (Japan). Tsukuba Research Center; Enomoto, Y.; Ichijima, K. [Nara Medical Univ., Kashihara (Japan). Dept. of Phathology

    2001-07-01

    Five ml of bone marrow was collected from the humerus of a 6 month old female dog by needle aspiration. The marrow was cultured in T-75 flask and expand the marrow mesenchymal cells. After 1 week in primary culture, cells were released by trypsin treatment, concentrated and loaded onto porous hydroxyapatite (HA) blocks. The marrow/HA constructs were subcultured in the presence of dexamethasone and beta-glycerophosphate (osteogenic medium). After 2 weeks of subculture, the autogenous cultured bone/HA constructs were subcutaneously implanted into the back of the dog. Histological findings of the constructs at 3 weeks after implantation revealed thick layer of lamellar bone together with active osteoblasts lining in many pore areas of the HA. High alkaline phosphatase activity could be detected in the construct. These results indicate that autogenous cultured bone/HA constructs can produce extensive bone formation after implantation in a large animal(dog). Therefore, based upon the fact that human marrow-derived culture bone/HA construct possesses osteogenic potential when it is grafted into nude mice, it can be expected that autogenous human cultured bone/ceramic grafts may be useful to reconstruct bone in the clinical setting. (orig.)

  3. Alternative method to treat oroantral communication and fistula with autogenous bone graft and platelet rich firbin

    Science.gov (United States)

    Niedzielska, Iwona; Borgiel-Marek, Halina; Różanowski, Bartosz

    2016-01-01

    Background Removing a tooth from the jaw results in the occurrence of oroantral communication in beneficial anatomic conditions or in the case of a iatrogenic effect. Popularized treatments of the oroantral communication have numerous faults. Large bone defect eliminates the chance to introduce an implant. Purpose of this work was assessment of the usefulness of autogenous bone graft and PRF in normal bone regeneration in the site of oroantral communication. Material and Methods Bone regeneration in the site of oroantral communication was assessed in 20 patients. Bone defects were supplemented autogenous bone graft from mental protuberance in 14 cases and from oblique line in 6 cases. The graft was covered with a PRF membrane. Results In the study group in all cases closure of the oroantral communication was observed. The average width of the alveolar was 13 mm and the average height was 12.5 mm. In 3 patients an average increase of alveolar height of 1.5 mm was observed. Conclusions This method may be the best option to prepare alveolar for new implant and prosthetic solutions. Key words:Oroantral communication, oroantral fistula, autogenous bone graft, bone regeneration, platelet rich fibrin. PMID:27475687

  4. Histomorphometric Evaluation of Anorganic Bovine Bone Coverage to Reduce Autogenous Grafts Resorption: Preliminary Results

    OpenAIRE

    C Maiorana; Beretta, M.; G B Grossi; Santoro, F.; A. Scott Herford; Nagursky, H; CICCIÙ, M.

    2011-01-01

    Physiologic resorption due to remodeling processes affects autogenous corticocancellous grafts in the treatment of atrophic jawbone alveolar ridges. Such a situation in the past made overgrafting of the recipient site mandatory to get enough bone support to dental implants in order to perform a prosthetic rehabilitation. Anorganic bovine bone, conventionally used to treat alveolar bone deficiencies in implant surgery, showed a high osteoconductive property thanks to its micro and macrostructu...

  5. Histological evaluation of the influence of magnetic field application in autogenous bone grafts in rats

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    Ponzoni Deise

    2009-01-01

    Full Text Available Abstract Background Bone grafts are widely used in oral and maxillofacial reconstruction. The influence of electromagnetic fields and magnets on the endogenous stimulation of target tissues has been investigated. This work aimed to assess the quality of bone healing in surgical cavities filled with autogenous bone grafts, under the influence of a permanent magnetic field produced by in vivo buried devices. Methods Metal devices consisting of commercially pure martensitic stainless steel washers and titanium screws were employed. Thirty male Wistar rats were divided into 3 experimental and 3 control groups. A surgical bone cavity was produced on the right femur, and a bone graft was collected and placed in each hole. Two metallic washers, magnetized in the experimental group but not in the control group, were attached on the borders of the cavity. Results The animals were sacrificed on postoperative days 15, 45 and 60. The histological analysis of control and experimental samples showed adequate integration of the bone grafts, with intense bone neoformation. On days 45 and 60, a continued influence of the magnetic field on the surgical cavity and on the bone graft was observed in samples from the experimental group. Conclusion The results showed intense bone neoformation in the experimental group as compared to control animals. The intense extra-cortical bone neoformation observed suggests that the osteoconductor condition of the graft may be more susceptible to stimulation, when submitted to a magnetic field.

  6. Results of autogenous trephine biopsy needle bone grafting in fractures of radius and ulna.

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    Lakhey, S; Shrestha, B P; Pradhan, R L; Pandey, B; Rijal, K P

    2005-01-01

    Cortico-Cancellous bone graft harvested from the anterior iliac crest by the conventional open method is associated with more morbidity and is more time consuming as compared to the percutaneous method using trephine biopsy needle. The aim of the study was to determine whether cancellous bone graft harvested from anterior iliac crest using trephine biopsy needle consistently achieved bone union in comminuted fractures and fractures of more than 3 weeks duration of radius and ulna and also to determine the morbidity at the donor site. Autogenous cancellous bone graft was harvested percutaneously from 28 iliac crests in 16 patients and applied at fracture sites of 30 forearm bones using a 4mm trephine biopsy needle after the fractures had been fixed with plate and screws. The patients were followed up regularly upto 6 to 9 months post - operatively in the OPD to determine the union status of the fractured bones and the morbidity at the donor site. 29 of the 30 fractures of the forearm bones united without any problems. The shaft of a trephine got bent during the harvesting procedure at the beginning of the study due to improper technique. Cancellous bone graft harvested from the anterior iliac crest results in predictable good union results in comminuted fractures of forearm bones and also fractures presenting after 3 weeks of injury. It is also an easier and quicker way of harvesting bone graft and is associated with lesser morbidity and earlier recovery as compared to conventional open method. PMID:16554860

  7. Effects of low-level laser therapy on autogenous bone graft stabilized with a new heterologous fibrin sealant.

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    de Oliveira Gonçalves, Jéssica Barbosa; Buchaim, Daniela Vieira; de Souza Bueno, Cleuber Rodrigo; Pomini, Karina Torres; Barraviera, Benedito; Júnior, Rui Seabra Ferreira; Andreo, Jesus Carlos; de Castro Rodrigues, Antonio; Cestari, Tania Mary; Buchaim, Rogério Leone

    2016-09-01

    Autogenous bone grafts are used to repair bone defects, and the stabilization is needed for bone regeneration. Laser photobiomodulation is a modality of treatment in clinical practice for tissue regeneration, and it has therapeutic effects as an anti-inflammatory, analgesic and modulating cellular activity. The aim of the present study was to evaluate the effects of low-level laser therapy (LLLT) on an autogenous bone graft integration process stabilized with a new heterologous fibrin sealant. Forty rats were divided into two groups: Autogenous Fibrin Graft (AFG, n=20), in which a 5mm dome osteotomy was conducted in the right parietal bone and the graft was adhered to the left side using fibrin sealant; and Autogenous Fibrin Graft Laser (AFGL, n=20), which was subjected to the same procedures as AFG with the addition of LLLT. The treatment was performed immediately following surgery and then three times a week until euthanasia, using an 830nm laser (30mW, 6J/cm(2), 0.116cm(2), 258.6mW/cm(2), 2.9J). Five animals from each group were euthanized at 10, 20, 30 and 40days postoperative, and the samples were submitted to histomorphological and histomorphometric analysis. Partial bone regeneration occurred, with new bone tissue integrating the graft to the recipient bed and small areas of connective tissue. Comparative analysis of the groups at the same intervals revealed minor interfaces in group AFGL, with statistically significant differences (p<0.05) at all of the analyzed intervals (10days p=0.0087, 20days p=0.0012, 30days p<0.0001, 40days p=0.0142). In conclusion, low-level laser therapy stimulated bone regeneration and accelerated the process of integration of autogenous bone grafts. PMID:27497370

  8. Autogenous iliac crest bone graft versus banked allograft bone in scoliosis surgery in patients with Duchenne muscular dystrophy

    OpenAIRE

    Nakazawa, Toshiyuki; Takaso, Masashi; Imura, Takayuki; Adachi, Kou; Fukushima, Kensuke; Saito, Wataru; Miyajima, Gennyo; Minatani, Atsushi; Shinntani, Ryousuke; Itoman, Moritoshi; Takahashi, Kazuhisa; Yamazaki, Masashi; Ohtori, Seiji; Sasaki, Atsushi

    2009-01-01

    A total of 36 consecutive nonambulatory DMD patients underwent scoliosis surgery. Patients were divided into two groups: the autogenous iliac crest bone graft group (the ICBG group; 20 patients) and the allogenous bone graft group (the ALBG group; 16 patients). The mean preoperative curves measured 87° and 31° at the last follow-up in the ICBG group and 83° and 28° in the ALBG group. In the ICBG group, three (15%) patients had intraoperative sacroiliac joint penetration, five (25%) had iliac ...

  9. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft in animals

    DEFF Research Database (Denmark)

    Jensen, T; Schou, S; Stavropoulos, Andreas;

    2012-01-01

    The objective of the present systematic review was to test the hypothesis of no differences between the use of Bio-Oss or Bio-Oss mixed with autogenous bone as graft for maxillary sinus floor augmentation (MSFA) applying the lateral window technique, as evaluated in animals. A MEDLINE (Pub...

  10. Pure orbital blowout fractures reconstructed with autogenous bone grafts: functional and aesthetic outcomes.

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    Kronig, S A J; van der Mooren, R J G; Strabbing, E M; Stam, L H M; Tan, J A S L; de Jongh, E; van der Wal, K G H; Paridaens, D; Koudstaal, M J

    2016-04-01

    The purpose of this study was to investigate the ophthalmic clinical findings following surgical reconstruction with autogenous bone grafts of pure blowout fractures. A retrospective review of 211 patients who underwent surgical repair of an orbital fracture between October 1996 and December 2013 was performed. Following data analysis, 60 patients who were followed up over a period of 1 year were included. A solitary floor fracture was present in 38 patients and a floor and a medial wall fracture in 22 patients. Comparing preoperative findings between these two groups, preoperative diplopia and enophthalmos were almost twice as frequent in the group with additional medial wall fractures: diplopia 8% and 14% and enophthalmos 18% and 55%, respectively. One year following surgery there was no diplopia present in either group. In the solitary floor fracture group, 3% still had enophthalmos. It can be concluded that at 1 year following the repair of pure orbital floor fractures using autogenous bone, good functional and aesthetic results can be obtained. In the group with both floor and medial wall fractures, no enophthalmos was found when both walls were reconstructed. When the medial wall was left unoperated, 29% of patients still suffered from enophthalmos after 1 year.

  11. Instrumented fusion of thoracolumbar fracture with type I mineralized collagen matrix combined with autogenous bone marrow as a bone graft substitute: a four-case report

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    Faundez, Antonio; Taylor, Sofia; Kaelin, André

    2006-01-01

    In order to avoid the morbidity from autogenous bone harvesting, bone graft substitutes are being used more frequently in spinal surgery. There is indirect radiological evidence that bone graft substitutes are efficacious in humans. The purpose of this four-case study was to visually, manually, and histologically assess the quality of a fusion mass produced by a collagen hydroxyapatite scaffold impregnated with autologous bone marrow aspirate for posterolateral fusion. Four patients sustained...

  12. Exchanging reamed nailing versus augmentative compression plating with autogenous bone grafting for aseptic femoral shaft nonunion: a retrospective cohort study

    OpenAIRE

    Jiang-ying, Ru; Yun-fei, Niu; Yu, Cong; Wen-bo, Kang; Hai-bin, Cang; Jian-ning, Zhao

    2015-01-01

    Objective: The purpose of this study was to compare the outcomes of exchanging reamed nailing (ERN) and augmentative compression plating (ACP) with autogenous bone grafting (BG) for the treatment of aseptic femoral shaft nonunion secondary to the treatment of intramedullary nailing (IMN).Methods: A multicenter retrospective study was performed for 178 patients (180 cases) of aseptic femoral shaft nonunion secondary to first treatment of IMN. All cases were fixed with either ERN (n=87) or ACP ...

  13. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft: a systematic review

    DEFF Research Database (Denmark)

    Jensen, Thomas; Schou, Søren; Stavropoulos, Andreas;

    2012-01-01

    and bone-to-implant contact compared with Bio-Oss. Conclusions: Therefore, the hypothesis of no differences between the use of Bio-Oss or Bio-Oss mixed with autogenous bone as graft for MSFA could neither be confirmed nor rejected. To cite this article: Jensen T, Schou S, Stavropoulos A, Terheyden H......Aims: The objective of the present systematic review was to test the hypothesis of no differences in the implant treatment outcome when Bio-Oss or Bio-Oss mixed with autogenous bone is used as graft for the maxillary sinus floor augmentation (MSFA) applying the lateral window technique. Material......, Holmstrup P. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft: a systematic review. Clin. Oral Impl. Res. xx, 2011; 000-000 doi: 10.1111/j.1600-0501.2011.02168.x....

  14. High‐Resolution Three‐Dimensional Computed Tomography Analysis of the Clinical Efficacy of Cultured Autogenous Periosteal Cells in Sinus Lift Bone Grafting

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    Ogawa, Shin; Hoshina, Hideyuki; Nakata, Koh; Yamada, Kazuho; Uematsu, Kohya; Kawase, Tomoyuki; Takagi, Ritsuo

    2015-01-01

    Abstract Background and Purpose Sinus lift (SL) using cultured autogenous periosteal cells (CAPCs) combined with autogenous bone and platelet‐rich plasma (PRP) was performed to evaluate the effect of cell administration on bone regeneration, by using high‐resolution three‐dimensional computed tomography (CT). Materials and Methods SL with autogenous bone and PRP plus CAPC [CAPC(+)SL] was performed in 23 patients. A piece of periosteum taken from the mandible was cultured in M199 medium with 10% fetal bovine serum (FBS) for 6 weeks. As control, 16 patients received SL with autogenous bone and PRP [CAPC(−)SL]. Three‐dimensional CT imaging was performed before and 4 months and 1 year after SL, and stratification was performed based on CT numbers (HUs) corresponding to soft tissue and cancellous or cortical bone. Results The augmented bone in CAPC(+)SL revealed an increase in HUs corresponding to cancellous bone as well as a decrease in HUs corresponding to grafted cortical bone. In addition, HUs corresponding to cancellous bone in the graft bed were increased in CAPC(+)SL but were decreased in CAPC(−)SL. Insertion torque during implant placement was significantly higher in CAPC(+)SL. Conclusion By promoting bone anabolic activity both in augmented bone and graft bed, CAPCs are expected to aid primary fixation and osseointegration of implants in clinical applications. PMID:26017402

  15. Bone Graft Alternatives

    Science.gov (United States)

    ... cadavers. The types of allograft bone used for spine surgery include fresh frozen and lyophilized (freeze dried). The ... the most common uses of bone grafts in spine surgery is during spinal fusion. The use of autogenous ...

  16. Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians

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    Kizito Chioma Ndukwe

    2014-01-01

    Full Text Available Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients′ records. This information include patients′ demographics (age and sex as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%. Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients and postoperative wound infection (eight patients were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care

  17. Comparison of autogenous bone graft donor site haemostatic agents used in spinal surgery

    OpenAIRE

    Copuroglu, Cem; Ercan, Selcuk; Ozcan, Mert; Ciftdemir, Mert; Turan, F. Nesrin; Yalniz, Erol

    2011-01-01

    Objective: The aim of our study was to investigate the effects of haemostatic agents used at the autograft donor sites in spinal fusion. Methods: The study included 66 patients (26 men, 40 women; mean age: 42.9 years) who underwent spinal fusion surgery between March 1999 and October 2002. Patients were randomly assigned to 4 different groups according to the haemostatic agents used during surgery. In Group 1, bone wax was used on the graft donor site. In Group 2, spongostan was used. In ...

  18. Clinical Comparison of Autogenous Bone Graft with and without Plasma Rich in Growth Factors in the Treatment of Grade II Furcation Involvement of Mandibular Molars

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    Lafzi, Ardeshir; Shirmohammadi, Adileh; Faramarzi, Masoumeh; Jabali, Sahar; Shayan, Arman

    2013-01-01

    Background and aims Plasma rich in growth factors (PRGF) is a concentrated suspension of growth factors, which is used to promote periodontal tissue regeneration. The aim of this randomized, controlled, clinical trial was to evaluate of the treatment of grade II mandibular molar furcation involvement using autogenous bone graft with and without PRGF. Materials and methods In this double-blind clinical trial, thirty mandibular molars with grade II furcation involvement in 30 patients were sele...

  19. Biomechanical studies of vertebroplasty by autogenous bone grafting%自体骨椎体成形术的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    王骅; 王静成; 王永祥

    2013-01-01

    Objective To study the biomechanical effects on the injury lumbar spine with vertebroplasty by autogenous bone grafting. Methods Nine cadaver lumbar spine specimens were randomly divided into 3 groups: normal group, fracture group, and fracture with vertebroplasty by autogenous bone grafting group. Data of the rigidity and stress were recorded and analyzed. Result Vertebroplasty by autogenous bone grafting improved stability of the fracture segment obviously (P<0.05), but it was still more instable than normal segment (P<0.05). Conclusion Vertebroplasty by autogenous bone grafting can provide stability partly, but it should be applied combined with internal fixation.%目的 探讨自体骨椎体成形术对损伤腰椎生物力学特性的影响.方法 9具尸体腰椎标本分为正常组、椎体压缩骨折组、自体骨椎体成形术组,分别进行生物力学测试,探讨损伤腰椎力学特性的变化.结果 自体骨椎体成形术能改善损伤腰椎的稳定性,但与正常椎体相比尚有差距,呈显著性差异(P<0.05).结论 自体骨椎体成形术部分改善了损伤腰椎的生物力学稳定性,应与内固定系统联合运用.

  20. No advantage to rhBMP-2 in addition to autogenous graft for fracture nonunion.

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    Takemoto, Richelle; Forman, Jordanna; Taormina, David P; Egol, Kenneth A

    2014-06-01

    Bone morphogenetic proteins are a necessary component of the fracture healing cascade. Few studies have delineated the efficacy of iliac crest bone graft and recombinant human bone morphogenetic protein 2 (rhBMP-2), especially, in comparison with the gold standard treatment of nonunion, which is autogenous bone graft alone. This study compared the outcome of patients with fracture nonunion treated with autogenous bone graft plus rhBMP-2 adjuvant vs patients treated with autogenous bone graft alone. A total of 118 consecutive patients who were to undergo long bone nonunion surgery with autogenous bone graft (50) or autogenous bone graft plus rhBMP-2 (68) were identified. Surgical intervention included either harvested iliac autogenous bone graft or autogenous bone graft plus 1.5 mg/mL of rhBMP-2 placed in and around the site of nonunion. No differences were found in the distribution of nonunion sites included within each group. Twelve-month follow-up was obtained on 100 of 118 patients (84.7%). Analyses of demographic characteristics (including tobacco), medical comorbidities, previous surgeries, and nonunion type (atrophic vs hypertrophic) did not differ. Postoperative complication rates did not differ. The percentage of patients who progressed to union did not differ. Mean time to union in the autogenous bone graft plus rhBMP-2 group was 6.6 months (±3.9) vs 5.4 (±2.7) months in the autogenous bone graft-only group (P=.06). Rates of revision (16.2% for rhBMP-2 plus autogenous bone graft vs 8% for autogenous bone graft) did not differ statistically (P=.19), nor did 12-month scores of pain and functional assessment. Although rhBMP-2 is a safe adjuvant, there was no benefit seen when rhBMP-2 was added to autogenous bone graft in the treatment of long bone nonunion. Given its high cost, rhBMP-2 should be reconsidered as an aid to autogenous bone graft in the treatment of nonunion. PMID:24972432

  1. Clinical Comparison of Autogenous Bone Graft with and without Plasma Rich in Growth Factors in the Treatment of Grade II Furcation Involvement of Mandibular Molars

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    Lafzi, Ardeshir; Shirmohammadi, Adileh; Faramarzi, Masoumeh; Jabali, Sahar; Shayan, Arman

    2013-01-01

    Background and aims Plasma rich in growth factors (PRGF) is a concentrated suspension of growth factors, which is used to promote periodontal tissue regeneration. The aim of this randomized, controlled, clinical trial was to evaluate of the treatment of grade II mandibular molar furcation involvement using autogenous bone graft with and without PRGF. Materials and methods In this double-blind clinical trial, thirty mandibular molars with grade II furcation involvement in 30 patients were selected. The test group received bone graft combined with PRGF, while the control group was treated with bone graft only. Clinical parameters included clinical probing depth (CPD), vertical clinical attachment level (V-CAL), horizontal clinical attachment level (H-CAL), location of gingival margin (LGM), surgically exposed horizontal probing depth of bony defect (E-HPD), vertical depth of bone crest (V-DBC), vertical depth of the base of bony defect (V-DBD), and length of the intrabony defect (LID). After six months, a re-entry surgery was performed. Data were analyzed by SPSS 14, using Kolmogorov, Mann-Whitney U, and paired t-test. Results After 6 months, both treatment methods led to significant improvement in V-CAL and H-CAL and significant decreases in CPD, E-HPD, V-DBD and LID; there was no significant difference in LGM and V-DBC in any of the treated groups compared to the baseline values. Also, none of the parameters showed significant differences between the study groups. Conclusion Although autogenous bone grafts, with or without PRGF, were successful in treating grade II furcation involvement, no differences between the study groups were observed. PMID:23486928

  2. Successful use of autogenous bone graft for the treatment of a radius-ulna nonunion in an amputee dog

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    B.W. Minto

    2015-08-01

    Full Text Available Fracture nonunions represent important complications in orthopedic surgeries. Nonunion repairs or bone defects are surgically challenging. Our aim was to describe a nonunion case, which was repaired with rapid bone recovery. An 8-month-old male mixed breed dog that has been previously operated was presented to the Veterinary Medical Teaching Hospital of São Paulo State University, with a right radius-ulna nonunion and an amputated contralateral forelimb. A cancellous bone graft was collected from a partially amputated limb, in order to correct the nonunion, and used in association with a locking plate. After four weeks, the bone graft had been incorporated into the original bone. Clinical union with good weight bearing was achieved after eight weeks.

  3. Bone Grafts

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    ... repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some types of fractures or cancers. Once your body accepts the bone ...

  4. Neglected anterior dislocation of shoulder with large Hillsach's lesion & deficient glenoid: Treated by autogenous bone graft & modified Latarjet procedure.

    Science.gov (United States)

    Peshin, Chetan; Jangira, Vivek; Gupta, Ravi Kumar; Jindal, Rohit

    2015-12-01

    Neglected anterior dislocation of shoulder is rare in spite of the fact that the anterior dislocation of the shoulder is seen in around 90% of the acute cases. Most of the series of neglected dislocation describe posterior dislocation to be far more common.(1) (,2) We hereby report a case of the neglected anterior shoulder dislocation in a 15 year old boy who had a history of epilepsy. There was a large Hill Sachs lesion in humeral head which was impacted in glenoid inferiorly and glenoid was eburnated at that margin. The humeral head was reconstructed with a tricortical iliac graft. Glenoid was reconstructed by transfer of coracoids process of scapula to antero-inferior glenoid (modified Latarjet procedure). This case is unique because management of humeral head defect with bone graft is not mentioned in anterior dislocation.

  5. Volumetric changes of the graft after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios

    DEFF Research Database (Denmark)

    Jensen, Thomas; Schou, Søren; Svendsen, Patricia Anne;

    2012-01-01

    composition was selected at random and placed concomitant with implant placement. Computed tomographies of the maxillary sinuses were obtained preoperatively, immediately postoperatively, and at euthanasia after 12 weeks. The volumetric changes of the graft were estimated using the Cavalieri principle...

  6. Randomized controlled analysis-autogenous bone peg graft improved offset hemiarthroplasty in high risk patients: a novel cost effective technique

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    Hashmukh Shantilal Varma

    2016-06-01

    Results: In patients with novel technique value of X was 1 mm+/-0.8 SD, whereas value of X in conventional technique the value of X was significantly higher of about 7.2 mm+/-1.6 SD and this was associated with increased femoral off set 47.2+/-2.0 SD and the correlation was found to be statistically significant (p<0.05. Furthermore, in group B where graft was not used subsidence was found in 6 patients (24%. None was revised during the period of follow up. Conclusions: Our preliminary results indicate that the approach proposed is feasible and effective in the management of intracapsular fracture neck femur in high risk patients with unipolar prosthesis. [Int J Res Med Sci 2016; 4(6.000: 1897-1902

  7. Computed tomography evaluation of autogenous graft in sinus lift surgery; Analise por tomografia computadorizada do enxerto autogeno na cirurgia de 'sinus lift'

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    Ajzen, Sergio Aron; Moscatiello, Rafael Andrade; Lima, Aida Maria Custodio de; Moscatiello, Vitoria Aparecida Muglia; Helio Kiitiro Yamashita [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem; Mosacatiello, Rafael Muglia; Nishiguchi, Celso Itiro [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Disciplina de Tecnica Operatoria e Cirurgia Experimental; Alves, Maria Teresa de Seixas [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Disciplina de Anatomia Patologica

    2001-02-01

    The objective was to quantify bone formation within autogenous bone grafts and autogenous bone grafts in combination with platelet-rich plasma obtained either from apheresis or centrifugation using computed tomography. This prospective, double-blind study was conducted in 34 male and female adult patients (mean age of 28 years and 8 months), with either unilateral or bilateral pneumatization of the maxillary sinuses, requiring bone graft for dental implant. All patients were submitted to computed tomography examinations prior and six months after sinus lift surgery. Fifty-three maxillary sinuses were operated and divided into three distinct groups: autogenous bone graft, autogenous bone graft in combination with platelet-rich plasma obtained by centrifugation, and autogenous bone graft in combination with platelet-rich plasma obtained by apheresis. The results showed that computed tomography demonstrated bone growth in height and width between the initial and the follow-up computed tomography scans in all three groups. However, no statistical difference was found either for bone height or width. It was concluded that clinical evidence demonstrates the effectiveness of autogenous bone grafts, particularly when used in combination with bone growth factors such as platelet-rich plasma, which allow prosthetic and functional restoration of maxillofacial structures through fixation of dental implants. (author)

  8. Biological and physical properties of autogenous vascularized fibular grafts in dogs

    International Nuclear Information System (INIS)

    The biological and biomechanical properties of normal fibulae, fibulae that had had a sham operation, and both vascularized and non-vascularized autogenous grafts were studied in dogs at three months after the operation. The study was designed to quantify and correlate changes in these properties in orthotopic, stably fixed, weight-bearing grafts and to provide a baseline for additional studies of allografts. The grafts were eight centimeters long and internally fixed. The mechanical properties of the grafts were studied by torsional testing. Metabolic turnover of the grafts was evaluated by preoperative labeling of the dogs with 3H-tetracycline for resorption of bone mineral and with 3H-proline for turnover of collagen. Cortical bone area and porosity were measured. Postoperative formation of bone was evaluated by sequential labeling with fluorochrome. The vascularized grafts resembled the fibulae that had had a sham operation and those that had not had an operation with regard to the total number of osteons and the remodeling process, as measured both morphometrically and metabolically. The vascularized grafts were stronger and stiffer than the non-vascularized grafts and were not different from the bones that had had a sham operation. In contrast, the non-vascularized grafts were smaller, weaker, less stiff, and more porotic, had fewer osteons, and demonstrated increased turnover and resorption compared with the vascularized grafts, the bones that had had a sham operation, and the bones that had not been operated on

  9. Horizontal Bone Augmentation Using Autogenous Block Grafts and Particulate Xenograft in the Severe Atrophic Maxillary Anterior Ridges: A Cone-Beam Computerized Tomography Case Series.

    Science.gov (United States)

    Monje, Alberto; Monje, Florencio; Hernández-Alfaro, Federico; Gonzalez-García, Raúl; Suárez-López del Amo, Fernando; Galindo-Moreno, Pablo; Montanero-Fernández, Jesús; Wang, Hom-Lay

    2015-07-01

    The aim of the present study was to use cone-beam computerized tomography (CBCT) to assess horizontal bone augmentation using block grafts, harvested from either the iliac crest (IC) or mandibular ramus (MR) combined with particulate xenograft and a collagen membrane for in the severe maxillary anterior ridge defects (cases Class III-IV according to Cadwood and Howell's classification). Fourteen healthy partially edentulous patients requiring extensive horizontal bone reconstruction in the anterior maxilla were selected for the study. Nineteen onlay block grafts (from IC or MR) were placed. The amount of horizontal bone gain was recorded by CBCT at 3 levels (5, 7, and 11 mm from the residual ridge) and at the time of bone grafting as well as the time of implant placement (≈5 months). Both block donor sites provided enough ridge width for proper implant placement. Nonetheless, IC had significantly greater ridge width gain than MR (Student t test) (4.93 mm vs 3.23 mm). This was further confirmed by nonparametric Mann-Whitney test (P = .007). Moreover, mean pristine ridge and grafted ridge values showed a direct association (Spearman coefficient of correlation = .336). A combination of block graft, obtained from the IC or MR, combined with particulate xenograft then covered with an absorbable collagen membrane is a predictable technique for augmenting anterior maxillary horizontal ridge deficiency.

  10. Combined bone grafting: an alternative method for bone healing stimulation

    International Nuclear Information System (INIS)

    The most provocative problem in bone grafting is the effectiveness of healing of the graft. When you use the heterogenous bone graft, it may take one or more than two years for consolidation and union depends on the graft quality and the situation of surrounding blood supply. In our preliminary report seven cases of freeze-dried heterogenous bone graft from the Bangkok Biomaterial Center were mixed with autogenous iliac bone graft from the patient in the ratio of 3:1. After that the healing was checked by clinical examination and X-ray in the periodic follow up. The causes of bone lost are post evacuation of benign bone tumor and post infection of bone after trauma. The result of bony union could be tested by clinical examination and showed in the X-ray films as early as 3 months post grafting

  11. Bone healing around nanocrystalline hydroxyapatite, deproteinized bovine bone mineral, biphasic calcium phosphate, and autogenous bone in mandibular bone defects

    DEFF Research Database (Denmark)

    Broggini, Nina; Bosshardt, Dieter D; Jensen, Simon S;

    2015-01-01

    The individual healing profile of a given bone substitute with respect to osteogenic potential and substitution rate must be considered when selecting adjunctive grafting materials for bone regeneration procedures. In this study, standardized mandibular defects in minipigs were filled with nanocr......The individual healing profile of a given bone substitute with respect to osteogenic potential and substitution rate must be considered when selecting adjunctive grafting materials for bone regeneration procedures. In this study, standardized mandibular defects in minipigs were filled...... with nanocrystalline hydroxyapatite (HA-SiO), deproteinized bovine bone mineral (DBBM), biphasic calcium phosphate (BCP) with a 60/40% HA/β-TCP (BCP 60/40) ratio, or particulate autogenous bone (A) for histological and histomorphometric analysis. At 2 weeks, percent filler amongst the test groups (DBBM (35.65%), HA...

  12. Applied anatomy of ankle lateral ligament reconstruction with periostum-patellar tendon-bone autogenous graft%自体髌骨膜-髌韧带-骨瓣重建踝外侧韧带的应用解剖

    Institute of Scientific and Technical Information of China (English)

    孙强; 周捍东; 郑加法

    2011-01-01

    目的 为自体髌骨膜-髌韧带-骨瓣重建踝关节外侧韧带提供解剖学基础.方法 在6侧经防腐同定的成人下肢标本及6侧新鲜标本上观测踝关节外侧韧带起止点及走行径路、髌韧带的解剖形态与起止点,在新鲜标本上摹拟重建手术.结果 髌韧带位置恒定,解剖层次表浅,切取方便,髌骨膜-髌韧带一骨瓣的髌韧带长度(4.1±0.4)cm,距腓前韧带长度(2.4±0.5)cm,跟腓韧带长度(3.1±0.4)cm.结论 (1)髌骨膜-髌韧带-骨瓣的髌韧带具有足够的长度,可形成移植供体;(2)髌骨膜-髌韧带-骨瓣复合体两端分别与骨及软骨创面固定,容易成活和恢复功能;(3)采用自体髌骨膜-髌韧带-骨瓣重建踝外侧韧带具有可行性.%Objective To provide anatomic basis for free autogenous periostum- patellar tendon-bone grafts to reconstruct the lateral ankle ligament.Methods The anatomic properties of lateral ankle and patellar ligaments were observed and measured on 12 adult cadavers, and the reconstruction of the lateral ankle ligament were simulated on 6 fresh specimens.Results The constant locations of the patellar ligament were easy to be incised; The lengths of the patellar ligaments and the calacaneofibular and anterior talofibular ligaments were (41.0 ±4.0)mm, (24.3 ±4.6)mm and (31.3 ±4.2)mm, respectively.Conclusions The anatomic properties of periostum-patellar tendon-bone was similar to that of lateral ankle ligaments, There were periostum-patellar tendon-bone ligament tissue with enough length for the lateral ankle joint ligaments reconstruction.The grafted periostum- patellar tendon-bone easily can survive on recipient site.Autogenous periostum- patellar tendon-bone Grafts could to be used to reconstruct the lateral ankle joint ligaments.

  13. Bone grafting: An overview

    Directory of Open Access Journals (Sweden)

    D. O. Joshi

    2010-08-01

    Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of

  14. Bone grafts in dentistry

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar

    2013-01-01

    Full Text Available Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation.

  15. Bone graft revascularization strategies

    NARCIS (Netherlands)

    W.F. Willems

    2014-01-01

    Reconstruction of avascular necrotic bone by pedicled bone grafting is a well-known treatment with little basic research supporting its application. A new canine model was used to simulate carpal bone avascular necrosis. Pedicled bone grafting proved to increase bone remodeling and bone blood flow,

  16. Simultaneous implant placement with ridge augmentation using an autogenous bone ring transplant.

    Science.gov (United States)

    Omara, M; Abdelwahed, N; Ahmed, M; Hindy, M

    2016-04-01

    The severely defective socket, in which implant placement within the remaining bone will result in a significantly off-axis implant position, precludes immediate implant placement and requires bone grafting as an initial surgical intervention. The aims of this study were to evaluate autogenous chin bone ring consolidation after the augmentation of severely defective sockets and the clinical application of these rings in the premolar-molar region with simultaneous implant placement in a one-stage procedure. Ten patients with 12 defective sockets were included. Sockets were prepared with a trephine bur. Bone rings with a tapped implant osteotomy were harvested from the chin with a larger trephine bur. Bone rings were fitted in the prepared sockets. An implant drill was used to prepare the bone apical to the ring through its central osteotomy. Implants were screwed through the rings and the apical bone. Patients were examined clinically and radiographically immediately and at 6 months postoperative. Crestal bone changes were measured and evaluated statistically. All grafted sockets showed bone healing with no significant crestal bone resorption and no infection; only one ring showed dehiscence, which healed during the follow-up period. All implants showed radiographic evidence of osseointegration. The autogenous chin bone ring augmentation technique was found to be a reliable alternative method for the management of severely defective sockets. PMID:26644216

  17. Team management of atrophic edentulism with autogenous inlay, veneer, and split grafts and endosseous implants: case reports.

    Science.gov (United States)

    Collins, T A; Brown, G K; Johnson, N; Massey, J A; Nunn, B D

    1995-02-01

    Predictable success of autogenous graft and implant reconstructions is critically dependent on preoperative alignment and prosthetic considerations planned by the surgeon and the restorative dentist in a team approach. In such cases the surgeon has an opportunity to place accurate bone grafts that allow implants to be secured in both the correct position and correct axis for good prosthetic restoration. With careful thought, the restorative dentist and surgeon can plan the location, shape, and volume of an implant-graft reconstruction. Nine requirements for successful onlay grating with implants and five case reports illustrating the team approach are presented.

  18. Autogenous bone block in the treatment of teeth with hopeless prognosis

    Directory of Open Access Journals (Sweden)

    Nymphea Pandit

    2012-01-01

    Full Text Available Background: Autogenous bone graft, although considered as a gold standard, has been relegated to background because of limited quantity and donor site morbidity. Revival of interest in its use has been reflected by its tremendous capacity for regeneration in less than ideal situation. Bone blocks have been used for implant site augmentation, with varied success. Aim: Aim of the study was to evaluate the efficacy of autogenous bone block in the regeneration of bone, for saving teeth with a hopeless prognosis. Settings and Design: A total of six patients and 12 sites with grade II and III mobile teeth were treated with autogenous bone blocks and fiber splinting. Subjects and Methods: Attachment loss, probing depths, and radiographic bone loss were recorded at baseline and at 12 months interval. Statistical Analysis Used: The Student paired t test was used for evaluation of the changes from baseline to 12 months. Results: At 12 months post-operatively, there was a highly significant amount of bone gain as compared to the baseline. The mean amount of bone loss reduced from 9.41 ± 1.16 to 5.41 ± 1.01. The clinical attachment loss reduced from 7.37 ± 1.24 mm to 3.79 ± 0.89 mm and probing depth reduced from 7 ± 1.67 mm to 5.5 ± 0.63 mm. The grafted bone was observed to have been incorporated with the host bone in most of the sites as evidenced by radiographs. Conclusions: For teeth with hopeless prognosis, this method can be considered to be a very viable alternative to extraction and replacement by costly implants.

  19. Mechanical properties of radial bone defects treated with autogenous graft covered with hydroxyapatite in rabbit Propriedades mecânicas de defeito de osso radial tratado com enxerto autógeno coberto com nano-hydroxyapatite em coelho

    Directory of Open Access Journals (Sweden)

    Davood Sharifi

    2012-03-01

    Full Text Available PURPOSE: To determine biomechanical property of autogenous bone graft covered with hydroxyapatite in the defect of radial bone in rabbit. METHODS: Eighteen adult male New Zealand white rabbits were used which were divided into three groups (I, II, III of six rabbits each. A segmental bone defect of 10 mm in length was created in the middle of the right radial shaft under general effective anesthesia in all rabbits and were stabilized using mini-plate with four screws. The defects In group I were left as such without filler, whereas in group II the defect were filled up with harvested 10 mm rib bone and in group III the defect were packed with rib bone covered with nano-hydroxyapatite. All rabbits in three groups were divided into two subgroups (one month and three months duration with three rabbits in each one. RESULTS: The mechanical property and the mean load for fracturing normal radial bone was recorded 388.2±6 N whereas it was 72.4±12.8 N for group I in 1 month duration which was recorded 182.4±14.2 N for group II and 211.6±10.4 N for group III at the end of 1 month. These values were 97.6±10.2 N for group I and 324.6±8.2 N for group II and 372.6±17.4 N for group III at the end of three months after implantation. CONCLUSION: Implantation of autologous graft covered with hydroxyapatite indicated to have positive effect in integral formation of qualitative callus at the site of fracture and early re-organization of callus to regain mechanical strength too.OBJETIVO: Determinar as propriedades biomecânicas de enxerto ósseo autógeno coberto com hidroxiapatita em defeito do osso radial em coelhos. MÉTODOS: Foram utilizados 18 coelhos adultos, machos, brancos, Nova Zelândia, distribuídos em três grupos (I, II, III de seis coelhos cada. Um defeito segmentar de 10 mm de comprimento foi criado no meio do eixo radial direito sob anestesia geral efetiva em todos os coelhos e foram fixados usando mini-placa com quatro parafusos. Os

  20. Changes of Ca2+ activated potassium channels and cellular proliferation in autogenous vein grafts

    Institute of Scientific and Technical Information of China (English)

    钱济先; 宋胜云; 马保安; 范清宇

    2003-01-01

    Objective: To investigate changes of Ca2+ activated potassium channels (KCa) in autogenous vein grafts. Methods: Contraction of venous ring was measured by means of perfusion in vitro. The intimal rabbits proliferation of vascular and proliferation of cultured smooth muscle cells(vascular smooth muscle cells, VSMCs)were observed by the means of computerised image analysis and MTT method respectively. Furthermore, whole cell mode of patch clamp was used to record KCa of VSMCs isolated from autogenous vein grafts. Results: One week after transplantation there were no significant differences of contraction and intimal relative thickness between autogenous vein grafts and control. Contraction and intimal relative thickness of autogenous vein graft were significantly increased 2 weeks after transplantation (P<0.05, n=8 vs control), and they was more enhanced 4 weeks after vein transplantation (P<0.01, n=8 vs control).TEA(blocker of Ca2+ activated potassium channels)increased MTT A490 nm value of VSMCs from femoral vein in a dose dependent manner(P<0.05, n=8). KCa current density was significantly attenuated in VSMCs from autogenous vein grafts (1-4) week after transplantation(P<0.05, n=5).Conclusion: KCa is inhibited in autogenous vein graft, which account for vasospasm and intimal proliferation.

  1. Proximal Tibial Bone Graft

    Science.gov (United States)

    ... Complications Potential problems after a PTBG include infection, fracture of the proximal tibia and pain related to the procedure. Frequently Asked Questions If proximal tibial bone graft is taken from my knee, will this prevent me from being able to ...

  2. The Palatal Bone Block Graft for Onlay Grafting Combined with Maxillary Implant Placement: A Case Series.

    Science.gov (United States)

    Gluckman, Howard; Du Toit, Jonathan; Salama, Maurice

    2016-01-01

    The aim of this study was to introduce an intraoral bone block harvesting technique--the palatal bone block graft (PBBG)--as an alternative harvest site for autogenous bone blocks. The PBBG technique was used to onlay graft esthetic zone defects simultaneous to implant placement in five patients. Measurable objectives were used to evaluate outcomes, and treatment was reassessed at up to 6 years. Defects of the maxilla were successfully grafted with PBBG in all five cases, and tissues remained stable at 1- and 6-year follow-ups. Harvesting an autogenous bone block from the palate is an advantageous, predictable, and reproducible method for augmenting buccofacial defects at implant placement, and may be considered as an alternative to conventional intraoral bone block donor sites when treating the maxilla.

  3. Proteínas morfogenéticas ósseas associadas a osso esponjoso autógeno na reparação de falhas experimentais na calota craniana de coelhos (Oryctolagus cuniculus Bone morphogenetic proteins associated with autogenous bone graft in the reparation of calvarial experimental defects of rabbits (Oryctolagus cuniculus

    Directory of Open Access Journals (Sweden)

    B.S. Monteiro

    2007-12-01

    ão determinou maior preenchimento ósseo.Aspects of bone repair were evaluated after implantation of bone morphogenetic proteins (BMP in different concentrations. They were carried by autogenous bone graft in defects created on skulls of 20 adult, young female rabbits, randomizedly divided into five experimental groups and were observed at five times. After exposure of skull bones, six bone defects on the fronto-parietal region of each animal were performed. The defect I was not filled, the II was completed filled with 3mg of autogenous bone graft and the defects III, IV, V, and VI were filled with autogenous bone graft associated with 0.5; 1; 2 and 5mg of BMP, respectively. In the post-mortem mesoscopic evaluations, it was observed that, independently of the treatment period of the defects, the bony filling began from the borders to the center, and from the botton to the surface of the lessions. The bony filling of the defect I was the smallest when compared with the others defects, in all the observation moments. It was also verified that until 2mg the higher the concentration of BMP used, better was the bone cover. Microscopically, it was verified in the first evaluations, on the seventh day, that the bony growth started from the borders and from the bottom of the lesion, with mobilization and differentiation of cells deriving from the periosteum and the meninges, respectively. In the subsequent evaluations, the osteoblastic activity also derived from "ossification islands" to ossification centers, located in the center of the flaw. The trabecular formation increased proportionally with the concentration of BMP used, and the apposition and bony organization increased proportionally with the time of observation. The presence of cartilaginous tissue was verified in all the flaws. In conclusion, the use the higher concentration of BMP did not determinate the better new bone formation. The association of BMP with autogenous bone graft contributed to the formation of new bony

  4. Treatment of Infected Tibial Nonunion with Bone Defect Using Central Bone Grafting Technique

    OpenAIRE

    Gulan, Gordan; Jotanović, Zdravko; Jurdana, Hari; Šestan, Branko; Rapan, Saša; Rubinić, Dušan; Ravlić-Gulan, Jagoda

    2012-01-01

    Treatment of infected tibial nonunion with bone defect represents a challenge for every orthopaedic surgeon. Various methods of treatment have been described for nonunions with infection, bone loss or both. One of them is the central bone grafting technique, which is a safe and effective treatment for nonunions of the tibia. The technique involves placement of autogenous cancellous bone from the iliac crest on the anterior surface of the interosseous membrane with the aim of creating...

  5. Nasal bone grafts from the removed hump used as overlay grafts to camouflage concave lateral crura.

    Science.gov (United States)

    Kubilay, Utku; Erdogdu, Suleyman; Sezen, Ozan Seymen

    2014-01-01

    Alar cartilage consists of a medial crus, middle crus and lateral crus. The lateral crus is an important aesthetic and functional structure of the nose. A 32-year-old male patient with concave lateral crura was operated by the authors. An open rhinoplasty with a dorsal approach to the septum is preferred. The nasal bones harvested from the hump, which is an autogenous graft trimmed and sutured on both concave lateral crura as an overlay camouflage grafts. Satisfactory result was achieved.

  6. Autogenous standard versus inside-out vein graft to repair facial nerve in rabbits

    Institute of Scientific and Technical Information of China (English)

    TANG Jie; WANG Xue-mei; HU Jing; LUO En; QI Meng-chun

    2008-01-01

    To evaluate autogenous vein grafts and inside-out vein grafts as conduits for the defects repair in the rabbit facial nerves.Methods:The 10 mm segments of buccal division of facial nerve were transected for 48 rabbits in this study.Then the gaps were immediately repaired by autogenous vein grafts or inside-out vein grafts in different groups. All the animals underwent the whisker movement test and electrophysiologic test during the following 16 weeks at different time points postoperatively. Subsequently,the histological examination was performed to observe the facial nerve regeneration morphologically.Results:At 8 weeks after operation,the facial nerve regeneration has significant difference between the experimental group and the control group in electrophysiologic test and histological observation. However,at the end of this study,16 weeks after operation,there was no significant difference between inside-out vein grafts and standard vein grafts in enhancing peripheral nerve regeneration.Conclusion:This study suggest that both kinds of vein grafts play positive roles in facial nerve regeneration after being repaired immediately,but the autogenous inside-out vein grafts might accelerate and facilitate axonal regeneration as compared with control.

  7. Transplantation of deproteined bovine cancellous bone combined with autogenous red marrow for repairing bony cavity defect due to benign bone tumor: Compared with autologous bone graft%脱蛋白牛松质骨结合自体红骨髓移植修复骨肿瘤性骨缺损:与自体骨移植材料为对照标准的效果比较

    Institute of Scientific and Technical Information of China (English)

    丁真奇; 周亮; 练克俭; 康两奇; 郭延杰; 翟文亮; 郭林新

    2006-01-01

    BACKGROUND: Autologous bone graft was always applied to repair bony cavity defect produced by benign bone tumor.OBJECTIVE: Taking autogenous bone graft for repairing bony cavity defect caused by bone tumor or tumor-like pathological change as control standard, to observe transplantation of deproteined bovine cancellous bone combined with autogenous red marrow in occluding the residual cavity and the density of newly formed bone.DESIGN: A randomized grouping design, controlled observation SETTING: Department of Orthopaedics, the 175 Hospital of Chinese PLA PARTICIPANTS:We recruited 175 cases of bony cavity defect who received treatment in the Department of Orthopaedics, the 175 Hospital of Chinese PLA from July 1993 to July 1998. They were randomly assigned into two groups: experimental group and control group. There were 63 cases treated in the experimental group. The average disease-suffering time was (6.2±2.1) months and bone defect was (136±30) mm3. There were 62 cases treated in the control group. The average disease-suffering time was (6.1±2.3)months, and bone defect was (133±37) mm3.METHODS: Deproteined bovine cancellous bone combined with autogenous red marrow was transplanted in the experimental group and autologous bone graft was applied in the control group. We curetted tumor completely, cauterized the wound with alcohol of 0.95 volume fraction, then curetted the area of cauterization to make it bled. Bone graft was applied.The quantity of implanted bone should be abundant, and disposed compactly. The X-ray films of the first week after operation were used as a standard for density of new bone growth. X-ray films were taken at the 3rd,6th and 8th months postoperatively, and the X-ray films of the eighth months after operation were used as a standard.MAIN OUTCOME MEASURES: To compare the bone union in two groups with a standard of residual cavity occluding and density of bone growth.RESULTS: All patients were followed up for an average of 20 months

  8. Evaluation of ABM/P-15 versus autogenous bone in an ovine lumbar interbody fusion model.

    Science.gov (United States)

    Sherman, Blake P; Lindley, Emily M; Turner, A Simon; Seim, Howard B; Benedict, James; Burger, Evalina L; Patel, Vikas V

    2010-12-01

    A prospective, randomized study was performed in an ovine model to compare the efficacy of an anorganic bovine-derived hydroxyapatite matrix combined with a synthetic 15 amino acid residue (ABM/P-15) in facilitating lumbar interbody fusion when compared with autogenous bone harvested from the iliac crest. P-15 is a biomimetic to the cell-binding site of Type-I collagen for bone-forming cells. When combined with ABM, it creates the necessary scaffold to initiate cell invasion, binding, and subsequent osteogenesis. In this study, six adult ewes underwent anterior-lateral interbody fusion at L3/L4 and L4/L5 using PEEK interbody rings filled with autogenous bone at one level and ABM/P-15 at the other level and no additional instrumentation. Clinical CT scans were obtained at 3 and 6 months; micro-CT scans and histomorphometry analyses were performed after euthanization at 6 months. Clinical CT scan analysis showed that all autograft and ABM/P-15 treated levels had radiographically fused outside of the rings at the 3-month study time point. Although the clinical CT scans of the autograft treatment group showed significantly better fusion within the PEEK rings than ABM/P-15 at 3 months, micro-CT scans, clinical CT scans, and histomorphometric analyses showed there were no statistical differences between the two treatment groups at 6 months. Thus, ABM/P-15 was as successful as autogenous bone graft in producing lumbar spinal fusion in an ovine model, and it should be further evaluated in clinical studies.

  9. Autogenous temporalis fascia patch graft for porous polyethylene (Medpor) sphere orbital implant exposure

    OpenAIRE

    Sagoo, M S; Olver, J M

    2004-01-01

    Background: Temporalis fascia has been recommended for hydroxyapatite sphere exposure. The aim of this study was to identify potential risk factors for exposure of porous polyethylene (Medpor) sphere implants and evaluate the use of autogenous temporalis fascia as a patch graft for exposure.

  10. Gore-Tex small-vessel angioplasty: A suitable substitute for the use of autogenous saphenous vein grafts

    OpenAIRE

    Garcia-Rinaldi, Raul; Rea, John E.; Gallagher, Michael W.; Laevsky, Marlene J.; Ogburn, Michael; Porter, Robert H.

    1980-01-01

    Autogenous saphenous vein has been the material of choice for small-vessel angioplasty and for circulatory access graft reconstruction. In an effort to conserve autogenous saphenous vein, we used expanded polytetrafluoroethylene (PTFE) grafts in 45 patients over a 12-month period. We used Gore-Tex* to reconstruct 17 circulatory access grafts, 16 carotid arteries, two brachial arteries, seven femoral arteries, and three popliteal anterior or posterior tibial arteries. The indications for recon...

  11. The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: A systematic review

    OpenAIRE

    Aloy Prósper, Amparo; Peñarrocha Oltra, David; Peñarrocha Diago, María; Peñarrocha Diago, Miguel

    2015-01-01

    Aim: The purpose of this study was to systematically review clinical studies examining the survival and success rates of implants placed with intraoral onlay autogenous bone grafts to answer the following question: do ridge augmentations procedures with intraoral onlay block bone grafts in conjunction with or prior to implant placement influence implant outcome when compared with a control group (guided bone regeneration, alveolar distraction, native bone or short dental implants.)? Material ...

  12. Viability of autogenous bone grafts obtained by using bone collectors: histological and microbiological study Viabilidade dos enxertos autógenos obtidos com a utilização de coletores para osso: estudo histológico e microbiológico

    Directory of Open Access Journals (Sweden)

    Alberto Blay

    2003-09-01

    Full Text Available The use of autogenous bone grafts is considered to be the best choice for reconstructive surgery. In the periodontal literature, the utilization of osseous coagulum was suggested by the end of the sixties. The purpose of this study is to consider the use of bone collectors (bone traps as an alternative method for obtaining material to fill small bone imperfections, such as fenestrations and dehiscences. Thirty samples were obtained from bone drilling during fixture installation in patients (13 men and 17 women, with an average age of 54 years requiring treatment at the Department of Periodontology and Implant Dentistry, University of Santo Amaro. These samples were fixed in 10% neutral formaldehyde for 24 hours and subjected to histological preparation, in order to evaluate the presence of viable osteoblasts. In addition, the material was placed in a fluid thioglycolate medium and incubated for 24 hours at 36 ± 1°C in aerobiosis and anaerobiosis. Bacterial growth evaluation was made by using six different culture media (MacConkey agar, blood agar base, mannitol salt agar, Anaerokit LTD medium, Anaerokit LTD - bile medium, Anaerinsol. The results show that, if proper care is taken to prevent saliva contamination during the surgical procedure, this method of collecting autogenous bone may be useful in situations where small amounts of bone are required.A utilização de enxertos autógenos é considerada a melhor opção nos tratamentos cirúrgicos de reconstrução óssea. Na literatura periodontal, a utilização de coágulo ósseo foi sugerida no final da década de 60. O objetivo deste estudo é considerar a utilização de coletores para osso como um método alternativo de se obter osso autógeno para preenchimento de defeitos ósseos como fenestrações e deiscências. Trinta amostras foram obtidas no processo de perfuração do tecido ósseo, durante a instalação de implantes em pacientes (13 homens e 17 mulheres, com média etária de

  13. Bone Grafting the Cleft Maxilla

    Science.gov (United States)

    ... systemic disease such as diabetes, or has poor oral hygiene, the risk that the graft may fail increases even more. Once the bone graft has been placed, there are three options that ... replacement (dental bridge); or 3) dental metallic bone implants. The ...

  14. Anatomic study of the lacrimal fossa and lacrimal pathway for bypass surgery with autogenous tissue grafting

    OpenAIRE

    Hai Tao; Zhi-zhong Ma; Hai-Yang Wu; Peng Wang; Cui Han

    2014-01-01

    Purpose: To study the microsurgical anatomy of the lacrimal drainage system and to provide anatomical evidence for transnasal endoscopic lacrimal drainage system bypass surgery by autogenous tissue grafting. Materials and Methods: A total of 20 Chinese adult cadaveric heads in 10% formaldehyde, comprising 40 lacrimal ducts were used. The middle third section of the specimens were examined for the following features: the thickness of the lacrimal fossa at the anterior lacrimal crest, vertical ...

  15. Histological Observation of Autogenous Bone Dust Grafting and Membrane Guided Regeneration Technology to Repair Skull Defects%自体颅骨粉末移植和膜引导再生技术修复兔颅骨缺损的组织学研究

    Institute of Scientific and Technical Information of China (English)

    陈敏建; 陆婷; 陈平

    2013-01-01

    Objective To repair the skull defects by using autogenous skull bone dust grafting and membrane guided regeneration technology, and to investigate its histological evolution. Methods Fifty New Zealand white rabbits were selected. A whole thick defect with the diameter of 1 cm was created in the parietal bone of every rabbit. The defect was grafted with autogenous skull bone dust and two pieces of absorbable membrane on two side. After 2, 4, 6, 8, 12 weeks, the defects were harvested for histological observation. Results Two weeks after operation, a large number of bone meal was observed in the defect area. Inward infiltration of inflammatory cells, capillaries and fibroblasts were observed. Bone meal was swallowed in the central area, new bone was formed in the surrounding area and a clear boundary was observed between the two area. Four weeks after operation, the boundary had moved a lot to the central area. New woven bone was thickened, the connection between the woven bone became more closely. Tissue and cell components had no obvious change compared with 2 weeks after operation. Six weeks after operation, bone meal was almost absorbed, the woven bone became thicker and the connection was more closely. Eight weeks after operation, no bone dust could be observed, a monolayer new bone was formed in the central area. The woven bone in the surrounding area was relatively thick and closely connected with normal bone. The primary bone marrow cavity was formed. Twelve weeks after operation, double new bone was observed in the central area. New bone remodeling and mature bone marrow cavity were also observed. The morphology and composition of bone marrow cavity had no difference compared with normal bone. Conclusion Histological evolution of autogenous bone dust grafting and membrane guided regeneration technology to repair skull defects is guided and induced bone regeneration.%目的:应用自体颅骨粉末移植和膜引导再生技术修复兔颅骨缺损模型

  16. Análise por tomografia computadorizada do enxerto autógeno na cirurgia de "sinus lift" Computed tomography evaluation of autogenous graft in sinus lift surgery

    Directory of Open Access Journals (Sweden)

    Sérgio Aron Ajzen

    2005-02-01

    Full Text Available OBJETIVO: Quantificar a formação óssea nos enxertos com e sem plasma rico em plaquetas, obtido pelos métodos de centrifugação e aférese, comparando os três tipos de enxertos realizados por meio de análise tomográfica. MATERIAIS E MÉTODOS: Este estudo prospectivo, duplo cego, utilizou uma amostra composta de 34 pacientes adultos, de ambos os sexos, com idade média de 48 anos e 8 meses, portadores de pneumatização unilateral ou bilateral dos seios maxilares, que necessitavam de enxertos ósseos, com a finalidade de melhorar as condições locais para a colocação dos implantes dentários. Todos os pacientes realizaram tomografia computadorizada antes da cirurgia. Foram operados 53 seios maxilares, divididos em três grupos: enxerto de plasma rico em plaquetas obtido pelos métodos de aférese, centrifugação e enxerto apenas de osso autógeno. Após seis meses do procedimento cirúrgico foram realizados novos exames de imagem. RESULTADOS: Pela avaliação tomográfica, houve crescimento em altura e em largura nos três grupos quando foram comparados os momentos inicial e final, entretanto, não houve diferença estatística para a altura e para a largura. CONCLUSÃO: Evidências clínicas demonstram a eficácia dos enxertos autógenos, principalmente os associados a fatores indutores de crescimento ósseo, como o plasma rico em plaquetas, recuperando o arcabouço maxilofacial, necessário para a reconstrução protética e funcional por meio de implantes dentários.OBJECTIVE: To quantify bone formation within autogenous bone grafts and autogenous bone grafts in combination with platelet-rich plasma obtained either from aphaeresis or centrifugation using computed tomography. MATERIALS AND METHODS: This prospective, double-blind study was conducted in 34 male and female adult patients (mean age of 28 years and 8 months, with either unilateral or bilateral pneumatization of the maxillary sinuses, requiring bone graft for dental

  17. Plasma rico em plaquetas associado ou não ao osso esponjoso autógeno no reparo de falhas ósseas experimentais Platelet rich plasma associated or not to autogenous bone graft on the reparation of experimental bone defects in the rabbits cranium

    Directory of Open Access Journals (Sweden)

    Paloma Sayegh Arreguy Silva

    2009-02-01

    do tipo corpo estranho, que atuou negativamente na fase inicial de reparação.The present study evaluated autogenous platelet rich plasma's (PRP influence on the reparation process of four bone defects made on rabbit's skull, associated or not to autogenous bone graft (EOE. Defect I received PRP only; defect II received 3mg of EOE only; defect III received EOE associated to PRP; defect IV was left to heal naturally, serving as control. After each surgery the animals were randomly divided into three groups that were euthanized at 30, 60 and 90 days. In the mesoscopic evaluation bone ingrowth started from the defect's borders to the center and from the bottom to the surface for all observation times on the control (VI and PRP only (I groups. In the groups treated with EOE only (II and EOE associated to PRP (III new bone was observed in the center of the defects. Radiographic analysis showed greater central radiopacity for groups treated with EOE only (II and EOE associated to PRP (III at all observation times. Microscopically in the group treated with EOE associated to PRP (III at 30 days the graft was indistinguishable from new bone present on the border of the defect, associated to a moderate quantity of a very vascularized and cellular fibrous connective tissue. This tissue showed an extracelular eosinophilic amorphous foamy material, associated to an inflammatory process constituted by lymphocytes and in less number by macrophages and multinucleated giant cells that may have negatively influenced early bone formation. At 60 and 90 days occasional spots of lymphocytic inflammation were observed. Both treatments, PRP associated or not to EOE, were similar for the bone ingrowth at the final time of observation; the graft used alone determined early bone reparation and thromboplastine used for the platelet gel formation incited a foreign body-like reaction that acted negatively on the initial reparation.

  18. Nonallograft osteoconductive bone graft substitutes.

    Science.gov (United States)

    Bucholz, Robert W

    2002-02-01

    An estimated 500,000 to 600,000 bone grafting procedures are done annually in the United States. Approximately (1/2) of these surgeries involve spinal arthrodesis whereas 35% to 40% are used for general orthopaedic applications. Synthetic bone graft substitutes currently represent only 10% of the bone graft market, but their share is increasing as experience and confidence in their use are accrued. Despite 15 to 20 years of clinical experience with various synthetic substitutes, there have been few welldesigned, controlled clinical trials of these implants. Synthetic bone graft substitutes consist of hydroxyapatite, tricalcium phosphate, calcium sulfate, or a combination of these minerals. Their fabrication technique, crystallinity, pore dimensions, mechanical properties, and resorption rate vary. All synthetic porous substitutes share numerous advantages over autografts and allografts including their unlimited supply, easy sterilization, and storage. However, the degree to which the substitute provides an osteoconductive structural framework or matrix for new bone ingrowth differs among implants. Disadvantages of ceramic implants include brittle handling properties, variable rates of resorption, poor performance in diaphyseal defects, and potentially adverse effects on normal bone remodeling. These inherent weaknesses have refocused their primary use to bone graft extenders and carriers for pharmaceuticals. The composition, histologic features, indications, and clinical experience of several of the synthetic bone graft substitutes approved for orthopaedic use in the United States are reviewed. PMID:11937865

  19. A new harvest site for bone graft in anterior cruciate ligament revision surgery.

    Science.gov (United States)

    Franceschi, Francesco; Papalia, Rocco; Di Martino, Alberto; Rizzello, Giacomo; Allaire, Robert; Denaro, Vincenzo

    2007-05-01

    During revision anterior cruciate ligament (ACL) surgery, femoral interference screws frequently require removal. This may lead to significant tunnel widening and possible graft fixation failure as a result. Solutions include drilling the revision tunnel in a different location, using stacked interference screws, or using bone graft to fill the defect. Autogenous iliac crest graft and allograft are both used, but there are significant comorbidities associated with each. We developed a new technique for harvesting autogenous bone graft that avoids many of the complications associated with other graft sources. By use of the existing surgical incision from the initial harvest of the bone-patellar tendon-bone autograft, bone from the medial tibial metaphyseal safe zone is harvested via an OATS tube harvester (Arthrex, Naples, FL). A bone plug 1 mm larger in size than the femoral defect is harvested and arthroscopically inserted via a press-fit technique. At 3 months after bone grafting, patients undergo revision ACL reconstruction. The proximal tibial metaphysis is a safe bone graft harvest site in revision ACL surgery and offers an effective method for filling large bony defects, allowing anatomic reconstruction of the ACL after bone healing has occurred. Furthermore, it eliminates the problems associated with allograft or use of a remote graft donor site. PMID:17478290

  20. Effects of liquid nitrogen cryotherapy and bone grafting on artificial bone defects in minipigs: a preliminary study.

    Science.gov (United States)

    Pogrel, M A; Regezi, J A; Fong, B; Hakim-Faal, Z; Rohrer, M; Tran, C; Schiff, T

    2002-06-01

    Liquid nitrogen cryotherapy has been advocated as an adjunct in the enucleation and curettage of locally aggressive lesions of the jaws. Simultaneous autogenous bone grafting has also been advocated to accelerate bone formation and reduce morbidity. There is, however, relatively little scientific basis for either of these hypotheses. In this study, nine Yucatan minipigs had artificial defects created in the mandible, which were treated with liquid nitrogen spray. Half of the defects were grafted with autogenous bone from the chin and half were closed primarily. Two animals were sacrificed 3 days postoperatively to measure the width of necrosis and the rest were sacrificed at 3 months to assess healing and new bone formation. It was found that drilling the artificial defects alone caused bone necrosis for a mean depth of 0.09 mm. Liquid nitrogen cryospray caused a mean depth of bone necrosis of 0.82 mm (range 0.51-1.52 mm). The defects that were bone grafted healed well clinically. Defects not bone grafted showed a 50% rate of wound breakdown and sequestrum formation with delayed healing. Vital staining showed a non-significantly greater rate of bone formation in the grafted defects. Digitally superimposed radiography showed a non-significantly greater bone density in the non-grafted defects at 3 months postoperatively. It appears that liquid nitrogen cryospray does devitalize an area of bone around defects in the mandible. The width of necrosis is usually less than 1 mm and subsequent healing is enhanced by autogenous bone grafting. This has clinical implications. PMID:12190137

  1. Autogenous tibial strut grafts used in severe kyphoscoliosis:surgical policies and preliminary results

    Institute of Scientific and Technical Information of China (English)

    CHEN Hui; QIU Yong; WANG Bin; YU Yang; ZHU Ze-zhang ZHU Li-hua

    2005-01-01

    Background Surgery for severe kyphoscoliosis is frequently unsatisfying because of loss of correction, high rate of pseudarthrosis and neurological complications.Several authors reported that the anterior fusion with strut grafts might improve the surgical outcome.This article describes and assesses the surgical strategies and the application of autogenous tibial strut in the treatment of severe kyphoscoliosis.Results The mean preoperative and postoperative kyphosis was 82°and 52°respectively, and the mean scoliosis was 84°and 44°respectively.Complications included pseudarthrosis (2 cases, one with graft fracture and the other with hook displacement), posterior elements fractures (4), pleura penetrations (3, in the plastic surgery of the thoracic cage), dura tear (2), exudative pleuritis (2, in the anterior surgery), and tibia fracture of the harvesting site (1).The mean loss of correction in coronal and sagittal plane was 6° and 7° respectively.Except for 1 case, the patients with incomplete paraplegia showed improvements to varying extents.Conclusion Autogenous tibial strut can provide excellent support to the kyphoscoliotic spine: it reduces pseudarthrodic rate, loss of correction and complications of graft harvest, it also prevents the occurrence of neurological impairment.

  2. Repair of the inferior vena cava with autogenous peritoneo-fascial patch graft following abdominal trauma: a case report.

    Science.gov (United States)

    Emmiler, Mustafa; Kocogullari, Cevdet Ugur; Yilmaz, Sezgin; Cekirdekci, Ahmet

    2008-01-01

    Abdominal vascular injuries are among the most challenging and lethal injuries in traumatized patients. Inferior vena cava is the most frequently injured vein during the blunt or penetrating trauma. The primary repair, end to end anastomosis, endovascular stenting, or graft interposition with autogenous or synthetic materials should be considered in selected cases. However, in cases the synthetic graft was preferred, intestinal contaminations due to small or large bowel perforation accompanying the trauma have been cited as a limiting factor for the use of such grafts as in the current case. However, a previous history of lower leg variceal surgery prevents the use of great saphenous vein as a graft. So in the present case, the authors report a patient with inferior vena cava injury repaired with autogenous peritoneo-fascial graft. The authors have used APF graft in traumatic inferior vena cava injury for the first time. PMID:18667465

  3. Stepwise surgical approach to diabetic partial foot amputations with autogenous split thickness skin grafting

    Directory of Open Access Journals (Sweden)

    Crystal L. Ramanujam

    2016-06-01

    Full Text Available In the surgical treatment of severe diabetic foot infections, substantial soft tissue loss often accompanies partial foot amputations. These sizeable soft tissue defects require extensive care with the goal of expedited closure to inhibit further infection and to provide resilient surfaces capable of withstanding long-term ambulation. Definitive wound closure management in the diabetic population is dependent on multiple factors and can have a major impact on the risk of future diabetic foot complications. In this article, the authors provide an overview of autogenous skin grafting, including anatomical considerations, clinical conditions, surgical approach, and adjunctive treatments, for diabetic partial foot amputations.

  4. Stepwise surgical approach to diabetic partial foot amputations with autogenous split thickness skin grafting.

    Science.gov (United States)

    Ramanujam, Crystal L; Zgonis, Thomas

    2016-01-01

    In the surgical treatment of severe diabetic foot infections, substantial soft tissue loss often accompanies partial foot amputations. These sizeable soft tissue defects require extensive care with the goal of expedited closure to inhibit further infection and to provide resilient surfaces capable of withstanding long-term ambulation. Definitive wound closure management in the diabetic population is dependent on multiple factors and can have a major impact on the risk of future diabetic foot complications. In this article, the authors provide an overview of autogenous skin grafting, including anatomical considerations, clinical conditions, surgical approach, and adjunctive treatments, for diabetic partial foot amputations. PMID:27283728

  5. Cephalic Arch Stenosis in Autogenous Haemodialysis Fistulas: Treatment With the Viabahn Stent-Graft

    Energy Technology Data Exchange (ETDEWEB)

    Shawyer, Andrew, E-mail: andrew.shawyer@bartsandthelondon.nhs.uk [The Royal London Hospital, Radiology Department (United Kingdom); Fotiadis, Nicos I., E-mail: fotiadis.nicholas@gmail.com [Royal Marsden Hospital, Radiology Department, The Royal Marsden NHS Foundation Trust (United Kingdom); Namagondlu, Girish, E-mail: girish.namagondlu@bartsandthelondon.nhs.uk [The Royal London Hospital, Renal Medicine Department (United Kingdom); Iyer, Arun, E-mail: arun.iyer@bartsandthelondon.nhs.uk [The Royal London Hospital, Radiology Department (United Kingdom); Blunden, Mark, E-mail: mark.blunden@bartsandthelondon.nhs.uk; Raftery, Martin, E-mail: martin.raftery@bartsandthelondon.nhs.uk; Yaqoob, Magdi, E-mail: magdi.yaqoob@bartsandthelondon.nhs.uk [The Royal London Hospital, Renal Medicine Department (United Kingdom)

    2013-02-15

    Cephalic arch stenosis (CAS) is an important and common cause of dysfunction in autogenous haemodialysis fistulas that requires multiple reinterventions and aggressive surveillance. We evaluated the safety and efficacy of the Viabahn stent-graft for the management of CAS. Between April 2005 and October 2011, 11 consecutive patients [four men and seven women (mean age 56.7 years)] with CAS and dysfunctional fistulas were treated with insertion of 11 Viabahn stent-grafts. Six stent-grafts were inserted due to residual stenosis after angioplasty and five for fistuloplasty-induced rupture. No patient was lost to follow-up. The technical and clinical success rate was 100 %. Primary access patency rates were 81.8 % [95 % confidence interval (CI) 0.482-0.977] at 6 months and 72.7 % (95 % CI 0.390-0.939) at 12 months. Secondary access patency rates were 90.9 % at 6 months (95 % CI 0.587-0.997). There were no procedure-related complications. Mean follow-up was 543.8 days (range 156-2,282). The use of the Viabahn stent-graft in the management of CAS is technically feasible and, in this small series, showed patency rates that compare favorably with historical data of angioplasty and bare stents.

