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Sample records for ceramic bone graft

  1. Calcium phosphate ceramics as bone graft substitutes in filling bone tumor defects

    Directory of Open Access Journals (Sweden)

    Saikia K

    2008-01-01

    Full Text Available Background: Synthetic bio-inert materials are currently used as an alternative to autogenous bone graft. Calcium hydroxyapatite (HA and Beta tri-calcium phosphate (β-TCP, which belong to the calcium phosphate ceramics group, are biocompatible and osteo-conductive. The purpose of this study is to analyse the use of HA and β-TCP in their ceramic forms as a bone graft substitute in filling bone voids after curettage of benign bone tumors. Materials and Methods: Twenty-four patients in the age range of 3.5-55 years (mean 14.3 years having benign bone tumors with bone defects were filled with bone graft substitute following curettage. In 20 patients bone defects were filled with block/granules of HA ceramic and in four with β-TCP. Fibular strut graft was packed with HA in four patients. The patients were followed up for an average of 18 months (range 12-36 months. Results: The functional status of the patients at follow-up was evaluated and compared with preoperative functional status. Early incorporation of graft substitutes became evident radiologically between 6 and 10 weeks (Stage I. Complete incorporation (Stage III was observed in an average of nine months (6-18 months. Clinical healing was observed before radiological healing. The average time taken to return to preoperative function was 14 weeks. There was no recurrence of lesion or growth retardation. Conclusion: Calcium hydroxyapatite and β-TCP are excellent bone graft substitutes for autogenous bone graft in filling voids after curettage of benign bone tumors.

  2. Osteoinductive ceramics as a synthetic alternative to autologous bone grafting

    NARCIS (Netherlands)

    Yuan, Huipin; Fernandes, H.A.M.; Habibovic, Pamela; de Boer, Jan; Barradas, A.M.C.; de Ruiter, Ad; Walsh, William R.; van Blitterswijk, Clemens; de Bruijn, Joost Dick

    2010-01-01

    Biomaterials can be endowed with biologically instructive properties by changing basic parameters such as elasticity and surface texture. However, translation from in vitro proof of concept to clinical application is largely missing. Porous calcium phosphate ceramics are used to treat small bone

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  4. Remodeling of injectable, low-viscosity polymer/ceramic bone grafts in a sheep femoral defect model.

    Science.gov (United States)

    Talley, Anne D; McEnery, Madison A; Kalpakci, Kerem N; Zienkiewicz, Katarzyna J; Shimko, Daniel A; Guelcher, Scott A

    2017-11-01

    Ceramic/polymer composite bone grafts offer the potential advantage of combining the osteoconductivity of ceramic component with the ductility of polymeric component, resulting in a graft that meets many of the desired properties for bone void fillers (BVF). However, the relative contributions of the polymer and ceramic components to bone healing are not well understood. In this study, we compared remodeling of low-viscosity (LV) ceramic/poly(ester urethane) composites to a ceramic BVF control in a sheep femoral condyle plug defect model. LV composites incorporating either ceramic (LV/CM) or allograft bone (LV/A) particles were evaluated. We hypothesized that LV/CM composites which have the advantageous handling properties of injectability, flowability, and settability would heal comparably to the CM control, which was evaluated for up to 2 years to study its long-term degradation properties. Remodeling of LV/CM was comparable to that observed for the CM control, as evidenced by new bone formation on the surface of the ceramic particles. At early time points (4 months), LV/CM composites healed similar to the ceramic clinical control, while LV/A components showed more variable healing due to osteoclast-mediated resorption of the allograft particles. At longer time points (12-15 months), healing of LV/CM composites was more variable due to the nonhomogeneous distribution and lower concentration of the ceramic particles compared to the ceramic clinical control. Resorption of the ceramic particles was almost complete at 2 years. This study highlights the importance of optimizing the loading and distribution of ceramic particles in polymer/ceramic composites to maximize bone healing. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2333-2343, 2017. © 2016 Wiley Periodicals, Inc.

  5. Bone grafting: An overview

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    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

  6. 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.

  7. Biocompatibility and antibacterial effect of silver doped 3D-glass-ceramic scaffolds for bone grafting.

    Science.gov (United States)

    Balagna, Cristina; Vitale-Brovarone, Chiara; Miola, Marta; Verné, Enrica; Canuto, Rosa Angela; Saracino, Silvia; Muzio, Giuliana; Fucale, Giacomo; Maina, Giovanni

    2011-02-01

    A 3D-glass-ceramic scaffold for bone tissue engineering with an interconnected macroporous network of pores was doped with silver ions in order to confer antibacterial properties. For this purpose, silver ions were selectively added to the scaffold surfaces through ion-exchange using an aqueous silver nitrate solution. The silver-doped scaffolds were characterized by means of leaching, in vitro antibacterial, and citotoxicity tests. In particular, the silver effect was examined through a broth dilution test in order to evaluate the proliferation of bacteria by counting the colonies forming units. Moreover, cytotoxicity tests were carried out to understand the effect of silver-containing scaffolds on cell adhesion, proliferation, and vitality. For all tests a comparison between silver-doped scaffold and silver-doped scaffold dry sterilized was performed.

  8. Negative effect of rapidly resorbing properties of bioactive glass-ceramics as bone graft substitute in a rabbit lumbar fusion model.

    Science.gov (United States)

    Lee, Jae Hyup; Ryu, Hyun-Seung; Seo, Jun-Hyuk; Lee, Do-Yoon; Chang, Bong-Soon; Lee, Choon-Ki

    2014-03-01

    Bioactive glass-ceramics have the ability to directly bind to bones and have been widely used as bone graft substitutes due to their high osteoconductivity and biocompatibility. CaO-SiO2-P2O5-B2O3 glass-ceramics are known to have good osteoconductivity and are used as bone graft extenders. This study aimed to evaluate the effects of the resorbing properties of glass-ceramics in bone fusion after producing and analyzing three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with high osteoconductivity that had enhanced resorption by having an increased B2O3 content. The three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with B2O3 contents of 8.0, 9.0, and 9.5 weight % were designated and grouped as P20B80, P10B90, and P5B95, respectively. Glass-ceramic types were tested for fusion rates and bone formation by employing the lumbar 5-6 intertransverse process fusion model in 51 New Zealand male rabbits. Bioactivity was assessed by soaking in simulated body fluid (SBF). In vitro study results showed sufficient hydroxycarbonate apatite layer formation occurred for P20B80 in1 day, for P10B90 in 3 days, and for P5B95 in 5 days after soaking in SBF. For the rabbit lumbar spine posterolateral fusion model, the autograft group recorded a 100% fusion rate with levels significantly higher than those of P20B80 (29.4%), P10B90 (0%), and P5B95 (14.3%), with high resorbing properties. Resorbing property differences among the three glass-ceramic groups were not significant. Histological results showed new bone formation confirming osteoconductivity in all three types of glass-ceramics. Radiomorphometric results also confirmed the resorbing properties of the three glass-ceramic types. The high resorbing properties and osteoconductivity of porous glass-ceramics can be advantageous as no glass-ceramics remain in the body. However, their relatively fast rate of resorption in the body negatively affects their role as an osteoconductive scaffold as glass-ceramics are resorbed before bony fusion.

  9. Novel Method for Loading Microporous Ceramics Bone Grafts by Using a Directional Flow

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    Michael Seidenstuecker

    2015-12-01

    Full Text Available The aim of this study was the development of a process for filling the pores of a β-tricalcium phosphate ceramic with interconnected porosity with an alginate hydrogel. For filling of the ceramics, solutions of alginate hydrogel precursors with suitable viscosity were chosen as determined by rheometry. For loading of the porous ceramics with the gel the samples were placed at the flow chamber and sealed with silicone seals. By using a vacuum induced directional flow, the samples were loaded with alginate solutions. The loading success was controlled by ESEM and fluorescence imaging using a fluorescent dye (FITC for staining of the gel. After loading of the pores, the alginate is transformed into a hydrogel through crosslinking with CaCl2 solution. The biocompatibility of the obtained composite material was tested with a live dead cell staining by using MG-63 Cells. The loading procedure via vacuum assisted directional flow allowed complete filling of the pores of the ceramics within a few minutes (10 ± 3 min while loading through simple immersion into the polymer solution or through a conventional vacuum method only gave incomplete filling.

  10. Bone Graft Alternatives

    Science.gov (United States)

    ... created in or between the bones of the spine by disease, injury, deformity or during a surgical procedure such as spinal ... be used in surgical procedures to stabilize the spine after a fracture or to correct deformity. What are Bone Graft Substitutes? Since both allograft ...

  11. Streamlining the generation of an osteogenic graft by 3D culture of unprocessed bone marrow on ceramic scaffolds.

    NARCIS (Netherlands)

    Ganguly, Anindita; Renard, A.J.S.; Jolink, C.; van Blitterswijk, Clemens; de Boer, Jan

    2012-01-01

    Mesenchymal stromal cells are present in very low numbers in the bone marrow, necessitating their selective expansion on tissue culture plastic prior to their use in tissue-engineering applications. MSC expansion is laborious, time consuming, unphysiological and not economical, thus calling for

  12. Dynamics of bone graft healing around implants

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    Narayan Venkataraman

    2015-01-01

    A few questions arise pertaining to the use of bone grafts along with implants are whether these are successful in approximation with implant. Do they accelerate bone regeneration? Are all defects ultimately regenerated with new viable bone? Is the bone graft completely resorbed or integrated in new bone? Does the implant surface characteristic positively affect osseointegration when used with a bone graft? What type of graft and implant surface can be used that will have a positive effect on the healing type and time? Finally, what are the dynamics of bone graft healing around an implant? This review discusses the cellular and molecular mechanisms of bone graft healing in general and in vicinity of another foreign, avascular body, namely the implant surface, and further, the role of bone grafts in osseointegration and/or clinical success of the implants.

  13. Proximal Tibial Bone Graft

    Science.gov (United States)

    ... the Big Toe Ailments of the Smaller Toes Diabetic Foot Treatments Currently selected Injections and other Procedures Treatments ... from which the bone was taken if the foot/ankle surgeries done at the same time allow for it. ... problems after a PTBG include infection, fracture of the proximal tibia and pain related ...

  14. Biological activity of tri-calciumphosphate/hydroxyl-apatite granules mixed with impacted morsellized bone graft. A study in rabbits.

    NARCIS (Netherlands)

    Arts, J.J.C.; Walschot, L.H.B.; Verdonschot, N.J.J.; Schreurs, B.W.; Buma, P.

    2007-01-01

    Reconstruction of bone defects with impacted morsellized cancellous bone grafts (MCB) is a popular method. Because of a shortage of human bone, mixing with biomaterials may be attractive. Ceramics may be used as bone graft extenders. In this study, various volume mixtures of biphasic

  15. Autogenous tooth bone graft: Ingenious bone regeneration material

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    Chadalavada Sarala

    2018-01-01

    Full Text Available Tooth-derived bone graft material, which is proved to be rich in bone growth factors and bone morphogenic proteins (BMPs, have been becoming a practical substitute to bone grafting. It can also be used as a carrier for growth factors and stem cells as reported in many recent studies. Autogenous-tooth bone grafting technique is significant as this biomaterial has excellent bone regeneration capacity and also relatively non-existent chances of antigenicity, genetic diseases and disease transmission. In this article, a broad overview of the published findings with regard to the properties and uses of tooth-derived regenerative bone grafting is discussed.

  16. 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.

  17. Strontium doping of bone graft extender

    Science.gov (United States)

    2011-01-01

    Background and purpose Allografts are often used during revision hip replacement surgery for stabilization of the implant. Resorption of the allograft may exceed new bone formation, and instability of the prosthesis can develop. We investigated whether strontium could regulate the imbalance of fast resorption of allograft and slower formation of new bone, because it is both an anabolic and an anticatabolic agent. Method Strontium was added to the implant interface environment by doping a hydroxyapatite bone graft extender. 10 dogs each received 2 experimental titanium implants. The implants were inserted within a 2.7-mm concentric gap in cancellous bone. The gap was filled with 50% (v/v) allograft mixed with 50% bone graft extender. The extender either had 5% strontium doping (SrHA) or was undoped (HA). After 4 weeks, osseointegration and mechanical fixation were evaluated by histomorphometry and by push-out test. Results SrHA bone graft extender induced a 1.2-fold increase in volume of new bone, a 1.2-fold increase in allograft remaining in the gap, and a 1.4-fold increase in surface area of the bone graft extender material in contact with new bone compared to HA bone graft extender. All these increases were statistically significant. SrHA bone graft extender did not significantly improve ongrowth of bone onto the implants or improve any of the mechanical push-out parameters compared to HA bone graft extender. Interpretation Doping of the HA bone graft extender with 5% strontium increased gap healing, preserved more of the allograft in the gap, and increased the ongrowth of bone onto the bone graft extender material, but did not improve mechanical fixation. PMID:21895497

  18. Carbon nanotube-based bioceramic grafts for electrotherapy of bone.

    Science.gov (United States)

    Mata, D; Horovistiz, A L; Branco, I; Ferro, M; Ferreira, N M; Belmonte, M; Lopes, M A; Silva, R F; Oliveira, F J

    2014-01-01

    Bone complexity demands the engineering of new scaffolding solutions for its reconstructive surgery. Emerging bone grafts should offer not only mechanical support but also functional properties to explore innovative bone therapies. Following this, ceramic bone grafts of Glass/hydroxyapatite (HA) reinforced with conductive carbon nanotubes (CNTs) - CNT/Glass/HA - were prepared for bone electrotherapy purposes. Computer-aided 3D microstructural reconstructions and TEM analysis of CNT/Glass/HA composites provided details on the CNT 3D network and further correlation to their functional properties. CNTs are arranged as sub-micrometric sized ropes bridging homogenously distributed ellipsoid-shaped agglomerates. This arrangement yielded composites with a percolation threshold of pc=1.5vol.%. At 4.4vol.% of CNTs, thermal and electrical conductivities of 1.5W·m(-1)·K(-1) and 55S·m(-1), respectively, were obtained, matching relevant requisites in electrical stimulation protocols. While the former avoids bone damaging from Joule's heat generation, the latter might allow the confinement of external electrical fields through the conductive material if used for in vivo electrical stimulation. Moreover, the electrically conductive bone grafts have better mechanical properties than those of the natural cortical bone. Overall, these highly conductive materials with controlled size CNT agglomerates might accelerate bone bonding and maximize the delivery of electrical stimulation during electrotherapy practices. © 2013.

  19. Posterolateral bone graft of the tibia.

    Science.gov (United States)

    Simpson, J M; Ebraheim, N A; An, H S; Jackson, W T

    1990-02-01

    A series of 30 high-energy tibial diaphyseal fractures in 30 patients were treated with posterolateral bone grafting (1984-1987). All of the fractures were open, a majority being Gustillo Type III with significant soft-tissue injury, comminution, or segmental bone loss. The common mechanisms of injury included motorcycle, pedestrian versus automobile, and motor vehicle accidents. Nineteen of 30 fractures were treated with a posterolateral bone graft within six months of the initial injury, and 11 of 30 were grafted after established nonunion. Union was obtained in 29 of 30 fractures (97%). Healing time from the time of grafting ranged from three to 12 months, with an average of 4.7 months. One patient had a below-knee amputation because of uncontrolled chronic osteomyelitis, drainage, and nonunion. Posterolateral bone grafts consistently produced rapid healing of delayed union as well as established nonunion.

  20. 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

    BACKGROUND: Harvesting techniques can affect cellular parameters of autogenous bone grafts in vitro. Whether these differences translate to in vivo bone formation, however, remains unknown. OBJECTIVE: The purpose of this study was to assess the impact of different harvesting techniques on bone fo......: Transplantation of autogenous bone particles harvested with four techniques in the present model resulted in moderate differences in terms of bone formation and graft resorption....

  1. [Histologic and biomechanic evaluation of posterolateral arthrodesis using a biphasic ceramic of calcium phosphate as bone substitute. Experimental study with sheep].

    Science.gov (United States)

    Guigui, P; Hardouin, P

    2000-01-01

    The effectiveness of a macroporous biphasic calcium phosphate ceramic was studied after laterovertebral arthrodesis in sheep. A ceramic with a TCP/HAP ratio of 35/65 was compared with autologous bone graft in an histomorphometric and biomechanical point of view. Quantitative analysis of the results indicated that the biphasic ceramic allows an arthrodesis after 12 months, although control graft is effective after six months. A large decrease of flexibility in all directions was obtained with the ceramic, similarly to autologous graft. No nonfusion case was observed. In conditions very close to the human surgery, a posterolateral fusion can be obtained using biphasic phosphate ceramic as bone substitute.

  2. Osteoinduction of bone grafting materials for bone repair and regeneration.

    Science.gov (United States)

    García-Gareta, Elena; Coathup, Melanie J; Blunn, Gordon W

    2015-12-01

    Regeneration of bone defects caused by trauma, infection, tumours or inherent genetic disorders is a clinical challenge that usually necessitates bone grafting materials. Autologous bone or autograft is still considered the clinical "gold standard" and the most effective method for bone regeneration. However, limited bone supply and donor site morbidity are the most important disadvantages of autografting. Improved biomaterials are needed to match the performance of autograft as this is still superior to that of synthetic bone grafts. Osteoinductive materials would be the perfect candidates for achieving this task. The aim of this article is to review the different groups of bone substitutes in terms of their most recently reported osteoinductive properties. The different factors influencing osteoinductivity by biomaterials as well as the mechanisms behind this phenomenon are also presented, showing that it is very limited compared to osteoinductivity shown by bone morphogenetic proteins (BMPs). Therefore, a new term to describe osteoinductivity by biomaterials is proposed. Different strategies for adding osteoinductivity (BMPs, stem cells) to bone substitutes are also discussed. The overall objective of this paper is to gather the current knowledge on osteoinductivity of bone grafting materials for the effective development of new graft substitutes that enhance bone regeneration. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Cell seeding chamber for bone graft substitutes

    OpenAIRE

    Hennig, J.; Schieker, Matthias; Seitz, H.