  6. Histological evaluation of healing after transalveolar maxillary sinus augmentation with bioglass and autogenous bone

    DEFF Research Database (Denmark)

    Stavropoulos, Andreas; Sima, Catalin; Sima, Andrea;

    2012-01-01

    OBJECTIVES: The aim was to evaluate histologically the outcome of a bioglass and autogenous bone (at 1 : 1 ratio) composite implantation for transalveolar sinus augmentation. METHODS: In 31 patients, during implant installation ca. 4 months after sinus augmentation, biopsies were harvested throug...

  7. Maxillary sinus floor elevation surgery with BioOss (R) mixed with a bone marrow concentrate or autogenous bone : test of principle on implant survival and clinical performance

    NARCIS (Netherlands)

    Rickert, D.; Vissink, A.; Slot, Jan; Sauerbier, S.; Meijer, H. J. A.; Raghoebar, G. M.

    2014-01-01

    The purpose of this study was to assess implant survival and 1-year clinical performance of implants placed in the posterior maxilla that had been subjected to maxillary sinus floor elevation surgery with bovine bone mineral (BioOss (R)) mixed with autogenous bone marrow concentrate or autogenous bo

  8. Nostril Base Augmentation Effect of Alveolar Bone Graft

    Directory of Open Access Journals (Sweden)

    Woojin Lee

    2013-09-01

    Full Text Available Background The aims of alveolar bone grafting are closure of the fistula, stabilization ofthe maxillary arch, support for the roots of the teeth adjacent to the cleft on each side.We observed nostril base augmentation in patients with alveolar clefts after alveolar bonegrafting. The purpose of this study was to evaluate the nostril base augmentation effect ofsecondary alveolar bone grafting in patients with unilateral alveolar cleft.Methods Records of 15 children with alveolar clefts who underwent secondary alveolar bonegrafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 werereviewed. Preoperative and postoperative worm’s-eye view photographs and reconstructedthree-dimensional computed tomography (CT scans were used for photogrammetry. Thedepression of the nostril base and thickness of the philtrum on the cleft side were measuredin comparison to the normal side. The depression of the cleft side pyriform aperture wasmeasured in comparison to the normal side on reconstructed three-dimensional CT.Results Significant changes were seen in the nostril base (P=0.005, the philtrum length(P=0.013, and the angle (P=0.006. The CT measurements showed significant changes in thepyriform aperture (P<0.001 and the angle (P<0.001.Conclusions An alveolar bone graft not only fills the gap in the alveolar process but alsoaugments the nostril base after surgery. In this study, only an alveolar bone graft was performedto prevent bias from other procedures. Nostril base augmentation can be achieved byperforming alveolar bone grafts in children, in whom invasive methods are not advised.

  9. Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study.

    LENUS (Irish Health Repository)

    Ong, J C Y

    2012-06-01

    The goal of this study was to determine differences in fracture stability and functional outcome between synthetic bone graft and natural bone graft with internal fixation of tibia plateau metaphyseal defects.

  10. REDUCTION OF MOBILITY OF PERIODONTALY AFFECTED TEETH AFTER GINGIVAL AUGMENTATION WITH AN AUTOGENOUS GINGIVAL GRAFT (Case Report.

    Directory of Open Access Journals (Sweden)

    Kamen Kotsilkov

    2015-02-01

    Full Text Available INTRODUCTION: The most severe complication of advanced periodontal lesions is the loss of teeth due to terminal attachment loss and high grade mobility. The goals of the treatment are the improving the plaque control stabilizing of the mobile teeth and arresting of the progression of gingival recession achieving gingival augmentation with adequate vestibulum depth. The autogenous graft is considered to be the most efficient approach where a significant increase of the attached gingiva is needed. OBJECTIVE: This presentation demonstrates the capacity of the autogenous gingival graft approach to reduce the high grade tooth mobility and to augment keratinized gingiva. METHODS: V.T. (46 with moderate generalized periodontitis. The examination reveals thin periodontal biotype, Class IV recessions on 31,41 with III grade mobility and terminal attachment loss, narrow vestibulum and lack of attached gingiva. An autogenous graft technique was selected to achieve simultaneous gingival augmentation and correction of vestibulum depth. RESULTS: A significant and stable increase of the attached gingiva is observed which led to better access for oral hygiene thus creating better conditions for successful long-term outcome. The root coverage was more that 40% and the tooth mobility was decreased to grade I. CONCLUSION: In the limitations of the presented case the free autogenous graft technique seems an appropriate approach in cases with deep Class IV recessions and high grade toot mobility in mandibular frontal area creating proper conditions for effective oral hygiene and decreasing tooth mobility by creating a sufficient amount of attached gingiva needed for the long term maintenance.

  11. Ortho- and heterotopic bone grafts in bifocal transport osteogenesis for craniofacial reconstruction--an experimental study in sheep.

    Science.gov (United States)

    Kramer, F-J; Mueller, M; Rahmstorf, M; Swennen, G R J; Dempf, R; Schierle, H

    2004-09-01

    Bifocal transport osteogenesis (BTO) is a promising technique for the reconstruction of extended osseous craniofacial defects. Aim of this study was to determine the potential of this technique related to various donor sites of the transport segment. In 10 adult sheep critical size defects of the calvaria were treated by gradual movement of a transport segment consisting either of autogenous regional free calvarial bone grafts (n=5) or autogenous illiac free bone grafts (n=5). Latency period was 5 days; the rate of distraction was 1mm per day and extended approximately 40 days. The consolidation period was 28 days. After harvesting, specimens were investigated by conventional radiography, CT-scans, histologically and by fluorescence. In both groups transport osteogenesis resulted in a complete closure of the critical size defect. Membranous bone formation and remodeling occurred during the entire period of distraction and consolidation. The volumes and thickness of newly formed bone at the defect site were increased significantly when calvarial bone grafts were used (P<0.05). Iliac bone grafts became progrediently smaller during distraction, while the volume of calvarial grafts remained relatively constant (P<0.05). In conclusion, transport segments consisting of calvarial and iliac bone resulted in a reliable closure of craniofacial critical size defects in adult organisms; the application of calvarial bone grafts resulted in an increased extend of bone formation.

  12. Within Patient Radiological Comparative Analysis of the Performance of Two Bone Graft Extenders Utilized in Posterolateral Lumbar Fusion: A Retrospective Case Series

    OpenAIRE

    Stewart, Geoffrey; Gage, Gary B.; Neidert, Gary; Adkisson, Huston Davis

    2016-01-01

    Two bone graft extenders differing in chemical composition were implanted contralaterally in 27 consecutive patients undergoing instrumented posterolateral lumbar fusion as standard-of-care. Bone marrow aspirate and autogenous bone graft were equally combined either with β-tricalcium phosphate (β-TCP) or a hybrid biomaterial [containing hyaluronic acid (HyA) but lacking a calcium salt] and implanted between the transverse processes. Fusion status on each side of the vertebrae was retrospectiv...

  13. Modified Weaver-Dunn Procedure Versus The Use of Semitendinosus Autogenous Tendon Graft for Acromioclavicular Joint Reconstruction

    Science.gov (United States)

    Hegazy, Galal; Safwat, Hesham; Seddik, Mahmoud; Al-shal, Ehab A.; Al-Sebai, Ibrahim; Negm, Mohame

    2016-01-01

    Background: The optimal operative method for acromioclavicular joint reconstruction remains controversial. The modified Weaver-Dunn method is one of the most popular methods. Anatomic reconstruction of coracoclavicular ligaments with autogenous tendon grafts, widely used in treating chronic acromioclavicular joint instability, reportedly diminishes pain, eliminates sequelae, and improves function as well as strength. Objective: To compare clinical and radiologic outcomes between a modified Weaver-Dunn procedure and an anatomic coracoclavicular ligaments reconstruction technique using autogenous semitendinosus tendon graft. Methods: Twenty patients (mean age, 39 years) with painful, chronic Rockwood type III acromioclavicular joint dislocations were subjected to surgical reconstruction. In ten patients, a modified Weaver-Dunn procedure was performed, in the other ten patients; autogenous semitendinosus tendon graft was used. The mean time between injury and the index procedure was 18 month (range from 9 – 28). Clinical evaluation was performed using the Oxford Shoulder Score and Nottingham Clavicle Score after a mean follow-up time of 27.8 months. Preoperative and postoperative radiographs were compared. Results: In the Weaver-Dunn group the Oxford Shoulder Score improved from 25±4 to 40±2 points. While the Nottingham Clavicle Score increased from 48±7 to 84±11. In semitendinosus tendon graft group, the Oxford Shoulder Score improved from 25±3 points to 50±2 points and the Nottingham Clavicle Score from 48±8 points to 95±8, respectively. Conclusion: Acromioclavicular joint reconstruction using the semitendinosus tendon graft achieved better Oxford Shoulder Score and Nottingham Clavicle Score compared to the modified Weaver-Dunn procedure. PMID:27347245

  14. Chondroblastoma in a metatarsal treated with autogenous fibular graft: a case report.

    Science.gov (United States)

    Dhatt, Sarvdeep S; Bhagwat, Kishan R; Kumar, Vishal; Dhillon, Mandeep Singh

    2012-01-01

    Chondroblastoma is a relatively rare tumor that mimics giant cell tumor and displays a predilection for long bones. In the present report, we describe the case of a benign chondroblastoma localized to the second metatarsal in a 20-year-old male who presented with a 2-year history of painless left foot swelling. Treatment of the tumor involved excision of the second metatarsal with use of an autologous structural fibular bone graft to stabilize the metatarsus and second toe. After 27 months of follow-up, the patient was ambulating well in regular shoes, with no clinical or radiographic evidence of tumor recurrence.

  15. Chondroblastoma in a metatarsal treated with autogenous fibular graft: a case report.

    Science.gov (United States)

    Dhatt, Sarvdeep S; Bhagwat, Kishan R; Kumar, Vishal; Dhillon, Mandeep Singh

    2012-01-01

    Chondroblastoma is a relatively rare tumor that mimics giant cell tumor and displays a predilection for long bones. In the present report, we describe the case of a benign chondroblastoma localized to the second metatarsal in a 20-year-old male who presented with a 2-year history of painless left foot swelling. Treatment of the tumor involved excision of the second metatarsal with use of an autologous structural fibular bone graft to stabilize the metatarsus and second toe. After 27 months of follow-up, the patient was ambulating well in regular shoes, with no clinical or radiographic evidence of tumor recurrence. PMID:22297106

  16. Evaluation of ABM/P-15 versus autogenous bone in an ovine lumbar interbody fusion model

    OpenAIRE

    Sherman, Blake P.; Lindley, Emily M.; Turner, A. Simon; Seim III, Howard B.; Benedict, James; Burger, Evalina L; Patel, Vikas V.

    2010-01-01

    A prospective, randomized study was performed in an ovine model to compare the efficacy of an anorganic bovine-derived hydroxyapatite matrix combined with a synthetic 15 amino acid residue (ABM/P-15) in facilitating lumbar interbody fusion when compared with autogenous bone harvested from the iliac crest. P-15 is a biomimetic to the cell-binding site of Type-I collagen for bone-forming cells. When combined with ABM, it creates the necessary scaffold to initiate cell invasion, binding, and sub...

  17. Impact of bone graft harvesting techniques on bone formation and graft resorption

    DEFF Research Database (Denmark)

    Saulacic, Nikola; Bosshardt, Dieter D; Jensen, Simon S;

    2015-01-01

    formation and graft resorption in vivo. MATERIAL AND METHODS: Four harvesting techniques were used: (i) corticocancellous blocks particulated by a bone mill; (ii) bone scraper; (iii) piezosurgery; and (iv) bone slurry collected from a filter device upon drilling. The grafts were placed into bone defects...

  18. Significance of changes in transforming growth factor-β mRNA levels in autogenous vein grafts

    Institute of Scientific and Technical Information of China (English)

    尤文俊; 萧明第; 袁忠祥

    2004-01-01

    Background This study was designed to investigate changes in mRNA levels of transforming growth factor-β(TGF-β), collagen Ⅰ, and collagen Ⅲ in autogenous vein grafts. Methods Twenty-four New Zealand rabbits were randomly divided into 4 groups with 6 rabbits each. The external jugular veins of the New Zealand rabbits were harvested and grafted into the ipsilateral carotid artery. All rabbits were fed with a standard diet. After the operation, the rabbits were sacrificed at 1, 2, 3, or 4 weeks. TGF-β, collagen Ⅰ, and collagen Ⅲ mRNA levels in the venous grafts were measured by semiquantitative methods at every time point. The contralateral external jugular veins were also harvested and analyzed as controls. Glyceraldehyde-3-phosphate dehydrogenase was used as an internal standard to normalize all samples for potential variations in mRNA content. In order to observe the expression of TGF-β protein, immunohistochemical SABC methods were used. Results One week postoperation, the mRNA level of TGF-β was upregulated to 1.73±0.19 in the vein graft and 1.21±0.16 in the control vein (P<0.01). High mRNA levels were maintained until week 4 postoperation. The mRNA levels of collagen Ⅰ and collagen Ⅲ were also significantly increased to 2.18±0.21 versus 1.12±0.24 and 1.08±0.13 versus 0.83±0.12, respectively (P<0.05). Immunohistochemical staining revealed a higher density of TGF-β expression in the vein grafts.Conclusions An uninterrupted increase in mRNA levels of TGF-β, collagen Ⅰ, and collagen Ⅲ is observed in autogenous vein grafts. This increase may be the major cause of intimal hyperplasia, sclerosis, and even graft failure.

  19. Vascularized tail bone grafts in rats.

    Science.gov (United States)

    Sempuku, T; Tamai, S; Mizumoto, S; Yajima, H

    1993-03-01

    A new experimental model for vascularized corticocancellous bone grafts was established by investigation of vascular anatomy of the tail in 15 adult Fischer 344 rats and determination of the viability of vascularized tail bone grafts into the abdominal wall in 22 7-week-old rats. The tail bones of 40 rats were then raised on the pedicle of the caudal artery and its venae comitantes, transferred to a resected portion in the femur, and observed for 16 weeks. The vascularized graft showed marked reactive periosteal bone formation during the first and second weeks following transfer, and thereafter, the graft continued to show active bone formation. In transverse section, the sharp processes became rounded. In the cancellous bone, both bone resorption and bone formation were noticeably activated early after transfer, although resorption predominated and the amount of the cancellous bone consequently diminished. The nonvascularized grafts showed "creeping substitution." The results suggest that morphologic adaptation occurs if living (i.e., vascularized) tail bones are transferred to long-bone femurs.

  20. Efficacy of guided bone regeneration using composite bone graft and resorbable collagen membrane in Seibert's Class I ridge defects: radiological evaluation.

    Science.gov (United States)

    Saravanan, Pushparajan; Ramakrishnan, T; Ambalavanan, N; Emmadi, Pamela; John, Thomas Libby

    2013-08-01

    The purpose of the study was to evaluate radiologically the efficacy of guided bone regeneration using composite bone graft (autogenous bone graft and anorganic bovine bone graft [Bio-Oss]) along with resorbable collagen membrane (BioMend Extend) in the augmentation of Seibert's class I ridge defects in maxilla. Bone width was evaluated using computerized tomography at day 0 and at day 180 at 2 mm, 4 mm, and 6 mm from the crest. There was a statistically significant increase in bone width between day 0 and day 180 at 2 mm, 4 mm, and 6 mm from the crest. The results of the study demonstrated an increase in bone width of Seibert's class I ridge defects in the maxilla of the study patients. PMID:23964779

  1. Effects of Hydroxyapatite on Bone Graft Resorption in an Experimental Model of Maxillary Alveolar Arch Defects

    Directory of Open Access Journals (Sweden)

    Ozgur Pilanci

    2013-06-01

    Full Text Available Most commonly used treatments use autologous bone grafts to address bony defects in patients with cleft palate. Major disadvantages of autogenous bone grafts include donor site morbidity and resorption. Suggestions to overcome such problems include biomaterials that can be used alone or in combination with bone. We examined the effect of hydroxyapatite cement on bone graft resorption in a rabbit maxillary alveolar defect model. We divided 16 young adult albino New Zealand rabbits into two groups. A defect 1 cm wide was created in each rabbit's maxillary arch. In Group 1, the removed bone was disrupted, and the pieces were replaced in the defect. In the other group, the pieces were replaced after mixing (1:1 with hydroxyapatite cement. Quantitative computed tomographic evaluation of these grafts was performed in axial and coronal planes for each rabbit at 2 and 12 weeks. In axial images at 12 weeks, the group without cement showed mean bone resorption of 15%. In the cement group, a mean volumetric increase of 68% was seen. No resorption occurred when bone grafts were mixed with hydroxyapatite cement. [Arch Clin Exp Surg 2013; 2(3.000: 170-175

  2. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography.

    Science.gov (United States)

    Xiao, W-L; Zhang, D-Z; Chen, X-J; Yuan, C; Xue, L-F

    2016-06-01

    Cone beam computed tomography (CBCT) allows for a significantly lower radiation dose than conventional computed tomography (CT) scans and provides accurate images of the alveolar cleft area. The osteogenic effect of guided bone regeneration (GBR) vs. conventional alveolar bone grafting alone for alveolar cleft defects was evaluated in this study. Sixty alveolar cleft patients were divided randomly into two groups. One group underwent GBR using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting only (non-GBR group). CBCT images were obtained at 1 week and at 3 months following the procedure. Using Simplant 11.04 software, the bone resorption rate was calculated and compared between the two groups. The bone resorption rate from 1 week to 3 months following bone grafting without the GBR technique was 36.50±5.04%, whereas the bone resorption rate using the GBR technique was 31.69±5.50% (P=0.017). The application of autogenous iliac bone combined with the GBR technique for alveolar bone grafting of alveolar cleft patients can reduce bone resorption and result in better osteogenesis.

  3. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography.

    Science.gov (United States)

    Xiao, W-L; Zhang, D-Z; Chen, X-J; Yuan, C; Xue, L-F

    2016-06-01

    Cone beam computed tomography (CBCT) allows for a significantly lower radiation dose than conventional computed tomography (CT) scans and provides accurate images of the alveolar cleft area. The osteogenic effect of guided bone regeneration (GBR) vs. conventional alveolar bone grafting alone for alveolar cleft defects was evaluated in this study. Sixty alveolar cleft patients were divided randomly into two groups. One group underwent GBR using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting only (non-GBR group). CBCT images were obtained at 1 week and at 3 months following the procedure. Using Simplant 11.04 software, the bone resorption rate was calculated and compared between the two groups. The bone resorption rate from 1 week to 3 months following bone grafting without the GBR technique was 36.50±5.04%, whereas the bone resorption rate using the GBR technique was 31.69±5.50% (P=0.017). The application of autogenous iliac bone combined with the GBR technique for alveolar bone grafting of alveolar cleft patients can reduce bone resorption and result in better osteogenesis. PMID:26876144

  4. PENGGUNAAN BONE GRAFT PADA PERAWATAN KERUSAKAN TULANG PERIODONTAL (Used Bone Graft for Periodontal Defect Treatment)

    OpenAIRE

    Elly Munadziroh; Mohamad Rubianto; Asti Meizarini

    2015-01-01

    Generally the signs and symptoms of advances periodontal disease are periodontal pockets formation to alveolar bone defect. Bone defect treated with placement a preparation material to promote new bone formation. Tissue transplantation were developed, to recontsruct bone defect with the placement of bone graft material. This paper will discuss the used of demineralied freeze dried bone allograft (DFDBA) and anorganic bone mineral combined with synthetic 15 amino acid sequence within type I co...

  5. Late sarcoma development after curettage and bone grafting of benign bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Picci, Piero, E-mail: piero.picci@ior.it [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy); Sieberova, Gabriela [Dept. of Pathology, National Cancer Institute, Bratislava (Slovakia); Alberghini, Marco; Balladelli, Alba; Vanel, Daniel [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy); Hogendoorn, Pancras C.W. [Dept. of Pathology, Leiden University Medical Center, Leiden (Netherlands); Mercuri, Mario [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy)

    2011-01-15

    Background and aim: Rarely sarcomas develop in previous benign lesions, after a long term disease free interval. We report the experience on these rare cases observed at a single Institution. Patients and methods: 12 cases curetted and grafted, without radiotherapy developed sarcomas, between 1970 and 2005, 6.5-28 years from curettage (median 18, average 19). Age ranged from 13 to 55 years (median 30, average 32) at first diagnosis; tumors were located in the extremities (9 GCT, benign fibrous histiocytoma, ABC, and solitary bone cyst). Radiographic and clinic documentation, for the benign and malignant lesions, were available. Histology was available for 7 benign and all malignant lesions. Results: To fill cavities, autogenous bone was used in 4 cases, allograft in 2, allograft and tricalcium-phosphate/hydroxyapatite in 1, autogenous/allograft in 1, heterogenous in 1. For 3 cases the origin was not reported. Secondary sarcomas, all high grade, were 8 osteosarcoma, 3 malignant fibrous histiocytoma, and 1 fibrosarcoma. Conclusions: Recurrences with progression from benign tumors are possible, but the very long intervals here reported suggest a different cancerogenesis for these sarcomas. This condition is extremely rare accounting for only 0.26% of all malignant bone sarcomas treated in the years 1970-2005 and represents only 8.76% of all secondary bone sarcomas treated in the same years. This incidence is the same as that of sarcomas arising on fibrous dysplasia, and is lower than those arising on bone infarcts or on Paget's disease. This possible event must be considered during follow-up of benign lesions.

  6. Full-thickness tissue engineered skin constructed with autogenic bone marrow mesenchymal stem cells

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To explore the feasibility of repairing clinical cutaneous deficiency, autogenic bone marrow mesen-chymal stem cells (BMSCs) were isolated and differentiated into epidermal cells and fibroblasts in vitro supplemented with different inducing factors and biomaterials to construct functional tissue- engineered skin. The results showed that after 72 h induction, BMSCs displayed morphologic changes such as typical epidermal cell arrangement, from spindle shape to round or oval; tonofibrils, melano-somes and keratohyaline granules were observed under a transmission electronic microscope. The differentiated cells expressed epidermal stem cell surface marker CK19 (59.66% ± 4.2%) and epidermal cells differentiation marker CK10. In addition, the induced epidermal cells acquired the anti-radiation capacity featured by lowered apoptosis following exposure to UVB. On the other hand, the collagen microfibrils deposition was noticed under a transmission electronic microscope after differentiating into dermis fibroblasts; RT-PCR identified collagen type I mRNA expression in differentiated cells; radioimmunoassay detected the secretion of interleukin-6 (IL-6) and interleukin-8 (IL-8) (up to 115.06 pg/mL and 0.84 ng/mL, respectively). Further in vivo implanting BMSCs with scaffold material short-ened skin wound repair significantly. In one word, autogenic BMSCs have the potential to differentiate into epidermal cells and fibroblasts in vitro, and show clinical feasibility acting as epidermis-like and dermis-like seed cells in skin engineering.

  7. Full-thickness tissue engineered skin constructed with autogenic bone marrow mesenchymal stem cells

    Institute of Scientific and Technical Information of China (English)

    HE LiJuan; PEI XueTao; NAN Xue; WANG YunFang; GUAN LiDong; BAI CiXian; SHI ShuangShuang; YUAN HongFeng; CHEN Lin; LIU DaQing

    2007-01-01

    To explore the feasibility of repairing clinical cutaneous deficiency, autogenic bone marrow mesenchymal stem cells (BMSCs) were isolated and differentiated into epidermal cells and fibroblasts in vitro supplemented with different inducing factors and biomaterials to construct functional tissueengineered skin. The results showed that after 72 h induction, BMSCs displayed morphologic changes such as typical epidermal cell arrangement, from spindle shape to round or oval; tonofibrils, melanosomes and keratohyaline granules were observed under a transmission electronic microscope. The differentiated cells expressed epidermal stem cell surface marker CK19 (59.66%±4.2%) and epidermal cells differentiation marker CK10. In addition, the induced epidermal cells acquired the anti-radiation capacity featured by lowered apoptosis following exposure to UVB. On the other hand, the collagen microfibrils deposition was noticed under a transmission electronic microscope after differentiating into dermis fibroblasts; RT-PCR identified collagen type Ⅰ mRNA expression in differentiated cells;radioimmunoassay detected the secretion of interleukin-6 (IL-6) and interleukin-8 (IL-8) (up to 115.06pg/mL and 0.84 ng/mL, respectively). Further in vivo implanting BMSCs with scaffold material shortened skin wound repair significantly. In one word, autogenic BMSCs have the potential to differentiate into epidermal cells and fibroblasts in vitro, and show clinical feasibility acting as epidermis-like and dermis-like seed cells in skin engineering.

  8. PENGGUNAAN BONE GRAFT PADA PERAWATAN KERUSAKAN TULANG PERIODONTAL (Used Bone Graft for Periodontal Defect Treatment

    Directory of Open Access Journals (Sweden)

    Elly Munadziroh

    2015-07-01

    Full Text Available Generally the signs and symptoms of advances periodontal disease are periodontal pockets formation to alveolar bone defect. Bone defect treated with placement a preparation material to promote new bone formation. Tissue transplantation were developed, to recontsruct bone defect with the placement of bone graft material. This paper will discuss the used of demineralied freeze dried bone allograft (DFDBA and anorganic bone mineral combined with synthetic 15 amino acid sequence within type I collagen (PepGen P-15 the potential healing of bone defect to enhance the optimum treatment of periodontal disease.

  9. Allogeneic and autogenous transplantations of MSCs in treatment of the physeal bone bridge in rabbits

    Directory of Open Access Journals (Sweden)

    Urbanova Lucie

    2008-09-01

    Full Text Available Abstract Background The aim of this experimental study on New Zealand's white rabbits was to find differences in the results of treating the distal physeal femoral defect by the transplantation of autologous or allogeneic mesenchymal stem cells (MSCs. After the excision of a created bone bridge in the distal physis of the right femur, modified composite scaffold with MSCs was transplanted into the defect. In animal Group A (n = 11 autogenous MSCs were implanted; in animal Group B (n = 15 allogeneic MSCs were implanted. An iatrogenic physeal defect of the left femur of each animal not treated by MSCs transplantation served as control. The rabbits were euthanized four months after the transplantation. The treatment results were evaluated morphometrically (femoral length and valgus deformity measurement and histologically (character and quality of the new cartilage. Results Four months after the transplantation, the right femurs of the animals in Group A were on average longer by 0.50 ± 0.04 cm (p = 0.018 than their left femurs, the right femurs of rabbits in Group B were on average longer by 0.43 ± 0.01 cm (p = 0.028 than their left femurs. 4 months after the therapeutic transplantation of MSCs valgus deformity of the distal part of the right femur of animals in Group A was significantly lower (by 4.45 ± 1.86° than that of their left femur (p = 0.028, in Group B as well (by 3.66 ± 0.95° than that of their left femur p = 0.001. However, no significant difference was found between rabbits with transplanted autogenous MSCs (Group A and rabbits with transplanted allogeneic MSCs (Group B either in the femur length (p = 0.495, or in its valgus deformity (p = 0.1597. After the MSCs transplantation the presence of a newly formed hyaline cartilage was demonstrated histologically in all the animals (both groups. The ability of transplanted MSCs to survive in the damaged physis was demonstrated in vivo by magnetic resonance, in vitro by Perls reaction

  10. Bone regeneration with cultured human bone grafts

    Energy Technology Data Exchange (ETDEWEB)

    Yoshikawa, T.; Nakajima, H. [Nara Medical Univ., Kashihara City (Japan). Dept. of Pathology; Nara Medical Univ., Kashihara City (Japan). Dept. of Orthopedic Surgery; Ohgushi, H.; Ueda, Y.; Takakura, Y. [Nara Medical Univ., Kashihara City (Japan). Dept. of Orthopedic Surgery; Uemura, T.; Tateishi, T. [National Inst. for Advanced Interdisciplinary Research (NAIR), Ibaraki (Japan). Tsukuba Research Center; Enomoto, Y.; Ichijima, K. [Nara Medical Univ., Kashihara City (Japan). Dept. of Pathology

    2001-07-01

    From 73 year old female patient, 3 ml of bone marrow was collected from the ilium. The marrow was cultured to concentrate and expand the marrow mesenchymal cells on a culture dish. The cultured cells were then subculturedeither on another culture dish or in porous areas of hydroxyapatite ceramics in the presence of dexamethasone and beta-glycerophosphate (osteo genic medium). The subculturedtissues on the dishes were analyzed by scanning electron microscopy (SEM), and subculturedtissues in the ceramics were implanted intraperitoneally into athymic nude mice. Vigorous growth of spindle-shaped cells and a marked formation of bone matrix beneath the cell layers was observed on the subculture dishes by SEM. The intraperitoneally implanted ceramics with cultured tissues revealed thick layer of lamellar bone together with active osteoblasts lining in many pore areas of the ceramics after 8 weeks. The in vitro bone formations on the culture dishes and in vivo bone formation in porous ceramics were detected. These results indicate that we can assemble an in vitro bone/ceramic construct, and due to the porous framework of the ceramic, the construct has osteogenic potential similar to that of autologous cancellous bone. A significant benefit of this method is that the construct can be made with only a small amount of aspirated marrow cells from aged patients with little host morbidity. (orig.)

  11. Space maintenance in autogenous fresh demineralized tooth blocks with platelet-rich plasma for maxillary sinus bone formation: a prospective study.

    Science.gov (United States)

    Kim, Eun-Suk; Kang, Ji-Yeon; Kim, Jae-Jin; Kim, Kyoung-Won; Lee, Eun-Young

    2016-01-01

    This prospective study evaluated the effectiveness of autogenous fresh demineralized tooth block (Auto-FDT block) with platelet-rich plasma (PRP) for maxillary sinus augmentation with simultaneous implant installation. Auto-FDT block with PRP was used in Group 1 (n = 15) and combined graft (allograft and xenograft) powder with PRP was used in Group 2 (n = 15). For up to 2 years after the final prosthesis was installed, clinical and radiographic examinations were performed to evaluate the amount of graft materials, residual alveolar height (RAH), sinus height (SH) after grafting, augmented graft height (AGH) and resorption height (RH). In ten cases, biopsies were harvested for histological and histomorphometric analyses. A total of 59 implants were placed in a severe atrophic posterior maxilla with less than 5 mm of RAH and sinus augmentation. None of the patients developed sinusitis or other complications, such as implant loss. The graft material extracted included one molar (or 2 premolars) in Group 1 and 1.8 cc in Group 2. The radiologic examination revealed the following average between-group difference SH (Group 1, 14.12 ± 1.63 mm vs Group 2, 16.51 ± 1.29 mm) and AGH (Group 1, 11.62 ± 2.22 mm vs Group 2, 13.65 ± 1.35 mm). However, sufficient SH and AGH were observed for the implants in the Auto-FDT block group. Two years after final prosthesis was installed, no between-group difference in the RH was observed (Group 1, 1.23 ± 0.73 mm vs Group 2, 1.77 ± 0.54 mm, P = 0.021). The histomorphometric analysis revealed no between-group difference in the new bone volume (Group 1, 23.13 ± 1.42 % vs Group 2, 24.18 ± 2.19 %, P = 0.548). The results showed that Auto-FDT block with PRP can be used in grafted sinuses for implants with only one extracted molar (or two premolars). Auto-FDT block with PRP promotes new bone formation that is comparable with combined grafts. Auto-FDT block with PRP is as an alternative to bone grafting

  12. Bone formation in cranial, mandibular, tibial and iliac bone grafts in rats

    DEFF Research Database (Denmark)

    Solheim, E; Pinholt, E M; Talsnes, O;

    1995-01-01

    Several studies have suggested that grafts from membranous derived bone (e.g., calvarial grafts) retain their volume better than those from endochondral derived bone (e.g., iliac bone grafts). Increased osteogenesis in grafts of the former type has been offered as the explanation. However, simple...

  13. Technical factors affecting cup stability in bone impaction grafting.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Verdonschot, N.J.J.; Schreurs, B.W.

    2007-01-01

    Favourable long-term clinical results can be achieved by the bone impaction technique in bone stock deficient acetabuli. Originally, firm impaction of manually prepared bone grafts using a rongeur was performed. An alternative technique for producing bone grafts is reaming from the pelvic wall or fe

  14. Bone graft substitutes for spine fusion: A brief review

    OpenAIRE

    Gupta, Ashim; Kukkar, Nitin; Sharif, Kevin; Main, Benjamin J; Albers, Christine E; El-Amin III, Saadiq F

    2015-01-01

    Bone graft substitutes are widely used in the field of orthopedics and are extensively used to promote vertebral fusion. Fusion is the most common technique in spine surgery and is used to treat morbidities and relieve discomfort. Allograft and autograft bone substitutes are currently the most commonly used bone grafts to promote fusion. These approaches pose limitations and present complications to the patient. Numerous alternative bone graft substitutes are on the market or have been develo...

  15. [Rehabilitation of facial paralysis using autogenous fascia lata graft. Stable results over time].

    Science.gov (United States)

    Graillon, N; Colson, T; Bardot, J

    2015-10-01

    Dynamic facial reanimation with free muscle or nerve transfers represents the mainstay of facial paralysis treatments particularly for perioral area and smile. These techniques are not always feasible, in such cases we perform a perioral suspension with fascia lata graft. However many teams blame this technique for short-term recurrence of the deformity. We describe in this paper details of our surgical technique, to improve the aesthetic result and stability over time, and the results and complications encountered. Fascia lata graft was sutured beyond the midline to the contralateral healthy lips, after tunneling through upper and lower orbicularis oris. Fascia lata graft was then tunneled through the buccal fat pad, then under the zygomatic arch to the temporal region, where the temporal aponeurosis was incised to make way for the fascia lata graft, which was fixed to the outer face of the temporal aponeurosis, applying slight overcorrection to the oral commissure. From 2003 to 2012, we performed this procedure on 8 patients. Results showed an immediate aesthetic improvement, stable over time. Perioral suspension with fascia lata graft is a surgical alternative when dynamic reanimation is not feasible.

  16. Sensory reinnervation of muscle spindles after repair of tibial nerve defects using autogenous vein grafts

    Institute of Scientific and Technical Information of China (English)

    Youwang Pang; Qingnan Hong; Jinan Zheng

    2014-01-01

    Motor reinnervation after repair of tibial nerve defects using autologous vein grafts in rats has previously been reported, but sensory reinnervation after the same repair has not been fully investigated. In this study, partial sensory reinnervation of muscle spindles was observed after repair of 10-mm left tibial nerve defects using autologous vein grafts with end-to-end anasto-mosis in rats, and functional recovery was conifrmed by electrophysiological studies. There were no signiifcant differences in the number, size, or electrophysiological function of reinnervated muscle spindles between the two experimental groups. These ifndings suggest that repair of short nerve defects with autologous vein grafts provides comparable results to immediate end-to-end anastomosis in terms of sensory reinnervation of muscle spindles.

  17. Long-term results of the use of autogenous cortical bone columellas to replace the stapes at stapedectomy.

    Science.gov (United States)

    Bauer, Miklós; Pytel, József; Vóna, Ida; Gerlinger, Imre

    2011-05-01

    The first author has been using an autogenous cortical bone columella to replace the stapes removed during stapedectomy since 1965. The audiograms of 21 of the 271 patients operated on with this method between 1965 and 1989 (i.e. 7.7% of the possible candidates) were available 20-35 (average 26.8) years postoperatively. The operation could be regarded as successful in 20 and unsuccessful in 1 patient in the long run. The audiological data are presented individually as averages of the values obtained at 0.5, 1, 2 and 3 kHz. The averaged data (n = 21): preoperative air conduction, 58.27; bone conduction, 24.46; and air-bone gap, 33.81 dB. Postoperative best air conduction, 19.07; bone conduction, 14.10; and air-bone gap, 4.97 dB. Postoperative recent air conduction, 45.77; bone conduction, 38.45; and air-bone gap, 7.32 dB. The best values were measured 1-8 (average 1.57) years postoperatively. In relation to the postoperative best value, the recent value of the air-bone gap had deteriorated by 2.35 dB, and that of the bone conduction by 24.35 dB. The small air-bone gap indicates that the deterioration of the hearing is mainly caused by the deterioration of the function of the inner ear and not by that of the conductive apparatus. The progression of the deterioration differs individually (0.3-1.6, average 0.93 dB/year) and accelerates with age. This finding seems to be a problem that does not depend on the operative technique. The data show that the autogenous bone columella ensures the same good and lasting results as the alloplastic solutions; moreover, there is no problem with the incus-prosthesis connection.

  18. Bone graft substitutes and bone morphogenetic proteins for osteoporotic fractures: What is the evidence?

    NARCIS (Netherlands)

    E.M.M. van Lieshout (Esther); V. Alt (Volker)

    2016-01-01

    textabstractDespite improvements in implants and surgical techniques, osteoporotic fractures remain challenging to treat. Among other major risk factors, decreased expression of morphogenetic proteins has been identified for impaired fracture healing in osteoporosis. Bone grafts or bone graft substi

  19. Vancomycin graft composite for infected bone defects

    International Nuclear Information System (INIS)

    Reconstructive surgery under septic conditions represents a major challenge in orthopaedics. Local application of antibiotics can provide high drug levels at the site of infection without systemic effects. However, removal of non-resorbable implants and filling of defects usually requires additional operative procedures. An ideal antibiotic carrier should provide for : 1) Effective bactericidal activity, especially against staphylococci including MRSA; 2) High and long lasting levels at the site of infection without local or systemic toxicity; 3) Repair of defects without a second stage procedure. Allogeneic cancellous bone is proven to be effective in restoration of bone stock. Vancomycin is effective against all gram-positive populations and the agent of choice for infections with MRSA. The aim of our study is to investigate the efficacy of a combination of both components in bone infection. Cancellous bone of human origin was processed during several steps and incubated in 10% vancomycin solution. The antimicrobial activity of the vancomycin graft composite (VGC) was evaluated using an agar diffusion bioassay against staphylococcus aureus and high performance liquid chromatography (HPLC). The testing period was up to 9 weeks. Elution of vancomycin from the graft was evaluated in 2.5% human albumin solution, which was exchanged every 24 hours. Concentration of vancomycin in allograft-bone was between 6.653[tg/g and 23.194gg/g with an average of 15.250 [tg/g, which is equivalent to 10.000 times the minimum inhibitory concentration (MIC) for s. aureus. The initial activity decreased to approx. 50% during the first week and approx. 30% at the end of the 9th week. The lowest values measured exceeded the MIC by 2000 times. Concentration in surrounding fluid decreased from 24.395,80 to 18,43pg/ml after 11 complete exchanges. Human cancellous bone, processed in an adequate way, offers capability to store high quantities of vancomycin. Vancomycin graft composites are

  20. Bone Forming Potential of An-Organic Bovine Bone Graft: A Cone Beam CT study

    OpenAIRE

    Uzbek, Usman Haider; Rahman, Shaifulizan Ab; Alam, Mohammad Khursheed; gillani, syed wasif

    2014-01-01

    Purpose: An-organic bovine bone graft is a xenograft with the potential of bone formation. The aim of this study was to evaluate the bone density using cone beam computed tomography scans around functional endosseous implant in the region of both augmented maxillary sinus with the an-organic bovine bone graft and the alveolar bone over which the graft was placed to provide space for the implants.

  1. Experimental Comparison of Cranial Particulate Bone Graft, rhBMP-2, and Split Cranial Bone Graft for Inlay Cranioplasty.

    Science.gov (United States)

    Hassanein, Aladdin H; Couto, Rafael A; Kurek, Kyle C; Rogers, Gary F; Mulliken, John B; Greene, Arin K

    2013-05-01

    Background :  Particulate bone graft and recombinant human bone morphogenetic protein-2 (rhBMP-2) are options for inlay cranioplasty in children who have not developed a diploic space. The purpose of this study was to determine whether particulate bone graft or rhBMP-2 has superior efficacy for inlay cranioplasty and to compare these substances to split cranial bone. Methods :  A 17 mm × 17 mm critical-sized defect was made in the parietal bones of 22 rabbits and managed in four ways: Group I (no implant; n=5), Group II (particulate bone graft; n=5), Group III (rhBMP-2; n=7), and Group IV (split cranial bone graft; n=5). Animals underwent microcomputed tomography and histologic analysis 16 weeks after cranioplasty. Results :  Defects without an implant (Group I) demonstrated inferior ossification (41.4%; interquartile range [IQR], 28.9% to 42.5%) compared to those treated with particulate bone graft (Group II: 99.5%; IQR, 97.8% to 100%), rhBMP-2 (Group III: 99.6%; IQR, 99.5% to 100%), or split cranial bone (Group IV: 100%) (P inlay calvarial defect areas equally, although the thickness of bone healed with rhBMP-2 is inferior. Clinically, particulate bone graft or split cranial bone graft may be superior to rhBMP-2 for inlay cranioplasty.

  2. Revascularisation of fresh compared with demineralised bone grafts in rats

    DEFF Research Database (Denmark)

    Solheim, E; Pinholt, E M; Talsnes, O;

    2001-01-01

    Revascularisation of bone grafts is influenced by both the anatomical origin and the pre-implantation processing of the graft. We investigated the revascularisation by entrapment of 141Ce (cerium)-labelled microspheres in large, fresh and demineralised syngeneic grafts of predominantly cancellous...

  3. Unicameral bone cysts managed with CHRONOS bone graft substitute: A case series.

    OpenAIRE

    Benjamin, Biju; Ketan PANDE

    2013-01-01

    A unicameral bone cyst (UBC) may require surgery if its location increases the risk for pathologic fracture, or if it is painful or increasing in size. This case series demonstrates that curettage and grafting with a bone graft substitute alone can result in healing of the UBC. Three children with UBC and pathological fractures were treated with curettage and grafting using bone graft substitute beta-tricalcium phosphate granules (CHRONOS). All three went on to full union of the fracture and ...

  4. 21 CFR 872.3930 - Bone grafting material.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3930 Bone grafting material. (a) Identification... “Class II Special Controls Guidance Document: Dental Bone Grafting Material Devices.” (See § 872.1(e) for...) Date premarket approval application (PMA) or notice of product development protocol (PDP) is...

  5. Rehabilitation of Avulsed Teeth in Fractured Jaws via Bone Grafting and Implant Placement: Report of Two Cases.

    Science.gov (United States)

    Jain, Anshul; Baliga, Shridhar

    2015-07-01

    The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implant-supported prostheses. Herein, two cases are presented where implant placement was done for upper anterior teeth, which were traumatized or avulsed following maxillofacial trauma. Both patients demonstrated a history of maxillofacial trauma and had undergone open reduction and internal fixation. The first patient had a severe maxillary alveolar defect treated via autogenous bone grafting and a six-month period was given for proper integration of the bone graft. The second patient was a smoker with very poor oral hygiene and a deep bite. Thus, implant placement was not initially justified. PMID:26877745

  6. Rehabilitation of Avulsed Teeth in Fractured Jaws via Bone Grafting and Implant Placement: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Anshul Jain

    2016-01-01

    Full Text Available The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implant-supported prostheses.Herein, two cases are presented where implant placement was done for upper anterior teeth, which were traumatized or avulsed following maxillofacial trauma. Both patients demonstrated a history of maxillofacial trauma and had undergone open reduction and internal fixation. The first patient had a severe maxillary alveolar defect treated via autogenous bone grafting and a six-month period was given for proper integration of the bone graft. The second patient was a smoker with very poor oral hygiene and a deep bite. Thus, implant placement was not initially justified.

  7. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones

    Directory of Open Access Journals (Sweden)

    Rubenbauer Bianka

    2009-12-01

    Full Text Available Abstract Background Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the market, this comparative study aims to evaluate healing characteristics of ununited bones treated with ORIF combined with either iliac-crest-autologous-bone-grafting (ICABG or demineralized-bone-matrix (DBM. Methods and results From 2000 to 2006 out of sixty-two consecutive patients with non-unions presenting at our Level I Trauma Center, twenty patients had ununited diaphyseal fractures of long bones and were treated by ORIF combined either by ICABG- (n = 10 or DBM-augmentation (n = 10. At the time of index-operation, patients of the DBM-group had a higher level of comorbidity (ASA-value: p = 0.014. Mean duration of follow-up was 56.6 months (ICABG-group and 41.2 months (DBM-group. All patients were clinically and radiographically assessed and adverse effects related to bone grafting were documented. The results showed that two non-unions augmented with ICABG failed osseous healing (20% whereas all non-unions grafted by DBM showed successful consolidation during the first year after the index operation (p = 0.146. No early complications were documented in both groups but two patients of the ICABG-group suffered long-term problems at the donor site (20% (p = 0.146. Pain intensity were comparable in both groups (p = 0.326. However, patients treated with DBM were more satisfied with the surgical procedure (p = 0.031. Conclusion With the use of DBM, the costs for augmentation of the non-union-site are more expensive compared to ICABG (calculated difference: 160

  8. Bone graft materials in fixation of orthopaedic implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... skeletal bones. The osteoconductive properties of the composite might be improved by adding bone marrow aspirate (BMA), which can be harvested during surgery. Other alternatives to bone graft are demineralised bone matrix (DBM) and human cancellous bone (CB). DBM is prepared by acid extraction of human...

  9. Compound graft with acellular exogenous dermis and autogenous thin skin reducing formation of scar%脱细胞异体真皮加自体薄皮复合移植减少瘢痕形成

    Institute of Scientific and Technical Information of China (English)

    侯新安; 李关欣; 石秋娟; 乔长顺

    2003-01-01

    @@ BACKGROUND:Autogenous skin graft is a common method in treatment of deep burn,late survive effect of grafted skin flap is directly related to its thickness.In clinic,therapeutic effect of full thickness graft is the best.However,due to large skin providing area that can't be sutured directly and survive rate of graft at infected wound surface is very low,its clinical application is limited,especially in deep burn with large area.This study is to search a best material repairing wound surface of deep burn,reduce proliferation of scar and protect limbs function.

  10. Secondary Alveolar Bone Grafting (CLEFTSiS) 2007-2010.

    Science.gov (United States)

    Paterson, Michael; Rae, Jennifer; Paterson, Paul; Gilgrass, Toby; Devlin, Mark; McIntyre, Grant

    2016-03-01

    Objective To determine whether alveolar bone graft outcomes for unilateral and bilateral cleft lip and palate patients have continued to improve since the reorganization of cleft services in Scotland in 2000. Design Retrospective analysis of postoperative anterior occlusal radiographs. Patients and Participants Eighty-one of 106 patients who were eligible for alveolar bone grafting between 2007 and 2010 had suitable postoperative radiographs available. Interventions Twenty-seven percent of the patients (n = 22) had presurgical orthodontic intervention. All patients underwent alveolar bone grafting with bone harvested from the iliac crest. Main Outcome Measures The Kindelan bone-fill index was used to evaluate success. Weighted kappa statistics were used to assess intra- and interobserver reproducibility. A comparison was made with results from 2000 to 2004 to assess any improvement. Chi-square tests (or Fisher exact test) were used to determine whether outcomes differed depending on the laterality of the cleft, use of presurgical expansion, or age at bone grafting. Results Interobserver scoring agreement was good (weighted kappa = .383). Intraobserver reproducibility was greater (weighted kappas of .835 and .620). Success was achieved in 99% of bone grafts, compared with 76% in the period from 2000 to 2004 (P < .001). There was no statistically significant relationship between the laterality of the cleft (P = 1.000), use of presurgical expansion (P = 1.000), or age at time of bone grafting and outcome (P = .259). Conclusion Scottish secondary alveolar bone graft outcomes improved during 2007 to 2010 in comparison to the 2000 to 2004 results. PMID:26914161

  11. Peri-Implant Tissue Findings in Bone Grafted Oral Cancer Patients Compared to non Bone Grafted Patients without Oral Cancer

    OpenAIRE

    Jan Wolff; Hideki Agata; George K. Sándor; Suvi Haimi

    2011-01-01

    ABSTRACT Objectives The aim of this study was to compare microbiological, histological, and mechanical findings from tissues around osseointergrated dental implants in patients who had undergone tumour resection and subsequent bone grafting with non bone grafted patients without a history of oral cancer and to develop an effective tool for the monitoring of the peri-implant tissues. A third aim was to assess and compare the masticatory function of the two patient groups after reconstruction w...

  12. Argus II retinal prosthesis implantation with scleral flap and autogenous temporalis fascia as alternative patch graft material: a 4-year follow-up

    Science.gov (United States)

    Matet, Alexandre; Amar, Nawel; Mohand-Said, Saddek; Sahel, José-Alain; Barale, Pierre-Olivier

    2016-01-01

    Introduction The Argus II retinal prosthesis is composed of an epiretinal electrode array positioned over the macula and connected to an extrascleral electronics case via a silicone cable, running through a sclerotomy. During implantation, the manufacturer recommends to cover the sclerotomy site with a patch of processed human pericardium to prevent postoperative hypotony and conjunctival erosion by the underlying electronics case. Due to biomedical regulations prohibiting the use of this material in France, we developed an alternative technique combining a scleral flap protecting the sclerotomy and an autogenous graft of superior temporalis fascia overlying the electronics case. Methods The purpose of this study is to describe the 4-year outcomes of this modified procedure in three subjects who underwent Argus II Retinal Prosthesis System implantation. Clinical data consisting of intraocular pressure measurements and tolerance in terms of conjunctival erosion or inflammation were retrospectively assessed over a 4-year postoperative follow-up. Results None of the three patients implanted with the modified technique developed ocular hypotony over 4 years. A normal, transient conjunctival inflammation occurred during the first postoperative month but conjunctival erosion was not observed in any of the three patients over 4 years. Four years after implantation, the autogenous temporalis fascia graft remained well tolerated and the retinal prosthesis was functional in all three patients. Conclusion The combination of an autograft of superficial temporalis fascia and a scleral flap efficiently prevented leakage through the sclerotomy site, ocular hypotony, and conjunctival erosion by the extrascleral electronics case. This modified technique is suitable for the implantation of existing and forthcoming retinal prostheses. Superficial temporalis fascia may also be used as alternative to commercial tectonic tissues for scleral wound repair in clinical settings where they

  13. Effects of a buried magnetic field on cranial bone reconstruction in rats

    Science.gov (United States)

    de ABREU, Maíra Cavallet; PONZONI, Deise; LANGIE, Renan; ARTUZI, Felipe Ernesto; PURICELLI, Edela

    2016-01-01

    ABSTRACT The understanding of bone repair phenomena is a fundamental part of dentistry and maxillofacial surgery. Objective The present study aimed to evaluate the influence of buried magnetic field stimulation on bone repair in rat calvaria after reconstruction with autogenous bone grafts, synthetic powdered hydroxyapatite, or allogeneic cartilage grafts, with or without exposure to magnetic stimulation. Material and Methods Ninety male Wistar rats were divided into 18 groups of five animals each. Critical bone defects were created in the rats’ calvaria and immediately reconstructed with autogenous bone, powdered synthetic hydroxyapatite or allogeneic cartilage. Magnetic implants were also placed in half the animals. Rats were euthanized for analysis at 15, 30, and 60 postoperative days. Histomorphometric analyses of the quantity of bone repair were performed at all times. Results These analyses showed significant group by postoperative time interactions (p=0.008). Among the rats subjected to autogenous bone reconstruction, those exposed to magnetic stimulation had higher bone fill percentages than those without magnetic implants. Results also showed that the quality of bone repair remained higher in the former group as compared to the latter at 60 postoperative days. Conclusions After 60 postoperative days, bone repair was greater in the group treated with autogenous bone grafts and exposed to a magnetic field, and bone repair was most pronounced in animals treated with autogenous bone grafts, followed by those treated with powdered synthetic hydroxyapatite and allogeneic cartilage grafts. PMID:27119765

  14. Bone graft complications: what can we do to prevent them?

    Science.gov (United States)

    Tandon, Rahul; Herford, Alan S.

    2014-03-01

    Introduction: Bone grafts are commonly used in oral and maxillofacial surgery, helping to restore missing bone structure and provide osseous support. In spite of their reported success, complications can and do arise. Examples include loosening and resorption of the graft, infection, and complete loss of the graft. These complications can potentially lead to larger defects, necessitating additional procedures to correct the problem. This not only causes great discomfort to the patient, but also drains considerable time and resources away from the clinician. Thus, improvements on identifying ways to identify and prevent these complications are constantly being sought. We have performed a literature review and identified several areas in the field of optics that could potentially help solve our problem. Optical Techniques: Raman spectroscopy has been shown to provide a transcutaneous measurement of bone mineral and matrix Raman bands. This could potentially provide surgeons with the ability to more accurately assess bone graft osseointegration. In-vivo near-infrared optical imaging could potentially provide accurate diagnosis of pathologic lesions such as osteosarcoma. Contrast-enhanced ultrasound could be used to detect vascular disturbances and other information related to the transplantation of osseous components. Conclusion: Bone graft complications can be one of the most devastating consequences of osseous surgery. As surgeons, we are constantly searching for ways to identify them earlier and prevent them. We hope that by presenting areas that could be used, we can gain a better insight to ways in which both fields can benefit.

  15. Effect of radiation therapy on autologous and allogeneic bone grafts

    International Nuclear Information System (INIS)

    Purpose: Currently no significant literature exists regarding the effects of therapeutic radiation on bone graft integrity in humans. As the combination of these procedures is frequently necessary in the treatment of neoplasms, we have retrospectively analyzed graft outcomes in irradiated sites. Materials and Methods: 40 autologous or allogeneic bone grafts in 35 patients treated at the Massachusetts General Hospital (MGH) between 1977 and 1995 were evaluated. Preoperative radiation was given in 28 cases, postoperative in 21 cases. Radiation was delivered as external beam photons, 160 MeV protons or brachytherapy implant. Doses ranged from 3 to 83 Gy. Grafts were located in the spine (17), pelvis (13), femur (5), humerus (2) and tibia (3). Functional graft survival and healing quality were determined radiographically. Failure free survival rates were calculated using the Kaplan-Meier method and linear regressions were performed using the Wilcoxan method. Results: Overall rates of graft survival were 86% at 1 yr and 73% at 5 yrs. For auto grafts and allografts the 1 yr rates were 100% and 80% (p=.96). No significant differences in outcome based on treatment chronology were found with survival rates of 81% for preoperative treatment and 86% for postoperative treatment. With linear regression analysis there was no relation between outcome and time between surgery and radiation (p=.89). Further, no relation between bone dose (preoperative + postoperative dose), graft dose (postoperative dose) or mean dose/day and outcome was found (p=.50, p=.49 and p=.43). Failures were evenly distributed amongst high and low dose groups. The use of chemotherapy did not significantly effect outcome with a survival rate of 85% compared to 87%. Tobacco use was a significant predictor of failure with 63% graft survival compared to 94% in non-smokers (p=.038). Quality of bone healing rated poor overall, but was highly variable and did not correlate with dose or chronology of therapy

  16. Bone graft substitutes in anterior cervical discectomy and fusion

    OpenAIRE

    Chau, Anthony M.T.; Mobbs, Ralph J.

    2009-01-01

    Anterior cervical discectomy with fusion is a common surgical procedure for patients suffering pain and/or neurological deficits and unresponsive to conservative management. For decades, autologous bone grafted from the iliac crest has been used as a substrate for cervical arthrodesis. However patient dissatisfaction with donor site morbidity has led to the search for alternative techniques. We present a literature review examining the progress of available grafting options as assessed in hum...

  17. Preparation and characterization of a novel bone graft composite containing bone ash and egg shell powder

    Indian Academy of Sciences (India)

    Gunasekaran Krithiga; Thotapalli P Sastry

    2011-02-01

    Egg shells which were hitherto discarded as wastes were collected, purified and powdered into a particle size in the range of 5–50 m. A composite bone graft material in cylindrical form was prepared using egg shell powder (ESP), bone ash (BA) and gelatin. These bone grafts were characterized for their FT–IR, TGA, XRD, SEM and mechanical properties. The mechanical studies indicate that the composite having a stoichiometric ratio of BA (3 g) and ESP (7 g) has shown better mechanical properties. X-ray diffraction (XRD) data indicated the crystallographic nature of BA is akin to hydroxyapatite (HA) and both BA and ESP did not lose their crystalline nature when bone grafts were prepared. This revealed that ESP may be used as a component in bone graft utilizing the solid waste from the poultry industry.

  18. Reconstruction of saddle nose deformity with calvarial bone graft

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of calvarial bone in the reconstruction of saddle nose deformity. Methods: The cross-sectional study was conducted at the Plastic Surgery Unit of Imam Reza Hospital, Tabriz University of Medical Sciences, Iran, from July 2004 to October 2009. It comprised 19 patients who underwent saddle nose deformity reconstruction with calvarial bone graft. All patients were operated upon under general anaesthesia. They were followed up periodically. Results: The patients followed up for 25 to 61 months for an average period of 39.2+-4.3 months. In 14 (74%) patients the result of the surgical intervention was excellent, while in 5 (26%) it was acceptable. All patients were satisfied and there was not displacement, absorption, distortion or infection of the graft. Conclusion: Calvarial bone graft is a viable option for the reconstruction of saddle nose deformity, especially in severe cases. (author)

  19. No negative effects of bone impaction grafting with bone and ceramic mixtures.

    NARCIS (Netherlands)

    Arts, J.J.C.; Gardeniers, J.W.M.; Welten, M.L.M.; Verdonschot, N.J.J.; Schreurs, B.W.; Buma, P.

    2005-01-01

    Reconstructing large loaded bone defects with ceramic bone graft extenders is tempting considering the expected future donor bone shortage. However, whether there are negative effects is unknown. Standardized large defects in the acetabulum of goats were created and subsequently reconstructed with m

  20. Within patient radiological comparative analysis of the performance of two bone graft extenders utilized in posterolateral lumbar fusion: a retrospective case series

    Directory of Open Access Journals (Sweden)

    Geoffrey eStewart

    2016-01-01

    Full Text Available Two bone graft extenders differing in chemical composition were implanted contralaterally in 27 consecutive patients undergoing instrumented posterolateral lumbar fusion as standard of care. Bone marrow aspirate and autogenous bone graft were equally combined either with β-tricalcium phosphate (β-TCP or a hybrid biomaterial (containing hyaluronic acid but lacking a calcium salt and implanted between the transverse processes. Fusion status on each side of the vertebrae was retrospectively graded (1-5 scale on AP planar X-ray at multiple visits as available, through approximately month 12. Additionally, consolidation or resorption since prior visit for each treatment was recorded. Sides receiving β-TCP extender showed marked resorption prior to bone consolidation during the first 6 months. By contrast, sides receiving the hybrid biomaterial containing integrated hyaluronic acid showed rapid bone consolidation by week 6-8, with maintenance of initial bone volume through month 12. Fusion grade was superior for the hybrid biomaterial, differing significantly from β-TCP at day 109 and beyond. Fusion success at >month 12 was 92.9% vs 67.9% for the hybrid biomaterial and β-TCP-treated sides, respectively. The hybrid biomaterial extender demonstrated a shortened time to fusion compared to the calcium-based graft. Mode of action has been demonstrated in the literature to differ between these compositions. Therefore, choice of synthetic biomaterial composition may significantly influence mode of action of cellular events regulating appositional bone growth.

  1. Composite ceramic bone graft substitute in the treatment of locally aggressive benign bone tumours.

    OpenAIRE

    Schindler, O. S.; Cannon, S.R.; Briggs, T. W.; Blunn, G. W.

    2008-01-01

    PURPOSE: To report the use of a composite ceramic bone graft substitute containing calcium sulphate and hydroxyapatite (HA) in the treatment of large expansive osteolytic benign bone tumours. METHODS: 4 women and 9 men aged 8 to 49 (mean, 22) years with aneurysmal bone cysts (n=6) or giant cell tumours (n=7) in the epi- or meta-physeal areas of the lower limbs underwent curettage, phenolisation, and filling with bone graft substitute containing calcium sulphate and HA. The mean tumour size wa...

  2. Argus II retinal prosthesis implantation with scleral flap and autogenous temporalis fascia as alternative patch graft material: a 4-year follow-up

    Directory of Open Access Journals (Sweden)

    Matet A

    2016-08-01

    Full Text Available Alexandre Matet,1,2 Nawel Amar,1,2 Saddek Mohand-Said,1–4 José-Alain Sahel,1–7 Pierre-Olivier Barale1,2 1INSERM and DHOS, CHNO des Quinze-Vingts, 2Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision, 3INSERM, 4CNRS, Paris, France; 5Institute of Ophthalmology, University College London, London, UK; 6Fondation Ophtalmologique Adolphe de Rothschild, 7Académie des Sciences, Institut de France, Paris, France Introduction: The Argus II retinal prosthesis is composed of an epiretinal electrode array positioned over the macula and connected to an extrascleral electronics case via a silicone cable, running through a sclerotomy. During implantation, the manufacturer recommends to cover the sclerotomy site with a patch of processed human pericardium to prevent postoperative hypotony and conjunctival erosion by the underlying electronics case. Due to biomedical regulations prohibiting the use of this material in France, we developed an alternative technique combining a scleral flap protecting the sclerotomy and an autogenous graft of superior temporalis fascia overlying the electronics case. Methods: The purpose of this study is to describe the 4-year outcomes of this modified procedure in three subjects who underwent Argus II Retinal Prosthesis System implantation. Clinical data consisting of intraocular pressure measurements and tolerance in terms of conjunctival erosion or inflammation were retrospectively assessed over a 4-year postoperative follow-up. Results: None of the three patients implanted with the modified technique developed ocular hypotony over 4 years. A normal, transient conjunctival inflammation occurred during the first postoperative month but conjunctival erosion was not observed in any of the three patients over 4 years. Four years after implantation, the autogenous temporalis fascia graft remained well tolerated and the retinal prosthesis was functional in all three patients. Conclusion: The combination of an

  3. Press-fit Femoral Fixation in ACL Reconstruction using Bone-Patellar Tendon-Bone Graft

    Directory of Open Access Journals (Sweden)

    Kaseb Mohammad Hasan

    2009-05-01

    Full Text Available Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months. Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86 preoperatively and 91.88(73-100 at the latest follow up (P < 0.005. No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft.

  4. Bioreactor activated graft material for early implant fixation in bone

    DEFF Research Database (Denmark)

    Snoek Henriksen, Susan; Ding, Ming; Overgaard, Søren

    2011-01-01

    Introduction The combined incubation of a composite scaffold with bone marrow stromal cells in a perfusion bioreactor could make up a novel hybrid graft material with optimal properties for early fixation of implant to bone. The aim of this study was to create a bioreactor activated graft (BAG......) material, which could induce early implant fixation similar to that of allograft. Two porous scaffold materials incubated with cells in a perfusion bioreactor were tested in this study. Methods and Materials Two groups of 8 skeletally mature female sheep were anaesthetized before aspiration of bone marrow...... from the iliac crest. For both groups, mononuclear cells were isolated, and injected into a perfusion bioreactor (Millenium Biologix AG, Switzerland). Scaffold granules (Ø~900-1500 µm, ~88% porosity) in group 1, consisted of hydroxyapatite (HA, 70%) with β-tricalcium-phosphate (β-TCP, 30%) (Danish...

  5. Peri-Implant Tissue Findings in Bone Grafted Oral Cancer Patients Compared to non Bone Grafted Patients without Oral Cancer

    Directory of Open Access Journals (Sweden)

    Jan Wolff

    2011-08-01

    Full Text Available Objectives: The aim of this study was to compare microbiological, histological, and mechanical findings from tissues around osseointergrated dental implants in patients who had undergone tumour resection and subsequent bone grafting with non bone grafted patients without a history of oral cancer and to develop an effective tool for the monitoring of the peri-implant tissues. A third aim was to assess and compare the masticatory function of the two patient groups after reconstruction with dental implants.Material and Methods: A total of 20 patients were divided into 2 groups. The first group was edentulous and treated with dental implants without the need for bone grafting. The second edentulous group, with a history of oral cancer involving the mandible, received onlay bone grafts with concurrent placement of dental implants. Microbiological, histological, mechanical and biochemical assessment methods, crevicular fluid flow rate, hygiene-index, implant mobility, and the masticatory function were analysed and compared in both patient groups.Results: The microbiological examinations showed no evidence of the three most common pathogenic bacteria: Porphyromonas gingivalis, Prevotella intermedius, Actinobacillus actinomycetencomitans. A causal relationship between specific microbes and peri-implant inflammation could not be found. All biopsies in both patient groups revealed early signs of soft tissue peri-implant inflammation.Conclusions: The crevicular fluid volume and grade of gingival inflammation around the dental implants were related. Peri-implant tissue findings were similar in the two patient groups despite the history of oral cancer and the need for bone grafting at the time of dental implant placement.

  6. Bone graft materials in fixation of orthopaedic implants in sheep.

    Science.gov (United States)

    Babiker, Hassan

    2013-07-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking skeletal bones. The osteoconductive properties of the composite might be improved by adding bone marrow aspirate (BMA), which can be harvested during surgery. Other alternatives to bone graft are demineralised bone matrix (DBM) and human cancellous bone (CB). DBM is prepared by acid extraction of human bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA/Collagen composite alone and in combination with BMA on the early fixation of porous coated titanium implants. In addition, the study compares also the effect of autograft with the gold standard allograft. By using a sheep model, the implants were inserted in the trabecular bone of femoral condyles. The test biomaterials were placed in a well defined peri-implant gap. After the observation period, the bone-implant specimens were harvested and evaluated mechanically by a destructive push

  7. Bone replacement following dental trauma prior to implant surgery - present status

    NARCIS (Netherlands)

    Hallman, Mats; Mordenfeld, Arne; Strandkvist, Tomas

    2009-01-01

    Dento-alveolar trauma often leads to a need for reconstruction of the alveolar crest before an implant can be placed. 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 i

  8. Efficacy of PRP in the Reconstruction of Mandibular Segmental Defects Using Iliac Bone Grafts

    OpenAIRE

    Magesh, D. P. Uma; Kumaravelu, C.; Maheshwari, G. Uma

    2012-01-01

    This retrospective study was conducted to evaluate the role of platelet-rich plasma (PRP) in the reconstruction of segmental mandibular defects using iliac bone grafts. Thirteen patients underwent reconstruction of post-resection segmental defects of the mandible using titanium reconstruction plates, cortico cancellous iliac bone graft. The patients were randomly separated into two groups. One group of the patients received a PRP graft in addition to the iliac bone graft. Post-operative dimen...

  9. Vascularized fibula grafts for reconstruction of bone defects after resection of bone sarcomas

    DEFF Research Database (Denmark)

    Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen;

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1-24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4...... (n = 2), and hip dislocation (n = 1). Limb-sparing surgery with reconstruction of bone defects using vascularized fibular grafts in BS cases is feasible with acceptable clinical results, but fractures should be expected in many patients....

  10. A histomorphometric meta-analysis of sinus elevation with various grafting materials

    Directory of Open Access Journals (Sweden)

    Handschel Jörg

    2009-06-01

    Full Text Available Abstract Several grafting materials have been used in sinus augmentation procedures including autogenous bone, demineralized freeze-dried bone (DFDBA, hydroxyapatite, β-tricalcium phosphate (β-TCP, anorganic deproteinized bovine bone and combination of these and others. Up to now a subject of controversy in maxillofacial surgery and dentistry is, what is the most appropriate graft material for sinus floor augmentation. Purpose The aim of this study is to provide a body of evidence-based data regarding grafting materials in external sinus floor elevation concerning the fate of the augmented material at the histomorphological level, through a meta-analysis of the available literature. Materials and methods The literature searches were performed using the National Library of Medicine. The search covered all English and German literature from 1995 until 2006. For analyzing the amount of bone the parameter "Total Bone Volume" (TBV was assessed. TBV is determined as the percentage of the section consisting of bone tissue. Results In a relatively early phase after implantation the autogenous bone shows the highest TBV values. Interestingly, the different TBV levels approximate during the time. After 9 months no statistically significant differences can be detected between the various grafting materials. Conclusion From a clinical point of view, the use of autogenous bone is advantageous if a prosthetic rehabilitation (with functional loading is expected within 9 months. In other cases the use of anorganic deproteinized bovine bone in combination with autogenous bone seems to be preferable. Donor side morbidity is ignored in this conclusion.

  11. Guided bone regeneration with local zoledronic acid and titanium barrier: An experimental study

    Science.gov (United States)

    Dundar, Serkan; Ozgur, Cem; Yaman, Ferhan; Cakmak, Omer; Saybak, Arif; Ozercan, Ibrahim Hanifi; Alan, Hilal; Artas, Gokhan; Nacakgedigi, Onur

    2016-01-01

    The aim of this study was to evaluate the effects on new bone formation of autogenous blood alone or in combination with zoledronic acid (ZA), a β-tricalcium phosphate (β-TCP) graft or ZA plus a β-TCP graft placed under titanium barriers. For this purpose, eight adult male New Zealand white rabbits were used in the study, each with four titanium barriers fixed around four sets of nine holes drilled in the calvarial bones. The study included four groups, each containing 2 rabbits. In the autogenous blood (AB group), only autogeneous blood was placed under the titanium barriers. The three experimental groups were the AB+ZA group, with autogenous blood plus ZA, the AB+β-TCP group, with autogeneous blood plus a β-TCP graft, and the AB+β-TCP+ZA group, with autogeneous blood plus a β-TCP graft and ZA mixture under the titanium barriers. The animals were sacrificed after 3 months. The amounts of new bone formation identified histomorphometrically were found to be higher after 3 months than at the time of surgery in all groups. The differences between the groups were examined with histomorphometric analysis, and statistically significant differences were identified at the end of the 3 months. The bone formation rate in the AB+β-TCP+ZA group was determined to be significantly higher than that in the other groups (P<0.05). In the AB+ZA and AB+β-TCP groups, the bone formation rate was determined to be significantly higher than that in the AB group (P<0.05). No statistically significant difference in bone formation rate was observed between the AB+β-TCP and AB+ZA groups. Local ZA used with autogeneous blood and/or graft material appears to be a more effective method than the use of autogeneous blood or graft alone in bone augmentation executed with a titanium barrier. PMID:27698687

  12. Bone grafting of the floor of the maxillary sinus for the placement of endosseous implants

    NARCIS (Netherlands)

    Raghoebar, GM; Vissink, A; Reintsema, H; Batenburg, RHK

    1997-01-01

    This study describes and evaluates a technique to augment the floor of the maxillary sinus and to widen the alveolar crest of the atrophic posterior maxilla with autogenous bone. The subjects were 43 patients whose maxillary alveolar crest was not high enough to permit reliable placement of endosseo

  13. Effects of pre- and postoperative irradiation on the healing of bone grafts in the rabbit

    International Nuclear Information System (INIS)

    Healing of cellular bone grafts irradiated at various times in the postsurgical course was compared to the healing characteristics of bone grafts placed into already irradiated tissue and to controls of irradiated host mandible in a rabbit model. Physical graft consolidation was assessed by load stress characteristics and serial histologic examination. Results indicated that grafts placed into already irradiated tissues failed to form bone in both phases of expected regeneration resulting in structurally weakened and histologically deficient ossicles. Bone grafts irradiated after placement were tolerant of irradiation. Bone grafts irradiated after four weeks were found to be less affected by irradiation than those irradiated within the first four weeks, forming an ossicle structurally and histologically superior to that of bone ossicles developed from grafts placed into irradiated tissues

  14. Segment distraction to reduce a wide alveolar cleft before alveolar bone grafting.

    NARCIS (Netherlands)

    Binger, T.; Katsaros, C.; Rucker, M.; Spitzer, W.J.