    2012-01-01

    There is an increasing demand for bone graft substitutes that are used as osteoconductive scaffolds in the treatment of bone defects and fractures. Achieving optimal bone regeneration requires initial cell seeding of the scaffolds prior to implantation. The cell seeding chamber is a closed assembly. It works like a sandglass. The position of the scaffold is between two reservoirs containing the fluid (e. g. blood). The fluid at the upper reservoir flows through the scaffold driven by gravity....

  4. Bone maintenance 5 to 10 years after sinus grafting.

    Science.gov (United States)

    Block, M S; Kent, J N; Kallukaran, F U; Thunthy, K; Weinberg, R

    1998-06-01

    This radiographic study determined the amount of bone around hydroxyapatite (HA)-coated dental implants that were placed into bone-grafted maxillary sinuses. Postoperative complex motion tomograms using the Grossman technique were taken on 16 patients who had 27 maxillary sinus grafts performed using particulate autogenous iliac bone with and without demineralized bone, autogenous iliac corticocancellous block with and without demineralized bone, and autogenous jaw bone with demineralized bone. Bone levels were measured from the new floor of the grafted sinus to the apex of the implant and to the alveolar crest. The resulting bone level measures were compared with the type of graft used. All patients had been restored for 5 to 10 years after simultaneous graft and implant placement. For all patients summed together, the average amount of bone from the top of the graft to the apex of the implant was 3.3 +/- 3.1 mm, and the average amount of bone from the top of the graft to the alveolar crest was 17.6 +/- 3.1 mm. The average level of bone in the sinuses of patients grafted with autogenous iliac bone was greater than the average level of bone in those grafted with autogenous bone combined with demineralized bone. The results of this study indicate that autogenous bone grafts are maintained in the maxillary sinus, but the results with autogenous bone alone are better than when demineralized bone is added. However, this difference may not be clinically significant.

  5. Shaped graft for aneurysmal bone cyst of upper limb bones.

    Science.gov (United States)

    Mostafa, Mohamed F; Abed, Yasser Y; Fawzy, Sallam I

    2017-11-01

    The optimal treatment of aneurysmal bone cyst remains challenging. The aim of this prospective study was to evaluate the results of using bone grafts shaped to the defects caused by aneurysmal bone cysts of upper limb bones. Fifteen patients (12 males and 3 females) with an average age of 12 years (range 6-16 years) were treated for aneurysmal bone cysts of upper limb bones by intralesional resection, argon beam coagulation and shaped bone graft. The grafts were harvested from 14 patients (11 fibulas and 3 iliac bones) and from the mother of one patient (proximal fibula). Osteosynthesis was required to stabilize the graft in four cases. The modified Enneking's scoring system was used for functional evaluation. One patient developed partial recurrence at 6 months and required reoperation. Superficial wound infection was encountered in one patient. Shortening of the humeral segment was seen in two patients (1 and 1.5 cm) but without angular deformity. After a mean follow-up of 45 months (range 24-68 months), the mean functional score was 97.3%. This technique proved to be reliable in obtaining a well reconstructed and growing bone with no or minimal deformity and good function.

  6. Vascularized fibular graft in infected tibial bone loss

    OpenAIRE

    C Cheriyan Kovoor; R Jayakumar; V V George; Vinod Padmanabhan; A J Guild; Sabin Viswanath

    2011-01-01

    Background : The treatment options of bone loss with infections include bone transport with external fixators, vascularized bone grafts, non-vascularized autogenous grafts and vascularized allografts. The research hypothesis was that the graft length and intact ipsilateral fibula influenced hypertrophy and stress fracture. We retrospectively studied the graft hypertrophy in 15 patients, in whom vascularized fibular graft was done for post-traumatic tibial defects with infection. Materials...

  7. Guided bone regeneration using autogenous tooth bone graft in implant therapy: case series.

    Science.gov (United States)

    Kim, Young-Kyun; Kim, Su-Gwan; Bae, Ji-Hyun; Um, In-Woong; Oh, Ji-Su; Jeong, Kyung-In

    2014-04-01

    Recently, techniques have been reported that involve the preparation of extracted teeth from patients used as particulated bone graft materials for bone graft purposes. For implant placement and bone graft, autogenous teeth bone graft materials were used in 15 patients, and clinically excellent results were obtained. In histological examination, favorable bony healing by osteoconduction was observed.

  8. 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... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone grafting material. 872.3930 Section 872.3930...

  9. Anterior palatal island advancement flap for bone graft coverage ...

    African Journals Online (AJOL)

    ... Palatal Island Advancement Flap was effective in bone graft coverage in premaxillary edentulous area. Conclusion: It can be used as an aid for bone graft coverage of premaxillary edentulous ridge, where the need for mucosa is small in width but long in length. Keywords: Anterior maxilla, bone graft, dental implant, ...

  10. Scaffolds with a standardized macro-architecture fabricated from several calcium phosphate ceramics using an indirect rapid prototyping technique

    NARCIS (Netherlands)

    Wilson, C.E.; van Blitterswijk, Clemens; Verbout, A.J.; Dhert, W.J.A.; de Bruijn, Joost Dick

    2011-01-01

    Calcium phosphate ceramics, commonly applied as bone graft substitutes, are a natural choice of scaffolding material for bone tissue engineering. Evidence shows that the chemical composition, macroporosity and microporosity of these ceramics influences their behavior as bone graft substitutes and

  11. Use and preservation methods of bone grafts in small animals

    Directory of Open Access Journals (Sweden)

    Rafael Garabet Agopian

    2016-09-01

    Full Text Available The present review describes the main characteristics of bone grafts used in small animals. Bone grafts are tissues without vasculature, which facilitate the production of new bone cells with osteogenic and osteoinductive factors that lead to the differentiation of cells and structural support for bone marrow. The transplant of a graft is followed by three stages: osteogenesis, or the formation of new bone; osteoinduction, which is the differentiation of cells; and osteoconduction, the process of growth of mesenchymal cells and capillaries that results in new bone formation. The composition of bone grafts may include spongy bone, cortical bone, cortical-spongy bone, cartilage or bone marrow. Grafts can also be classified according to their origin, being autogenous tissue when they are transplanted from the same individual, allogenous (homologous when originating from another individual of the same species, and xenogenous when obtained from a different species.

  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. Influence of particle size of autogenous bone grafts on the early stages of bone regeneration: A histologic and stereologic study in rabbit calvarium

    DEFF Research Database (Denmark)

    Pallesen, L.; Schou, S.; Aaboe, Merete

    2002-01-01

    autogenous bone grafts, bone regeneration, calvarial defects, histology, particle size, particulated bone grafts, rabbits, revascularization, stereology......autogenous bone grafts, bone regeneration, calvarial defects, histology, particle size, particulated bone grafts, rabbits, revascularization, stereology...

  14. New bone formation in the maxillary sinus without bone grafts.

    Science.gov (United States)

    Sohn, Dong-Seok; Lee, Ji-Soo; Ahn, Mi-Ra; Shin, Hong-In

    2008-09-01

    Various sinus augmentation procedures, using bone substitutes, have been used to place dental implants in the atrophic posterior maxilla. The aim of this article is to evaluate the possibility of new bone formation in the maxillary sinus without a bone graft. Ten patients without significant sinus pathosis were selected for this study. The bony window was prepared in the lateral wall using the ultrasonic piezoelectric bone surgery device (Surgybone, Silfradent srl, Sofia, Italy). The sinus membrane was elevated superiorly and implants were placed simultaneously to maintain the space under the sinus membrane for new bone formation. As the methods of sealing the lateral access window of the sinus, patients were divided into 2 groups. Nonresorbable membrane was used to seal the lateral access window of the maxillary sinus after implant placement in 5 cases (group A). Replaceable bony window was used to seal the lateral wall of the sinus in another 5 cases (group B). Computed tomograms were taken immediately before and after surgery, at the uncovering of the implant, and after a 6 month healing period. A bone biopsy was taken on the previous bony window area to evaluate new bone formation. A total of 21 implants in lengths of 10 to 15 mm (mean, 13 mm) were placed, with an average residual bone height of 5 mm (range, 1-9 mm). All implants remained stable during the study period in clinical evaluations. New bone formation and new sinus floors were found in radiographic and histologic evaluations. The human study showed the capacity of new bone formation in the maxillary sinus with membrane elevation only and simultaneous implant placement beyond the original sinus floor. New bone formation without additional bone graft in the maxillary sinus is revealed from the clinical, radiographic, and histologic results, but furthermore long-term studies are needed to confirm this.

  15. Anterior Palatal Island Advancement Flap for Bone Graft Coverage ...

    African Journals Online (AJOL)

    Anterior Palatal Island Advancement Flap for Bone Graft. Coverage: Technical Note. Amin Rahpeyma, Saeedeh Khajehahmadi1. INTRODUCTION. The most important step in bone graft augmentation of alveolar process is soft tissue coverage. Dehiscence of the wound leads to graft exposure and subsequent problems.

  16. Assessment of bone healing on tibial fractures treated with wire osteosynthesis associated or not with infrared laser light and biphasic ceramic bone graft (HATCP) and guided bone regeneration (GBR): Raman spectroscopy study

    Science.gov (United States)

    Bastos de Carvalho, Fabíola; Aciole, Gilberth Tadeu S.; Aciole, Jouber Mateus S.; Silveira, Landulfo, Jr.; Nunes dos Santos, Jean; Pinheiro, Antônio L. B.

    2011-03-01

    The aim of this study was to evaluate, through Raman spectroscopy, the repair of complete tibial fracture in rabbits fixed with wire osteosynthesis - WO, treated or not with infrared laser light (λ 780nm, 50mW, CW) associated or not to the use of HATCP and GBR. Surgical fractures were created under general anesthesia (Ketamine 0.4ml/Kg IP and Xilazine 0.2ml/Kg IP), on the tibia of 15 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 WO. Animals of groups III and V were grafted with hydroxyapatite + GBR technique. Animals of groups IV and V were irradiated at every other day during two weeks (16J/cm2, 4 x 4J/cm2). Observation time was that of 30 days. After animal death the specimens were kept in liquid nitrogen for further analysis by Raman spectroscopy. Raman spectroscopy showed significant differences between groups (pfracture healing and the association with HATCP and GBR resulted on increased deposition of calcium hydroxyapatite.

  17. Expansion of Bone Marrow Mesenchymal Stromal Cells in Perfused 3D Ceramic Scaffolds Enhances In Vivo Bone Formation.

    Science.gov (United States)

    Hoch, Allison I; Duhr, Ralph; Di Maggio, Nunzia; Mehrkens, Arne; Jakob, Marcel; Wendt, David

    2017-12-01

    Bone marrow-derived mesenchymal stromal cells (BMSC), when expanded directly within 3D ceramic scaffolds in perfusion bioreactors, more reproducibly form bone when implanted in vivo as compared to conventional expansion on 2D polystyrene dishes/flasks. Since the bioreactor-based expansion on 3D ceramic scaffolds encompasses multiple aspects that are inherently different from expansion on 2D polystyrene, we aimed to decouple the effects of specific parameters among these two model systems. We assessed the effects of the: 1) 3D scaffold vs. 2D surface; 2) ceramic vs. polystyrene materials; and 3) BMSC niche established within the ceramic pores during in vitro culture, on subsequent in vivo bone formation. While BMSC expanded on 3D polystyrene scaffolds in the bioreactor could maintain their in vivo osteogenic potential, results were similar as BMSC expanded in monolayer on 2D polystyrene, suggesting little influence of the scaffold 3D environment. Bone formation was most reproducible when BMSC are expanded on 3D ceramic, highlighting the influence of the ceramic substrate. The presence of a pre-formed niche within the scaffold pores had negligible effects on the in vivo bone formation. The results of this study allow a greater understanding of the parameters required for perfusion bioreactor-based manufacturing of osteogenic grafts for clinical applications. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. The effect of loading in regenerated bone in dehiscence defects following a combined approach of bone grafting and GBR.

    Science.gov (United States)

    Zambon, Riccardo; Mardas, Nikos; Horvath, Attilla; Petrie, Aviva; Dard, Michel; Donos, Nikos

    2012-05-01

    To evaluate by histology the effect of loading on the regenerated bone at dehiscence type defects around implants when treated with a combined approach of bone grafting and guided bone regeneration (GBR). In twelve Göttingen mini-pigs, the lower premolars and first molars were extracted and the alveolar process was reduced in width. After 3 months, two Straumann SLActive (Straumann AG, Basel, Switzerland) implants were placed in each hemi-mandible. Twelve implants were placed into the reduced alveolar ridge (group P) with no further defect or treatment on the site, while on 36 implants, buccal dehiscence defects were created and treated as follows: Group T1: synthetic bone substitute (Straumann Bone Ceramic, SBC, Straumann AG). Group T2: SBC with a polyethylene glycol membrane (Straumann MembraGel, Straumann AG); Group N: the dehiscence remained untreated. Three months following implantation, long, custom-made, healing abutments were placed in one hemi-mandible only to ensure functional loading. After 2 months, histological analysis was performed. A trend for lower residual defect height and higher bone-to-implant contact was observed in the loaded sites compared with non-loaded sites in groups P, T1 and N. In group T2, the opposite effect was observed. In terms of bone formation, sites treated with SBC grafting and GBR (group T2) exhibited the largest surface area of regenerated bone followed by T1 and N. Significant resorption of the graft particles was noted in group T2 and the graft surface area occupied by SBC was significantly higher in group T1 compared with group T2 (P < 0.05). Loading may have a positive effect on bone-to-implant contact in implants inserted in pristine bone or inserted in dehiscence sites and treated by grafting/no grafting. © 2011 John Wiley & Sons A/S.

  19. Bone grafts utilized in dentistry: an analysis of patients' preferences.

    Science.gov (United States)

    Fernández, Ramón Fuentes; Bucchi, Cristina; Navarro, Pablo; Beltrán, Víctor; Borie, Eduardo

    2015-10-20

    Many procedures currently require the use of bone grafts to replace or recover bone volume that has been resorbed. However, the patient's opinion and preferences must be taken into account before implementing any treatment. Researchers have focused primarily on assessing the effectiveness of bone grafts rather than on patients' perceptions. Thus, the aim of this study was to explore patients' opinions regarding the different types of bone grafts used in dental treatments. One hundred patients were randomly chosen participated in the study. A standardized survey of 10 questions was used to investigate their opinions regarding the different types of bone grafts used in dental treatments. Descriptive statistics were calculated for the different variables, and absolute frequencies and percentages were used as summary measures. A value of p grafts with the lowest rates of refusal were autologous grafts (3 %) and alloplastics (2 %). No significant differences were found between the various types of bone grafts in the sociodemographic variables or the refusal/acceptance variable. Similarly, no significant relations were observed between a specific religious affiliation and the acceptance/refusal rates of the various types of graft. Allografts and xenografts elicited the highest refusal rates among the surveyed patients, and autologous bone and alloplastics were the most accepted bone grafts. Moreover, no differences were found in the sociodemographic variables or religious affiliations in terms of the acceptance/refusal rates of the different bone grafts.

  20. Preparation and characterization of a novel bone graft composite ...

    Indian Academy of Sciences (India)

    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 ...

  1. Novel technique for passing tendon grafts through bone tunnels.

    Science.gov (United States)

    Levy, Jeffrey A; Farber, Gerald L; Taylor, Kenneth F

    2012-11-01

    Anatomic reconstruction in orthopedic surgery often requires the passage of soft tissue through bone tunnels. Difficulties may arise due to anatomic constraints surrounding the bone tunnels or the graft size. The authors present a novel technique for passing tendon grafts through bone tunnels that is simple, readily available, effective, and comparatively inexpensive. Copyright 2012, SLACK Incorporated.

  2. Sites of Autologous Bone Grafts in Orthopaedic Traumatology ...

    African Journals Online (AJOL)

    Results: Outcome was satisfactory in 72 patients. 6 patients reported pain in the iliac crest. In 11 patients, the scar to the iliac crest was unsightly. Conclusion: The authors conclude that the commonly used donor sites for autologous bone grafts are safe. Keywords:autologous bone graft, pseudoarthrosis, bone reconstruction

  3. 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

  4. Efficacy of anterior cervical fusion: comparison of titanium cages, polyetheretherketone (PEEK) cages and autogenous bone grafts.

    Science.gov (United States)

    Chou, Yu-Cheng; Chen, Der-Cherng; Hsieh, Wanhua Annie; Chen, Wu-Fu; Yen, Pao-Sheng; Harnod, Tomor; Chiou, Tsung-Lang; Chang, Yuh-Lin; Su, Chain-Fa; Lin, Shinn-Zong; Chen, Shin-Yuan

    2008-11-01

    This retrospective study was designed to analyze and compare the efficacy and outcomes of anterior cervical fusion using titanium cages, polyetheretherketone (PEEK) cages and autogenous tricortical bone grafts. Fifty-five patients who underwent segmental anterior discectomy with a follow-up period up to 12 months enrolled in this study. They were divided into three groups: titanium cage with biphasic calcium phosphate ceramic (Triosite; Zimmer, Berlin, Germany) in group A (n=27); PEEK cage with Triosite in group B (n=9); and autogenous tricortical iliac crest bone graft in group C (n=19). The fusion rates after 6 months were 37.21% in group A , 93.3% in group B, and 84.85% in group C. The fusion rates after 1 year in groups A, B, and C were 46.51%, 100% and 100%, respectively. The PEEK cage is a viable alternative to autogenous tricortical bone grafts in anterior cervical fusion.

  5. Free and microvascular bone grafting in the irradiated dog mandible

    Energy Technology Data Exchange (ETDEWEB)

    Altobelli, D.E.; Lorente, C.A.; Handren, J.H. Jr.; Young, J.; Donoff, R.B.; May, J.W. Jr.

    1987-01-01

    Microvascular and free rib grafts were placed in 4.5 cm defects in an edentate mandibular body defect 18 to 28 days after completion of 50 Gy of irradiation from a /sup 60/Co source. The animals were sacrificed from two to forty weeks postoperatively and evaluated clinically, radiographically, and histologically. There was a marked difference in the alveolar mucosal viability with the two grafts. Mucosal dehiscence was not observed over any of the microvascular grafts, but was present in seven-eighths of the free grafts. Union of the microvascular bone graft to the host bone occurred within six weeks. In contrast, after six weeks the free graft was sequestered in all the animals. An unexpected finding with both types of graft was the marked subperiosteal bone formation. This bone appeared to be derived from the host bed, stabilizing and bridging the defects bilaterally. The results suggest that radiated periosteum may play an important role in osteogenesis.

  6. Allogenic bone grafts in post-traumatic juxta-articular defects: Need for allogenic bone banking.

    Science.gov (United States)

    Mishra, Anil Kumar; Vikas, Rohit; Agrawal, H S

    2017-07-01

    Allogenic bone banking provide both structural and granular bone grafts for various orthopaedic, spinal, oncological and dental surgeries. However allogenic bones, presently, are not readily available. This article discusses the clinical applications of the allogenic grafts, the screening criteria and procedure for maintenance of such a bone banking facility. This article demonstrates the effective role of allogenic bone in a case of post-traumatic bone loss situation and discusses the growing need and present situation of bone banking in our country.

  7. Gallic acid grafting modulates the oxidative potential of ferrimagnetic bioactive glass-ceramic SC-45.

    Science.gov (United States)

    Corazzari, Ingrid; Tomatis, Maura; Turci, Francesco; Ferraris, Sara; Bertone, Elisa; Prenesti, Enrico; Vernè, Enrica

    2016-12-01

    Magnetite-containing glass-ceramics are promising bio-materials for replacing bone tissue after tumour resection. Thanks to their ferrimagnetic properties, they generate heat when subjected to an alternated magnetic field. In virtue of this they can be employed for the hyperthermic treatment of cancer. Moreover, grafting anti-cancer drugs onto their surface produces specific anti-neoplastic activity in these biomaterials. Gallic acid (GA) exhibits antiproliferative activity which renders it a promising candidate for anticancer applications. In the present paper, the reactivity of ferrimagnetic glass-ceramic SC-45 grafted with GA (SC-45+GA) was studied in terms of ROS release, rupture of the C-H bond of the formate molecule and Fenton reactivity by EPR/spin trapping in acellular systems. The ability of these materials to cause lipid peroxidation was assessed by UV-vis/TBA assay employing linoleic acid as a model of membrane lipid. The results, compared to those obtained with SC-45, showed that GA grafting (i) significantly enhanced the Fenton reactivity and (ii) restored the former reactivity of SC-45 towards both the C-H bond and linoleic acid which had been completely suppressed by prolonged contact with water. Fe 2+ centres at the surface are probably implicated. GA, acting as a pro-oxidant, reduces Fe 3+ to Fe 2+ by maintaining a supply of Fe 2+ at the surface of SC-45+GA. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. The Influence of Barrier Membranes on Autologous Bone Grafts

    NARCIS (Netherlands)

    Gielkens, P. F. M.; Schortinghuis, J.; de Jong, J. R.; Paans, A. M. J.; Ruben, J. L.; Raghoebar, G. M.; Stegenga, B.; Bos, R. R. M.

    2008-01-01

    In implant dentistry, there is continuing debate regarding whether a barrier membrane should be applied to cover autologous bone grafts in jaw augmentation. A membrane would prevent graft remodeling with resorption and enhance graft incorporation. We hypothesized that membrane coverage does not

  9. Repair of tegmen defect using cranial particulate bone graft.

    Science.gov (United States)

    Greene, Arin K; Poe, Dennis S

    2015-01-01

    Bone paté is used to repair cranial bone defects. This material contains bone-dust collected during the high-speed burring of the cranium. Clinical and experimental studies of bone dust, however, have shown that it does not have biological activity and is resorbed. We describe the use of bone paté using particulate bone graft. Particulate graft is harvested with a hand-driven brace and 16mm bit; it is not subjected to thermal injury and its large size resists resorption. Bone paté containing particulate graft is much more likely than bone dust to contain viable osteoblasts capable of producing new bone. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Bone grafts using autogenous tooth blocks: a case series.

    Science.gov (United States)

    Kim, Young-Kyun; Kim, Su-Gwan; Um, In-Woong; Kim, Kyung-Wook

    2013-12-01

    A case study was conducted to examine the clinical results and histologic healing of bone grafts performed using an autogenous tooth block (AutoBT block), which was developed recently and proprietary. Guided bone regeneration, extraction socket graft, sinus bone graft, and ridge augmentation were performed using autogenous tooth block graft material in 12 patients from March 2009 to June 2010. The clinical outcomes of each case were examined, and tissue specimens were collected from 1 case 2.5 months after the bone graft for histopathological analysis. All of the cases had successful bone graft results. One patient developed wound dehiscence after surgery, although favorable secondary healing was achieved. One implant resulted in osseointegration failure. A histopathologic examination was performed after 2.5 months and showed excellent bone healing due to osteoconduction. The AutoBT block was incorporated into the upper soft tissue, aponeurosis, and lower recipient bone. There were no notable complications associated with the bone transplant materials. The AutoBT block is clinically useful for a variety of bone grafts.

  11. Volume changes of grafted autogenous bone in sinus augmentation procedure.

    Science.gov (United States)

    Sbordone, Carolina; Sbordone, Ludovico; Toti, Paolo; Martuscelli, Ranieri; Califano, Luigi; Guidetti, Franco

    2011-06-01

    To evaluate associations between the osseous remodeling and the 3-dimensional features of both the grafted bone and the recipient site, as well as the density of the grafted bone, and to assess the relation between the degree of bone resorption and the type of autogenous bone-grafting procedure or the source (block or particulate bone from iliac crest or block bone from chin). A retrospective chart review of patients receiving sinus lifting and grafting procedures for implant positioning was conducted: radiographic analysis of the volume and area of both sinuses and autogenous bone grafts was performed, as per Smolka et al and Krennmair et al. The volumetric remodeling--measured at 1 year after implant positioning as the percentage of residual bone (%R)--was correlated, with Spearman analysis, to 3-dimensional features of both graft and recipient sites. All quantities correlated with %R at a statistically significant level were used for 2-dimensional and multidimensional visualizations with scattergrams. Twenty-five iliac crest or chin grafts were inlay positioned in the maxillary sinuses of patients. Computed tomography scans, taken before implant positioning and after 1 year, showed a 1-year negligible volume remodeling for block graft from chin (97.9%) but slightly greater resorption values (%R) for particulate and block grafts from iliac crest (93.8% and 83.3%, respectively). Three- and four-dimensional scattergrams of significant data resulting from Spearman correlation tests (particulate and block grafts both from iliac crest) showed a variation of the remodeling pattern dependent on 3-dimensional features, namely inlay graft thickness, surface area of the graft in contact with basal bone, volume of the recipient site, and surface area of the graft projecting into the sinus cavity. Retrospective data analysis shows that iliac crest grafts positioned on a small basal bone volume (≤ 2.5 mL) may point to a very favorable remodeling of the volume when the

  12. A Novel Porcine Graft for Regeneration of Bone Defects

    Directory of Open Access Journals (Sweden)

    Eisner Salamanca

    2015-05-01

    Full Text Available Bone regeneration procedures require alternative graft biomaterials to those for autogenous bone. Therefore, we developed a novel porcine graft using particle sizes of 250–500 μm and 500–1000 μm in rabbit calvarial bone defects and compared the graft properties with those of commercial hydroxyapatite (HA/beta-tricalcium phosphate (β-TCP over eight weeks. Surgery was performed in 20 adult male New Zealand white rabbits. During a standardized surgical procedure, four calvarial critical-size defects of 5 mm diameter and 3 mm depth were prepared. The defects were filled with HA/β-TCP, 250–500 μm or 500–1000 μm porcine graft, and control defects were not filled. The animals were grouped for sacrifice at 1, 2, 4, and 8 weeks post-surgery. Subsequently, sample blocks were prepared for micro-computed tomography (micro-CT scanning and histological sectioning. Similar bone formations were observed in all three treatment groups, although the 250–500 μm porcine graft performed slightly better. Rabbit calvarial bone tissue positively responded to porcine grafts and commercial HA/β-TCP, structural analyses showed similar crystallinity and porosity of the porcine and HA/β-TCP grafts, which facilitated bone formation through osteoconduction. These porcine grafts can be considered as graft substitutes, although further development is required for clinical applications.

  13. Effect of maxillary sinus floor augmentation without bone grafts

    Directory of Open Access Journals (Sweden)

    D Shiva Kumar

    2013-01-01

    Full Text Available Objective: The objective of the present review was to determine the effectiveness of maxillary sinus floor augmentation without bone grafts using lateral window technique. Materials and Methods: PubMed and Cochrane databases were searched for relevant articles. We also included articles by hand search until June 2012. The analysis included both human and animal studies which satisfied the following criteria: Minimum of 6 months follow-up, no use of bone grafts, and lateral window approach to the sinus. Results: We included 22 articles in the review. A descriptive analysis of the constructed evidence tables indicated that there is evidence of predictable a mount of bone formation in the maxillary sinus augmentation without the use of bone grafts. Conclusion: Within the limits of the articles and data available, maxillary sinus augmentation without bone graft might be considered effective inpredictable bone formation.

  14. Use and preservation methods of bone grafts in small animals

    Directory of Open Access Journals (Sweden)

    Rafael Garabet Agopian

    2016-09-01

    Full Text Available http://dx.doi.org/10.5007/2175-7925.2016v29n3p11 The present review describes the main characteristics of bone grafts used in small animals. Bone grafts are tissues without vasculature, which facilitate the production of new bone cells with osteogenic and osteoinductive factors that lead to the differentiation of cells and structural support for bone marrow. The transplant of a graft is followed by three stages: osteogenesis, or the formation of new bone; osteoinduction, which is the differentiation of cells; and osteoconduction, the process of growth of mesenchymal cells and capillaries that results in new bone formation. The composition of bone grafts may include spongy bone, cortical bone, cortical-spongy bone, cartilage or bone marrow. Grafts can also be classified according to their origin, being autogenous tissue when they are transplanted from the same individual, allogenous (homologous when originating from another individual of the same species, and xenogenous when obtained from a different species.

  15. Circumferential bone grafting around an absorbable gelatin sponge core reduced the amount of grafted bone in the induced membrane technique for critical-size defects of long bones.

    Science.gov (United States)

    Cho, Jae-Woo; Kim, Jinil; Cho, Won-Tae; Kim, Jin-Kak; Song, Jong Hoon; Kim, Hyung-Jin; Masquelet, Alain C; Oh, Jong-Keon

    2017-10-01

    The objectives of the study were to introduce a circumferential bone graft around an absorbable gelatin sponge core using an induced membrane technique, to assess its ability to reduce the required amount of graft and to maintain the bone graft, and to evaluate the clinical outcomes in the management of critical-size bone defects. Circumferential bone grafting using a staged induced membrane technique for managing critical-size bone defects was performed in 21 patients. Postoperative computed tomography scans were performed 7days after Hemovac drain removal and 3 months after bone grafting. Volumetric measurements of the defect size, gelatin sponge proportion, and amount of grafted bone were performed by two independent observers using three-dimensional (3D) software. The critical-size defects were located at the metadiaphyseal area of 11 tibias, eight femurs, and two humeri. The average defect size was 8.9cm in length and 65.2cm3 in volume. The absorbable gelatin sponge core replaced 21.4% (average) of the defect volume. There was no significant deterioration in the shape of the grafted bone among the serial 3D models. Eighteen patients (86%) were healed radiographically at 9.1 months (average). Our study suggests that circumferential bone grafting in association with the induced membrane technique could reduce the required amount of bone graft and adequately maintain graft position and shape, with favourable clinical outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Bioreactor cultivation of anatomically shaped human bone grafts.

    Science.gov (United States)

    Temple, Joshua P; Yeager, Keith; Bhumiratana, Sarindr; Vunjak-Novakovic, Gordana; Grayson, Warren L

    2014-01-01

    In this chapter, we describe a method for engineering bone grafts in vitro with the specific geometry of the temporomandibular joint (TMJ) condyle. The anatomical geometry of the bone grafts was segmented from computed tomography (CT) scans, converted to G-code, and used to machine decellularized trabecular bone scaffolds into the identical shape of the condyle. These scaffolds were seeded with human bone marrow-derived mesenchymal stem cells (MSCs) using spinner flasks and cultivated for up to 5 weeks in vitro using a custom-designed perfusion bioreactor system. The flow patterns through the complex geometry were modeled using the FloWorks module of SolidWorks to optimize bioreactor design. The perfused scaffolds exhibited significantly higher cellular content, better matrix production, and increased bone mineral deposition relative to non-perfused (static) controls after 5 weeks of in vitro cultivation. This technology is broadly applicable for creating patient-specific bone grafts of varying shapes and sizes.

  17. Enhancement of bone regeneration with the combination of platelet-rich fibrin and synthetic graft.

    Science.gov (United States)

    Nacopoulos, Cleopatra; Dontas, Ismene; Lelovas, Pavlos; Galanos, Antonis; Vesalas, Anna-Maria; Raptou, Panagiota; Mastoris, Michael; Chronopoulos, Eustathios; Papaioannou, Nikolaos

    2014-11-01

    Platelet-rich fibrin (PRF) is a relatively new developed platelet concentrate with several benefits over platelet-rich plasma. The aim of this study was to compare healing properties of PRF and its combination with a ceramic synthetic material (graft) composed of hydroxyapatite and b-tricalcium phosphate in an animal model. A bone deficit was surgically created in each femoral condyle of 15 New Zealand white rabbits. In each animal, 1 limb had (a) PRF only and the other (b) PRF plus synthetic graft material randomly implanted. Experimental animals were killed 3 months postoperatively. Histological and radiological examinations were made by means of computed tomography and peripheral quantitative computed tomography. Mean density of the healed bone was statistically significantly greater when synthetic material was used (P synthetic material resulted in more cortical and subcortical bone formation (P = 0.038 and P = 0.037, respectively). The addition of the ceramic material significantly increased the formation of new bone, providing a better substrate for bone regeneration.

  18. Alveolar cleft closure with iliac bone graft: A case report.

    Directory of Open Access Journals (Sweden)

    Tichvy Tammama

    2017-04-01

    Conclusion: The timing of alveolar bone grafting usually associated with the state of the developing of dentition. Post operative management is important to get a good result, and to prevent any complications.

  19. Resorbable screws for fixation of autologous bone grafts

    NARCIS (Netherlands)

    Raghoebar, GM; Liem, RSB; Bos, RRM; van der Wal, JE; Vissink, A

    The aim of this study was to evaluate the suitability of resorbable screws made of poly (D,L-lactide) acid (PDLLA) for fixation of autologous bone grafts related to graft regeneration and osseointegration of dental implants. In eight edentulous patients suffering from insufficient retention of their

  20. Thumb proximal phalanx reconstruction with nonvascularized corticocancellous olecranon bone graft.

    Science.gov (United States)

    Soong, Maximillian

    2015-01-01

    Large segmental bone defects of the phalanges reportedly have been treated with free vascularized grafts from the hand, foot, or knee, or with nonvascularized grafts from the iliac crest. A nonvascularized structural corticocancellous graft from a local site would be advantageous. The olecranon has been used as a source of both cancellous and corticocancellous graft. The authors describe a unique case of the use of nonvascularized corticocancellous olecranon bone graft for structural purposes in a mutilating thumb injury. The patient injured the left thumb with a miter saw, resulting in a large degloving wound over a severely comminuted fracture of the proximal phalanx, with segmental bone loss between a base fragment and displaced condylar fragments. Provisional pin fixation was performed at the time of initial emergent irrigation and debridement, along with repairs of the extensor pollicis longus, radial digital nerve, and dorsal digital nerve. This was followed 3 weeks later by non-vascularized corticocancellous bone grafting from the olecranon to the proximal phalanx under regional anesthesia. The thumb was mobilized at 11 weeks, and solid union was radiographically confirmed at 6 months. The patient achieved moderate active range of motion and was able to return to work as a physical therapist. The elbow healed uneventfully and without pain or fracture at the donor site. This case shows that robust structural bone graft for the phalanges may be obtained from the nearby olecranon, under regional anesthesia, without microsurgery, and with potential advantages over the iliac crest. Copyright 2015, SLACK Incorporated.

  1. Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone.

    Science.gov (United States)

    Kang, Young-Hoon; Kim, Hyun-Min; Byun, June-Ho; Kim, Uk-Kyu; Sung, Iel-Yong; Cho, Yeong-Cheol; Park, Bong-Wook

    2015-12-30

    Jaw bone and iliac bone are the most frequently used autologous bone sources for dental implant placement in patients with atrophic alveolar ridges. However, the comparative long-term stability of these two autologous bone grafts have not yet been investigated. The aim of this study was to compare the stability of simultaneously placed dental implants with autologous bone grafts harvested from either the iliac crest or the intraoral jaw bone for severely atrophic alveolar ridges. In total, 36 patients (21 men and 15 women) were selected and a retrospective medical record review was performed. We compared the residual increased bone height of the grafted bone, peri-implantitis incidence, radiological density in newly generated bones (HU values), and implant stability using resonance frequency analysis (ISQ values) between the two autologous bone graft groups. Both autologous bone graft groups (iliac bone and jaw bone) showed favorable clinical results, with similar long-term implant stability and overall implant survival rates. However, the grafted iliac bone exhibited more prompt vertical loss than the jaw bone, in particular, the largest vertical bone reduction was observed within 6 months after the bone graft. In contrast, the jaw bone graft group exhibited a slower vertical bone resorption rate and a lower incidence of peri-implantitis during long-term follow-up than the iliac bone graft group. These findings demonstrate that simultaneous dental implantation with the autologous intraoral jaw bone graft method may be reliable for the reconstruction of edentulous atrophic alveolar ridges.

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

    OpenAIRE

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

    2012-01-01

    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...