    2003-01-01

    OBJECTIVE: To demonstrate a method for reduction of wide alveolar clefts prior to bone grafting. This method aims to facilitate bone grafting and achieve adequate soft tissue coverage of the graft with attached gingiva. CASE REPORT: Treatment of a patient with bilateral cleft lip and palate with a s

  15. A new double bone-double bundle patellar tendon-bone graft model: A calf model study

    OpenAIRE

    Öztürk, Hayati; Öztemur, Zekeriya; Bulut, Okay; Tezeren, Seyfi Gündüz

    2011-01-01

    AbstractThe aim of this study is to improve a new graft model for anatomic double bundle Anterior Crucial Ligament reconstruction (ACL). The aim of ACL reconstruction is to reproduce the functions of the native ACL. An anatomic double bundle ACL reconstruction utilizes two separate grafts to replace the Anterior Medial (AM) and Posterior Lateral (PL) bundles of the ACL. Bone-Patellar Tendon-Bone (BPTB) Graft was harvested from calf knee. Patellar tendon and distal bone were split as longitudi...

  16. Morbidity from iliac crest bone harvesting

    NARCIS (Netherlands)

    Kalk, WWI; Raghoebar, GM; Jansma, J; Boering, G

    1996-01-01

    Purpose: The iliac crest is the most common donor site for autogenous bone grafting in maxillofacial surgery. The aim of this study was to evaluate retrospectively the morbidity of bone harvesting from the inner table of the anterior iliac crest. Patients and Methods: Sixty-five patients were recall

  17. Analysis of reconstruction using non-vascularized iliac bone graft for patients with mandibular defects%非血管化髂骨移植重建下颌骨缺损的临床分析

    Institute of Scientific and Technical Information of China (English)

    谢富强; 孙健

    2012-01-01

    Objective To make a clinical retrospective analysis of reconstruction using autogenous non-vascularized iliac bone graft for patients with mandibular defects, and then to evaluate the treatment effectiveness and operation announcements of this method. Methods 34 patients who were suffered from discontinued mandibule because of tumor or trauma, were treated with autogenous non-vascularized iliac bone graft. The surgery technique, postoperative outcomes and complications were analyzed. Results In 34 patients adopted non-vascularized iliac bone graft, 31 patients adopted rigid internal fixation with titanium mini plate, 3 patients with bridging titanium plate. 27 bone grafts survived completely, the overall success rate was 79.41%. 3(8.82%) of the bone grafts healed after infection, 4(11.76%) bone grafts lost because of infection. Conclusion The autogenous non-vascularized iliac bone graft is one of the most important way for the reconstruction of mandibular defects. The methods of internal fixation includes titanium mini pate and bridging titanium plate.%目的 对非血管化髂骨移植重建下颌骨缺损的病例进行临床回顾性分析,探讨其治疗效果及手术注意事项.方法 选择因肿瘤和外伤致下颌骨缺损后行自体非血管化髂骨同期移植重建术修复的34例患者为研究对象,分析其手术方法、术后效果及并发症的发生情况.结果 采用游离非血管化髂骨同期移植重建下颌骨缺损的34例患者中,小钛板双排内固定31例,重建板内固定3例.34例患者中,成功病例27例(79.41%),良好病例3例(8.82%),失败病例4例(11.76%).失败原因均为感染而取出植入骨.结论 自体非血管化髂骨移植重建术是下颌骨缺损重建的重要方法之一,内固定的方式有小钛板和重建板.

  18. A histomorphometric meta-analysis of sinus elevation with various grafting materials

    OpenAIRE

    Handschel Jörg; Simonowska Melani; Naujoks Christian; Depprich Rita A; Ommerborn Michelle A; Meyer Ulrich; Kübler Norbert R

    2009-01-01

    Abstract Several grafting materials have been used in sinus augmentation procedures including autogenous bone, demineralized freeze-dried bone (DFDBA), hydroxyapatite, β-tricalcium phosphate (β-TCP), anorganic deproteinized bovine bone and combination of these and others. Up to now a subject of controversy in maxillofacial surgery and dentistry is, what is the most appropriate graft material for sinus floor augmentation. Purpose The aim of this study is to provide a body of evidence-based da...

  19. Circulation, bone scans, and tetracycline labeling in microvascularized and vascular bundle implanted rib grafts

    International Nuclear Information System (INIS)

    The circulation in microvascularized rib grafts has been compared with that in conventional rib grafts and in those augmented by a direct vascular bundle implantation into the bone grafts. A new experimental model has been designed to correlate vascular perfusion, bone scan patterns, tetracycline labeling, and histological findings in these bone grafts. Posterior microvascularized rib grafts were found to have a circulatory pattern identical to that of the normal rib. Failed microvascularized rib grafts were revascularized more slowly than conventional rib grafts. Vascular bundles implanted into rib grafts remained patent and increased the rate of revascularization. The stripping or preservation of periosteum had no observable effects on the rate or pattern of conventional rib graft revascularization. The circulation in rib grafts was accurately reflected in technetium 99 bone scans, as was the patency of the anastomoses of microvascularized rib grafts and of implanted vascular bundles. In contrast, tetracycline labeling was repeatedly observed in avascular areas of bone grafts and, therefore, is not a reliable indicator of bone graft circulation

  20. Local treatment of a bone graft by soaking in zoledronic acid inhibits bone resorption and bone formation. A bone chamber study in rats

    Directory of Open Access Journals (Sweden)

    Belfrage Ola

    2012-12-01

    Full Text Available Abstract Background Bone grafts are frequently used in orthopaedic surgery. Graft remodelling is advantageous but can occur too quickly, and premature bone resorption might lead to decreased mechanical integrity of the graft. Bisphosphonates delay osteoclastic bone resorption but may also impair formation of new bone. We hypothesize that these effects are dose dependent. In the present study we evaluate different ways of applying bisphosphonates locally to the graft in a bone chamber model, and compare that with systemic treatment. Methods Cancellous bone grafts were placed in titanium chambers and implanted in the tibia of 50 male rats, randomly divided into five groups. The first group served as negative control and the grafts were rinsed in saline before implantation. In the second and third groups, the grafts were soaked in a zoledronic acid solution (0.5 mg/ml for 5 seconds and 10 minutes respectively before being rinsed in saline. In the fourth group, 8 μL of zoledronic acid solution (0.5 mg/ml was pipetted onto the freeze-dried grafts without rinsing. The fifth group served as positive control and the rats were given zoledronic acid (0.1 mg/kg systemically as a single injection two weeks after surgery. The grafts were harvested at 6 weeks and analysed with histomorphometry, evaluating the ingrowth distance of new bone into the graft as an equivalent to the anabolic osteoblast effect and the amount (bone volume/total volume; BV/TV of remaining bone in the remodelled graft as equivalent to the catabolic osteoclast effect. Results In all chambers, almost the entire graft had been revascularized but only partly remodelled at harvest. The ingrowth distance of new bone into the graft was lower in grafts soaked in zoledronic acid for 10 minutes compared to control (p = 0.007. In all groups receiving zoledronic acid, the BV/TV was higher compared to control. Conclusions This study found a strong inhibitory effect on bone resorption by

  1. Posterior lumbar inter-body fusion (PLIF) using autogenous bone and cage with pedicle screw instrumentation versus PLIF using cage with pedicle screw instrumentation in adult spondylolisthesis

    Institute of Scientific and Technical Information of China (English)

    Dou Yusheng; Hao Dingjun; Wen Shiming

    2005-01-01

    Objective: To compare the clinical outcomes of PLIF using autogenous bone and cage with pedicle screw fixation (group 2) and simple cage fusion with pedicle screw fixation (group 1) in adult spondylolisthesis.Methods: 27 patients with minimum follow-up of 24 months, treated by inter-body fusion with pedicle screw fixation were prospectively studied. Disc space height, degree of slippage and fusion rate had been compared before and after operation between the two groups. Results: After minimum 24 month's follow-up, there was no significant difference between the two groups in terms of the amount of blood loss, duration of hospital stay, back pain,radiating pain, fusion rate, or complication (P>0.05). however, there was a significant difference between the two groups in terms of disc space height and percentage of slippage (P<0.05). Conclusion: PLIF using autogenous bone and cage with pedicle screw fixation more beneifical to improve fusion rate and prevent long-term instabilities than simple cage fusion with pedicle screw fixation in adult spondylolisthesis.

  2. No effect of Osteoset, a bone graft substitute, on bone healing in humans: a prospective randomized double-blind study

    DEFF Research Database (Denmark)

    Petruskevicius, Juozas; Nielsen, Mette Strange; Kaalund, Søren;

    2002-01-01

    We studied the effects of a newly marketed bone substitute, Osteoset, on bone healing in a tibial defect in humans. 20 patients undergoing an ACL (anterior cruciate ligament) reconstruction with bone-patella tendon-bone graft were block-randomized into 2 groups of 10 each. In the treatment group...

  3. Enhancement of the Regenerative Potential of Anorganic Bovine Bone Graft Utilizing a Polyglutamate-Modified BMP2 Peptide with Improved Binding to Calcium-Containing Materials.

    Science.gov (United States)

    Bain, Jennifer L; Bonvallet, Paul P; Abou-Arraj, Ramzi V; Schupbach, Peter; Reddy, Michael S; Bellis, Susan L

    2015-09-01

    Autogenous bone is the gold standard material for bone grafting in craniofacial and orthopedic regenerative medicine. However, due to complications associated with harvesting donor bone, clinicians often use commercial graft materials that may lose their osteoinductivity due to processing. This study was aimed to functionalize one of these materials, anorganic bovine bone (ABB), with osteoinductive peptides to enhance regenerative capacity. Two peptides known to induce osteoblastic differentiation of mesenchymal stem cells were evaluated: (1) DGEA, an amino acid motif within collagen I and (2) a biomimetic peptide derived from bone morphogenic protein 2 (BMP2pep). To achieve directed coupling of the peptides to the graft surface, the peptides were engineered with a heptaglutamate domain (E7), which confers specific binding to calcium moieties within bone mineral. Peptides with the E7 domain exhibited greater anchoring to ABB than unmodified peptides, and E7 peptides were retained on ABB for at least 8 weeks in vivo. To assess the osteoinductive potential of the peptide-conjugated ABB, ectopic bone formation was evaluated utilizing a rat subcutaneous pouch model. ABB conjugated with full-length recombinant BMP2 (rBMP2) was also implanted as a model for current clinical treatments utilizing rBMP2 passively adsorbed to carriers. These studies showed that E7BMP2pep/ABB samples induced more new bone formation than all other peptides, and an equivalent amount of new bone as compared with rBMP2/ABB. A mandibular defect model was also used to examine intrabony healing of peptide-conjugated ABB. Bone healing was monitored at varying time points by positron emission tomography imaging with (18)F-NaF, and it was found that the E7BMP2pep/ABB group had greater bone metabolic activity than all other groups, including rBMP2/ABB. Importantly, animals implanted with rBMP2/ABB exhibited complications, including inflammation and formation of cataract-like lesions in the eye, whereas

  4. Bone grafting with granular biomaterial in segmental maxillary osteotomy: A case report

    Directory of Open Access Journals (Sweden)

    Orion Luiz Haas Junior

    2016-01-01

    Conclusion: This is the first report of bone grafting with a granular biomaterial in segmental maxillary osteotomy. Successful formation of new bone with density greater than that of the surrounding tissue was achieved, preventing pseudarthrosis and postoperative instability.

  5. 浓缩自体骨髓移植配合中药治疗骨不连临床研究%Effect of Concentrated Autogenous Bone Marrow Stem Cell Transplant Combined with Traditional Chinese Medicine on Bone Nonunion

    Institute of Scientific and Technical Information of China (English)

    尹世昌; 焦振华; 王功国; 汉吉健

    2011-01-01

    Objective:To observe the curative effect of concentrated autogenous bone marrow stem cell transplant combined with traditional Chinese medicine on bone nonunion. Methods.. All 50 patients with bone nonunion were divided into treatment group (A group) which treated by percutaneous autogenous bone marrow stem cell transplant combined with traditional Chinese medicine,and control group (B group) which treated by autogenous bone marrow stem cell transplant only,with 25 cases in each group. The growth of the bony callus and the healing time were observed after treatment. The curative effect was evaluated. Results: All patients in A group with fracture eventually healed, the average healing time was 6.8 months. While,22 patients in B group with fracture eventually healed,the average healing time was 8.4 months. There was statistically significant in fracture healing time between the two groups (P<0.05). Conclusion: Percutaneous autogenous bone marrow stem cell transplant combined with traditional Chinese medicine can improve osteogenesis and promote fracture healing.%目的:观察自体浓缩骨髓移植结合中药骨愈康对骨不连治疗的效果.方法:浓缩自体骨髓移植阳中药组(A组)采用局部经皮自体骨髓移植结合中药内服治疗骨不连患者25例,另设浓缩自体骨髓移植组(B组)采用单纯自体骨髓移植治疗骨不连患者25例,观察X线所示骨痂形成情况和临床体征,评价2组在治疗前后的骨折愈合情况.结果:A组25例患者骨折最终愈合,平均愈合时间6.8个月.B组22例患者骨折最终愈合,平均愈合时间8.4个月.2组骨折愈合时间比较差异有统计学意义(P<0.05).结论:自体骨髓移植结合中药骨愈康可以改善成骨能力,促进骨折愈合.

  6. Treatment of chondroblastoma of the calcaneus with a secondary aneurysmal bone cyst using endoscopic curettage without bone grafting.

    Science.gov (United States)

    Otsuka, Takanobu; Kobayashi, Masaaki; Yonezawa, Masato; Kamiyama, Fumiaki; Matsushita, Yasusi; Matsui, Nobuo

    2002-04-01

    Chondroblastoma is a relatively rare benign bone tumor. Approximately 7% of chondroblastomas occur in the calcaneus, and 17% of chondroblastoma associated with cystic lesions. We report a case of a chondroblastoma in the calcaneus with a secondary aneurysmal bone cyst treated successfully by endoscopic curettage without bone grafting. New bone formation is facilitated by minimal damage to the bone and soft tissue. The cosmetic results of this procedure are good. Two years later, the patient is asymptomatic with no radiographic evidence of recurrence. Endoscopic curettage without bone grafting is a promising new treatment for chondroblastoma.

  7. Hard and Soft Tissue Management of a Localized Alveolar Ridge Atrophy with Autogenous Sources and Biomaterials: A Challenging Clinical Case

    Science.gov (United States)

    Andreoni, D.

    2016-01-01

    Particularly in the premaxillary area, the stability of hard and soft tissues plays a pivotal role in the success of the rehabilitation from both a functional and aesthetic aspect. The present case report describes the clinical management of a localized alveolar ridge atrophy in the area of the upper right canine associated with a thin gingival biotype with a lack of keratinized tissue. An autogenous bone block harvested from the chin associated with heterologous bone particles was used to replace the missing bone, allowing for a prosthetic driven implant placement. Soft tissues deficiency was corrected by means of a combined epithelialized and subepithelial connective tissue graft. The 3-year clinical and radiological follow-up demonstrated symmetric gingival levels of the upper canines, with physiological peri-implant probing depths and bone loss. Thus, the use of autogenous tissues combined with biomaterials might be considered a reliable technique in case of highly aesthetic demanding cases.

  8. Hard and Soft Tissue Management of a Localized Alveolar Ridge Atrophy with Autogenous Sources and Biomaterials: A Challenging Clinical Case

    Directory of Open Access Journals (Sweden)

    C. Maiorana

    2016-01-01

    Full Text Available Particularly in the premaxillary area, the stability of hard and soft tissues plays a pivotal role in the success of the rehabilitation from both a functional and aesthetic aspect. The present case report describes the clinical management of a localized alveolar ridge atrophy in the area of the upper right canine associated with a thin gingival biotype with a lack of keratinized tissue. An autogenous bone block harvested from the chin associated with heterologous bone particles was used to replace the missing bone, allowing for a prosthetic driven implant placement. Soft tissues deficiency was corrected by means of a combined epithelialized and subepithelial connective tissue graft. The 3-year clinical and radiological follow-up demonstrated symmetric gingival levels of the upper canines, with physiological peri-implant probing depths and bone loss. Thus, the use of autogenous tissues combined with biomaterials might be considered a reliable technique in case of highly aesthetic demanding cases.

  9. The relationship between revascularisation and osteogenesis in fresh or demineralised bone grafts

    DEFF Research Database (Denmark)

    Solheim, E; Pinholt, E M; Talsnes, O;

    2001-01-01

    .50, p = 0.001), no correlation could be demonstrated in demineralised grafts (r = 0.09, p = 0.6). The results may indicate differences in the mechanisms of vascularisation and osteogenesis in the grafts used fresh or after demineralization but are, at present, difficult to fully explain.......Bone formation generally depends on adequate blood flow. Failure of bone grafts has been attributed to delayed revascularisation of the graft. We compared the relationship between revascularisation and osteogenesis, evaluated as entrapment of (141)Ce-labelled microspheres and uptake of (85)Sr......, respectively, in fresh or demineralised syngeneic bone grafts 3 weeks after heterotopic implantation in rats. Whereas a moderately high linear correlation between (85)Sr and (141)Ce radioactivity was found both in the (intact) host iliac bone (r = 0.75, p = 0.0001) and implanted fresh syngeneic grafts (r = 0...

  10. Treatment of severe bone deficiency in acetabular revision surgery using a reinforcement device and bone grafting

    Institute of Scientific and Technical Information of China (English)

    ZHAI Ji-liang; LIN Jin; JIN Jin; QIAN Wen-wei; WENG Xi-sheng

    2011-01-01

    Background Severe acetabular bone deficiency is a major challenge in acetabular revision surgery. Most cases require reconstruction of the acetabulum with bone grafting and a reinforcement device. The purpose of this study was to evaluate the results of this procedure for severe acetabular bone deficiency in acetabular revision surgery.Methods This study involved 12 patients (2 males and 10 females) with severe acetabular bone defects who underwent implantation of a reinforcement device (ring or cage) and bone grafting between February 2003 and October 2008. Using the Paprosky classification, 2 cases were Paprosky ⅡC, 6 were ⅢA, and 4 were ⅢB. The mean age at the time of surgery was 63.0 years (range, 46-78 years). During revision surgery, a reinforcement ring was implanted in 6patients, and a cage in 6 patients. The clinical and radiographic results were evaluated retrospectively. The mean duration of follow-up was 37 months (range, 9-71 months).Results The average Harris Hip Score improved from 35.2 preoperatively to 82.9 at the time of the final follow-up visit.The results were excellent in 8 hips (66.7%), good in 2 (16.7%), and fair in 2 (16.7%). Osteolysis was found in 1 case, but did not worsen. Three patients had yellow wound effusion, with healing after administration of dressing changes,debridement, and antibiotics. Dislocation occurred in a 62-year-old woman. Closed reduction was performed, and dislocation did not recur. There was no evidence of intraoperative acetabular fracture, nerve injury, ectopic ossification,aseptic loosening, or infection.Conclusion Reconstruction with a reinforcement device and bone grafting is an effective approach to the treatment of acetabular bone deficiency in acetabular revision surgery, given proper indications and technique.

  11. Secondary bone grafting for alveolar cleft in children with cleft lip or cleft lip and palate

    NARCIS (Netherlands)

    J. Guo; C. Li; Q. Zhang; G. Wu; S.A. Deacon; J. Chen; H. Hu; S. Zou; Q. Ye

    2011-01-01

    BACKGROUND: Secondary alveolar bone grafting has been widely used to reconstruct alveolar cleft. However, there is still some controversy. OBJECTIVES: To compare the effectiveness and safety of different secondary bone grafting methods. SEARCH STRATEGY: The final electronic and handsearches were car

  12. Bone graft substitutes for the treatment of traumatic fractures of the extremities [Knochenersatzmaterialien zur Behandlung von traumatischen Frakturen der Extremitäten

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2012-06-01

    Full Text Available [english] Bone graft substitutes are increasingly being used as supplements to standard care or as alternative to bone grafts in the treatment of traumatic fractures.The efficacy and cost-effectiveness of bone graft substitutes for the treatment of traumatic fractures as well as the ethical, social and legal implications of their use are the main research questions addressed.A systematic literature search was conducted in electronic medical databases (MEDLINE, EMBASE etc. in December 2009. Randomised controlled trials (RCT, where applicable also containing relevant health economic evaluations and publications addressing the ethical, social and legal aspects of using bone graft substitutes for fracture treatment were included in the analysis. After assessment of study quality the information synthesis of the medical data was performed using metaanalysis, the synthesis of the health economic data was performed descriptively. 14 RCT were included in the medical analysis, and two in the heath economic evaluation. No relevant publications on the ethical, social and legal implications of the bone graft substitute use were found. In the RCT on fracture treatment with bone morphogenetic protein-2 (BMP-2 versus standard care without bone grafting (RCT with an elevd high risk of bias there was a significant difference in favour of BMP-2 for several outcome measures. The RCT of calcium phosphate (CaP cement and bone marrow-based composite materials versus autogenous bone grafts (RCT with a high risk of bias revealed significant differences in favour of bone graft substitutes for some outcome measures. Regarding the other bone graft substitutes, almost all comparisons demonstrated no significant difference.The use of BMP-2 in addition to standard care without bone grafting led in the study to increased treatment costs considering all patients with traumatic open fractures. However, cost savings through the additional use of BMP-2 were calculated in a

  13. [Use of the calvarium for bone grafting in cranio-maxillo-facial surgery].

    Science.gov (United States)

    Raulo, Y; Baruch, J

    1990-01-01

    Bone grafts's traditional donor sites in cranio-maxillo-facial surgery have been for many years and are still in some occasions the ribs, iliac crest and tibia. Bone grafts taken from the calvaria have been used by some surgeons in the past but its wide acceptance was only achieved after Paul Tessier had reported his own experience. The calvaria is composed of inner and outer tables that encloses a layer of cancellous bone called the diploe. A high degree of variability exist with respect to skull thickness. Nevertheless parietal bones is the preferable site for the harvesting of the graft. The embryonic origin of the cranium should be responsible for greater survival of the graft. Membranous bone would maintain its volume to a greater extent than endochondral bone when autografted in the cranio-facial region. However this remains controversial. Two techniques can be used for the harvesting of a calvarial bone grafts. A split thickness calvarial graft involves removal of the outer table while leaving the inner layer in place. Its main disadvantage is the relatively thinness of the bone transferred. A full thickness segment of skull involves the cranium cavity be entered. A half of the graft can be split along the diploe space and returned to fill the donor site. The other half is used for reconstruction. It is a more complicated procedure. Cranial grafts have been used in the following cases. Correction of contour defect of the forehead and zygomatic bones, orbital floor reconstruction, restoration of the nasal bridge, bone grafting of the maxilla and mandibule. The advantages are the following: the donor and recipient sites are in adjacent surgical fields, the donor site scar is hidden in the scalp, morbidity associated with removing the graft is almost inexistent. (ABSTRACT TRUNCATED AT 250 WORDS)

  14. The composite of bone marrow concentrate and PRP as an alternative to autologous bone grafting.

    Directory of Open Access Journals (Sweden)

    Mohssen Hakimi

    Full Text Available One possible alternative to the application of autologous bone grafts represents the use of autologous bone marrow concentrate (BMC. The purpose of our study was to evaluate the potency of autologous platelet-rich plasma (PRP in combination with BMC. In 32 mini-pigs a metaphyseal critical-size defect was surgically created at the proximal tibia. The animals were allocated to four treatment groups of eight animals each (1. BMC+CPG group, 2. BMC+CPG+PRP group, 3. autograft group, 4. CPG group. In the BMC+CPG group the defect was filled with autologous BMC in combination with calcium phosphate granules (CPG, whereas in the BMC+CPG+PRP group the defect was filled with the composite of autologous BMC, CPG and autologous PRP. In the autograft group the defect was filled with autologous cancellous graft, whereas in the CPG group the defect was filled with CPG solely. After 6 weeks radiological and histomorphometrical analysis showed significantly more new bone formation in the BMC+CPG+PRP group compared to the BMC+CPG group and the CPG group. There were no significant differences between the BMC+CPG+PRP group and the autograft group. In the PRP platelets were enriched significantly about 4.7-fold compared to native blood. In BMC the count of mononuclear cells increased significantly (3.5-fold compared to the bone marrow aspirate. This study demonstrates that the composite of BMC+CPG+PRP leads to a significantly higher bone regeneration of critical-size defects at the proximal tibia in mini-pigs than the use of BMC+CPG without PRP. Furthermore, within the limits of the present study the composite BMC+CPG+PRP represents a comparable alternative to autologous bone grafting.

  15. Reconstruction of large limb bone defects with a double-barrel free vascularized fibular graft

    Institute of Scientific and Technical Information of China (English)

    BI Zheng-gang; HAN Xing-guang; FU Chun-jiang; CAO Yang; YANG Cheng-lin

    2008-01-01

    Background The use of a free,vascularized fibular graft is an important technique for the reconstruction of large defects in long bones.The technique has many advantages in strong,tubular bones; a more reliable vascular anatomy with a large vascular diameter and long pedicle is used,minimizing donor-site morbidity.Due to limitations in both fibular anatomy and mechanics,they cannot effectively be used to treat large limb bone defects due to their volume and strength.Methods From 1990 to 2001,16 clinical cases of large bone defects were treated using vascularized double-barrel fibular grafts.Patients were evaluated for an average of 10 months after surgery.Results All the patients achieved bony union; the average bone union took 10 months post surgery,and no stress fractures occurred.Compared with single fibular grafts,the vascularized double-barrel fibular grafts greatly facilitate bony union and are associated with fewer complications,suggesting that the vascularized double-barrel fibular graft is a valuable procedure for the correction of large bone defects in large,long bones in addition to enhancing bone intensity.Conclusions The vascularized double-barrel fibular graft is superior to the single fibular graft in stimulating osteogenous activity and biological mechanics for the correction of very large bone defects in large,long bones.Free vascularized folded double-barrel fibular grafts can not only fill up large bone defects,but also improve the intensity margin.Therefore,this study also widens its application and enlarges the treatment targets.However,in the case of bone deformability,special attention should be paid to bone fixation and protection of donor and recipient sites.

  16. Alendronate reduced peri-tunnel bone loss and enhanced tendon graft to bone tunnel healing in anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    PPY Lui

    2013-01-01

    Full Text Available Peri-tunnel bone loss after anterior cruciate ligament (ACL reconstruction is commonly observed, both clinically and experimentally. We aimed to study the effect and mechanisms of different doses of alendronate in the reduction of peri-tunnel bone loss and promotion of graft-bone tunnel healing in ACL reconstruction. Eighty-four ACL-reconstructed rats were divided into 4 groups. Alendronate at different dosages, or saline, were injected subcutaneously weekly, for 2 or 6 weeks post-reconstruction, for vivaCT (computed tomography imaging, biomechanical tests, histology and immunohistochemistry. Alendronate significantly increased bone mass and density of tissue inside bone tunnels except at the epiphyseal region of tibial tunnel. The femoral tunnel diameter decreased significantly in the mid-dose and high-dose alendronate groups compared to that in the saline group at week 6. Alendronate significantly increased the peri-tunnel bone mass and density along all tunnel regions at week 6. Better graft-bone tunnel integration and intra-tunnel graft integrity were observed in the alendronate groups. The ultimate load was significantly higher in the mid-dose and high-dose alendronate groups at week 2, but not at week 6. There was a reduction in matrix metalloprotein (MMP1, MMP13 and CD68-positive cells at the peri-tunnel region and graft-bone interface in the alendronate-treated group compared to the saline group. Alendronate reduced peri-tunnel bone resorption, increased mineralised tissue inside bone tunnel as well as histologically and biomechanically promoted graft-bone tunnel healing, probably by reducing the expression of MMP1, MMP13 and CD68-positive cells. Alendronate might be used for reducing peri-tunnel bone loss and promoting graft-bone tunnel healing at early stage post-ACL reconstruction.

  17. Amalgamation of allogenic bone graft, platelet-rich fibrin gel, and PRF membrane in auto-transplantation of an impacted central incisor.

    Science.gov (United States)

    Chaudhary, Zainab; Kumar, Yuvika Raj; Mohanty, Sujata; Khetrapal, Ambica

    2015-01-01

    "Social six" teeth refers to the maxillary incisors and canines that play a vital role in the appearance of an individual and absence of any one of them has a significant psycho-social impact. Hence, early treatment and rehabilitation of the same are extremely important. A multitude of treatment options ranging from orthodontic extrusion, extraction followed by implant placement, fixed partial denture, and auto-transplantation have been advocated. This case report discusses the unique amalgamation of platelet-rich fibrin (PRF), demineralized freeze-dried bone graft with use of PRF membrane during auto-transplantation of an impacted central incisor. The authors have focused on maximum usage of autogenous materials in the most economic and least invasive manner. Furthermore, this amalgamation has been used to provide rehabilitation in the least span of time.

  18. Amalgamation of allogenic bone graft, platelet-rich fibrin gel, and PRF membrane in auto-transplantation of an impacted central incisor

    Directory of Open Access Journals (Sweden)

    Zainab Chaudhary

    2015-01-01

    Full Text Available "Social six" teeth refers to the maxillary incisors and canines that play a vital role in the appearance of an individual and absence of any one of them has a significant psycho-social impact. Hence, early treatment and rehabilitation of the same are extremely important. A multitude of treatment options ranging from orthodontic extrusion, extraction followed by implant placement, fixed partial denture, and auto-transplantation have been advocated. This case report discusses the unique amalgamation of platelet-rich fibrin (PRF, demineralized freeze-dried bone graft with use of PRF membrane during auto-transplantation of an impacted central incisor. The authors have focused on maximum usage of autogenous materials in the most economic and least invasive manner. Furthermore, this amalgamation has been used to provide rehabilitation in the least span of time.

  19. Optimal graft source for allogeneic hematopoietic stem cell transplant: bone marrow or peripheral blood?

    Science.gov (United States)

    Adhikari, Janak; Sharma, Priyadarshani; Bhatt, Vijaya Raj

    2016-08-01

    Peripheral blood (PB), compared with bone marrow graft, has higher stem cell content, leads to faster engraftment and is more convenient for collection. Consequently, the use of PB graft has significantly increased in recent years. Although the use of PB graft is acceptable or even preferred to bone marrow graft in matched related donor allogeneic transplant due to a possibility of improved survival, PB graft increases the risk of chronic graft-versus-host disease and associated long-term toxicities in the setting of matched unrelated donor allogeneic transplant. In haploidentical transplant, mitigation of graft-versus-host disease with the use of post-transplant cyclophosphamide is a hypothesis-generating possibility; however, available studies have significant limitations to draw any definite conclusion. PMID:27168462

  20. Application of tridimensional intravertebral bone graft combined with AxiaLIF technique in lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Xiangdong Duan

    2009-05-01

    Full Text Available "nLumbar interbody fusion techniques are becoming more and more minimally invasive. AxiaLIF technique can be used in low back pain caused by degenerative disc disease or minor spondylolisthesis, but there are risks for fusion failure. Intravertebral bone graft is performed in painful osteoporotic or posttraumatic vertebral compression fractures (VCFs. Until now, no attempt has been made to apply intravertebral bone graft with AxiaLIF technique."nSo first, we hypothesize a novel method for tridimensional intravertebral bone graft with a special designed bone grafting instrument and describe it vividly. The special instrument would mainly consist of a hollow tube and a rod, the distal parts of them would be shape into 45o slope, so the direction of grafting would be decided by the slope. By rotating the tube we can deliver cancellous bone granules in one plane, but by retreating the tube we can perform tridimensional intravertebral bone graft. Second, intravertebral bone graft is supposed to be performed combined with AxiaLIF technique in order to create biologic vertebral reconstruction and raise fusion rate. We believe this is the first description of such a method, future clinical studies are needed to validate these hypotheses.

  1. Vascularized Fibula Grafts for Reconstruction of Bone Defects after Resection of Bone Sarcomas

    Science.gov (United States)

    Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen; Rechnitzer, Catherine; Daugaard, Søren; Muhic, Aida

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1–24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4/3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n = 2), humeral diaphysis (n = 2), humeral proximal diaphysis and epiphysis (n = 1), femoral diaphysis (n = 1), ulnar diaphysis (n = 1), and tibial diaphysis (n = 1). One patient with Ewing's sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26–75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis (n = 2), and hip dislocation (n = 1). Limb-sparing surgery with reconstruction of bone defects using vascularized fibular grafts in BS cases is feasible with acceptable clinical results, but fractures should be expected in many patients. PMID:20490263

  2. Bone grafts and dental implants in the reconstruction of the severely atrophied, edentulous maxilla

    OpenAIRE

    Johansson, Björn

    2001-01-01

    In two prospective, clinical studies the stability of implants and prosthetic constructions were evaluated after three years of loading. In the first study, the implant and the bridge stability of 39 patients with 1-stage bone grafts, were compared to a reference-group of 37 patients who did not need bone grafts. In the second study, 40 patients were randomised to have either 1-stage sinus inlay bloc grafts or 2-stage sinus inlay particulated grafts. Implant success in Paper 1, was 75.3% in...

  3. Revascularization of calvarial, mandibular, tibial, and iliac bone grafts in rats

    DEFF Research Database (Denmark)

    Pinholt, E M; Solheim, E; Talsnes, O;

    1994-01-01

    area of harvest of bone graft is important regarding early revascularization, but the results do not support the theory that different embryological mode of development is the cause since mandibula (high 141Ce index) and calvaria (low 141Ce index) are of membranous origin and iliac bone (high 141Ce...... index) and tibia (low 141Ce index) are of endochondral origin. The difference in revascularization between the different grafts may be explained by differences in quantity of cancellous bone since cancellous bone is revascularized faster than cortical bone....

  4. Evaluation of bone response to synthetic bone grafting material treated with argon-based atmospheric pressure plasma

    Energy Technology Data Exchange (ETDEWEB)

    Beutel, Bryan G., E-mail: bryanbeutel@gmail.com; Danna, Natalie R.; Gangolli, Riddhi; Granato, Rodrigo; Manne, Lakshmiprada; Tovar, Nick; Coelho, Paulo G.

    2014-12-01

    Bone graft materials are utilized to stimulate healing of bone defects or enhance osseointegration of implants. In order to augment these capabilities, various surface modification techniques, including atmospheric pressure plasma (APP) surface treatment, have been developed. This in vivo study sought to assess the effect of APP surface treatment on degradation and osseointegration of Synthograft™, a beta-tricalcium phosphate (β-TCP) synthetic bone graft. The experimental (APP-treated) grafts were subjected to APP treatment with argon for a period of 60 s. Physicochemical characterization was performed by environmental scanning electron microscopy, surface energy (SE), and x-ray photoelectron spectroscopy analyses both before and after APP treatment. Two APP-treated and two untreated grafts were surgically implanted into four critical-size calvarial defects in each of ten New Zealand white rabbits. The defect samples were explanted after four weeks, underwent histological analysis, and the percentages of bone, soft tissue, and remaining graft material were quantified by image thresholding. Material characterization showed no differences in particle surface morphology and that the APP-treated group presented significantly higher SE along with higher amounts of the base material chemical elements on it surface. Review of defect composition showed that APP treatment did not increase bone formation or reduce the amount of soft tissue filling the defect when compared to untreated material. Histologic cross-sections demonstrated osteoblastic cell lines, osteoid deposition, and neovascularization in both groups. Ultimately, argon-based APP treatment did not enhance the osseointegration or degradation of the β-TCP graft. Future investigations should evaluate the utility of gases other than argon to enhance osseointegration through APP treatment. - Highlights: • Degradation/osseointegration of bone graft treated with argon-based APP is studied. • APP treatment did

  5. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

    OpenAIRE

    SHEN, Jia-zuo; YAO, Jian-fei; LIN, Da-sheng; Lian, Ke-jian; Ding, Zhen-qi; Lin, Bin; GUO, Zhi-min; Zhang, Ming-Hua; Li, Qiang; LI, Lin; Qi, Peng

    2012-01-01

    Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise. Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS) and standard dynamic hip screws (DHS) in an animal model. Design: Testing of specifically designed fixation devices in a pig animal model....

  6. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

    OpenAIRE

    Jia-zuo SHEN, Jian-fei YAO, Da-sheng LIN, Ke-jian LIAN, Zhen-qi DING, Bin LIN, Zhi-min GUO, Ming-hua ZHANG, Qiang LI, Lin LI, Peng QI

    2012-01-01

    Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise.Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS) and standard dynamic hip screws (DHS) in an animal model.Design: Testing of specifically designed fixation devices in a pig animal model.In...

  7. Prospective Analysis of Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients

    Science.gov (United States)

    Reddy, M Gokul Chandra; Babu, V Ramesh; Rao, V Eswar; Chaitanya, J Jaya; Allareddy, S; Reddy, C Charan Kumar

    2015-01-01

    Background: To assess the success of the uptake of bone graft in cleft alveolus of the cleft lip and palate patients, quantitatively through computed tomography (CT) scan 6 months postoperative. To assess the successful eruption of permanent lateral incisor or canine in the bone grafted area. Materials and Methods: The children age group of 9-21 years with unilateral cleft lip and palate came to the hospital, needing secondary alveolar bone grafting. A detailed history and clinical examination of the patient was taken. A 3D CT scan was taken and the volume of the cleft was measured pre-operatively. After ambulatory period, 3D CT scan of the alveolar cleft region was taken and volume of the bone grafted was measured and patient was discharged from the hospital. After 6 months, patient was recalled and again 3D CT scan was taken and the volume of remaining bone was measured. Results: The mean volume of the defect pre-operatively is 0.80 cm3 with a standard deviation of 0.36 cm3 with minimum volume of the defect 0.44 cm3 and maximum volume of the defect 1.60 cm3. The mean volume of the bone post-operative immediately after grafting is 1.01 cm3 with a standard deviation of 0.52 cm3 with minimum of bone volume is 0.48 cm3 and maximum of 2.06 cm3. The mean volume of the bone after 6 months after bone grafting is 0.54 cm3 with a standard deviation of 0.33 cm3, minimum bone volume of 0.22 cm3 and maximum bone volume of 1.42 cm3. Conclusion: The CT scan is a valuable radiographic imaging modality to assess and follow the clinical outcome of secondary alveolar bone grafting. PMID:25954076

  8. A RETROSPECTIVE STUDY OF BILATERAL ALVEOLAR BONE GRAFTING

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. To evaluate the treatment results of bilateral alveolar bone grafting (BABG) in patients with bilateral complete clefts of lip and palate.Methods. A retrospective study was performed in 66 bilateral complete cleft lip and palate patients who received the procedure of BABG, among them 15 were primary BABG and 51 were secondary BABG. The patients were further divided into three groups according to age and eruption stage of the canine at the time of surgery. The result of BABG was evaluated on the radiographs. Results. (1)The overall success rate of BABG was 75.0%, with 83.3% and 72.5% for primary and secondary BABG respectively; (2)The marginal bone level was found to be significantly higher in the youngest age group than in the other groups both for primary and secondary BABG; (3)For both primary and secondary BABG, Group C (patients' age more than 16 years) had the least optimal success rate, with 66.7% and 65.4% respectively. Conclusion. Simultaneous primary palate repair and BABG is safe and feasible procedure for treating unoperated bilateral complete cleft lip and cleft palate patients. For both primary and secondary BABG, significantly better results can be achieved if the operation is performed before eruption of the canine.

  9. Alveolar bone grafting in association with polyostotic fibrous dysplasia and bisphosphonate-induced abnormal bone turnover in a bilateral cleft lip and palate patient: a case report.

    Science.gov (United States)

    Kodama, Yasumitsu; Ogose, Akira; Oguri, Yoshimitsu; Ubaidus, Sobhan; Iizuka, Tateyuki; Takagi, Ritsuo

    2012-09-01

    A case is presented of extensive alveolar bone grafting in a patient with bilateral cleft lip and palate and polyostotic fibrous dysplasia. The patient previously underwent bisphosphonate therapy. Because of an abnormal and often decreased bone turnover caused by the fibrous dysplasia and the bisphosphonate therapy, bone grafting in such a patient poses several potential difficulties. In addition, the histomorphometric analysis of the bone grafts showed markedly decreased bone turnover. However, alveolar bone grafting using the iliac crest was performed successfully. Sufficient occlusion was achieved by postoperative low-loading orthodontic treatment.

  10. Establishment of an animal model of a pasteurized bone graft, with a preliminary analysis of muscle coverage or FGF-2 administration to the graft

    Directory of Open Access Journals (Sweden)

    Nakayama Koichi

    2009-08-01

    Full Text Available Abstract Background Pasteurized bone grafting is used following the excision of a bone tumor for the purpose of eliminating neoplastic cells while preserving bone-inducing ability. In the hopes of guaranteeing the most favourable results, the establishment of an animal model has been urgently awaited. In the course of establishing such a model, we made a preliminary examination of the effect of muscle coverage or fibroblast growth factor 2 (FGF-2 administration radiographically. Methods Forty pasteurized intercalary bone grafts of the Wistar rat femur treated at 60°C for 30 min were reimplanted and stabilized with an intramedullary nail (1.1 mm in diameter. Some grafts were not covered by muscle after the implantation, so that they could act as a clinical model for wide resection, and/or these were soaked with FGF-2 solution prior to implantation. The grafts were then divided into 3 groups, comprising 12 grafts with muscle-covering but without FGF-2 (MC+; FGF2-, 12 grafts without muscle-covering and without FGF-2 (MC-; FGF2- and 16 grafts without muscle covering but with FGF-2 (MC-; FGF2+. Results At 2 weeks after grafting, the pasteurized bone model seemed to be successful in terms of eliminating living cells, including osteocytes. At 4 weeks after grafting, partial bone incorporation was observed in half the (MC+; FGF2- cases and in half the (MC-; FGF2+ cases, but not in any of the (MC-; FGF2- cases. At 12 weeks after grafting, bone incorporation was seen in 3 out of 4 in the (MC+; FGF2- group (3/4: 75% and in 3 out of 8 in the (MC-; FGF2+ group (3/8: 38%. However, most of the grafted bones without FGF-2 were absorbed in all the cases, massively, regardless of whether there had been muscle-covering (MC+; FGF2-; 4/4: 100% or no muscle-covering (MC-; FGF2-; 4/4: 100%, while bone absorption was noted at a lower frequency (2/8: 25% and to a lower degree in the (MC-; FGF2+ group. Conclusion In conclusion, we have established an animal pasteurized

  11. Stability of dental implants in grafted bone in the anterior maxilla: longitudinal study.

    LENUS (Irish Health Repository)

    Al-Khaldi, Nasser

    2010-06-06

    We aimed to assess the stability over time of dental implants placed in grafted bone in the maxilla using resonance frequency analysis, and to compare the stability of implants placed in grafted and non-grafted bone. Data were collected from 23 patients (15 test and 8 controls) in whom 64 implants (Brånemark system, Nobel Biocare, Göteborg, Sweden) were placed in accordance with the two-stage surgical protocol. In the test group 36 fixtures were placed in grafted bone, and in the control group 28 fixtures were placed in non-grafted bone. Resonance frequency analysis was used to assess the test sites at implant placement and abutment connection. The mean (SD) implant stability quotient (ISQ) for test sites at the time of implant placement was 61.91 (6.68), indicating excellent primary stability, and was 63.53 (5.76) at abutment connection. ISQ values at abutment connection were similar for test and control sites. Implants placed in grafted bone compared favourably with those in non-grafted bone, and showed excellent stability.

  12. Histologic Evaluation of Critical Size Defect Healing With Natural and Synthetic Bone Grafts in the Pigeon ( Columba livia ) Ulna.

    Science.gov (United States)

    Tunio, Ahmed; Jalila, Abu; Goh, Yong Meng; Shameha-Intan; Shanthi, Ganabadi

    2015-06-01

    Fracture and bone segment loss are major clinical problems in birds. Achieving bone formation and clinical union in a fracture case is important for the survival of the bird. To evaluate the efficacy of bone grafts for defect healing in birds, 2 different bone grafts were investigated in the healing of a bone defect in 24 healthy pigeons ( Columba livia ). In each bird, a 1-cm critical size defect (CSD) was created in the left ulna, and the fracture was stabilized with external skeletal fixation (ESF). A graft of hydroxyapatite (HA) alone (n = 12 birds) or demineralized bone matrix (DBM) combined with HA (n = 12 birds) was implanted in the CSD. The CSD healing was evaluated at 3 endpoints: 3, 6, and 12 weeks after surgery. Four birds were euthanatized at each endpoint from each treatment group, and bone graft healing in the ulna CSD was evaluated by histologic examination. The CSD and graft implants were evaluated for quality of union, cortex development, and bone graft incorporation. Results showed no graft rejection in any bird, and all birds had connective tissue formation in the defect because of the bone graft application. These results suggest that bone defect healing can be achieved by a combination of osteoinductive and osteoconductive bone graft materials for clinical union and new bone regeneration in birds. The combination of DBM and HA resulted in a better quality bone graft (P < .05) than did HA alone, but there was no significant differences in cortex development or bone graft incorporation at 3, 6, or 12 weeks. From the results of this study, we conclude that HA bone grafts, alone or in combination with DBM, with external skeletal fixation is suitable and safe for bone defect and fracture treatment in pigeons.

  13. Use of Nasal Septal Bone for Septal Extension Graft after Jaw Surgery

    Directory of Open Access Journals (Sweden)

    Gui Rak Kim, MD

    2013-11-01

    Conclusions: Use of septal bone for septal extension graft may serve as a valuable option in septal cartilage–depleted patients. It gives a strong construct for tip surgery with patient satisfaction.

  14. Cemented total hip arthroplasty with impacted morcellized bone-grafts to restore acetabular bone defects in congenital hip dysplasia.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Melenhorst, J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2001-01-01

    We evaluated the results of 27 acetabular reconstructions in 21 patients with secondary osteoarthritis resulting from congenital dysplasia of the hip in which the acetabular bone defects were restored with impacted morcellized bone-grafts in combination with a cemented cup. At an average follow-up o

  15. Experimental posterolateral spinal fusion with beta tricalcium phosphate ceramic and bone marrow aspirate composite graft

    OpenAIRE

    Gupta Ankit; Chauhan Vijendra; Chauhan Neena; Sharma Sansar; Maheshwari Rajesh; Agarwal Atul

    2010-01-01

    Background: Beta tricalcium phosphate is commonly used in metaphyseal defects but its use in posterolateral spinal fusion remains controversial. There are very few published animal studies in which use of beta tricalcium phosphate has been evaluated in the posterolateral lumbar arthrodesis model. Hence we conducted a study to evaluate the potential of composite graft of beta tricalcium phosphate and bone marrow aspirate in comparison to autologous bone graft, when used for posterolateral spin...

  16. Osseous and dental outcomes of primary gingivoperiosteoplasty with iliac bone graft: A radiological evaluation.

    Science.gov (United States)

    Touzet-Roumazeille, Sandrine; Vi-Fane, Brigitte; Kadlub, Natacha; Genin, Michaël; Dissaux, Caroline; Raoul, Gwenaël; Ferri, Joël; Vazquez, Marie-Paule; Picard, Arnaud

    2015-07-01

    Primary alveolar cleft repair has two main purposes: to restore normal morphology and normal function. Gingivoperiosteoplasty with bone grafting in mixed dentition has been a well-established procedure. We hypothesized that 1) performance of this surgery in deciduous dentition would provide favorable bone graft osseointegration, and 2) would improve the support of incisor teeth eruption, thereby avoiding maxillary growth disturbances. We conducted a retrospective study of clinical and tridimensional radiological data for 73 patients with alveolar clefts (with or without lip and palate clefts) who underwent gingivoperiosteoplasty with iliac bone graft in deciduous dentition. Pre- and post-operative Cone Beam Computed Tomography (CBCT) comparison allowed evaluation of the ratio between bone graft volume and initial cleft volume (BGV/ICV ratio), and measurement of central incisor teeth movements. This series of 73 patients included 44 males and 29 females, with a mean age of 5.5 years. Few complications were observed. Post-operative CBCT was performed at 7.4 months. The mean BGV/ICV ratio was 0.62. Axial rotation was significantly improved post-operatively (p = 0.004). Gingivoperiosteoplasty with iliac bone graft is safe when performed in deciduous dentition and results in a sufficient bone graft volume to support lateral incisor eruption and upper central incisor tooth position improvement.

  17. Bone grafting, corticotomy, and orthodontics: treatment of cleft alveolus in a chinese cohort.

    Science.gov (United States)

    Mao, Li-Xia; Shen, Guo-Fang; Fang, Bing; Xia, Yun-Hui; Ma, Xu-Hui; Wang, Bo

    2013-11-01

    Objective : A multimodal therapy was applied to solve a set of related problems including collapse of the posterior segment, high level gingival margin of canine, and resorption of grafted bone in a cohort of Chinese youngsters with cleft lip and palate. This study aimed to evaluate the benefits of this treatment procedure. Methods : Thirty patients with unilateral cleft lip and palate were included in this prospective study. All patients had previously undergone only cleft lip and palate repair and presented with alveolar cleft and an obvious step in the gingival margin between the canine tooth and the teeth beside it. A multimodal therapy that included bone grafting, corticotomy, and orthodontics was applied to solve these problems. Grafted bone volume, parallelism of the roots, root resorption, gingival margin, and mobility of the canine on the cleft side were established before surgery, 1 week after surgery, and after straightening of the canine. Results : Less than 25% of the grafted bone was reabsorbed in 25 of the 30 patients, while less than 50% was resorbed in the remaining five. The roots of the canines on the cleft side were mostly parallel to the adjacent teeth. Root resorption and mobility of the canines were slight. The difference in the gingival margin between the canines on the cleft side and the other side was small. Conclusions : Canines moved into the grafted bone safely and effectively, thus achieving a normal gingival margin and retaining grafted bone volume in one operation. PMID:22849663

  18. Handling of the bone long pseudoarthrosis with autologo structural bone graft in failure osteosynthesis

    International Nuclear Information System (INIS)

    We find in the literature that the usual way to treat pseudoarthrosis always includes the removal of the material used to stabilize the fractures, with bring along high hospital and social costs for the patient and the family. The treatment we purpose is the appliance of an autologo structural iliac bone graft, trapezoid form, throughout a minimal incision into the lesion. We treated 12 patients that included 14 long bones in a two year period, age range of 23,2 y 12 (86%) patients with femur pseudoarthrosis, 1 (7%) with tibia y 1 (7%) humerus. we obtained 100% consolidation at 5 months after surgery. no complications reported from the patients, and an important reduce in hospital and social costs

  19. Bone graft substitutes and bone morphogenetic proteins for osteoporotic fractures: what is the evidence?

    Science.gov (United States)

    Van Lieshout, Esther M M; Alt, Volker

    2016-01-01

    Despite improvements in implants and surgical techniques, osteoporotic fractures remain challenging to treat. Among other major risk factors, decreased expression of morphogenetic proteins has been identified for impaired fracture healing in osteoporosis. Bone grafts or bone graft substitutes are often used for stabilizing the implant and for providing a scaffold for ingrowth of new bone. Both synthetic and naturally occurring biomaterials are available. Products generally contain hydroxyapatite, tricalcium phosphate, dicalcium phosphate, calcium phosphate cement, calcium sulfate (plaster of Paris), or combinations of the above. Products have been used for the treatment of osteoporotic fractures of the proximal humerus, distal radius, vertebra, hip, and tibia plateau. Although there is generally consensus that screw augmentation increased the biomechanical properties and implant stability, the results of using these products for void filling are not unequivocal. In osteoporotic patients, Bone Morphogenetic Proteins (BMPs) have the potential impact to improve fracture healing by augmenting the impaired molecular and cellular mechanisms. However, the clinical evidence on the use of BMPs in patients with osteoporotic fractures is poor as there are no published clinical trials, case series or case studies. Even pre-clinical literature on in vitro and in vivo data is weak as most articles focus on the beneficial role for BMPs for restoration of the underlying pathophysiological factors of osteoporosis but do not look at the specific effects on osteoporotic fracture healing. Limited data on animal experiments suggest stimulation of fracture healing in ovariectomized rats by the use of BMPs. In conclusion, there is only limited data on the clinical relevance and optimal indications for the use of bone graft substitute materials and BMPs on the treatment of osteoporotic fractures despite the clinical benefits of these materials in other clinical indications. Given the

  20. Surgical treatment of multifocal giant cell tumor of carpal bones with preservation of wrist function: case report.

    Science.gov (United States)

    Tarng, Yih-Wen; Yang, Shan-Wei; Hsu, Chien-Jen

    2009-02-01

    We report a rare case of multifocal giant cell tumor of bone involving the trapezium, trapezoid, capitate, and scaphoid with soft tissue extension. Following intralesional resection, an autogenous corticocancellous iliac crest bone graft was used to fill the resultant defect and preserve carpal height and radiocarpal motion. Successful union with no recurrence was noted at 1-year follow-up.

  1. "Percutaneous bone marrow grafting of fracture (An experimental study in rabbits "

    Directory of Open Access Journals (Sweden)

    Motamedi M

    2003-05-01

    Full Text Available Since bone marrow has been shown to contain osteoprogenitor cells, an experiment was devised to test its effects when injected percutaneously into osteotomies sites in rabbit radii. In this experimental study, the osteogenicity and its effect on early bone repair of bone marrow grafts were investigated. The purpose of this study was to determine whether bone marrow grafted percutaneously led to increased bone production or had any effect on the early healing of fractures. The parameters tested included, cross-sectional area of callus (XS, breaking load (BL, tensile strength (TS and callus volume (CV at the fracture site. At two weeks post grafting four parameters, specially callus volume, were significantly higher 0.001

  2. Successful treatment of a humeral capitulum osteonecrosis with bone morphogenetic protein-7 combined with autologous bone grafting

    OpenAIRE

    Marsell, Richard; Hailer, Nils P

    2014-01-01

    We present the case of a 27-year-old female with subcortical osteonecrosis of the humeral capitulum. Percutaneous retrograde drilling of the lesion and application of recombinant human bone morphogenetic protein (BMP)-7 were combined with autologous bone grafting. At follow-up the patient was almost pain-free, had normalized her range of motion, and radiography showed consolidation of the lesion without any heterotopic bone formation. By timing surgery prior to subchondral collapse, biomechan...

  3. Treatment of the benign bone tumors including femoral neck lesion using compression hip screw and synthetic bone graft

    OpenAIRE

    Nakamura Tomoki; Matsumine Akihiko; Asanuma Kunihiro; Matsubara Takao; Sudo Akihiro

    2015-01-01

    Purpose: The proximal femur is one of the most common locations for benign bone tumors and tumor like conditions. We describe the clinical outcomes of the surgical treatment of benign lesions of the proximal femur including femoral neck using compression hip screw and synthetic bone graft. Methods: Thirteen patients with benign bone tumors or tumor like conditions of the proximal femur including femoral neck were surgically treated. Their average age at the time of presentatio...

  4. Incompatible SLA bone marrow graft in the pig after fractionated irradiation and administration of cyclosporin A

    International Nuclear Information System (INIS)

    A series of fractionated partial irradiations which consisted of either 3 gray x 6 times or 3 gray x 4 times, combined with pharmacological immunosuppression (Cyclosporin A: Cs-A) ensure a SLA semidifferent bone marrow graft in the pig. Bone marrow and peripheral blood lymphocytes chimerism was readily detectable. No graft versus host disease (GVHD) symptoms were noticed as long as Cs-A was given at a sufficient dose. However when Cs-A treatment was stopped GVHD or rejection of the graft developed rapidly

  5. 钛网结合异体骨移植联合人骨形成蛋白与自体骨移植在种植前牙槽嵴骨增量中的应用对比%Comparison of Application of Titanium Mesh Combined with Allograft Combined with Human Bone Morphogenetic Protein and Autogenous Bone Transplantation in Alveolar Bone Augmentation

    Institute of Scientific and Technical Information of China (English)

    崔延军; 王红光; 程汇

    2015-01-01

    Objective To compare the application of titanium mesh combined with allograft combined with human bone morphogenetic protein and autogenous bone transplantation in alveolar bone augmentation.Methods A total of 46 cases receiving anterior implant plus alveolar bone increment admitted to Tianmen City First People′s Hospital from Jan.2008 to Dec.2011 were randomly divided into two groups according to random-number table method,group A(n =23) using titanium mesh combined with allograft combined with human bone morphogenetic protein,while group B (n =23) using autogenous bone graft.The alveolar ridge width,the incremental effects and postoperative bone implant stability were compared before and after surgery.Results Postoperative average alveolar ridge width of group A was significantly higher than that of group B [(6.9 ±0.5) mm vs (5.6 ±0.3) mm,P <0.01]; the cure rate of group A was 94.1%,of group B was 60.0%,and the clinical efficacy of group A was better than group B with statistically significant difference (P <0.05); no-loosening rate after 4 months implant was 91.2% in group A,50.6% in group B,the sta-bility of group A was much better than group B,with statistically significant difference(P <0.05).Conclu-sion Titanium mesh combined with allogeneic bone graft combined with human bone morphogenetic protein can significantly increase patient alveolar bone mass and help to stabilize the implant after surgery .%目的:比较钛网结合异体骨移植联合人骨形成蛋白与自体骨移植在种植前牙槽嵴骨增量中的应用效果。方法将2008年1月至2011年12月天门市第一人民医院收治的46例前牙种植并行牙槽嵴骨增量的患者依据随机数字表法分为两组:A 组23例,采用钛网结合异体骨移植联合人骨形成蛋白的方法;B 组23例,采用自体骨移植的方法。比较两组患者手术前后牙槽嵴宽度、骨增量效果及术后种植体稳定性。结果术后 A 组牙槽嵴

  6. Experience of using vascularized bone grafts in reconstructive surgery of the upper limbs

    Science.gov (United States)

    Atamanov, E. A.; Keosyan, V. T.; Bryukhanov, A. V.; Tsaregorodtseva, E. M.; Danilov, A. V.

    2015-11-01

    The article describes the results of treatment patients with defects and diseases of bone tissue using bone grafting with vascularized bone grafts from different areas of the body. The results of treatment of 27 patients with bone tissue defects of the upper extremities are demonstrated. 16 of patients had scaphoid nonunion. 2 cases of nonunion were reported: one scaphoid nonunion due to unstable osteosynthesis and one lunate fragmentation nonunion in patient with late stage Kienbock`s disease. Vascularized bone graft from distal radius was used in both cases. We had two cases of delayed union at 18 months in surgical treatment of scaphoid. 2 patients had metacarpal bone defect, 1 patient with radius bone defect, 2 patients with SLAC (scapholunate advanced collapse), 2 patients with bone defect of the humerus, 1 patient with bone defect of the ulna. In all cases we used vascularized bone crafts from various anatomical areas. We achieved union in all other cases. The study shows high efficiency of upper extremity bone defect replacement methods.

  7. Treatment of oroantral fistula with autologous bone graft and application of a non-reabsorbable membrane

    Directory of Open Access Journals (Sweden)

    Adele Scattarella, Andrea Ballini, Felice Roberto Grassi, Andrea Carbonara, Francesco Ciccolella, Angela Dituri, Gianna Maria Nardi, Stefania Cantore, Francesco Pettini

    2010-01-01

    Full Text Available Aim: The aim of the current report is to illustrate an alternative technique for the treatment of oroantral fistula (OAF, using an autologous bone graft integrated by xenologous particulate bone graft.Background: Acute and chronic oroantral communications (OAC, OAF can occur as a result of inadequate treatment. In fact surgical procedures into the maxillary posterior area can lead to inadvertent communication with the maxillary sinus. Spontaneous healing can occur in defects smaller than 3 mm while larger communications should be treated without delay, in order to avoid sinusitis. The most used techniques for the treatment of OAF involve buccal flap, palatal rotation - advancement flap, Bichat fat pad. All these surgical procedures are connected with a significant risk of morbidity of the donor site, infections, avascular flap necrosis, impossibility to repeat the surgical technique after clinical failure, and patient discomfort.Case presentation: We report a 65-years-old female patient who came to our attention for the presence of an OAF and was treated using an autologous bone graft integrated by xenologous particulate bone graft. An expanded polytetrafluoroethylene titanium-reinforced membrane (Gore-Tex ® was used in order to obtain an optimal reconstruction of soft tissues and to assure the preservation of the bone graft from epithelial connection.Conclusions: This surgical procedure showed a good stability of the bone grafts, with a complete resolution of the OAF, optimal management of complications, including patient discomfort, and good regeneration of soft tissues.Clinical significance: The principal advantage of the use of autologous bone graft with an expanded polytetrafluoroethylene titanium-reinforced membrane (Gore-Tex ® to guide the bone regeneration is that it assures a predictable healing and allows a possible following implant-prosthetic rehabilitation.

  8. Tooth Movement out of the Bony Wall Using Augmented Corticotomy with Nonautogenous Graft Materials for Bone Regeneration

    OpenAIRE

    Kye-Bok Lee; Dong-Yeol Lee; Hyo-Won Ahn; Seong-Hun Kim; Eun-Cheol Kim; Igor Roitman

    2014-01-01

    This prospective randomized split-mouth study was performed to compare the effects of augmented corticotomy with those of different nonautogenous bone graft materials combined with orthodontic tooth movement in dogs. Decortication was performed on the buccal bone surface of 6 male beagle dogs that were randomly assigned to receive grafts of deproteinized bovine bone mineral, irradiated cortical bone, or synthetic bone. Immediate orthodontic force was applied to the second and third premolars ...

  9. Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis

    Directory of Open Access Journals (Sweden)

    T. A. G. van Vugt

    2016-01-01

    Full Text Available Osteomyelitis is a common occurrence in orthopaedic surgery, which is caused by different bacteria. Treatment of osteomyelitis patients aims to eradicate infection by debridement surgery and local and systemic antibiotic therapy. Local treatment increases success rates and can be performed with different antimicrobial bone graft substitutes. This review is performed to assess the level of evidence of synthetic bone graft substitutes in osteomyelitis treatment. According to the PRISMA statement for reporting systematic reviews, different types of clinical studies concerning treatment of osteomyelitis with bone graft substitutes are included. These studies are assessed on their methodological quality as level of evidence and bias and their clinical outcomes as eradication of infection. In the fifteen included studies, the levels of evidence were weak and in ten out of the fifteen studies there was a moderate to high risk of bias. However, first results of the eradication of infection in these studies showed promising results with their relatively high success rates and low complication rates. Due to the low levels of evidence and high risks of bias of the included studies, these results are inconclusive and no conclusions regarding the performed clinical studies of osteomyelitis treatment with antimicrobial bone graft substitutes can be drawn.

  10. Onlay Rib Bone Graft in Elevation of Reconstructed Auricle: 17 Years of Experience

    Directory of Open Access Journals (Sweden)

    Taehoon Kim

    2013-05-01

    Full Text Available Background  A cartilage wedge block and covering flap are standard procedures for firmelevation of the ear in microtia correction. However, using costal cartilage for elevation ofthe reconstructed auricle can be insufficient, and the fixed cartilage wedge block may beabsorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and usesup fascia, a potential source of reconstruction material. Therefore, we propose an innovativemethod using autologous onlay rib bone graftfor auricular elevation ofmicrotia.Methods  From February 1995 to August 2012, 77 patients received a first stage operationwith a rib cartilage framework graft. In the second stage operation, a small full thickness ofrib bone was harvested through the previous donor scar. The bihalved rib bone was insertedinto the subperiosteal pocket beneath the cartilage framework.Results  The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. Allof the patients sustained the elevation of their ears very well during the follow-up period.Donorsite problems, exceptfor hypertrophic scars,were not observed. Surgery-related complications,specifically skin necrosis, infection, or hematoma, occurred in 4 cases.Conclusions  Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate materialthan cartilage, due to the bone-to-bone contact between thebone graft and the temporal bone. Postoperative minor correction of the elevation degree isstraightforward and the skin graft survives better. Therefore, reconstructed auricle elevationusing onlay rib bone graftis a useful and valuablemethod.

  11. Minimally invasive harvest of a quadriceps tendon graft with or without a bone block.

    Science.gov (United States)

    Fink, Christian; Herbort, Mirco; Abermann, Elisabeth; Hoser, Christian

    2014-08-01

    The quadriceps tendon (QT) as a graft source for anterior cruciate ligament (ACL) and posterior cruciate ligament reconstruction has recently achieved increased attention. Although many knee surgeons have been using the QT as a graft for ACL revision surgery, it has never gained universal acceptance for primary ACL reconstruction. The QT is a very versatile graft that can be harvested in different widths, thicknesses, and lengths. Conventionally, the QT graft is harvested by an open technique, requiring a 6 to 8 cm longitudinal incision, which often leads to unpleasant scars. We describe a new, minimally invasive, standardized approach in which the QT graft can be harvested through a 2- to 3-cm skin incision and a new option of using the graft without a bone block. PMID:25264512

  12. Ordinary and Activated Bone Grafts: Applied Classification and the Main Features

    Directory of Open Access Journals (Sweden)

    R. V. Deev

    2015-01-01

    Full Text Available Bone grafts are medical devices that are in high demand in clinical practice for substitution of bone defects and recovery of atrophic bone regions. Based on the analysis of the modern groups of bone grafts, the particularities of their composition, the mechanisms of their biological effects, and their therapeutic indications, applicable classification was proposed that separates the bone substitutes into “ordinary” and “activated.” The main differential criterion is the presence of biologically active components in the material that are standardized by qualitative and quantitative parameters: growth factors, cells, or gene constructions encoding growth factors. The pronounced osteoinductive and (or osteogenic properties of activated osteoplastic materials allow drawing upon their efficacy in the substitution of large bone defects.

  13. Secondary Alveolar Bone Grafting and Iliac Cancellous Bone Harvesting for Patients With Alveolar Cleft.

    Science.gov (United States)

    Pan, Weiyi; Wu, Chenzhou; Yang, Zheng; Duan, Zexi; Su, Zhifei; Wang, Peiqi; Zheng, Qian; Li, Chunjie

    2016-06-01

    To assess the efficacy of present interventions optimizing the result of secondary alveolar bone grafting (SABG) and the interventions alleviating the donor site morbidity after iliac cancellous bone harvesting. Researches were identified by searching the electronic database of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Chinese BioMedical Literature Database, and the China National Knowledge Infrastructure. In addition, relevant journals and references of the included studies were searched manually. The Oxford 2011 Levels of Evidence were applied to assess the methodological quality of selected studies, and the best evidence synthesis system was applied afterward to measure the strength of evidence. As a result, 42 studies were considered eligible and included, among which 4 were of high quality while 38 were of low quality. Thirty lines of evidences were acquired after the synthesis, among which 13 were rated as moderate while 17 were rated as insufficient. As for the interventions optimizing the result of SABG, moderate evidence confirmed the efficacy of preoperative orthodontic treatment, the superiority of performing SABG before the eruption of canine, and the accuracy of cone beam computed tomography in preoperative estimation of the cleft volume. As for the interventions alleviating the morbidity of iliac cancellous bone harvesting, moderate evidence confirmed the treatment benefit of the interventions below: minimally invasive technique, including trephine and Shepard osteotomy; preemptive analgesia, including continuous bupivacaine infusion or transversus abdominis plane block. As for the rest interventions, only insufficient evidence was found. PMID:27244214

  14. Bone grafting versus distraction osteogenesis in pre-implant surgery. Literature review

    Directory of Open Access Journals (Sweden)

    Fotios TZERMPOS

    2013-08-01

    Full Text Available Nowadays there is an increasing demand for implant-supported prosthetic rehabilitation of the edentulous ridges. However problems occur regarding adequate bone support for implants. Loss of alveolar bone may be gradual due to age resorption or due to previous local pathology. Alveolar bone augmentation may be achieved by using a variety of different techniques.The aim of the present paper is to compare two methods for bone augmentation: distraction osteogenesis and bone grafting. Advantages and disadvantages of each one are presented and discussed together with their ability to reconstruct the deficient edentulous ridges with ultimate purpose the placement of implants upported prostheses.

  15. Two-Stage Revision Anterior Cruciate Ligament Reconstruction: Bone Grafting Technique Using an Allograft Bone Matrix.

    Science.gov (United States)

    Chahla, Jorge; Dean, Chase S; Cram, Tyler R; Civitarese, David; O'Brien, Luke; Moulton, Samuel G; LaPrade, Robert F

    2016-02-01

    Outcomes of primary anterior cruciate ligament (ACL) reconstruction have been reported to be far superior to those of revision reconstruction. However, as the incidence of ACL reconstruction is rapidly increasing, so is the number of failures. The subsequent need for revision ACL reconstruction is estimated to occur in up to 13,000 patients each year in the United States. Revision ACL reconstruction can be performed in one or two stages. A two-stage approach is recommended in cases of improper placement of the original tunnels or in cases of unacceptable tunnel enlargement. The aim of this study was to describe the technique for allograft ACL tunnel bone grafting in patients requiring a two-stage revision ACL reconstruction.

  16. Two-Stage Revision Anterior Cruciate Ligament Reconstruction: Bone Grafting Technique Using an Allograft Bone Matrix.

    Science.gov (United States)

    Chahla, Jorge; Dean, Chase S; Cram, Tyler R; Civitarese, David; O'Brien, Luke; Moulton, Samuel G; LaPrade, Robert F

    2016-02-01

    Outcomes of primary anterior cruciate ligament (ACL) reconstruction have been reported to be far superior to those of revision reconstruction. However, as the incidence of ACL reconstruction is rapidly increasing, so is the number of failures. The subsequent need for revision ACL reconstruction is estimated to occur in up to 13,000 patients each year in the United States. Revision ACL reconstruction can be performed in one or two stages. A two-stage approach is recommended in cases of improper placement of the original tunnels or in cases of unacceptable tunnel enlargement. The aim of this study was to describe the technique for allograft ACL tunnel bone grafting in patients requiring a two-stage revision ACL reconstruction. PMID:27274452

  17. Immobilization of a bone and cartilage stimulating peptide to a synthetic bone graft.

    Science.gov (United States)

    Wang, Vivian; Misra, Gauri; Amsden, Brian

    2008-05-01

    A synthetic peptide fragment of human collagen type I (BCSP-1) was linked to the surface of a commercially available ceramic in an effort to improve the properties of the bone graft substitute to accelerate local healing. BCSP-1 was covalently immobilized on the surface of the ceramic via the linkers 3-aminopropyl-triethoxysilane (APTES) and suberic acid bis-N-hydroxysuccinimide ester (DSS). The chosen chemistry was non-cytotoxic. A rat calvaria cell assay using alkaline phosphatase (ALP) as an osteoblast differentiation marker, showed that modifying the surface of the ceramic was enough to enhance ALP activity, although the total cell population on the surface decreased. A significant increase in ALP activity/cell was noted with serum albumin bound to the surface, however, the BCSP-1 bound surface exhibited an even greater ALP activity that showed a surface concentration dependent trend. An optimal BCSP-1 surface density in the range of 0.87-2.24 nmol/cm2 elicited the maximum ALP activity/cell at day 6 of culture. The peptide bound ceramic generated an ALP activity/cell that was roughly 3-fold higher than the non-modified ceramic and 2-fold higher than the APTES-grafted ceramic. PMID:18030432

  18. Clinical evaluation of bone- patellar tendon- bone grafts for anterior cruciate ligament injury

    International Nuclear Information System (INIS)

    One thousand and thirty-eight cases of Anterior Cruciate Ligament (ACL) rupture were treated between January 2002 and November 2010. Eight hundred sixty-six cases (83.9%) were observed for at least six months. All cases were reconstructed with a bone to tendon to bone (BTB) graft from the patella. Much effort was made to return the patient to a competitive sports activity level within one year. The age at suffering from the initial injury ranged from 9 to 74 years old with a mean of 24.7 years old. There were 493 female (50.7%) and 427 male (49.3%) cases. The injured side was right in 408 cases and left in 458 cases. The mean postoperative observation period was 449.2 days. The number of patients who felt 80% or more certain that they could return to competitive sports activities was 538 (61.9%). From the MRI findings, continuity of the reconstructed graft was observed in 793 cases (98.5%). Arthroscopy after reconstruction was performed in 775 cases (89.5%). The reconstructed ACL was observed to be covered with an adequate synovium in 629 cases (81.2%). The medial meniscus and lateral meniscus showed no changes in 657 cases (84.8%) and 666 cases (85.9%) respectively. Reconstructions performed less than two weeks after injury showed no significant differences in terms of Range Of Motion (ROM), arthroscopic findings, or the number of patients who could return to competitive sports activities. Statistically significantly more patients who underwent their reconstruction at an age over forty experienced a loss motion of five degree in extension or ten degree in flexion and resumed a lower level of sports activities. Patients who underwent the reconstruction could return to exercises for muscle strengthening and ROMs within 2 weeks. Patients over forty years old who underwent their reconstruction could prevent their menisci from fraying, tearing, or undergoing osteoarthritic changes. (author)

  19. Randomized controlled analysis-autogenous bone peg graft improved offset hemiarthroplasty in high risk patients: a novel cost effective technique

    OpenAIRE

    Hashmukh Shantilal Varma; Sachin Upadhyay; Nuthan Jagadeesh

    2016-01-01

    Background: Femoral neck fractures in elderly with comorbidities are a serious and increasing challenge. Surgery remains the mainstay of treatment for early rehabilitation. In present Indian scenario, the two major factors that drive our strategy for treatment are affordability and use of cemented prosthesis in high risk patients. The primary objective is to develop a technique that not only maintains the hip biomechanics after arthroplasty but also cost-effective. Methods: Fifty high ris...