  3. Bone Grafts in Jaw Cysts- Hydroxyapatite & Allogenic Bone – A Comparative Study

    Directory of Open Access Journals (Sweden)

    Showkat Mamun

    2009-11-01

    Full Text Available Background: Auto bone is the gold standard in bone grafting. However, the morbidity and additional surgical time associated with its collection, as well as the limited supply, have stimulated the search for substitutes. Allograft is more limited than autograft because it yields more variable clinical results. Composite synthetic grafts offer an alternative because Hydroxyapatite is chemically identical to the inorganic matrix of living bones and it can be processed synthetically. The intent was to evaluate these two graft materials for clinical use and to provide an insight on the different grafting strategies to enhance bone formation. Objective: To find out the bone healing process and the prognostic value for the patient using hydroxyapatite alloplastic material and allogenic bone graft. Method: Total 28 patients were included in the study after the clinical and radiological evaluation where 14 cases were treated with allogenic-bone graft and rest 14 cases were treated with hydroxyapatite alloplastic material after enucleation of the cystic lesion in random manner. The integration of hydroxyapatite and allogenic bone was assessed with postoperative lesion diameter, trabecular pattern, histopathological and scintigraphic examination of the successful graft cases. Statistical analysis was carried out by ‘unpaired T test' and ‘Chi square' test. Result: The radiological, histopathological and scintigraphical outcome of the patients treated with hydroxyaptite granule bone graft were clinically and statistically superior in comparison with those who were treated with allogenic bone graft. Conclusion: This safe and osteoconductive hydroxyapatite appears suitable for filling bone defects and bone cavities, showing less resorption and a rapid osseous integration. Key words: Hydroxyapatite; allogenic bone; scintigraphy; radiology; histopathology.DOI: 10.3329/bsmmuj.v2i1.3707 BSMMU J 2009; 2(1: 25-30

  4. Is there evidence that barrier membranes prevent bone resorption in autologous bone grafts during the healing period? A systematic review

    NARCIS (Netherlands)

    Gielkens, Pepijn F. M.; Bos, Ruud R. M.; Raghoebar, Gerry M.; Stegenga, Boudewijn

    2007-01-01

    Introduction: Autologous bone is considered the "reference standard" for bone-grafting procedures. A barrier membrane covering an autologous bone graft (guided bone regeneration [GBR]) is expected to prevent graft resorption. Good clinical results have been reported for GBR, although potential

  5. Harvesting olecranon bone graft in adults by using bone biopsy trephine

    Directory of Open Access Journals (Sweden)

    Fatih Kabakas

    2016-08-01

    Conclusion: Bone graft harvesting with trephine is technically easy and fast, and donor site morbidity is diminished compared other methods and donor sites. It can be performed under axillary anesthesia and provides adequate amounts of bone graft for upper extremity reconstructions. [Hand Microsurg 2016; 5(2.000: 44-49

  6. [Experimental study of delayed implantation on bone grafts].

    Science.gov (United States)

    Zhang, Guo-Zhi; Zhang, Guo-Quan

    2007-05-01

    To explore the feasibility of transplantation of frozen autogenous mandible with delayed implantation. Operations were performed to create two defects in the bilateral mandible of 16 dogs. The left defect was grafted by composite transplantation of frozen autogenous mandible (immersed in -196 degrees C liquid nitrogen) with fresh cancellous ilium (composite transplantation group, CTG). The right defect was grafted by fresh ilium (iliac transplantation group, ITG). Three months after transplantation one IMZ TPS dental implant was placed into the graft of each side. At 3, 6, 9, 12 weeks postoperatively, 4 animals were sacrificed respectively and the grafts with dental implant were harvested for gross observation, X-Ray examination and histological evaluation to compare peri-implant bone healing between composite transplantation group and iliac transplantation group. There was no absorbing bone density reducing image of peri-implant at each stage. The quantified X-Ray gray extent displayed obvious variation of interfacial bone density between two kinds of grafts at 3 weeks, 6 weeks and 9 weeks after implantation. The composite transplantation group obviously surpassed the iliac transplantation group. At 12 weeks after the implantation, there was no significant difference between the peri-implant bones of both sides. There was satisfactory osseointegration between the implants and the two kinds of grafts. The healing style of peri-implant bone was similar. Good osseointegration was performed between the implant and the composite transplantation of frozen autogenous mandible following delayed implantation.

  7. Vascularized connective tissue flap for bone graft coverage.

    Science.gov (United States)

    Herford, Alan S; Cooper, Todd C; Maiorana, Carlo; Cicciù, Marco

    2011-04-01

    Alveolar defects are characterized by missing soft and hard tissues. It is often necessary to combine secondary procedures to address the soft-tissue component. The authors describe a technique that uses a split-thickness flap design that is placed over the crest of the remaining ridge and extends in a palatal direction. This allows advancement of the flap with its exposed connective tissue over the bone graft and provides restoration of both bone and keratinized tissue. Seventeen patients with defects involving the anterior maxilla who required grafting procedures were including in this study. All patients had an autogenous bone graft (n  =  17) combined with osseointegrated implants (n  =  41). A split-thickness flap design was used at the time of bone graft placement (primary) in 9 patients and at the time of implant uncovering (secondary) in 8 patients. There were no cases of flap necrosis or dehiscence with exposure of the bone graft. All patients demonstrated an increase in keratinized tissue involving the peri-implant area. An apical repositioned split-thickness flap provides an increased zone of keratinized tissue with improved esthetics and implant maintenance. This technique can be performed simultaneously with the grafting procedure, thus avoiding extensive undermining of the adjacent soft tissue.

  8. Tissue-engineered fabrication of an osteochondral composite graft using rat bone marrow-derived mesenchymal stem cells.

    Science.gov (United States)

    Gao, J; Dennis, J E; Solchaga, L A; Awadallah, A S; Goldberg, V M; Caplan, A I

    2001-08-01

    This study tested the tissue engineering hypothesis that construction of an osteochondral composite graft could be accomplished using multipotent progenitor cells and phenotype-specific biomaterials. Rat bone marrow-derived mesenchymal stem cells (MSCs) were culture-expanded and separately stimulated with transforming growth factor-beta1 (TGF-beta1) for chondrogenic differentiation or with an osteogenic supplement (OS). MSCs exposed to TGF-beta1 were loaded into a sponge composed of a hyaluronan derivative (HYAF-11) for the construction of the cartilage component of the composite graft, and MSCs exposed to OS were loaded into a porous calcium phosphate ceramic component for bone formation. Cell-loaded HYAFF-11 sponge and ceramic were joined together with fibrin sealant, Tisseel, to form a composite osteochondral graft, which was then implanted into a subcutaneous pocket in syngeneic rats. Specimens were harvested at 3 and 6 weeks after implantation, examined with histology for morphologic features, and stained immunohistochemically for type I, II, and X collagen. The two-component composite graft remained as an integrated unit after in vivo implantation and histologic processing. Fibrocartilage was observed in the sponge, and bone was detected in the ceramic component. Observations with polarized light indicated continuity of collagen fibers between the ceramic and HYAFF-11 components in the 6-week specimens. Type I collagen was identified in the neo-tissue in both sponge and ceramic, and type II collagen in the fibrocartilage, especially the pericellular matrix of cells in the sponge. These data suggest that the construction of a tissue-engineered composite osteochondral graft is possible with MSCs and different biomaterials and bioactive factors that support either chondrogenic or osteogenic differentiation.

  9. Mandibular defect reconstruction with nonvascularized iliac crest bone graft.

    Science.gov (United States)

    Okoje, V N; Obimakinde, O S; Arotiba, J T; Fasola, A O; Ogunlade, S O; Obiechina, A E

    2012-01-01

    Reconstruction of mandibular defect is a challenge to the head and neck surgeon because of associated functional and esthetic problems. Our experience with the use of nonvascularized iliac crest bone graft is hereby reported. The aim was to report our experience with the use of nonvascularized iliac crest bone for mandibular defect reconstruction at University College Hospital, Ibadan. Nigeria. A retrospective descriptive study was performed. Cases of mandibular reconstruction with iliac crest bone graft between January 2001 and December 2007 were included in this study. Grafts were secured with either a stainless steel wire or a titanium plate. Preoperative diagnosis, postoperative follow-up records including investigations, diagnosis of graft infection and subsequent treatment modalities were extracted from the available records. Descriptive variables were analyzed with SPSS version 14. A total of 47 patients had mandibular defect reconstruction with nonvascularized iliac crest block bone during the study period. Thirty-eight patients had graft secured with transosseous wire [NVIBw] while 9 had a titanium plate [NVIBp]. The male:female ratio was 26:21 while the mean age of the patients was 24.6±4.25 years. Ten patients (21.3%) developed persistent graft infection during the postoperative period. All cases of infection occurred in patients who had transosseous wiring and analysis showed that 60% of the infected grafts revealed mixed microbial isolates containing Klebsiela spp, Pseudomonas Aeurogenosa, and E coli. Six (60%) of the infected grafts were removed as a result of unabated infection while 4 (40%) were successfully treated by exploration and pus drainage. Nonvascularized iliac crest bone graft provides an affordable and less technical choice for mandibular reconstruction with minimal complications in a resource-limited economy.

  10. Biphasic calcium phosphate–casein bone graft fortified with Cassia ...

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science; Volume 38; Issue 1. Biphasic calcium phosphate–casein bone graft fortified with Cassia occidentalis for bone tissue engineering and regeneration. B Santhosh Kumar T Hemalatha R Deepachitra R Narasimha Raghavan P Prabu T P Sastry. Volume 38 Issue 1 February 2015 ...

  11. Safety and morbidity of intra-oral zygomatic bone graft harvesting:development of a novel bone harvesting technique

    OpenAIRE

    Kainulainen, V.

    2004-01-01

    Abstract This study focuses on the development of a bone collecting device for intra-oral bone harvesting and on the introduction of a new bone graft donor site, zygomatic bone. A bone collector was constructed and tested in vitro. This bone collector is suitable and efficient in dental implant related bone grafting surgery. It was also found to be more efficient and with a larger capacity in bone harvesting when compared to the two commercially available bone collectors. A zygoma...

  12. Subantral bone grafts, a comparative study of the degree of resorption of alloplastic versus autologous grafts.

    Science.gov (United States)

    Onişor-Gligor, Florin; Juncar, Mihai; Câmpian, Radu Septimiu; BăciuŢ, Grigore; Bran, Simion; BăciuŢ, Mihaela Felicia

    2015-01-01

    The placement of dental implants in the posterior region of the maxillary may pose some difficulties caused by the quality and particularly, the quantity of the subantral bone reserve, which are overcome by subantral bone augmentation. The current study performs a comparative evaluation of the quality and especially, of the stability of alloplastic and autologous materials used for subantral bone augmentation. This study included 21 patients who underwent subantral bone augmentation with alloplastic and autologous material. The patients were followed-up over a 24-month period after bone augmentation, during which the osseointegration rate of dental implants and the stability of subantral grafts were evaluated. The rate of failure of dental implants placed in autologous material grafts was 1.89% (0.036±9.398), while the rate of failure of those placed in alloplastic material was 7.69% (1.960±19.194). Bone resorption was higher within 12 months of dental implant placement both for the alloplastic material (9.87±3.76%) and the autologous material (18.87±3.25%), while 12-24 months after bone augmentation it diminished. The implants placed in the autologous bone grafts had a lower rate of failure compared to those placed in the alloplastic material grafts; in contrast, alloplastic material had a lower resorption rate compared to autologous material.

  13. Vascularized bone grafts for congenital pseudarthrosis of the tibia.

    Science.gov (United States)

    Kanaya, F; Tsai, T M; Harkess, J

    1996-01-01

    Eight vascularized fibula grafts and two vascularized rib grafts were used for the treatment of 10 Boyd's Type II congenital pseudarthrosis of the tibia. All but one vascularized fibula graft united within 4 months. The two vascularized rib grafts did not unite until receiving a conventional bone graft. Nine spontaneous fractures were seen in four patients; all were subsequently treated successfully with cast or conventional bone graft. Corrective osteotomies were done in two patients. Follow-up averaged 8 years and 5 months (range, 5 years and 1 month to 14 years and 4 months). Average age at end of follow-up was 13 years and 6 months (range, 7 years and 10 months to 20 years and 4 months). After bony union was achieved, shortening of the affected leg averaged 3.8 centimeters, flexion deformity averaged 20 degrees, and valgus deformity averaged 24 degrees. In three patients, whose leg discrepancy averaged 4.9 centimeters, the leg was lengthened at an average patient age of 13 years and 9 months (age range, 11 years and 7 months to 15 years and 2 months). The resulting limb length discrepancy averaged 2.2 centimeters. Vascularized bone grafting is a reliable technique for achieving bony union in congenital pseudarthrosis of the tibia. Residual shortening may be corrected later by limb lengthening.

  14. Bare bone graft with vascularised iliac crest for mandibular reconstruction.

    Science.gov (United States)

    Sarukawa, Shunji; Noguchi, Tadahide; Oh-iwa, Ichiro; Sunaga, Ataru; Uda, Hirokazu; Kusama, Mikio; Sugawara, Yasushi

    2012-01-01

    "Bare bone graft" with a vascularised iliac crest is a procedure involving no soft tissue for intraoral lining, and the intraoral defect is covered with epithelial cells through secondary healing of the exposed bone. A vascularised iliac crest flap is transferred to a segmental mandibular defect intraorally in the position of the osteotomized stump upwardly. Granulation tissue is usually observed on the stump of the bone graft about 1 week after surgery. When sufficient granulation is observed after approximately 4 weeks, "resurfacing" is performed to prevent interference of hypergranulation tissue with epithelization. Resurfacing involves wiping the granulation tissue from the surface of the bone and covering with a plastic prosthesis fitted to the alveolus. A total of 11 patients underwent bare bone graft with a vascularised iliac crest. Resurfacing was performed at an average of 2.1 times for each patient. All wounds in the oral cavity were completely epithelialized from 2 weeks to 3 months after surgery. Complications with the recipient side occurred in four patients. Bare bone graft with the iliac crest is one favourable option for mandibular reconstruction utilising the particular shape of the bone without the attached soft tissue. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  15. Marginal bone loss in implants placed in grafted maxillary sinus.

    Science.gov (United States)

    Galindo-Moreno, Pablo; Fernández-Jiménez, Andrés; O'Valle, Francisco; Silvestre, Francisco J; Sánchez-Fernández, Elena; Monje, Alberto; Catena, Andrés

    2015-04-01

    The purpose of this study is to evaluate the vertical and horizontal graft bone resorption (GR) in grafted maxillary sinuses and the marginal bone loss (MBL) around implants placed in the sinuses with different prosthetic connections and to determine the effect of other clinical factors on these tissue responses at 6 and 18 months postloading. A total of 254 implants were placed in 150 grafted maxillary sinuses of 101 patients (51.5% female) with mean age of 52.2 years (range, 32-82 years). GR and MBL measurements were made in implants placed with two different prosthetic connections (internal and external) at 6 and 18 months postloading. The complex samples general linear model was used to analyze the influence of patient age, gender, smoking habit, history of periodontal disease, implantation timing (simultaneous vs deferred), and prosthetic abutment length on radiographic GR and MBL values. At 18 months postloading, the MBL ranged from 0 mm to 5.89 mm; less than 1 mm was lost around 49.0% (mesial) and 44.3% (distal) of the implants, while no bone was lost around 32.9% (mesial) and 26.7% (distal). The GR was significantly affected by smoking, remnant alveolar bone height, graft length, graft height, gender, and age, and it significantly decreased over time. The MBL was influenced by the type of connection, implantation timing, and prosthetic abutment length. The MBL was greater with longer postloading interval and higher patient age and in smokers. Resorption of grafts that combine autogenous cortical bone with anorganic bovine bone is dependent on the anatomic features of the sinus and is not affected by the time elapsed after the first 6 months. The MBL in implants placed in these grafted areas is time dependent and mainly related to potentially modifiable clinical decisions and patient habits. © 2013 Wiley Periodicals, Inc.

  16. Is Bone Grafting Necessary in the Treatment of Malunited Distal Radius Fractures?

    NARCIS (Netherlands)

    Disseldorp, D.J.; Poeze, M.; Hannemann, P.F.; Brink, P.R.G.

    2015-01-01

    Background Open wedge osteotomy with bone grafting and plate fixation is the standard procedure for the correction of malunited distal radius fractures. Bone grafts are used to increase structural stability and to enhance new bone formation. However, bone grafts are also associated with donor site

  17. 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.

  18. Journey of bone graft materials in periodontal therapy: A chronological review

    Directory of Open Access Journals (Sweden)

    Jitendra Kumar

    2016-01-01

    Full Text Available Bone, the basic building block of the healthy periodontium, is affected in most of the periodontal diseases and can be managed either by mechanically recontouring it or by grafting techniques, which encourages regeneration where it has been lost. Bone replacement grafts are widely used to promote bone formation and periodontal regeneration. Bone grafting, placing bone or bone substitutes into defects created by the disease process, acts like a scaffold upon which the body generates its own, new bone. A wide range of bone grafting materials, including bone grafts and bone graft substitutes, have been applied and evaluated clinically, including autografts, allografts, xenografts, and alloplasts. This review provides an overview of the clinical application, biologic function, and advantages and disadvantages of various types of bone graft materials used in periodontal therapy till date with emphasis on recent advances in this field.

  19. Vascularized fibular graft in infected tibial bone loss

    Directory of Open Access Journals (Sweden)

    C Cheriyan Kovoor

    2011-01-01

    Full Text Available Background : The treatment options of bone loss with infections include bone transport with external fixators, vascularized bone grafts, non-vascularized autogenous grafts and vascularized allografts. The research hypothesis was that the graft length and intact ipsilateral fibula influenced hypertrophy and stress fracture. We retrospectively studied the graft hypertrophy in 15 patients, in whom vascularized fibular graft was done for post-traumatic tibial defects with infection. Materials and Methods : 15 male patients with mean age 33.7 years (range 18 - 56 years of post traumatic tibial bone loss were analysed. The mean bony defect was 14.5 cm (range 6.5 - 20 cm. The mean length of the graft was 16.7 cm (range 11.5 - 21 cm. The osteoseptocutaneous flap (bone flap with attached overlying skin flap from the contralateral side was used in all patients except one. The graft was fixed to the recipient bone at both ends by one or two AO cortical screws, supplemented by a monolateral external fixator. A standard postoperative protocol was followed in all patients. The hypertrophy percentage of the vascularized fibular graft was calculated by a modification of the formula described by El-Gammal. The followup period averaged 46.5 months (range 24 - 164 months. The Pearson correlation coefficient (r was worked out, to find the relationship between graft length and hypertrophy. The t-test was performed to find out if there was any significant difference in the graft length of those who had a stress fracture and those who did not and to find out whether there was any significant difference in hypertrophy with and without ipsilateral fibula union. The Chi square test was performed to identify whether there was any association between the stress fracture and the fibula union. Given the small sample size we have not used any statistical analysis to determine the relation between the percentage of the graft hypertrophy and stress fracture. Results : Graft

  20. Bone grafting for alveolar ridge reconstruction. Review of 166 cases.

    Directory of Open Access Journals (Sweden)

    FUED SAMIR SALMEN

    Full Text Available ABSTRACT Objective: to investigate the predictive factors of failure in bone grafts for alveolar ridge augmentation and implant surgery. Methods: we reviewed the charts of 166 patients operated between 1995 and 2014. A total of 248 grafting procedures were performed. We submitted the data to the binomial test at 5% significance. Results: grafts to gain width of the alveolar ridge (65.32% were more frequent than sinus lifting (p<0.0001 and the number of grafts to the posterior maxilla (48.8% was greater than in other regions (p<0.01; 6.04% of the grafts were lost. The losses in anterior (p<0.0309 and posterior (p<0.0132 maxilla were higher than in the mandible. There were 269 implants installed in the grafted areas, of which only 4.83% were lost. The number of implants lost (4.51% in areas of onlay grafts was not statistically higher than those placed after sinus lifting (2.63%, p<0.2424. Losses were greater in the anterior (53.85% and posterior (38.46% maxilla than in the mandible (p<0.031. Regarding patients' age, 76.92% of the lost grafts (p<0.006 and 80% of the lost implants (p<0.001 were installed in patients over 40 years. Conclusion: failure rate was higher both for grafts and dental implants in the maxilla and in patients over 40 years of age.