  20. Recombinant human bone morphogenetic protein-2 in debridement and impacted bone graft for the treatment of femoral head osteonecrosis.

    Directory of Open Access Journals (Sweden)

    Wei Sun

    Full Text Available The purpose of this study was to compare the clinical outcomes of impacted bone graft with or without recombinant human bone morphogenetic protein-2 (rhBMP-2 for osteonecrosis of the femoral head (ONFH. We examined the effect of bone-grafting through a window at the femoral head-neck junction, known as the "light bulb" approach, for the treatment of ONFH with a combination of artificial bone (Novobone mixed with or without rhBMP-2. A total of 42 patients (72 hips were followed-up from 5 to 7.67 years (average of 6.1 years. The patients with and without BMP were the first group (IBG+rhBMP-2 and the second group (IBG, respectively. The clinical effectiveness was evaluated by Harris hip score (HHS. The radiographic follow-up was evaluated by pre-and postoperative X-ray and CT scan. Excellent, good, and fair functions were obtained in 36, 12, and 7 hips, respectively. The survival rate was 81.8% and 71.8% in the first and second group, respectively. However, the survival rate was 90.3% in ARCO stage IIb, c, and only 34.6% in ARCO stage IIIa (P<0.05. It was concluded that good and excellent mid-term follow-up could be achieved in selected patients with ONFH treated with impacted bone graft operation. The rhBMP-2 might improve the clinical efficacy and quality of bone repair.

  1. Sacral Fracture Nonunion Treated by Bone Grafting through a Posterior Approach

    Directory of Open Access Journals (Sweden)

    Sang Yang Lee

    2013-01-01

    Full Text Available Nonunion of a sacral fracture is a rare but serious clinical condition which can cause severe chronic pain, discomfort while sitting, and significant restriction of the level of activities. Fracture nonunions reportedly occur most often after nonoperative initial treatment or inappropriate operative treatment. We report a case of fracture nonunion of the sacrum and pubic rami that resulted from non-operative initial treatment, which was treated successfully using bone grafting through a posterior approach and CT-guided percutaneous iliosacral screw fixation combined with anterior external fixation. Although autologous bone grafting has been the gold standard for the treatment of pelvic fracture nonunions, little has been written describing the approach. We utilized a posterior approach for bone grafting, which could allow direct visualization of the nonunion site and preclude nerve root injury. By this procedure, we were able to obtain the healing of fracture nonunion, leading to pain relief and functional recovery.

  2. A comparative study of calcium sulfate artificial bone graft versus allograft in the reconstruction of bone defect after tumor curettage

    Institute of Scientific and Technical Information of China (English)

    Yang Yongkun; Niu Xiaohui; Zhang Qing; Hao Lin; Ding Yi; Xu Hairong

    2014-01-01

    Background Cavity reconstruction after benign bone tumor removal is varied and controversial.AIIograft is widely used but is associated with complications.New bone substitutes,such as calcium sulfate artificial bone,have been introduced for bone tumor operation.However,the bone healing response of artificial bone has not been compared with allograft bone.We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors.Methods We retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction.The two groups were well matched.The mean follow-up time of the study group was 19.9 (12-55) months.We investigated bone healing response,complications,and factors affecting bone healing.Results At the last follow-up,84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P=0.013).The initial healing rate showed no significant difference between the two groups (100% vs.96%,P=0.153).The mean healing times for calcium sulfate and allograft bone were 9.6 (3-42) months and 13.8 (3-36) months,respectively (P <0.01).Complications in the study group were minor and resolved.Implant volume was a significant factor affecting bone healing.Conclusion The calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage,especially in smaller cavities.

  3. Different bone regeneration patterns in periimplant circumferential gap defects grafted with two types of osteoconductive biomaterial.

    Science.gov (United States)

    Lee, Jung-Seok; Sohn, Joo-Yeon; Lim, Hyun-Chang; Jung, Ui-Won; Choi, Seong-Ho

    2016-08-01

    This study aimed to determine healing patterns in periimplant gap defect grafted with demineralized bovine bone mineral (DBBM) and porous titanium granules (PTG), which are known to induce a minimal tissue reaction and to undergo minimal biodegradation in healing process. Experiments were performed using a standardized periimplant gap-defect model in dogs with two observational periods: 4 and 8 weeks. Circumferential defects were surgically induced around dental implants on unilateral mandibles in five dogs, and collagen barrier membranes were placed over the DBBM and PTG grafts at two experimental sites and over a nongrafted site. Four weeks later, the same procedures were performed on the contralateral mandible, and the animals allowed to heal for a further 4 weeks, after which they were sacrificed and their mandibles with graft/control sites harvested for histologic evaluation. Both types of grafted biomaterials significantly enhanced the defect fill with newly formed bone, but the bone-to-implant contact (BIC) was significantly increased only at sites that had been grafted with DBBM. The two experimental sites exhibited different healing patterns, with new bone formation being observed on the surface of the DBBM particles throughout the defect, while there was no de novo bone formation on the PTG surface, but rather appositional bone growth from the base and lateral walls of the defect. It has been suggested that gap-defect filling with DBBM around dental implants may enhance both BIC and defect fill; however, the present findings show that defect grafting with PTG enhances only defect fill and not BIC. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1202-1209, 2016. PMID:26087247

  4. Long-term outcome of secondary alveolar bone grafting in cleft lip and palate patients

    DEFF Research Database (Denmark)

    Meyer, Steffen; Pedersen, Kirsten Mølsted

    2013-01-01

    The objective was to assess the long-term outcome of secondary alveolar bone grafting (SABG) in cleft lip and palate patients and to examine relationships between preoperative and postoperative factors and overall long-term bone graft success. The records of 97 patients with cleft lip and palate......, who had secondary alveolar bone grafting of 123 alveolar clefts, were examined. Interalveolar bone height was assessed radiographically a minimum of 10 years after grafting using a 4-point scale (I-IV), where types I and II were considered a success. After an average follow-up of 16 years after SABG...... (range = 10.2-22.7 years), 101 of the 123 grafts (82%) were categorised as successes. Mean age in the success group was 12.1 years and 13.6 years in the failure group (p = 0.03). It was found that the success rate was significantly lower (p = 0.02) if SABG was performed after eruption of the tooth distal...

  5. No effect of bone morphogenetic protein-7 (OP-1) on the incorporation of impacted bone grafts in a realistic acetabular model.

    NARCIS (Netherlands)

    Buma, P.; Arts, J.J.C.; Gardeniers, J.W.M.; Verdonschot, N.J.J.; Schreurs, B.W.

    2008-01-01

    Bone morphogenetic proteins (BMPs) accelerate bone repair in experimental and clinical conditions. Impacted Morsellized Cancellous Bone grafts (MCB) are successfully used to reconstruct bone defects after failed hip implants. The main question in this study was if BMP-7 (OP-1) mixed with MCB could a

  6. Evaluation of laser photobiomodulation on healing of bone defects grafted with bovine bone in diabetic rats

    Science.gov (United States)

    Paraguassú, Gardênia Matos; da Costa Lino, Maíra Doria Martinez; de Carvalho, Fabíola Bastos; Cangussu, Maria Cristina; Pinheiro, Antônio Luiz Barbosa; Ramalho, Luciana Maria Pedreira

    2012-09-01

    Previous studies have shown positive effects of Low Level Laser Therapy (LLLT) on the repair of bone defects, but there is a few that associates bone healing in the presence of a metabolic disorder such as Diabetes Mellitus, a systemic disorder associated to impair of the repair of different tissues. The aim of this study was to assess, histologically, the repair of surgical defects created in the femur of diabetic and non-diabetic rats treated or not with LLLT (λ780nm, 70mW, CW, o/˜0.4mm, 16J/cm2 per session) associated or not to the use of a biomaterial. Surgical tibial bone defects were created in 60 animals that were divided into 4 groups: Group B (non-diabetic + biomaterial); Group BL (non-diabetic + biomaterial + LLLT); Group BD (diabetic + biomaterial); Group BDL (diabetic + biomaterial + LLLT). The irradiated group received 16 J/cm2 per session divided into 4 points around the defect, being the first irradiation carried out immediately after surgery and repeated every 48h for 14 days. The animals were killed 15, 21 and 30 days after surgery. The specimens underwent a semi-quantitative analysis. The results showed inflammation more intense in the BD and BDL groups than in the B and BL groups in the period of 15 days (p = 0.02), however the cortical repair in the BDL group was below 25% in more than half of the specimens, while in the BD group, the repair was more than to 25% in all specimens. At 30 days, both osteoblastic activity and collagen deposition were significantly higher in the B group when compared to the BD group (p=0.04). Bone deposition was significantly higher in the BL group (p=0.023) than in BDL group. It is concluded that LLLT has a positive biomodulative effect in the early stages of the healing process of bone defects grafted with biomaterial in diabetic and non-diabetic rats.

  7. Fresh-frozen bone: case series of a new grafting material for sinus lift and immediate implants.

    LENUS (Irish Health Repository)

    Viscioni, A

    2010-08-01

    Although autologous bone is considered to be the gold standard grafting material, it needs to be harvested from patients, a process that can be off-putting and can lead to donor site morbidity. For this reason, homologous fresh-frozen bone (FFB) was used in the current study as an alternative graft material.

  8. USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY

    Science.gov (United States)

    Roos, Milton Valdomiro; Roos, Bruno Dutra; Giora, Taís Stedile Busin; Taglietti, Thiago Martins

    2015-01-01

    To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical structural homologous bone graft and cemented implants, between June 1999 and February 2008. Of these, 21 fulfilled all the criteria required for this study. The patients underwent pre and postoperative clinical assessments using the Harris Hip Score. Preoperative, immediate postoperative and late postoperative radiographs were also evaluated, with comparisons of fracture consolidation, radiographic signs of graft consolidation, changes to the bone stock and femoral bone quality, and femoral alignment. Results: Nine patients (42.9%) underwent femoral reconstruction following mechanical failure of total hip arthroplasty and 12 cases (57.1%) underwent femoral reconstruction following periprosthetic fracture. Regarding the postoperative clinical classification, the results were considered satisfactory in 85.7% of the cases and unsatisfactory in 14.3%. Radiographic signs of graft consolidation were seen in all cases. There was an increase in bone stock in 90.5% of the hip reconstructions, as measured by the cortical index. Furthermore, the changes to femoral bone quality were considered good in 66.7% of the cases. Conclusion: The use of cortical structural homologous bone grafts for both femoral reconstructive surgery on total hip arthroplasty and periprosthetic fractures is a good treatment option for selected cases, enabling satisfactory clinical and radiographic results. PMID:27026955

  9. 治疗胫骨骨折不愈合的正中植骨方法介绍%Introducing a method of central bone grafting for nonunion of tiabial fractures

    Institute of Scientific and Technical Information of China (English)

    张功林; 葛宝丰

    2012-01-01

    引起胫骨骨折不愈合的原因较多,主要有局部感染、软组织缺损、骨缺损、骨折对位不良、骨端髓腔闭塞以及损伤的严重程度等.正中植骨方法(Central bone grafting)治疗选择性胫骨骨折不愈合优于其他治疗方法,并发症较低.该方法采用外侧入路,经腓骨的前侧进入,将取自髂骨的新鲜自体骨植在胫腓骨之间和胫骨不愈合平面的上下端.应用内固定有利于纠正骨折畸形和促进骨折愈合.正中植骨技术是治疗胫骨不愈合安全有效的方法.%Nonunion of the tibia fracture may be caused by local infection,soft tissue defect,bone defect,fracture malaignment, bone marrow cavity block and degree of injury and so on. For less complications, central bone grafting is better than other methods for the treatment of selected nonunions of the tibia fracture. This procedure is performed through lateral approach, anterior to the fibula. Fresh autogenous bone from the iliac crest is used to form a central bridge between the tibia and fibula and the nonunion of the tibia at top and below. Application of internal fixation is beneficial to correct deformity and promote fracture healing. Central bone grafting is a safe and effective treatment for nonunions of the tibia.

  10. Increased serum IgE concentrations during infection and graft versus host disease after bone marrow transplantation.

    OpenAIRE

    Walker, S. A.; Rogers, T. R.; Perry, D; Hobbs, J R; Riches, P G

    1984-01-01

    Serum IgE concentrations estimated in 25 bone marrow transplant recipients during episodes of infection or graft versus host disease, or both, were raised not only in some patients with acute graft versus host disease but also in many patients with infection. Raised values were not seen in chronic graft versus host disease. The routine estimation of serum IgE in bone marrow transplant recipients had minimal value because of the lack of specificity of the IgE response.

  11. Reimplantation of cultivated human bone cells from the posterior maxilla for sinus floor augmentation. Histological results from a randomized controlled clinical trial

    DEFF Research Database (Denmark)

    Hermund, N.U.; Stavropoulos, Andreas; Donatsky, O;

    2012-01-01

    OBJECTIVES: The aim of the present randomized clinical study was to evaluate histologically whether the addition of cultivated, autogenous bone cells to a composite graft of deproteinized bovine bone mineral (DBBM) and autogenous bone (AB) for sinus floor augmentation (SFA) enhance bone formation...... compared with what achieved after SFA with DBBM + AB alone. MATERIAL AND METHODS: Twenty patients with remaining posterior maxillary alveolar crest height of less than 3 mm received SFA after randomization either with an DBBM and AB composite in a 1 : 1 ratio or with DBBM + AB supplemented with autogenous...... bone cells, which were cultivated from a bone biopsy harvested earlier from the tuberosity area. Four months after SFA, two cylindrical biopsies were taken from the augmented sinuses concomitantly with the implant site preparation by means of a trephine bur. An additional biopsy was taken from...

  12. Evaluation of hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute for posterolateral spinal fusion

    Directory of Open Access Journals (Sweden)

    Bansal Sanjay

    2009-01-01

    Full Text Available Background: Autologous cancellous bone is the most effective biological graft material. However, harvest of autologous bone is associated with significant morbidity. Since porous hydroxyapatite and beta-tricalcium phosphate are biodegradable materials and can be replaced by bone tissue, but it lacks osteogenic property. We conducted a study to assess their use as a scaffold and combine them with bone marrow aspirate for bone regeneration using its osteogenic property for posterolateral spinal fusion on one side and autologous bone graft on the other side and compare them radiologically in terms of graft incorporation and fusion. Materials and Methods: Thirty patients with unstable dorsal and lumbar spinal injuries who needed posterior stabilization and fusion were evaluated in this prospective study from October 2005 to March 2008. The posterior stabilization was done using pedicle screw and rod assembly, and fusion was done using hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute over one side of spine and autologous bone graft obtained from iliac crest over other side of spine. The patients were followed up to a minimum of 12 months. Serial radiographs were done at an interval of 3, 6, and 12 months and CT scan was done at one year follow-up. Graft incorporation and fusion were assessed at each follow-up. The study was subjected to statistical analysis using chi-square and kappa test to assess graft incorporation and fusion. Results: At the end of the study, radiological graft incorporation and fusion was evident in all the patients on the bone graft substitute side and in 29 patients on the autologous bone graft side of the spine ( P > 0.05. One patient showed lucency and breakage of distal pedicle screw in autologous bone graft side. The interobserver agreement (kappa had an average of 0.72 for graft incorporation, 0.75 for fusion on radiographs, and 0.88 for the CT scan findings

  13. “Over-inlay” block graft and differential morphometry: a novel block graft model to study bone regeneration and host-to-graft interfaces in rats

    Science.gov (United States)

    2016-01-01

    Purpose The aim of this study was to present new a model that allows the study of the bone healing process, with an emphasis on the biological behavior of different graft-to-host interfaces. A standardized “over-inlay” surgical technique combined with a differential histomorphometric analysis is presented in order to optimize the use of critical-size calvarial defects in pre-clinical testing. Methods Critical-size defects were created into the parietal bone of 8 male Wistar rats. Deproteinized bovine bone (DBBM) blocks were inserted into the defects, so that part of the block was included within the calvarial thickness and part exceeded the calvarial height (an “over-inlay” graft). All animals were sacrificed at 1 or 3 months. Histomorphometric and immunohistochemical evaluation was carried out within distinct regions of interest (ROIs): the areas adjacent to the native bone (BA), the periosteal area (PA) and the central area (CA). Results The animals healed without complications. Differential morphometry allowed the examination of the tissue composition within distinct regions: the BA presented consistent amounts of new bone formation (NB), which increased over time (24.53%±1.26% at 1 month; 37.73%±0.39% at 3 months), thus suggesting that this area makes a substantial contribution toward NB. The PA was mainly composed of fibrous tissue (71.16%±8.06% and 78.30%±2.67%, respectively), while the CA showed high amounts of DBBM at both time points (78.30%±2.67% and 74.68%±1.07%, respectively), demonstrating a slow remodeling process. Blood vessels revealed a progressive migration from the interface with native bone toward the central area of the graft. Osterix-positive cells observed at 1 month within the PA suggested that the periosteum was a source of osteoprogenitor elements. Alkaline phosphatase data on matrix deposition confirmed this observation. Conclusions The present model allowed for a standardized investigation of distinct graft

  14. Reengineering autologous bone grafts with the stem cell activator WNT3A.

    Science.gov (United States)

    Jing, Wei; Smith, Andrew A; Liu, Bo; Li, Jingtao; Hunter, Daniel J; Dhamdhere, Girija; Salmon, Benjamin; Jiang, Jie; Cheng, Du; Johnson, Chelsey A; Chen, Serafine; Lee, Katherine; Singh, Gurpreet; Helms, Jill A

    2015-04-01

    Autologous bone grafting represents the standard of care for treating bone defects but this biomaterial is unreliable in older patients. The efficacy of an autograft can be traced back to multipotent stem cells residing within the bone graft. Aging attenuates the viability and function of these stem cells, leading to inconsistent rates of bony union. We show that age-related changes in autograft efficacy are caused by a loss in endogenous Wnt signaling. Blocking this endogenous Wnt signal using Dkk1 abrogates autograft efficacy whereas providing a Wnt signal in the form of liposome-reconstituted WNT3A protein (L-WNT3A) restores bone forming potential to autografts from aged animals. The bioengineered autograft exhibits significantly better survival in the hosting site. Mesenchymal and skeletal stem cell populations in the autograft are activated by L-WNT3A and mitotic activity and osteogenic differentiation are significantly enhanced. In a spinal fusion model, aged autografts treated with L-WNT3A demonstrate superior bone forming capacity compared to the standard of care. Thus, a brief incubation in L-WNT3A reliably improves autologous bone grafting efficacy, which has the potential to significantly improve patient care in the elderly. PMID:25682158

  15. Bone impaction grafting and a cemented cup after acetabular fracture at 3-18 years.

    NARCIS (Netherlands)

    Schreurs, B.W.; Zengerink, M.; Welten, M.L.M.; Kampen, A. van; Slooff, T.J.J.H.

    2005-01-01

    The outcome of total hip arthroplasty after acetabular fracture is compromised. We studied if the bone impaction grafting technique could provide long-term prosthesis survival in deformed and irregular acetabula. We studied 20 hips in 20 patients (mean age, 53.3 years; range, 35-75 years) that were

  16. Nanocomposites and bone regeneration

    Science.gov (United States)

    James, Roshan; Deng, Meng; Laurencin, Cato T.; Kumbar, Sangamesh G.

    2011-12-01

    This manuscript focuses on bone repair/regeneration using tissue engineering strategies, and highlights nanobiotechnology developments leading to novel nanocomposite systems. About 6.5 million fractures occur annually in USA, and about 550,000 of these individual cases required the application of a bone graft. Autogenous and allogenous bone have been most widely used for bone graft based therapies; however, there are significant problems such as donor shortage and risk of infection. Alternatives using synthetic and natural biomaterials have been developed, and some are commercially available for clinical applications requiring bone grafts. However, it remains a great challenge to design an ideal synthetic graft that very closely mimics the bone tissue structurally, and can modulate the desired function in osteoblast and progenitor cell populations. Nanobiomaterials, specifically nanocomposites composed of hydroxyapatite (HA) and/or collagen are extremely promising graft substitutes. The biocomposites can be fabricated to mimic the material composition of native bone tissue, and additionally, when using nano-HA (reduced grain size), one mimics the structural arrangement of native bone. A good understanding of bone biology and structure is critical to development of bone mimicking graft substitutes. HA and collagen exhibit excellent osteoconductive properties which can further modulate the regenerative/healing process following fracture injury. Combining with other polymeric biomaterials will reinforce the mechanical properties thus making the novel nano-HA based composites comparable to human bone. We report on recent studies using nanocomposites that have been fabricated as particles and nanofibers for regeneration of segmental bone defects. The research in nanocomposites, highlight a pivotal role in the future development of an ideal orthopaedic implant device, however further significant advancements are necessary to achieve clinical use.

  17. THE EFFECT OF 2-BUTYL-CYANOACRYLATE ADHESIVE IN OSTEOTOMIES AND BONE GRAFTS IN RABBITS: MACROSCOPIC AND RADIOGRAPHIC CHARACTERISTICS

    OpenAIRE

    Xavier, Mário Sérgio Viana; Leite, Vilnei Mattioli

    2015-01-01

    Objective: To evaluate the effect of butyl-2-cyanoacrylate tissue adhesive in osteotomies and bone grafts, with regard to macroscopic and radiographic characteristics. Methods: Forty-eight rabbits were used, randomly divided into four groups of 12 animals, with observation periods of two, four, eight and 16 weeks. Both thoracic limbs were operated in each animal and two osteotomies were performed in each of the radii, withdrawing a bone fragment (bone graft) of 1 cm in length. On one side, th...

  18. Design and optimization of a tissue-engineered bone graft substitute

    Science.gov (United States)

    Shimko, Daniel Andrew

    2004-12-01

    In 2000, 3.1 million surgical procedures on the musculoskeletal system were reported in the United States. For many of these cases, bone grafting was essential for successful fracture stabilization. Current techniques use intact bone obtained either from the patient (autograft) or a cadaver (allograft) to repair large defects, however, neither source is optimal. Allografts suffer integration problems, and for autografts, the tissue supply is limited. Because of these shortcomings, and the high demand for graft tissues, alternatives are being explored. To successfully engineer a bone graft replacement, one must employ a three pronged research approach, addressing (1) the cells that will inhabit the new tissue, (2) the culture environment that these cells will be exposed to, and (3) the scaffold in which these cells will reside. The work herein examines each of these three aspects in great detail. Both adult and embryonic stem cells (ESCs) were considered for the tissue-engineered bone graft. Both exhibited desirable qualities, however, neither were optimal in all categories examined. In the end, the possibility of teratoma formation and ethical issues surrounding ESCs, made the use of adult marrow-derived stem cells in the remaining experiments obligatory. In subsequent experiments, the adult stem cells' ability to form bone was optimized. Basic fibroblast growth factor, fetal bovine serum, and extracellular calcium supplementation studies were all performed. Ultimately, adult stem cells cultured in alpha-MEM supplemented with 10% fetal bovine serum, 10mM beta-glycerophosphate, 10nM dexamethasone, 50mug/ml ascorbic acid, 1%(v/v) antibiotic/antimycotic, and 10.4mM CaCl2 performed the best, producing nearly four times more mineral than any other medium formulation. Several scaffolds were then investigated including those fabricated from poly(alpha-hydroxy esters), tantalum, and poly-methylmethacrylate. In the final study, the most appealing cell type, medium

  19. Bone Repair on Fractures Treated with Osteosynthesis, ir Laser, Bone Graft and Guided Bone Regeneration: Histomorfometric Study

    Science.gov (United States)

    dos Santos Aciole, Jouber Mateus; dos Santos Aciole, Gilberth Tadeu; Soares, Luiz Guilherme Pinheiro; Barbosa, Artur Felipe Santos; Santos, Jean Nunes; Pinheiro, Antonio Luiz Barbosa

    2011-08-01

    The aim of this study was to evaluate, through the analysis of histomorfometric, the repair of complete tibial fracture in rabbits fixed with osteosynthesis, treated or not with infrared laser light (λ780 nm, 50 mW, CW) associated or not to the use of hydroxyapatite and guided bone regeneration (GBR). Surgical fractures were created, under general anesthesia (Ketamina 0,4 ml/Kg IP and Xilazina 0,2 ml/Kg IP), on the dorsum of 15 Oryctolagus rabbits that were divided into 5 groups and maintained on individual cages, at day/night cycle, fed with solid laboratory pelted diet and had water ad libidum. On groups II, III, IV and V the fracture was fixed with wire osteosynthesis. Animals of groups III and V were grafted with hydroxyapatite and GBR technique used. Animals of groups IV and V were irradiated at every other day during two weeks (16 J/cm2, 4×4 J/cm2). Observation time was that of 30 days. After animal death (overdose of general anesthetics) the specimes were routinely processed to wax and underwent histological analysis by light microscopy. The histomorfometric analysis showed an increased bone neoformation, increased collagen deposition, less reabsorption and inflammation when laser was associated to the HATCP. It is concluded that IR laser light was able to accelerate fracture healing and the association with HATCP and GBR resulted on increased deposition of CHA.

  20. Bone marrow mesenchymal stem cell transplantation combined with core decompression and bone grafting in the repair of osteonecrosis of femoral head

    Institute of Scientific and Technical Information of China (English)

    Zhang Yang; Wang Nan; Yang Li-feng; Ma Ji; Li Zhi

    2015-01-01

    BACKGROUND: Core decompression alone for osteonecrosis of femoral head easily causes fovea of femoral head and colapse of inner microstructure. Therefore, autologous bone is needed for filing and supporting. Moreover, bone marrow stem cel transplantation can decrease the incidence of femoral head colapse. OBJECTIVE:To discuss the clinical effects of core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels for osteonecrosis of femoral head. METHODS: A total of 33 patients were treated by core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels in the Fourth Department of Bone Surgery, Central Hospital Affiliated to Shenyang Medical Colege in China from December 2012 to May 2013. RESULTS AND CONCLUSION:After the treatment by core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels, Harris hip function score increased and pain disappeared in patients with osteonecrosis of femoral head. They could do various labors. Radiographs or CT examination displayed normal femoral head in 30 hips, accounting for 79%. Pain significantly reduced. Normal or slight limp walking was found in 15 hips, accounting for 40%. There were 35 hips in patients, whose walking distance was extended, accounting for 92%. 24 hips dysfunction was improved markedly, accounting for 63%. Al results suggested that core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels improved the local blood supply of femoral head, and played a positive role in promoting the necrotic bone absorption and bone repairing.

  1. Use of autologous bone graft in anterior cervical decompression: morbidity & quality of life analysis.

    LENUS (Irish Health Repository)

    Heneghan, Helen M

    2009-01-01

    BACKGROUND: Autologous iliac crest graft has long been the gold standard graft material used in cervical fusion. However its harvest has significant associated morbidity, including protracted postoperative pain scores at the harvest site. Thus its continued practice warrants scrutiny, particularly now that alternatives are available. Our aims were to assess incidence and nature of complications associated with iliac crest harvest when performed in the setting of Anterior Cervical Decompression (ACD). Also, to perform a comparative analysis of patient satisfaction and quality of life scores after ACD surgeries, when performed with and without iliac graft harvest. METHODS: All patients who underwent consecutive ACD procedures, with and without the use of autologous iliac crest graft, over a 48 month period were included (n = 53). Patients were assessed clinically at a minimum of 12 months postoperatively and administered 2 validated quality of life questionnaires: the SF-36 and Cervical Spine Outcomes Questionnaires (Response rate 96%). Primary composite endpoints included incidence of bone graft donor site morbidity, pain scores, operative duration, and quality of life scores. RESULTS: Patients who underwent iliac graft harvest experienced significant peri-operative donor site specific morbidity, including a high incidence of pain at the iliac crest (90%), iliac wound infection (7%), a jejunal perforation, and longer operative duration (285 minutes vs. 238 minutes, p = 0.026). Longer term follow-up demonstrated protracted postoperative pain at the harvest site and significantly lower mental health scores on both quality of life instruments, for those patients who underwent autologous graft harvest CONCLUSION: ACD with iliac crest graft harvest is associated with significant iliac crest donor site morbidity and lower quality of life at greater than 12 months post operatively. This is now avoidable by using alternatives to autologous bone without compromising clinical

  2. Preoperative implant planning considering alveolar bone grafting needs and complication prediction using panoramic versus CBCT images

    International Nuclear Information System (INIS)

    This study was performed to determine the efficacy of observers' prediction for the need of bone grafting and presence of perioperative complications on the basis of cone-beam computed tomography (CBCT) and panoramic radiographic (PAN) planning as compared to the surgical outcome. One hundred and eight partially edentulous patients with a need for implant rehabilitation were referred for preoperative imaging. Imaging consisted of PAN and CBCT images. Four observers carried out implant planning using PAN image datasets, and at least one month later, using CBCT image datasets. Based on their own planning, the observers assessed the need for bone graft augmentation as well as complication prediction. The implant length and diameter, the need for bone graft augmentation, and the occurrence of anatomical complications during planning and implant placement were statistically compared. In the 108 patients, 365 implants were installed. Receiver operating characteristic analyses of both PAN and CBCT preoperative planning showed that CBCT performed better than PAN-based planning with respect to the need for bone graft augmentation and perioperative complications. The sensitivity and the specificity of CBCT for implant complications were 96.5% and 90.5%, respectively, and for bone graft augmentation, they were 95.2% and 96.3%, respectively. Significant differences were found between PAN-based planning and the surgery of posterior implant lengths. Our findings indicated that CBCT-based preoperative implant planning enabled treatment planning with a higher degree of prediction and agreement as compared to the surgical standard. In PAN-based surgery, the prediction of implant length was poor.

  3. Preoperative implant planning considering alveolar bone grafting needs and complication prediction using panoramic versus CBCT images

    Energy Technology Data Exchange (ETDEWEB)

    Guerrero, Maria Eugenia; Jacobs, Reinhilde [OIC, OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven (Belgium); Noriega, Jorge [Master of Periodontology, Universidad San Martin de Porres, Lima (Peru)

    2014-09-15

    This study was performed to determine the efficacy of observers' prediction for the need of bone grafting and presence of perioperative complications on the basis of cone-beam computed tomography (CBCT) and panoramic radiographic (PAN) planning as compared to the surgical outcome. One hundred and eight partially edentulous patients with a need for implant rehabilitation were referred for preoperative imaging. Imaging consisted of PAN and CBCT images. Four observers carried out implant planning using PAN image datasets, and at least one month later, using CBCT image datasets. Based on their own planning, the observers assessed the need for bone graft augmentation as well as complication prediction. The implant length and diameter, the need for bone graft augmentation, and the occurrence of anatomical complications during planning and implant placement were statistically compared. In the 108 patients, 365 implants were installed. Receiver operating characteristic analyses of both PAN and CBCT preoperative planning showed that CBCT performed better than PAN-based planning with respect to the need for bone graft augmentation and perioperative complications. The sensitivity and the specificity of CBCT for implant complications were 96.5% and 90.5%, respectively, and for bone graft augmentation, they were 95.2% and 96.3%, respectively. Significant differences were found between PAN-based planning and the surgery of posterior implant lengths. Our findings indicated that CBCT-based preoperative implant planning enabled treatment planning with a higher degree of prediction and agreement as compared to the surgical standard. In PAN-based surgery, the prediction of implant length was poor.

  4. Angiogenic factor-enriched platelet-rich plasma enhances in vivo bone formation around alloplastic graft material

    OpenAIRE

    Kim, Eun-Seok; Kim, Jae-Jin; Park, Eun-Jin

    2010-01-01

    PURPOSE Although most researchers agree that platelet-rich plasma (PRP) is a good source of autogenous growth factors, its effect on bone regeneration is still controversial. The purpose of this study was to evaluate whether increasing angiogenic factors in the human PRP to enhance new bone formation through rapid angiogenesis. MATERIAL AND METHODS In vitro, the human platelets were activated with application of shear stress, 20 µg/ml collagen, 2 mM CaCl2 and 10U thrombin/1 × 109 platelets. L...

  5. 人工骨加自体骨修复中老年外伤性前牙牙槽骨缺损的临床研究%Clinical study of the artificial bone and autogenous bone in repairing traumatic anterior alveolar bone defects in the middle-aged and elderly people

    Institute of Scientific and Technical Information of China (English)

    廖福琴; 朱菲; 张昊; 张丽军

    2013-01-01

    目的 探讨胶原基纳米骨(nHAC)加自体骨修复中老年外伤性前牙牙槽骨缺损的临床疗效.方法 选择23例中老年因外伤前牙牙槽骨缺损需植骨者,用nHAC加术区游离的自体骨修复缺损,采用固定正畸技术对松动牙进行固定.术后1、2、3、6、12个月复诊,术前术后均对病损部位进行临床及X线检查,观察缺损程度及新骨形成和骨密度改变.结果 nHAC加自体骨修复中老年外伤性前牙牙槽骨缺损愈合成功率95.65%,脱位牙复位固定治疗成功率88.23%,所有患者无不良症状和体征,牙槽骨高度和宽度明显得到改善.X线片显示:胶原基纳米骨(nHAC)加自体骨植入区可见新生骨小梁,骨密度增强,骨质疏松有所改善,植入骨与宿主骨组织融为一体,牙槽骨缺损修复.结论 nHAC加自体骨修复外伤性前牙牙槽骨缺损可以增强牙槽骨密度,恢复牙槽骨的丰满度,保留了更多的牙齿,也为义齿修复提供了良好的生理基础.%Objective To investigate the clinical efficacy of the mixture of nano-hydroxyapative/collagen composite (nHAC)and autogenous bone on repairing traumatic anterior alveolar bone defects in the middle-aged and elderly people.Methods Twenty-three middle-aged and elderly patients,who had traumatic anterior alveolar bone defects and needed bone transplanting,were selected.They were treated with the mixture of nHAC and autogenous bone to repair the traumatic alveolar bone defects.Edgewise appliance was used for reduction and fixation in traumatic dislocated teeth.After1,2,3,6,and 12 months,all the patients needed subsequent visit.Clinical and X-ray examination of bone defects were performed to observe the degree of bone defects,new bone formation,and bone mineral density before and after the treatment.Results Among all the 23 patients,the therapeutic effective rate of using the mixture of nHAC and autogenous bone to repair traumatic anterior alveolar bone defects was 95.65

  6. Evaluation of hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute for posterolateral spinal fusion

    OpenAIRE

    Bansal Sanjay; Chauhan Vijendra; Sharma Sansar; Maheshwari Rajesh; Juyal Anil; Raghuvanshi Shailendra

    2009-01-01

    Background: Autologous cancellous bone is the most effective biological graft material. However, harvest of autologous bone is associated with significant morbidity. Since porous hydroxyapatite and beta-tricalcium phosphate are biodegradable materials and can be replaced by bone tissue, but it lacks osteogenic property. We conducted a study to assess their use as a scaffold and combine them with bone marrow aspirate for bone regeneration using its osteogenic property for posterolateral spina...

  7. Internal fixation and muscle pedicle bone grafting in femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Gupta A

    2008-01-01

    Full Text Available Background: The treatment of displaced intracapsular femoral neck fracture is still an unsolved problem. Non-union and avascular necrosis are the two main complications of this fracture, especially if patient presents late. Muscle pedicle bone grafting has been advocated to provide additional blood supply. We present analysis of our 32 cases of displaced femoral neck fracture treated by internal fixation and quadratus femoris based muscle pedicle bone grafting. Materials and Methods: Open reduction and internal fixation with muscle pedicle grafting was done in 32 patients. The age of patients varied from 14-62 years (average age 45 years with male to female ratio of 13:3. Twenty-nine fractures were more than three weeks old. All the cases were treated by Meyers′ procedure. The fracture was internally fixed after open reduction and then a muscle pedicle graft was applied. It was supplemented by cancellous bone graft in seven cases. Fixation was done by parallel cancellous lag screws ( n = 19, crossed Garden′s screws ( n = 7, parallel Asnis screws ( n = 5 and Moore′s pin ( n = 1.Quadratus femoris muscle pedicle graft was used in 32 cases. In the initial 12 cases the graft was fixed with circumferential proline sutures, but later, to provide a secure fixation, the graft was fixed with a cancellous screw ( n = 20. Postoperative full weight bearing was deferred to an average of 10 weeks. Results: Union was achieved in 26/29 (89.65% cases which could be followed for an average period of 3.4 years, (2-8.5 years with good functional results and had the ability to squat and sit cross-legged. Results were based on hip rating system given by Salvatti and Wilson. The results were excellent in 15 cases, good in four cases, fair in four cases and poor in six cases. Complications were avascular necrosis ( n = 2, transient foot drop ( n = 2, coxa-vara ( n = 1 and temporary loss of scrotal sensation ( n = 1. Conclusion: Muscle pedicle bone grafting with

  8. A new Fe-Mn-Si alloplastic biomaterial as bone grafting material: In vivo study

    Science.gov (United States)

    Fântânariu, Mircea; Trincă, Lucia Carmen; Solcan, Carmen; Trofin, Alina; Strungaru, Ştefan; Şindilar, Eusebiu Viorel; Plăvan, Gabriel; Stanciu, Sergiu

    2015-10-01

    Designing substrates having suitable mechanical properties and targeted degradation behavior is the key's development of bio-materials for medical application. In orthopedics, graft material may be used to fill bony defects or to promote bone formation in osseous defects created by trauma or surgical intervention. Incorporation of Si may increase the bioactivity of implant locally, both by enhancing interactions at the graft-host interface and by having a potential endocrine like effect on osteoblasts. A Fe-Mn-Si alloy was obtained as alloplastic graft materials for bone implants that need long recovery time period. The surface morphology of the resulted specimens was investigated using scanning electrons microscopy (VegaTescan LMH II, SE detector, 30 kV), X-ray diffractions (X'Pert equipment) or X-ray dispersive energy analyze (Bruker EDS equipment). This study objective was to evaluate in vivo the mechanisms of degradation and the effects of its implantation over the main metabolic organs. Biochemical, histological, plain X radiography and computed tomography investigations showed good compatibility of the subcutaneous implants in the rat organism. The implantation of the Fe-Mn-Si alloy, in critical size bone (tibiae) defect rat model, did not induced adverse biological reactions and provided temporary mechanical support to the affected bone area. The biodegradation products were hydroxides layers which adhered to the substrate surface. Fe-Mn-Si alloy assured the mechanical integrity in rat tibiae defects during bone regeneration.

  9. 镜下髓芯减压BAM骨诱导人工骨治疗股骨头坏死的临床研究%Treatment with BAM artificial bone and autogenous marrow cells implantation after arthroscopic core decompression for ischemic necrosis of femoral head

    Institute of Scientific and Technical Information of China (English)

    李康养; 黄永翔; 李艳玲; 马楚平; 易伟宏; 欧迪军

    2012-01-01

    Objective: To evaluate the feasibility and clinical effects of treatment with BAM artificial bone and autogenous marrow cells implantation after arthroscopic core decompression for ischemic necrosis of femoral head. MethodS:From 2009 to 2011, 25 cases (30 hips) at Ficat stage II and 5 cases (6 hips) at Ficat stage III were selected, and had arthroscopic core decompression with the assistance of ar-throscopy and the localization of C-shaped fluoroscopic machine. Lesion tissues were cleared completely, internal and external environment of femoral head was improved and transplantation of the BAM induced artificial bone and autogenous marrow cells was performed. Follow up were conducted for 3,12 and 24 months after the operation. Harris hip score,X-ray and MRI were performed to evaluate the stability of staging and clinical effect. Results: All patients were followed up for 12 to 24 months. According to Harris hip score, total excellent and good rate was 86. 11%. X-ray showed good bone repairment, and MRI showed no significant decrease in sign of focal zone. Conclusions:Minimally invasive grafting BAM artificial bone and autogenous marrow cells by core decompression under arthroscopy shows advantage of exact diagnosis and localization, as well as minimally invasion. It is effective in the treatment of ischemic necro-sis of the femoral head at stage II and stage HI A .%目的:评估关节镜辅助下髓芯减压植入BAM骨诱导人工骨与自体骨髓细胞治疗早期股骨头坏死可行性和临床疗效..方法:将2009~2011年确诊的股骨头坏死按Ficat分期Ⅱ期25例30髋,Ⅲ期5例6髋;在C型臂透视定位及关节镜辅助下,有效准确地进行髓芯减压,对股骨头内病变组织清除彻底,改善股骨头内外环境,植入BAM骨诱导人工骨与自体骨髓细胞.术后3、12、24个月进行随诊,以Harris髋关节评分、X线片及MRI观察病变分期稳定性及临床疗效为评价指标.结果:全部病例随访12~24个月,按

  10. TREATMENT OF SCAPHOID NONUNION WITH OLECRANON BONE GRAFT AND COMPRESSION SCREW

    Science.gov (United States)

    NEDER, ANTONIO TUFI; FRANCESCHINI, EDUARDO TRALDI; PARDINI, ARLINDO GOMES; RIBERTO, MARCELO; MAZZER, NILTON

    2016-01-01

    ABSTRACT Objective: To evaluate the outcome of olecranon bone graft and compression screw for the treatment of nonunion of the Lichtman type I scaphoid. Method: We evaluated 15 patients of 32 who underwent surgical treatment for nonunion of the Lichtman type I scaphoid with olecranon bone graft and screw compression. Results: We obtained 100% consolidation in our sample. The mean flexion of the wrist on the affected side was 68° and 75° on the non-affected side. The average extension was 63° and 72°, respectively. The average grip strength was 35 kgf. This corresponds to 98% of the handgrip strength of the non-affected side, which was 37 kgf. The DASH score averaged 5 points. Conclusion: We believe that the use of bone graft obtained from the olecranon and secured with cannulated screw is a resolute technique for cases of linear nonunion of the Lichtmann type I scaphoid. It has the advantages of a new anesthesia for removal of the graft and the access is easy, providing a good exposure for removal and good aesthetic results. Level of evidence IV. Case series. PMID:27217819

  11. From natural bone grafts to tissue engineering therapeutics: Brainstorming on pharmaceutical formulative requirements and challenges.

    Science.gov (United States)

    Baroli, Biancamaria

    2009-04-01

    Tissue engineering is an emerging multidisciplinary field of investigation focused on the regeneration of diseased or injured tissues through the delivery of appropriate molecular and mechanical signals. Therefore, bone tissue engineering covers all the attempts to reestablish a normal physiology or to speed up healing of bone in all musculoskeletal disorders and injuries that are lashing modern societies. This article attempts to give a pharmaceutical perspective on the production of engineered man-made bone grafts that are described as implantable tissue engineering therapeutics, and to highlight the importance of understanding bone composition and structure, as well as osteogenesis and bone healing processes, to improve the design and development of such implants. In addition, special emphasis is given to pharmaceutical aspects that are frequently minimized, but that, instead, may be useful for formulation developments and in vitro/in vivo correlations.

  12. Osteogenic Matrix Cell Sheets Facilitate Osteogenesis in Irradiated Rat Bone

    Directory of Open Access Journals (Sweden)

    Yoshinobu Uchihara

    2015-01-01

    Full Text Available Reconstruction of large bone defects after resection of malignant musculoskeletal tumors is a significant challenge in orthopedic surgery. Extracorporeal autogenous irradiated bone grafting is a treatment option for bone reconstruction. However, nonunion often occurs because the osteogenic capacity is lost by irradiation. In the present study, we established an autogenous irradiated bone graft model in the rat femur to assess whether osteogenic matrix cell sheets improve osteogenesis of the irradiated bone. Osteogenic matrix cell sheets were prepared from bone marrow-derived stromal cells and co-transplanted with irradiated bone. X-ray images at 4 weeks after transplantation showed bridging callus formation around the irradiated bone. Micro-computed tomography images at 12 weeks postoperatively showed abundant callus formation in the whole circumference of the irradiated bone. Histology showed bone union between the irradiated bone and host femur. Mechanical testing showed that the failure force at the irradiated bone site was significantly higher than in the control group. Our study indicates that osteogenic matrix cell sheet transplantation might be a powerful method to facilitate osteogenesis in irradiated bones, which may become a treatment option for reconstruction of bone defects after resection of malignant musculoskeletal tumors.

  13. Secondary alveolar bone grafting in cleft of the lip and palate patients

    Directory of Open Access Journals (Sweden)

    Abhilashaa Walia

    2011-01-01

    Full Text Available Aim: The aim was to restore the function and form of both arches with a proper occlusal relationship and eruption of tooth in the cleft area. Materials and Methods: Eleven patients were selected irrespective of sex and socio-economic status and whose age was within the mixed dentition period. Iliac crest is grafted in cleft area and subsequently evaluated for graft success using study models, and periapical and occlusal radiographs. Results: At the time of evaluation teeth were erupted in the area and good alveolar bone levels were present. Premaxilla becomes immobile with a good arch form and arch continuity. There are no major complications in terms of pain, infection, paraesthesia, hematoma formation at donor site without difficulty in walking. There is no complication in terms of pain, infection, exposure of graft, rejection of graft, and wound dehiscence at the recipient site. Discussion: It is evident that secondary alveolar grafting during the mixed dentition period is more beneficial for patients at the donor site as well as the recipient site. Conclusion: Long-term follow-up is required to achieve maximum advantage of secondary alveolar grafting; the age of the patient should be within the mixed dentition period, irrespective of sex, socio-economic status. It may be unilateral or bilateral.

  14. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

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    Jia-zuo SHEN, Jian-fei YAO, Da-sheng LIN, Ke-jian LIAN, Zhen-qi DING, Bin LIN, Zhi-min GUO, Ming-hua ZHANG, Qiang LI, Lin LI, Peng QI

    2012-01-01

    Full Text Available Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise.Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS and standard dynamic hip screws (DHS in an animal model.Design: Testing of specifically designed fixation devices in a pig animal model.Interventions/Methods: We designed Hb-DHS and DHS devices appropriate to the femoral neck and head of experimental animals and used them in eight pigs (4-month-old, male or female, 30-40 kg/each. Under anesthesia, we induced medium neck type, Garden III type femoral neck fractures in each pig with fracture gaps of 0.5 mm and then fixed each left femur with Hb-DHS and each right femur with DHS. We assessed the animals radiographically and by postmortem visual appraisal of evidence of bone healing 8 and 16 weeks postoperatively.Results: There were significant differences in radiographic and general findings between the Hb-DHS and DHS groups at weeks 8 and 16 postoperatively. We found statistically significant differences between the Hb-DHS and DHS groups in bone healing scores, trabecular bone volume percentage and bone mineral density as assessed on plain radiographs and computed tomography images (P < 0.05. There were also significant differences between the Hb-DHS and DHS groups in postmortem visually assessed indicators of bone healing at both 8 and 16 weeks postoperatively.Conclusions: The Hb-DHS device promotes femoral neck bone union, stimulates trabecular bone formation, increases BMD and has advantages over DHS for internal fixation of femoral neck fractures. This animal experiment will contribute to developing optimal treatment for femoral neck fractures in young adults.

  15. Histological and morphometric aspects of ridge preservation with a moldable, in situ hardening bone graft substitute

    Directory of Open Access Journals (Sweden)

    Jurišić M.

    2013-01-01

    Full Text Available Biphasic calcium phosphates (BCP are widely used in alveolar ridge regeneration as a porous scaffold for new bone formation. The aim of this case series was to evaluate the regenerative effect of the combination of BCP and polylactide-co-glycolide (PLGA which can serve as a barrier membrane during bone regeneration. The study included five patients. Four months into the healing period, bone samples were collected for histological and morphometric analyses. The results of morphometric analysis showed that newly formed bone represented 32.2 ± 6.8% of the tissue, 31.9 ± 8.9% was occupied by residual graft and 35.9 ± 13.5% by soft tissue. Active osteogenesis was seen around the particles of the graft. The particles were occupied mostly by immature woven bone and connective tissue. The quality and quantity of newly formed bone, after the use of BCP/PLGA for ridge preservation, can be adequate for successful implant therapy after tooth extraction. [Projekat Ministarstva nauke Republike Srbije, br. OI 175021 i br. OI 173009

  16. Evaluation of different graft material in type 1 tympanoplasty

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    Kshitij Patil

    2014-01-01

    Full Text Available Aims and Objective: The present study was undertaken to compare the results of various autogeneous tissues temporalis fascia, tragal perichondrium, and fascia lata as graft materials for the type 1 tympanoplasty. Materials and Methods: A total of 120 cases with large, subtotal and total perforation were considered in the study. Of the 120 cases, temporalis fascia graft was used in 60 cases (Group-I, tragal perichondrium graft in 40 cases (Group-II, and fascia lata graft in 20 cases (Group-III. The results were evaluated in the form of rate of graft success, hearing gain, and mean residual air-bone gap with respect to the graft materials. Results and Observation: A nonsignificant association was observed between the groups, that is, temporalis fascia (Group-I, tragal perichondrium (Group-II, and fascia lata (Group-III and the graft uptake. (P = 0.96 > 0.05 and air bone closure (χ2 = 2.908, P = 0.059 > 0.05. Conclusion: The graft take-up rate and Hearing improvement are similar for the different graft materials used. Size of the perforation doesn′t significantly influence the success rate of tympanoplasty as per our study. Normal translucent appearance of neotympanum in the postoperative period was seen only with temporalis fascia, while in tragal perichondrial and fascia lata grafts the neotympanum was whitish, thicker, and translucent to opaque.

  17. Structural mechanical properties of radiation-sterilized human Bone-Tendon-Bone grafts preserved by different methods.

    Science.gov (United States)

    Gut, Grzegorz; Marowska, Joanna; Jastrzebska, Anna; Olender, Ewa; Kamiński, Artur

    2016-06-01

    To avoid the risk of infectious disease transmission from donor to recipient, allografts should be terminally sterilized. In the previous paper (Kaminski et al. in Cell Tissue Bank 10:215-219, 2009) we presented the effect of various methods of preservation (deep fresh freezing, glycerolization, lyophilization), followed by irradiation with different doses of electron beam (EB), on material (intrinsic) mechanical properties of human patellar tendons cut out as for anterior cruciate ligament reconstruction, obtained in failure tensile test. As structural mechanical properties are equally important to predict the behaviour of the graft as a whole functional unit, the purpose of the present paper was to show the results for failure load and elongation, obtained in the same experiment. Paired Bone-Tendon-Bone grafts (BTB) were prepared from cadaveric human patella tendons with both patellar and tibial attachments. They were preserved by deep freezing, glycerolization or lyophilization and subsequently EB-irradiated with the doses of 25, 35, 50 or 100 kGy (fresh-frozen grafts) or a single dose of 35 kGy (glycerolized and lyophilized grafts). Each experimental (irradiated) group was provided with control (non-irradiated), donor-matched group. The specimens from all groups were subjected to mechanical failure tensile test with the use of Instron system in order to measure their structural properties (failure load and elongation). All lyophilized grafts were rehydrated before mechanical testing. In our study we did not observe significant deterioration of structural mechanical properties of BTB grafts processed by fresh-freezing and then terminal sterilized with growing doses of EB up to 100 kGy. In contrast, BTB grafts processed by glycerolization or lyophilization and irradiated with 35 kGy showed significant decrease of failure load. Obtained results suggest that deep-frozen irradiated grafts retain their initial mechanical properties to an extent which does not

  18. Structural mechanical properties of radiation-sterilized human Bone-Tendon-Bone grafts preserved by different methods.

    Science.gov (United States)

    Gut, Grzegorz; Marowska, Joanna; Jastrzebska, Anna; Olender, Ewa; Kamiński, Artur

    2016-06-01

    To avoid the risk of infectious disease transmission from donor to recipient, allografts should be terminally sterilized. In the previous paper (Kaminski et al. in Cell Tissue Bank 10:215-219, 2009) we presented the effect of various methods of preservation (deep fresh freezing, glycerolization, lyophilization), followed by irradiation with different doses of electron beam (EB), on material (intrinsic) mechanical properties of human patellar tendons cut out as for anterior cruciate ligament reconstruction, obtained in failure tensile test. As structural mechanical properties are equally important to predict the behaviour of the graft as a whole functional unit, the purpose of the present paper was to show the results for failure load and elongation, obtained in the same experiment. Paired Bone-Tendon-Bone grafts (BTB) were prepared from cadaveric human patella tendons with both patellar and tibial attachments. They were preserved by deep freezing, glycerolization or lyophilization and subsequently EB-irradiated with the doses of 25, 35, 50 or 100 kGy (fresh-frozen grafts) or a single dose of 35 kGy (glycerolized and lyophilized grafts). Each experimental (irradiated) group was provided with control (non-irradiated), donor-matched group. The specimens from all groups were subjected to mechanical failure tensile test with the use of Instron system in order to measure their structural properties (failure load and elongation). All lyophilized grafts were rehydrated before mechanical testing. In our study we did not observe significant deterioration of structural mechanical properties of BTB grafts processed by fresh-freezing and then terminal sterilized with growing doses of EB up to 100 kGy. In contrast, BTB grafts processed by glycerolization or lyophilization and irradiated with 35 kGy showed significant decrease of failure load. Obtained results suggest that deep-frozen irradiated grafts retain their initial mechanical properties to an extent which does not

  19. Bone grafting and one-stage revision of THR - biological reconstruction and effective antimicrobial treatment using antibiotic impregnated allograft bone.

    Science.gov (United States)

    Winkler, Heinz

    2012-01-01

    Infection of a total hip replacement (THR) is considered one of the most serious complications in orthopaedic surgery. Problems derive from the presence of biofilms with inherent resistance to usual antibiotic treatment and bone defects resulting from infection induced osteolysis. Discussions on the choice of treatment mainly focus on the chance of eradicating the infection in either one or more stages. The advantages of only one operation with regard to patients' satisfaction, functional results and economical burden are evident. However, the fear of re-infection usually leads surgeons to multiple stage procedures, mostly using antibiotic loaded spacers in the interval. Spacers have no effect on biofilms and are associated with a high rate of complications such as breakage or dislocation. Cemented revisions show several disadvantages like reduction of biomechanical properties through added antibiotics, inferior long term results, difficulties of removal in case of recurrence etc. Uncemented implants appear more advantageous but are at risk of becoming colonised by remaining biofilm fragments. To overcome this risk higher local concentrations of antibiotics are needed. Allograft bone may be impregnated with high loads of antibiotics using special incubation techniques, resulting in an antibiotic bone compound (ABC). ABC provides local concentrations exceeding those of cement by more than a 100-fold and efficient release is prolonged for several weeks. At the same time it is likely to restore bone stock, which is usually compromised after removal of an infected endoprosthesis. Based on these considerations new protocols for one-stage exchange of infected THR have been established. Bone voids may be filled with ABC, uncemented implants may be fixed in original healthy bone. Recent studies indicate an overall success rate of more than 90% with one operation, without any adverse side effects. Incorporation of allografts appears as after grafting with unimpregnated bone

  20. Ceacam1 separates graft-versus-host-disease from graft-versus-tumor activity after experimental allogeneic bone marrow transplantation.

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    Sydney X Lu

    Full Text Available Allogeneic bone marrow transplantation (allo-BMT is a potentially curative therapy for a variety of hematologic diseases, but benefits, including graft-versus-tumor (GVT activity are limited by graft-versus-host-disease (GVHD. Carcinoembryonic antigen related cell adhesion molecule 1 (Ceacam1 is a transmembrane glycoprotein found on epithelium, T cells, and many tumors. It regulates a variety of physiologic and pathological processes such as tumor biology, leukocyte activation, and energy homeostasis. Previous studies suggest that Ceacam1 negatively regulates inflammation in inflammatory bowel disease models.We studied Ceacam1 as a regulator of GVHD and GVT after allogeneic bone marrow transplantation (allo-BMT in mouse models. In vivo, Ceacam1(-/- T cells caused increased GVHD mortality and GVHD of the colon, and greater numbers of donor T cells were positive for activation markers (CD25(hi, CD62L(lo. Additionally, Ceacam1(-/- CD8 T cells had greater expression of the gut-trafficking integrin α(4β(7, though both CD4 and CD8 T cells were found increased numbers in the gut post-transplant. Ceacam1(-/- recipients also experienced increased GVHD mortality and GVHD of the colon, and alloreactive T cells displayed increased activation. Additionally, Ceacam1(-/- mice had increased mortality and decreased numbers of regenerating small intestinal crypts upon radiation exposure. Conversely, Ceacam1-overexpressing T cells caused attenuated target-organ and systemic GVHD, which correlated with decreased donor T cell numbers in target tissues, and mortality. Finally, graft-versus-tumor survival in a Ceacam1(+ lymphoma model was improved in animals receiving Ceacam1(-/- vs. control T cells.We conclude that Ceacam1 regulates T cell activation, GVHD target organ damage, and numbers of donor T cells in lymphoid organs and GVHD target tissues. In recipients of allo-BMT, Ceacam1 may also regulate tissue radiosensitivity. Because of its expression on both the

  1. Miniplate fixation for the repair of segmental mandibular defects filled with autogenous bone in cats Uso de miniplacas na fixação de mandíbulas de gatos com defeitos segmentares preenchidos com osso autógeno

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    Adelina Maria da Silva

    2011-06-01

    Full Text Available PURPOSE: To evaluate the use of maxillofacial miniplate 1.5 in the repair of segmental mandibular defects filled with autogenous bone in cats. METHODS: Twelve adult cats were divided into two groups. A segmental defect of 4mm was created in one of the hemimandibles and filled with autogenous iliac crest bone graft. The operated hemimandible was fixed with a 1.5mm titanium miniplate. In group 1 (n=6, the defect was performed in the body of the mandible, behind the 1st molar. In group 2 (n=6, the defect was performed between the 4nd premolar and 1st molar, with extraction of the 1st molar. Oral alimentation was reinitiated 24 hours after surgery. Cats were euthanized at 20 weeks postoperative. RESULTS: Incorporation of the graft was suggested by the radiographs taken 20 weeks after surgery. Macroscopic examination confirmed alignment and bone union of operated hemimandibles. Histological examination showed formation of woven bone in rostral and caudal mandible/graft interfaces. The percentage of bone tissue at these areas was measured by the histometry. There was no statistically significant difference between the values of group 1(64.48 ± 4.51 and group 2 (71.69 ± 14.47 (Mann-Whitney's test p= 0.294. CONCLUSION: The use of miniplate 1.5 for the fixation of mandibular defects filled with autogenous bone in cats provided the main goals in the treatment of mandibular fractures: bone union, normal dental occlusion and immediate return to oral alimentation.OBJETIVO: Avaliar o uso de miniplacas na fixação de mandíbulas de gatos com defeitos segmentares preenchidos com osso autógeno. MÉTODOS: Foram utilizados 12 gatos adultos divididos em dois grupos de seis animais cada. Em uma das hemimandíbulas foi criado um defeito segmentar de 4mm, preenchido com enxerto autógeno do osso ilíaco. A hemimandíbula operada foi fixada com uma miniplaca 1.5 de titânio. No grupo 1, o defeito foi realizado caudalmente ao 1º molar e no grupo 2, entre o 4º pr

  2. Histologic and histomorphometric study of bone repair around short dental implants inserted in rabbit tibia, associated with tricalcium phosphate graft bone

    OpenAIRE

    Marlice Azoia Lukiantchuki Barbosa; Liogi Iwaki Filho; Lilian Cristina Vessoni Iwaki; Maria Raquel Marçal Natali; Wilton Mitsunari Takeshita; Sérgio Sábio

    2014-01-01

    The use of short dental implants represents one way to overcome this limitation, in association with bone grafting procedures. Tricalcium phosphate-based grafts are among those widely used. The purpose of this study was to assess the biocompatibility of this biomaterial in the coverage of bone defects around short dental implants. Ten New Zealandrabbits were used in this study, each animal received 4 implants, two were placed in the right tibia region (control group) and two in the left tibia...

  3. Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery

    OpenAIRE

    Kaveh Bashti; Mohammad Naghi Tahmasebi; Hasan Kaseb; Farzam Farahmand; Mohammad Akbar; Amir Mobini

    2015-01-01

      Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL) reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine ...

  4. Exploring CBCT-Based DICOM Files. A Systematic Review on the Properties of Images Used to Evaluate Maxillofacial Bone Grafts

    OpenAIRE

    Rubens SPIN-NETO; Marcantonio, Elcio; Gotfredsen, Erik; Wenzel, Ann

    2011-01-01

    Previous studies suggests that cone beam computerized tomography (CBCT) images could provide reliable information regarding the fate of bone grafts in the maxillofacial region, but no systematic information regarding the standardization of CBCT settings and properties is available, i.e., there is a lack of information on how the images were generated, exported, and analyzed when bone grafts were evaluated. The aim of this study was to (1) do a systematic review on which type of CBCT-based DIC...

  5. An Injectable Hydrogel as Bone Graft Material with Added Antimicrobial Properties

    Science.gov (United States)

    Tommasi, Giacomo; Perni, Stefano

    2016-01-01

    Currently, the technique which provides the best chances for a successful bone graft, is the use of bone tissue from the same patient receiving it (autograft); the main limitations are the limited availability and the risks involved in removing living bone tissue, for example, explant site pain and morbidity. Allografts and xenografts may overcome these limitations; however, they increase the risk of rejection. For all these reasons the development of an artificial bone graft material is particularly important and hydrogels are a promising alternative for bone regeneration. Gels were prepared using 1,4-butanediol diacrylate as crosslinker and alpha tricalciumphosphate; ZnCl2 and SrCl2 were added to the aqueous phase. MTT results demonstrated that the addition of strontium had a beneficial effect on the osteoblast cells density on hydrogels, and zinc instead did not increase osteoblast proliferation. The amount of calcium produced by the osteoblast cells quantified through the Alizarin Red protocol revealed that both strontium and zinc positively influenced the formation of calcium; furthermore, their effect was synergistic. Rheology properties were used to mechanically characterize the hydrogels and especially the influence of crosslinker's concentration on them, showing the hydrogels presented had extremely good mechanical properties. Furthermore, the antimicrobial activity of strontium and zinc in the hydrogels against methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis was determined. PMID:27174392

  6. Internal fixation and bone grafting for intraarticular nonunion of tibial plateau: a report of four cases

    Institute of Scientific and Technical Information of China (English)

    Ramesh K Sen; Ashwani Soni; Uttam Chand Saini; Daljit Singh

    2011-01-01

    Intraarticular nonunion of tibial plateau is rare.In the literature,only 9 patients were found to be treated for intraarticular tibial plateau nonunion and they got varying results.Internal fixation along with bone grafting was done as a standard treatment in all cases.We treated 4 different profile cases of intraarticular tibial plateau nonunion in our institution by 4 different methods.We treated these cases with plaster of paris cast,internal fixation along with bone graft,arthrodesis with K-nail and total knee replacement.Case 1 was treated with plaster of paris (POP)cast as the patient refused surgery.The fracture was united and the patient was fully satisfied with full range of motion despite valgus malalignment.Case 2 was managed with open reduction internal fixation along with bone grafting.The patient had a good union and got full range of motion at the knee joint.Case 3 was treated with total knee arthroplasty due to her old age and got satisfactory result.Case 4 was an infected nonunion.Arthrodesis was done and the patient could walk with full weight bearing independently.We conclude that internal fixation along with bone grafting may not be suitable in all cases of intraarticular nonunion of tibial plateau.Causes of nonunion,present condition and range of motion of the knee joint,as well as the age of patient should be all considered and the treatment should be individualised according to each patient's situation.

  7. Improving the Clinical Evidence of Bone Graft Substitute Technology in Lumbar Spine Surgery

    OpenAIRE

    Hsu, Wellington K.; Nickoli, M. S.; Wang, J.C.; Lieberman, J. R.; An, H S; Yoon, S. T.; Youssef, J. A.; Brodke, D.S.; McCullough, C. M.

    2012-01-01

    Bone graft substitutes have been used routinely for spine fusion for decades, yet clinical evidence establishing comparative data remains sparse. With recent scrutiny paid to the outcomes, complications, and costs associated with osteobiologics, a need to improve available data guiding efficacious use exists. We review the currently available clinical literature, studying the outcomes of various biologics in posterolateral lumbar spine fusion, and establish the need for a multicenter, indepen...

  8. USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY

    OpenAIRE

    Roos, Milton Valdomiro; Roos, Bruno Dutra; Giora, Taís Stedile Busin; Taglietti, Thiago Martins

    2015-01-01

    To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical...

  9. Analysis of donor sites for mandibular bone grafts by computerized cone beam tomography to evaluate bone remodeling

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    Thomaz Wassall

    2009-01-01

    Full Text Available Objective: To analyze the graft donor site (posterior region of the mandible by means of cone-beam volumetric tomographies to assess boneremodeling, verifying the degree of morbidity with regard to this parameter. Methods: The sample was composed of twenty individuals, irrespective of age, gender and ASA I and ASA II surgical risk classification. Three volume computed tomographies were performed: one before surgery, another seven days after surgery and the last 180 days after surgery. Image acquisition by volumetric cone-beam tomography and the computer program Dental Slice were used to make the measurements. Results: Statistics showed that there was significant bone remodeling. Although there are several concerns about the graft donor sites, no data were obtained in the literature, about the assessment of bone remodeling of the donor site. Conclusion: Mean remodeling in the posterior region of the mandible, assessed 180 days after graft removal is 81.3%, on an average, andmorbidity in the posterior donor site of the mandible has been small, when compared with the other donor sites, both intra-oral and extra-oral, according to the data in the specific literature.

  10. 早期应用富血小板血浆凝胶对自体脂肪组织移植存活率的影响%Platelet-rich plasma fibrin glue in the early stage for survival rate of autogeneic fat graft

    Institute of Scientific and Technical Information of China (English)

    黎洪棉; 柳大烈; 吴涛; 赵培冉; 梁双武

    2011-01-01

    背景:自体颗粒脂肪组织填充广泛用于修复重建领域,移植后组织大量被吸收可严重影响远期效果.目的:观察早期应用富血小板血浆对自体移植脂肪组织存活率的影响.方法:取健康成年人腹部脂肪组织颗粒进行纯化,同时抽取少量静脉血,采用离心法提取自体富血小板血浆,利用纤维蛋白胶的物理特性制备含有富血小板血浆的脂肪组织复合移植物,在裸鼠背部中线两侧各分离一个腔隙,富血小板血浆组将脂肪组织颗粒-富血小板血浆凝胶随机注射入一侧腔隙深筋膜下,对侧仅注入脂肪组织颗粒作为对照组.结果与结论:移植后1个月和3个月,与对照组比较,富血小板血浆组移植脂肪局部的血管增生均较明显(P < 0.05),脂肪质量保持率均较高(P < 0.05);移植物脂肪细胞纤维坏死率均较低(P < 0.05).提示早期应用富血小板血浆凝胶可促进移植脂肪组织局部的血管再生,增加脂肪组织的质量保持率,减少脂肪移植后的纤维坏死程度.%BACKGROUND: Autogeneic fat is the ideal filling material in aesthetic and reconstructive surgery. However, the autogeneic fat graft produces serious impact on long-term effect because much fat would be absorbed after transplantation. Accordingly,difficulties in this field are how to increase the survival rate of autogeneic fat graft.OBJECTIVE: To investigate the effect of platelet-rich plasma (PRP) on the survival rate of autogeneic free grain fat grafts.METHODS: The fat was harvested from abdominal region of healthy adults and purified. At the same time, venous blood was taken from concurrent patients and PRP was prepared by centrifugation. The grafts were made using fibrin glue combined with PRP according to the physical characteristics of fibrin glue. A subdermal pocket was created in each side of the dorsal midline,the grafts which carried fat particle and PRP fibrin glue were randomly implanted below the deep fascia of

  11. Evaluation of alveolar bone grafting in unilateral cleft lip and palate patients using a computer-aided diagnosis system

    Energy Technology Data Exchange (ETDEWEB)

    Sutthiprapaporn, Pipop; Kongsomboon, Supaporn; Limmonthol, Saowaluck; Pisek, Poonsak; Keinprasit, Chutimaporn [Khon Kaen University, Khon Kaen (Thailand); Tanimoto, Keiji; Nakamoto, Takashi [Dept. of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan)

    2012-09-15

    This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either 'non-cleft side' or 'cleft side'. The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. The pixel area showed a significant difference between the 'non-cleft side' and 'cleft side' in group 0 (404.27{+-}103.72/117.73{+-}92.25; p=0.00), group 1 (434.29{+-}86.70/388.31{+-}109.51; p=0.01), and group 4 (430.98{+-}98.11/366.71{+-}154.59; p=0.02). No significant differences were found in group 2 (423.57{+-}98.12/383.47{+-}135.88; p=0.06) or group 3 (433.02{+-}116.07/384.16{+-}146.55; p=0.19). Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.

  12. Different bone graft fusion materials applied in lumbar interbody fusion%不同植骨融合材料在腰椎椎体间脊柱融合中的应用

    Institute of Scientific and Technical Information of China (English)

    覃建朴; 王翀; 张朋云; 曹广如; 蔡玉强; 廖文波

    2016-01-01

    背景:脊柱融合治疗时选择合适的替代移植骨具有重要的意义,能够解决自体骨移植及其他移植材料带来的弊端。目的:观察不同植骨融合材料性能,探讨不同植骨融合材料在犬腰椎椎体间脊柱融合中的应用效果。方法:选取45只中华田园犬建立腰椎椎体间脊柱融合模型,建模后随机分3组,分别植入自体髂骨、重组人骨形态发生蛋白2复合材料和同种异体髂骨,分析不同植骨融合材料在犬腰椎椎体间脊柱融合中的效果。结果与结论:①融合率:重组人骨形态发生蛋白2复合材料组犬融合率显著高于其他组(P <0.05);②Oswestry 功能障碍指数:重组人骨形态发生蛋白2复合材料组术后 Oswestry 功能障碍指数显著低于其他2组(P <0.05);②组织学形态:苏木精-伊红染色显示,术后12周,与其他2组相比,重组人骨形态发生蛋白2犬完全骨性融合,且形成了连续骨小梁,植入骨与犬上下椎体完全粘连;④结果提示:重组人骨形态发生蛋白2复合材料更能够促更好地促进脊柱愈合,效果优于自体和同种异体骨移植。%BACKGROUND: The choice of suitable bone graft substitute is vital for spinal fusion treatment, which can solve some limitations caused by autogenous bone graft and other materials. OBJECTIVE: To investigate properties of different bone graft fusion materials, and to explore their application in dog spinal fusion of lumbar vertebral body. METHODS: Forty-five Chinese rural dogs were enrol ed to prepare lumbar interbody fusion models, and then were randomized into three groups transplanted with autogenous ilium, recombinant human bone morphogenetic protein-2 composite or al ograft ilium, respectively. Afterwards, effects of different materials in the lumbar interbody fusion were analyzed. RESULTS AND CONCLUSION: The fusion rate of the composite group was significantly higher than those of the other

  13. Autogenous Deformation of Concrete

    DEFF Research Database (Denmark)

    Autogenous deformation of concrete can be defined as the free deformation of sealed concrete at a constant temperature. A number of observed problems with early age cracking of high-performance concretes can be attributed to this phenomenon. During the last 10 years , this has led to an increased...... focus on autogenous deformation both within concrete practice and concrete research. Since 1996 the interest has been significant enough to hold international, yearly conferences entirely devoted to this subject. The papers in this publication were presented at two consecutive half-day sessions...... at the American Concrete Institute’s Fall Convention in Phoenix, Arizona, October 29, 2002. All papers have been reviewed according to ACI rules. This publication, as well as the sessions, was sponsored by ACI committee 236, Material Science of Concrete. The 12 presentations from 8 different countries indicate...