  1. Healing of cortical bone grafts in athymic rats

    Energy Technology Data Exchange (ETDEWEB)

    Kirkeby, O.J.; Nordsletten, L.; Skjeldal, S. (Institute for Surgical Research, University of Oslo, Oslo (Norway))

    1992-01-01

    We studied healing of allogeneic and syngeneic cortical tibial segment grafts in athymic and normal rats. After 3, 6, and 12 weeks, the weight, circulation; and mineralization rate of the healing segment, and mechanical strength and stiffness of the healing tibia were measured. There were no differences between allogeneic and syngeneic grafts in athymic and normal animals at 3 or 6 weeks. After 12 weeks, the vascularization and mineralization of the grafts, but not of the surrounding callus, were smaller in the allogeneic grafts in the normal recipients than in the other groups. Also after 12 weeks, the stiffness of the healing tibiae was less in allogeneic grafts in normal recipients than in the other groups. The strength of the allogeneic grafts was less than the strength of the syngeneic grafts in both athymic and normal recipients. This suggests that T-cell-mediated rejection is responsible for decreased vascularization and mineralization of alogenecic bone and that the difference in strength between allogeneic and syngeneci grafts in not due to T-lymphocyte graft rejection. (au).

  2. Bone Grafts: MedlinePlus Health Topic

    Science.gov (United States)

    ... Health) Journal Articles References and abstracts from MEDLINE/PubMed (National Library of Medicine) Article: Single posterior surgical management for lumbosacral tuberculosis: titanium mesh versus... Article: Wrapping grafting for congenital pseudarthrosis of ...

  3. Bone grafts and biomaterials substitutes for bone defect repair: A review

    Directory of Open Access Journals (Sweden)

    Wenhao Wang

    2017-12-01

    Full Text Available Bone grafts have been predominated used to treat bone defects, delayed union or non-union, and spinal fusion in orthopaedic clinically for a period of time, despite the emergency of synthetic bone graft substitutes. Nevertheless, the integration of allogeneic grafts and synthetic substitutes with host bone was found jeopardized in long-term follow-up studies. Hence, the enhancement of osteointegration of these grafts and substitutes with host bone is considerably important. To address this problem, addition of various growth factors, such as bone morphogenetic proteins (BMPs, parathyroid hormone (PTH and platelet rich plasma (PRP, into structural allografts and synthetic substitutes have been considered. Although clinical applications of these factors have exhibited good bone formation, their further application was limited due to high cost and potential adverse side effects. Alternatively, bioinorganic ions such as magnesium, strontium and zinc are considered as alternative of osteogenic biological factors. Hence, this paper aims to review the currently available bone grafts and bone substitutes as well as the biological and bio-inorganic factors for the treatments of bone defect.

  4. Surgical Treatment of an Aneurysmal Bone Cyst with Avascular Bone Graft.

    Science.gov (United States)

    Ulici, Alexandru; Nahoi, Catalin; Carp, Madalina; Fodor, Ioan; Dinu, Cristina

    2017-01-01

    Background: Aneurysmal bone cyst is a solitary bone tumor, expansile and lytic most often seen in the second decade of life, more frequently in men than in women (2: 1). They can occur in any bone, most common in the metaphysis of the long bones of the lower limbs. Although it is a benign tumor formation, aneurysmal cysts may have an aggressive local evolution and can cause a significant decrease in bone strength. The pacient may present local pain, the appearance of local deformation due to a tumor mass or occurrence of pathological fractures. Traditionally these lesions were treated surgically (curettage or resection and bone grafting) with a relapse rate of about 20%. Because bone resection may lead to bone defects, deformations or damage in the affected limb's function, lately the preferred treatement percutaneous sclerotherapy using fibrosing alcoholic agents. We present the case of a 14 year old pacient submitted for pain and deformity at the distal third of the right forearm with insidious onset and exacerbated lately. Following clinical investigations, laboratory and histopathology he was diagnosed with aneurysmal bone cyst of the right ulna. Since sclerotherapy is not available in our clinic, we initially performed an excisional biopsy with curettage of the lesion. Because the tumor still had an aggressive postoperative evolution, we decided for a bone resection and reconstruction using an avascular peroneal graft. Postoperative, the patient presents a favorable short and medium term evolution, the disappearance of pain and resumed function of the affected segment. Radiologically bone graft integration can be observed, with no evidence of local recurrence. Although modern tehniques for treating anurysmal bone cyst include either injecting fibrosing alcoholic agents or resection and grafting using vascular bone graft, the traditional tehnique described by Merle d'Aubigne which implies the usage of avascular bone graft is still heplful, leading to succesful

  5. Alveolar ridge augmentation with the perforated and nonperforated bone grafts.

    Science.gov (United States)

    de Avila, Erica Dorigatti; Filho, José Scarso; de Oliveira Ramalho, Lizete Toledo; Real Gabrielli, Mario Francisco; Pereira Filho, Valfrido Antônio

    2014-02-01

    Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure. Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft. We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.

  6. An autoradiographic study of bone grafts in small animals.

    Science.gov (United States)

    Hildmann, H; Tiedjen, K U; Hildmann, A

    1986-01-01

    Bone remodelling was studied in allografts and isografts by means of autoradiography. Collagen and proteoglycans of the organic bone matrix were labelled with H-3 amino acids and S-35 sodium sulphate. The principles of primary bone formation are followed in graft remodelling as well. Matrix breakdown and reformation are carried out by mononuclear cells. Components of the original matrix can be seen in osteoclasts, perivascular cells, osteoblasts, young osteocytes, and in new bone. The label allows tracing of these components and proves their reuse.

  7. Autoradiographic study of bone grafts in small animals

    Energy Technology Data Exchange (ETDEWEB)

    Hildmann, H.; Tiedjen, K.U.; Hildmann, A.

    1986-07-01

    Bone remodelling was studied in allografts and isografts by means of autoradiography. Collagen and proteglycanes of the organic bone matrix were labelled with H-3 amino acids and S-35 sodium sulphate. The principles of primary bone formation are followed in graft remodelling as well. Matrix breakdown and reformation are carried out by mononuclear cells. Components of the original matrix can be seen in osteoclasts, perivascular cells, osteoblasts, young osteocytes, and in new bone. The label allows tracing of these components and proves their reuse.

  8. The role of autologous bone graft in surgical treatment of hypertrophic nonunion of midshaft clavicle fractures

    Directory of Open Access Journals (Sweden)

    Hui-Kuang Huang

    2012-05-01

    Conclusion: LC-DCP fixation is an effective method for treating hypertrophic nonunion of mid-shaft clavicle fracture. Local bone graft is sufficient to achieve necessary union, and autologous bone graft from other sites of the body appears unnecessary.

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

    NARCIS (Netherlands)

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

    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

  10. Onlay bone graft maintenance using guided bone regeneration, platelet rich plasma, and their combination.

    Science.gov (United States)

    Younis, Mohammed; Elshahat, Ahmed; Elhabbaa, Gamal; Fareed, Ahmed; Safe, Ikram

    2014-11-01

    Onlay bone grafts have a bad reputation of resorption with loss of contour and volume. Rigid fixation reduces the incidence of resorption but does not prevent it. Literature shows reduction of resorption by applying guided bone regeneration (GBR) barriers and platelet-rich plasma (PRP). Investigating the effect of combining them together to reduce resorption was the aim of this study. This study included 4 groups: control group, GBR group, PRP group, and GBR + PRP group. Twenty rabbits were used (40 mandibular halves). Onlay bone grafts were fixed by titanium miniscrews in all groups. Computed tomography scans of harvested mandibles after euthanasia allowed calculations of bone graft volume and density. Onlay bone graft volumes in all experimental groups were significantly higher than in the control group. Volume maintenance in the GBR group was significantly higher than in the PRP group. There was no significant difference in the volume of onlay bone grafts between the group of combined GBR + PRP and GBR alone. It was concluded that, to maintain the volume of onlay bone grafts, either GBR or PRP can be added. Combining them did not add any advantage over the GBR alone.

  11. Calvarial autogenous bone graft for maxillary ridge and sinus reconstruction for rehabilitation with dental implants.

    Science.gov (United States)

    Bastos, Alliny Souza; Spin-Neto, Rubens; Conte-Neto, Nicolau; Galina, Keidy; Boeck-Neto, Rodolfo Jorge; Marcantonio, Cláudio; Marcantonio, Elcio; Marcantonio, Elcio

    2014-08-01

    Autogenous bone grafting is the gold-standard technique for bone augmentation procedures prior to implant placement. If the amount of available intraoral donor bone is insufficient, it is necessary to harvest bone graft from extraoral sites, such as calvaria. Although this technique is well established, only a few case reports show the histological analysis of the grafted bone at the moment of implant placement. This article reports the case of a 48-year-old female patient with a critical atrophic maxillary ridge reconstructed using autogenous calvarial bone graft prior to implant placement, with clinical and histological evaluation. Bone was collected under general anesthesia from the parietal bone. The outer cortical originated the bone blocks, and the medullar bone layer between was collected to be used in the sinus augmentation procedure, together with 5 of the bone blocks triturated. Six months after bone augmentation, 8 implants were placed in the grafted area and 2 biopsies were retrieved (anterior and the posterior regions), allowing the visualization of the bone-remodeling process in the grafted areas. The patient had a stable recovery. Our results showed that although necrotic bone could still be seen in the outer layer of the grafted area, the interface between this necrotic bone and the already remodeled bone was consistent with biocompatibility. Two-year radiographic evaluation showed success of the grafts and the implants in supporting an esthetic and functionally stable prosthesis. Summarizing, calvarial bone grafts are a viable alternative for the attainment of adequate bone volume prior to implant placement.

  12. Alveolar ridge augmentation with the perforated and nonperforated bone grafts

    OpenAIRE

    Avila, Erica Dorigatti de [UNESP; Scarso Filho, José; de Oliveira Ramalho, Lizete Toledo; Real Gabrielli, Mario Francisco; Pereira Filho, Valfrido Antonio

    2014-01-01

    Purpose Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. Methods Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the...

  13. Canine investigation of rhBMP-2, autogenous bone graft, and rhBMP-2 with autogenous bone graft for the healing of a large segmental tibial defect.

    Science.gov (United States)

    Boyce, Andrew S; Reveal, Greg; Scheid, D Kevin; Kaehr, David M; Maar, Dean; Watts, Melanie; Stone, Marcus B

    2009-01-01

    The purpose of this study was to compare the effects of bone morphogenetic protein, bone morphogenetic protein with autogenous bone graft (ABG), and ABG alone on the healing of a large bone defect in the canine tibia. Fifteen 45- to 55-lb canines were randomly assigned to 1 of 5 treatment groups, 3 per group. The groups included (1) recombinant human bone morphogenetic protein (rhBMP-2, 0.43 mg/mL)/absorbable collagen sponge (ACS) + collagen/ceramic matrix (CCM), (2) rhBMP-2 (0.22 mg/mL) ACS + CCM, (3) rhBMP-2 (0.43 mg/mL) ACS + ABG, (4) rhBMP-2 (0.22 mg/mL) ACS + ABG, and (5) ABG alone. A 5-mL defect was created in the right tibia and fixed with a 4.5 mm locking plate and 1 of the grafts described above implanted. X-rays were taken biweekly for 12 weeks and evaluated for radiographic union. Representative histology was also examined. All defects treated with rhBMP-2 (any combination) healed at 6.0 +/- 0.9 weeks. None of the ABG alone-treated defects were healed at 12 weeks. Dogs receiving rhBMP-2/ACS + CCM healed at 5.7 +/- 0.8 weeks, whereas rhBMP-2/ACS + ABG defects healed at 6.3 +/- 0.8 weeks. Histology showed healing consistent with 12-week radiologic results. Large segmental defects in canine tibiae can be effectively healed with stable fixation and rhBMP-2/ACS + ABG or CCM. These conclusions may offer insight into the clinical treatment of segmental defect nonunions in the human.

  14. 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.

  15. Effects of Recombinant Human Bone Morphogenetic Protein-2 Dose and Ceramic Composition on New Bone Formation and Space Maintenance in a Canine Mandibular Ridge Saddle Defect Model.

    Science.gov (United States)

    Talley, Anne D; Kalpakci, Kerem N; Shimko, Daniel A; Zienkiewicz, Katarzyna J; Cochran, David L; Guelcher, Scott A

    2016-03-01

    Treatment of mandibular osseous defects is a significant clinical challenge. Maintenance of the height and width of the mandibular ridge is essential for placement of dental implants and restoration of normal dentition. While guided bone regeneration using protective membranes is an effective strategy for maintaining the anatomic contour of the ridge and promoting new bone formation, complications have been reported, including wound failure, seroma, and graft exposure leading to infection. In this study, we investigated injectable low-viscosity (LV) polyurethane/ceramic composites augmented with 100 μg/mL (low) or 400 μg/mL (high) recombinant human bone morphogenetic protein-2 (rhBMP-2) as space-maintaining bone grafts in a canine mandibular ridge saddle defect model. LV grafts were injected as a reactive paste that set in 5-10 min to form a solid porous composite with bulk modulus exceeding 1 MPa. We hypothesized that compression-resistant LV grafts would enhance new bone formation and maintain the anatomic contour of the mandibular ridge without the use of protective membranes. At the rhBMP-2 dose recommended for the absorbable collagen sponge carrier in dogs (400 μg/mL), LV grafts maintained the width and height of the host mandibular ridge and supported new bone formation, while at suboptimal (100 μg/mL) doses, the anatomic contour of the ridge was not maintained. These findings indicate that compression-resistant bone grafts with bulk moduli exceeding 1 MPa and rhBMP-2 doses comparable to that recommended for the collagen sponge carrier support new bone formation and maintain ridge height and width in mandibular ridge defects without protective membranes.

  16. Autogenous bone graft associated with enamel matrix proteins in bone repair.

    Science.gov (United States)

    Prata, Celina A; Lacerda, Suzie A; Brentegani, Luiz Guilherme

    2007-12-01

    Autogenous bone has been used with success as implants in intrabony defects, because of its biological advantages and osteogenic potential. The objective of this study was to evaluate histological and histometrically the bony repair in intrabony defects after dental extractions in rats with graft of a combination of the enamel matrix protein (EMP) (Emdogain, Strauman USA, LLC, Andover, MA. Headquarters in Basel, Switzerland) and autogenous bone. Male rats (Rattus norvegicus, Wistar variety) weighing from 250 to 300 g were anesthetized and submitted to the extraction of the superior incisive and divided in (a) group with autogenous bone (fragment of bone of the alveolar ridge was grafted inside the alveolus) and (b) group with autogenous bone associated with EMP. The animals were killed on the 7th, 21st, and 42nd day after the extraction. The maxillae were processed to obtain fine sections (5 microm) stained with hematoxylin-eosin. The percentual volume of bone tissue in contiguous areas of the graft was calculated through a counting point system of image. The results showed that the bone fragments grafted in the cervical third of the alveolus developed a progressive osseointegration without foreign-body reaction. The quantification of the bony repair in the areas adjacent to the graft showed that the autogenous bone associated with EMP produced a greater amount of bone (10%-15% by analysis of variance, P = 0.05) in all the studied periods. It was concluded that the autogenous bone associated with EMP grafted in bony defects, immediately after the dental extraction in rats, demonstrated biocompatibility and accelerated the repair of bone defect.

  17. Treatment of femoral head osteonecrosis using bone impaction grafting.

    NARCIS (Netherlands)

    Rijnen, W.H.C.; Gardeniers, J.W.M.; Buma, P.; Yamano, K.; Slooff, T.J.J.H.; Schreurs, B.W.

    2003-01-01

    Even in extensive osteonecrosis of the femoral head in younger patients, a femoral head-preserving method is preferable. We developed a new technique using the lateral approach as used in traditional core biopsy; the osteonecrotic lesion was removed and impacted bone grafts were used to regain

  18. A giant paediatric mandibular aneurysmal bone cyst and reconstruction with bilateral iliac bone graft.

    Science.gov (United States)

    Yuca, K; Kiris, M; Avcu, S; Bayram, I; Cankaya, H; Kiroğlu, A F

    2009-01-01

    A giant paediatric mandibular aneurysmal bone cyst and reconstruction with bilateral iliac bone graft. Aneurysmal bone cyst (ABC) is an unusual, non-neoplastic, expansile lesion of the bone. ABC is not a true cyst and it is characterised by the replacement of bone by fibro-osseous tissue containing blood-filled sinusoidal or cavernous spaces. The expanding mass often disrupts the normal bony architecture, with erosion of the cortex. Surgical treatment consists of complete excision or curettage. In this report, we present a 5-year-old girl with a huge aneurysmal bone cyst in the corpus of the mandible, which was reconstructed with bone graft taken from bilateral anterior iliac crests.

  19. 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.

  20. 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...

  1. Ankle arthrodesis with bone graft after distal tibia resection for bone tumors.

    Science.gov (United States)

    Campanacci, Domenico Andrea; Scoccianti, Guido; Beltrami, Giovanni; Mugnaini, Marco; Capanna, Rodolfo

    2008-10-01

    Treatment of distal tibial tumors is challenging due to the scarce soft tissue coverage of this area. Ankle arthrodesis has proven to be an effective treatment in primary and post-traumatic joint arthritis, but few papers have addressed the feasibility and techniques of ankle arthrodesis in tumor surgery after long bone resections. Resection of the distal tibia and reconstruction by ankle fusion using non-vascularized structural bone grafts was performed in 8 patients affected by malignant (5 patients) or aggressive benign (3 patients) tumors. Resection length of the tibia ranged from 5 to 21 cm. Bone defects were reconstructed with cortical structural autografts (from contralateral tibia) or allografts or both, plus autologous bone chips. Fixation was accomplished by antegrade nailing (6 cases) or plating (2~cases). All the arthrodesis successfully healed. At followup ranging from 23 to 113 months (average 53.5), all patients were alive. One local recurrence was observed with concomitant deep infection (a below-knee amputation was performed). Mean functional MSTS score of the seven available patients was 80.4% (range, 53 to 93). Resection of the distal tibia and arthrodesis of the ankle with non-vascularized structural bone grafts, combined with autologous bone chips, can be an effective procedure in bone tumor surgery with durable and satisfactory functional results. In shorter resections, autologous cortical structural grafts can be used; in longer resections, allograft structural bone grafts are needed.

  2. 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.

  3. Management of contaminated bone grafts: an experimental in vitro study.

    Science.gov (United States)

    Hooe, W; Steinberg, B

    1996-07-01

    This study tested various protocols for bone decontamination after bacterial contact to determine if these treatments altered bone structure. Femurs from five Sprague-Dawley rats were sectioned and separated into eight groups. These were contaminated in a broth containing Pseudomonas aeroginosa and Staphylococcus aureus. Subsequently, the groups were treated with eight different decontamination regimens. A Scheffe's Grouping test was used to statistically compare the bacterial counts after each treatment protocol. Treatment with 4% chlorhexidine gluconate and 4% alcohol, Neosporin, cefazolin, and saline solution had little effect on bacterial growth. However, povidone-iodine, autoclaving, and ethyl alcohol with ethanol did significantly decrease the bacterial colony counts from the bone specimens. The autoclave and ethyl alcohol/ethanol induced changes in bony histologic examination. Results suggested that povidone-iodine decontaminates bone specimens without altering histologic conditions. Determination of successful grafting of bone treated with this protocol is required before its recommendation for clinical use.

  4. Comparison of two beta-tricalcium phosphate composite grafts used for reconstruction of mandibular critical size bone defects.

    Science.gov (United States)

    Nolff, M C; Gellrich, N-C; Hauschild, G; Fehr, M; Bormann, K-H; Rohn, K; Spalthoff, S; Rücker, M; Kokemüller, H

    2009-01-01

    The aim was to compare osseointegration of blood perfused beta-tricalcium phosphate cylinders (beta-TCPB) with similar composites that were additionally loaded with cancellous bone and bone marrow (beta-TCPB/BM/CB) for mandibular reconstruction. Twelve German Black-Headed sheep with an average weight of 72.5 +/- 10 kg underwent segmental resection of the right hemi-mandible. The animals that were assigned to group A (n = 6) were reconstructed using beta-TCPB while the sheep that were assigned to group B received beta-TCPB/BM/CB grafts. Tissue quality was histologically assessed and bone-, scaffold-, cartilage- and fibrous-tissue area were estimated using semiautomated histomorphometrical software. Composite grafts that were loaded with bone marrow and cancellous bone (beta-TCPB/BM/CB) exhibited significant (pceramic remnants were rare and disconnected. Bone maturity within group A was inferior and none of the specimens showed defect union. The defect centre was still occupied by a ceramic core. Bone and bone marrow augmented beta-tricalcium phosphate composites may qualify as a promising alternative to autograft bone for mandibular reconstruction in human and veterinary medicine.

  5. Ceramic cement as a potential stand-alone treatment for bone fractures: An in vitro study of ceramic-bone composites.

    Science.gov (United States)

    Koh, Ilsoo; Gombert, Yvonne; Persson, Cecilia; Engqvist, Håkan; Helgason, Benedikt; Ferguson, Stephen J

    2016-08-01

    A vertebral burst fracture (VBF) treated with vertebroplasty using a ceramic cement consists of four regions; native bone fragments, native ceramic cement, ceramic cement-trabecular bone (ceramic-bone) composite and ceramic-bone interface. Although the mechanical properties of native bone and native ceramic cements have been well investigated, the mechanical properties of ceramic-bone composite and ceramic-bone interface remain unknown. Therefore, the aim of this study was to determine the mechanical properties of ceramic-bone composites and ceramic-bone interfaces. Two types of ceramic cement, calcium aluminate (CAC) with (w/F) and without (wo/F) fiber reinforcement, were investigated. Ceramic-bone composite (Full, wo/F and w/F) and ceramic-bone interface (Fract, wo/F and w/F) groups were tested to determine their compressive and tensile properties. While a continuous bone cylinder was used for samples in the Full groups, each bone cylinder for the samples in the Fract groups contained a 3mm geometrical discontinuity to mimic the fracture gaps in VBFs. Two Cement groups (wo/F and w/F) and a Bone group were included in the study as controls. Micro-CT images were used to determine the bone morphological parameters, as potential predictors of the mechanical properties of Full and Fract groups. The compressive strengths of Full and Fract groups were substantially lower than native CAC, but higher than bone. The tensile strength of the Full group was equal to bone, while the tensile strength of the Fract group was equivalent to CAC. Variable relationships between the bone morphological parameters and mechanical properties of Full and Fract groups were observed. Fiber reinforcement at an injectable level had a minimal influence on the mechanical properties. CAC augmentation does not provide adequate stabilization of bone fragments. The interface between bone and cement represents a weak point. The effect of cement augmentation cannot be predicted by bone morphological

  6. 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= 4/3/1) o...... (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....

  7. Processing strategies for smart electroconductive carbon nanotube-based bioceramic bone grafts

    Science.gov (United States)

    Mata, D.; Oliveira, F. J.; Ferreira, N. M.; Araújo, R. F.; Fernandes, A. J. S.; Lopes, M. A.; Gomes, P. S.; Fernandes, M. H.; Silva, R. F.

    2014-04-01

    Electroconductive bone grafts have been designed to control bone regeneration. Contrary to polymeric matrices, the translation of the carbon nanotube (CNT) electroconductivity into oxide ceramics is challenging due to the CNT oxidation during sintering. Sintering strategies involving reactive-bed pressureless sintering (RB + P) and hot-pressing (HP) were optimized towards prevention of CNT oxidation in glass/hydroxyapatite (HA) matrices. Both showed CNT retentions up to 80%, even at 1300 °C, yielding an increase of the electroconductivity in ten orders of magnitude relative to the matrix. The RB + P CNT compacts showed higher electroconductivity by ˜170% than the HP ones due to the lower damage to CNTs of the former route. Even so, highly reproducible conductivities with statistical variation below 5% and dense compacts up to 96% were only obtained by HP. The hot-pressed CNT compacts possessed no acute toxicity in a human osteoblastic cell line. A normal cellular adhesion and a marked orientation of the cell growth were observed over the CNT composites, with a proliferation/differentiation relationship favouring osteoblastic functional activity. These sintering strategies offer new insights into the sintering of electroconductive CNT containing bioactive ceramics with unlimited geometries for electrotherapy of the bone tissue.

  8. Bone microbial contamination influences autogenous grafting in sinus augmentation.

    Science.gov (United States)

    Verdugo, Fernando; Castillo, Ana; Moragues, María D; Pontón, José

    2009-08-01

    The oral occurrence of putative microbial pathogens in humans has been documented in health and disease. The presence of periodontopathogens in patients with a history of periodontal disease may have a negative impact on bone regeneration. This investigation was conducted to confirm the presence of periodontal pathogens in bone particles harvested intraorally for maxillary sinus augmentation and to assess the clinical and radiographic outcomes 6 to 12 months after bone augmentation. Culture and polymerase chain reaction (PCR)-based identification were performed by paper-point sampling of intraorally harvested bone particles in a group of 12 maintenance patients undergoing maxillary sinus augmentation. Radiographs were taken to assess and compare bone healing and volume gain at baseline and at 6 to 12 months after augmentation. The presence of periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans [previously Actinobacillus actinomycetemcomitans], Prevotella intermedia, Tannerella forsythia [previously T. forsythensis], Fusobacterium nucleatum, Parvimonas micra [previously Peptostreptococcus micros or Micromonas micros], Campylobacter rectus, enteric Gram-negative rods, and Dialister pneumosintes) was identified in 10 of 12 patients (83%) by culture, PCR, or both and was associated with greater bone volume loss at 6 months postaugmentation. The PCR-positive triad, P. gingivalis, A. actinomycetemcomitans, and P. intermedia, was associated with pronounced volume loss of the grafted sinus at 6 months. To the best of our knowledge, this is the first study to confirm osseous microbial contamination with major periodontopathogens in individuals undergoing maxillary sinus augmentation with a history of periodontitis. The effect on the grafting outcome translated into bone volume loss in the grafted sinus 6 months postaugmentation. Specific microbial contamination may have an impact on osteogenesis in osseous regeneration.

  9. Plasma spraying of bioactive glass-ceramics containing bovine bone

    Directory of Open Access Journals (Sweden)

    Annamária Dobrádi

    2017-06-01

    Full Text Available Natural bone derived glass-ceramics are promising biomaterials for implants. However, due to their price and weak mechanical properties they are preferably applied as coatings on load bearing implants. This paper describes result obtained by plasma spraying of bioactive glass-ceramics containing natural bone onto selected implant materials, such as stainless steel, alumina, and titanium alloy. Adhesion of plasma sprayed coating was tested by computed X-ray tomography and SEM of cross sections. The results showed defect free interface between the coating and substrate, without cracks or gaps. Dissolution rate of the coating in simulated body fluid (SBF was readily controlled by the bone additives (phase composition, as well as microstructure. The SBF treatment of the plasma sprayed coating did not influence the boundary between the coating and substrate.

  10. Biological interface of bone graft substitute materials : experimental studies on interactions between biomaterials and bone cells

    OpenAIRE

    Mladenovic, Zivko

    2011-01-01

    Bone graft substitute materials are becoming more common as alternative therapy strategies when bone defects in patients need to be treated. The interaction between bone cells and biomaterials occur at the surface of the materials. A great deal is known about the importance of surface topography and physic-chemical properties of biomaterials. It is also known that cells require proteins in order to interact with biomaterials. Less is known about how material properties and proteins interact f...

  11. Pharmacokinetics of gentamicin eluted from a regenerating bone graft substitute

    DEFF Research Database (Denmark)

    Stravinskas, M; Horstmann, P; Ferguson, J

    2016-01-01

    . Emerging bacterial resistance poses a major threat and new innovative treatment modalities are urgently needed to curb its current trajectory. MATERIALS AND METHODS: We present a new biphasic ceramic bone substitute consisting of hydroxyapatite and calcium sulphate for local antibiotic delivery......OBJECTIVES: Deep bone and joint infections (DBJI) are directly intertwined with health, demographic change towards an elderly population, and wellbeing.The elderly human population is more prone to acquire infections, and the consequences such as pain, reduced quality of life, morbidity, absence...... in combination with bone regeneration. Gentamicin release was measured in four setups: 1) in vitro elution in Ringer's solution; 2) local elution in patients treated for trochanteric hip fractures or uncemented hip revisions; 3) local elution in patients treated with a bone tumour resection; and 4) local elution...

  12. Demineralized Xenogenic Dentin and Autogenous Bone as Onlay Grafts to Rabbit Tibia.

    Science.gov (United States)

    Al-Asfour, Adel; Farzad, Payam; Al-Musawi, Ala; Dahlin, Christer; Andersson, Lars

    2017-04-01

    The present study was undertaken to evaluate the healing pattern of xenogenic demineralized dentin onlay grafts in comparison with autogenous bone grafts to the rabbit tibia. Eight 6-month-old New Zealand male rabbits were used in the experiments. Standardized sized dentin blocks from human premolars and similar autogenous bone blocks harvested from tibia were grafted as onlay blocks on each tibia (n = 8 × 2). All animals were killed after a healing period of 12 weeks. Healing was uneventful for all animals. In general, both the dentin and bone block grafts were fused to the bone, resorbed, and replaced by bone and connective tissue to a varying degree. Both types of grafts were still present after 12 weeks, on an average to approximately one third of the original sizes. Resorption cavities could be seen in the dentin with bone formation. Zones of osseous replacement resorption of the dentin could be noted. In both graft types, higher rate of bone formation was seen at the interface between graft and recipient site. Demineralized xenogenic dentin onlay grafts showed similar resorption characteristics as autogenous bone onlay grafts, being resorbed in a similar rate during 12 weeks. New bone formation occurred mainly in terms of replacement resorption in the interface between dentin/bone graft and native bone.

  13. 3D computed tomographic evaluation of secondary alveolar bone grafts in cleft lip and palate patients

    Energy Technology Data Exchange (ETDEWEB)

    Ohkubo, Fumio; Akai, Hidemi; Hosaka, Yoshiaki [Showa Univ., Tokyo (Japan). School of Medicine

    2001-04-01

    Alveolar bone grafting in patients with cleft lip and palate has becomes a routine part of most treatment regimes. This study was undertaken to estimate how much bone needs to be grafted into the cleft cavity and to evaluate the grafted bone using 3-DCT over a period from the early postoperative stage to after one year. Seventy-five patients divided into four groups according to the type of cleft were studied. All patients underwent secondary alveolar bone grafting using particulate cancellous bone from the anterior iliac crest. The bone graft areas were divided into two regions: the extra-cleft region and the intra-cleft region. The weight and the volume of the grafted bone were correlated and the average density was 1.5 g/ml regardless of the cleft type. The bone in the extra-cleft region could be seen in almost all slices of the CT scans, from the lower alveolar process to the piriform aperture. The extra-cleft graft ratio of unilateral and bilateral cleft lip and palate is higher than that of cleft lip and alveolus. The extra-cleft grafting is necessary to restore facial symmetry. The grafted bone was decreased in both height and volume following three months and adequate bone bridging was maintained for one year. We concluded that 3-DCT findings are one of the most valuable methods to evaluate postoperative conditions after alveolar bone grafting. (author)

  14. Effects of the placement of endosseous implants in vascularized bone grafts on bone union in beagle dogs.

    Science.gov (United States)

    Kobayashi, E; Ishihara, O; Mataga, I

    2005-09-01

    Recently, reconstructive surgery with revascularized osteocutaneous flaps has been used to restore function in patients with bone defects caused by surgery for oral cancer. However, few basic studies have addressed problems such as the union of bone segments after osteotomy, the effects of dental implant placement on blood flow, and bone formation at the bone:implant interface in grafted bone. Nine adult beagle dogs were divided into three groups of three dogs each. Each group received osteotomized vascularized tibial grafts, osteotomized tibial grafts with implants (implants placed in contralateral limbs as control), or simple (non-vascularized) tibial grafts. The development of bone around the implants was studied by histological examination, contact micro-radiography (CMR), and fluorescent bone labeling. In the dogs receiving osteotomized vascularized tibial grafts, bone bridging was confirmed at both the medial and distal junctions of the bone segments after 4 weeks. Additional newly formed bone was observed after 8 weeks, and bone union at the surface of the segments was completed after 12 weeks. In contrast, bone formation was clearly delayed in dogs receiving simple (non-vascularized) tibial grafts. Histologically, no difference in bone union was evident between limbs with dental implants in tibial bone and control limbs without implants, suggesting that implant placement does not negatively affect revascularization. Fluorescent bone labeling technique confirmed high vascularity of the vascularized tibial bone grafts but not of the simple (non-vascularized) tibial bone grafts early after the procedure. Our results suggest that osseointegration occurred around dental implants placed at the same time as reconstruction with osteotomized vascularized bone grafts in this animal model.

  15. Bupivacaine for pain reduction after iliac crest bone graft harvest.

    Science.gov (United States)

    O'Neill, Kevin R; Lockney, Dennis T; Bible, Jesse E; Crosby, Colin G; Devin, Clinton J

    2014-05-01

    Iliac crest bone graft remains the gold standard in achieving spinal arthrodesis, but chronic pain from graft harvest occurs in up to 39% of patients. Studies have shown that a single administration of local anesthetic reduces short-term pain, but they have not adequately investigated possible longer-term benefits. The goal of this study was to determine whether local administration of bupivacaine after iliac crest bone graft harvesting reduces pain and improves patient-reported outcomes. In this prospective, randomized, controlled, and blinded clinical study, 40 patients were identified who underwent posterior spine fusion with iliac crest bone graft and were randomized to receive either bupivacaine (treatment group, n=20) or saline (control group, n=20) at the iliac crest bone graft site. Pain at the harvest site was determined by a series of 12 visual and numeric pain scale assessments. Short Form-12 mental and physical component scores, EuroQol-5D, and Oswestry Disability Index assessments were made, along with determination of patient satisfaction and self-reported outcome of surgery. Baseline pain and outcome assessments were statistically similar (P>.05). Average pain scores were lower for all 12 assessments in the treatment group at mean follow-up of 5 weeks (significant differences in 6 assessments) and 20 weeks (significant differences in 2 assessments). No significant differences were found in Short Form-12 and EuroQol-5D scores. For patients who underwent lumbar fusion, the treatment group had significantly improved Oswestry Disability Index scores (mean±SD=10.8±7.1 vs 18.7±5.9, P=.012). Significantly more patients in the treatment group reported that surgery met all expectations (90% vs 50%, P=.016). This study is the 1st to show that a single administration of bupivacaine at the iliac crest bone graft harvest site during posterior spine fusion surgery can result in improved outcomes and reduced pain far beyond the anesthetic duration of activity

  16. 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

    Some studies have suggested that membranous bone grafts undergo less resorption than endochondral grafts, and faster revascularization of the former has been proposed as the explanation. We studied fresh syngeneic full-thickness bone grafts from calvaria, mandibula, tibia diaphysis, and iliac bon...