  14. Tooth movement out of the bony wall using augmented corticotomy with nonautogenous graft materials for bone regeneration.

    Science.gov (United States)

    Lee, Kye-Bok; Lee, Dong-Yeol; Ahn, Hyo-Won; Kim, Seong-Hun; Kim, Eun-Cheol; Roitman, Igor

    2014-01-01

    This prospective randomized split-mouth study was performed to compare the effects of augmented corticotomy with those of different nonautogenous bone graft materials combined with orthodontic tooth movement in dogs. Decortication was performed on the buccal bone surface of 6 male beagle dogs that were randomly assigned to receive grafts of deproteinized bovine bone mineral, irradiated cortical bone, or synthetic bone. Immediate orthodontic force was applied to the second and third premolars for buccal tipping for 6 weeks. The pocket depth and width of keratinized tissue (WKT) were measured. Histologic and histomorphometric analyses were performed. The probing depth, WKT, and ratio of the area of new bone to that of total bone on the buccal side were not significantly different between groups. All groups had considerable new bone formation on the pressure side. New bone formation on the buccal side and buccal plate formation in the coronal direction along the root surfaces were induced by the bone-derived and PDL-derived mesenchymal matrix, respectively. The angular change between groups was significantly different (P corticotomy using nonautogenous graft materials facilitated tooth movement without fenestrations and accelerated new bone formation on the pressure side. PMID:25247172

  15. Tooth Movement out of the Bony Wall Using Augmented Corticotomy with Nonautogenous Graft Materials for Bone Regeneration

    Directory of Open Access Journals (Sweden)

    Kye-Bok Lee

    2014-01-01

    Full Text Available This prospective randomized split-mouth study was performed to compare the effects of augmented corticotomy with those of different nonautogenous bone graft materials combined with orthodontic tooth movement in dogs. Decortication was performed on the buccal bone surface of 6 male beagle dogs that were randomly assigned to receive grafts of deproteinized bovine bone mineral, irradiated cortical bone, or synthetic bone. Immediate orthodontic force was applied to the second and third premolars for buccal tipping for 6 weeks. The pocket depth and width of keratinized tissue (WKT were measured. Histologic and histomorphometric analyses were performed. The probing depth, WKT, and ratio of the area of new bone to that of total bone on the buccal side were not significantly different between groups. All groups had considerable new bone formation on the pressure side. New bone formation on the buccal side and buccal plate formation in the coronal direction along the root surfaces were induced by the bone-derived and PDL-derived mesenchymal matrix, respectively. The angular change between groups was significantly different (P < 0.001. Augmented corticotomy using nonautogenous graft materials facilitated tooth movement without fenestrations and accelerated new bone formation on the pressure side.

  16. The use of absorbable membranes for Guided Bone Regeneration in horizontal localized bone defects.

    Directory of Open Access Journals (Sweden)

    Adamantia VLACHAKI

    2016-08-01

    Full Text Available SUMMARY: One of the most widely used techniques for the reconstruction of horizontal alveolar defects is Guided Bone Regeneration (GBR. Aim of this literature review is to present and evaluate the clinical techniques for horizontal GBR in localized bone defects with the use of bone grafts and barrier absorbable membranes. In order to accomplish this literature review, a survey in website Pubmed was carried out, with key words: GBR in horizontal defects, GBR in localized defects, bone substitutes, absorbable membranes. Experimental animal studies, studies which described the autogenous block techniques and studies which described GBR with nonabsorbable membranes were excluded from this literature review. GBR was found to be a well document and predictable technique for horizontal localized bone defects, in order to place dental implants. Also the use of xenogenous bone graft in combination with absorbable membrane presents a lot of encouraging results, with high success and survival implant rate.

  17. Self-deploying shape memory polymer scaffolds for grafting and stabilizing complex bone defects: A mouse femoral segmental defect study.

    Science.gov (United States)

    Baker, Richard M; Tseng, Ling-Fang; Iannolo, Maria T; Oest, Megan E; Henderson, James H

    2016-01-01

    Treatment of complex bone defects places a significant burden on the US health care system. Current strategies for treatment include grafting and stabilization using internal metal plates/screws, intramedullary rods, or external fixators. Here, we introduce the use of shape memory polymer (SMP) materials for grafting and adjunct stabilization of segmental defects. Self-deploying SMP grafts and SMP sleeves capable of expanding and contracting, respectively, under intraoperative conditions were developed and evaluated in a mouse segmental defect model in vivo. Integration between grafts/sleeves and native bone was assessed using x-ray radiography, microcomputed tomography, and torsional mechanical testing. We found that SMP grafts were able to integrate with the native bone after 12 weeks, maintain defect stability, and provide torsional mechanical properties comparable to an allograft alone treatment; however no gross de novo bone formation was observed. SMP sleeves did not inhibit bony bridging at the margins, and limbs treated with a sleeve/allograft combination had torsional mechanical properties comparable to limbs treated with an allograft alone. In vitro torsional and bending tests suggest sleeves may provide additional torsional stability to defects. Incorporation of shape memory into synthetic bone graft substitutes and adjunct stabilization devices is anticipated to enhance functionality of synthetic materials employed in both applications.

  18. Chondroblastoma with secondary aneurysmal bone cyst of the hamate: case report.

    Science.gov (United States)

    Rhee, Peter C; Novais, Eduardo N; Shives, Thomas C; Shin, Alexander Y

    2012-03-01

    Chondroblastoma of the carpals is rare, can mimic other benign bone tumors, and presents a diagnostic challenge. There have been few cases of benign tumors involving the hamate, with only one reported case of chondroblastoma, which was treated with complete hamate excision. We present a case of chondroblastoma with secondary aneurysmal bone cyst of the hamate treated with curettage, high-speed burring, phenol, and autogenous iliac crest bone grafting. At the time of the most recent radiographic follow-up, there was full graft incorporation, preserved hamate morphology, and no evidence of recurrence.

  19. Comparison of lyophilization, and freezing in honey as techniques to preserve cortical bone allografts used to repair experimental femoral defects in domestic adult cats

    Directory of Open Access Journals (Sweden)

    M.P. Ferreira

    2012-04-01

    Full Text Available Cats with orthopedic conditions are a prominent part of the clinical work of veterinary. Conditions such as comminuted fractures, bone tumors and non-unions are often difficult to repair and may require the use of bone grafts for treatment. This study evaluated cortical bone allografts preserved in honey, frozen or lyophilized for correcting long bone defects created in the diaphysis of the right femur of domestic cats (n=24. In the control group (n=6, the defect was repaired using autogenous cortical bone graft. In the remaining animals (n=6/group, the defect was repaired with cortical bone allografts preserved in honey, frozen or lyophilized. Success of graft incorporation and length of time for consolidation were assessed through clinical, radiographic and histological evaluations performed up to 180 days. In the control, frozen, honey and lyophylized groups, respectively, success of graft incorporation was 91.6%, 83.3%, 75%, and 25%, with corresponding mean length of time for consolidation of 83.1, 78, 105 and 120 days. Incorporation percentage in the lyophilized group was significantly lower than in the frozen and control groups. In conclusion, bone grafts preserved in honey or frozen were effective for repairing cortical defects in the femurs of cats as compared to autogenous cortical bone grafts.

  20. Octacalcium phosphate ceramics combined with gingiva-derived stromal cells for engineered functional bone grafts

    International Nuclear Information System (INIS)

    Biocompatible ceramic fillers are capable of sustaining bone formation in the proper environment. The major drawback of these scaffolding materials is the absence of osteoinductivity. To overcome this limitation, bioengineered scaffolds combine osteoconductive components (biomaterials) with osteogenic features such as cells and growth factors. The bone marrow mesenchymal stromal cells (BMMSCs) and the β-tricalcium phosphate (β-TCP) are well-known and characterized in this regard. The present study was conducted to compare the properties of novel octacalcium phosphate ceramic (OCP) granules with β-TCP (Cerasorb®), gingiva-derived mesenchymal stromal cells (GMSCs) properties with the BMMSCs and osteogenic and angiogenic properties of a bioengineered composite based on OCP granules and the GMSCs. This study demonstrates that GMSCs and BMMSCs have a similar osteogenic capacity. The usage of OCP ceramic granules in combination with BMMSCs/GMSCs significantly affects the osteo- and angiogenesis in bone grafts of ectopic models. (paper)

  1. Sinus lift tissue engineering using autologous pulp micro-grafts: A case report of bone density evaluation

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    Giorgio Brunelli

    2013-01-01

    Full Text Available Background: Although autografts are the standard procedure for bone grafting, the use of bone regeneration by means of dental pulp stem cell is an alternative that opens a new era in this field. Rigenera Protocol is a new technique able to provide the surgeon autologous pulp micro-grafts. Materials and Methods: At the Department of Oral Surgery, Don Orione Hospital, Bergamo, Italy, one patient underwent sinus lift elevation with pulp stem micro-grafts gentle poured onto collagen sponge. A CT scan control was performed after 4 months and DICOM data were processed with medical imaging software which gives the possibility to use a virtual probe to extract the bone density. Pearson′s Chi-square test was used to investigate difference in bone density (BD between native and newly formed bone. Results: BD in newly formed bone is about the double of native bone. Conclusion: This report demonstrated that micro-grafts derived from dental pulp poured onto collagen sponge are a useful method for bone regeneration in atrophic maxilla.

  2. Outcome of diaphyseal forearm fracture-nonunions treated by autologous bone grafting and compression plating

    Directory of Open Access Journals (Sweden)

    Albertoni Walter

    2009-05-01

    Full Text Available Abstract Background The treatment of forearm fracture-nonunions continues to represent a therapeutic challenge, and reported outcomes are moderate at best. Limiting aspects of this particular anatomic location include the relation between restoration of shaft length with the anatomy and long-term functional outcome of adjacent joints, as well as the risk of elbow and wrist stiffness related to prolonged immobilization. The present study was designed to assess the outcome of autologous bone grafting with compression plating and early functional rehabilitation in patients with forearm fracture non-unions. Methods Prospective follow-up study in 31 consecutive patients presenting with non-unions of the forearm diaphysis (radius, n = 11; ulna, n = 9; both bones, n = 11. Surgical revision was performed by restoring anatomic forearm length by autologous bone grafting of the resected non-union from the iliac crest and compression plating using a 3.5 mm dynamic compression plate (DCP or limited-contact DCP (LC-DCP. The main outcome parameters consisted of radiographic bony union and functional outcome, as determined by the criteria defined by Harald Tscherne in 1978. Patients were routinely followed on a short term between 6 weeks to 6 months, with an average long-term follow-up of 3.6 years (range 2 to 6 years. Results Radiographically, a bony union was achieved in 30/31 patients within a mean time of 3.5 months of revision surgery (range 2 to 5 months. Clinically, 29/31 patients showed a good functional outcome, according to the Tscherne criteria, and 26/31 patients were able to resume their previous work. Two postoperative infections occurred, and one patient developed a persistent infected nonunion. No case of postoperative failure of fixation was seen in the entire cohort. Conclusion Revision osteosynthesis of forearm nonunions by autologous iliac crest bone grafting and compression plating represents a safe and efficacious modality for the

  3. Management of scaphoid nonunion with avascular necrosis using 1,2 intercompartmental supraretinacular arterial bone graft

    Directory of Open Access Journals (Sweden)

    Mohamad Dehghani

    2014-01-01

    Full Text Available Background: 1,2 ICSRA, introduced by Aidembery et al., is a well-established technique, with up to 100% union rate among different studies . The purpose of our study was to evaluate the outcome of scaphoid nonunion undergoing 1,2 ICSRA bone graft in Iran. Materials and Methods: All participants who presented sequentially over a period of 24 months between 2010 and 2013 with nonunion scaphoid fracture with AVN in proximal pole were included in the study. Anteroposterior and lateral view plain radiographs of carpal bones were obtained for diagnosis of nonunion, and a diagnosis of avascular necrosis was made by MRI of the scaphoid. Subjects underwent 1,2 ICSRA bone graft surgery. Patients were assessed based on radiographs and the Mayo Wrist Score (MWS questionnaire on before and after surgery. Data were analyzed using SPSS ver. 18 by paired t test. Results: Overall, 16 patients (100% male were included in the study. Mean age of subjects was 27.50 ± 5.86 (18 to 38. Mean Mayo score was 36.63 ± 8.92 and 83.75 ± 9.22 before and 6 month after surgery, respectively, and the difference was statistically significant (P < 0.001. after 8 weeks, 10 (62.5% had union, and after 12 weeks, all subjects had union. Nine (56.25% of our patients had excellent functional outcome, 5 (31.25% had good and 2 (12.5% had satisfactory functional outcome. Conclusion: 1,2 ICSRA is a proper pedicle of vascularized bone graft due to the ease of visibility and dissection. The functional results and union rates were satisfactory in our study.

  4. Guided tissue regeneration and bone grafts in the treatment of furcation defects.

    Science.gov (United States)

    Caffesse, R G; Nasjleti, C E; Plotzke, A E; Anderson, G B; Morrison, E C

    1993-11-01

    The present study evaluated the effects of guided tissue regeneration (GTR), with and without demineralized freeze-dried cortical bone grafts, in the treatment of furcation defects in 4 female beagle dogs with naturally occurring periodontal disease. The root surfaces were thoroughly debrided. Four weeks later, full thickness facial and lingual mucoperiosteal flaps were reflected using inverse bevel incisions on both sides of the mandible involving the 2nd, 3rd, and 4th premolar, and the 1st molar teeth. Following debridement, notches were placed on the roots at the level of supporting bone. Test quadrants were randomly selected and furcations were filled with reconstituted, demineralized, freeze-dried human cortical bone grafts. Following bone grafting, all defects were covered with an expanded polytetrafluoroethylene (ePTFE) membrane, which was sutured with 4-0 sutures. Afterward, interproximal sutures were placed through the flaps, assuring the flaps covered the membranes completely. The contralateral side, serving as control, was treated by debridement only and application of ePTFE membrane. All membranes were removed 6 weeks after surgery. Dogs were sacrificed at 4 months after surgery. Both mesio-distal and bucco-lingual histologic sections were evaluated by descriptive histology. Linear measurements and surface area determination of the furcal tissues were carried out using the microscope attached to a digitizer. Twelve to 20 nonserial sections were made of the mid-buccal aspects of each root of each treated tooth. Half of these sections were stained with Harris' hematoxylin and eosin (H&E) and the other half stained with Mallory's trichrome stain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8295103

  5. Inhibitory effect of arresten recombinant protein on neointimal hyperplasia of venous autografts In a rat autogenous vein graft model%重组arresten蛋白对自体移植静脉内膜增生的抑制作用

    Institute of Scientific and Technical Information of China (English)

    宋自芳; 郑启昌; 尚丹; 舒晓刚; 熊俊; 胡青刚

    2008-01-01

    Objective To investigate the inhibitory effect of prokaryotie-expressed arresten recombinant protein on neointimal hyperplasia of autogenous vein graft in rats. Methods Human arresten recombinant protein was expressed and purified from pRSET prokaryotic expression system. The model of autogenous vein graft was prepared by transplanting the external jugular vein into aorta in Wistar rats by means of micro-surgery. The rats were divided into three groups : sham operation group, autograft control group,autograft experimental group. From 3rd day after transplantation,arresten protein was injected intra-peritoneally daily at a dosage of 4 mg/(kg·d).Four weeks after treatment,venous autografts were removed at autopsy and subjected to histopathological examination and immanohistochemical staining. Results In autograft control and experimental groups,the venous autografts displayed well-developed neointimal proliferative lesions composed of a large number of smooth muscle cells that stained positive for α-SMA. The neointimal hyperplasia resulted in vascular lumen stricture in venous autografts. In autograft experimental group,the neointimal hyperplasia was suppressed obviously, and its neointimal area (0.12 ±0.07) mm2 and NIA/MA ratio (0.373 +0.085 ) of venous autografts were significantly reduced as compared with those in control group (0.38 + 0.11)mm2, 1.621±0.086 (P<0.01). And its PCNA labeling index of neointimal cells was significantly lower than that in control group (15.62±3.97) % vs (56.36±3.49) % (P<0.01). Conclusion Recombinant arresten protein could significantly inhibit the proliferation of neointimal smooth muscle cells and the development of neointimal hyperplasia of venous autografts in rats. Arresten is a powerful inhibitor of restenosis after vascular reconstructive operation with a potential for therapeutic use.%目的 观察原核表达人arresten重组蛋白对自体移植静脉内膜增生的抑制作用.方法 用pRSET原核表达系统表达

  6. Engineering anatomically shaped vascularized bone grafts with hASCs and 3D-printed PCL scaffolds.

    Science.gov (United States)

    Temple, Joshua P; Hutton, Daphne L; Hung, Ben P; Huri, Pinar Yilgor; Cook, Colin A; Kondragunta, Renu; Jia, Xiaofeng; Grayson, Warren L

    2014-12-01

    The treatment of large craniomaxillofacial bone defects is clinically challenging due to the limited availability of transplantable autologous bone grafts and the complex geometry of the bones. The ability to regenerate new bone tissues that faithfully replicate the anatomy would revolutionize treatment options. Advances in the field of bone tissue engineering over the past few decades offer promising new treatment alternatives using biocompatible scaffold materials and autologous cells. This approach combined with recent advances in three-dimensional (3D) printing technologies may soon allow the generation of large, bioartificial bone grafts with custom, patient-specific architecture. In this study, we use a custom-built 3D printer to develop anatomically shaped polycaprolactone (PCL) scaffolds with varying internal porosities. These scaffolds are assessed for their ability to support induction of human adipose-derived stem cells (hASCs) to form vasculature and bone, two essential components of functional bone tissue. The development of functional tissues is assessed in vitro and in vivo. Finally, we demonstrate the ability to print large mandibular and maxillary bone scaffolds that replicate fine details extracted from patient's computed tomography scans. The findings of this study illustrate the capabilities and potential of 3D printed scaffolds to be used for engineering autologous, anatomically shaped, vascularized bone grafts.

  7. Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery

    Directory of Open Access Journals (Sweden)

    Kaveh Bashti

    2015-01-01

    Full Text Available   Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine model. Methods: Twenty pairs of bovine knees were harvested after death. Soft tissue was removed and the Achilles tendon was harvested to be used as an ACL graft. It was secured into the bone tunnel on the tibial side via two different methods: Bashti Bone Plug technique and conventional screw method. Biomechanical strength was measured using 200 N and 300 N cyclic loading on the graft. Pull out strength was also tested until the graft fails. Results: No graft failure was observed after 200 N and 300 N cyclic loading in either fixation methods. When testing for pull out failure, 21 tendons (53% were torn and 19 tendons (48% slipped out. No fixation failure occurred, which did not reveal a significant difference between the bone plug or interference screw group (P=0.11. The mean pull out force until failure of the graft was 496±66 N in the screw group and 503±67 N in the bone plug group (P=0.76. Conclusions: Our suggested fixation technique of Bashti bone plug is a native, cheap, and feasible method that provides comparable biomechanical strength with interference screw when soft tissue fixation was attempted in bovine model.

  8. Percutaneous reduction combined with bone graft in treatment of displaced intra-articular calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    Wang Xianhui; Mei Jiong; Li Shanzhu; Ni Ming; Shang Hongjing

    2009-01-01

    Objective: To introduce the experience and key points of percutaneous reduction combined with bone graft to treat calcaneal fractures. Methods: Percutaneous reduction and internal fixation combined with bone graft was performed from April 2004 to April 2006 on 15 cases (16 sides) with intra-articular calcaneal fractures including 13 males (14 feet) and 2 females (2 feet) ,with average age of 36. 6 years (24-61 years). All patients underwent radiography including lateral and axial views for calcaneus, oblique view for foot and three-dimensional CT imaging reconstruction. According to Sanders classification, there were 12 feet of type Ⅱ (3 type Ⅱ a, 3 type Ⅱ b and 8 type Ⅱ c)and 2 feet of type lilac. The length of calcaneus was recovered through traction by Steinmann pin which passed through calcaneal tubercle perpendicularly and the posterior facet was elevated until reduction by a curve scissors through an 0.5 cm incision along the primary fracture line of lateral calcaneus. The calcaneus was fixed with different cannulated cancellous screws according to the type of fractures. Then bone graft was injected to fill the defect of calcaneus through lateral incision. Results: All patients were followed up for an average of 18.4 months (ranged, 12 to 34 months). No complication such as wound infection, screw breakage and calcaneum varus was found postoperatively. The average time for bone healing was 10 weeks. The results were excellent in 12 cases, good in 4 cases according to the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. The rate of excellent and good clinical results was 100%. The mean AOFAS hindfoot score in tongue type group (86.5+4.4) was better than in joint depression type group (81.2±1.7, P<0.05). Radiography showed basic restoration of Bohler's angle, Gissane's angle and calcaneal shape. Conclusion: The combination of percutaneous reduction and injectable bone graft is suitable for surgical treatment of Sanders 11 and III type

  9. Development of a Three-Dimensional (3D Printed Biodegradable Cage to Convert Morselized Corticocancellous Bone Chips into a Structured Cortical Bone Graft

    Directory of Open Access Journals (Sweden)

    Ying-Chao Chou

    2016-04-01

    Full Text Available This study aimed to develop a new biodegradable polymeric cage to convert corticocancellous bone chips into a structured strut graft for treating segmental bone defects. A total of 24 adult New Zealand white rabbits underwent a left femoral segmental bone defect creation. Twelve rabbits in group A underwent three-dimensional (3D printed cage insertion, corticocancellous chips implantation, and Kirschner-wire (K-wire fixation, while the other 12 rabbits in group B received bone chips implantation and K-wire fixation only. All rabbits received a one-week activity assessment and the initial image study at postoperative 1 week. The final image study was repeated at postoperative 12 or 24 weeks before the rabbit scarification procedure on schedule. After the animals were sacrificed, both femurs of all the rabbits were prepared for leg length ratios and 3-point bending tests. The rabbits in group A showed an increase of activities during the first week postoperatively and decreased anterior cortical disruptions in the postoperative image assessments. Additionally, higher leg length ratios and 3-point bending strengths demonstrated improved final bony ingrowths within the bone defects for rabbits in group A. In conclusion, through this bone graft converting technique, orthopedic surgeons can treat segmental bone defects by using bone chips but with imitate characters of structured cortical bone graft.

  10. Development of a Three-Dimensional (3D) Printed Biodegradable Cage to Convert Morselized Corticocancellous Bone Chips into a Structured Cortical Bone Graft.

    Science.gov (United States)

    Chou, Ying-Chao; Lee, Demei; Chang, Tzu-Min; Hsu, Yung-Heng; Yu, Yi-Hsun; Liu, Shih-Jung; Ueng, Steve Wen-Neng

    2016-04-20

    This study aimed to develop a new biodegradable polymeric cage to convert corticocancellous bone chips into a structured strut graft for treating segmental bone defects. A total of 24 adult New Zealand white rabbits underwent a left femoral segmental bone defect creation. Twelve rabbits in group A underwent three-dimensional (3D) printed cage insertion, corticocancellous chips implantation, and Kirschner-wire (K-wire) fixation, while the other 12 rabbits in group B received bone chips implantation and K-wire fixation only. All rabbits received a one-week activity assessment and the initial image study at postoperative 1 week. The final image study was repeated at postoperative 12 or 24 weeks before the rabbit scarification procedure on schedule. After the animals were sacrificed, both femurs of all the rabbits were prepared for leg length ratios and 3-point bending tests. The rabbits in group A showed an increase of activities during the first week postoperatively and decreased anterior cortical disruptions in the postoperative image assessments. Additionally, higher leg length ratios and 3-point bending strengths demonstrated improved final bony ingrowths within the bone defects for rabbits in group A. In conclusion, through this bone graft converting technique, orthopedic surgeons can treat segmental bone defects by using bone chips but with imitate characters of structured cortical bone graft.

  11. Six Years Follow-up of Spinal Tuberculosis Treated by Anterior Debridement, Instrumentation and Bone Grafting

    Institute of Scientific and Technical Information of China (English)

    Hao Dingjun; Dou Yusheng; Wen Shiming; He Baorong

    2007-01-01

    @@ Tuberculosis of the spine comprises approximately 50% of all skeletal cases. 50 years ago,costotranseversectomy was the preferred surgical treatment. The primary limitation of costotranseversectomy has the difficulty exposing the entire phlegmon. Frequently multiple debridement were required to adequately remove all evidence of infection. In the 1970s, posterior debridement was used. Posterior debridement also had many disadvantages, including long-term bed rest, increased risk of pulmonary and urinary infection, poor fusion rate, and high recurrence rate of infection,and residual kyphosis [1]. Because of the limitations with posterior and posterior lateral approaches, anterior approaches for debridement, instrumentation,and bone grafting are more commonly used today.Anterior treatment will prevent progression of kyphosis, prevent recurrence, and protect the position of the graft material.

  12. Healing patterns of critical size bony defects in rats after grafting with bone substitutes soaked in recombinant human bone morphogenetic protein-2: histological and histometric evaluation.

    Science.gov (United States)

    Mokbel, N; Naaman, N; Nohra, J; Badawi, N

    2013-09-01

    The aim of the study was to evaluate the effect of different bone substitutes soaked in recombinant human bone morphogenetic protein-2 (rhBMP-2) on the healing of critical size defects in calvarial bone. Defects were created in 24 Sprague Dawley rats. The rhBMP-2 was diluted to obtain a final concentration of 0.2mg/ml. Rats were divided into four groups and treated as follows: in the first group the defect was filled with anorganic bovine bone mineral (ABBM) and rhBMP-2, the second group was treated with freeze-dried bone allograft (FDBA) and rhBMP-2, and the third group was treated with autogenous bone (AUTO). In the control group the defects were left untreated. Animals were killed after 8weeks and calcified histological sections prepared. Histometric measurements showed that mean (SD) bone formation was 4.00 (1.69)mm(2) in the ABBM group, 2.56 (1.06)mm(2) in the FDBA group, and 2.30 (0.34)mm(2) in the AUTO group. The difference between the ABBM group and the other 3 groups was significant (p<0.0001) with a mean bone formation of 0.82 (0.25)mm(2) in the control group. There was no significant difference between the FDBA and the AUTO groups (p=0.96). Within the limits of this study we concluded that the addition of rhBMP-2 to bone substitutes was efficacious in regenerating bone in critical size bone defects in calveria in rats. PMID:22939894

  13. Repair of segmental bone defect using Totally Vitalized tissue engineered bone graft by a combined perfusion seeding and culture system.

    Directory of Open Access Journals (Sweden)

    Lin Wang

    Full Text Available BACKGROUND: The basic strategy to construct tissue engineered bone graft (TEBG is to combine osteoblastic cells with three dimensional (3D scaffold. Based on this strategy, we proposed the "Totally Vitalized TEBG" (TV-TEBG which was characterized by abundant and homogenously distributed cells with enhanced cell proliferation and differentiation and further investigated its biological performance in repairing segmental bone defect. METHODS: In this study, we constructed the TV-TEBG with the combination of customized flow perfusion seeding/culture system and β-tricalcium phosphate (β-TCP scaffold fabricated by Rapid Prototyping (RP technique. We systemically compared three kinds of TEBG constructed by perfusion seeding and perfusion culture (PSPC method, static seeding and perfusion culture (SSPC method, and static seeding and static culture (SSSC method for their in vitro performance and bone defect healing efficacy with a rabbit model. RESULTS: Our study has demonstrated that TEBG constructed by PSPC method exhibited better biological properties with higher daily D-glucose consumption, increased cell proliferation and differentiation, and better cell distribution, indicating the successful construction of TV-TEBG. After implanted into rabbit radius defects for 12 weeks, PSPC group exerted higher X-ray score close to autograft, much greater mechanical property evidenced by the biomechanical testing and significantly higher new bone formation as shown by histological analysis compared with the other two groups, and eventually obtained favorable healing efficacy of the segmental bone defect that was the closest to autograft transplantation. CONCLUSION: This study demonstrated the feasibility of TV-TEBG construction with combination of perfusion seeding, perfusion culture and RP technique which exerted excellent biological properties. The application of TV-TEBG may become a preferred candidate for segmental bone defect repair in orthopedic and

  14. Reparación ósea mediante aloimplantes sometidos a diferentesmétodos de conservación en conejos Allogeneic bone grafts treated with different conservation methodsfor bone repair in rabbits

    Directory of Open Access Journals (Sweden)

    G. Dasso

    1998-01-01

    Full Text Available Debido a las limitantes de los implantes de hueso de origen autogénico y a la ineficiencia de los implantes de hueso fresco de origen alogénico ha sido necesario incursionar en el área de los implantes de hueso alogénico procesados. Con este objetivo se utilizaron 27 conejos raza blanco neozelandés de 3 a 5 meses de edad, quienes recibieron los diferentes tipos de aloimplantes de hueso esponjoso (desproteinizados, congelados o hervidos para evaluar el grado de reparación de una lesión previamente realizada en la tibia. Los animales fueron sacrificados a las dos, cuatro y ocho semanas postcirugía y la evaluación se realizó a través de cortes histológicos. Determinándose que a las dos semanas post-cirugía no hubo mayor diferencia entre los distintos grupos analizados, pero sí lo hubo a las cuatro y ocho semanas post-cirugía, donde se observó claramente una mayor eficiencia de los implantes desproteinizados. Esto se debe a que el hipoclorito de sodio destruye los elementos antigénicos presentes en el implante, lo que disminuye las probabilidades de rechazo por parte del huésped y facilita la llegada de células indiferenciadas que se diferencian a osteoblastos formando así hueso neoformado, por lo tanto, esto se refleja en un mayor grado de reparación en comparación con los implantes tratados por congelación y más aún si lo comparamos con los aloimplantes tratados por ebullición. Esta información puede ser de gran utilidad para la implementación de un banco de huesos destinado a corregir lesiones del sistema esqueléticoDue to limitations in the availability of autogeneic bone and to the inefficiency of the fresh allogeneic bone grafts, it has been necessary to evaluate the use of allogeneic processed bone. Therefore, the ability of three procedures -freezing, boiling and desproteinization of allogeneic bone- to repair experimentally created defects in rabbit tibia was tested. Tibia, 2, 4 and 8 weeks after surgery were

  15. Design of ceramic-based cements and putties for bone graft substitution

    OpenAIRE

    M Bohner

    2010-01-01

    In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements), and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considere...

  16. Design of ceramic-based cements and putties for bone graft substitution

    Directory of Open Access Journals (Sweden)

    M Bohner

    2010-07-01

    Full Text Available In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements, and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considered, including mixing and delivery, sterilization, and shelf-life.

  17. Design of ceramic-based cements and putties for bone graft substitution.

    Science.gov (United States)

    Bohner, M

    2010-01-01

    In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements), and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considered, including mixing and delivery, sterilization, and shelf-life. PMID:20574942

  18. Open Defective Trapezium Fracture Treated with Local Bone Graft: A Case Report

    Directory of Open Access Journals (Sweden)

    Omer Ersen

    2014-12-01

    Full Text Available Generally fractures of trapezium are uncommon and account for 3-5% of all carpal fractures. About 20% of these are vertical sagittal split fractures and rarely occur isolated. The number of reported cases of open trapezium fractures is few. Open trapezium injuries of thumb are demanding injuries that need accurate restoration of damaged stuructures to gain normal thumb function. Otherwise it results in impairment of funtion due to limitation of motion, pain and weakness of the thumb. In this case report treatment of trapezium fracture with corticocancellous bone grafting from distal radius presented.

  19. Correlations between initial cleft size and dental anomalies in unilateral cleft lip and palate patients after alveolar bone grafting

    Science.gov (United States)

    Jabbari, Fatima; Reiser, Erika; Thor, Andreas; Hakelius, Malin; Nowinski, Daniel

    2016-01-01

    Objective To determine in individuals with unilateral cleft lip and palate the correlation between initial cleft size and dental anomalies, and the outcome of alveolar bone grafting. Methods A total of 67 consecutive patients with non-syndromic unilateral complete cleft lip and palate (UCLP) were included from the cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. All patients were operated by the same surgeon and treated according to the Uppsala protocol entailing: lip plasty at 3 months, soft palate closure at 6 months, closure of the residual cleft in the hard palate at 2 years of age, and secondary alveolar bone grafting (SABG) prior to the eruption of the permanent canine. Cleft size was measured on dental casts obtained at the time of primary lip plasty. Dental anomalies were registered on radiographs and dental casts obtained before bone grafting. Alveolar bone height was evaluated with the Modified Bergland Index (mBI) at 1 and 10-year follow-up. Results Anterior cleft width correlated positively with enamel hypoplasia and rotation of the central incisor adjacent to the cleft. There was, however, no correlation between initial cleft width and alveolar bone height at either 1 or 10 years follow-up. Conclusions Wider clefts did not seem to have an impact on the success of secondary alveolar bone grafting but appeared to be associated with a higher degree of some dental anomalies. This finding may have implications for patient counseling and treatment planning. PMID:26923345

  20. Chondroblastoma of the patella with aneurysmal bone cyst.

    Science.gov (United States)

    Tan, Honglue; Yan, Mengning; Yue, Bing; Zeng, Yiming; Wang, You

    2014-01-01

    Chondroblastoma of the patella is rare. Aneurysmal bone cysts, which develop from a prior lesion such as a chondroblastoma, are seldom seen in the patella. The authors report a case of a 36-year-old man who presented with 2 years of right knee pain without calor, erythema, pain on palpation, or abnormal range of motion. Radiological studies suggested aneurysmal bone cyst. The lesion was excised with curettage and the residual cavity filled with autogenous bone graft. Histopathology revealed chondroblastoma associated with a secondary aneurysmal bone cyst. In the follow-up period, the patient demonstrated normal joint activities with no pain. Normal configuration of the patella and bone union were shown on plain radiographs. The authors present a review of the literature of all cases of patellar chondroblastoma with aneurysmal bone cyst. This case is the 14th report of aneurysmal bone cyst arising in a chondroblastoma of the patella. According to the literature, computed tomography and magnetic resonance imaging are useful in the study of these lesions. The pathologic diagnosis is based on the presence of chondroblastoma and aneurysmal bone cyst. Treatment of this lesion includes patellectomy, curettage alone, and curettage with bone grafting. Despite the risk of recurrence of this lesion in the patella, the authors first recommend curettage followed by filling the cavity with bone graft. To protect the anterior tension of the patella intraoperatively, the bone window should be made at the medial edge of the patella to perform the curettage and bone grafting.

  1. Chondroblastoma of the patella with aneurysmal bone cyst.

    Science.gov (United States)

    Tan, Honglue; Yan, Mengning; Yue, Bing; Zeng, Yiming; Wang, You

    2014-01-01

    Chondroblastoma of the patella is rare. Aneurysmal bone cysts, which develop from a prior lesion such as a chondroblastoma, are seldom seen in the patella. The authors report a case of a 36-year-old man who presented with 2 years of right knee pain without calor, erythema, pain on palpation, or abnormal range of motion. Radiological studies suggested aneurysmal bone cyst. The lesion was excised with curettage and the residual cavity filled with autogenous bone graft. Histopathology revealed chondroblastoma associated with a secondary aneurysmal bone cyst. In the follow-up period, the patient demonstrated normal joint activities with no pain. Normal configuration of the patella and bone union were shown on plain radiographs. The authors present a review of the literature of all cases of patellar chondroblastoma with aneurysmal bone cyst. This case is the 14th report of aneurysmal bone cyst arising in a chondroblastoma of the patella. According to the literature, computed tomography and magnetic resonance imaging are useful in the study of these lesions. The pathologic diagnosis is based on the presence of chondroblastoma and aneurysmal bone cyst. Treatment of this lesion includes patellectomy, curettage alone, and curettage with bone grafting. Despite the risk of recurrence of this lesion in the patella, the authors first recommend curettage followed by filling the cavity with bone graft. To protect the anterior tension of the patella intraoperatively, the bone window should be made at the medial edge of the patella to perform the curettage and bone grafting. PMID:24683664

  2. Osteointegration of soft tissue grafts within the bone tunnels in anterior cruciate ligament reconstruction can be enhanced

    OpenAIRE

    Kuang, GM; Yau, WP; Lu, WW; Chiu, KY

    2010-01-01

    Anterior cruciate ligament reconstruction with a soft tissue autograft (hamstring autograft) has grown in popularity in the last 10 years. However, the issues of a relatively long healing time and an inferior histological healing result in terms of Sharpey-like fibers connection in soft tissue grafts are still unsolved. To obtain a promising outcome in the long run, prompt osteointegration of the tendon graft within the bone tunnel is essential. In recent decades, numerous methods have been r...

  3. Mandible vertical height correction using lingual bone-split pedicle onlay graft technique

    Directory of Open Access Journals (Sweden)

    Coen Pramono D

    2006-09-01

    Full Text Available As edentulous mandible become atrophic, a denture bearing area will also be reduced. Difficulty in the removable prosthesis rehabilitation will be present as well. The purpose of this paper reports an innovative surgical technique to cope a problem of unstable complete lower denture due to bone atrophy and resulted of vertical height reduction of the anterior region of the mandible necessary for denture retention. Vertical advancement of the lower jaw using lingual bone split pedicle onlay graft technique in the anterior region of the mandible and followed by secondary epithelization vestibuloplasty in achieving the vertical height dimension. The surgery was achieved satisfactorily as the vertical dimension of the mandible anterior region had increased and the denture seated more stable comparing with the previous denture worn by the patient. It concluded that the surgery was achieved with a great result as the vertical height of the anterior region of the mandible had increased positively therefore lead the denture seated more stable.

  4. The use of autogenous fascia lata to correct lid and orbital deformities.

    OpenAIRE

    Flanagan, J C; Campbell, C. B.

    1981-01-01

    Autogenous and homologous fascia lata have been used to correct many problems in ophthalmic surgery. This paper has described the use of autogenous fascia late to correct lid retraction secondary to thyroid ophthalmopathy, cicatricial entropion and extruding orbital implants. The surgical procedures have been briefly discussed, as well as the presentation of one clinical example of each procedure the pathologic and immunologic aspects of fascia lata grafts will be reported at a later date.

  5. Use of genetically modified muscle and fat grafts to repair defects in bone and cartilage

    Directory of Open Access Journals (Sweden)

    CH Evans

    2009-12-01

    Full Text Available We report a novel technology for the rapid healing of large osseous and chondral defects, based upon the genetic modification of autologous skeletal muscle and fat grafts. These tissues were selected because they not only possess mesenchymal progenitor cells and scaffolding properties, but also can be biopsied, genetically modified and returned to the patient in a single operative session. First generation adenovirus vector carrying cDNA encoding human bone morphogenetic protein-2 (Ad.BMP-2 was used for gene transfer to biopsies of muscle and fat. To assess bone healing, the genetically modified (“gene activated” tissues were implanted into 5mm-long critical size, mid-diaphyseal, stabilized defects in the femora of Fischer rats. Unlike control defects, those receiving gene-activated muscle underwent rapid healing, with evidence of radiologic bridging as early as 10 days after implantation and restoration of full mechanical strength by 8 weeks. Histologic analysis suggests that the grafts rapidly differentiated into cartilage, followed by efficient endochondral ossification. Fluorescence in situ hybridization detection of Y-chromosomes following the transfer of male donor muscle into female rats demonstrated that at least some of the osteoblasts of the healed bone were derived from donor muscle. Gene activated fat also healed critical sized defects, but less quickly than muscle and with more variability. Anti-adenovirus antibodies were not detected. Pilot studies in a rabbit osteochondral defect model demonstrated the promise of this technology for healing cartilage defects. Further development of these methods should provide ways to heal bone and cartilage more expeditiously, and at lower cost, than is presently possible.

  6. Comparison of clinical efficacies of single segment transforaminal lumbar interbody fusion with cage versus autogenous morselized bone for degenerative lumbar spinal stenosis: a prospective randomized controlled study%椎间融合器植入与单纯自体颗粒骨植骨治疗退变性腰椎管狭窄症的比较

    Institute of Scientific and Technical Information of China (English)

    刘培盛; 刘小臻; 乔雪静; 都文楠; 罗大伟; 郑修军

    2014-01-01

    Objective To compare the clinical efficacies of single segment transforaminal lumbar interbody fusion (TLIF) with cage versus autogenous morselized bone for degenerative lumbar spinal stenosis.Methods A total of 87 patients undergoing single segment TLIF were randomly divided into 2 groups.A cage was implanted into intervertebral space in group A patients while autogenous morselized bone in group B patients.Operative duration,blood loss,length of stay and cost of hospitalization of two groups were recorded.They were followed up at 1 week,12,24 months post-operation.Oswestry disability index (ODI),visual analogue scale (VAS) fusion rates,intervertebral space and foramen height restoration,lumbar lordosis and postoperative complications were compared between two groups.Results No significant inter-group difference existed in operative duration,blood loss or length of stay.However,the average hospitalization cost in group A were 18% higher than that of group B (P < 0.05).Both groups achieved excellent clinical outcomes within 2 years.ODI,VAS score improvement rates and postoperative complication rates were not statistically different.Lumbar fusion rate was 86.7% in group A versus 85.7% in group B after 2 years.And there was no significant difference (P > 0.05).The heights of intervertebral space and foramen in group A achieved a better recovery than those of group B.Both groups had similar improvements of lumbar lordosis.Conclusion For degenerative lumbar spinal stenosis,usage of interbody cage is more effective in terms of recovery of intervertebral space and foraminal height compared with usage of bone graft.However it brings no better clinical efficacy while the usage of autogenous morselized bone is more cost-effective.Two grafting methods yield similar overall clinical outcomes.%目的 比较单节段经椎间孔腰椎椎间融合术(TLIF)手术中椎间融合器植入或单纯自体颗粒骨植骨两种融合方式治疗退变性腰椎管

  7. Assessment of bone repair following the use of anorganic bone graft and membrane associated or not to 830-nm laser light

    Science.gov (United States)

    de Assis Limeira, Francisco, Jr.; Barbosa Pinheiro, Antônio L.; Marquez de Martinez Gerbi, Marleny E.; Pedreira Ramalho, Luciana Maria; Marzola, Clovis; Carneiro Ponzi, Elizabeth A.; Soares, Andre O.; Bandeira de Carvalho, Lívia C.; Vieira Lima, Helena Cristina; Oliveira Gonçalves, Thais; Silva Meireles, Gyselle C.; Possa, Thaise R.

    2003-06-01

    The aim of this study was to assess the effect of LLLT (λ830nm, Thera lase, DMC Equipmentos, Sao Carlos, SP, Brazil, 40mW, CW, spot size 0.60mm, 16J/cm2 per session) on the repair of bone defects on the femur of Wistar albinus rats which were grafted with anorganic bovine bone associated or not to bovine bone membrane. Five randomized groups were studied: I (Control); II (anorganic bovine bone); III (anorganic bovine bone + LLLT); IV (anorganic bovine bone + bovine bone membrane) and V (anorganic bovine bone + bovine bone membrane + LLLT). The animals were irradiated at every 48h during 15 days, the first irradiation was performed immediately after the procedure. The animals were irradiated transcutaneuosly in four points around the defect. At each point a dose of 4J/cm2 was given (f~0,60mm, 40mW) totaling 16J/cm2 per session. The animals were sacrificed 15, 21 and 30 days after surgery. The specimens were routinely processed to wax and stained with H&E and Picrosírius stains and analyzed under light microscopy. The results showed evidence of a more advanced repair on the irradiated groups when compared to non-irradiated ones. The repair of irradiated groups was characterized by both increased bone formation and amount of collagen fibers around the graft within the cavity early, considering the osteoconductive capacity of the anorganic bovine bone and the increment of the cortical repair in specimens with membrane. It is concluded that LLLT had a positive effect on the repair of bone defect submitted the implantation of graft associated or not to the use of biological membrane.

  8. Placement of implants in an ossifying fibroma defect obliterated with demineralized, freeze-dried bone allograft and Plasma-rich growth factor

    Directory of Open Access Journals (Sweden)

    Umashankar Pal

    2012-01-01

    Full Text Available There has been considerable clinical interest in combining the grafts, particularly bone allografts for support for dental implants, soft-tissue support, periodontal maintenance, and ovate pontic formation. The use of demineralized, freeze-dried bone allograft (DFDBA offers certain advantages over other graft materials and can avoid the need for a second-site surgery for autogenous donor bone. The advantages of DFDBA include handling properties, osteoinductivity, membrane tenting, and less susceptibility to migration after placement. This article will review available grafting materials and demonstrate a case of ossifying fibroma of the mandible, which was treated by curettage and hollow cavity filled with DFDBA. Six months follow-up period showed successful graft result and this grafted bone form was utilized for implant supported prosthesis.

  9. The effects of bone marrow aspirate, bone graft, and collagen composites on fixation of titanium implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Sandri, Monica;

    2012-01-01

    contamination, and non union as well as the potential risk of disease transmission. Hydroxyapatite and collagen composites (HA/Collagen) have the potential in mimicking and replacing skeletal bones. This study attempted to determine the effects of newly developed HA/Collagen-composites with and without bone....../Collagen-BMA; autograft or allograft. Allograft was served as the control group. The observation period was 5 weeks. The sheep were euthanized and both femurs were harvested. A push-out mechanical test and histological analysis were performed. Results: No significant differences were seen in the mechanical properties...

  10. External fixation and bone grafting for collapsed and comminuted distal radius fracture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Shuang-xi; GU Fang-rui; PENG Yong-li; ZHU Guang-ming; FU Jiang; LU Jun-yue; WANG Jiang-tao; LIU Zhang-min

    2005-01-01

    Objective: To study the therapeutic effect of collapsed and comminuted distal radius fracture. Methods: Twenty-six patients with collapsed and comminuted distal radius fracture were hospitalized from July 1998 to June 2003. All fractures were treated by the methods of open reduction, sustained bone grafting and passing joint external fixator to restore the anatomic shape of distal radius. Results: All 26 cases were followed up, and the results showed that the fractures have been united radiographically. The joint surfaces were intact and there was no length discrepancy occurred in patient's radius. The average volar tilt was 6° to 15° and the average ulnar tilt was 18° to 25°. According to the Dieust criterion, 19 cases were rated as excellent and 7 as good. Conclusions: The method that applying passing joint external fixator and bone grafting for the treatment of collapsed and comminuted distal radius fracture could maintain the stability of fracture and restore the length of radius and the intact of joint surface.

  11. Imaging of vascularized fibular grafts in large bone reconstruction in skeletally immature patients

    International Nuclear Information System (INIS)

    Objective. To describe the imaging findings of vascularized fibular grafts (VFG) in large bone reconstruction in children and teenagers. Design and patients. Fifteen patients aged from 4 to 19 years underwent VFG for bone reconstruction for primary tumors involving bone in 13 cases and for chronic osteomyelitis in 2 cases. Lesions were located in the femur (6 cases), the tibia (6 cases), the humerus, the distal fibula and the ilium. Radiographic follow-up was performed in all patients, radionuclide studies in 12 patients and MRI in 8. Results. Plain films showed a lamellated periosteal reaction on the VFG within 3 weeks following the procedure in all cases. Fusion of VFG and host bone occurred during the first 3 months. Radionuclide uptake of the VFG was seen in all cases but one. MRI showed cortical thickening and conservation of the high signal intensity of fatty marrow on T1-weighted sequences, and periosteal enhancement on dynamic post-contrast studies in all but one of the patients. Conclusion. Radionuclide studies and MRI show the periosteal enhancement and assess the viability of the VFG satisfactorily. However, we feel that plain films may be sufficient to ascertain this viability. (orig.). With 4 figs., 1 tab

  12. Imaging of vascularized fibular grafts in large bone reconstruction in skeletally immature patients

    Energy Technology Data Exchange (ETDEWEB)

    Panuel, M. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France)]|[Department of Radiology, CHU Nord, 13 - Marseille (France)]|[Anthropology Department, Universite de la Mediterranee, Marseille (France); Petit, P. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Jouve, J.L. [Department of Pediatric Orthopedics, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Portier, F. [Department of Radiology, CHU Nord, 13 - Marseille (France); Legre, R. [Department of Plastic Surgery, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Bourliere, B. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Devred, P. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France)

    1997-07-07

    Objective. To describe the imaging findings of vascularized fibular grafts (VFG) in large bone reconstruction in children and teenagers. Design and patients. Fifteen patients aged from 4 to 19 years underwent VFG for bone reconstruction for primary tumors involving bone in 13 cases and for chronic osteomyelitis in 2 cases. Lesions were located in the femur (6 cases), the tibia (6 cases), the humerus, the distal fibula and the ilium. Radiographic follow-up was performed in all patients, radionuclide studies in 12 patients and MRI in 8. Results. Plain films showed a lamellated periosteal reaction on the VFG within 3 weeks following the procedure in all cases. Fusion of VFG and host bone occurred during the first 3 months. Radionuclide uptake of the VFG was seen in all cases but one. MRI showed cortical thickening and conservation of the high signal intensity of fatty marrow on T1-weighted sequences, and periosteal enhancement on dynamic post-contrast studies in all but one of the patients. Conclusion. Radionuclide studies and MRI show the periosteal enhancement and assess the viability of the VFG satisfactorily. However, we feel that plain films may be sufficient to ascertain this viability. (orig.). With 4 figs., 1 tab.

  13. Predictive value of ridge dimensions on autologous bone graft resorption in staged maxillary sinus augmentation surgery using Cone-Beam CT.

    NARCIS (Netherlands)

    Klijn, R.J.; Beucken, J.J.J.P van den; Bronkhorst, E.M.; Berge, S.J.; Meijer, G.J.; Jansen, J.B.M.J.

    2012-01-01

    INTRODUCTION: No studies are available that provide predictive parameters regarding the expected amount of resorption after maxillary sinus augmentation surgery using autologous bone grafts. Therefore, the aim of this study was to determine parameters influencing the outcome of the bone graft resorp

  14. Osteogenic protein 1 device increases bone formation and bone graft resorption around cementless implants

    DEFF Research Database (Denmark)

    Jensen, Thomas B; Overgaard, Søren; Lind, Martin;

    2002-01-01

    In each femoral condyle of 8 Labrador dogs, a non weight-bearing hydroxyapatite-coated implant was inserted surrounded by a 3 mm gap. Each gap was filled with bone allograft or ProOsteon with or without OP-1 delivered in a bovine collagen type I carrier (OP-1 device). 300 microg OP-1 was used in ...

  15. Effect of Simvastatin collagen graft on wound healing of defective bone

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jun Ho; Kim, Gyu Tae [Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, Seoul (Korea, Republic of); Choi, Yong Suk; Lee, Hyeon Woo; Hwang, Eui Hwan [Institute of Oral Biology, School of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    2008-09-15

    To observe and evaluate the effects of Simvastatin-induced osteogenesis on the wound healing of defective bone. 64 defective bones were created in the parietal bone of 32 New Zealand White rabbits. The defects were grafted with collagen matrix carriers mixed with Simvastatin solution in the experimental group of 16 rabbits and with collagen matrix carriers mixed with water in the controlled group. The rabbits were terminated at an interval of 3, 5, 7, and 9 days, 2, 4, 6, and 8 weeks after the formation of defective bone. The wound healing was evaluated by soft X-ray radiography. The tissues within defective bones were evaluated through the analysis of flow cytometry for the manifestation of Runx2 and Osteocalcin, and observed histopathologically by using H-E stain and Masson's trichrome stain. Results : 1. In the experimental group, flow cytometry revealed more manifestation of Runx2 at 5, 7, and 9 days and Osteocalcin at 2 weeks than in the controlled groups, but there was few difference in comparison with the controlled group. 2. In the experimental group, flow cytometry revealed considerably more cells and erythrocytes at 5, 7, and 9 days in comparison with the controlled group. 3. In the experimental group, soft x-ray radiography revealed the extended formation of trabeculation at 2, 4, 6, and 8 weeks. 4. Histopathological features of the experimental group showed more fibroblasts and newly formed vessels at 5 and 7 days, and the formation of osteoid tissues at 9 days, and the newly formed trabeculations at 4 and 6 weeks. As the induced osteogenesis by Simvastatin, there was few contrast of the manifestation between Runx2 and Osteocalcin based on the differentiation of osteoblasts. But it was considered that the more formation of cells and erythrocytes depending on newly formed vessels in the experimental group obviously had an effect on the bone regeneration.

  16. FUNCTIONAL OUTCOME OF ACCELERATED REHABILITATION IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE PATELLAR TENDON BONE GRAFT A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Hiranyakumar

    2016-03-01

    Full Text Available INTRODUCTION An ideal rehabilitation program post anterior cruciate ligament reconstruction enables an individual to return to pre injury levels at a faster rate with minimal to no risk of reinjury to the graft. Rehabilitation protocols have changed considerably over time in the past. It has become “aggressive”, meaning an intensive rehabilitation which includes greater variety of exercises and sports related training. AIM OF THE STUDY The aim of our study is to assess the outcome of accelerated rehabilitation post anterior cruciate ligament (ACL reconstruction. METHODOLOGY 106 patients were operated by a single surgeon underwent arthroscopic anterior cruciate ligament reconstruction using bone patella tendon bone graft and partial meniscectomy for associated meniscal tear. Patients were put on an accelerated rehabilitation protocol designed in our institute on first post-operative day, under the guidance of a physical therapist in consultation with the operated surgeon. Patients were followed up at 3 weeks, 6 months and 9 months, post onset of rehabilitation, patients were assessed using KT1000 Arthrometer and Lysholm knee scoring system. RESULTS Out of 106 patients, who were selected, 96(91% were males and 10(9% were females. The mean pre-operative Lysholm score was 55.09. Post operatively, while on accelerated rehabilitation program the Lysholm scores were 69.73 at 3 weeks, 89.13 at 6 months and 89.19 at 9 months. In our pre-operative evaluation mean KT 1000 arthrometer score was 10.53 and post-operative at six months was 3.49. At nine months 105 patients had excellent results whereas 1 patient had good result. CONCLUSION Accelerated rehabilitation protocol enables the patient to functionally recover faster to pre injury levels. A rehabilitation protocol for 6 months is sufficient in enabling a patient to get back to pre-injury levels. Functional outcome is the same with or without associated meniscal injuries.

  17. BMP-2基因修饰自体BMSCs移植促进兔下颌骨牵张成骨新骨形成的实验研究%EXPERIMENTAL STUDY ON TRANSPLANTATION OF BMP-2 GENE TRANSFECTED AUTOGENOUS BONE MESENCHYMAL STEM CELLS FOR PROMOTING BONE REGENERATION IN RABBIT MANDIBULAR DISTRACTION OSTEOGENESIS

    Institute of Scientific and Technical Information of China (English)

    黄旋平; 周诺; 江献芳; 杨媛媛; 李华; 谢庆条

    2012-01-01

    目的:检测骨形态发生蛋白-2(BMP-2)基因mRNA及其蛋白的表达,探讨BMP-2基因修饰自体骨髓间充质干细胞(BMSCs)移植对兔下颌骨牵张成骨新骨形成的促进作用.方法:取新西兰白兔36只随机分为3组,每组12只.建立牵张成骨动物模型,在固定期第2天,实验组于牵张间隙注射200 μL的BMP-2基因修饰的自体BMSCs液;对照组注射等量自体BMSCs液;空白组注射等量生理盐水.分别于固定2,6周通过逆转录多聚酶链式反应(RT-PCR)、免疫组化等手段检测BMP-2基因mRNA及其蛋白的表达情况.结果:实验组牵张间隙新生骨组织均可见BMP-2基因mRNA和其蛋白强阳性表达.结论:BMP-2基因修饰的自体BMSCs移植能有效促进兔下颌骨牵张成骨新骨形成.%Objective:To examine the expressions of both bone morphogenetic protein-2 (BMP-2) gene mR-NA and related proteins and investigate the promotive effect of transplantation of BMP-2 gene transfected autogenous bone mesenchymal stem cells on bone regeneration in rabbit mandibular distraction osteogene-sis. Methods: Thirty-six New Zealand's white rabbits were randomly divided into three groups with twelve in each. All objects -were prepared into distraction osteogenesis surgical model on right mandibles. On the 2nd day of consolidation, experimental, control, and blank groups -were injected -with the same amount of 200 juL of the solution with BMP-2 gene transfected autogenous bone mesenchymal stem cells, the solution with autogenous bone mesenchymal stem cells, and physiological saline at distraction gap, respectively. The expressions of BMP-2 mRNA and related proteins -were examined by RT-PCR and immunohistochem-istry at the ends of the 2nd and 6th -week consolidations, respectively. Results: Strongly positive expression of both BMP-2 gene mRNA and related proteins were confirmed on regenerated bone in distraction gap. Conclusion: The transplantation of BMP-2 gene transfected autogenous bone

  18. Effect of zoledronate acid treatment on osseointegration and fixation of implants in autologous iliac bone grafts in ovariectomized rabbits.

    Science.gov (United States)

    Qi, Mengchun; Hu, Jing; Li, Jianping; Li, Jinyuan; Dong, Wei; Feng, Xiaojie; Yu, Jing

    2012-01-01

    One main problem associated with alveolar bone augmentation in implant dentistry is resorption of grafted bone, which may be further compromised by systemic skeletal disorders such as osteoporosis. Zoledronate acid (ZOL) is the most potent bisphosphonate to treat osteoporosis and therefore it is hypothesized to be able to invert the negative effect of osteoporosis on osseointegration and fixation of dental implants in autologous bone grafts. In this study, 56 rabbits received bilateral ovariectomy (OVX) (40 rabbits) or sham operation (16 rabbits). Three months later, 8 animals from each group were sacrificed for bone mineral density (BMD) examination. Then the remaining animals underwent bilateral autologous iliac bone grafting with simultaneous implantation of titanium implants in tibiae and were divided into 5 groups (n=8): Sham, OVX, Loc-ZOL (local treatment), Sys-ZOL (systemic treatment) and Loc+Sys-ZOL (local plus systemic) group. At 3 months after implantation, all animals were sacrificed and specimens were harvested for examinations. Both BMD and histological examinations of femurs showed osteoporotic changes after ovariectomy, while systemic treatment with ZOL restored mineralized bone. Micro-CT examination demonstrated that OVX group showed significant decrease of mineralized bone and implant-bone contact when compared with sham control, whereas both systemic and local treatments of ZOL significantly increased mineralized bone and implant-bone contact in ovariectomized animals. However, the best effects were observed in Loc+Sys-ZOL group (combined use of ZOL) and most of bone indices were similar to (IBCR, p>0.05) or higher than (BV/TV, Conn.D and Tb.N) (peffects were also confirmed by histomorphometric analysis of bone indices on implant-bone contact and mineralized bone. In addition, biomechanical testing further supported the beneficial effect of ZOL treatment and maximal removal torque of titanium implants was observed in Loc+Sys-ZOL group. In

  19. A New Method for Xenogeneic Bone Graft Deproteinization: Comparative Study of Radius Defects in a Rabbit Model.

    Directory of Open Access Journals (Sweden)

    Pengfei Lei

    Full Text Available Deproteinization is an indispensable process for the elimination of antigenicity in xenograft bones. However, the hydrogen peroxide (H2O2 deproteinized xenograft, which is commonly used to repair bone defect, exhibits limited osteoinduction activity. The present study was designed to develop a new method for deproteinization and compare the osteogenic capacities of new pepsin deproteinized xenograft bones with those of conventional H2O2 deproteinized ones.Bones were deproteinized in H2O2 or pepsin for 8 hours. The morphologies were compared by HE staining. The content of protein and collagen I were measured by the Kjeldahl method and HPLC-MS, respectively. The physical properties were evaluated by SEM and mechanical tests. For in vivo study, X-ray, micro-CT and HE staining were employed to monitor the healing processes of radius defects in rabbit models transplanted with different graft materials.Compared with H2O2 deproteinized bones, no distinct morphological and physical changes were observed. However, pepsin deproteinized bones showed a lower protein content, and a higher collagen content were preserved. In vivo studies showed that pepsin deproteinized bones exhibited better osteogenic performance than H2O2 deproteinized bones, moreover, the quantity and quality of the newly formed bones were improved as indicated by micro-CT analysis. From the results of histological examination, the newly formed bones in the pepsin group were mature bones.Pepsin deproteinized xenograft bones show advantages over conventional H2O2 deproteinized bones with respect to osteogenic capacity; this new method may hold potential clinical value in the development of new biomaterials for bone grafting.

  20. Clinical application of heterogeneous acellular dermal matrix used in alveolar bone grafting%异种脱细胞真皮基质膜在齿槽裂植骨术中的临床应用

    Institute of Scientific and Technical Information of China (English)

    李可兴; 刘曙光

    2014-01-01

    Objective To observe the effect of bone repair and evaluate its esthetic outcome with heterogeneous acellular dermal matrix cover the alveolar cleft bone grafting area in the alveolar cleft operation.Methods In 67 cases,unilateral cleft palate,were treated by alveolar cleft conventional surgical method.Cancellous iliac bone grafting were control group,heterogeneous acellular dermal matrix cover the alveolar cleft bone grafting area were treatment group.Radiographs was taken at 1 st,3 rd,6 th,12 th,18 th,24 th month postoperatively to observe the bone regeneration alveolar cleft zone.Results The alveolar cleft graft area new bone formation with Ⅰ,Ⅱ,Ⅲ,Ⅳ grade after 6 months in control group was 15,11,9,6 cases and in treatment group was 13,9,3,1 case.The graft survival rate and success rate (97.8%,84.3%) of treatment group were higher than that of control group (84.5%,63.7%),the difference was statistically significant (P < 0.05).Conclusion The successful rate of operation could be warranted,by the joint application of autogenous iliac bone grafts and heterogeneous acellular dermal matrix in the alveolar cleft operation.%目的 在齿槽裂手术中,将异种脱细胞真皮基质膜覆盖齿槽裂植骨区,观察新骨形成状况,评价植骨修复效果.方法 选择67例单侧齿槽裂患者,按治疗方法不同分为对照组和试验组.对照组单纯应用髂骨骨松质移植41例,试验组应用异种脱细胞真皮基质膜加髂骨骨松质移植26例.术后1,3,6,12,18,24个月随访,X线片观察齿槽裂植骨区新骨生成情况.结果 对照组病例术后6个月齿槽裂植骨区新骨形成Ⅰ,Ⅱ,Ⅲ,Ⅳ级分别为15,11,9,6例,齿槽裂植骨成活率为84.5%,临床成功率为63.7%.而试验组病例植骨区新骨形成Ⅰ,Ⅱ,Ⅲ,Ⅳ级分别为13,9,3,1例.齿槽裂植骨成活率为97.8%,临床成功率为84.3%.两组植骨成活率、临床成功率比较差异有统计学意义(P<0.05).结论 自体髂骨加异

  1. The long-term efficacy and clinical application of acellular allograft dermal with autogenous skin grafts in wound repair%异体脱细胞真皮联合自体皮复合移植在创面修复中的应用及远期疗效观察

    Institute of Scientific and Technical Information of China (English)

    吕大伦; 端龙胜; 王云龙; 李敏; 丁伟

    2010-01-01

    Objective To find an ideal cover material for repairing of deep-burned functional part and scar deformity. Methods The wound of ulcer,scar and wound of the deep-burned functional part excised were covered with acellular allograft derma plus autogenous split-thickness skin graft. Results 30 cases were included in this study. The survival rate of the composite skin grafts was 100%. All the composite skin grafts were smooth and soft,had good elasticity, and the joint functions were good. Conclusion Acellular allograft dermal with autologous skin is an ideal covering material for repairing wound of function parts%目的 寻找功能部位深度烧伤创面与瘢痕畸形修复的理想覆盖材料.方法 将功能部位的深度烧伤、瘢痕切除后创面或溃疡创面行脱细胞异体真皮+自体刃厚皮复合移植.结果 30例患者复合皮全部成活,复合皮光滑柔软,局部弹性好,关节功能恢复良好.结论 脱细胞异体真皮+自体皮是功能部位创面修复的理想覆盖材料.

  2. Allogeneic versus autologous derived cell sources for use in engineered bone-ligament-bone grafts in sheep anterior cruciate ligament repair.

    Science.gov (United States)

    Mahalingam, Vasudevan D; Behbahani-Nejad, Nilofar; Horine, Storm V; Olsen, Tyler J; Smietana, Michael J; Wojtys, Edward M; Wellik, Deneen M; Arruda, Ellen M; Larkin, Lisa M

    2015-03-01

    The use of autografts versus allografts for anterior cruciate ligament (ACL) reconstruction is controversial. The current popular options for ACL reconstruction are patellar tendon or hamstring autografts, yet advances in allograft technologies have made allogeneic grafts a favorable option for repair tissue. Despite this, the mismatched biomechanical properties and risk of osteoarthritis resulting from the current graft technologies have prompted the investigation of new tissue sources for ACL reconstruction. Previous work by our lab has demonstrated that tissue-engineered bone-ligament-bone (BLB) constructs generated from an allogeneic cell source develop structural and functional properties similar to those of native ACL and vascular and neural structures that exceed those of autologous patellar tendon grafts. In this study, we investigated the effectiveness of our tissue-engineered ligament constructs fabricated from autologous versus allogeneic cell sources. Our preliminary results demonstrate that 6 months postimplantation, our tissue-engineered auto- and allogeneic BLB grafts show similar histological and mechanical outcomes indicating that the autologous grafts are a viable option for ACL reconstruction. These data indicate that our tissue-engineered autologous ligament graft could be used in clinical situations where immune rejection and disease transmission may preclude allograft use.

  3. Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Aravind Buddula

    2011-01-01

    Full Text Available Aim: To study the long-term survival of dental implants placed in native or grafted bone in irradiated bone in subjects who had received radiation for head and neck cancer. Materials and Methods: A retrospective chart review was conducted for all patients who received dental implants following radiation treatment for head and neck cancer between May 1, 1987 and July 1, 2008. Only patients irradiated with a radiation dose of 50 Gy or greater and those who received dental implants in the irradiated field after head and neck radiation were included in the study. The associations between implant survival and patient/implant characteristics were estimated by fitting univariate marginal Cox proportional hazards models. Results: A total of 48 patients who had prior head and neck radiation had 271 dental implants placed during May 1987-July 2008. There was no statistically significant difference between implant failure in native and grafted bone (P=0.76. Survival of implants in grafted bone was 82.3% and 98.1% in maxilla and mandible, respectively, after 3 years. Survival of implants in native bone in maxilla and mandible was 79.8% and 100%, respectively, after 3 years. For implants placed in the native bone, there was a higher likelihood of failure in the maxilla compared to the mandible and there was also a tendency for implants placed in the posterior region to fail compared to those placed in the anterior region. Conclusion: There was no significant difference in survival when implants were placed in native or grafted bone in irradiated head and neck cancer patients. For implants placed in native bone, survival was significantly influenced by the location of the implant (maxilla or mandible, anterior or posterior.

  4. Treatment of Thoracolumbar Vertebrate Fracture by Transpedicular Morselized Bone Grafting in Vertebrae for Spinal Fusion and Pedicle Screw Fixation

    Institute of Scientific and Technical Information of China (English)

    Jinguo WANG; Hua WU; Xiaolin DING; Yutian LIU

    2008-01-01

    To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A (n=20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B (n=50) did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B (group A: 6.4 degree; group B: 5.4 degree)/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B (P=0.0001). Postoperatively, greater anterior height was achieved in group A than in group B (P<0.01). During follow-up study, anterior vertebral height was maintained only in Group A (P<0.001). Both group A and group B showed good Denis pain scores (P1 and P2) but group A outdid group B in terms of control of severe and constant pain (P4 and P5). By Frankel criteria, the changes in neurological functions in group A was better than those of group B (P<0.001). It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with

  5. "Plug" ósseo autógeno para orifícios de trepanação: nota técnica Autogenic bone plug to seal burr holes: technical note

    Directory of Open Access Journals (Sweden)

    JOSUÉ GUIMARÃES GRANHA VIALOGO

    1999-12-01

    Full Text Available Vários materiais são utilizados para ocluir os orifícios de trepanação em neurocirurgia, por motivos variados: para evitar fístula liquórica após trepanações, para auxiliar a fixação do "flap" ósseo e por motivos estéticos, na região frontal. Dentre estes materiais citamos os heterólogos (botões de silicone, miniplacas de metal, cera de osso, metilmetacrilato, gelfoam, cimento de polímero vegetal, cerâmica de hidroxiapatita, e os autólogos (pó de osso originado da trepanação, gordura, músculo, aponeurose. Os materiais heterólogos ou sintéticos podem provocar reação de corpo estranho com erosão da pele e exposição do material, tornando necessária sua retirada, em tempo variável no pós-operatório. Há cerca de três anos, o autor vem utilizando um botão ou "plug" ósseo autólogo, feito com surgicel e o pó de osso proveniente da trepanação, com bom resultado estético eliminando as desconfortáveis depressões cranianas pós-trepanação. Apresentamos a técnica de confecção deste prático `plug ósseo autólogo'. Nas neuroendoscopias, praticamente sanou-se o problema da fístula liquórica e reação de corpo estranho. Encorajamos a utilização deste botão ósseo autólogo em nosso meio, como método eficiente, econômico e biologicamente aceitável para ocluir orifícios cranianos de trepanação.Many neurosurgical procedures can be performed by a single burr hole: neuroendoscopy, microvascular decompression, stereotactic procedures, chronic subdural haematomas. It is technically difficult to suture and close the dura, located at the bottom of such holes, which can lately lead to CSF leakage. On the other hand, the surgical material used to seal the burr holes can be divided in heterogenic (metal screws, silicon plugs, gelfoam, bone wax, metilmetacrilate, hidroxiapatite, and autogenic (fat, aponeurosis, muscle, and bone dust from trephination. The heterogenic group always brings the possibility of

  6. Clinical and Histological Results of Vertical Ridge Augmentation of Atrophic Posterior Mandible with Inlay Technique of Cancellous Equine Bone Blocks

    Directory of Open Access Journals (Sweden)

    Pistilli R

    2013-12-01

    Full Text Available Aim: We want to evaluate a new bone block material in the inlay technique, for the vertical bone augmentation of a posterior atrophic mandible, in order to perfom aesthetic and prosthetic rehabilitation and enable implant insertion. Materials & Methods: Inlay technique and the subsequent successful implant rehabilitation in the atrophic right posterior mandible in a 42-year-old woman, was completed using a cancellous equine bone block as grafting material. Results: Three months after surgical procedure both clinical and histological aspects show complete integration of the biomaterial with the surrounding bone and three dental implants were placed. Computed tomography and conventional radiography showed a 5mm mean vertical bone gain. Conclusion: Cancellous equine bone grafts may be an effective alternative to autogenous bone and/or inorganic bovine bone for reconstruction of the posterior mandible using inlay technique.

  7. Sinus floor augmentation surgery using autologous bone grafts from various donor sites: a meta-analysis of the total bone volume.

    NARCIS (Netherlands)

    Klijn, R.J.; Meijer, G.J.; Bronkhorst, E.M.; Jansen, J.A.

    2010-01-01

    BACKGROUND: To date, no studies have been published that evaluated histomorphometric data from a large number of patients while comparing different sites and methods of autologous bone grafting in sinus floor augmentation procedures. A meta-analysis of the English literature from January 1995 till A

  8. Fabrication of nano-hydroxyapatite/collagen/osteonectin composites for bone graft applications

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Susan; Ngiam, Michelle; Chan, Casey K; Ramakrishna, S [Division of Bioengineering, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 117576 (Singapore)

    2009-04-15

    Mineralized type I collagen (collagen I) nanofibers and their nanofibril bundles make up the microstructure of natural bone tissue, which range from nanometers to micrometers. However, attempts to achieve this hierarchically assembled structure in vitro have been unsuccessful. In this study, we added osteonectin into the collagen I solution, either at a high or low weight ratio (osteonectin: collagen I = 1:30 or 1:90) before co-precipitation. Results indicated that spindle-like nano-hydroxyapatite (nano-HA) was deposited on collagen/osteonectin and pure osteonectin (control) groups. Furthermore, transmission electron microscope (TEM) and scanning electron microscope (SEM) results showed that the assembled mineralized fiber bundles were formed randomly at different levels from 50 nm, 250 nm to 1100 nm. However, when we replaced collagen I with collagen II, osteonectin addition did not induce the formation of mineralized fiber bundles. The participation of osteonectin in the assembly of the mineralized fibers could provide new insights into the novel mineralization function of osteonectin for bone development in vivo and advancing new biomimetic methods for bone graft applications.

  9. Is bone transplantation the gold standard for repair of alveolar bone defects?

    Science.gov (United States)

    Raposo-Amaral, Cassio Eduardo; Bueno, Daniela Franco; Almeida, Ana Beatriz; Jorgetti, Vanda; Costa, Cristiane Cabral; Gouveia, Cecília Helena; Vulcano, Luiz Carlos; Fanganiello, Roberto D; Passos-Bueno, Maria Rita; Alonso, Nivaldo

    2014-01-01

    New strategies to fulfill craniofacial bone defects have gained attention in recent years due to the morbidity of autologous bone graft harvesting. We aimed to evaluate the in vivo efficacy of bone tissue engineering strategy using mesenchymal stem cells associated with two matrices (bovine bone mineral and α-tricalcium phosphate), compared to an autologous bone transfer. A total of 28 adult, male, non-immunosuppressed Wistar rats underwent a critical-sized osseous defect of 5 mm diameter in the alveolar region. Animals were divided into five groups. Group 1 (n = 7) defects were repaired with autogenous bone grafts; Group 2 (n = 5) defects were repaired with bovine bone mineral free of cells; Group 3 (n = 5) defects were repaired with bovine bone mineral loaded with mesenchymal stem cells; Group 4 (n = 5) defects were repaired with α-tricalcium phosphate free of cells; and Group 5 (n = 6) defects were repaired with α-tricalcium phosphate loaded with mesenchymal stem cells. Groups 2-5 were compared to Group 1, the reference group. Healing response was evaluated by histomorphometry and computerized tomography. Histomorphometrically, Group 1 showed 60.27% ± 16.13% of bone in the defect. Groups 2 and 3 showed 23.02% ± 8.6% (p = 0.01) and 38.35% ± 19.59% (p = 0.06) of bone in the defect, respectively. Groups 4 and 5 showed 51.48% ± 11.7% (p = 0.30) and 61.80% ± 2.14% (p = 0.88) of bone in the defect, respectively. Animals whose bone defects were repaired with α-tricalcium phosphate and mesenchymal stem cells presented the highest bone volume filling the defects; both were not statistically different from autogenous bone. PMID:24551445

  10. Is bone transplantation the gold standard for repair of alveolar bone defects?

    Science.gov (United States)

    Raposo-Amaral, Cassio Eduardo; Bueno, Daniela Franco; Almeida, Ana Beatriz; Jorgetti, Vanda; Costa, Cristiane Cabral; Gouveia, Cecília Helena; Vulcano, Luiz Carlos; Fanganiello, Roberto D; Passos-Bueno, Maria Rita

    2014-01-01

    New strategies to fulfill craniofacial bone defects have gained attention in recent years due to the morbidity of autologous bone graft harvesting. We aimed to evaluate the in vivo efficacy of bone tissue engineering strategy using mesenchymal stem cells associated with two matrices (bovine bone mineral and α-tricalcium phosphate), compared to an autologous bone transfer. A total of 28 adult, male, non-immunosuppressed Wistar rats underwent a critical-sized osseous defect of 5 mm diameter in the alveolar region. Animals were divided into five groups. Group 1 (n = 7) defects were repaired with autogenous bone grafts; Group 2 (n = 5) defects were repaired with bovine bone mineral free of cells; Group 3 (n = 5) defects were repaired with bovine bone mineral loaded with mesenchymal stem cells; Group 4 (n = 5) defects were repaired with α-tricalcium phosphate free of cells; and Group 5 (n = 6) defects were repaired with α-tricalcium phosphate loaded with mesenchymal stem cells. Groups 2–5 were compared to Group 1, the reference group. Healing response was evaluated by histomorphometry and computerized tomography. Histomorphometrically, Group 1 showed 60.27% ± 16.13% of bone in the defect. Groups 2 and 3 showed 23.02% ± 8.6% (p = 0.01) and 38.35% ± 19.59% (p = 0.06) of bone in the defect, respectively. Groups 4 and 5 showed 51.48% ± 11.7% (p = 0.30) and 61.80% ± 2.14% (p = 0.88) of bone in the defect, respectively. Animals whose bone defects were repaired with α-tricalcium phosphate and mesenchymal stem cells presented the highest bone volume filling the defects; both were not statistically different from autogenous bone. PMID:24551445

  11. Is bone transplantation the gold standard for repair of alveolar bone defects?

    Directory of Open Access Journals (Sweden)

    Cassio Eduardo Raposo-Amaral

    2014-01-01

    Full Text Available New strategies to fulfill craniofacial bone defects have gained attention in recent years due to the morbidity of autologous bone graft harvesting. We aimed to evaluate the in vivo efficacy of bone tissue engineering strategy using mesenchymal stem cells associated with two matrices (bovine bone mineral and α-tricalcium phosphate, compared to an autologous bone transfer. A total of 28 adult, male, non-immunosuppressed Wistar rats underwent a critical-sized osseous defect of 5 mm diameter in the alveolar region. Animals were divided into five groups. Group 1 (n = 7 defects were repaired with autogenous bone grafts; Group 2 (n = 5 defects were repaired with bovine bone mineral free of cells; Group 3 (n = 5 defects were repaired with bovine bone mineral loaded with mesenchymal stem cells; Group 4 (n = 5 defects were repaired with α-tricalcium phosphate free of cells; and Group 5 (n = 6 defects were repaired with α-tricalcium phosphate loaded with mesenchymal stem cells. Groups 2–5 were compared to Group 1, the reference group. Healing response was evaluated by histomorphometry and computerized tomography. Histomorphometrically, Group 1 showed 60.27% ± 16.13% of bone in the defect. Groups 2 and 3 showed 23.02% ± 8.6% (p = 0.01 and 38.35% ± 19.59% (p = 0.06 of bone in the defect, respectively. Groups 4 and 5 showed 51.48% ± 11.7% (p = 0.30 and 61.80% ± 2.14% (p = 0.88 of bone in the defect, respectively. Animals whose bone defects were repaired with α-tricalcium phosphate and mesenchymal stem cells presented the highest bone volume filling the defects; both were not statistically different from autogenous bone.

  12. Preliminary study showing safety/efficacy of nanoss bioactive versus vitoss as bone graft expanders for lumbar noninstrumented fusions

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2015-01-01

    Conclusion: In this preliminary study of patients undergoing multilevel lumbar lamienctomies with posterolateral noninstrumented fusions, results were nearly comparable utilizing Vitoss or NanOss as bone graft expanders. Although the number of NanOss patients was substantially lower, the comparable efficacy and absence of postoperative complications for noninstrumented fusions is promising.

  13. Clinical study of reconstructing the medial malleolus with free grafting of fibular head composite tendon bone flap

    Institute of Scientific and Technical Information of China (English)

    WU Shui-pei

    2008-01-01

    Objective: To explore new surgical procedure for repairing and reconstructing medial malleolus and soft tissue defect.Methods: According to the size of medial malleolus and composite soft tissue defect, vascular fibular head composite tendon bone flap free grafting using anterior tibial recurrent vessel as the perforating branch was designed to reconstruct the medial malleolar saddle and triangular ligament, and composite back broadest muscle flap free grafting was designed to repair the medical malleolar wound surface. From January 2000 to December 2006, the technique was used in 5 male patients who were injured by machine or in traffic accidents, causing bone and soft tissue defect. The size of wound surface ranged from 19 cm×12 cm to 24 cm×12 cm.Results: The wound surface was healed at the first stage in 4 cases, and the other case had infection and was cured in 6 months with anti infection therapy. Postoperative follow-ups from 6 months to 6 years showed that grafted bones and free cutaneous flaps were healed well, malleolar joints were stable, joint movement was normal, and the appearance was satisfactory. The overall outcome was good.Conclusion: Fibular head composite tendon bone flap free grafting is effective for repairing medical malleolar defect.

  14. An integrative approach for comparing microcirculation between normal and alveolar cleft gingiva in children scheduled for secondary bone grafting procedures

    NARCIS (Netherlands)

    D.M.J. Milstein; Y.W. Cheung; L. Ziukaite; C. Ince; H.P. van den Akker; J.A.H. Lindeboom

    2013-01-01

    Objective The aim of this study was to compare microcirculatory parameters in normal versus alveolar cleft gingiva in children selected for secondary bone grafting procedures. Study Design This study included 11 consecutive patients with complete unilateral alveolar clefts who required secondary bon

  15. The tent pole splint: a bone-supported stereolithographic surgical splint for the soft tissue matrix expansion graft procedure.

    Science.gov (United States)

    Cillo, Joseph E; Theodotou, Nicholas; Samuels, Marc; Krajekian, Joseph

    2010-06-01

    This report details the use of computer-aided planning and intraoperative stereolithographic direct-bone-contact surgical splints for the accurate extraoral placement of dental implants in the soft tissue matrix expansion (tent pole) graft of the severely resorbed mandible. PMID:20231048

  16. Metacarpal resection with a contoured iliac bone graft and silicone rubber implant for metacarpal giant cell tumor: a case report.

    Science.gov (United States)

    Carlow, S B; Khuri, S M

    1985-03-01

    A definitive surgical procedure for a giant cell tumor that combines metacarpal resection with an iliac bone graft and arthroplasty with a silicone rubber implant is proposed for the elderly patient. The results were encouraging in one patient who had a cosmetically and functionally acceptable hand and no evidence of recurrence.

  17. Brånemark and ITI dental implants in the human bone-grafted maxilla: a comparative evaluation

    DEFF Research Database (Denmark)

    Pinholt, Else M

    2003-01-01

    The development of new characteristics concerning implant surface makes it interesting to clinically compare different implant systems in the bone-grafted maxilla. The aim of this evaluation was to compare clinical data of a two-staged procedure on the augmented extremely atrophic maxilla using e...

  18. Thoracolumbar spinal fractures : radiological results of transpedicular fixation combined with transpedicular cancellous bone graft and posterior fusion in 183 patients

    NARCIS (Netherlands)

    Leferink, VJM; Zimmerman, KW; Veldhuis, EFM; ten Vergert, EM; ten Duis, HJ

    2001-01-01

    In internal posterior fixation of thoracolumbar fractures combined with transpedicular cancellous bone graft and posterior fusion of the intervertebral facet joints at the level of the destroyed end plate it is still uncertain as to whether significant vertebral body collapse and loss of correction

  19. Locking plate fixation combined with iliac crest bone autologous graft for proximal humerus comminuted fracture

    Institute of Scientific and Technical Information of China (English)

    Zhu Lian; Liu Yueju; Yang Zongyou; Li Han; Wang Juan; Zhao Changping; Chen Xiao

    2014-01-01

    Background Although the use of an intramedullary fibular allograft together with locking plate fixation can provide additional medial support and prevent varus malalignment in displaced proximal humeral fractures with promising results,the fibular autograft donor site often sustains significant trauma and cannot restore the articular surface of comminuted fractures.The aim of this study was to evaluate the clinical and radiographic outcomes of a locking plate and crest bone autologous graft for treating proximal humerus comminuted fractures.Methods We assessed the functional outcomes and complication rates in 40 patients with proximal humerus comminuted fractures.Eighteen patients were treated with a locking plate and an autologous crest bone graft (experimental group),and 22 were treated with only the locking plate and no bone graft (control group).Postoperative assessments included radiographic imaging,range of motion analysis,pain level based on the visual analogue scale (VAS),and the SF-36 (Short Form (36) Health Survey),as well as whether patients could retum to their previous occupation.Results All fractures healed both clinically and radiologically in the experimental group.There was no more than 2 mm collapse of the humeral head,and no osteonecrosis or screw penetration of the articular surface.In contrast,two patients had a nonunion in the control group,and they eventually accepted total shoulder replacements.The average time from surgery to radiographic union was significantly shorter in the experimental group ((4.66±1.63) months) compared with the control group ((5.98±1.57) months) (P <0.05).For the experimental versus controls groups,the mean shoulder active flexion (148.00±18.59 vs.121.73±17.20) degrees,extension (49.00±2.22 vs.42.06±2.06) degrees,internal rotation (45.00±5.61 vs.35.00±3.55)degrees,external rotation (64.00±9.17 vs.52.14±5.73)degrees,and abduction (138.00±28.78 vs.105.95±15.66) degrees were all significantly higher (all P

  20. Cytocompatibility Evaluation of Grafted IKVAV PLEOF Hydrogels with Bone Marrow Mesenchymal Stem Cells

    Institute of Scientific and Technical Information of China (English)

    LI Binbin; ZHANG Ping; YIN Yixia; QIU Tong; TAO Yuan; WANG Xinyu; LI Shipu

    2014-01-01

    The novel hydrogels-grafted IKVAV poly (lactide-co-ethylene oxide-co-fumarate) (PLEOF) hydrogels (GIPHs) were developed. The rat bone marrow mesenchymal stem cells (BMMSCs) were employed, and the cell vitality and apoptosis assays were carried out to evaluate the cytocomptibility of GIPHs. Our data demonstrated that the influence of GIPHs on the proliferation of BMMSCs was in a concentration and time dependent manner. The proliferative ability of BMMSCs in GIPHs-treated group (100μg/mL) after 72 h presented a maximum response which was 30.1%more than that of control group. The numbers of apoptotic cells in GIPHs-treated group (100μg/mL) were just as much as that of control group after 24 h treatment. The GIPHs are able to provide an appropriate environment for BMMSCs survival and proliferation.

  1. Engineering interaction between bone marrow derived endothelial cells and electrospun surfaces for artificial vascular graft applications.

    Science.gov (United States)

    Ahmed, Furqan; Dutta, Naba K; Zannettino, Andrew; Vandyke, Kate; Choudhury, Namita Roy

    2014-04-14

    The aim of this investigation was to understand and engineer the interactions between endothelial cells and the electrospun (ES) polyvinylidene fluoride-co-hexafluoropropylene (PVDF-HFP) nanofiber surfaces and evaluate their potential for endothelialization. Elastomeric PVDF-HFP samples were electrospun to evaluate their potential use as small diameter artificial vascular graft scaffold (SDAVG) and compared with solvent cast (SC) PVDF-HFP films. We examined the consequences of fibrinogen adsorption onto the ES and SC samples for endothelialisation. Bone marrow derived endothelial cells (BMEC) of human origin were incubated with the test and control samples and their attachment, proliferation, and viability were examined. The nature of interaction of fibrinogen with SC and ES samples was investigated in detail using ELISA, XPS, and FTIR techniques. The pristine SC and ES PVDF-HFP samples displayed hydrophobic and ultrahydrophobic behavior and accordingly, exhibited minimal BMEC growth. Fibrinogen adsorbed SC samples did not significantly enhance endothelial cell binding or proliferation. In contrast, the fibrinogen adsorbed electrospun surfaces showed a clear ability to modulate endothelial cell behavior. This system also represents an ideal model system that enables us to understand the natural interaction between cells and their extracellular environment. The research reported shows potential of ES surfaces for artificial vascular graft applications. PMID:24564790

  2. Relationship between alveolar cleft bone grafting and facial skeletal growth%牙槽突裂植骨与颌骨生长发育的关系

    Institute of Scientific and Technical Information of China (English)

    韶青华; 陈振琦

    2013-01-01

      牙槽突裂植骨是唇腭裂患者序列治疗的重要组成部分。学者们在植骨时机的选择上存在分歧,主要分为一期植骨和二期植骨,原因在于不同时期植骨对颌骨生长发育的影响不同。本文分别从这两个植骨时机上阐述了其植骨来源以及植骨与颌骨生长发育的关系。%Bone grafting of alveolar cleft is an essential step in the sequential management of patients with clefts of lip, alveolus and palate. There is little agreement on the optimal time, which includes primary bone grafting and secondary bone grafting. This is caused by the effects of alveolar bone grafting in different times on facial skeletal growth. This article described the sources of bone graft as well as the relationship between bone grafting and facial skeletal growth from the two bone graft timing.

  3. Restriction specificity of virus-specific cytotoxic T cells from thymectomised irradiated bone marrow chimeras reconstituted with thymus grafts

    International Nuclear Information System (INIS)

    Adult-thymectomised lethally irradiated mice A that were reconstituted with T-cell-depleted bone marrow cells of (A X B)F1 origin plus fetal thymus grafts of (B X C)F1 origin generated virus-specific T cells restricted to B alone; adult-thymectomised and lethally irradiated (A X B)F1 mice that were reconstituted with T-cell depleted bone marrow cells of (A X B)F1 origin plus fetal thymus grafts of A and of B origin generated virus-specific T cells restricted to A or to B. These results do not reveal obvious suppressive influences of host or stem-cell origin that might have explained results obtained with various irradiated bone marrow or thymus chimeras, they indicate that the thymus' influence on maturing T cells is one of the limiting steps in the selection of T cells' restriction specificities. (Auth.)

  4. Comprehensive Review of Adipose Stem Cells and Their Implication in Distraction Osteogenesis and Bone Regeneration

    Directory of Open Access Journals (Sweden)

    Mina W. Morcos

    2015-01-01

    Full Text Available Bone is one of the most dynamic tissues in the human body that can heal following injury without leaving a scar. However, in instances of extensive bone loss, this intrinsic capacity of bone to heal may not be sufficient and external intervention becomes necessary. Several techniques are available to address this problem, including autogenous bone grafts and allografts. However, all these techniques have their own limitations. An alternative method is the technique of distraction osteogenesis, where gradual and controlled distraction of two bony segments after osteotomy leads to induction of new bone formation. Although distraction osteogenesis usually gives satisfactory results, its major limitation is the prolonged duration of time required before the external fixator is removed, which may lead to numerous complications. Numerous methods to accelerate bone formation in the context of distraction osteogenesis have been reported. A viable alternative to autogenous bone grafts for a source of osteogenic cells is mesenchymal stem cells from bone marrow. However, there are certain problems with bone marrow aspirate. Hence, scientists have investigated other sources for mesenchymal stem cells, specifically adipose tissue, which has been shown to be an excellent source of mesenchymal stem cells. In this paper, the potential use of adipose stem cells to stimulate bone formation is discussed.

  5. Scaffold-free Three-dimensional Graft From Autologous Adipose-derived Stem Cells for Large Bone Defect Reconstruction

    Science.gov (United States)

    Dufrane, Denis; Docquier, Pierre-Louis; Delloye, Christian; Poirel, Hélène A.; André, Wivine; Aouassar, Najima

    2015-01-01

    Abstract Long bone nonunion in the context of congenital pseudarthrosis or carcinologic resection (with intercalary bone allograft implantation) is one of the most challenging pathologies in pediatric orthopedics. Autologous cancellous bone remains the gold standard in this context of long bone nonunion reconstruction, but with several clinical limitations. We then assessed the feasibility and safety of human autologous scaffold-free osteogenic 3-dimensional (3D) graft (derived from autologous adipose-derived stem cells [ASCs]) to cure a bone nonunion in extreme clinical and pathophysiological conditions. Human ASCs (obtained from subcutaneous adipose tissue of 6 patients and expanded up to passage 4) were incubated in osteogenic media and supplemented with demineralized bone matrix to obtain the scaffold-free 3D osteogenic structure as confirmed in vitro by histomorphometry for osteogenesis and mineralization. The 3D “bone-like” structure was finally transplanted for 3 patients with bone tumor and 3 patients with bone pseudarthrosis (2 congenital, 1 acquired) to assess the clinical feasibility, safety, and efficacy. Although minor clones with structural aberrations (aneuploidies, such as tri or tetraploidies or clonal trisomy 7 in 6%–20% of cells) were detected in the undifferentiated ASCs at passage 4, the osteogenic differentiation significantly reduced these clonal anomalies. The final osteogenic product was stable, did not rupture with forceps manipulation, did not induce donor site morbidity, and was easily implanted directly into the bone defect. No acute (development, were associated with the graft up to 4 years after transplantation. We report for the first time that autologous ASC can be fully differentiated into a 3D osteogenic-like implant without any scaffold. We demonstrated that this engineered tissue can safely promote osteogenesis in extreme conditions of bone nonunions with minor donor site morbidity and no oncological side effects. PMID

  6. Osteogenic protein-1 increases the fixation of implants grafted with morcellised bone allograft and ProOsteon bone substitute: an experimental study in dogs

    DEFF Research Database (Denmark)

    Baad-Hansen, Thomas Einer; Overgaard, S; Lind, M;

    2007-01-01

    weeks osteogenic protein-1 increased bone formation and the energy absorption of implants grafted with allograft and ProOsteon. A composite of allograft, ProOsteon and osteogenic protein-1 was comparable, but not superior to, allograft used on its own. ProOsteon alone cannot be recommended as a......Impacted bone allograft is often used in revision joint replacement. Hydroxyapatite granules have been suggested as a substitute or to enhance morcellised bone allograft. We hypothesised that adding osteogenic protein-1 to a composite of bone allograft and non-resorbable hydroxyapatite granules...... surrounded by a concentric 3 mm gap. These gaps were randomly allocated to four different procedures in each dog: 1) bone allograft used on its own; 2) ProOsteon used on its own; 3) allograft and ProOsteon used together; or 4) allograft and ProOsteon with the addition of osteogenic protein-1. After three...

  7. COMPARATIVE STUDY OF CLINICAL OUTCOME OF ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION BONE PATELLAR TENDON BONE GRAFT V/S HAMSTRING GRAFT

    Directory of Open Access Journals (Sweden)

    Priyank

    2015-08-01

    fulfilling the predetermined inclusion and exclusion criteria were included in the study. STATISTICAL METHODS : Intergroup comparison was analysed by K - Independent sample t test. Intragroup comparison was analysed by Paired t - test. RESULTS : Patients were divided into two groups and treated with using Bone - patellar tendon - bone graft and Hamstring graft respectively. Mean age group of patients was 29.16 yrs. (range 16 - 51yrs and 30.88 yrs. (range 19 - 48yrs in group A and B respectively we found the incidence of ACL injury in 15 - 44 years age group to be greater than twice the general population. A mean delay in surgery of 4.66 months (range 2 - 12 months since the time of injury in group A and 4.46 months (range 2 - 7 months in group B was observed. Subjective IKDC evaluation was done at the end of 12 months. Ther e was no difference in both the groups in the terms of effusion, passive motion, knee compartment findings, ligament examination, X - ray findings. Functional test and IKDC grade of both the groups showed statistically very highly significant improvement. Ho wever, there was statistically very high Harvest site pathology in group A. CONCLUSION : We found that there is statistically no significant difference in the overall clinical outcome between hamstring autograft with transfix and bone - patellar tendon bone autograft with interference screw except that the patellar tendon group had a greater tendency of having donor site morbidity compared to the hamstring tendon group.

  8. Acetabular defect reconstruction with impacted morsellized bone grafts or TCP/HA particles. A study on the mechanical stability of cemented cups in an artificial acetabulum model.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Verdonschot, N.J.J.; Schreurs, B.W.; Buma, P.

    2002-01-01

    In revision surgery of the acetabulum bone defects can be filled with impacted human morsellized bone grafts. Because of a worldwide limited availability of human bone, alternatives are being considered. In this study we compared the initial stability of acetabular cups after reconstructing a cavita

  9. Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation

    Directory of Open Access Journals (Sweden)

    Giovanni Di Giacomo

    2013-01-01

    Full Text Available Aims: One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. Materials and Methods: A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. Results: The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P < 0.01. Discussion: To our knowledge, there are no studies in literature that show the causes of coracoid bone graft osteolysis after Latarjet procedure. Conclusion: Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level of Evidence: Level 4. Clinical Relevance: Prospective case series, Treatment study.

  10. Impaction grafting with morsellised allograft and tricalcium phosphate-hydroxyapatite: incorporation within ovine metaphyseal bone defects.

    Science.gov (United States)

    Pratt, J N J; Griffon, D J; Dunlop, D G; Smith, N; Howie, C R

    2002-08-01

    An ovine model was used to investigate the in vivo properties of impacted tricalcium phosphate-hydroxyapatite (TCP-HA) aggregates, varying in chemical composition (ratio of TCP to HA) and particle size distribution (8 versus 3 particle size ranges). All pellets were impacted to a standard compactive effort. Eight sheep underwent implantation of pellets in 4 metaphyseal defects in both rear limbs. Treatment groups consisted of: (1) allograft (clinical control). (2) 50/50 allograft/80% HA/20% TCP in 8 particle size ranges, (3) 50/50 allograft/80% TCP/20% HA in 8 sizes and (4) 50/50 allograft/80% HA/20% TCP in only 3 sizes of particles. Healing of defects was evaluated at 14 weeks with computed tomography, histology and histomorphometry. The computer tomography (CT) density measured in all defects containing synthetic agents was higher than in defects filled with allograft alone (p<0.01). Defects containing 8 sizes of 80% HA/ 20% TCP granules (group 2) achieved lower histological scores and contained less bone than the clinical control (p<0.05), whereas groups 3 and 4 did not differ from the control. Although all synthetic agents were osteoconductive, our results suggest that increasing the ratio of TCP over HA and limiting the number of particle size ranges to 3 instead of 8 improve the performance of impacted aggregates as graft expanders. Evaluation under loading conditions of morsellised allograft expanded with 80% TCP/20% HA (BoneSave) in 3 particle size ranges is warranted.

  11. Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Kleiner JB

    2016-05-01

    Full Text Available Jeffrey B Kleiner, Hannah M Kleiner, E John Grimberg Jr, Stefanie J Throlson The Spine Center of Innovation, The Medical Center of Aurora, Aurora, CO, USA Study design: Disk material removed (DMR during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF surgery was compared to the corresponding bone graft (BG volumes inserted at the time of fusion. A novel BG delivery tool (BGDT was used to apply the BG. In order to establish the percentage of DMR during T-LIF, it was compared to DMR during anterior diskectomy (AD. This study was performed prospectively. Summary of background data: Minimal information is available as to the volume of DMR during a T-LIF procedure, and the relationship between DMR and BG delivered is unknown. BG insertion has been empiric and technically challenging. Since the volume of BG applied to the prepared disk space likely impacts the probability of arthrodesis, an investigation is justified. Methods: A total of 65 patients with pathology at L4-5 and/or L5-S1 necessitating fusion were treated with a minimally invasive T-LIF procedure. DMR was volumetrically measured during disk space preparation. BG material consisting of local autograft, BG extender, and bone marrow aspirate were mixed to form a slurry. BG slurry was injected into the disk space using a novel BGDT and measured volumetrically. An additional 29 patients who were treated with L5-S1 AD were compared to L5-S1 T-LIF DMR to determine the percent of T-LIF DMR relative to AD. Results: DMR volumes averaged 3.6±2.2 mL. This represented 34% of the disk space relative to AD. The amount of BG delivered to the disk spaces was 9.3±3.2 mL, which is 2.6±2.2 times the amount of DMR. The BGDT allowed uncomplicated filling of the disk space in <1 minute. Conclusion: The volume of DMR during T-LIF allows for a predictable volume of BG delivery. The BGDT allowed complete filling of the entire prepared disk space. The T-LIF diskectomy debrides 34% of the disk

  12. Proximal Tibia Chondroblastoma Treated With Curettage and Bone Graft and Cement Use.

    Science.gov (United States)

    Cho, Hwan Seong; Park, Yeong Kyoon; Oh, Joo Han; Lee, Jung Hyun; Han, Ilkyu; Kim, Han-Soo

    2016-01-01

    Chondroblastoma has a predilection for the epiphyses or apophyses of long tubular bones. Management of lesions in the proximal tibia is challenging because it is difficult to gain access to intraepiphyseal lesions for completion of curettage. From October 2007 to December 2011, 9 patients with de novo chondroblastoma of the proximal tibia underwent surgery at the authors' institution. All patients initially presented with pain, and 5 patients had limitation of range of motion of the ipsilateral knee. Four lesions abutted the tibial attachment sites of the cruciate ligaments. Surgical procedures included intralesional tumor curettage, additional burring, and packing of the defect with bone graft and/or bone cement. The extra-articular approach was used according to tumor location. The medial or lateral parapatellar approach was used when the tumor was located in the anterior two-thirds of the horizontal plane. When a lesion was located in the posterior third, the posteromedial or posterolateral approach was used as the lesion was cornered. Mean duration of follow-up was 47.2 months (range, 27-80 months). No local recurrence or pulmonary metastasis was noted at latest follow-up. Mean functional score was 29.3 points (range, 28-30 points). All patients fully recovered range of motion in the affected knee. No avulsion fracture or anteroposterior instability of the knee joint was detected. Results of the current study suggest that intralesion curettage followed by additional burring with an extra-articular approach is a successful treatment option for chondroblastoma of the proximal tibia.

  13. Proximal Tibia Chondroblastoma Treated With Curettage and Bone Graft and Cement Use.

    Science.gov (United States)

    Cho, Hwan Seong; Park, Yeong Kyoon; Oh, Joo Han; Lee, Jung Hyun; Han, Ilkyu; Kim, Han-Soo

    2016-01-01

    Chondroblastoma has a predilection for the epiphyses or apophyses of long tubular bones. Management of lesions in the proximal tibia is challenging because it is difficult to gain access to intraepiphyseal lesions for completion of curettage. From October 2007 to December 2011, 9 patients with de novo chondroblastoma of the proximal tibia underwent surgery at the authors' institution. All patients initially presented with pain, and 5 patients had limitation of range of motion of the ipsilateral knee. Four lesions abutted the tibial attachment sites of the cruciate ligaments. Surgical procedures included intralesional tumor curettage, additional burring, and packing of the defect with bone graft and/or bone cement. The extra-articular approach was used according to tumor location. The medial or lateral parapatellar approach was used when the tumor was located in the anterior two-thirds of the horizontal plane. When a lesion was located in the posterior third, the posteromedial or posterolateral approach was used as the lesion was cornered. Mean duration of follow-up was 47.2 months (range, 27-80 months). No local recurrence or pulmonary metastasis was noted at latest follow-up. Mean functional score was 29.3 points (range, 28-30 points). All patients fully recovered range of motion in the affected knee. No avulsion fracture or anteroposterior instability of the knee joint was detected. Results of the current study suggest that intralesion curettage followed by additional burring with an extra-articular approach is a successful treatment option for chondroblastoma of the proximal tibia. PMID:26726978

  14. 9 CFR 113.113 - Autogenous biologics.

    Science.gov (United States)

    2010-01-01

    ... AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Inactivated Bacterial Products § 113.113 Autogenous biologics. Autogenous biologics shall be prepared from... serial or subserial of autogenous bacterial product other than the first serial or subserial...

  15. Methodological approach for the evaluation of homologous bone graft use in post-extractive atrophic alveolar ridges

    Directory of Open Access Journals (Sweden)

    B. Musante

    2013-01-01

    Full Text Available The aim of this study is to investigate the in vivo efficacy of Puros® cancellous particulate allograft bone in the regeneration of post-extractive sites. Twelve molar or premolar sites were selected. Seven days after minimally invasive tooth extraction, Puros® cancellous particulate allografts were inserted into the elected sites. TC Cone-Beam investigation and at 4 months from surgery; bone height and width were evaluated. Five months after surgery, biopsy samples of the regenerated sites were taken and histologically analyzed to qualitatively evaluate bone regeneration. TC analysis showed, a mean bone gain of 4.1 mm in height and 2.02 mm in width. The histological analysis of the samples showed intense bone metabolic activity with active osteoblasts on the implant surface, at the level of the native bone-graft interface and in the grafted area. The radiographic and histological analyses demonstrate an optimal bonen regeneration, both in terms of quality and quantity using Puros®.

  16. Expression of bone morphogenic protein 2/4, transforming growth factor-β1, and bone matrix protein expression in healing area between vascular tibia grafts and irradiated bone-experimental model of osteonecrosis

    International Nuclear Information System (INIS)

    Purpose: For the surgical treatment of osteoradionecrosis after multimodal therapy of head-and-neck cancers, free vascular bone grafts are used to reconstruct osseous structures in the previously irradiated graft bed. Reduced, or even absent osseous healing in the transition area between the vascular graft and the irradiated graft bed represents a clinical problem. Inflammatory changes and fibrosis lead to delayed healing, triggered by bone morphogentic protein 2/4 (BMP2/4) and transforming growth factor (TGF)-β1. Given the well-known fibrosis-inducing activity of TGF-β1, an osteoinductive effect has been reported for BMP2/4. However, the influence of irradiation (RT) on this cytokine expression remains elusive. Therefore, the aim of the present in vivo study was to analyze the expression of BMP2/4, TGF-β1, collagen I, and osteocalcin in the transition area between the bone graft and the graft bed after RT. Methods and materials: Twenty Wistar rats (male, weight 300-500 g) were used in this study. A free vascular tibia graft was removed in all rats and maintained pedicled in the groin region. Ten rats underwent RT with 5 x 10 Gy to the right tibia, the remainder served as controls. After 4 weeks, the previously removed tibia grafts were regrafted into the irradiated (Group 1) and nonirradiated (Group 2) graft beds. The interval between RT and grafting was 4 weeks. After a 4-week osseous healing period, the bone grafts were removed, and the transition area between the nonirradiated graft and the irradiated osseous graft bed was examined histomorphometrically (National Institutes of Health imaging program) and immunohistochemically (avidin-biotin-peroxidase complex) for the expression of BMP2/4, TGF-β1, collagen I, and osteocalcin. Results: Absent or incomplete osseous healing of the graft was found in 9 of 10 rats after RT with 50 Gy and in 1 of 10 of the rats with nonirradiated osseous grafts. Histomorphometrically, the proportion of osseous healing in the

  17. Graft-versus-leukemia effects from donor lymphocyte infusion after nonmyeloablative allogeneic bone marrow transplantation in mice

    Institute of Scientific and Technical Information of China (English)

    DU Bing; LI De-peng; XU Kai-lin; PAN Xiu-ying

    2005-01-01

    Background Nonmyeloablative allogeneic bone marrow transplantation has been used since the 1990s as a new hematological stem cell transplantation strategy for treating hematological diseases. The purpose of this study was to explore the graft-versus-leukemia (GVL) effects of donor lymphocyte infusions (DLIs) after nonmyeloablative allogeneic bone marrow transplantations, while assessing the declines in treatment-associated morbidity, mortality, and graft-versus-host disease (GVHD).Methods A total of 615 (H-2k) mice were injected with L615 tumor cells and received 500 cGy (60Coγ-ray) irradiation three days later, followed by an allogeneic bone marrow transplantation (allo-BMT). The allo-grafts consisted of 3×107 bone marrow cells and 1×107 spleen cells from BALB/C (H-2d) donor mice. Two days after the allo-BMT, the recipient mice were given 200 mg/kg of cyclophosphamide. Subsequently, recipient mice were infused with either donor spleen cells (2×107) on day 14 or 21, or donor spleen cells (5×107) pretreated with hydrocortisone and cyclosporin A (CsA) in vitro on day 14 post-BMT.Results The median survival time of mice that received DLI on day 21 and pretreated DLI on day 14 post-BMT was longer than that of controls and the day 14 DLI group (P<0.01). No evidence of severe GVHD was observed in the day 21 DLI group nor in the day 14 treated DLI group. Mixed chimerism was confirmed in the day 14 DLI group, the day 14 treated DLI group, and the day 21 DLI group on the thirteenth day post-transplantation; full donor chimerism was observed two weeks after DLI.Conclusion Donor lymphocyte infusion after nonmyeloablative bone marrow transplantation may reduce transplantation-associated morbidity and mortality while strengthening graft-versus-leukemia effects.

  18. Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT

    Science.gov (United States)

    Savani, Bipin N.; Labopin, Myriam; Blaise, Didier; Niederwieser, Dietger; Ciceri, Fabio; Ganser, Arnold; Arnold, Renate; Afanasyev, Boris; Vigouroux, Stephane; Milpied, Noel; Hallek, Michael; Cornelissen, Jan J.; Schwerdtfeger, Rainer; Polge, Emmanuelle; Baron, Frédéric; Esteve, Jordi; Gorin, Norbert C.; Schmid, Christoph; Giebel, Sebastian; Mohty, Mohamad; Nagler, Arnon

    2016-01-01

    Increasing numbers of patients are receiving reduced intensity conditioning regimen allogeneic hematopoietic stem cell transplantation. We hypothesized that the use of bone marrow graft might decrease the risk of graft-versus-host disease compared to peripheral blood after reduced intensity conditioning regimens without compromising graft-versus-leukemia effects. Patients who underwent reduced intensity conditioning regimen allogeneic hematopoietic stem cell transplantation from 2000 to 2012 for acute leukemia, and who were reported to the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation were included in the study. Eight hundred and thirty-seven patients receiving bone marrow grafts were compared with 9011 peripheral blood transplant recipients after reduced intensity conditioning regimen. Median follow up of surviving patients was 27 months. Cumulative incidence of engraftment (neutrophil ≥0.5×109/L at day 60) was lower in bone marrow recipients: 88% versus 95% (P<0.0001). Grade II to IV acute graft-versus-host disease was lower in bone marrow recipients: 19% versus 24% for peripheral blood (P=0.005). In multivariate analysis, after adjusting for differences between both groups, overall survival [Hazard Ratio (HR) 0.90; P=0.05] and leukemia-free survival (HR 0.88; P=0.01) were higher in patients transplanted with peripheral blood compared to bone marrow grafts. Furthermore, peripheral blood graft was also associated with decreased risk of relapse (HR 0.78; P=0.0001). There was no significant difference in non-relapse mortality between recipients of bone marrow and peripheral blood grafts, and chronic graft-versus-host disease was significantly higher after peripheral blood grafts (HR 1.38; P<0.0001). Despite the limitation of a retrospective registry-based study, we found that peripheral blood grafts after reduced intensity conditioning regimens had better overall and leukemia-free survival than bone marrow grafts. However

  19. Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction

    Directory of Open Access Journals (Sweden)

    Carlo Maiorana

    2016-01-01

    Full Text Available The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix allow for a complete restoration of the atrophic ridge without invasive harvesting procedures. A maxillary reconstruction of an atrophic ridge by means of tissue substitutes and its histological features are then presented.

  20. Application of modern computer-aided technologies in the production of individual bone graft: A case report

    Directory of Open Access Journals (Sweden)

    Mirković Siniša

    2015-01-01

    Full Text Available Introduction. An autologous bone (bone derived from the patient himself is considered to be a “golden standard” in the treatment of bone defects and partial atrophic alveolar ridge. However, large defects and bone losses are difficult to restore in this manner, because extraction of large amounts of autologous tissue can cause donor-site problems. Alternatively, data from computed tomographic (CT scan can be used to shape a precise 3D homologous bone block using a computer-aided design-computer-aided manufacturing (CAD-CAM system. Case report. A 63-year old male patient referred to the Clinic of Dentistry of Vojvodina in Novi Sad, because of teeth loss in the right lateral region of the lower jaw. Clinical examination revealed a pronounced resorption of the residual ridge of the lower jaw in the aforementioned region, both horizontal and vertical. After clinical examination, the patient was referred for 3D cone beam (CBCT scan that enables visualization of bony structures and accurate measurement of dimensions of the residual alveolar ridge. Considering the large extent of bone resorption, the required ridge augmentation was more than 3 mm in height and 2 mm in width along the length of some 2 cm, thus the use of granular material was excluded. After consulting prosthodontists and engineers from the Faculty of Technical Sciences in Novi Sad we decided to fabricate an individual (custom bovine-derived bone graft designed according to the obtained 3D CBCT scan. Conclusion. Application of 3D CBCT images, computer-aided systems and software in manufacturing custom bone grafts represents the most recent method of guided bone regeneration. This method substantially reduces time of recovery and carries minimum risk of postoperative complications, yet the results fully satisfy the requirements of both the patient and the therapist.

  1. Platelet-rich plasma-induced bone marrow mesenchymal stem cells versus autologous nerve grafting for sciatic nerve repair

    Institute of Scientific and Technical Information of China (English)

    Changsuo Xia; Yajuan Li; Wen Cao; Zhaohua Yu

    2010-01-01

    Autologous nerve grafting is the gold standard of peripheral nerve repair.We previously showed that autologous platelet-rich plasma(PRP)contains high concentrations of growth factors and can induce in vitro cultured bone marrow mesenchymal stem cells(BMSCs)to differentiate into Schwann cells.Here we used PRP-induced BMSCs combined with chemically extracted acellular nerves to repair sciatic nerve defects and compared the effect with autologous nerve grafting.The BMSCs and chemically extracted acellular nerve promoted target muscle wet weight restoration,motor nerve conduction velocity,and axonal and myelin sheath regeneration,with similar effectiveness to autologous nerve grafting.This finding suggests that PRP induced BMSCs can be used to repair peripheral nerve defects.

  2. Implant surface preparation in the surgical treatment of experimental peri-implantitis with autogenous bone graft and ePTFE membrane in cynomolgus monkeys

    DEFF Research Database (Denmark)

    Schou, Søren; Holmstrup, Palle; Jørgensen, Torben;

    2003-01-01

    peri-implantitis; treatment; implant surface preparation; nonhuman primates; histology; stereology......peri-implantitis; treatment; implant surface preparation; nonhuman primates; histology; stereology...

  3. Bone-Marrow Storage and Transplantation

    International Nuclear Information System (INIS)

    The authors present some results from their experiments on bone-marrow storage and transplantation. The main problems with preservation of stored bone marrow are the duration, temperature, adjuvant substances and the significance of viability tests during the conservation processes. The results showed that: • Storage of bone marrow at +4eC produces a progressive decrease in its restoring capacity versus storage time. • While bone marrow stored for 24 h is able to restore 100% of dogs lethally irradiated with 600 rad, after 10 days of storage only 20% of the animals can be restored. • No correlation exists between the actual survival of dogs and that calculated by dye exclusion tests, which indicate a rather high (70%) viability, even after 10 days bone-marrow storage at +4°C. • DNA degradation (depolymerization) measurements of the bone marrow may be used as a supplementary test for checking the viability or restoration potency of bone-marrow cells after storage. • In the freezing process, the optimum contact time between glycerol and the bone-marrow cells is 15 min. Results of experiments regarding certain bone-marrow transplantation problems showed that: • The best time to administer bone marrow is between 24 and 48 h after irradiation. • No survivors were obtained with dogs lethally irradiated with 600 rad by administering autogenic or allogenic DNA extracted from bone marrow, spleen or liver. • Histocompatibility related to sex may play an important role in the bone-marrow graft. The lowest survival of C57BL mice was obtained when the donors were males and the recipients females. • In radioprotection with foetal haemocytopoietic tissues, the donor's age represents one of the main factors. The best results were obtained in experiments on rats, with 19- to 20-day foetal liver (period of complete and maximum haemocytopoietic activity). The tissues mentioned below may be connected with the appearance of certain typical signs of secondary syndrome

  4. Autogenous tooth transplantation: an alternative to replace extracted tooth

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2015-09-01

    Full Text Available Background: The gold standard treatment to replace missing tooth is dental implants, however, in certain cases, such as in young patients its placement is contraindicated. Autogenous tooth transplantation, which has been widely done in Scandinavian countries for many years, may become a good alternative to overcome this problem. Purpose: This article attempted to provide information about the indication, treatment planning, surgical technique and the successful result of autogenous tooth transplantation. Case: A fifteen year old male patient presented with large caries and periapical disease of his lower left first molar, which was partially erupted and the roots was not fully formed in radiograph. Case management: Autogenous tooth transplantation procedure was performed consisting of extraction of #36, odontectomy of #38 followed by its implantation to socket #36 and fixation of the transplanted tooth to the adjacent teeth. Post operative evaluation was done on regular basis within 18 months period. There was no complaint, the tooth was clinically stable and no evidence of periodontal problem. Serial radiographs showed healing of alveolar bone and periodontal tissue, and the complete root formation was evident by 18 months post operatively. Conclusion: Autogenous tooth transplantation is a potential alternative to replace extracted tooth. Provided that the case be properly planned and operation carefully performed, successful result of this treatment can be achieved.

  5. Investigating Oral Microbiome Profiles in Children with Cleft Lip and Palate for Prognosis of Alveolar Bone Grafting.

    Science.gov (United States)

    Liu, Luwei; Zhang, Qian; Lin, Jiuxiang; Ma, Lian; Zhou, Zhibo; He, Xuesong; Jia, Yilin; Chen, Feng

    2016-01-01

    In this study, we sought to investigate the oral microbiota structure of children with cleft lip and palate (CLP) and explore the pre-operative oral bacterial composition related to the prognosis of alveolar bone grafting. In total, 28 patients (19 boys, 9 girls) with CLP who were scheduled to undergo alveolar bone grafting for the first time were recruited. According to the clinical examination of operative sites at the third month after the operation, the individuals were divided into a non-inflammation group (n = 15) and an inflammation group (n = 13). In all, 56 unstimulated saliva samples were collected before and after the operation. The v3-v4 hypervariable regions of the 16S rRNA gene were sequenced using an Illumina MiSeq sequencing platform. Based on the beta diversity of the operational taxonomic units (OTUs) in the inflammation and non-inflammation samples, the microbial variation in the oral cavity differed significantly between the two groups before and after the operation (P < 0.05). Analysis of the relative abundances of pre-operative OTUs revealed 26 OTUs with a relative abundance higher than 0.01%, reflecting a significant difference of the relative abundance between groups (P < 0.05). According to a principal component analysis of the pre-operative samples, the inflammation-related OTUs included Tannerella sp., Porphyromonas sp., Gemella sp., Moraxella sp., Prevotella nigrescens, and Prevotella intermedia, most of which were enriched in the inflammation group and showed a significant positive correlation. A cross-validated random forest model based on the 26 different OTUs before the operation was able to fit the post-operative status of grafted sites and yielded a good classification result. The sensitivity and specificity of this classified model were 76.9% and 86.7%, respectively. These findings show that the oral microbiota profile before alveolar bone grafting may be related to the risk of post-operative inflammation at grafted sites. PMID

  6. Investigating Oral Microbiome Profiles in Children with Cleft Lip and Palate for Prognosis of Alveolar Bone Grafting

    Science.gov (United States)

    Liu, Luwei; Zhang, Qian; Lin, Jiuxiang; Ma, Lian; Zhou, Zhibo; He, Xuesong; Jia, Yilin; Chen, Feng

    2016-01-01

    In this study, we sought to investigate the oral microbiota structure of children with cleft lip and palate (CLP) and explore the pre-operative oral bacterial composition related to the prognosis of alveolar bone grafting. In total, 28 patients (19 boys, 9 girls) with CLP who were scheduled to undergo alveolar bone grafting for the first time were recruited. According to the clinical examination of operative sites at the third month after the operation, the individuals were divided into a non-inflammation group (n = 15) and an inflammation group (n = 13). In all, 56 unstimulated saliva samples were collected before and after the operation. The v3-v4 hypervariable regions of the 16S rRNA gene were sequenced using an Illumina MiSeq sequencing platform. Based on the beta diversity of the operational taxonomic units (OTUs) in the inflammation and non-inflammation samples, the microbial variation in the oral cavity differed significantly between the two groups before and after the operation (P < 0.05). Analysis of the relative abundances of pre-operative OTUs revealed 26 OTUs with a relative abundance higher than 0.01%, reflecting a significant difference of the relative abundance between groups (P < 0.05). According to a principal component analysis of the pre-operative samples, the inflammation-related OTUs included Tannerella sp., Porphyromonas sp., Gemella sp., Moraxella sp., Prevotella nigrescens, and Prevotella intermedia, most of which were enriched in the inflammation group and showed a significant positive correlation. A cross-validated random forest model based on the 26 different OTUs before the operation was able to fit the post-operative status of grafted sites and yielded a good classification result. The sensitivity and specificity of this classified model were 76.9% and 86.7%, respectively. These findings show that the oral microbiota profile before alveolar bone grafting may be related to the risk of post-operative inflammation at grafted sites. PMID

  7. The effect of polystyrene sodium sulfonate grafting on polyethylene terephthalate artificial ligaments on in vitro mineralisation and in vivo bone tissue integration

    Science.gov (United States)

    Vaquette, Cédryck; Viateau, Véronique; Guérard, Sandra; Anagnostou, Fani; Manassero, Mathieu; Castner, David G.; Migonney, Véronique

    2013-01-01

    This study investigates the impact of polystyrene sodium sulfonate (PolyNaSS) grafting onto the osseointegration of a polyethylene terephthalate artificial ligament (Ligament Advanced Reinforcement System, LARS™) used for Anterior Cruciate Ligament (ACL). The performance of grafted and non-grafted ligaments was assessed in vitro by culturing human osteoblasts under osteogenic induction and this demonstrated that the surface modification was capable of up-regulating the secretion of ALP and induced higher level of mineralisation as measured 6 weeks post-seeding by Micro-Computed Tomography. Grafted and non-grafted LARS™ were subsequently implanted in an ovine model for ACL reconstruction and the ligament-to-bone interface was evaluated by histology and biomechanical testing 3 and 12 months post-implantation. The grafted ligaments exhibited more frequent direct ligament-to-bone contact and bone formation in the core of the ligament at the later time point than the nongrafted specimens, the grafting also significantly reduced the fibrous encapsulation of the ligament 12 months post-implantation. However, this improved osseo-integration was not translated into a significant increase in the biomechanical pull-out loads. These results provide evidences that PolyNaSS grafting improved the osseo-integration of the artificial ligament within the bone tunnels. This might positively influence the outcome of the surgical reconstructions, as higher ligament stability is believed to limit micro-movement and therefore permits earlier and enhanced healing. PMID:23790438

  8. Optimization of dental status improves long-term outcome after alveolar bone grafting in unilateral cleft lip and palate.

    Science.gov (United States)

    Jabbari, Fatima; Skoog, Valdemar; Reiser, Eicka; Hakelius, Malin; Nowinski, Daniel

    2015-03-01

    Objective : To evaluate the importance of dental status for long-term outcome after alveolar bone grafting in patients with unilateral cleft lip and palate. Design : Retrospective longitudinal study. Setting : Cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. Patients : A total of 67 consecutive patients with unilateral complete cleft lip and palate. Interventions : Secondary alveolar bone grafting, prior to the eruption of the permanent canine, was performed at the average age of 10.0 years (range, 8.5 to 12.0 years). Main Outcome Measures : Alveolar bone height was evaluated with the modified Bergland index at 1 and 10 years after surgery. Results : Of the patients, 97% had modified Bergland index grade I and the remaining 3% had modified Bergland index grade II at 1 year after surgery. At 10 years' follow-up, 43% showed modified Bergland index grade I; 55%, modified Bergland index grade II; and 2% (one patient), modified Bergland index grade III. The degree of dental anomalies in the cleft area, such as enamel hypoplasia, incisor rotation, incisor inclination, canine inclination, and oral hygiene registered preoperatively, all correlated negatively to the modified Bergland index at 10 years after surgery. Enamel hypoplasia (ρ = 0.70195, P < .0001), followed by canine inclination (ρ = 0.55429, P < .0001), showed the strongest correlation to reduced bone height in the cleft area. Conclusions : In patients with unilateral cleft lip and palate, excellent results from secondary alveolar bone grafting in terms of bone height in the alveolar cleft tend to decrease with time. This seems to be correlated with factors that might to some extent be treated preoperatively through adequate planning and execution of the orthodontic treatment. PMID:24568558

  9. Clinical observation of particulate cancellous bone impaction grafting in combination with total hip arthroplasty for acetabular reconstruction

    Institute of Scientific and Technical Information of China (English)

    LIU Xian-zhe; YANG Shu-hua; XU Wei-hua; LIU Guo-hui; YANG Cao; LI Jin; YE Zhe-wei; LIU Yong; ZHANG Yu-kun

    2008-01-01

    Objective: To investigate the effect of particulate cancellous bone impaction grafting in combination with total hip arthroplasty (THA) for acetabular reconstruction in patients with posttraumatic arthritis and bone loss afteracetabular fractures.Methods: Totally 15 consecutive cases with unilateral acetabular fracture were treated with bone impaction grafting in combination with THA in our department.There were 10 males and 5 females with mean age of 48.2 years (ranging from 36 to 73 years).Eight cases had the fracture at left hips,7 at right hips.The average age at injury was 28 years (ranging from 18 to 68 years).The mean follow-up period was 4.3 years (ranging from 2 to 7 years).Results: Compared with mean 42 points (ranging from 10 to 62) of the preoperative Harris score,the survival cases at the final follow-up had mean 84 points (ranging from 58 to 98).One patient had mild pain in the hip.No revision of the acetabular or femoral component was undertaken during the follow-up.Normal rotational centre of most hips was recovered except 2 cases in which it was 0.8 mm higher than that in opposite side.All of them had a stable radiographic appearance.Progressive radiolucent fines were observed in I,III zones in 2 cases.One patient had a nonprogressive radiolucent fine in zone III.The cup prosthesis was obviously displaced (6 mm) in one patient,but had not been revised.Conclusion: Particulate cancellous bone impaction grafting in combination with THA as a biological solution is an attractive procedure for acetabular reconstruction in patients with posttraumatic arthritis and bone loss after acetabular fracture,which can not only restore acetabular bone stock but also repair normal hip anatomy and its function.

  10. STUDY OF AN ASSESSMENT OF THE FATE OF CALCIUM HYDROXY APATITE BLOCK WITH CORTICO CANCELLOUS BONE GRAFT USED IN COMMUNITED FRACTURES OF LONG BONE OF LOWER LIMB

    Directory of Open Access Journals (Sweden)

    Ahmad

    2015-03-01

    Full Text Available INTRODUCTION: In recent years there has been an increasing interest in biologically active calcium phosphate ceramic materials for orthopaedic application. A number of materials from human, animal or non - biological sources have been used to fill defects with or without additional autogenus bone. It would be ideal to have bone substitute w hich is easily fabricated and preserved, is biocompatible with bone, and is biodegradable. The calcium phosphate system, and in particular hydroxyappatite (HA, has long been the subject of intensive investigation. MATERIAL AND METHODS: This observational two year study was undertaken at S.N. Medical College and Hospital, Agra (U.P.. The patients having the comminuted fracture of the long bone of lower limbs were treated with autogenus bone graft and calcium hydroxy Apatite bone block. Functional results w ere presented according to Klemm and Borner (1986 criteria. RESULTS: The total cases studied were 25 out of which 21 cases had fracture of both bones of leg and 4 were of fracture femur. The patients were aged between 15 to 70 years. Most of the patients were males and the common mode of injury was road traffic accident. An excellent result were seen in the majority 9(36% of patients while 8(32% patients showed a good result and 6(24% showed a fair result. 17(68% patients had compound fracture while 8( 32% patients were having closed fracture. CONCLUSION: Calcium Hydroxy Apatite is a suitable alternative to bone graft. There was no evidence of any foreign body reaction and infection at the Calcium Hydroxy Apatite implanted site. There was satisfactory h ealing of all the comminuted fractures. The movement of adjacent joints was nearly normal. No refracture was observed on follow up.

  11. Grafting after sinus lift with anorganic bovine bone alone compared with 50:50 anorganic bovine bone and autologous bone: results of a pilot randomised trial at one year.

    Science.gov (United States)

    Meloni, S M; Jovanovic, S A; Lolli, F M; Cassisa, C; De Riu, G; Pisano, M; Lumbau, A; Lugliè, P F; Tullio, A

    2015-05-01

    Our aim was to compare the outcome of implants inserted in maxillary sinuses augmented with anorganic bovine bone grafts compared with those augmented with mixed 50:50 bovine and autologous bone grafts. Twenty sinuses with 1-4mm of residual crestal height below the maxillary sinuses were randomised into two groups according to a parallel group design (n=10 in each). Sinuses were grafted using a lateral approach. In one group the grafts were 50:50 anorganic bovine bone and autologous bone and in the other anorganic bovine bone alone. After 7 months, 32 implants had been inserted. Outcome measures were survival of implants, complications, marginal changes in the height of the bone, and soft tissue variables (pocket probing depth and bleeding on probing). Probabilities of less than 0.05 were accepted as significant. No patient failed to complete the trial and no implant had failed at 1 year. There were some minor complications. After 12 months, the mean (SD) marginal bone loss (mm) was 1.06 (0.61) in the 50:50 group and 1.19 (0.53) in the anorganic bovine group. The mean (SD) values for pocket probing depth (mm) and bleeding on probing (score) were 2.49 (0.38) and 1.59 (0.82) in the 50:50 group and 2.31 (0.64) and 1.36 (0.87) in the anorganic bovine group (neither difference was significant). The present data are consistent with the hypothesis that the outcome of implants inserted in sinuses grafted with either material is comparable. PMID:25796408

  12. Preliminary documentation of the comparable efficacy of vitoss versus NanOss bioactive as bone graft expanders for posterior cervical fusion

    OpenAIRE

    Nancy E Epstein

    2015-01-01

    Background: Laminectomies with posterior cervical instrumented fusions often utilize bone graft expanders to supplement cervical lamina/iliac crest autograft/bone marrow aspirate (BMA). Here we compared posterior fusion rates utilizing two graft expanders; Vitoss (Orthovita, Malvern, PA, USA) vs. NanOss Bioactive (Regeneration Technologies Corporation [RTI: Alachua, FL, USA]). Methods: Two successive prospective cohorts of patients underwent 1-3 level laminectomies with 5-9 level posterio...

  13. BOHLER'S ANGLE: CORRELATION WITH OUTCOME IN DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES TREATED WITH LOCKING COMPRESSION PLATE FIXATION WITH AND WITHOUT BONE GRAFTING

    OpenAIRE

    Deepak P; Eknath D; Vijayanand; Satish

    2014-01-01

    BOHLER'S ANGLE: correlation with outcome in displaced intra-articular calcaneal fractures Treated with locking compression Plate Fixation with and without bone grafting. AIMS: The aim is an accurate reduction of the fracture with reconstruction of Bohler’s angle, length and axis and sub talar joint surface. To determine whether autologous bone graft supplementation is beneficial in achieving and maintaining restoration of Calcaneal height and anatomic reduction. SETTINGS AND ...

  14. Enhancement of the grafting efficiency by the new method of fetal liver-bone marrow scheduled transplantation

    International Nuclear Information System (INIS)

    To enhance the grafting efficiency of bone marrow transplantation, lethally Irradiated recipient Kunming mice were transplantation with fetal liver-bone marrow scheduled transplantation. (FL-BMST) The numbers of WBC, nucleated cells were near to normal level 17 d after irradiation in FL-BMST group transplantation with 1 x 106 bone marrow cells, the indexes of CFU-E, CFU-GM, CFU-F, CFU-S, were returned to normal; the degree of GVHD in the FL-BMST group was slighter than that in sing bone marrow transplantation group; and the survival rate of mice was 60%, which was significantly higher than that of routine single bone marrow transplantation group. 'Niches' vacated each time could be fully used and be improved, be increased by fetal liver-bone marrow scheduled transplantation, so the homing of stem cells was increased, and the number of transplanted bone marrow cells could be decreased. So this new method was a better method than routine bone singe marrow transplantation

  15. Dynamics of Alloplastic Bone Grafts on an Early Stage of Corticotomy-Facilitated Orthodontic Tooth Movement in Beagle Dogs

    OpenAIRE

    Hyung-Joo Choi; Dong-Yeol Lee; Tae-Woo Kim

    2014-01-01

    Alveolar augmented corticotomy is effective in accelerating orthodontic tooth movement, but the effect only lasts for a relatively short time. Therefore, the purpose of this study was to investigate the underlying biology of the immediate periodontal response to orthodontic tooth movement after a corticotomy with alloplastic bone grafts. The results demonstrated that measurable tooth movement began as early as 3 days after the intervention in beagle dogs. Based on the results and histological...

  16. Outcome after open reduction and internal fixation of intraarticular fractures of the calcaneum without the use of bone grafts

    OpenAIRE

    Pendse Aniruddha; Daveshwar R; Bhatt Jay; Shivkumar

    2006-01-01

    Background: Intraarticular fractures of calcaneum are commenest type of calcaneal fractures. Lots of controversies exist about the ideal management for them. The focus is now shifting on operative management by open reduction and internal fixation for these fractures with or without the use of bone grafts. Method: Thirty intraarticular fractures classified by Essex Lopresti radiological classification, were treated by open reduction and fixation. The patients were followed over a mean peri...

  17. Minimally Invasive Harvest of a Quadriceps Tendon Graft With or Without a Bone Block

    OpenAIRE

    Fink, Christian; Herbort, Mirco; Abermann, Elisabeth; Hoser, Christian

    2014-01-01

    The quadriceps tendon (QT) as a graft source for anterior cruciate ligament (ACL) and posterior cruciate ligament reconstruction has recently achieved increased attention. Although many knee surgeons have been using the QT as a graft for ACL revision surgery, it has never gained universal acceptance for primary ACL reconstruction. The QT is a very versatile graft that can be harvested in different widths, thicknesses, and lengths. Conventionally, the QT graft is harvested by an open technique...

  18. Treatment of tibial defect and bone nonunion with limb shortening with external fixator and reconstituted bone xenograft

    Institute of Scientific and Technical Information of China (English)

    王志刚; 刘建; 胡蕴玉; 孟国林; 金格勒; 袁志; 王海强; 戴先文

    2003-01-01

    Objective: To explore the effect of external fixator and reconstituted bone xenograft (RBX) in the treatment of tibial bone defect, tibial bone nonunion and congenital pseudarthrosis of the tibia with limb shortening. Methods: Twenty patients ( 13 males and 7 females) with tibial bone defect, tibial bone nonunion or congenital pseudarthrosis of the tibia with limb shortening were treated with external fixation. Two kinds of external fixators were used: a half ring sulcated external fixator used in 13 patients and a combined external fixator in 7 patients. Foot-drop was corrected at the same time with external fixation in 4 patients. The shortened length of the tibia was in the range of 2-9 cm, with an average of 4.8 cm. For bone grafting, RBX was used in 12 patients, autogenous ilium was used in 3 patients and autogenous fibula was implanted as a bone plug into the medullary canal in 1 case, and no bone graft was used in 4 patients. Results: All the 20 patients were followed-up for 8 months to 7 years, averaging 51 months. Satisfactory function of the affected extremities was obtained. All the shortened extremities were lengthened to the expected length. For all the lengthening area and the fracture sites, bone union was obtained at the last. The average healing time of 12 patients treated with RBX was 4.8 months. Conclusions: Both the half ring sulcated external fixator and the combined external fixator have the advantages of small trauma, simple operation, elastic fixation without stress shielding and non-limitation from local soft tissue conditions, and there is satisfactory functional recovery of affected extremities in the treatment of tibial bone defects, tibial bone nonunion and congenital pseudarthrosis of the tibia combined with limb shortening. RBX has good biocompatibility and does not cause immunological rejections. It can also be safely used in treatment of bone nonunion and has reliable effect to promote bone healing.

  19. Unicameral bone cyst of the lunate in an adult: case report

    Directory of Open Access Journals (Sweden)

    Alici Tugrul

    2010-10-01

    Full Text Available Abstract We report a case of a symptomatic unicameral (simple bone cyst of the lunate in a 42-year- old woman. The lesion was treated with curettage and cancellous autogenous iliac bone grafting. At five years of follow-up the wrist was pain free, there were no limitations of motion, and the radiographs showed complete obliteration of the cavity. To the best of our knowledge, no other unicameral bone cyst of the lunate has been reported in an adult. Cysts with significant cavities at the carpal bones in an adult should be approached cautiously, as they may require early curettage and bone grafting for healing, before collapse and degenerative changes occur.

  20. Ability of bone graft substitutes to support the osteoprogenitor cells: An in-vitro study

    Institute of Scientific and Technical Information of China (English)

    Ziad; Dahabreh; Michalis; Panteli; Ippokratis; Pountos; Mark; Howard; Peter; Campbell; Peter; V; Giannoudis

    2014-01-01

    AIM: To compare seven commercially available bone graft substitutes(BGS) in terms of these properties and without using any additional biological growth factors.METHODS: Porcine osteoprogenitor cells were loaded on seven commercially available BGS and allowed to proliferate for one week followed by osteogenic induction. Staining for live/dead cells as well as scanning electron microscopy(SEM) was carried out to determine viability and cellular binding. Further outcome measures included alkaline phosphatase(ALP) assays with normalisation for DNA content to quantify osteogenic potential. Negative and positive control experiments were carried out in parallel to validate the results.RESULTS: Live/dead and SEM imaging showed higher viability and attachment with β-tricalcium phosphate(β-TCP) than with other BGS(P < 0.05). The average ALP activity in nmol/mL(normalised value for DNA content in nmol/μg DNA) per sample was 657.58(132.03) for β-TCP, 36.22(unable to normalise) for calcium sulphate, 19.93(11.39) for the Hydroxyapatite/Tricalcium Phosphate composite, 14.79(18.53) for polygraft, 13.98(8.15) for the highly porous β-Tricalcium Phosphate, 5.56(10.0) for polymers, and 3.82(3.8) for Hydroxyapatite.CONCLUSION: Under the above experimental conditions, β-TCP was able to maintain better the viability of osteoprogenitor cells and allow proliferation and differentiation(P < 0.05).

  1. On the Feasibility of Utilizing Allogeneic Bone Blocks for Atrophic Maxillary Augmentation

    Directory of Open Access Journals (Sweden)

    Alberto Monje

    2014-01-01

    Full Text Available Purpose. This systematic review was aimed at assessing the feasibility by means of survival rate, histologic analysis, and causes of failure of allogeneic block grafts for augmenting the atrophic maxilla. Material and Methods. A literature search was conducted by one reviewer in several databases. Articles were included in this systematic review if they were human clinical trials in which outcomes of allogeneic bone block grafts were studied by means of survival rate. In addition other factors were extracted in order to assess their influence upon graft failure. Results. Fifteen articles fulfilled the inclusion criteria and subsequently were analyzed in this systematic review. A total of 361 block grafts could be followed 4 to 9 months after the surgery, of which 9 (2.4% failed within 1 month to 2 months after the surgery. Additionally, a weighed mean 4.79 mm (95% CI: 4.51–5.08 horizontal bone gain was computed from 119 grafted sites in 5 studies. Regarding implant cumulative survival rate, the weighed mean was 96.9% (95% CI: 92.8–98.7%, computed from 228 implants over a mean follow-up period of 23.9 months. Histologic analysis showed that allogeneic block grafts behave differently in the early stages of healing when compared to autogenous block grafts. Conclusion. Atrophied maxillary reconstruction with allogeneic bone block grafts represents a reliable option as shown by low block graft failure rate, minimal resorption, and high implant survival rate.

  2. Bone-Forming Capabilities of a Newly Developed NanoHA Composite Alloplast Infused with Collagen: A Pilot Study in the Sheep Mandible

    Directory of Open Access Journals (Sweden)

    Charles Marin

    2013-01-01

    Full Text Available Lateral or vertical bone augmentation has always been a challenge, since the site is exposed to constant pressure from the soft tissue, and blood supply only exists from the donor site. Although, for such clinical cases, onlay grafting with autogenous bone is commonly selected, the invasiveness of the secondary surgical site and the relatively fast resorption rate have been reported as a drawback, which motivated the investigation of alternative approaches. This study evaluated the bone-forming capability of a novel nanoHA alloplast infused with collagen graft material made from biodegradable polylactic acid/polyglycolic acid versus a control graft material with the same synthesized alloplast without the nanoHA component and collagen infiltration. The status of newly formed bone and the resorption of the graft material were evaluated at 6 weeks in vivo histologically and three dimensionally by means of 3D microcomputed tomography. The histologic observation showed that newly formed bone ingrowth and internal resorption of the block were observed for the experimental blocks, whereas for the control blocks less bone ingrowth occurred along with lower resorption rate of the block material. The three-dimensional observation indicated that the experimental block maintained the external geometry, but at the same time successfully altered the graft material into bone. It is suggested that the combination of numerous factors contributed to the bone ingrowth and the novel development could be an alternative bone grafting choice.

  3. Human mandible bone defect repair by the grafting of dental pulp stem/progenitor cells and collagen sponge biocomplexes

    Directory of Open Access Journals (Sweden)

    R d’Aquino

    2009-11-01

    Full Text Available In this study we used a biocomplex constructed from dental pulp stem/progenitor cells (DPCs and a collagen sponge scaffold for oro-maxillo-facial (OMF bone tissue repair in patients requiring extraction of their third molars. The experiments were carried out according to our Internal Ethical Committee Guidelines and written informed consent was obtained from the patients. The patients presented with bilateral bone reabsorption of the alveolar ridge distal to the second molar secondary to impaction of the third molar on the cortical alveolar lamina, producing a defect without walls, of at least 1.5 cm in height. This clinical condition does not permit spontaneous bone repair after extraction of the third molar, and eventually leads to loss also of the adjacent second molar. Maxillary third molars were extracted first for DPC isolation and expansion. The cells were then seeded onto a collagen sponge scaffold and the obtained biocomplex was used to fill in the injury site left by extraction of the mandibular third molars. Three months after autologous DPC grafting, alveolar bone of patients had optimal vertical repair and complete restoration of periodontal tissue back to the second molars, as assessed by clinical probing and X-rays. Histological observations clearly demonstrated the complete regeneration of bone at the injury site. Optimal bone regeneration was evident one year after grafting. This clinical study demonstrates that a DPC/collagen sponge biocomplex can completely restore human mandible bone defects and indicates that this cell population could be used for the repair and/or regeneration of tissues and organs.

  4. Histologic and histomorphometric study of bone repair around short dental implants inserted in rabbit tibia, associated with tricalcium phosphate graft bone

    Directory of Open Access Journals (Sweden)

    Marlice Azoia Lukiantchuki Barbosa

    2014-10-01

    Full Text Available The use of short dental implants represents one way to overcome this limitation, in association with bone grafting procedures. Tricalcium phosphate-based grafts are among those widely used. The purpose of this study was to assess the biocompatibility of this biomaterial in the coverage of bone defects around short dental implants. Ten New Zealandrabbits were used in this study, each animal received 4 implants, two were placed in the right tibia region (control group and two in the left tibia region (test group. Forty implants were used, with 4mm diameter and 6mm length. For the control group, holes 6 mmdeep were made, and the implants were then inserted at the level of bone tissue. In the control group, the implants of 6 mmin length were inserted to its full length, while in the test group, the same implant was inserted up to 4 mmand left exposed 2 mm. These 2 mmexposed were coated with a bone substitute of tricalcium phosphate and a collagen membrane. After three months, the animals were prepared for histomorphometric analysis, which showed that the control group had a higher number of osteoblasts per μm2 than the test group (p < 0.001. It was concluded that under these experimental conditions, tricalcium phosphate showed tissue biocompatibility and osteoconductive potential.