  17. Evaluation of rhBMP-2/collagen/TCP-HA bone graft with and without bone marrow cells in the canine femoral multi defect model.

    Science.gov (United States)

    Luangphakdy, V; Shinohara, K; Pan, H; Boehm, C; Samaranska, A; Muschler, G F

    2015-01-12

    Recombinant human bone morphogenetic protein-2, when applied to an absorbable type 1 bovine collagen sponge (rhBMP-2/ACS) is an effective therapy in many bone grafting settings. Bone marrow aspirate (BMA) has also been used as a source of transplantable osteogenic connective tissue progenitors. This study was designed to characterize the performance of a scaffold comprising rhBMP-2/ACS in which the sponge wraps around tri-calcium phosphate hydroxyapatite granules (rhBMP-2/ACS/TCP-HA) and to test the hypothesis that addition of BMA will improve the performance of this construct in the Canine Femoral Multi Defect Model. In each subject, two sites were grafted with rhBMP-2/ACS/TCP-HA scaffold loaded with BMA clot and two other sites with rhBMP-2/ACS/TCP-HA scaffold loaded with wound blood (WB). After correction for unresorbed TCP-HA granules, sites grafted with rhBMP-2/ACS/TCP-HA+BMA and rhBMP-2/ACS/TCP-HA+WB were similar, with mean percent bone volumes of 10.9 %±1.2 and 11.2 %±1.2, respectively. No differences were seen in quantitative histomorphometry. While bone formation using both constructs was robust, this study did not support the hypothesis that the addition of unprocessed bone marrow aspirate clot improved bone regeneration in a site engrafted with rhBMP-2/ACS/TCP-HA+BMA. In contrast to prior studies using this model, new bone formation was greater at the center of the defect where TCP-HA was distributed. This finding suggests a potential synergy between rhBMP-2 and the centrally placed ceramic and cellular components of the graft construct. Further optimization may also require more uniform distribution of TCP-HA, alternative cell delivery strategies, and a more rigorous large animal segmental defect model.

  18. Injectable PolyHIPEs as High Porosity Bone Grafts

    Science.gov (United States)

    Moglia, Robert S.; Holm, Jennifer L.; Sears, Nicholas A.; Wilson, Caitlin J.; Harrison, Dawn M.; Cosgriff-Hernandez, Elizabeth

    2011-01-01

    Polymerization of high internal phase emulsions (polyHIPEs) is a relatively new method for the production of high porosity scaffolds. The tunable architecture of these polyHIPE foams make them attractive candidates for tissue engineered bone grafts. Previously studied polyHIPE systems require either toxic diluents or high cure temperatures which prohibit their use as an injectable bone graft. In contrast, we have developed an injectable polyHIPE that cures at physiological temperatures to a rigid, high-porosity foam. First, a biodegradable macromer, propylene fumarate dimethacrylate (PFDMA), was synthesized that has appropriate viscosity and hydrophobicity for emulsification. The process of surfactant selection is detailed with particular focus on the key structural features of both polymer (log P values, hydrogen bond acceptor sites) and surfactant (HLB values, hydrogen bond donor sites) that enable stable HIPE formation. Incubation of HIPEs at 37°C was used to initiate radical crosslinking of the unsaturated double bond of the methacrylate groups to polymerize the continuous phase and lock in the emulsion geometry. The resulting polyHIPEs exhibited ~75% porosity, pore sizes ranging from 4 to 29 μm, and an average compressive modulus and strength of 33 and 5 MPa, respectively. These findings highlight the great potential of these scaffolds as injectable, tissue engineered bone grafts. PMID:21861465

  19. Injectable polyHIPEs as high-porosity bone grafts.

    Science.gov (United States)

    Moglia, Robert S; Holm, Jennifer L; Sears, Nicholas A; Wilson, Caitlin J; Harrison, Dawn M; Cosgriff-Hernandez, Elizabeth

    2011-10-10

    Polymerization of high internal phase emulsions (polyHIPEs) is a relatively new method for the production of high-porosity scaffolds. The tunable architecture of these polyHIPE foams makes them attractive candidates for tissue engineered bone grafts. Previously studied polyHIPE systems require either toxic diluents or high cure temperatures which prohibit their use as an injectable bone graft. In contrast, we have developed an injectable polyHIPE that cures at physiological temperatures to a rigid, high-porosity foam. First, a biodegradable macromer, propylene fumarate dimethacrylate (PFDMA), was synthesized that has appropriate viscosity and hydrophobicity for emulsification. The process of surfactant selection is detailed with particular focus on the key structural features of both polymer (logP values, hydrogen bond acceptor sites) and surfactant (HLB values, hydrogen bond donor sites) that enable stable HIPE formation. Incubation of HIPEs at 37 °C was used to initiate radical cross-linking of the unsaturated double bond of the methacrylate groups to polymerize the continuous phase and lock in the emulsion geometry. The resulting polyHIPEs exhibited ~75% porosity, pore sizes ranging from 4 to 29 μm, and an average compressive modulus and strength of 33 and 5 MPa, respectively. These findings highlight the great potential of these scaffolds as injectable, tissue engineered bone grafts.

  20. Connective tissue graft combined with autogenous bone graft in the treatment of peri-implant soft and hard tissue defect.

    Science.gov (United States)

    Deliberador, Tatiana Miranda; Vieira, Juliana Souza; Bonacin, Rodrigo; Storrer, Carmen L Mueller; Santos, Felipe Rychuv; Giovanini, Allan Fernando

    2015-02-01

    The use of dental implants to improve functional and esthetic demands of dentition has increased significantly over the past two decades. Soft and hard tissue management is one of the factors contributing to improved esthetic results. This report describes the correction of an esthetic problem in a single implant combined connective tissue graft and autogenous bone graft. Four months after the surgical procedure, it could be observed that the combination of connective tissue graft and autogenous bone graft resulted in the augmentation of hard and soft tissue in the peri-implant area with favorable esthetic outcomes.

  1. 3D Printing of Calcium Phosphate Ceramics for Bone Tissue Engineering and Drug Delivery.

    Science.gov (United States)

    Trombetta, Ryan; Inzana, Jason A; Schwarz, Edward M; Kates, Stephen L; Awad, Hani A

    2017-01-01

    Additive manufacturing, also known as 3D printing, has emerged over the past 3 decades as a disruptive technology for rapid prototyping and manufacturing. Vat polymerization, powder bed fusion, material extrusion, and binder jetting are distinct technologies of additive manufacturing, which have been used in a wide variety of fields, including biomedical research and tissue engineering. The ability to print biocompatible, patient-specific geometries with controlled macro- and micro-pores, and to incorporate cells, drugs and proteins has made 3D-printing ideal for orthopaedic applications, such as bone grafting. Herein, we performed a systematic review examining the fabrication of calcium phosphate (CaP) ceramics by 3D printing, their biocompatibility in vitro, and their bone regenerative potential in vivo, as well as their use in localized delivery of bioactive molecules or cells. Understanding the advantages and limitations of the different 3D printing approaches, CaP materials, and bioactive additives through critical evaluation of in vitro and in vivo evidence of efficacy is essential for developing new classes of bone graft substitutes that can perform as well as autografts and allografts or even surpass the performance of these clinical standards.

  2. Comparative Efficacies of Collagen-Based 3D Printed PCL/PLGA/β-TCP Composite Block Bone Grafts and Biphasic Calcium Phosphate Bone Substitute for Bone Regeneration.

    Science.gov (United States)

    Hwang, Kyoung-Sub; Choi, Jae-Won; Kim, Jae-Hun; Chung, Ho Yun; Jin, Songwan; Shim, Jin-Hyung; Yun, Won-Soo; Jeong, Chang-Mo; Huh, Jung-Bo

    2017-04-17

    The purpose of this study was to compare bone regeneration and space maintaining ability of three-dimensional (3D) printed bone grafts with conventional biphasic calcium phosphate (BCP). After mixing polycaprolactone (PCL), poly (lactic-co-glycolic acid) (PLGA), and β-tricalcium phosphate (β-TCP) in a 4:4:2 ratio, PCL/PLGA/β-TCP particulate bone grafts were fabricated using 3D printing technology. Fabricated particulate bone grafts were mixed with atelocollagen to produce collagen-based PCL/PLGA/β-TCP composite block bone grafts. After formation of calvarial defects 8 mm in diameter, PCL/PLGA/β-TCP composite block bone grafts and BCP were implanted into bone defects of 32 rats. Although PCL/PLGA/β-TCP composite block bone grafts were not superior in bone regeneration ability compared to BCP, the results showed relatively similar performance. Furthermore, PCL/PLGA/β-TCP composite block bone grafts showed better ability to maintain bone defects and to support barrier membranes than BCP. Therefore, within the limitations of this study, PCL/PLGA/β-TCP composite block bone grafts could be considered as an alternative to synthetic bone grafts available for clinical use.

  3. Comparative Evalution of G bone (Hydroxyapatite) and G-Graft (Hydroxyapatite with Collagen) as Bone Graft Material in Mandibular III Molar Extraction Socket.

    Science.gov (United States)

    Panday, Vijayendra; Upadhyaya, Vivekananda; Berwal, Vikas; Jain, Kapil; Sah, Nupur; Sarathi, Partha; Swami, Pushp Chander

    2015-03-01

    Bone grafting is a dynamic phenomenon. It is a surgical procedure that replaces missing bone with material either from patient's own body, or, an artificial, synthetic or natural substitute. A successful bone graft when applied, heals, becomes incorporated, re-vascularises and eventually assumes the form desired. The main purpose of this present study was to radiologically assess and compare the regenerative potential of hydroxyapatite with Collagen (G-Graft) and hydroxyapatite (G-Bone) and to evaluate the clinical usefulness of these materials to enhance bone healing in third molar extraction sites through bone formation. The study was carried out in the Department of Oral & Maxillofacilal Surgery, patients were divided into three groups. The rationale for assigning the patients to the groups was strictly random: Group I - G-Graft (Hydroxyapatite with Collagen) was used as Bone graft material, Group II - Bone graft material used was G-Bone (Hydroxyapatite), Group III-control group (no grafts was used). Orthopentomogram(OPG) images were taken intra-operatively, just after extraction in the Group III (control), after extraction but before graft placement in Group I & II (study groups) and post-operatively at the end of first month and third month. Bone density of the post-extraction sockets was measured at four random areas through 'densitometric analysis' software in the OPG program (Kodak 8000C Digital Panoramic System, Eastman Kodak Company) and an average value was recorded at each review. The percentage increase in bone density between 1(st) month & 3(rd) month was 7.55± 12.43 in Group I (G Graft), 4.41± 5.4859 in Group II (G Bone), while that Group III (control) was found to be -0.82 ± 3.96. The bone density increase was found to be statistically highly significant (p<0.01)) between all groups. The present study concluded that G-Graft has a definite regenerative potential and is better than G-bone and can be used in bony defects to enhance the bone healing

  4. Aneurysmal bone cysts treated by curettage, cryotherapy and bone grafting

    NARCIS (Netherlands)

    Schreuder, HWB; Veth, RPH; Pruszczynski, M; Lemmens, JAM; Molenaar, WM; Schraffordt Koops, H.

    We treated 26 patients with 27 aneurysmal bone cysts by curettage and cryotherapy and evaluated local tumour control. complications and functional outcome. The mean follow-up time was 37 months (19 to 154), There was local recurrence in one patient. Two patients developed deep wound infections and

  5. Reinforcing the Mucoperiosteal Pocket with the Scarpa Fascia Graft in Secondary Alveolar Bone Grafting: A Retrospective Controlled Outcome Study.

    Science.gov (United States)

    Lonic, Daniel; Yamaguchi, Kazuaki; Chien-Jung Pai, Betty; Lo, Lun-Jou

    2017-10-01

    Secondary alveolar bone grafting is the gold standard for the treatment of alveolar clefts in cleft lip and palate patients. The authors present a modified method using a Scarpa fascia graft that is placed deep into the mucoperiosteal pocket for watertight sealing of the bone graft chamber and limiting the graft position to the alveolar region for bony stability and tooth support. The outcome was assessed for clinical success in terms of bone graft stability and infection rate. Seventy-four unilateral complete cleft lip and palate patients were enrolled in this retrospective study consisting of equal-size Scarpa fascia and control groups of consecutive unilateral complete cleft lip and palate patients undergoing secondary alveolar bone grafting. Occlusal radiographs of the alveolar cleft taken at least 1 year postoperatively were evaluated for Spearman correlated Bergland and Witherow scales. Statistical evaluation was conducted using t test, chi-square test, and odds ratio. The clinical success rate (Bergland types I and II) of the Scarpa fascia procedure was significantly higher (67.6 versus 94.6 percent, respectively), with a significantly lower infection rate (16.2 versus 2.7 percent, respectively) and a high correlation of Bergland and Witherow scales (0.964; p fascia group. The authors' new method of alveolar bone grafting with the Scarpa fascia graft is safe and effective, and has one of the highest documented success rates. Therapeutic, III.

  6. The surgical approach and source of bone graft for symptomatic nonunion of the scaphoid.

    Science.gov (United States)

    Hull, W J; House, J H; Gustillo, R B; Kleven, L; Thompson, W

    1976-01-01

    In 2 groups of patients treated by bone grafting for scaphoid nonunions, one group had a dorsal or dorsolateral surgical approach with a bone graft from the radius while the other group had a volar approach with an iliac graft. The best results were obtained with an iliac graft. Through the volar approach it is relatively easy to avoid damage to the scaphoid arterial supply. A small proximal vascular pole led to a failure rate of 36%.

  7. Grafting cyclodextrins to calcium phosphate ceramics for biomedical applications

    DEFF Research Database (Denmark)

    Jacobsen, P.A.L.; Nielsen, J.L.; Juhl, M.V.

    2012-01-01

    The grafting of hydroxyapatite/beta-tricalcium phosphate with β-cyclodextrin was achieved using a two step reaction with (3-glycidyloxypropyl)trimethoxysilane as a linker. Firstly, the silane group was brought to react with the hydroxyl groups at the surface of the hydroxyapatite/beta-tricalcium ...

  8. Evaluation of the Healing Potential of Demineralized Dentin Matrix Fixed with Recombinant Human Bone Morphogenetic Protein-2 in Bone Grafts

    Directory of Open Access Journals (Sweden)

    Sang-Yun Kim

    2017-09-01

    Full Text Available We aimed to evaluate the efficacy of demineralized dentin matrix (DDM fixed with recombinant human bone morphogenetic protein-2 (rhBMP-2 through an experimental and a clinical study. Unilateral upper second and third premolars of eight beagles were extracted. A mucoperiosteal flap was elevated around the extraction socket, and a bone defect was made using a surgical drill. Each DDM was fixed with rhBMP-2, and autogenous bone was grafted at the bone defect area with a collagenous membrane. The beagles were euthanized at two, four, eight, and 12 weeks after receiving the bone graft. Block specimens involving grafted bone and surrounding natural bone were extracted. A total of 23 patients who received bone grafts using human DDM fixed with rhBMP-2 (AutoBT BMP with implant placements (36 implants; maxilla: 14, mandible: 22 were selected. The implant stability, marginal bone loss, and clinical outcome were evaluated. Three trephine cores were harvested fourmonths after bone grafting, and histologic examination was performed. In the histological evaluation performed four weeks after the bone graft, autogenous bone showed 52% new bone formation and DDM fixed with rhBMP-2 showed 33% new bone formation. Twelve weeks after the bone graft, autogenous bone showed 75% new bone formation and DDM fixed with rhBMP-2 showed 48% new bone formation. In the clinical study, favorable osseointegration was obtained in 35 out of 36 implant sites (one case of osseointegration failure. In all cases, severe complications were not observed. Histomorphometrically, new bone formation was observed in 14.98% of the cases. The residual DDM particles were 6.22%. AutoBT BMP provides good osteoinductive and osteoconductive potential and clinical efficacy.

  9. The use of bone-graft substitutes in large bone defects: any specific needs?

    Science.gov (United States)

    Calori, G M; Mazza, E; Colombo, M; Ripamonti, C

    2011-09-01

    The gold standard for restoring bone defects is still considered to be autologous bone grafting. However, clinical benefits are not guaranteed and donor-site complications and morbidity is not infrequent. Research is on-going for the development of alternative bone substitutes of both biological and synthetic origin. The purpose of this study was to evaluate the type of materials used and their efficacy for the treatment of large bone defects in traumatology and orthopaedic surgery. A literature review was carried out of Embase and PubMed databases. Inclusion criteria were articles in English language focusing on the use of bone substitutes in trauma and orthopaedic surgery for the treatment of bone defects and included details on the structural, biological or biomechanical properties of the pure product. Furthermore, based on two clinical challenges, fracture non-union and impaction grafting we elaborated on the use of polytherapy for large bone defects as guided by the diamond concept. All the products indicated in this manuscript possess osteoconductive activities but have different resorption times and biomechanical properties. Bone graft substitute materials are used for a wide range of clinical applications even when the level of clinical evidence is low. The size and location of the defect and the local biological and mechanical environment as well as the biomechanical characteristics of the material determine the type of device that can be implanted in a bone defect. Proper assessment of the biological and mechanical environment and accurate patient selection are necessary to judge the extent of therapy the injury warrants. A sound understanding of various aspects of biomaterial properties and their relation and influence towards bone healing is of utmost importance. We suggest the application of polytherapy for the treatment of large bone defects and advocate the use of the diamond concept as a guideline. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone

    National Research Council Canada - National Science Library

    Kang, Young-Hoon; Kim, Hyun-Min; Byun, June-Ho; Kim, Uk-Kyu; Sung, Iel-Yong; Cho, Yeong-Cheol; Park, Bong-Wook

    2015-01-01

    .... The aim of this study was to compare the stability of simultaneously placed dental implants with autologous bone grafts harvested from either the iliac crest or the intraoral jaw bone for severely...