  5. The improved biological response of shark tooth bioapatites in a comparative in vitro study with synthetic and bovine bone grafts.

    Science.gov (United States)

    López-Álvarez, M; Pérez-Davila, S; Rodríguez-Valencia, C; González, P; Serra, J

    2016-01-01

    Autologous bone is considered to be the gold standard for bone tissue regeneration, providing more highly efficient functional responses compared to synthetic materials, and avoiding the rejection risks of allogenic grafts. However, it presents limitations for certain types of surgery due to its high resorption levels and donor site morbidity. Different biphasic synthetic composites, based onnon-apatitic calcium phosphates enriched with apatitic phases-such as hydroxyapatite, and bioderived bone grafts of bovine and porcine origin-are proposed as lower resorption materials due to their higher crystalline structure. The present work proposes two new sources of bioapatites for bone filler applications obtained from the dentine and enameloid of shark teeth, respectively. These bioapatites each present a characteristic apatite-based composition and additional enrichments of specific trace elements, such as magnesium and fluorine, with proven roles in bone metabolism. Their processing and physicochemical characterization (SEM, FT-Raman and XRD) is presented, together with an in vitro evaluation of osteogenic activity compared to a commercial bovine mineralized matrix and synthetic HA/β TCP grafts. The results proved the globular morphology (0.5-1.5 μm) and porosity (~50 μm and ~0.5-1 μm) of shark dentine bioapatites with biphasic composition: apatitic (hydroxyapatite and apatite-(CaF)), non-apatitic (whitlockite), and an apatitic phase (fluorapatite), organized in oriented crystals in enameloid bioapatites. An evaluation of the pre-osteoblast MC3T3-E1 morphology revealed the colonization of pores in dentine bioapatites and an aligned cell growth in the oriented enameloid crystals. A higher proliferation (p  <  0.01) was detected at up to 21 d in both the shark bioapatites and synthetic biphasic graft with respect to the bovine mineralized matrix. Finally, the great potential of porous biphasic dentine bioapatites enriched with Mg and the aligned

  6. Staphylococcal biofilm formation on the surface of three different calcium phosphate bone grafts: a qualitative and quantitative in vivo analysis.

    Science.gov (United States)

    Furustrand Tafin, Ulrika; Betrisey, Bertrand; Bohner, Marc; Ilchmann, Thomas; Trampuz, Andrej; Clauss, Martin

    2015-03-01

    Differences in physico-chemical characteristics of bone grafts to fill bone defects have been demonstrated to influence in vitro bacterial biofilm formation. Aim of the study was to investigate in vivo staphylococcal biofilm formation on different calcium phosphate bone substitutes. A foreign-body guinea-pig infection model was used. Teflon cages prefilled with β-tricalcium phosphate, calcium-deficient hydroxyapatite, or dicalcium phosphate (DCP) scaffold were implanted subcutaneously. Scaffolds were infected with 2 × 10(3) colony-forming unit of Staphylococcus aureus (two strains) or S. epidermidis and explanted after 3, 24 or 72 h of biofilm formation. Quantitative and qualitative biofilm analysis was performed by sonication followed by viable counts, and microcalorimetry, respectively. Independently of the material, S. aureus formed increasing amounts of biofilm on the surface of all scaffolds over time as determined by both methods. For S. epidermidis, the biofilm amount decreased over time, and no biofilm was detected by microcalorimetry on the DCP scaffolds after 72 h of infection. However, when using a higher S. epidermidis inoculum, increasing amounts of biofilm were formed on all scaffolds as determined by microcalorimetry. No significant variation in staphylococcal in vivo biofilm formation was observed between the different materials tested. This study highlights the importance of in vivo studies, in addition to in vitro studies, when investigating biofilm formation of bone grafts.

  7. 关节镜下自体肌腱移植重建前交叉韧带术后并发症的研究进展%Research progress on the postoperative complications of arthroscopic anterior cruciate ligament reconstruction using autogenous tendon grafts

    Institute of Scientific and Technical Information of China (English)

    赵阳; 张春礼

    2015-01-01

    As an important therapy for anterior cruciate ligament ( ACL ) ruptures,ACL reconstruction using autogenous tendon grafts has been gradually accepted by the majority of doctors and patients,but there is a lack of an intensive study on the postoperative complications.Deep vein thrombosis ( DVT ),peripheral neuropathy and muscle weakness may be caused by the use of tourniquets.The joint infection rate after arthroscopic ACL reconstruction is about 0.3%-1.7%.The pollution of surgical tools and grafts is the main cause of postoperative knee infections.The infection chance will be increased due to soft tissue injuries in harvesting tendons and the use of internal fixation.Erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP ) are considered to be the effective laboratory indexes in early diagnosis of infections after ACL reconstruction.The application of sensitive antibiotics,repeated arthrocentesis and arthroscopic debridment are important and effective in the treatment of knee joint infections.Injuries of the infrapatellar branch of the saphenous nerve and the lateral sural cutaneous nerve may lead to sensory disability in the anterior region and the distal end of the affected knee.The choice of incision location and fixed position of the affected limb are related to nerve injuries.The incidence of cysts after ACL reconstruction is not high,and tibial tunnel cyst and cruciate ligament cyst are relatively common.The symptoms can be alleviated with the treatment of arthroscopic cystectomy.The incidence of postoperative fibrosis of the knee joint is 4%-35%,which is mainly associated with tunnel positioning,combined soft tissue injuries and postoperative rehabilitation exercise.

  8. Determination of orthodontic tooth movement and tissue reaction following demineralized freeze-dried bone allograft grafting intervention

    Directory of Open Access Journals (Sweden)

    Massoud Seifi

    2012-01-01

    Full Text Available Background: Socket preservation after tooth extraction is one of the indications of bone grafting to enhance preorthodontic condition. The aim of this study is to determine the effects of socket preservation on the immediate tooth movement, alveolar ridge height preservation and orthodontic root resorption. Materials and Methods: In a split-mouth technique, twelve sites in three dogs were investigated as an experimental study. Crushed demineralized freeze-dried bone allograft (DFDBA (CenoBone® was used as the graft material. The defects were made by the extraction of 3 rd premolar. On one side of each jaw, the defects were preserved by DFDBA and defects of the other side left opened as the control group. Simultaneously the teeth adjacent to the defects were pulled together by a NiTi coil spring. After eight weeks, the amount of (OTM, alveolar height, and root resorption were measured. Analysis of variance was used for purpose of comparison. Results: There was a slight increase in OTM at grafted sites as they were compared to the control sites (P<0.05. Also a significant bone resorption in control site and successful socket preservation in experimental site were observed. Reduction of root resorption at the augmented site was significant compared to the normal healing site (P<0.05. Conclusion: Using socket preservation, tooth movement can be immediately started without waiting for the healing of the recipient site. This can provide some advantages like enhanced rate of OTM, its approved effects on ridge preservation that reduces the chance of dehiscence and the reduction of root resorption.

  9. Enhancement of bone marrow allografts from nude mice into mismatched recipients by T cells void of graft-versus-host activity.

    OpenAIRE

    Lapidot, T; Lubin, I; Terenzi, A; Faktorowich, Y; Erlich, P; Reisner, Y

    1990-01-01

    Transplantation of 8 x 10(6) C57BL/6-Nu+/Nu+ (nude) bone marrow cells into C3H/HeJ recipients after conditioning with 8 Gy of total body irradiation has resulted in a markedly higher rate of graft rejection or graft failure compared to that found in recipients of normal C57BL/6 or C57BL/6-Bg+/Bg+ (beige) T-cell-depleted bone marrow. Mixing experiments using different numbers of nude bone marrow cells with or without mature thymocytes (unagglutinated by peanut agglutinin) revealed that engraft...

  10. External fixation combined with limited internal flxation and bone grafting for Pilon fracture%有限内固定结合外固定架治疗胫骨远端 Pilon骨折临床观察

    Institute of Scientific and Technical Information of China (English)

    刘建; 刘俊宾; 王文珠; 郑卫东

    2014-01-01

    目的:观察有限内固定结合外固定架治疗胫骨Pilon骨折的临床效果。方法采用三维单侧多功能外固定支架结合有限切开内固定治疗Ruedi和Allgower分型中Ⅱ、Ⅲ型有移位骨折57例。结果根据Pi-lon骨折复位的Burwell-Charnley放射学标准及踝关节主观评分结果示,优45例,良10例,差2例。术后并发症:4例感染,3例皮肤坏死,2例发生骨筋膜综合征,5例踝关节功能障碍但未见骨不连或畸形愈合。结论根据Pilon骨折的类型和软组织损伤程度选择合适的手术方式和手术时机,合理使用外固定支架结合有限内固定维持骨折复位和下肢力线,干骺端缺损区充分植骨,整复关节面,适当功能锻炼,晚负重,术后可达到良好的临床效果。%Objective To investigate the clinical efficacy of external fixation combined with limited internal fixation and bone graft for the treatment of Pilon fractures .Methods Fifty-seven patients of Ruedi and AllgowerⅡ ,Ⅲ type of displaced fracture from March 2008 to October 2013 had treated with external fixation combined with limited internal flxation and bone grafting .Results According to Mazur function assessment system ,the curative effect was excellent in 45 patients ,good in 10 patients and poor in 2 patients .The complications included wound in-fection in 4 cases ,skin necrosis in 3 cases ,fascia syndrome in 2 cases and functional disturbance of ankle in 5 cases . Conclusion Accurate assess local soft tissue conditions for Pilon fractures is essential .According to Pilon fracture type and degree of soft tissue injury ,appropriate surgical method and surgical opportunity can be selected .External fixation combined with limited internal fixation and bone grafting maintains fracture reduction and mechanical axis of lower limb .Metaphyseal bone defect area can be filled with autogenous bone or artificial bone to prompt restora-tion of articular surface .Appropriate

  11. Bone tissue regeneration indento-alveolar surgery : clinical and experimental studies on biomaterials and bone graft substitutes

    OpenAIRE

    Sahlin-Platt, Annika

    2011-01-01

    Pathological processes in the alveolar and facial bones can lead to bone loss that may not heal with complete regeneration. Biomaterials can be used to facilitate the healing process and/or as a bone substitute, but the mechanisms are not fully understood. Persistent leakage of bacteria/bacterial toxins, after root canal treatment, may lead to a residual bone defect. The healing is dependent on a placed dental biomaterial providing a tight seal. The composition of the filling material may als...

  12. Effects of LED phototherapy on bone defects grafted with MTA, bone morphogenetic proteins, and guided bone regeneration in a rodent model: a description of the bone repair by light microscopy

    Science.gov (United States)

    Pinheiro, Antonio Luiz B.; Aciole, Gilberth T. S.; Soares, Luiz G. P.; Correia, Neandder A.; N. dos Santos, Jean

    2011-03-01

    We carried out a histological analysis on surgical bone defects grafted or not with MTA, treated or not with LED, BMPs and GBR. We have used several models to assess the effects of laser on bone. Benefits of the isolated or combined use them on bone healing has been suggested. There is no previous report on their association with LED light. 90 rats were divided into 10 groups. On Groups II and I the defect were filled with the clot. On Group II, were further irradiated. On groups III-VI, defect was filled with MTA + Collagen gel (III); animals of group IV were further irradiated. On groups V and VI, the defects filled with the MTA were covered with a membrane. Animals of Group VI were further irradiated. On Groups VII and VIII a pool of BMPs was added to the MTA and was further irradiated. On groups IX and X, the MTA + BMP graft was covered with a membrane. On group X, the defect was further irradiated. LED (λ850 +/- 10nm, 150mW, A= 0.5cm2, 54s, 0.3W/cm2, 16 J/cm2) was applied at 48 h intervals during 15 days. Specimens were taken, processed, cut and stained with H&E and Sirius red and underwent histological analysis. The results showed that MTA seemed not being affected by LED light. However, its use positively affected healing around the graft. It is concluded that MTA is not affected by the LED light due to it characteristics, but beneficial results with LED usage was found.

  13. Additional bone graft accelerates healing of clavicle non-unions and improves long-term results after 8.9 years: a retrospective study

    OpenAIRE

    Schnetzke, Marc; Morbitzer, Christian; Aytac, Sara; Erhardt, Matthias; Frank, Christian; Muenzberg, Matthias; Studier-Fischer, Stefan; Helbig, Lars; Suda, Arnold J.; Gruetzner, Paul-Alfred; Guehring, Thorsten

    2015-01-01

    Background Clavicle non-unions can occur after both conservative and operative treatment failure. Here, we investigated the outcome of patients with delayed fracture healing or non-unions of the clavicle. Patients underwent revision surgery by plate osteosynthesis of the clavicle with or without bone grafting. Our aim was to determine rates of bone healing and the functional long-term outcome. Methods The study population of 58 consecutive patients was divided into group 1 (n = 25; no bone gr...

  14. Bone marrow transplantation in the rat. I. Histologic correlations and quantitation of cellular infiltrates in acute graft-versus-host disease.

    OpenAIRE

    Renkonen, R; Häyry, P.

    1984-01-01

    In an attempt to define which cytologic manifestations of inflammation are characteristic of acute graft-versus-host disease (aGVHD), the authors have analyzed hematologic reconstitution in the bone marrow, spleen, and blood of bone marrow transplant recipients and correlated these events to concomitant cytologic changes in the parenchymal target organs. After bone marrow transplantation from Lewis to BN strain, the strongest inflammatory changes were observed in the liver, a "model" parenchy...

  15. Bone Substitutes for Peri-Implant Defects of Postextraction Implants

    Directory of Open Access Journals (Sweden)

    Pâmela Letícia Santos

    2013-01-01

    Full Text Available Placement of implants in fresh sockets is an alternative to try to reduce physiological resorption of alveolar ridge after tooth extraction. This surgery can be used to preserve the bone architecture and also accelerate the restorative procedure. However, the diastasis observed between bone and implant may influence osseointegration. So, autogenous bone graft and/or biomaterials have been used to fill this gap. Considering the importance of bone repair for treatment with implants placed immediately after tooth extraction, this study aimed to present a literature review about biomaterials surrounding immediate dental implants. The search included 56 articles published from 1969 to 2012. The results were based on data analysis and discussion. It was observed that implant fixation immediately after extraction is a reliable alternative to reduce the treatment length of prosthetic restoration. In general, the biomaterial should be used to increase bone/implant contact and enhance osseointegration.

  16. Human Histologic and Radiographic Evidence of Bone Formation in a Previously Infected Maxillary Sinus Graft Following Debridement Without Regrafting: A Case Report.

    Science.gov (United States)

    Khouly, Ismael; Phelan, Joan A; Muñoz, Carlos; Froum, Stuart J

    2016-01-01

    The aim of this case report was to evaluate the histologic and radiographic new bone formation following maxillary sinus reentry surgery without a bone graft. A 61-year-old woman was referred with a failure of a sinus augmentation procedure. A reentry procedure was performed to retreat the sinus complication. The procedure involved removal of the bone graft plus debridement of the sinus. No additional bone graft material was used. A cone beam computed tomography scan was taken 6 months following the reentry procedure. During implant placement surgery, a core biopsy specimen was retrieved, stored, and prepared to obtain thin ground undecalcified sections. The histologic and radiographic analysis showed formation of new bone at the time of implant placement. At 18 months following implant placement, successful evidence of integration was determined by implant stability and radiographs. Space maintained by the previously elevated sinus membrane at the time of sinus reentry was sufficient to induce formation of bone without regrafting. However, more cases involving survival of implants placed in augmented sinuses without the use of bone grafts at the time of reentry are needed to confirm the results of this case report study. PMID:27560677

  17. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review

    Directory of Open Access Journals (Sweden)

    Kuldip Salgotra

    2016-04-01

    Full Text Available Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7% men and 1 (14.3% women among the patients. Overall 5 (71.5% patients had transcervical and 2 (28.5% had subcapital fractures. At the end of 6 months, 6 (85.7% patients were pain free and on plain radiographs fracture union was noted. One (14.3% patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures.

  18. Reengineered graft copolymers as a potential alternative for the bone tissue engineering application by inducing osteogenic markers expression and biocompatibility.

    Science.gov (United States)

    Thangavelu, Muthukumar; R Narasimha, Raghavan; Adithan, Aravinthan; A, Chandrasekaran; Jong-Hoon, Kim; Thotapalli Parvathaleswara, Sastry

    2016-07-01

    Composite scaffolds of nano-hydroxyapatite with demineralized bone matrix were prepared and they were graft copolymerized for better bone regeneration and drug delivery applications. The graft copolymers were characterized for their physiochemical properties using conventional methods like FTIR, TGA, XRD and SEM. The scaffolds were seeded with 3T3 and MG63 cells for studying their biocompatibility and their temporal expression of ALP activity, the rate of calcium deposition and their gene expression of collagen type I (Coll-1), osteopontin (OP), osteonectin (ON), and osteocalcin (OC) were studied. In vivo studies were conducted using sub-cutaneous implantation models in male Wister rats for 6 months. Periodic radiography and post-autopsy histopathology was analysed at 15days, 1, 2, 3, 4, 5, and 6 months. The obtained in vitro results clearly confirm that the bone scaffolds prepared in this study are biocompatible, superior osteoinductivity, capable of supporting growth, maturation of MG 63 osteoblast like cells; the gene expression profile revealed that the material is capable of supporting the in vitro growth and maturation of osteoblast-like cells and maturation. The in vivo results stand a testimony to the in vitro results in proving the biocompatibility and osteoinductivity of the materials.

  19. Reengineered graft copolymers as a potential alternative for the bone tissue engineering application by inducing osteogenic markers expression and biocompatibility.

    Science.gov (United States)

    Thangavelu, Muthukumar; R Narasimha, Raghavan; Adithan, Aravinthan; A, Chandrasekaran; Jong-Hoon, Kim; Thotapalli Parvathaleswara, Sastry

    2016-07-01

    Composite scaffolds of nano-hydroxyapatite with demineralized bone matrix were prepared and they were graft copolymerized for better bone regeneration and drug delivery applications. The graft copolymers were characterized for their physiochemical properties using conventional methods like FTIR, TGA, XRD and SEM. The scaffolds were seeded with 3T3 and MG63 cells for studying their biocompatibility and their temporal expression of ALP activity, the rate of calcium deposition and their gene expression of collagen type I (Coll-1), osteopontin (OP), osteonectin (ON), and osteocalcin (OC) were studied. In vivo studies were conducted using sub-cutaneous implantation models in male Wister rats for 6 months. Periodic radiography and post-autopsy histopathology was analysed at 15days, 1, 2, 3, 4, 5, and 6 months. The obtained in vitro results clearly confirm that the bone scaffolds prepared in this study are biocompatible, superior osteoinductivity, capable of supporting growth, maturation of MG 63 osteoblast like cells; the gene expression profile revealed that the material is capable of supporting the in vitro growth and maturation of osteoblast-like cells and maturation. The in vivo results stand a testimony to the in vitro results in proving the biocompatibility and osteoinductivity of the materials. PMID:26998863

  20. Outcomes of hard palate mucosa 6 months after autogenous hard palate mucosa grafting for posterior lamellar eyelid reconstruction%硬腭黏膜移植重建眼睑后层半年后硬腭黏膜的转归

    Institute of Scientific and Technical Information of China (English)

    刘桂琴; 黎明; 应方微; 欧阳明

    2013-01-01

    目的 评价硬腭黏膜重建下睑后层后的转归.方法 对2007年至2011年在深圳市眼科医院诊治的13例下睑恶性肿瘤患者行Moth切除、硬腭黏膜移植联合眼周皮瓣转移重建眼睑及睑缘粘连术,6个月后行睑缘粘连分离术,术中切取睑缘部分硬腭黏膜送病理组织学检查,于术后第一天用裂隙灯显微镜检查眼前节,用激光角膜共焦显微镜检查活体硬腭黏膜.结果 病例在裂隙灯显微镜下眼睑形态良好,角膜透明.在激光角膜共焦显微镜下位于眼睑中部的硬腭黏膜上皮层的细胞结构清晰,排列规则,细胞边界清晰,几乎没有细胞激活现象及炎性细胞,可见小动脉和小静脉及其内流动的血细胞,上皮嵴结构较清晰,边界尚清楚.光学显微镜下硬腭黏膜上皮角化不明显,上皮与固有膜交界处较平坦,上皮钉突和乳头均不明显,发现杯状样细胞,结构类似结膜上皮.结论 硬腭黏膜移植重建下睑后层6个月时与残余眼睑组织相容良好,受眼局部微环境的影响,逐渐向结膜的形态发生了改变.%Objective To assess the outcomes of hard palate mucosa after autogenous hard palate mucosa grafting for posterior lamellar eyelid reconstruction.Methods Thirteen patients with malignant tumor on the lower eyelids were treated at Shenzhen Eye Hospital between 2007 and 2011.All patients underwent reconstruction of the lower eyelids using hard palate mucosal grafts combination with orbicularis musculocutaneous flap and ankyloblepharon following Moth tumor excision,and division ankyloblepharon 6 months later.During division ankyloblepharon,a small piece of hard palate mucosal was resected from palpebral margin and examined by pathology.The ocular anterior segment was examined by slit lamp microscope,and the hard palate mucosal on the lower eyelids was examined by laser corneal confocal microscopy the next day.Results A satisfactory lid shape and position and transparent cornea were

  1. Horizontal Guided Bone Regeneration in the Esthetic Area with rhPDGF-BB and Anorganic Bovine Bone Graft: A Case Report.

    Science.gov (United States)

    Chiantella, Giovanni Carlo

    2016-01-01

    The present article describes the treatment given to a patient who underwent horizontal ridge augmentation surgery in the maxillary anterior area due to the premature loss of the maxillary central incisors. The complete dehiscence of the buccal plate was detected after elevation of mucoperiosteal flaps. The lesion was overfilled with deproteinized bovine xenograft particles combined with recombinant human platelet-derived growth factor BB (rhPDGF-BB) and covered with a porcine collagen barrier hydrated with the same growth factor. The soft tissues healed with no adverse complications. After 12 months, reentry surgery was carried out to place endosseous implants. Complete bone regeneration with the presence of bone-like tissue was observed. Cross-sectional computed tomography scan images confirmed integration of the bone graft and reconstruction of the lost hard tissue volume. The implants were inserted in an optimal three-dimensional position, thus facilitating esthetic restoration. Two years after insertion of final crowns, cone beam computed tomography scans displayed the stability of regenerated hard tissues around the implants. Controlled clinical studies are necessary to determine the benefit of hydrating bovine bone particles and collagen barriers with rhPDGF-BB for predictable bone regeneration of horizontal lesions. PMID:26697562

  2. 5. Accelerated Fracture Healing Targeting Periosteal Cells: Possibility of Combined Therapy of Low-Intensity Pulsed Ultrasound (LIPUS), Bone Graft, and Growth Factor (bFGF).

    Science.gov (United States)

    Uchida, Kentaro; Urabe, Ken; Naruse, Koji; Mikuni-Takagaki, Yuko; Inoue, Gen; Takaso, Masashi

    2016-08-01

    We have studied the mechanism of fracture healing, and the effect of LIPUS, bone graft and growth factor on accelerating fracture healing. We present here the results of our research. To examine callus formation cells in fracture healing, we made marrow GFP chimera mice and a fracture model of marrow mesenchymal stem cell GFP chimera mice. It was demonstrated that periosteal cells were essential for callus formation. We focused on periosteal cells and examined the effect of LIPUS. In an in vitro experiment using a cultured part of the femur, LIPUS promoted ossification of the periosteal tissue. Further, LIPUS accelerated VEGF expression in the experiment using the femoral fracture model of mice. From these results, it was suggested that activation of periosteal cells might play a role in the fracture healing mechanism of LIPUS. Next, we discussed the possibility of combined therapy of LIPUS, bone graft and growth factor. Therapy involving the topical administration of bFGF using a controlled release system and bone graft could promote callus formation. In addition, LIPUS was able to promote membranaceous ossification after the bone graft. It was suggested that combined therapy of LIPUS, bone graft and bFGF could be a new option for treating fractures. PMID:27441766

  3. Ultrasonography and Radiography Evaluation of the Cartilage Graft in Repair of Experimentally Induced Radial Bone Defect in Rabbit

    Directory of Open Access Journals (Sweden)

    Foad Sadi

    2010-01-01

    Full Text Available We would like to thank to the Faculty of Specialized Veterinary Sciences research council. Science and Research Branch of Islamic Azad University, Punak Tehran for approval and financial support to finish this project. Problems statement: The purpose of this research was to determine the biological effect of cartilage graft as a bone defect filler and osteogenetic stimulation to speed up bone healing too. Approach: Sixteen adult male New Zealand white rabbits having body weight ranged from 3.0-3.5 Kg. Under general anesthesia, a segmental full thickness bone defect of 10 mm in length was created in the middle of the right radial shaft in all rabbits. They were divided into two groups of 6 rabbits each. Group I was considered as control and the fractured site was fixed using finger bone plate with 4 screws, whereas the ear cartilage of 1×1 cm graft was used to fill the gap after fracture fixation in Group II. Rabbits in two groups were subdivided into 2 subgroups of 1 and 2 months duration with 4 rabbits in each. Radiography and two dimensional and color Doppler sonography were done before and after creating defects and on 15, 30 and 60 days to evaluate local reaction as far as new blood vessels network and callus formation are concerned. Results: On the radiographs during the whole process, bone repair in Group I was not as perfect as those in Group II samples and trace of internal callus filled the gap incompletely in 60 days in Group I, whereas in Group II internal callus almost was formed on 30 days and in addition intercortical callus was seen supporting to cover and filled the gap completely in this group. Sonographic findings confirmed the protrusion of newly formed blood vascular network in 30 days in Group I and from 15 days in Group II and remarkably increased till end of observation period. Conclusion: Cartilage graft is suitable alternative bone filler and radiography and sonography are reliable techniques to trace local reaction at

  4. Dynamics of Alloplastic Bone Grafts on an Early Stage of Corticotomy-Facilitated Orthodontic Tooth Movement in Beagle Dogs

    Directory of Open Access Journals (Sweden)

    Hyung-Joo Choi

    2014-01-01

    Full Text Available Alveolar augmented corticotomy is effective in accelerating orthodontic tooth movement, but the effect only lasts for a relatively short time. Therefore, the purpose of this study was to investigate the underlying biology of the immediate periodontal response to orthodontic tooth movement after a corticotomy with alloplastic bone grafts. The results demonstrated that measurable tooth movement began as early as 3 days after the intervention in beagle dogs. Based on the results and histological findings, augmented corticotomy-facilitated orthodontic tooth movement might enhance the condition of the periodontal tissue and the stability of the outcomes of orthodontic treatment.

  5. Dynamics of alloplastic bone grafts on an early stage of corticotomy-facilitated orthodontic tooth movement in beagle dogs.

    Science.gov (United States)

    Choi, Hyung-Joo; Lee, Dong-Yeol; Kim, Tae-Woo

    2014-01-01

    Alveolar augmented corticotomy is effective in accelerating orthodontic tooth movement, but the effect only lasts for a relatively short time. Therefore, the purpose of this study was to investigate the underlying biology of the immediate periodontal response to orthodontic tooth movement after a corticotomy with alloplastic bone grafts. The results demonstrated that measurable tooth movement began as early as 3 days after the intervention in beagle dogs. Based on the results and histological findings, augmented corticotomy-facilitated orthodontic tooth movement might enhance the condition of the periodontal tissue and the stability of the outcomes of orthodontic treatment. PMID:25276787

  6. Obtention of injectable platelets rich-fibrin (i-PRF) and its polymerization with bone graft: technical note.

    Science.gov (United States)

    Mourão, Carlos Fernando de Almeida Barros; Valiense, Helder; Melo, Elias Rodrigues; Mourão, Natália Belmock Mascarenhas Freitas; Maia, Mônica Diuana-Calasans

    2015-01-01

    The use of autologous platelet concentrates, represent a promising and innovator tools in the medicine and dentistry today. The goal is to accelerate hard and soft tissue healing. Among them, the platelet-rich plasma (PRP) is the main alternative for use in liquid form (injectable). These injectable form of platelet concentrates are often used in regenerative procedures and demonstrate good results. The aim of this study is to present an alternative to these platelet concentrates using the platelet-rich fibrin in liquid form (injectable) and its use with particulated bone graft materials in the polymerized form.

  7. Obtention of injectable platelets rich-fibrin (i-PRF and its polymerization with bone graft: technical note

    Directory of Open Access Journals (Sweden)

    Carlos Fernando de Almeida Barros Mourão

    2015-12-01

    Full Text Available The use of autologous platelet concentrates, represent a promising and innovator tools in the medicine and dentistry today. The goal is to accelerate hard and soft tissue healing. Among them, the platelet-rich plasma (PRP is the main alternative for use in liquid form (injectable. These injectable form ofplatelet concentrates are often used in regenerative procedures and demonstrate good results. The aim of this study is to present an alternative to these platelet concentrates using the platelet-rich fibrin in liquid form (injectable and its use with particulated bone graft materials in the polymerized form.

  8. Rapid maxillary expansion in alveolar cleft repaired with a tissue-engineered bone in a canine model.

    Science.gov (United States)

    Huang, Jialiang; Tian, Bo; Chu, Fengting; Yang, Chenjie; Zhao, Jun; Jiang, Xinquan; Qian, Yufen

    2015-08-01

    This study aims to investigate the effects of orthodontic expansion on graft area of a tissue-engineered bone (TEB) BMSCs/β-TCP, and to find an alternative strategy for the therapy of alveolar cleft. A unilateral alveolar cleft canine model was established and then treated with BMSCs/β-TCP under rapid maxillary expansion (RME). Sequential fluorescent labeling, radiography and helical computed tomography were used to evaluate new bone formation and mineralization in the graft area. Hematoxylin-eosin staining and Van Gieson׳s picro fuchsin staining were performed for histological and histomorphometric observation. ALP activity, mineralization and the expression of osteogenic differentiation related genes of BMSCs that grew on the β-TCP scaffold were promoted by their cultivation in osteogenic medium. Based on fact, TEB was constructed. After 8 weeks of treatment with BMSCs/β-TCP followed by RME, new bone formation and mineralization of the dogs were markedly accelerated, and bone resorption was significantly reduced, compared with the untreated dogs, or those only treated with autogenous iliac bone. The treatment with both TEB and RME evidently made the bone trabecula more abundant and the area of bone formation larger. What is more, there were no significant differences between BMSCs/β-TCP group and the group treated with autogenous bone and RME. This study further revealed that TEB was not only a feasible clinical approach for patients with alveolar cleft, but also a potential substituent of autogenous bone, and its combination with RME might be an alternative strategy for the therapy of alveolar cleft.

  9. Maxillary sinus floor augmentation on humans: Packing simulations and 8 months histomorphometric comparative study of anorganic bone matrix and β-tricalcium phosphate particles as grafting materials

    OpenAIRE

    Martinez, A; Franco, J.; Saiz, E.; Guitian, F.

    2010-01-01

    The present study compares the behaviour of an anorganic bone matrix material and a synthetic β-Tricalcium phosphate employed as grafting materials in a sinus floor augmentation two step protocol in humans. In order to estimate the initial occupation level for the two materials, an ‘in vitro’ simulation has been performed to analyse macroporosity created due to particle packing in terms of porosity and interparticle distances. Grafting in the sinus floor augmentation was performed by filling ...

  10. Comparison of microstructures between block grafts from the mandibular ramus and calvarium for horizontal bone augmentation of the maxilla: a case series study.

    Science.gov (United States)

    Monje, Alberto; Monje, Florencio; Chan, Hsun-Liang; Suarez, Fernando; Villanueva-Alcojol, Laura; Garcia-Nogales, Agustin; Wang, Hom-Lay

    2013-01-01

    The primary purpose of this clinical study was to compare architectural metric parameters using microcomputed tomography (micro-CT) between sites grafted with blocks harvested from the mandibular ramus and calvarium for horizontal bone augmentation in the maxilla. The second aim was to compare the primary stability of implants placed in both types of block grafts. Ten consecutive healthy partially edentulous patients requiring extensive horizontal bone reconstruction in the maxilla were included. A total of 14 block grafts (7 each from the mandibular ramus and calvarium) were studied. After 4 to 6 months of healing, 41 implants were placed: 24 implants (58.5%) in calvarial (group 1) and 17 (41.5%) in ramus grafts (group 2). A resonance frequency analysis (RFA) was performed to test implant stability. Furthermore, two biopsy specimens were randomly selected for histomorphometric analysis. Micro-CT analyses showed no significant difference in the morphometric parametric values analyzed between groups. Furthermore, RFA also showed no difference between groups. However, slightly higher RFA values were noted for implants placed in ramus grafts. Bone quality, as assessed by micro-CT and histomorphometric analyses, was similar in both ramus and calvarial block grafts. In addition, there was no difference in primary implant stability between groups.

  11. Three-Dimensional Upper Lip and Nostril Sill Changes After Cleft Alveolus Reconstruction Using Autologous Bone Grafting Versus Recombinant Human Bone Morphogenetic Protein-2.

    Science.gov (United States)

    Raposo-Amaral, Cassio Eduardo; Denadai, Rafael; Alonso, Nivaldo

    2016-06-01

    Cleft alveolus in patients with unilateral complete cleft lip and palate has been alternatively reconstructed with recombinant human bone morphogenetic protein (rhBMP)-2. However, its effects on upper lip and nostril sill anatomy are not known. Thus, the objective of this investigation was to assess and compare upper lip and nostril sill changes after cleft alveolus reconstruction with autologous bone from the iliac crest region and rhBMP-2. Patients were randomly allocated into 2 groups. In group 1, autologous bone from the iliac crest region was used to fill the cleft alveolus (n = 4), and in group 2, rhBMP-2 was used to fill the cleft alveolus (n = 8). Preoperatively and at one after the surgery, computerized tomography (CT) was performed. Reformatted CT imaging was used to perform cephalometric linear measurements of the upper lip and nostril sill regions. Inter- and intragroup data of the pre and postoperative reformatted CT measurements of the upper lip and nostril sill regions did not show differences (P >0.05) in cutaneous upper lip height and projection, nostril sill elevation, and subnasale projection. There were no significant upper lip and nostril sill anatomical changes after cleft alveolus reconstruction using autologous bone grafting and rhBMP-2. PMID:27244210

  12. BOHLER'S ANGLE: CORRELATION WITH OUTCOME IN DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES TREATED WITH LOCKING COMPRESSION PLATE FIXATION WITH AND WITHOUT BONE GRAFTING

    Directory of Open Access Journals (Sweden)

    Deepak P

    2014-09-01

    Full Text Available BOHLER'S ANGLE: correlation with outcome in displaced intra-articular calcaneal fractures Treated with locking compression Plate Fixation with and without bone grafting. AIMS: The aim is an accurate reduction of the fracture with reconstruction of Bohler’s angle, length and axis and sub talar joint surface. To determine whether autologous bone graft supplementation is beneficial in achieving and maintaining restoration of Calcaneal height and anatomic reduction. SETTINGS AND DESIGN: Level 1 trauma center, Prospective, randomized. METHODS AND MATERIAL: Consecutive 46 patients who had fracture calcaneum were treated by open reduction and internal fixation by locking plate with and without bone graft during the period from November 2009 to April 2012. STATISTICAL ANALYSIS USED: AOFAS-Ankle-Hind foot Scale, t Test. RESULTS: Fewer complications and statistically significant better results related to treatment with locking plates with bone grafting confirmed in comparison to without bone grafting ones were noted for intra-articular calcaneal fractures. In Group A the mean time for union was 10.39wks. The results were good and excellent in 86.95%, 8.69 % had fair result and 4.34% had poor results. In Group B the mean time for union was 11.95 wks. The overall results were good and excellent in 73.91%, 13.04 % had fair result and 13.04 % had poor results. CONCLUSIONS: The operative treatment of intra-articular calcaneal fractures could restore Böhler's angle better and the patient could return to full weight bearing earlier. We confirmed that autologous bone graft supplementation is beneficial in achieving and maintaining restoration of calcaneal height and anatomic reduction.

  13. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A COMPARISON BETWEEN BONE PATELLAR TENDON BONE GRAFT AND LIPSCOMB PROCEDURE - A FOLLOWUP STUDY OF 7 YEARS

    Directory of Open Access Journals (Sweden)

    Vijayamohan S

    2016-07-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament injury has become more common and the demand by the patients to return to pre-injury level of activity has made reconstruction of the ligament very crucial. Though there are various techniques in reconstructing the anterior cruciate ligament, in this study, we compare two most commonly used techniques to see whether there is any significant difference in the outcome. METHODS Study included 25 patients in the age group of 19-36 years, of which 23 were males. The patients were divided randomly into 2 groups, and 15 patients underwent Anterior Cruciate Ligament reconstruction using Bone Patellar Tendon Bone Graft and 10 patients had Hamstring graft. RESULTS Patients were followed up at regular intervals monthly for the first six months and then at three monthly intervals. Patients were assessed using Knee Scoring Scale of Lysholm and Gillquist and International Knee Documentation Committee (IKDC scoring system. In addition, activity level, harvest site pain, thigh atrophy, kneeling pain and hamstring pain were assessed. All patients were followed up for a minimum period of 2 years. 20% of both groups were able to return to strenuous activity level, and 67% of Patellar tendon group and 50% of the Hamstring tendon group were able to return to moderate level of activity. 55% of patients in the patellar tendon group and 20% of patients in the hamstring tendon group had donor site pain in the first 6 months. 73% of patients in the hamstring group had at least 10 mm of thigh wasting. Pain on kneeling was seen only in the patellar tendon group (35% while hamstring pain was found only in the hamstring group (20%. CONCLUSIONS Patients in the patellar tendon group had increased anterior stability and were able to return to strenuous occupation. The difference in thigh atrophy between the two groups was not significant. The hamstring group had lower graft harvest site morbidity. Lachman test was the single most accurate

  14. Osseointegration of dental implants in 3D-printed synthetic onlay grafts customized according to bone metabolic activity in recipient site.

    Science.gov (United States)

    Tamimi, Faleh; Torres, Jesus; Al-Abedalla, Khadijeh; Lopez-Cabarcos, Enrique; Alkhraisat, Mohammad H; Bassett, David C; Gbureck, Uwe; Barralet, Jake E

    2014-07-01

    Onlay grafts made of monolithic microporous monetite bioresorbable bioceramics have the capacity to conduct bone augmentation. However, there is heterogeneity in the graft behaviour in vivo that seems to correlate with the host anatomy. In this study, we sought to investigate the metabolic activity of the regenerated bone in monolithic monetite onlays by using positron emission tomography-computed tomography (PET-CT) in rats. This information was used to optimize the design of monetite onlays with different macroporous architecture that were then fabricated using a 3D-printing technique. In vivo, bone augmentation was attempted with these customized onlays in rabbits. PET-CT findings demonstrated that bone metabolism in the calvarial bone showed higher activity in the inferior and lateral areas of the onlays. Histological observations revealed higher bone volume (up to 47%), less heterogeneity and more implant osseointegration (up to 38%) in the augmented bone with the customized monetite onlays. Our results demonstrated for the first time that it is possible to achieve osseointegration of dental implants in bone augmented with 3D-printed synthetic onlays. It was also observed that designing the macropore geometry according to the bone metabolic activity was a key parameter in increasing the volume of bone augmented within monetite onlays.

  15. Reduced graft-versus-host disease-inducing capacity of T cells after activation, culturing, and magnetic cell sorting selection in an allogeneic bone marrow transplantation model in rats

    NARCIS (Netherlands)

    Weijtens, M; van Spronsen, A; Hagenbeek, A; Braakman, E; Martens, A

    2002-01-01

    Graft-versus-host disease (GvHD), a major complication of allogeneic bone marrow transplantation, has been ascribed to mature T cells in the graft. Because T cells play an important role in engraftment of the bone marrow and decrease the probability of relapse of leukemia, a treatment strategy was d

  16. Graft Remodeling following Transcrestal Sinus Floor Elevation via the Gel-Pressure Technique (GPT and Pasteous Nano-Crystalline Hydroxyapatite Bone Substitute

    Directory of Open Access Journals (Sweden)

    Bernhard Pommer

    2015-06-01

    Full Text Available Bone grafting of the maxillary sinus is attempted to compensate for sinus pneumatization and permit reliable insertion of endosseous dental implants for prosthetic rehabilitation. The aim of the present clinical investigation was to study bone regeneration four months after transcrestal sinus floor elevation via the Gel-Pressure Technique (GPT and application of pasteous nano-crystalline hydroxyapatite bone substitute. A total of 25 patients with deficient alveolar ridges in the posterior maxilla (mean residual bone height: 4.7 ± 1.8 mm were subjected to 32 flapless transcrestal sinus floor augmentations and simultaneous insertion of 40 implants. Sinus membrane elevation height averaged 11.2 ± 2.7 mm and minimal vertical graft resorption of 0.1 mm was observed after four months. Radiographic bone density averaged 460 Hounsfield units in regions adjacent to the native jawbone (1 to 7 mm distance, while reduction of bone density by −7.2%, −11.3%, −14.8%, −19.6% and −22.7% was recorded in more apical regions of 8, 9, 10, 11, and ≥12 mm distance to the original sinus floor, respectively. The results suggest that graft remodeling is completed up to a distance of 7 mm within a healing period of four months after sinus augmentation using nano-crystalline hydroxyapatite bone substitute material.

  17. BMP2-loaded hollow hydroxyapatite microspheres exhibit enhanced osteoinduction and osteogenicity in large bone defects.

    Science.gov (United States)

    Xiong, Long; Zeng, Jianhua; Yao, Aihua; Tu, Qiquan; Li, Jingtang; Yan, Liang; Tang, Zhiming

    2015-01-01

    The regeneration of large bone defects is an osteoinductive, osteoconductive, and osteogenic process that often requires a bone graft for support. Limitations associated with naturally autogenic or allogenic bone grafts have demonstrated the need for synthetic substitutes. The present study investigates the feasibility of using novel hollow hydroxyapatite microspheres as an osteoconductive matrix and a carrier for controlled local delivery of bone morphogenetic protein 2 (BMP2), a potent osteogenic inducer of bone regeneration. Hollow hydroxyapatite microspheres (100±25 μm) with a core (60±18 μm) and a mesoporous shell (180±42 m(2)/g surface area) were prepared by a glass conversion technique and loaded with recombinant human BMP2 (1 μg/mg). There was a gentle burst release of BMP2 from microspheres into the surrounding phosphate-buffered saline in vitro within the initial 48 hours, and continued at a low rate for over 40 days. In comparison with hollow hydroxyapatite microspheres without BMP2 or soluble BMP2 without a carrier, BMP2-loaded hollow hydroxyapatite microspheres had a significantly enhanced capacity to reconstitute radial bone defects in rabbit, as shown by increased serum alkaline phosphatase; quick and complete new bone formation within 12 weeks; and great biomechanical flexural strength. These results indicate that BMP2-loaded hollow hydroxyapatite microspheres could be a potential new option for bone graft substitutes in bone regeneration. PMID:25609957

  18. No evidence of myocardial restoration following transplantation of mononuclear bone marrow cells in coronary bypass grafting surgery patients based upon cardiac SPECT and 18F-PET

    OpenAIRE

    Ünal Nermin; Scheid Christof; Schmidt Matthias; Müller-Ehmsen Jochen; Tossios Paschalis; Moka Detlef; Schwinger Robert HG; Mehlhorn Uwe

    2006-01-01

    Abstract Background We tested the hypothesis, that intramyocardial injection of mononuclear bone marrow cells combined with coronary artery bypass grafting (CABG) surgery improves tissue viability or function in infarct regions with non-viable myocardium as assessed by nuclear imaging techniques. Methods Thus far, 7 patients (60 ± 10 [SD] years) undergoing elective CABG surgery after a myocardial infarction were included in this study. Prior to sternotomy, bone marrow was harvested by sternal...

  19. P-15 small peptide bone graft substitute in the treatment of non-unions and delayed union. A pilot clinical trial

    OpenAIRE

    Gomar, Francisco; Orozco, Rafael; Villar, Jose Luis; Arrizabalaga, Federico

    2006-01-01

    Treatment of non-unions and delayed unions often requires osteogenic material. Recently, a biomimetic bone matrix that simulates the cellular environment of hard tissue, identified as P-15, was introduced to the orthopaedic community. A total of 22 patients with mal-union or delayed union fractures was treated from June 2000 to October 2003 with P15- bone graft substitute (P15-BGS) in the site of fracture and mostly with internal fixation. Patients were examined by independent radiographic an...

  20. Anterior Lumbar Intervertebrai Fusion with Artificial Bone in Place of Autologous Bone

    Institute of Scientific and Technical Information of China (English)

    徐卫国; 陈安民; 冯旭; 印卫锋

    2003-01-01

    The feasibility of anterior lumbar intervertebral fusion with artificial bone in place of au-togenous bone was investigated. Porous hydroxyapatite(HA)/ZrO2 ceramics loading bone morpho-genetic protein (BMP) were implanted after removal of lumbar vertebral disc in rabbits. The adja-cent intervertebral discs were also removed by the same way and autogenous illic bone was implan-ted. SEM observation and biomechanical test were carried out. Compound bone had a bit lower os-teoinductive activity than autogenous bone by SEM(Osteoindutive activity of artificial bone in 12weeks was the same as that of autogenous bone in 9 weeks). Biomechanical test revealed that com-pound bone had lower anti-pull strength than autogenous bone (P<0. 001), but there was no sig-nificant difference in anti-pull strength between compound bone at 12th week and autogenous boneat 9th week (P>0.05). It was concluded that compound bone could be applied for anterior spinalfusion, especially for those patients who can't use autogenous bone.

  1. Effects of LED Phototherapy on Bone Defects Grafted with MTA in a Rodent Model: A Description of the Bone Repair by Light Microscopy

    Science.gov (United States)

    Soares, Luiz Guilherme Pinheiro; Santos, Nicole Ribeiro Silva; Correia, Neandder A.; dos Santos, Jean Nunes; Pinheiro, Antônio Luiz Barbosa

    2011-08-01

    We carried out a histological analysis on bone defects grafted (MTA) treated or not with LED, BMPs and GBR. Benefits of the isolated or combined use these techniques on bone repair have been suggested, but there is no report on their association with LED light. 36 rats were divided into 4 groups each subdivided into 3. Defects on G II and I were filled with the blood clot. G II was further irradiated with LED. G III-IV were filled with MTA+Collagen gel; G IV was further irradiated. LED was applied over the defect at 48 h intervals and repeated for 15 days. Specimens were processed, cut and stained with H&E and Sirius red and underwent histological analysis. The results showed that MTA, due to its characteristics seemed not being directly affected by the LED light. But, the use of LED positively affect bone repair similarly to what was observed on different studies by our team using other biomaterials and laser. It is concluded that MTA seems not be directed affected by the LED light due to it characteristics. However, the beneficial results reported with its usage might be improved by the use of LED PT.

  2. Biphasic calcium phosphate–casein bone graft fortified with Cassia occidentalis for bone tissue engineering and regeneration

    Indian Academy of Sciences (India)

    B Santhosh Kumar; T Hemalatha; R Deepachitra; R Narasimha Raghavan; P Prabu; T P Sastry

    2015-02-01

    Research on traditional herbs is gaining momentum owing to their potent medical properties, among which Cassia occidentalis (CO) is a promising herb, with osteogenic potential. The study investigates the efficacy of CO extract incorporated biphasic calcium phosphate as an osteoinductive material. Prepared bone implants were characterized physico-chemically using FT-IR, TGA, XRD, SEM and EDX. The implants were analysed further for mechanical and biological properties. The results revealed that CO extract-incorporated bone implants possessed better compression strength and it was able to induce proliferation and enhance alkaline phosphatase activity in SaOS-2 cells. The implant proves to be promising for bone tissue engineering, and hence it demands further in vivo evaluation.

  3. Generating 3D tissue constructs with mesenchymal stem cells and a cancellous bone graft for orthopaedic applications

    Energy Technology Data Exchange (ETDEWEB)

    Arca, Turkan; Genever, Paul [Department of Biology, University of York, York, YO10 5DD (United Kingdom); Proffitt, Joanne, E-mail: paul.genever@york.ac.uk [TSL Centre of Biologics, Covidien, Allerton Bywater, Castleford, WF10 2DB (United Kingdom)

    2011-04-15

    Bone matrix (BM) is an acellular crosslinked porcine-derived cancellous bone graft, and therefore may provide advantages over other synthetic and naturally derived materials for use in orthopaedic surgery. Here, we analysed the potential of BM to support the growth and differentiation of primary human multipotent stromal cells/mesenchymal stem cells (MSCs) in order to predict in vivo bone regeneration events. Imaging with laser scanning confocal microscopy and scanning electron microscopy showed that 1 day after static seeding, a dense population of viable MSCs could be achieved on scaffolds suggesting they could be used for in vivo delivery of cells to the implant site. Long-term growth analysis by confocal imaging and histology demonstrated that BM was permissive to the growth and the 3D population of primary MSCs and an enhanced green fluorescent protein expressing osteosarcoma cell line, eGFP.MG63s, over several days in culture. Measurement of alkaline phosphatase (ALP) activities and mRNA expression levels of osteogenic markers (Runx-2, ALP, collagen type I, osteonectin, osteocalcin and osteopontin) indicated that BM supported osteogenesis of MSCs when supplemented with osteogenic stimulants. Upregulation of some of these osteogenic markers on BM, but not on tissue culture plastic, under non-osteogenic conditions suggested that BM also had osteoinductive capacities.

  4. Using inverted autogenous veins to substitute arteries in a canine model

    Directory of Open Access Journals (Sweden)

    Nikeghbalian Saman

    2010-01-01

    Full Text Available Aims : Rapid harvesting of autogenous graft over a wire is an optional way in trauma surgery and it places the inverted conduit so that its adventitial layer is within the lumen of the graft. Our aim of this study was to compare the patency of inverted autogenous graft vs noninverted graft in dogs. Settings and Design : Experimental animal models. Materials and Methods : In this experimental study, 12 dogs were anesthetized and 10 cm of the external jugular vein was excised. The vein was equally divided into two 5-cm sections. One section was inverted and the other was left intact. Afterward, 5 cm of both the femoral arteries were removed and the right (inverted and the left (not inverted arteries were grafted, respectively. The patency of the arteries was evaluated by Color Doppler ultrasonography immediately postoperation and up to 6 months thereafter. Statistical Analysis : Data were analyzed with Fisher′s exact test using SPSS version 15. P value below 0.05 was significant. Results: None of the 12 inverted vein grafts were patent at 3 rd to 14 th days follow-up with Doppler ultrasonography. All of them were completely obstructed by thrombosis. However, 11 (92% of the noninverted vein grafts were patent both at 3 and 6 months follow-up. One of the noninverted grafts was almost completely obstructed with thrombosis (90% and the other 2 were incompletely obstructed with intimal thickening. Conclusions : Despite many favorable results in the previous studies with regard to excellent patency of inverted vein graft, our results were disappointing and we recommend using the graft in the right direction and taking care to preserve the intima intact.

  5. Preliminary documentation of the comparable efficacy of vitoss versus NanOss bioactive as bone graft expanders for posterior cervical fusion

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2015-01-01

    Conclusion: In this preliminary study combining cervical laminectomy/fusions, the time to fusion (5.65 vs. 5.35 months, pseudarthrosis (2.7% vs. 0%, and infection rates (2.7% vs. 0% were nearly comparable sequentially utilizing Vitoss (72 patients vs. NanOss (20 patients as bone graft expanders.

  6. Five years follow-up of implant-prosthetic rehabilitation on a patient after mandibular ameloblastoma removal and ridge reconstruction by fibula graft and bone distraction

    Directory of Open Access Journals (Sweden)

    Giacomo Oteri

    2012-01-01

    Full Text Available This case report presents a combination of surgical and prosthetic solutions applied to a case of oral implant rehabilitation in post-oncologic reconstructed mandible. Bone resection due to surgical treatment of large mandibular neoplasm can cause long-span defects. Currently, mandibular fibula free flap graft is widely considered as a reliable technique for restoring this kind of defect. It restores the continuity of removed segment and re-establishes the contour of the lower jaw. However, the limited height of grafted fibula does not allow the insertion of regular length implants, therefore favouring vertical distraction osteogenesis as an important treatment choice. This report presents a patient affected by extensive mandibular ameloblastoma who underwent surgical reconstruction by fibula free flap because of partial mandibular resection. Guided distraction osteoneogenesis technique was applied to grafted bone, in order to obtain adequate bone height and to realize a prosthetically guided placement of 8 fixtures. After osseointegration, the patient was rehabilitated with a full arch, screw-retained prosthetic restoration. At five-years follow up, excellent integration of grafted tissue, steady levels of bone around the fixtures and healthy peri-implant tissues were reported.

  7. Effect of fly ash on autogenous shrinkage

    Energy Technology Data Exchange (ETDEWEB)

    Pipat Termkhajornkit; Toyoharu Nawa; Masashi Nakai; Toshiki Saito [Hokkaido University, Hokkaido (Japan). Division of Structural and Geotechnical Engineering, Graduate School of Engineering

    2005-03-01

    The correlation between autogenous shrinkage and degree of hydration of fly ash was determined with the selective dissolution method. Then, the relationship between the degree of hydration of fly ash and autogenous shrinkage was examined. The results showed that the degree of hydration of fly ash increased as its Blaine surface area increased. The degree of hydration of fly ash increased with time, and autogenous shrinkage increased corresponding to the increase in the degree of hydration of fly ash. Moreover, it was found that the total quantity of Al{sub 2}O{sub 3} in cement-fly ash samples affected autogenous shrinkage at early ages, but the long-term influence was very small.

  8. CLINICAL STUDY OF TRANSVERSAL AUGMENTATION IN BONE DEFECTS OF THE MAXILLARY AESTETHIC AREA

    Directory of Open Access Journals (Sweden)

    Vasile NICOLAE

    2015-12-01

    Full Text Available Scope: To outline the importance of autogenic bone graft addition for correcting bone defects in the frontal and lateral maxillary area, and for achieving outstanding esthetic results in cases of large bone defects. Materials and method: A total number of 478 argumentations has been performed in the implantology and dental clinic of the Emergency Military Hospital Sibiu between 2009 and 2013. Results and discussion: The transversal rehabilitation techniques of frontal maxillary ridges, representing 57.2% of all addressed cases, were the most frequent ones, justifying the fact that the frontal maxillary area, aesthetically sensitive, is of special attention for both patients and specialists. Conclusions: In relation with the magnitude of alveolar bone transversal resorption and soft tissue anatomy, surgical procedures are required for bone addition, for obtaining acceptable aesthetic and functional results. To this end, evaluation of defects and systematization of the suitable addition techniques have been carried out.

  9. Outcome after open reduction and internal fixation of intraarticular fractures of the calcaneum without the use of bone grafts

    Directory of Open Access Journals (Sweden)

    Pendse Aniruddha

    2006-01-01

    Full Text Available Background: Intraarticular fractures of calcaneum are commenest type of calcaneal fractures. Lots of controversies exist about the ideal management for them. The focus is now shifting on operative management by open reduction and internal fixation for these fractures with or without the use of bone grafts. Method: Thirty intraarticular fractures classified by Essex Lopresti radiological classification, were treated by open reduction and fixation. The patients were followed over a mean period of 30 months (25-40 months. Results: All the fractures united at a mean duration of 14 weeks. 86% patients had excellent functional outcome with one patient having fair and one having poor functional outcome. Conclusion: Open reduction and internal fixation with plate is a good method for treatment of intraarticular fractures of calcaneum to achieve anatomical restoration of articular surface under vision, stable fixation, early mobilization and an option for primary subtalar arthrodesis if deemed necessary.

  10. Complete resection and immediate reconstruction with costochondral graft for recurrent aneurysmal bone cyst of the mandibular condyle.

    Science.gov (United States)

    Ziang, Zhuo; Chi, Yang; Minjie, Chen; Yating, Qiu; Xieyi, Cai

    2013-11-01

    Aneurysmal bone cyst is a non-neoplastic expansile lesion characterized by replacement with fibro-osseous tissue and blood-filled cavernous spaces. Involvement of the condyle is rare, and only 11 cases have been reported in English-language literature to date. Its common treatment modalities are lesion excision or condylar resection, but recurrence is high in patients treated with the former. The authors reported a 19-year-old female patient with swelling of the right preauricular region, who had a surgical curettage history in another hospital. The lesion was completely resected and the jaw was immediately reconstructed with costochondral graft with the help of SurgiCase software. The patient has been symptom-free for 6 months postoperatively.

  11. Study of PRF Combined with Autogenous Bone Marrow Stem Cells on Alveolar Bone Defect%PRF复合自体骨髓间充质干细胞修复兔牙槽骨缺损的研究

    Institute of Scientific and Technical Information of China (English)

    张文丽; 李淑慧; 陈诚; 李一鸣; 周晶; 吴佩玲

    2015-01-01

    目的:观察富血小板纤维蛋白(platelet-rich fibrin,PRF)复合自体第3代骨髓间充质干细胞(bone marrow stem cells,BMSCs)修复牙槽骨缺损的能力.方法:取健康雄性2月龄新西兰兔36只,随机分为4组:PRF+BMSCs组、PRF组、BMSCs组、空白对照组,均在全麻下微创拔除下颌左侧中切牙.4组实验动物分别在4、8、12周处死.取其下颌骨进行牙槽骨标本测量,X线观察,组织学观察.结果:牙槽骨标本测量比较:4组牙槽嵴宽度、高度丧失值均存在差异(P<0.05);析因分析示PRF与BMSCs复合使用修复牙槽骨的效果优于单独使用PRF或BMSCs(P<0.05).X线、组织学观察表明术后4、8、12周时拔牙窝骨吸收程度:PRF+ BMSCs组<PRF组<BM-SCs组<空白对照组,PRF+ BMSCs组成骨情况均优于PRF组、BMSCs组、空白对照组.结论:PRF复合自体BMSCs可以促进牙槽骨的再生与修复,具有潜在的临床应用价值.

  12. 乳突尖部分切除加自体骨粉鼓室上壁重建在鼓室成形术中的应用%Mastoidale partial resection and superior tympanic wall reconstruction with autogenous bone meal in tympanoplasty

    Institute of Scientific and Technical Information of China (English)

    陈学华; 纪树芳; 李卡凡; 梅晓峰

    2013-01-01

    Objective To explore the value of mastoidale partial resection and superior tympanic wall reconstruction with autogenous bone meal in tympanoplasty. Methods A total of 42 patients with chronic suppurative otitis media (CSOM) were treated with open tympanoplasty. Among these patients,22 patients were treated with autologous bone hearing reconstruction (autologous bone group) and 20 patients were treated with titanium auricular bone reconstruction (titanium auricular bone group) . The dry ear rate,dry ear time,external auditory canal shape,hearing and complication were observed after operation in the two groups. Results The postauricular incisions of all patients in the two groups were primary healing,and there was no postoperative complications such as vertigo, facial nerve paralysis and tinnitus and tinnitus, etc. After operation, the mastoid cavity recovered with good epithelization, and without escharosis, otopiesis or adhesion. The dry ear rate in autologous bone group and titanium auricular bone group was 95.5% (21/22)and 95.0% (19/20) .respectively;there was no significant difference in dry ear rate between the two groups ( P > 0. 05 ). There was no significant difference in dry ear time between the two groups (P >0.05). Before treatment,there was no significant difference in air conduction auditory threshold and air-bone gap between the two groups (P >0. 05). The air conduction auditory threshold and air-bone gap after treatment were significantly lower than those before treatment in the two group(P <0. 05). After treatment, the air conduction auditory threshold and air-bone gap in titanium auricular bone group were significantly lower than those in autologous bone group (P < 0. 05). Conclusions Facial nerve monitoring can effectively identify the exposed facial nerve or thin bone canal facial nerve,and could avoid facial nerve injury during surgery. The mastoidale partial resection and superior tympanic wall reconstruction with autogenous bone meal

  13. Alveolar bone grafting in the treatment of midline alveolar cleft and diastema in incomplete median cleft lip.

    Science.gov (United States)

    Liao, H-T; Chen, C-H; Bergeron, L; Ko, E W-C; Chen, P K T; Chen, Y-R

    2008-10-01

    Median cleft lip is a rare congenital anomaly. The wide diastema with mesial tipping observed in these patients has been largely overlooked. A midline submucosal alveolar cleft prevents adequate treatment. The purpose of this article is to describe an alveolar bone grafting (ABG) technique used in the combined surgical-orthodontic approach to diastema treatment in patients presenting with incomplete median cleft lip. Patients treated for incomplete median cleft lip and diastema were identified in the clinic registry from 1981 to 2007. Six patients were identified; 4 underwent ABG before permanent maxillary incisor eruption, the other 2 were seen later when they were 11 years old. All 6 ABGs were successful. The incisors erupted through the graft or were successfully moved into it with lasting results. Follow-up ranged from 8 to 21 years. The existence of a midline submucosal alveolar cleft and subsequent diastema should be recognized and addressed in all patients who present with incomplete median cleft lip repair. This includes taking maxillary occlusal view X-rays before the age of 5 years to detect the cleft, and proceed to ABG if necessary, generally before permanent maxillary incisor eruption. PMID:18771899

  14. A modified technique of bone grafting pedicled with femoral quadratus for alcohol-induced osteonecrosis of the femoral head

    Institute of Scientific and Technical Information of China (English)

    WANG Yi-sheng; ZHANG Yi; LI Jun-wei; YANG Guo-hui; LI Jin-feng; YANG Jie; YANG Guang-hui

    2010-01-01

    Background Quadratus femoris pedicled bone grafting has yielded satisfactory long-term clinical outcome for osteonecrosis of the femoral head (ONFH) in pre-collapse ONFH without extensive lesion. However, for pre-collapse ONFH with extensive necrotic area, it is still challenging to preserve the femoral head. The current study aimed to introduce a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus and to evaluate its short-term outcomes.Methods From January 2008 to December 2008, 10 ONFH patients (12 hips) underwent operations by a new technique of deliquesce strut with titanium mesh containing bone grafting pedicled with the femoral quadratus (group A).According to the ARCO classification system, there were two hips in stage Ⅱ B and 10 hips in stage Ⅱ C. Also in the same period, 12 ONFH patients (16 hips) underwent operations by the conventional procedure of quadratus femoris pedicled bone grafting (group B). There were 6 hips in stage Ⅱ B and 10 hips in stage Ⅱ C. All patients were males and suffered from alcohol induced ONFH. For the new technique, the necrotic area was evaluated, and a titanium mesh piece of the same size (range from 2.5 cm×2.8 cm to 2.8 cm×3.4 cm) was obtained and shaped to match the contour of the head. The cancellous bone was first placed underneath the subchondral bone and was densely impacted (about 1 to 2 mm thick).Then the titanium mesh piece was inserted. The length of the decompressive trough was measured. A titanium cylinder mesh cage with a diameter of 1.6 cm of the same length was obtained, with a "U" shaped window in the wall being created to make room for the muscle pedicle. The muscle pedicle bone was inserted into the titanium mesh cage to form a bone graft-titanium cage complex and, then the complex was inserted. The hundred percent score method was used for outcome evaluation. Clinical and radiographic outcomes were compared between group A and group B

  15. Radiographic evaluation of the symphysis menti as a donor site for an autologous bone graft in pre-implant surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bari, Roberto Di; Cicconetti, Andrea [Dept. of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Rome (Italy); Coronelli, Roberto [Dr. Coronelli Dental Clinic, Rome (Italy)

    2013-09-15

    This study was performed to obtain a quantitative evaluation of the cortical and cancellous bone graft harvestable from the mental and canine regions, and to evaluate the cortical vestibular thickness. This study collected cone-beam computed tomographic (CBCT) images of 100 Italian patients. The limits of the mental region were established: 5 mm in front of the medial margin of each mental foramen, 5 mm under the apex of each tooth present, and above the inferior mandibular cortex. Cortical and cancellous bone volumes were evaluated using SimPlant software (SimPlant 3-D Pro, Materialize, Leuven, Belgium) tools. In addition, the cortical vestibular thickness (minimal and maximal values) was evaluated in 3 cross-sections corresponding to the right canine tooth (3R), the median section (M), and the left canine tooth (3L). The cortical volume was 0.71±0.23 mL (0.27-1.96 mL) and the cancellous volume was 2.16±0.76 mL (0.86-6.28 mL). The minimal cortical vestibular thickness was 1.54±0.41 mm (0.61-3.25 mm), and the maximal cortical vestibular thickness was 3.14±0.75mm(1.01-5.83 mm). The use of the imaging software allowed a patient-specific assessment of mental and canine region bone availability. The proposed evaluation method might help the surgeon in the selection of the donor site by the comparison between bone availability in the donor site and the reconstructive exigency of the recipient site.

  16. Structural changes and biological responsiveness of an injectable and mouldable monetite bone graft generated by a facile synthetic method.

    Science.gov (United States)

    Cama, G; Gharibi, B; Knowles, J C; Romeed, S; DiSilvio, L; Deb, S

    2014-12-01

    Brushite (dicalcium phosphate dihydrate) and monetite (dicalcium phosphate anhydrous) are of considerable interest in bone augmentation owing to their metastable nature in physiological fluids. The anhydrous form of brushite, namely monetite, has a finer microstructure with higher surface area, strength and bioresorbability, which does not transform to the poorly resorbable hydroxyapatite, thus making it a viable alternative for use as a scaffold for engineering of bone tissue. We recently reported the formation of monetite cements by a simple processing route without the need of hydrothermal treatment by using a high concentration of sodium chloride in the reaction mix of β-tricalcium phosphate and monocalcium phosphate monohydrate. In this paper, we report the biological responsiveness of monetite formed by this method. The in vitro behaviour of monetite after interaction and ageing both in an acellular and cellular environment showed that the crystalline phase of monetite was retained over three weeks as evidenced from X-ray diffraction measurements. The crystal size and morphology also remained unaltered after ageing in different media. Human osteoblast cells seeded on monetite showed the ability of the cells to proliferate and express genes associated with osteoblast maturation and mineralization. Furthermore, the results showed that monetite could stimulate osteoblasts to undergo osteogenesis and accelerate osteoblast maturation earlier than cells cultured on hydroxyapatite scaffolds of similar porosity. Osteoblasts cultured on monetite cement also showed higher expression of osteocalcin, which is an indicator of the maturation stages of osteoblastogenesis and is associated with matrix mineralization and bone forming activity of osteoblasts. Thus, this new method of fabricating porous monetite can be safely used for generating three-dimensional bone graft constructs. PMID:25297314

  17. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials

    DEFF Research Database (Denmark)

    Jensen, Simon Storgård; Terheyden, Hendrik

    2009-01-01

    periods. The heterogeneity of the available data did not allow identifying one superior grafting protocol for any of the osseous defect types under investigation. However, a series of grafting materials can be considered well-documented for different indications based on this review. There is a high level......PURPOSE: The objective of this review was to evaluate the efficacy of different grafting protocols for the augmentation of localized alveolar ridge defects. MATERIALS AND METHODS: A MEDLINE search and an additional hand search of selected journals were performed to identify all levels of clinical...... evidence except expert opinions. Any publication written in English and including 10 or more patients with at least 12 months of follow-up after loading of the implants was eligible for this review. The results were categorized according to the presenting defect type: (1) dehiscence and fenestration...

  18. The use of implantable bone stimulators in nonunion treatment.

    Science.gov (United States)

    Hughes, Michael S; Anglen, Jeffrey O

    2010-03-01

    Delayed or failure of bone healing in fracture, osteotomy, and arthrodesis patients continues to be a clinical dilemma. Electromagnetic stimulation is 1 modality demonstrated in many studies to aid bone healing; however, relatively few studies depict the use and complications associated with direct current implantable bone stimulators. Over a 9-year period, we studied a consecutive series of 120 adult patients who underwent implantation of a direct current bone stimulator. The goals of this study were to determine the time until healing, the presence of infection, and the need for additional nonunion surgery or salvage procedure following internal bone stimulator placement for nonunion treatment. Of the factors affecting the time until healing, tobacco smoking was a significant factor associated with increased time until healing. Tobacco smoking and duration of nonunion prior to implantable bone stimulator placement were both significant factors in the need for revision nonunion surgery or salvage procedure after implantable bone stimulator placement. Deep soft tissue infection or osteomyelitis was a significant factor predicting prolonged time to healing, subsequent infection following implantable bone stimulator placement, and the need for revision or salvage surgery. With the relative lack of complications directly attributable to electromagnetic implantable bone stimulators, their use may be an effective adjuvant to stable internal fixation and autogenous bone grafting in healing nonunions. However, the use of implantable bone stimulators in patients with nonunion prior to deep soft tissue infection or osteomyelitis exhibited an increased rate of postoperative infection in this study. PMID:20349861

  19. Autologous grafts of double-strut fibular cortical bone plate to treat the fractures and defects of distal femur: a case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu; LI Jian-jun; KONG Zhan; YANG Dong-xiang; YUAN Xiang-nan

    2011-01-01

    We reported a 23-year-old man who was involved in a high-speed motorcycle accident. He sustained a closed fracture at the right distal femur. The primary fracture happened on February 2008. He underwent open reduction and internal fixation with cloverleaf plate. And one hundred days after the surgery, the proximal screws were pulled-out, but the bone union was not achieved. Treat ment consisted of exchanging the cloverleaf plate with a locking compression plate and using an auto-iliac bone graft to fill the nonunion gap. In July 2009, the patient had a sharp pain in the right lower limb. The X-ray revealed that the plate implanted last year was broken, causing a nonunion at the fracture site. Immediately the plate and screws were removed and an intramedullary nail was inserted reversely from the distal femur as well as a 7 cm long bone from the right fibula was extracted and longitudinally split into two pieces to construct cortical bone plates. Then we placed them laterally and medially to fracture site, drilled two holes respectively, and fastened them with suture. We carried on auto-iliac bone grafting with the nonunion bone grafts. The follow-up at 15 months after operation showed that the treatment was successful, X-ray confirmed that there was no rotation and no angular or short deformity. We briefly reviewed the literature regarding such an unusual presentation and discussed in details the possible etiology and the advantages of autologous double-strut fibular grafts to cope with such an intractable situation.

  20. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  1. Graft-derived anti-HPA-2b production after allogeneic bone-marrow transplantation

    DEFF Research Database (Denmark)

    Taaning, E; Jacobsen, N; Morling, N

    1994-01-01

    We report on a male who received a bone-marrow allograft from his HLA identical sister for acute myelogenous leukaemia. After transplantation, the patient suffered from refractoriness to the transfusions of HLA-matched platelets and a strong platelet-specific antibody, anti-HPA-2b, of IgG1 subclass...... was demonstrated in the patient's serum. In the serum of the bone-marrow donor a weak IgG1 anti-HPA-2b was demonstrated. IgG allotyping of the patient and donor showed identical results. We could not determine the origin of the anti-HPA-2b, although we hypothesize that the anti-HPA-2b was produced...... by immunocompetent donor lymphocytes infused with the suspension of bone-marrow cells....

  2. Brachymetatarsia of the fourth metatarsal, lengthening scarf osteotomy with bone graft

    Directory of Open Access Journals (Sweden)

    Ankit Desai

    2013-09-01

    Full Text Available A 16-year-old girl presented with left fourth metatarsal shortening causing significant psychological distress. She underwent lengthening scarf osteotomy held with an Omnitech® screw (Biotech International, France with the addition of two 1 cm cancellous cubes (RTI Biologics, United States. A lengthening z-plasty of the extensor tendons and skin were also performed. At 6 weeks the patient was fully weight bearing and at one-year follow up, the patient was satisfied and discharged. A modified technique of lengthening scarf osteotomy is described for congenital brachymatatarsia. This technique allows one stage lengthening through a single incision with graft incorporation by 6 weeks.

  3. Real-Time Assessment of Guided Bone Regeneration in Standardized Calvarial Defects Using a Combination of Bone Graft and Platelet-Derived Growth Factor With and Without Collagen Membrane: An In Vivo Microcomputed Tomographic and Histologic Experiment in Rats.

    Science.gov (United States)

    Alrasheed, Abdulaziz; Al-Ahmari, Fatemah; Ramalingam, Sundar; Nooh, Nasser; Wang, Cun-Yu; Al-Hezaimi, Khalid

    2016-01-01

    The aim of the present in vivo microcomputed tomography (μCT) and histologic experiment was to assess the efficacy of guided bone regeneration (GBR) around standardized calvarial defects using recombinant human platelet-derived growth factor (rhPDGF) with and without resorbable collagen membrane (RCM). A total of 50 female Wistar albino rats with a mean age of 7.5 months and mean weight of 275 g were used. The calvarium was exposed following midsagittal scalp incision and flap reflection. A full-thickness standardized calvarial defect (4.6 mm diameter) was created. Study animals were randomly divided into five groups based on biomaterials used for GBR within the defect: (1) no treatment (negative control), (2) bone graft alone (BG), (3) bone graft covered by RCM (BG + RCM), (4) bone graft soaked in rhPDGF (BG + rhPDGF), and (5) bone graft soaked in rhPDGF and covered with RCM (BG + rhPDGF + RCM). In vivo μCT for determination of newly formed bone volume (NFBV) and mineral density (NFBMD) and remnant bone particles volume (RBPV) and mineral density (RBPMD) was done at baseline and at 2, 4, 6, and 8 weeks postoperatively. Eight weeks following surgery, the animals were sacrificed and harvested calvarial specimens were subjected to histologic and biomechanical analysis. There was an increase in NFBV and NFBMD associated with a corresponding decrease in RBPV and RBPMD in all the study groups. Two-way analysis of variance revealed significant differences in the measured values within and between the groups across the timelines examined during the study period (P RCM, and BG + rhPDGF + RCM groups, the NFBMD was similar in all the groups except negative control. The greatest decreases in RBPV and RBPMD were observed in the BG + rhPDGF + RCM group in comparison to the other groups. Similarly, BG + rhPDGF + RCM groups had hardness and elastic modulus similar to that of natural bone. The in vivo μCT results were validated by the qualitative histologic findings. In real

  4. Assessment laser phototherapy on bone defects grafted or not with biphasic synthetic micro-granular HA + β-tricalcium phosphate: histological study in an animal model

    Science.gov (United States)

    Soares, Luiz Guilherme P.; Marques, Aparecida M. C.; Aciole, Jouber Mateus S.; Trindade, Renan; Santos, Jean N.; Pinheiro, Antônio Luiz B.

    2014-02-01

    Beside of biomaterials, Laser phototherapy has shown positive results as auxiliary therapy on bone repair. The aim of this study was to evaluate, through histological analysis, the influence of Laser phototherapy in the process of repair of bone defects grafted or not with Hydroxyapatite. Forty rats were divided into 4 groups each subdivided into 2 subgroups according to the time of sacrifice. Surgical bone defects were made on femur of each animal with a trephine drill. On animals of group Clot the defect was filled only by blood, on group Laser the defect filled with the clot and further irradiated. In group Biomaterial the defect was filled with HA + β-TCP graft. In group Laser + Biomaterial, the defect was filled with biomaterial and further irradiated. The irradiation protocols were performed every 48 hours during for 15 days. Animal death occurred after 15 and 30 days. The specimens were routinely processed and evaluated by light microscopy. Qualitative analysis showed that group Laser + Biomaterial was in a more advanced stage of repair at the end of the experimental time. It was concluded that the Laser irradiation improved the repair of bone defects grafted or not.

  5. The Effect of 58S Bioactive Glass Coating on Polyethylene Terephthalates in Graft-Bone Healing

    Institute of Scientific and Technical Information of China (English)

    Yang Wu; Shiyi Chen; Jia Jiang; Hong Li; Kai Gao; Pengyun Zhang

    2012-01-01

    In this study the effects of surface modification of Polyethylene Terephthalates (PET) fibers with 58S bioactive glasses on osteoblasts proliferation and osseointegration in the tibia-articular tendon-bone healing model were investigated.PET sheets were coated with 58S bioactive glass and uncoated PET sheets were used as a control.Scanning Electron Microscope (SEM) and X-ray photoelectron spectrometer were adopted to analyze the surface characteristics of the fibers.MT3T3-E 1 cells were cultured with the PET fibers and the MTT and ALP were tested at 1,3,5 days.Twenty-four skeletally mature male New Zealand white rabbits were randomly divided into two groups,the 58S-PET group and the PET group.Both groups underwent a surgical procedure to establish a tibia-articular tendon-bone healing model.Mechanical examinations and histological assays were taken to verify the coating effects in vivo.Results of both MTT and ALP tests show significant differences (P < 0.01) between the 58S-PET group and the PET group.At 6 weeks and 12 weeks,the max load-to-failure was significantly higher in the 58S-PET group.In the histological assays,distinct new bone formation was observed only in the 58S-PET group and stronger osseointegration was seen in the 58S-PET group than that in the control group.The 58S-coating on PET could enhance the proliferation and activity of the osteoblasts and therefore promote the new bone formation and tendon-bone healing.

  6. Acellular allogeneic nerve grafting combined with bone marrow mesenchymal stem cell transplantation for the repair of long-segment sciatic nerve defects:biomechanics and validation of mathematical models

    Institute of Scientific and Technical Information of China (English)

    Ya-jun Li; Bao-lin Zhao; Hao-ze Lv; Zhi-gang Qin; Min Luo

    2016-01-01

    We hypothesized that a chemically extracted acellular allogeneic nerve graft used in combination with bone marrow mesenchymal stem cell transplantation would be an effective treatment for long-segment sciatic nerve defects. To test this, we established rabbit models of 30 mm sciatic nerve defects, and treated them using either an autograft or a chemically decellularized allogeneic nerve graft with or without simultaneous transplantation of bone marrow mesenchymal stem cells. We compared the tensile properties, electrophysiological function and morphology of the damaged nerve in each group. Sciatic nerves repaired by the allogeneic nerve graft combined with stem cell trans-plantation showed better recovery than those repaired by the acellular allogeneic nerve graft alone, and produced similar results to those observed with the autograft. These ifndings conifrm that a chemically extracted acellular allogeneic nerve graft combined with transplanta-tion of bone marrow mesenchymal stem cells is an effective method of repairing long-segment sciatic nerve defects.

  7. Management of Radicular Cyst Using Platelet-Rich Fibrin & Iliac Bone Graft - A Case Report.

    Science.gov (United States)

    Vidhale, Gaurav; Jain, Deepali; Jain, Sourabh; Godhane, Alkesh Vijayrao; Pawar, Ganesh R

    2015-06-01

    Radicular cyst is one of the most commonly occurring cyst in the oral cavity it is usually preceded by trauma or an infectious condition which is followed by enlargement. In recent times there are several treatment procedures that are being applied in order to improve the postoperative condition and to accelerate the process of healing and regeneration in the affected site. A 22-year-old patient reported to our OPD with the chief complaint of swelling on the left side of the face since 2-3 months, on investigating it was diagnosed as Radicular cyst which was initially treated by endodontic treatment of the involved tooth followed by enucleation of the cyst further an apicoectomy was done. Finally a PRF and iliac crest graft was placed for aesthetic rehabilitation with 21. PMID:26266233

  8. Biocelulose grafts: the future in artificial vascular grafts? preliminar results

    OpenAIRE

    Silva, Ivone; Loureiro, Luís; Araújo, Anabela; Alexandre F. Leitão; Faria, Miguel; Gama, F. M.

    2013-01-01

    Introduction: Vascular grafts, autogenous or artificial, are used to replace, bypass or maintain function of occluded, damaged, or diseased blood vessels of small, medium and large diameter. Vascular prostheses may be manufactured from synthetic, biological or biosynthetic materials. To our knowledge this is the first study to look at the hemocompatibility of bacterial cellulose membrane reinforced by the presence of polyvinyl alcohol. Materials/ methods The first aim of ...

  9. Raman spectroscopy of the organic and mineral structure of bone grafts

    Energy Technology Data Exchange (ETDEWEB)

    Timchenko, E V; Timchenko, P E; Taskina, L A [S.P. Korolev Samara State Aerospace University, Samara (Russian Federation); Volova, L T; Ponomareva, Yu V [Samara State Medical University, Samara (Russian Federation)

    2014-07-31

    We report the results of experimental Raman spectroscopy of donor bone samples (rat, rabbit and human) with varying degrees of mineralisation. Raman spectra are obtained for the Raman bands of 950 – 962 cm{sup -1} (PO{sub 4}){sup 3-}, 1065 – 1070 cm{sup -1} (CO{sub 3}){sup 2-} and 1665 cm{sup -1} (amide I). In demineralised bone, a sharp (98%) decrease in the intensities of 950 – 962 and 1065 – 1070 cm{sup -1} bands is observed, which is accompanied by the emergence of the 1079 – 1090 cm{sup -1} band corresponding to the hydrated amorphous state CO{sub 3}{sup -3}. (laser biophotonics)

  10. Comparison of three calcium phosphate bone graft substitutes from biomechanical, histological, and crystallographic perspectives using a rat posterolateral lumbar fusion model.

    Science.gov (United States)

    Hu, Ming-Hsien; Lee, Pei-Yuan; Chen, Wen-Cheng; Hu, Jin-Jia

    2014-12-01

    This study evaluated the effectiveness of three calcium phosphate bone graft substitutes with different chemical compositions on spinal fusion using a rat posterolateral lumbar fusion model. Specifically, two recently developed non-dispersive tetracalcium phosphate/dicalcium phosphate anhydrous-based calcium phosphate cements (CPCs), namely a CPC consisting of equimolar amounts of the two compounds (nd-CPC) and a CPC consisting of a two-fold greater amount of dicalcium phosphate anhydrous (DCP-rich CPC), were compared with a commercial calcium phosphate bone graft (c-CPG) consisting of hydroxyapatite (60%) and β-tricalcium phosphate (40%). Single-level posterolateral lumbar fusion was performed at the L4-L5 vertebrae in fifteen adult rats (n=5 for each group). Spinal fusion was evaluated with radiographs, manual palpation, mechanical testing, micro-CT, and histology 8 weeks post-surgery. In particular, the crystallographic phases in the three substitutes were identified before and 8 weeks after their implantation. Manual palpation revealed stable constructs in nearly all of the spine specimens. The stiffness and bending load of fused spines in the two CPC groups were comparable to those in the c-CPG group. The radiographs specifically revealed implant resorption and bone remodeling in the DCP-rich CPC group. Analysis of 3D micro-CT images revealed that the bone volume ratio in the DCP-rich CPC group was significantly greater than those in the nd-CPC and c-CPG groups. Histology showed that the DCP-rich CPC group exhibited the highest degree of bone regeneration and osseointegration. Notably, DCP-rich CPC led to a pronounced phase transformation, generating the greatest amount of poorly crystalline apatite among the three groups, which together with adequate resorption may explain the aforementioned positive findings. We therefore conclude that of the bone graft substitutes considered, DCP-rich CPC has the greatest potential to be used in spinal fusion.

  11. Comparison of three calcium phosphate bone graft substitutes from biomechanical, histological, and crystallographic perspectives using a rat posterolateral lumbar fusion model.

    Science.gov (United States)

    Hu, Ming-Hsien; Lee, Pei-Yuan; Chen, Wen-Cheng; Hu, Jin-Jia

    2014-12-01

    This study evaluated the effectiveness of three calcium phosphate bone graft substitutes with different chemical compositions on spinal fusion using a rat posterolateral lumbar fusion model. Specifically, two recently developed non-dispersive tetracalcium phosphate/dicalcium phosphate anhydrous-based calcium phosphate cements (CPCs), namely a CPC consisting of equimolar amounts of the two compounds (nd-CPC) and a CPC consisting of a two-fold greater amount of dicalcium phosphate anhydrous (DCP-rich CPC), were compared with a commercial calcium phosphate bone graft (c-CPG) consisting of hydroxyapatite (60%) and β-tricalcium phosphate (40%). Single-level posterolateral lumbar fusion was performed at the L4-L5 vertebrae in fifteen adult rats (n=5 for each group). Spinal fusion was evaluated with radiographs, manual palpation, mechanical testing, micro-CT, and histology 8 weeks post-surgery. In particular, the crystallographic phases in the three substitutes were identified before and 8 weeks after their implantation. Manual palpation revealed stable constructs in nearly all of the spine specimens. The stiffness and bending load of fused spines in the two CPC groups were comparable to those in the c-CPG group. The radiographs specifically revealed implant resorption and bone remodeling in the DCP-rich CPC group. Analysis of 3D micro-CT images revealed that the bone volume ratio in the DCP-rich CPC group was significantly greater than those in the nd-CPC and c-CPG groups. Histology showed that the DCP-rich CPC group exhibited the highest degree of bone regeneration and osseointegration. Notably, DCP-rich CPC led to a pronounced phase transformation, generating the greatest amount of poorly crystalline apatite among the three groups, which together with adequate resorption may explain the aforementioned positive findings. We therefore conclude that of the bone graft substitutes considered, DCP-rich CPC has the greatest potential to be used in spinal fusion. PMID

  12. Reconstruction of irradiated mandible after segmental resection of osteoradionecrosis-a technique employing a microvascular latissimus dorsi flap and subsequent particulate iliac bone grafting

    DEFF Research Database (Denmark)

    Hillerup, Soren; Elberg, Jens Jorgen; Thorn, Jens Jorgen;

    2014-01-01

    , and the defect site was primed with a LD musculocutaneous flap wrapped around the reconstruction plate to bring in vascularized tissue and optimize healing conditions for a subsequent particulate iliac free bone graft reconstruction. The management of defect closure was successful in all 15 patients. Twelve......The fibula osteocutaneous flap has revolutionized the options of mandibular segmental defect bridging in osteoradionecrosis (ORN). In selected cases, however, the fibula flap is not an option because of atherosclerosis or other features that compromise the vascularity of the lower leg and foot....... The aim of this study is to present an alternative method of mandibular segmental reconstruction employing a latissimus dorsi (LD) flap and subsequent particulate iliac free bone graft reconstruction. In 15 patients with ORN, a mandibular segmental defect was bridged with a reconstruction plate...

  13. 30 CFR 35.20 - Autogenous-ignition temperature test.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Autogenous-ignition temperature test. 35.20... Autogenous-ignition temperature test. (a) Purpose. The purpose of this test, referred to hereinafter as the ignition-temperature test, is to determine the lowest autogenous-ignition temperature of a hydraulic...

  14. Arresting rampant dental caries with silver diamine fluoride in a young teenager suffering from chronic oral graft versus host disease post-bone marrow transplantation: a case report

    OpenAIRE

    Chu, Chun-Hung; Lee, Angeline Hui-Cheng; Zheng, Liwu; Mei, May Lei; Chan, Godfrey Chi-fung

    2014-01-01

    BACKGROUND: Rampant caries is an advanced and severe dental disease that affects multiple teeth. This case describes the management of rampant caries in a young teenager suffering from chronic oral graft versus host disease after allogeneic bone marrow transplantation. CASE PRESENTATION: A 14-year-old Chinese boy suffering from beta-thalassemia major was referred to the dental clinic for the management of rampant dental caries. An oral examination revealed pale conjunctiva, bruising of lips, ...

  15. Bone healing response to a synthetic calcium sulfate/β-tricalcium phosphate graft material in a sheep vertebral body defect model

    OpenAIRE

    Yang, H. L.; Zhu, X S; Chen, L.; Chen, C. M.; Mangham, D C; Coulton, L A; Aiken, S. S.

    2012-01-01

    Abstract The introduction of a material able to promote osteogenesis and remodelling activity in a clinically relevant time frame in vertebroplasty and kyphoplasty procedures may have patient benefit. We report the in-vivo performance of a biphasic synthetic bone graft material (Genex Paste, Biocomposites, UK) [test material], composed of calcium sulfate and β-tricalcium phosphate, implanted into a sheep vertebral defect model. Cavities drilled into 4 adjacent vertebrae (L2 to L5) of 24 skele...

  16. Influence of Autologus Adipose Derived Stem Cells and PRP on Regeneration of Dehiscence-Type Defects in Alveolar Bone: A Comparative Histochemical and Histomorphometric Study in Dogs

    Science.gov (United States)

    Aziz Aly, Lobna Abdel; El- Menoufy, Hala; Hassan, Amal; Ragae, Alyaa; Atta, Hazem Mahmoud; Roshdy, Nagwa Kamal; Rashed, Laila Ahmed; Sabry, Dina

    2011-01-01

    Background and Objectives: Autogenous bone grafts is considered to be the best choice for reconstructive surgery. Adipose Derived Stromal Cells (ASCs) represents a promising tool for new clinical concepts in supporting cellular therapy. The goal of our study was to investigate bone regeneration following application of autologous ASCs with or without Platelet-Rich Plasma (PRP) at dehiscence-type defects in alveolar bone in dogs. Methods and Results: Standardized buccal dehiscence defects (4× 3×3 mm) were surgically created in eighteen dogs, the defects were grafted with either ASCs -PRP, ASCs alone, or without grafting material. Three months later; a bone core was harvested from grafted and non grafted sites for histological, histochemical and histomorphometric assessment. There was no evidence of inflammation or adverse tissue reaction with either treatment. Defects grafted with ASCs-PRP showed a significantly higher result (p≤ 0.05), with a mean area % of spongy bone and compact bone of (64.96±5.37 and 837.62±24.95), compared to ASCs alone (47.65±1.43 and 661.92±12.65) and without grafting (33.55± 1.74 and 290.85±7.27) respectively. The area % of lamellated bone increased significantly reaching its highest level in group A followed by group B. Also a significant increase in area % of neutral mucopolysaccharides and calcified reactivity of Masson|s Trichrome stain in groups A and B compared to group C was obtained. Conclusions: Our results suggest that, the addition of PRP to ASCs enhances bone formation after 3 months and may be clinically effective in accelerating postsurgical healing in both periodontal and maxillofacial surgical applications. PMID:24298335

  17. 牙槽嵴裂植骨失败因素的探讨%Discusion of the influence factors of the failure of alveolar cleft bone graft

    Institute of Scientific and Technical Information of China (English)

    柳新华; 张新华; 侯春林; 侯伟; 马雪芳

    2012-01-01

    目的:探讨可能的导致牙槽嵴裂植骨失败的有关因素.方法:对217例病例进行临床研究,分析植骨年龄、裂隙类型以及操作方式与植骨手术成功的关系.结果:大龄患者植骨失败率显著高于9~11岁患者,双侧牙槽嵴裂失败率高于单侧,单侧完全性裂失败率高于不完全性裂和隐裂.结论:植骨年龄、裂隙类型以及操作方式是影响植骨手术成功与否的几个关键因素.双侧裂隙软组织严重缺乏者,可考虑先行一侧牙槽嵴裂骨移植术,待植入骨生长稳定后,再行另一侧植骨,手术操作动作须熟练、力度要准确,无张力严密缝合,减少手术创伤、植骨量要适度.%Objective To explore the factors whith influence the results of alveolar clefe bone graft. Methods 217 patients with alveolar cleft were discussed.we analysis the relationship between the patients' age,clinical classification and operation mode. Results Older patients bone graft failure rate was significantly higher than 9 to 11 patients, bilateral alveolar cleft bone graft! failure rate was higher than unilateral,unilateral complete cleft bone graft failure rate was higher than the incomplete and submucosal cleft. Conclusion The patients'age.clinical classification and operation mode are the key factors in the alveolar cleft bone grafting.If the bilateral alveolar cleft patients'soft tissue are lack seriously.we may be operate one side.During operation.surgical operation action must be skilled.the force should be accurate, suture should be not only no tension but also strict.surgical trauma should be reduced, the bone mass should be modest.

  18. A novel approach to human cranial tissue regeneration and frontal sinus obliteration with an autogenous platelet-rich/fibrin-rich composite matrix: 10 patients with a 6-10 year follow-up.

    Science.gov (United States)

    Mendonça-Caridad, Jose; Lopez, Pedro Juiz; Fayos, Francisco Vidal; Miery, Gustavo

    2013-06-01

    Advanced frontal sinus disease non-responsive to conservative therapy has been treated with fat obliteration for decades. More recently, a wide variety of autogenous, allogenic or synthetic materials have also been used. In this study we present a treatment based on totally autogenous procedures and materials that was successfully implemented in 10 patients and followed up for a period of 6-10 years, to evaluate the feasibility of a new approach for the treatment of frontal sinus disease and other related cranial osseous derangements, based on regenerative medicine as an alternative to fat or other obliterating or grafting materials. Platelet-rich and -poor plasma (PRP, PPP) are set to clot with cortical shavings from the skull surface. After surgically stimulating the sinus to encourage cell chemotaxis, migration and homing, the bioactive scaffold is placed and covered with a PPP membrane and a periosteal flap. Ten patients with pathologies ranging from devastating infection to invasive tumours or trauma were treated with this regenerative procedure in a single-stage surgery. All patients had an uneventful recovery with bone formation and no complications or recurrences over the years. The application of modern principles in tissue regeneration and wound healing has resulted in a favourable outcome, with no complications or sequelae, in a series of 10 patients with advanced frontal sinus disease over a long period of time.

  19. Use of a Bone Graft Drill Harvester to Create the Fenestration During Arthroscopic Ulnohumeral Arthroplasty.

    Science.gov (United States)

    Wijeratna, Malin D; Ek, Eugene T; Hoy, Gregory A; Chehata, Ash

    2015-10-01

    The Outerbridge-Kashiwagi procedure, or ulnohumeral arthroplasty, was described in 1978 as a method of treating elbow arthritis by creating a fenestration in the olecranon fossa. This fenestration diminishes the likelihood of recurrent spurs in the olecranon fossa and coronoid fossa, without loss of structural bony strength. Arthroscopic techniques have now been developed to perform this procedure. We describe an efficient method of creating the fenestration between the olecranon fossa and coronoid fossa during an arthroscopic ulnohumeral arthroplasty, or Outerbridge-Kashiwagi procedure, that also reduces the amount of residual bone debris produced during the resection.

  20. The use of bovine screws to promote bone formation using a tibia model in dogs

    Science.gov (United States)

    Bianchini, Marco Aurélio; Pontual, Marco Antônio B; Bez, Leonardo; Benfatti, César Augusto M; Boabaid, Fernanda; Somerman, Martha J; Magini, Ricardo S

    2013-01-01

    The objective of this study was to evaluate the use of a unique resorbable bovine bone screw, to stimulate bone formation. Bovine bone screws were inserted in the tibia beagle dogs. Each animal received 8 screws, divided into Groups A (screws + no membranes), B (screws + titanium reinforced membranes) and C (bone defects treated with autogenous bone grafts). Animals were sacrificed at 2, 4 and 6 months. New bone was measured with a periodontal probe and reported an average of 7.4 mm in vertical bone gain for Group B, 3.6 mm for Group A and 1.7 mm for Group C. Submission to Kruskal-Wallis test showed statistical differences between groups (p<0,05). Histological examination revealed an intimate contact between the newly formed bone and the resorbing bone screws. Conclusion: Bovine bone screws provide environment for new bone formation and thus may provide an alternative therapy for enhancing bone formation vertically, including for regenerative procedures as well as prior to implant therapy. PMID:23058228

  1. The effect of Hydroxyapatite/collagen I composites, bone marrow aspirate and bone graft on fixation of bone implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan

    of bone implants.   Materials and Methods: Titanium alloy implants were inserted into bilateral femoral condyles of 8 skeletally mature sheep, four in each sheep. The implant has a circumferential gap of 2 mm. The gap was filled with: HA/coll; HA/coll-BMA; autograft or allograft. Allograft was served...

  2. Hydatid disease of scapula and upper third of humerus treated by en bloc excision and fibular bone grafting

    Directory of Open Access Journals (Sweden)

    Chari P

    2007-01-01

    Full Text Available 35-year-old male patient presented with gradually increasing painful swelling of the right shoulder, which was incised and drained and wound persisted as a discharging sinus on the anterolateral aspect of the deltoid region with seropurulent discharge. A clinical diagnosis of tuberculosis of the shoulder was made. Plain skiagram of the right shoulder revealed multicystic lesion involving the entire scapula and upper third of the humerus with loss of joint space and pathological fracture at the junction of upper one-third and lower two-thirds of the humerus. A clinico-radiological diagnosis of hydatid disease was made. In view of the extensive involvement of the scapula with stiff shoulder and an active sinus, a two-stage surgical procedure was performed. Stage 1 consisted of en bloc excision of the scapula, upper half of the humerus and lateral end of the clavicle. Stage II surgery, consisting of fibular bone grafting. Tablet albendazole (400 mg, thrice daily was given as systemic scolicidal agent. This case is reported in view of it′s rarity and to highlight the management.

  3. Remoção da cartilagem articular associada ou não a implante homógeno ou enxerto autógeno de osso esponjoso em cães submetidos à artrodese atlantoaxial Joint cartilage removal associated or not to homologous implant or autologous cancellous bone graft in dogs submitted to atlantoaxial arthrodesis

    Directory of Open Access Journals (Sweden)

    Rafael Festugatto

    2013-03-01

    same amount. Group III (GIII: this was the same procedure as GI, however, was used autogenous cancellous bone graft at the given location. Radiographic examinations were performed on all animals at 30, 60 and 90 days postoperatively. At 90 days of PO was carried out euthanasia of animals for testing of manual palpation and CT evaluation and histological. Samples were kept in solution in 10% buffered formaldehyde for fixation for a minimum of 72 hours and after, decalcified in formic acid and sodium citrate for subsequent processing and included in paraffin. Sections were stained with hematoxylin-eosin for light microscopy evaluation. Statistical analysis of the association between the degree of joint fusion assessed by manual palpation, the digitized radiographic images and CT scans and treatment groups, we applied the Chi-square test of independence. The test results were evaluated by the exact significance and considered statistically significant at 5% significance (P<0.05. By manual palpation test and by the CT images can be seen that there was no statistically significant difference between groups at 90 days postoperatively. Radiographic analysis of the atlantoaxial joint showed that the degree of fusion was similar among treatments, no statistical difference at 30, 60 and 90 days postoperatively. Regarding the histopathological study of atlantoaxial joint of dogs after 90 days postoperatively was found that bone formation in group I had 25% of each intensity (absent, mild, moderate, severe in group II, 75% lighter and 25% sharp and in group III, 25% moderate and 75% severe. It can be concluded that the use of graft homogenous preserved in 98% glycerin in dogs undergoing atlantoaxial fusion method is a viable alternative for treatment of atlantoaxial instability. There is no difference in the degree of joint fusion and bone formation when the technique of atlantoaxial arthrodesis in dogs is associated with autogenous cancellous bone graft or implant homogenous. The

  4. Fibular Allograft and Demineralized Bone Matrix for the Treatment of Slipped Capital Femoral Epiphysis.

    Science.gov (United States)

    Murray, Travis; Morscher, Melanie A; Krahe, Amy M; Adamczyk, Mark J; Weiner, Dennis S

    2016-05-01

    Previous studies documented the use of fibular allograft in the treatment of slipped capital femoral epiphysis (SCFE) with bone graft epiphysiodesis (BGE). This study describes the results of using a 10-mm diameter premilled fibular allograft packed with demineralized bone matrix placed across the physis in an open surgical approach under image intensification. A review identified 45 cases of BGE using fibular allograft and demineralized bone matrix in 34 patients with a diagnosis of SCFE performed by a single surgeon during an 8-year period. Thirty-four cases (25 patients) had at least 1 year of follow-up and were included in the study. Medical records were reviewed for complications, subsequent surgeries, and time to physeal closure. Of the 34 cases included, there were no cases of acute chondrolysis. Complications included 1 case of bone graft extrusion that required surgical replacement and 1 re-slip requiring surgical stabilization. Five cases of avascular necrosis (AVN) were encountered (1 unstable slip with total head AVN, and 4 stable slips with 3 total head and 1 partial head AVN). In 1 patient, small loose bony fragments were noted on postoperative radiographs that appeared outside of the articular surface of the hip and were asymptomatic. Two patients encountered wound healing issues that resolved with appropriate wound care. In light of the occurrence of AVN in stable cases, BGE with autogenous corticocancellous graft is preferable to BGE with autologous fibular graft for the treatment of SCFE. [Orthopedics. 2016; 39(3):e519-e525.].

  5. Therapeutic efficacy of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting for tuberculosis of lumbar vertebra

    Directory of Open Access Journals (Sweden)

    Jia-ming LIU

    2015-11-01

    Full Text Available Objective To evaluate the efficacy and safety of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting in the treatment of tuberculosis of mono-segmental lumbar vertebra. Methods From January 2010 to April 2013, 21 patients (9 males and 12 females with an average age of 49.1 years with mono-segmental tuberculosis of lumbar vertebra underwent surgery in our hospital were included. Eight patients had neurological deficit. The focus of tuberculosis was located on one side of the vertebral body, and all the patients had obvious signs of bone destruction on CT and MRI. All the patients were given anti-tuberculosis chemotherapy for 2-3 weeks before surgery. The local bone chips and autologous iliac cancellous bone were used as the intervertebral bone graft. Postoperative plain radiographs and CT were obtained to evaluate the fusion rate and degree of lumbar lordosis. The visual analogue scale score (VAS, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP before and after operation, and at final follow-up date were recorded. Results All the patients were followed up for 25.3±4.2 months. The mean operation time was 157±39 minutes, and the average blood loss was 470±143ml. The fusion rate of the interbody bone graft was 95.2%, with an average fusion period of 6.1±2.5 months. The neurological function was improved by 100%, and no severe complication or neurological injury occured. The preoperative and postoperative lordosis angles of the lumbar spine were 21.4°±5.7° and 33.6°±3.1°, respectively, and it was 31.3°±2.7° at the final follow up. The preoperative and postoperative VAS scores were 7.8±2.6 and 2.4±1.7 respectively, and it was 0.9±0.7 at the final follow up. The ESR and CRP were significantly decreased 3 months after surgery, and they became normal at 6 months. Conclusion Pedicle screw-rod internal fixation after one-stage posterior

  6. Effect of a Bone Graft Substitute β Tricalcium Phosphate on Osteoblastic Genes mRNA Exprssion

    Institute of Scientific and Technical Information of China (English)

    QIU Tong; WANG Youfa; HAN Yinchao; JIANG Xin; LI Shipu

    2012-01-01

    To investigate the molecular aspects of osteoblastic interactions with β tricalcium phosphate (β-TCP) particles,human osteoblast-like MG-63 cells were cultured with β-TCP particles at a density of 6 mg/mL culture medium for 48 h.Then,the mRNA expression of selected genes were quantified by realtime polymerase chain reaction (PCR),including the attachment-related genes (α integrin and actin),the proliferation-related gene (c-jun),and the osteoblastic markers genes (type Ⅰ collagen,osteonectin,alkaline phosphatase,RUNX2 and osteoclain).The results showed that β-TCP particles (the average size 809 nm)significantly promote the attachment and the proliferation of MG-63 cells,and slightly enhance the osteoblastic differentiation based on the analyses of the related genes expression.This study provided scientific evidences to better reveal the underlines of functions of β-TCP in bone repair.

  7. Early resorption of an artificial bone graft made of calcium phosphate for cranioplasty: case report

    Directory of Open Access Journals (Sweden)

    Monaco BA

    2013-11-01

    Full Text Available Bernardo Assumpção de Monaco, Erich Talamoni Fonoff, Manoel Jacobsen TeixeiraDivision of Functional Neurosurgery, Department of Neurology, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, BrazilAbstract: The treatment of uncomplicated osteoma consists of an en bloc resection, or curettage, of the tumor, followed by cranioplasty. Here, we present a case report of a patient treated for a parietal osteoma, followed by a calcium phosphate cranioplasty, with early resorption after 3 months, which was presented by a sinking flap above the resection area. This case suggests that synthetic cranioplasty should be preferred, even in small skull-gap areas.Keywords: cranioplasty, bone cement, osteoma, calcium phosphate, resorption

  8. Changes of porous poly( ɛ-caprolactone) bone grafts resulted from e-beam sterilization process

    Science.gov (United States)

    Oláh, L.; Filipczak, K.; Czvikovszky, T.; Czigány, T.; Borbás, L.

    2007-08-01

    The most important mechanical feature of poly( ɛ-caprolactone) (PCL) foams applied in bone tissue engineering as a scaffold, has been investigated as a function of irradiation dose. Radiation is proposed for the sterilization of the polymer before the implantation. Polycaprolactone scaffold foams were obtained by combination of compression molding and particulate leaching techniques. The porogen was changed in the range 74-96 w% and the irradiation dose was varied from 25 to 150 kGy. Our results show that yield strength is not a function of radiation dose, but is rather influenced by the porosity, while the critical strain is mainly dependent on the dose. All these together mean that the modulus of the elasticity of PCL foams is dependent on both the porosity and the dose.

  9. Autogenous Phenomena in Cement-Based Materials

    DEFF Research Database (Denmark)

    Jensen, Ole Mejlhede

    Denne afhandling er skrevet med henblik på opnåelse af den danske doktorgrad i teknik, dr.techn. Den vedrører autogene fænomener i cementbaserede materialer – primært deformation og ændring af den relative luftfugtighed (RF). I afhandlingen er det belyst, hvordan betydningen af disse fænomener bl...

  10. Evaluation of bone regenerative capacity in rats claverial bone defect using platelet rich fibrin with and without beta tri calcium phosphate bone graft material

    Directory of Open Access Journals (Sweden)

    Walid Ahmed Abdullah

    2016-07-01

    Conclusion: The addition of β-TCP to PRF significantly improved bone regeneration in the first 2 weeks after surgery. Although the differences between results with and without the addition of β-TCP to PRF were statistically insignificant from weeks 3 to 6, it was nevertheless apparent that the group receiving the combination showed better results. We suggest a synergistic mechanism for this effect.

  11. Culture of osteoblasts on bio-derived bones

    Institute of Scientific and Technical Information of China (English)

    LAN Xu; YANG Zhi-ming; GE Bao-feng; LIU Xue-mei

    2005-01-01

    Objective: To study the effect of bio-derived bones, as substitutes of autogenous bone grafts and demineralized cadaver bones, on the attachment, spreading and proliferation of isolated osteoblasts. Methods: Osteoblasts were isolated from the calvaria of a fetal rabbit through sequential collagenase digestion. In the attachment study, the osteoblasts labeled with 3H-leucine were incubated with the bio-derived bone materials in sterile microcentrifugale tubes for 15, 90 and 180 minutes, and 24 hours, respectively. The attached cells were collected and the radioactivity was measured with liquid scintillation spectrometry. In the proliferation study, the osteoblasts were cultured with the bio-derived bone materials for 24 hours and 3H-thymidine was added during the last 2 hours of the incubation. The attached cells were collected and the radioactivity was measured with liquid scintillation spectrometry. Osteoblasts were seeded on the bone graft materials for 60 or 120 minutes, 24 or 48 hours, and 3 or 7 days, then the co-culture was processed for scanning electron microscopy to observe the interaction of osteoblasts and the bio-derived bone materials. Results: Osteoblasts attached to the bio-derived bone materials in a time-dependent manner. There were significantly (P<0.05) more attached cells after 180 minutes than after 15 and 90 minutes of incubations (P<0.05). Osteoblasts were proliferated in a large amount on the surface and in the materials. Osteoblasts seeded onto 100 mg bio-derived bones resulted in significantly (P<0.05) more measurable proliferation than those seeded onto 10 mg bones. Osteoblasts appeared round as they attached to the materials, then flattened and spread over with time passing. Conclusions: Bio-derived bones can provide a good environment for the attachment and proliferation of osteoblasts.

  12. Graft versus host disease in the bone marrow, liver and thymus humanized mouse model.

    Directory of Open Access Journals (Sweden)

    Matthew B Greenblatt

    Full Text Available Mice bearing a "humanized" immune system are valuable tools to experimentally manipulate human cells in vivo and facilitate disease models not normally possible in laboratory animals. Here we describe a form of GVHD that develops in NOD/SCID mice reconstituted with human fetal bone marrow, liver and thymus (NS BLT mice. The skin, lungs, gastrointestinal tract and parotid glands are affected with progressive inflammation and sclerosis. Although all mice showed involvement of at least one organ site, the incidence of overt clinical disease was approximately 35% by 22 weeks after reconstitution. The use of hosts lacking the IL2 common gamma chain (NOD/SCID/γc(-/- delayed the onset of disease, but ultimately did not affect incidence. Genetic analysis revealed that particular donor HLA class I alleles influenced the risk for the development of GVHD. At a cellular level, GVHD is associated with the infiltration of human CD4+ T cells into the skin and a shift towards Th1 cytokine production. GVHD also induced a mixed M1/M2 polarization phenotype in a dermal murine CD11b+, MHC class II+ macrophage population. The presence of xenogenic GVHD in BLT mice both presents a major obstacle in the use of humanized mice and an opportunity to conduct preclinical studies on GVHD in a humanized model.

  13. Rehabilitation instruction after intervertebral bone graft internal fixation of lumbar spondylolisthesis%腰椎滑脱椎体间植骨固定术后的康复指导

    Institute of Scientific and Technical Information of China (English)

    张晋亭

    2003-01-01

    @@ BACKGROUND:Internal fixation of lumbral spondylolisthesis has resolved the problem caused by vertebral translocation and postoperative rehabilitation instruction can prevent moving of bone.Directed to different stages,suitable posture and rehabilitation function exercises can effectively prevent loose intervertebral grafted bone and adhesion of nerve root.

  14. Secondary aneurysmal bone cystic change of the chondroblastoma, mistaken for a primary aneurysmal bone cyst in the patella.

    Science.gov (United States)

    Chung, Jin Wha; Lee, Hwa Sung

    2014-03-01

    A 29-year-old woman complained of a 3-month history of left knee pain without trauma history. X-ray showed a well-defined osteolytic lesion with a sclerotic margin in the patella and magnetic resonance imaging showed T1-low and T2-high signal intensity with different fluid level. Our impression was an aneurysmal bone cyst. At surgery, the lesion was a blood-filled cystic cavity, surrounded by a gray or brownish tissue. Hemorrhagic soft tissues with recognizable bone fragments were observed. Curettage and autogenous bone graft was done. Microscopically, sheets of tumor cells were intermingled with some areas of eosinophilic chondroid matrix. The tumor cells showed oval-shaped nuclei with moderate eosinophilic cytoplasm. Several multinucleated giant cells and blood filled cystic cavities were observed. The final diagnosis was a chondroblastoma with a secondary aneurysmal bone cyst. At the post-operative 1.5-year follow-up, grafted bones were well incorporated radiographically and there were no recurrent evidence or any other abnormal symptoms. PMID:24639947

  15. Secondary aneurysmal bone cystic change of the chondroblastoma, mistaken for a primary aneurysmal bone cyst in the patella.

    Science.gov (United States)

    Chung, Jin Wha; Lee, Hwa Sung

    2014-03-01

    A 29-year-old woman complained of a 3-month history of left knee pain without trauma history. X-ray showed a well-defined osteolytic lesion with a sclerotic margin in the patella and magnetic resonance imaging showed T1-low and T2-high signal intensity with different fluid level. Our impression was an aneurysmal bone cyst. At surgery, the lesion was a blood-filled cystic cavity, surrounded by a gray or brownish tissue. Hemorrhagic soft tissues with recognizable bone fragments were observed. Curettage and autogenous bone graft was done. Microscopically, sheets of tumor cells were intermingled with some areas of eosinophilic chondroid matrix. The tumor cells showed oval-shaped nuclei with moderate eosinophilic cytoplasm. Several multinucleated giant cells and blood filled cystic cavities were observed. The final diagnosis was a chondroblastoma with a secondary aneurysmal bone cyst. At the post-operative 1.5-year follow-up, grafted bones were well incorporated radiographically and there were no recurrent evidence or any other abnormal symptoms.

  16. Scaffold- and Cell System-Based Bone Grafts in Tissue Engineering (Review

    Directory of Open Access Journals (Sweden)

    Kuznetsova D.S.

    2014-12-01

    Full Text Available The review considers the current trends in tissue engineering including maxillofacial surgery based on the use of scaffolds, autologous stem cells and bioactive substances. The authors have shown the advantages and disadvantages of basic materials used for scaffold synthesis — three-dimensional porous or fiber matrices serving as a mechanical frame for cells; among such materials there are natural polymers (collagen, cellulose, fibronectin, chitosan, alginate and agarose, fibroin, synthetic polymers (polylactide, polyglycolide, polycaprolactone, polyvinyl alcohol and bioceramics (hydroxyapatite, tricalcium phosphate and bioactive glasses. There have been demonstrated the matrix techniques, special attention being paid to innovative technologies of rapid prototyping — the process of 3D-imaging according to a digital model. The most applicable of these techniques for biopolymers are laser stereolithography, selective laser sintering, fused deposition modeling, and 3D-printing. Great emphasis has been put on the use of bioactive substances in the process of obtaining scaffold-based bioengineered constructions — setting of stem cells on matrices before their transplantation to the defect area. Special attention has been given to a current trend of cellular biology — the application of multipotent mesenchymal stromal cells (most common marrow cells used in bone tissue regeneration, in particular, the available sources of their isolation and the variants of directed osteogenic differentiation have been presented. The review covers the characteristics and aims of bioactive substance inclusion in scaffold structure — not only to induce osteogenic differentiation, but also to attract new stem cells of a carrier, as well as promote angiogenesis.

  17. Impact of cytomegalovirus and grafts versus host disease on the dynamics of CD57+CD28-CD8+ T cells after bone marrow transplant

    Directory of Open Access Journals (Sweden)

    Ana Verena Almeida Mendes

    2008-01-01

    Full Text Available OBJECTIVES: The present study aimed to evaluate the dynamics of CD28 and CD57 expression in CD8+ T lymphocytes during cytomegalovirus viremia in bone marrow transplant recipients. METHODS: In a prospective study, blood samples were obtained once weekly once from 33 healthy volunteers and weekly from 33 patients. To evaluate the expression of CD57 and CD28 on CD8+ T lymphocytes, flow cytometry analysis was performed on blood samples for four months after bone marrow transplant, together with cytomegalovirus antigenemia assays. RESULTS: Compared to cytomegalovirus-seronegative healthy subjects, seropositive healthy subjects demonstrated a higher percentage of CD57+ and a lower percentage of CD28+ cells (p<0.05. A linear regression model demonstrated a continuous decrease in CD28+ expression and a continuous increase in CD57+ expression after bone marrow transplant. The occurrence of cytomegalovirus antigenemia was associated with a steep drop in the percentage of CD28+ cells (5.94%, p<0.01 and an increase in CD57+ lymphocytes (5.60%, p<0.01. This cytomegalovirus-dependent effect was for the most part concentrated in the allogeneic bone marrow transplant patients. The development of acute graft versus host disease, which occurred at an earlier time than antigenemia (day 26 vs. day 56 post- bone marrow transplant, also had an impact on the CD57+ subset, triggering an increase of 4.9% in CD57+ lymphocytes (p<0.05. CONCLUSION: We found continuous relative changes in the CD28+ and CD57+ subsets during the first 120 days post- bone marrow transplant, as part of immune system reconstitution and maturation. A clear correlation was observed between the expansion of the CD57+CD28-CD8+ T lymphocyte subpopulation and the occurrence of graft versus host disease and cytomegalovirus viremia.

  18. MC1288, a vitamin D analog, prevents acute graft-versus-host disease in rat bone marrow transplantation.

    Science.gov (United States)

    Pakkala, I; Taskinen, E; Pakkala, S; Räisänen-Sokolowski, A

    2001-04-01

    The major obstacle to successful bone marrow transplantation (BMT) is graft-versus-host disease (GVHD). Vitamin D analogs have shown their efficacy in solid organ transplantation. The purpose of this study was to investigate the suitability of a novel vitamin D analog, MC1288, in the prevention of acute GVHD in a rat BMT model. Allogeneic BMT were performed from Lewis to BN rats (n = 18). The animals were divided into four groups: an untreated control group, MC1288, cyclosporin A (CsA), and MC1288 + CsA-treated groups. Rats were harvested for histology and immunohistochemistry on day 20 after BMT. Histological changes for GVHD in liver, skin, and spleen were scored. Positivity in immunostaining was quantified as the number of positive cells/high power field. Treatment with MC1288 decreased clinical signs of GVHD compared with untreated or CsA-treated rats. Histological manifestations of GVHD, expressed as mean total increment, were significantly lower (1.4 +/- 0.5) in MC1288 than in untreated (5.0 +/- 1.6) or CsA (3.5 +/- 1.0) groups. Combining MC1288 and CsA further improved histology (1.1 +/- 0.6). The expression of CD4, CD8, MHC class II, interleukin-2 receptor, nitric oxide 2, and NKR-P1A (NK cells) positivity was significantly decreased in the liver and skin of BMT rats by MC1288. MC1288 was effective in preventing clinical and histological signs and symptoms of GVHD. This novel vitamin D analog could be used as an immunomodulating agent in BMT.

  19. Immediate placement and provisionalization of maxillary anterior single implant with guided bone regeneration, connective tissue graft, and coronally positioned flap procedures.

    Science.gov (United States)

    Waki, Tomonori; Kan, Joseph Y K

    2016-01-01

    Immediate implant placement and provisionalization in the esthetic zone have been documented with success. The benefit of immediate implant placement and provisionalization is the preservation of papillary mucosa. However, in cases with osseous defects presenting on the facial bony plate, immediate implant placement procedures have resulted in facial gingival recession. Subepithelial connective tissue grafts for immediate implant placement and provisionalization procedures have been reported with a good esthetic outcome. Biotype conversion around implants with subepithelial connective tissue grafts have been advocated, and the resulting tissues appear to be more resistant to recession. The dimensions of peri-implant mucosa in a thick biotype were significantly greater than in a thin biotype. Connective tissue graft with coronally positioned flap procedures on natural teeth has also been documented with success. This article describes a technique combining immediate implant placement, provisionalization, guided bone regeneration (GBR), connective tissue graft, and a coronally positioned flap in order to achieve more stable peri-implant tissue in facial osseous defect situations.

  20. Immediate placement and provisionalization of maxillary anterior single implant with guided bone regeneration, connective tissue graft, and coronally positioned flap procedures.

    Science.gov (United States)

    Waki, Tomonori; Kan, Joseph Y K

    2016-01-01

    Immediate implant placement and provisionalization in the esthetic zone have been documented with success. The benefit of immediate implant placement and provisionalization is the preservation of papillary mucosa. However, in cases with osseous defects presenting on the facial bony plate, immediate implant placement procedures have resulted in facial gingival recession. Subepithelial connective tissue grafts for immediate implant placement and provisionalization procedures have been reported with a good esthetic outcome. Biotype conversion around implants with subepithelial connective tissue grafts have been advocated, and the resulting tissues appear to be more resistant to recession. The dimensions of peri-implant mucosa in a thick biotype were significantly greater than in a thin biotype. Connective tissue graft with coronally positioned flap procedures on natural teeth has also been documented with success. This article describes a technique combining immediate implant placement, provisionalization, guided bone regeneration (GBR), connective tissue graft, and a coronally positioned flap in order to achieve more stable peri-implant tissue in facial osseous defect situations. PMID:27092345

  1. Comparison of three calcium phosphate bone graft substitutes from biomechanical, histological, and crystallographic perspectives using a rat posterolateral lumbar fusion model

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Ming-Hsien [Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Department of Orthopedics, Show-Chwan Memorial Hospital, Changhua 50544, Taiwan (China); Department of Orthopedic Surgery, Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan (China); Lee, Pei-Yuan [Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Department of Orthopedics, Show-Chwan Memorial Hospital, Changhua 50544, Taiwan (China); Chen, Wen-Cheng, E-mail: wincheng0925@yahoo.com.tw [Department of Fiber and Composite Materials, College of Engineering, Feng Chia University, Taichung 40724, Taiwan (China); Hu, Jin-Jia, E-mail: jjhu@mail.ncku.edu.tw [Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Medical Device Innovation Center, National Cheng Kung University, Tainan 701, Taiwan (China)

    2014-12-01

    This study evaluated the effectiveness of three calcium phosphate bone graft substitutes with different chemical compositions on spinal fusion using a rat posterolateral lumbar fusion model. Specifically, two recently developed non-dispersive tetracalcium phosphate/dicalcium phosphate anhydrous-based calcium phosphate cements (CPCs), namely a CPC consisting of equimolar amounts of the two compounds (nd-CPC) and a CPC consisting of a two-fold greater amount of dicalcium phosphate anhydrous (DCP-rich CPC), were compared with a commercial calcium phosphate bone graft (c-CPG) consisting of hydroxyapatite (60%) and β-tricalcium phosphate (40%). Single-level posterolateral lumbar fusion was performed at the L4–L5 vertebrae in fifteen adult rats (n = 5 for each group). Spinal fusion was evaluated with radiographs, manual palpation, mechanical testing, micro-CT, and histology 8 weeks post-surgery. In particular, the crystallographic phases in the three substitutes were identified before and 8 weeks after their implantation. Manual palpation revealed stable constructs in nearly all of the spine specimens. The stiffness and bending load of fused spines in the two CPC groups were comparable to those in the c-CPG group. The radiographs specifically revealed implant resorption and bone remodeling in the DCP-rich CPC group. Analysis of 3D micro-CT images revealed that the bone volume ratio in the DCP-rich CPC group was significantly greater than those in the nd-CPC and c-CPG groups. Histology showed that the DCP-rich CPC group exhibited the highest degree of bone regeneration and osseointegration. Notably, DCP-rich CPC led to a pronounced phase transformation, generating the greatest amount of poorly crystalline apatite among the three groups, which together with adequate resorption may explain the aforementioned positive findings. We therefore conclude that of the bone graft substitutes considered, DCP-rich CPC has the greatest potential to be used in spinal fusion

  2. Evaluation of anorganic bovine-derived hydroxyapatite matrix/cell binding peptide as a bone graft material in the treatment of human periodontal infrabony defects: A clinico-radiographic study

    OpenAIRE

    Ghousia Fatima; Ravindra Shivamurthy; Srinath Thakur; Mohammad Abdul Baseer

    2015-01-01

    Background: Various bone graft materials have been used in the treatment of periodontal defects. A synthetic bone substitute material composed of P-15 with anorganic bone mineral has been scantly studied. Hence, the present study was aimed to evaluate and compare the efficacy of anorganic bovine-derived hydroxyapatite matrix (ABM)/cell binding peptide (P-15) in human periodontal infrabony defects with that of open flap debridement (OFD) alone. Materials and Methods: A split-mouth, randomized ...

  3. THE EFFECT OF SKIN GRAFTING AT DIFFERENT TIME POST BLOOD TRANSFUSION AND BONE MARROW TRANSPLANTATION ON RATS COMBINED RADIATION--BURN INJURY

    Institute of Scientific and Technical Information of China (English)

    冉新泽; 阎永堂; 程天民; 林远; 郑怀恩; 魏书庆

    1998-01-01

    After the rats were iufficted with 8Gy total body gamma ray irradiation and 15% total body surface area (TBSA) full thickness burn injury, they were treated with blood transfusion (BT) and bone marrow transplantation (BMT). Then the survival of allografts grafted on the eschareetomized burn wounds in the 24, 48 and 72 h postinjury was observed. It was found that when the burn wounds were closed with allografts in the 24h postinjury, there were an early elevation of leucocytes, the appearance of the donor''s cells and a significantly higher survival rate of the rats on the 30 day postinjury. The allogaafts could survive longer and wounds showed no signs of infection and healed quicker. When the allografts were grafted in the 48 h or 72 h postinjury, only harmful effects to hasten the death of rats were observed.

  4. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review

    Science.gov (United States)

    Salgotra, Kuldip; Kohli, Sarabjeet; Vishwakarma, Nilesh

    2016-01-01

    Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft) and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG) using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7%) men and 1 (14.3%) women among the patients. Overall 5 (71.5%) patients had transcervical and 2 (28.5%) had subcapital fractures. At the end of 6 months, 6 (85.7%) patients were pain free and on plain radiographs fracture union was noted. One (14.3%) patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures. PMID:27331067

  5. Mitigation strategies for autogenous shrinkage cracking

    DEFF Research Database (Denmark)

    Bentz, Dale P.; Jensen, Ole Mejlhede

    2004-01-01

    of the cement, the addition of saturated lightweight fine aggregates, the use of controlled permeability formwork, and the new concept of "water-entrained" concrete. As with any remedy, new problems may be created by the application of each of these strategies. But, with careful attention to detail in the field......As the use of high-performance concrete has increased, problems with early-age cracking have become prominent. The reduction in water-to-cement ratio, the incorporation of silica fume, and the increase in binder content of high-performance concretes all contribute to this problem. In this paper......, the fundamental parameters contributing to the autogenous shrinkage and resultant early-age cracking of concrete are presented. Basic characteristics of the cement paste that contribute to or control the autogenous shrinkage response include the surface tension of the pore solution, the geometry of the pore...

  6. Analysis on Application Bottleneck of Repairing Bone Defects with Tissue Engineered Bone%组织工程骨修复骨缺损的应用瓶颈分析

    Institute of Scientific and Technical Information of China (English)

    李凯

    2012-01-01

    Bone defects caused by bone cancer treatment are common in clinical, however the only way to repair the defects is bone graft. According to sources, the bone graft material can be divided into autogenous bone, allograft bone ,xenograft bone and artificial bone substitute materials. The rise of bone tissue engineering brings new options for the treatment of bone defects. The use of artificial bone tissue engineering training not only fixes the large area of bone defect, but also can be prepared and shaped in large quantity according to need,which makes it an ideal bone repair material. Here is to make a review' on the application status of tissue engineered bone in the treatment of bone defects.%骨肿瘤的治疗导致骨缺损很常见,修复缺损的方法是采取骨移植.骨移植材料根据来源大致可分为自体骨、同种异体骨、异种骨和人工骨替代材料.骨组织工程的兴起为骨缺损的治疗带来新的选择.利用骨组织工程培养的人工骨不仅可以修复大面积骨缺损,而且可以按需塑形并大量制备,是一种理想的骨修复材料.现就组织工程骨在治疗骨缺损中的应用现状进行综述.

  7. Influence of physico-chemical material characteristics on staphylococcal biofilm formation – A qualitative and quantitative in vitro analysis of five different calcium phosphate bone grafts

    Directory of Open Access Journals (Sweden)

    M Clauss

    2014-07-01

    Full Text Available Various compositions of synthetic calcium phosphates (CaP have been proposed and their use has considerably increased over the past decades. Besides differences in physico-chemical properties, resorption and osseointegration, artificial CaP bone graft might differ in their resistance against biofilm formation. We investigated standardised cylinders of 5 different CaP bone grafts (cyclOS, chronOS (both β-TCP (tricalcium phosphate, dicalcium phosphate (DCP, calcium-deficient hydroxyapatite (CDHA and α-TCP. Various physico-chemical characterisations e.g., geometrical density, porosity, and specific surface area were investigated. Biofilm formation was carried out in tryptic soy broth (TSB and human serum (SE using Staphylococcus aureus (ATCC 29213 and S. epidermidis RP62A (ATCC 35984. The amount of biofilm was analysed by an established protocol using sonication and microcalorimetry. Physico-chemical characterisation showed marked differences concerning macro- and micropore size, specific surface area and porosity accessible to bacteria between the 5 scaffolds. Biofilm formation was found on all scaffolds and was comparable for α-TCP, chronOS, CDHA and DCP at corresponding time points when the scaffolds were incubated with the same germ and/or growth media, but much lower for cyclOS. This is peculiar because cyclOS had an intermediate porosity, mean pore size, specific surface area, and porosity accessible to bacteria. Our results suggest that biofilm formation is not influenced by a single physico-chemical parameter alone but is a multi-step process influenced by several factors in parallel. Transfer from in vitro data to clinical situations is difficult; thus, advocating the use of cyclOS scaffolds over the four other CaP bone grafts in clinical situations with a high risk of infection cannot be clearly supported based on our data.

  8. Influence of physico-chemical material characteristics on staphylococcal biofilm formation--a qualitative and quantitative in vitro analysis of five different calcium phosphate bone grafts.

    Science.gov (United States)

    Clauss, M; Furustrand Tafin, U; Betrisey, B; van Garderen, N; Trampuz, A; Ilchmann, T; Bohner, M

    2014-07-18

    Various compositions of synthetic calcium phosphates (CaP) have been proposed and their use has considerably increased over the past decades. Besides differences in physico-chemical properties, resorption and osseointegration, artificial CaP bone graft might differ in their resistance against biofilm formation. We investigated standardised cylinders of 5 different CaP bone grafts (cyclOS, chronOS (both β-TCP (tricalcium phosphate)), dicalcium phosphate (DCP), calcium-deficient hydroxyapatite (CDHA) and α-TCP). Various physico-chemical characterisations e.g., geometrical density, porosity, and specific surface area were investigated. Biofilm formation was carried out in tryptic soy broth (TSB) and human serum (SE) using Staphylococcus aureus (ATCC 29213) and S. epidermidis RP62A (ATCC 35984). The amount of biofilm was analysed by an established protocol using sonication and microcalorimetry. Physico-chemical characterisation showed marked differences concerning macro- and micropore size, specific surface area and porosity accessible to bacteria between the 5 scaffolds. Biofilm formation was found on all scaffolds and was comparable for α-TCP, chronOS, CDHA and DCP at corresponding time points when the scaffolds were incubated with the same germ and/or growth media, but much lower for cyclOS. This is peculiar because cyclOS had an intermediate porosity, mean pore size, specific surface area, and porosity accessible to bacteria. Our results suggest that biofilm formation is not influenced by a single physico-chemical parameter alone but is a multi-step process influenced by several factors in parallel. Transfer from in vitro data to clinical situations is difficult; thus, advocating the use of cyclOS scaffolds over the four other CaP bone grafts in clinical situations with a high risk of infection cannot be clearly supported based on our data.

  9. Bone mesenchymal stem cell sheet transplantation combined with autologous iliac bone for repair of alveolar cleft%骨髓间充质干细胞膜片复合自体髂骨移植修复牙槽嵴裂

    Institute of Scientific and Technical Information of China (English)

    沈悦; 马海英; 张彦升; 王娟; 时炳正

    2014-01-01

    BACKGROUND:Autogenous iliac bone graft for repair of alveolar cleft often cannot achieve a stable therapeutic effect, and the graft resorption rate varies with each individual that is influenced by many factors. OBJECTIVE:To observe the bone resorption after bone marrow mesenchymal stem cel sheet transplantation with autogenous iliac cancelous bone for alveolar cleft repair. METHODS:Bilateral alveolar cleft models were prepared in dogs. Using the self-control method, bone marrow mesenchymal stem cel sheet combined with autogenous iliac bone (experimental group) and autogenous iliac bone alone (control group) were respectively implanted into the bilateral alveolar clefts. Mandible CT and microCT were used to compare the bone resorption rate, bone volume fraction, trabecular thickness, trabecular separation, and bone mineral density. RESULTS AND CONCLUSION:The bone resorption rate was significantly lower in the experimental group than the control group at 3 and 6 postoperative months (P 0.05). These findings indicate that bone marrow mesenchymal stem cel sheet transplantation combined with autogenous iliac bone graft can reduce bone resorption rate and meanwhile, promote new bone formation.%背景:临床上使用自体髂骨移植方法修复牙槽嵴裂,常常不能获得稳定的治疗效果,移植骨吸收率因人而异,受到许多因素的影响。  目的:观察骨髓间充质干细胞膜片复合自体髂骨松质骨块移植修复牙槽嵴裂术后的骨吸收情况。  方法:制备实验犬双侧牙槽嵴裂模型,采用自体对照的办法,在实验犬上颌骨两侧的裂隙分别植入骨髓间充质干细胞膜片复合犬自体髂骨骨块(实验组)和单纯犬自体髂骨骨块(对照组)。通过颌骨CT及micro CT对植骨区的骨吸收率、骨体积分数、骨小梁厚度、骨小梁分离度、骨密度进行比较。  结果与结论:术后3,6个月时实验组的骨吸收率明显低于对照组,差

  10. The bone marrow microenvironment is similarly impaired in allogeneic hematopoietic stem cell transplantation patients with early and late poor graft function.

    Science.gov (United States)

    Kong, Y; Wang, Y-T; Hu, Y; Han, W; Chang, Y-J; Zhang, X-H; Jiang, Z-F; Huang, X-J

    2016-02-01

    Poor graft function (PGF), including early and late PGF, is a serious complication following allotransplant. We recently reported that bone marrow microenvironment abnormalities may occur in cases of late PGF. Whether these abnormalities occur in early PGF remains unknown. To answer this question, we performed a nested case-control study comparing cellular elements of the bone marrow microenvironment in 10 subjects with early PGF, 30 subjects with late PGF and 40 subjects without PGF. Bone marrow endosteal cells, perivascular cells and endothelial cells were analyzed by flow cytometry and by hematoxylin-eosin and immunohistochemical staining in situ. Subjects with early and late PGF had similar abnormalities in these cell types compared with transplant recipients without PGF. However, none of the aforementioned elements of the bone marrow microenvironment were significantly different between early and late PGF patients. Our data suggest that similar abnormalities in the bone marrow microenvironment may occur in early and late PGF post allotransplant. Cellular approaches, such as the administration of mesenchymal stem cells, promise to be beneficial therapeutic strategies in patients with early or late PGF.

  11. Nanomaterial N-CP/DLPLG as potent1onal tissue graft in osteoreparation in combination with bone marrow cells on subcutaneous implantation model

    Directory of Open Access Journals (Sweden)

    Janićijević Jelena M.

    2008-01-01

    Full Text Available The need for bone graft materials in osteoreparation is tremendous. Many researches have shown that calcium-phosphate bioceramics have good biocompatibility and osteoconductivity. We used nanocomposite biomaterial calcium phosphate coated with poly (dl-lactide-co-glycolide or N-CP/DLPLG. The goal of this investigation was to examine weather N-CP/DLPLG has ability to sustain growth of bone marrow cells after subcutaneous implantation in Balb/c mice. For that purpose N-CP/DLPLG implants with and without bone marrow cells (control were made. Implants were extracted after eight days and eight weeks. In implants loaded with bone marrow cells after eight days and eight weeks we observed fields rich in cells, angiogenesis and collagen genesis. These results showed that N-CP/DLPLG has property of tissue scaffold which sustain bone marrow cells growth and collagen production. This represents a good way for further examination of N-CP/DLPLG as potentional tissue scaffold in osteoreparation.

  12. 聚甲基丙烯酸甲酯和自体骨加强的椎弓根螺钉技术治疗退变性脊柱侧凸的临床疗效比较%Autogenous bone and polymethylmethacrylate augmentation of screw fixation for degenerative scoliosis

    Institute of Scientific and Technical Information of China (English)

    谢杨; 傅强; 陈自强; 石志才; 朱晓东; 孙晓飞; 李明

    2012-01-01

    Objective To compare the clinical effect of autogenous bone and polymethylmethacrylate (PMMA) augmentation of screw fixation in degenerative scoliosis with osteoporosis. Methods A retrospective analysis was conducted on 31 consecutive patients with degenerative scoliosis combined with osteoporosis who accepted pedicle screw fixation from December 2000 to December 2006. Fourteen of them underwent fixation with pedicle screw by augmentation with PMMA and the other 17 patients with autogenous bone. Peri-operative data were recorded. Preoperative, postoperative and final follow up corrective effects were compared. Results No significant difference was found in clinical data except for administration time of oral pain relief medicines and surgery cost between the two surgical strategies. Cement leakage was observed in 2 patients in PMMA augmentation group, but there was no evidence of nerve damage. Conclusion There is no difference in surgical effect between two surgery strategies on degenerative scoliosis combined with osteoporosis. Less oral pain medicines are taken in the polymethylmethacrylate-augmented pedicle screw fixation and fusion, but with much more cost and danger of cement leakage.%目的 比较应用聚甲基丙烯酸甲酯( PMMA)和自体骨加强的椎弓根螺钉技术治疗合并骨质疏松的退变性脊柱侧凸的临床疗效.方法 回顾性分析2000年12月至2006年12月手术治疗的31例伴骨质疏松的退变性脊柱侧凸患者,其中14例采用PMMA加强钉道,17例采用自体骨加强钉道.记录并发症等围手术期情况,比较手术前后及随访期间侧凸的矫正效果.结果 两种手术除口服止痛药使用时间和手术费用外,其他临床数据差异无统计学意义,PMMA加强组中2例出现骨水泥渗漏,但未出现神经损伤的症状.结论 两种手术对伴骨质疏松的退变性脊柱侧凸的临床疗效无明显差异,PMMA加强的椎弓根螺钉内固定融合术可减少口服止痛药的用量,

  13. Bolt from the Blue: A Large Foreign Body in the Maxillary Antrum Necessitating Delayed Primary Reconstruction with Split Cranial Bone Graft.

    Science.gov (United States)

    Sharma, Ramesh K; Vemula, Guru Karna; John, Jerry R

    2016-09-01

    We report an unusual case of a large metallic foreign body embedded in the maxillary antrum leading to extensive bony destruction of the mid-face following a road side accident in a 12-year-old boy. There was extensive bony loss that necessitated reconstruction for both aesthetic and functional reasons. The same was accomplished by using split cranial bone graft in a delayed primary manner after a gap of 7 days following initial debridement. There was primary healing with good aesthetic and functional results. PMID:27516840

  14. 正畸牙移入牙槽突裂患者植骨区的牙CT评价%Evaluation of orthodontic teeth moving in bone graft area by dental CT

    Institute of Scientific and Technical Information of China (English)

    吴军; 王国民

    2012-01-01

    Objective To evaluate alveolar bone shape changing after orthodontic teeth moving in the alveolar bone graft area by dental CT. Methods Three unilateral complete alveolar cleft patients were chosen in this study. Patients were examined before and after alveolar bone grafting, after orthodontic treatment by dental CT. The alveolar bone shape changing after orthodontic teeth moving in bone graft area was evaluated. Results The orthodontic teeth could move in the bony graft area, and graft alveolar bone could reshape the morphology followed the teeth move in. Conclusion Alveolar bone grafting and orthodontic treatment are good for reconstruct dental arch integrity.%目的 应用牙CT评价正畸牙移入牙槽突裂患者植骨区后牙槽骨的形态变化.方法 对3位牙槽突裂患者在植骨前后和正畸治疗后行牙槽突裂裂隙区的三维牙CT检查,分析正畸牙移入植骨区域后,正畸牙位置及牙槽骨的形态变化.结果 牙槽突裂植骨术后,正畸牙可以顺利移入植入骨区域,正畸牙的牙根尖位置发生明显的位移,牙槽骨会随正畸牙的移动发生塑形改变,而不仅仅是牙齿在牙槽骨内的移动.结论 牙槽突裂植骨及正畸治疗有益于重建牙弓的完整性.

  15. A comparative study of the regenerative effect of sinus bone grafting with platelet-rich fibrin-mixed Bio-Oss® and commercial fibrin-mixed Bio-Oss®: an experimental study.

    Science.gov (United States)

    Xuan, Feng; Lee, Chun-Ui; Son, Jeong-Seog; Jeong, Seung-Mi; Choi, Byung-Ho

    2014-06-01

    Anorganic bovine bone (Bio-Oss®) particles are one of the most popular grafting materials. The particles are often mixed with platelet-rich fibrin (PRF) or a commercial fibrin (Tisseel®) to form a mouldable graft material. The objective of this study was to compare the potentials of PRF-mixed Bio-Oss® and Tisseel®-mixed Bio-Oss® to enhance bone regeneration in a canine sinus model. Six mongrel dogs were used in this study. After elevating the sinus membrane in both maxillary sinus cavities, an implant was placed into the sinus cavity. In one of the sinus cavities, the PRF/Bio-Oss® composite was grafted, and the Tisseel®/Bio-Oss® composite was grafted in the other sinus cavity. After a 6 month healing period, bone formation in the graft sites and bone-implant contact were evaluated. The mean osseointegration rate was 43.5 ± 12.4% and new bone formation rate 41.8 ± 5.9% in the PRF/Bio-Oss® composite sites. In the Tisseel®/Bio-Oss® composite sites they were 30.7 ± 7.9% and 31.3 ± 6.4%. There were statistically significant differences between the groups. The findings from this study suggest that when platelet-rich fibrin is used as an adjunct to Bio-Oss® particles for bone augmentation in the maxillary sinus, bone formation in the graft sites is significantly greater than when Tisseel® is used. PMID:23911120

  16. [Distraction osteogenesis of deficient alveolar bone prior to dental rehabilitation].

    Science.gov (United States)

    Shilo, D; Emodi, O; Aizenbud, D; Rachmiel, A

    2015-07-01

    Implant supported rehabilitation has become very common in treatment plans nowadays, yet many patients lack the vertical and horizontal bone dimensions required for endosseous implant insertion. Distraction osteogenesis is a technique in which bone is generated by progressive elongation of two bone fragments following an osteotomy or corticotomy. Distraction osteogenesis of the alveolar ridge as a treatment modality in implant dentistry is a very useful technique that allows for adequate bone formation suitable for implant insertion. Alveolar distraction can be unidirectional, bidirectional, multidirectional or horizontal. Alveolar distraction osteogenesis can be performed by using intraosseous distraction devices, intraosseous distraction implants or by extraosseous devices which are the most prevalent today. Distraction osteogenesis has many advantages such as gradual lengthening of the bone with no need for an autogenous bone graft and lack of the associated donor site morbidity as well as distraction of the surrounding soft tissue together with the transported bone. One of the major challenges when using alveolar distraction osteogenesis is controlling the vector of distraction, this problem should be further addressed in future researches. We describe different methods for alveolar distraction osteogenesis, including the surgical procedure, latency period, lengthening and consolidation period. We also discuss the advantages, disadvantages and complications of the method. In this manuscript a case of mandibular alveolar deficiency following mandibular fracture and loss of teeth and the alveolar bone is presented. This patient was treated by alveolar distraction osteogenesis with excellent results. This patient was later rehabilitated . using endosseous implants as demonstrated by radiographs. Alveolar distraction osteogenesis provides a method to regain both hard tissue and soft tissue without additional grafting and is an efficient modality in cases of medium

  17. Marginal bone resorption around dental implants placed in grafted sinuses; an up-to-30-month clinical and radiological follow-up

    International Nuclear Information System (INIS)

    Objective: To determine the relative success of two different bone grafting material - putty and powder forms of De-mineralised Bone Matrix (DBM) - used in sinus lift procedure. Methods: The retrospective study was conducted at the Department of Oral and Maxillofacial Surgery, Ankara University, Ankara, Turkey, and comprised data related to the patients referred for bilateral maxillary sinus augmentation between 2007 and 2010. During the period, 48 endoosseous implants were placed concurrently with the sinus augmentation in 12 patients. Marginal bone loss around the implants was measured at the time of loading, 12 and 30 months after the treatment. SPSS 11.5 was used for data analysis. Results: Of the 12 patients, 8 (66.6%) were females and 4 (33.3%) were males. All implants osseointegrated in both the putty and powder groups well without any significant clinical finding. Th