  11. Accuracy of Coracoid Bone Graft Placement: Open versus Arthroscopic Latarjet.

    Science.gov (United States)

    Russo, Adriano; Grasso, Andrea; Arrighi, Annalisa; Pistorio, Angela; Molfetta, Luigi

    2017-06-01

    Purpose  The aim of this study was to compare the accuracy of the coracoid bone graft placement with the open Latarjet-Patte and arthroscopic Latarjet (arthro-Latarjet) procedures in the treatment of anterior instability of the shoulder. Methods  Forty-six patients affected by anterior shoulder instability were divided into two groups. In group A ( n  = 25), patients were operated by arthroscopic Latarjet (arthro-Latarjet) procedure and in group B ( n  = 21), patients were operated by open Latarjet-Patte procedure. Instrumental investigation was based on three-dimensional computed tomography (3D-CT) at a minimum 1-year follow-up. Graft placement and integration, divergence and posterior protrusion of the screws, and glenohumeral osteoarthritis were considered as outcomes. Statistical analysis was performed with chi-square or Fisher's exact test. Significance was set at p  Latarjet-Patte procedure showed better results than those of the arthro-Latarjet group in reference to the positioning of the graft on the coronal plane ( p  = 0.025). No significant differences between the groups were observed for graft integration, divergence of the screws, posterior protrusion of the screws, and osteoarthritis. Level of Evidence  Level II, nonrandomized prospective comparative study.

  12. Maxillary reconstruction using anterolateral thigh flap and bone grafts.

    Science.gov (United States)

    Bianchi, Bernardo; Ferri, Andrea; Ferrari, Silvano; Copelli, Chiara; Sesenna, Enrico

    2009-01-01

    Loss of the maxilla and midfacial bone buttresses after tumor resections can lead to severe functional and esthetic consequences. The loss of palate function may lead to oro-nasal communication, nasal speech, and oral intake difficulties. Several techniques have been proposed for maxillary defects reconstruction including prosthesis, locoregional flaps, or free flaps. The authors propose the use of anterolateral thigh free flap and iliac crest, or calvaria bone graft association for reconstruction of this kind of defects. Between November 2003 and June 2007, eight patients underwent maxillectomies, with preservation of the orbital contents and simultaneous reconstruction using this technique. : All the flaps were harvested and transplanted successfully. No major complication occurred and only one patient developed a palatal dehiscence with partial necrosis of the skin of the flap. There were no complications at the donor sites. Speech was assessed as normal in five patients, intelligible in two patients, and poor in one patient. Six patients returned to normal diets, while two patients were restricted to soft diets. The esthetic results were evaluated by the patients themselves as good (in five cases) and acceptable (in two cases). In the remaining case, the esthetic result was deemed to be poor, due to ectropion and poor color matching of the skin used for the external coverage. The good results obtained using this technique encourage the choice of the association of anterolateral thigh and bone grafts for reconstructing maxillary complex defects. Copyright 2009 Wiley-Liss, Inc. Microsurgery 2009.

  13. Synthetic Parathyroid Hormone May Augment Bone Volume in Autogenous Grafts: A Study in Rats.

    Science.gov (United States)

    dos Santos, Rodrigo A B; Ferreira, Marcelo S; Mafra, Carlos Eduardo S; Holzhausen, Marinella; de Lima, Luiz Antônio Pugliesi Alves; Mendes Pannuti, Cláudio; César Neto, João Batista

    2016-01-01

    Synthetic parathyroid hormone [PTH(1-34)] has been investigated for its benefits on bone healing and osteoporosis treatment; however, there is little information regarding bone grafts. This study therefore investigates the effect of PTH(1-34) on autogenous bone graft healing. Bone grafts were harvested from the calvarium of rats with a trephine bur (3-mm internal diameter) and placed on the cortex near the mandible angle with a titanium screw. Animals were randomly assigned to group 1 (control): subcutaneous injections of saline solution, three times a week (n = 15); group 2: 2 μg/kg PTH(1-34), three times a week (n = 15); and group 3: 40 μg/kg PTH(1-34), three times a week (n = 15). Thirty days postoperatively, the animals were killed, and specimens (implant + bed + graft) were removed and used for undecalcified sections. The following histometric parameters were evaluated: total bone thickness (TT) (bed + gap + graft), graft thickness (GT) (adjacent to the implant), bone-to-implant contact (BIC), and bone area (BA) (within the limits of the threads). Five additional animals were sacrificed immediately after surgery (zero hour) to register bed and graft sizes before healing. Group 3 showed significantly greater bone gain compared with groups 1 and 2 (TT and GT, P bone gain (1.21%). Data analysis revealed a significant difference for group 3 compared with groups 1 and 2 (P 0.05). Systemic administration of PTH(1-34) augmented bone volume in autogenous grafts.

  14. 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...

  15. Bone grafting for alveolar ridge reconstruction. Review of 166 cases.

    Science.gov (United States)

    Salmen, Fued Samir; Oliveira, Marina Reis; Gabrielli, Marisa Aparecida Cabrini; Piveta, Ana Cláudia Gabrielli; Pereira, Valfrido Antonio; Gabrielli, Mario Francisco Real

    2017-01-01

    to investigate the predictive factors of failure in bone grafts for alveolar ridge augmentation and implant surgery. we reviewed the charts of 166 patients operated between 1995 and 2014. A total of 248 grafting procedures were performed. We submitted the data to the binomial test at 5% significance. grafts to gain width of the alveolar ridge (65.32%) were more frequent than sinus lifting (pimplants installed in the grafted areas, of which only 4.83% were lost. The number of implants lost (4.51%) in areas of onlay grafts was not statistically higher than those placed after sinus lifting (2.63%, pimplants (pdental implants in the maxilla and in patients over 40 years of age. investigar os fatores preditivos de falhas em enxertos ósseos para aumento do rebordo alveolar e cirurgia de implantes. os prontuários de 166 pacientes, operados entre 1995 e 2014, foram revistos. Um total de 248 enxertos foi realizado. Os dados foram submetidos ao teste binomial a 5% de significância. os enxertos para ganho em espessura do rebordo alveolar (65,32%) foram mais frequentes do que levantamentos de seio maxilar (pimplantes nas áreas enxertadas e apenas 4,83% perdidos. O número de implantes perdidos (4,51%) em áreas de enxertos em bloco não foi estatisticamente maior do que na área de seios maxilares enxertados (2,63%) (pimplantes perdidos (pimplantes dentários realizados em maxila e em pacientes com mais de 40 anos de idade.

  16. Bone graft substitutes for the treatment of traumatic fractures of the extremities.

    Science.gov (United States)

    Hagen, Anja; Gorenoi, Vitali; Schönermark, Matthias P

    2012-01-01

    HEALTH POLITICAL AND SCIENTIFIC BACKGROUND: 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 elevated 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

  17. The Effect of Bisphasic Calcium Phosphate Block Bone Graft Materials with Polysaccharides on Bone Regeneration

    Directory of Open Access Journals (Sweden)

    Hyun-Sang Yoo

    2017-01-01

    Full Text Available In this study, bisphasic calcium phosphate (BCP and two types of polysaccharide, carboxymethyl cellulose (CMC and hyaluronic acid (HyA, were used to fabricate composite block bone grafts, and their physical and biological features and performances were compared and evaluated in vitro and in vivo. Specimens of the following were prepared as 6 mm diameter, 2 mm thick discs; BPC mixed with CMC (the BCP/CMC group, BCP mixed with crosslinked CMC (the BCP/c-CMC group and BCP mixed with HyA (the BCP/HyA group and a control group (specimens were prepared using particle type BCP. A scanning electron microscope study, a compressive strength analysis, and a cytotoxicity assessment were conducted. Graft materials were implanted in each of four circular defects of 6 mm diameter in calvarial bone in seven rabbits. Animals were sacrificed after four weeks for micro-CT and histomorphometric analyses, and the findings obtained were used to calculate new bone volumes (mm3 and area percentages (%. It was found that these two values were significantly higher in the BCP/c-CMC group than in the other three groups (p < 0.05. Within the limitations of this study, BCP composite block bone graft material incorporating crosslinked CMC has potential utility when bone augmentation is needed.

  18. 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.

  19. Early bone resorption of free microvascular reanastomized bone grafts for mandibular reconstruction--a comparison of iliac crest and fibula grafts.

    Science.gov (United States)

    Mertens, Christian; Decker, Christian; Engel, Michael; Sander, Anja; Hoffmann, Jürgen; Freier, Kolja

    2014-07-01

    Patients with continuous bone defects of the mandible after ablative tumor surgery need bony reconstruction for proper function and aesthetics. Free microvascular reanastomized bone grafts provide a clinically proven option for such patients, yet the optimal source of donor tissue has not yet been established. The aim of this study was to evaluate and compare the bone volume stability of vascularized bone grafts, particularly in the early highly resorptive phase, from the iliac crest (DCIA) and the fibula and to assess the implantologic rehabilitations. Thirty-six patients with mandibular continuity defects due to tumor resection were reconstructed by the use of vascularized bone grafts; 21 patients received DCIA flaps and 15 patients received a composite free fibular flap, depending on the size and location of the defect. Bone resorption was assessed using digital panographs. Radiographs were taken immediately after bone reconstruction, 6 months postoperatively, prior to implant surgery, and at prosthetic loading. After a mean observation period of 6 months, vertical bone resorption was 6.79% for the patients of the iliac crest group (DCIA), 10.20% after 11 months, and 12.58% after 17 months. Fibular grafts showed a bone resorption of 5.30% after a mean observation time of 6 months, 8.26% after 11 months, and 16.95% after 17 months. Eighteen patients received 71 implants for implant-retained dental reconstructions. Microvascular reanastomized bone grafts represent a reliable treatment option for reconstruction in cases of large defects of the mandible, with low graft resorption in the early healing phase. Additionally, the compared grafts provide sufficient bone volume to permit implant rehabilitation. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. Virtual Surgery Planning and Three-Dimensional Printing Template to Customize Bone Graft Toward Implant Insertion.

    Science.gov (United States)

    Pham Dang, Nathalie; Lafarge, Agathe; Depeyre, Arnaud; Devoize, Laurent; Barthélémy, Isabelle

    2017-03-01

    Premaxillary tooth loss and bone deficiency or atrophy often occur in facial trauma. Onlay bone graft and implants have so far been the best means of restoring function and esthetic appearance. Void space between the graft and the jaw bone, over projection and mucosal trauma can cause mucosal dehiscence, bone exposure, or resorption and can compromise implant survival. Virtual surgical planning using 3-dimensional printing technology has improved the efficiency of craniofacial surgery. The drawbacks of this technology are its cost and time-consuming preparation. However, the democratization of high-performance 3-dimensional printing and open-source software have enabled surgeons to master the procedure. The authors applied this innovative technology to customize bone graft for insertion of a premaxillary implant. It enabled us to custom-make the bone graft on the template and to perfectly embed the graft in the gap with a reduce operating time and a good osteointegration.

  1. Normalization of glenohumeral articular contact pressures after Latarjet or iliac crest bone-grafting.

    Science.gov (United States)

    Ghodadra, Neil; Gupta, Aman; Romeo, Anthony A; Bach, Bernard R; Verma, Nikhil; Shewman, Elizabeth; Goldstein, Jordan; Provencher, Matthew T

    2010-06-01

    Multiple bone-grafting procedures have been described for patients with glenoid bone loss and shoulder instability. The purpose of this study was to investigate the alterations in glenohumeral contact pressure associated with the placement and orientation of Latarjet or iliac crest bone graft augmentation and to compare the amount of glenoid bone reconstruction with two coracoid face orientations. Twelve fresh-frozen cadaver shoulders were tested in static positions of humeral abduction (30 degrees , 60 degrees , and 60 degrees with 90 degrees of external rotation) with a 440-N compressive load. Glenohumeral contact pressure and area were determined sequentially for (1) the intact glenoid; (2) a glenoid with an anterior bone defect involving 15% or 30% of the glenoid surface area; (3) a 30% glenoid defect treated with a Latarjet or iliac crest bone graft placed 2 mm proud, placed flush, or recessed 2 mm in relation to the level of the glenoid; and (4) a Latarjet bone block placed flush and oriented with either the lateral (Latarjet-LAT) or the inferior (Latarjet-INF) surface of the coracoid as the glenoid face. The amount of glenoid bone reconstructed was compared between the Latarjet-LAT and Latarjet-INF conditions. Bone grafts in the flush position restored the mean peak contact pressure to 116% of normal when the iliac crest bone graft was used (p Latarjet-INF bone block was used (p Latarjet-LAT bone block was used (p Latarjet-LAT bone block resulted in mean peak pressures that were significantly higher than those associated with the iliac crest bone graft (p Latarjet-INF bone block (p Latarjet-LAT bone block led to restoration of the glenoid articular contact surface from the 30% defect state to a 5% defect state. Augmentation of the 30% glenoid defect with the Latarjet-INF bone block resulted in complete restoration to the intact glenoid articular surface area. Glenohumeral contact pressure is optimally restored with a flush iliac crest bone graft or with a

  2. Biofilm formation by staphylococci on fresh, fresh-frozen and processed human and bovine bone grafts.

    Science.gov (United States)

    Clauss, M; Tafin, U F; Bizzini, A; Trampuz, A; Ilchmann, T

    2013-01-30

    Biofilm formation is a multi-step process influenced by surface properties. We investigated early and mature biofilm of Staphylococcus aureus on 4 different biological calcium phosphate (CaP) bone grafts used for filling bone defects. We investigated standardised cylinders of fresh and fresh-frozen human bone grafts were harvested from femoral heads; processed humanand bovine bone grafts were obtained preformed. Biofilm formation was done in tryptic soy broth (TSB) using S. aureus (ATCC 29213) with static conditions. Biofilm density after 3 h (early biofilm) and 24 h (mature biofilm) was investigated by sonication and microcalorimetry. After 3 h, bacterial density was highest on fresh-frozenandfresh bone grafts. After 24 h, biofilm density was lowest on freshbone grafts (p  0.05). The lowest increase in bacterial density was detected on fresh bone grafts (p bone grafts showed minor structural differences in architecture but marked differences concerning serum coverage and the content of bone marrow, fibrous tissue and bone cells. These variations resulted in a decreased biofilm density on freshand fresh-frozenbone grafts after 24 h, despite an increased early biofilm formation and might also be responsible for the variations in colony morphology (small colonies). Detection of small colony variants by microcalorimetry might be a new approach to improve the understanding of biofilm formation.

  3. Clinical evaluation of ridge augmentation using autogenous tooth bone graft material: case series study.

    Science.gov (United States)

    Lee, Ji-Young; Kim, Young-Kyun; Yi, Yang-Jin; Choi, Joon-Ho

    2013-08-01

    Interest in bone graft material has increased with regard to restoration in cases of bone defect around the implant. Autogenous tooth bone graft material was developed and commercialized in 2008. In this study, we evaluated the results of vertical and horizontal ridge augmentation with autogenous tooth bone graft material. This study targeted patients who had vertical or horizontal ridge augmentation using AutoBT from March 2009 to April 2010. We evaluated the age and gender of the subject patients, implant stability, adjunctive surgery, additional bone graft material and barrier membrane, post-operative complication, implant survival rate, and crestal bone loss. We performed vertical and horizontal ridge augmentation using powder- or block-type autogenous tooth bone graft material, and implant placement was performed on nine patients (male: 7, female: 2). The average age of patients was 49.88±12.98 years, and the post-operative follow-up period was 35±5.31 months. Post-operative complications included wound dehiscence (one case), hematoma (one case), and implant osseointegration failure (one case; survival rate: 96%); however, there were no complications related to bone graft material, such as infection. Average marginal bone loss after one-year loading was 0.12±0.19 mm. Therefore, excellent clinical results can be said to have been obtained. Excellent clinical results can be said to have been obtained with vertical and horizontal ridge augmentation using autogenous tooth bone graft material.

  4. Cell therapy of hip osteonecrosis with autologous bone marrow grafting

    Directory of Open Access Journals (Sweden)

    Hernigou Philippe

    2009-01-01

    Full Text Available Background: One of the reasons for bone remodeling leading to an insufficient creeping substitution after osteonecrosis in the femoral head may be the small number of progenitor cells in the proximal femur and the trochanteric region. Because of this lack of progenitor cells, treatment modalities should stimulate and guide bone remodeling to sufficient creeping substitution to preserve the integrity of the femoral head. Core decompression with bone graft is used frequently in the treatment of osteonecrosis of the femoral head. In the current series, grafting was done with autologous bone marrow obtained from the iliac crest of patients operated on for early stages of osteonecrosis of the hip before collapse with the hypothesis that before stage of subchondral collapse, increasing the number of progenitor cells in the proximal femur will stimulate bone remodeling and creeping substitution and thereby improve functional outcome. Materials and Methods: Between 1990 and 2000, 342 patients (534 hips with avascular osteonecrosis at early stages (Stages I and II were treated with core decompression and autologous bone marrow grafting obtained from the iliac crest of patients operated on for osteonecrosis of the hip. The percentage of hips affected by osteonecrosis in this series of 534 hips was 19% in patients taking corticosteroids, 28% in patients with excessive alcohol intake, and 31% in patients with sickle cell disease. The mean age of the patients at the time of decompression and autologous bone marrow grafting was 39 years (range: 16-61 years. The aspirated marrow was reduced in volume by concentration and injected into the femoral head after core decompression with a small trocar. To measure the number of progenitor cells transplanted, the fibroblast colony forming unit was used as an indicator of the stroma cell activity. Results: Patients were followed up from 8 to 18 years. The outcome was determined by the changes in the Harris hip score

  5. Cellular bone matrices: viable stem cell-containing bone graft substitutes.

    Science.gov (United States)

    Skovrlj, Branko; Guzman, Javier Z; Al Maaieh, Motasem; Cho, Samuel K; Iatridis, James C; Qureshi, Sheeraz A

    2014-11-01

    Advances in the field of stem cell technology have stimulated the development and increased use of allogenic bone grafts containing live mesenchymal stem cells (MSCs), also known as cellular bone matrices (CBMs). It is estimated that CBMs comprise greater than 17% of all bone grafts and bone graft substitutes used. To critically evaluate CBMs, specifically their technical specifications, existing published data supporting their use, US Food and Drug Administration (FDA) regulation, cost, potential pitfalls, and other aspects pertaining to their use. Areview of literature. A series of Ovid, Medline, and Pubmed-National Library of Medicine/National Institutes of Health (www.ncbi.nlm.nih.gov) searches were performed. Only articles in English journals or published with English language translations were included. Level of evidence of the selected articles was assessed. Specific technical information on each CBM was obtained by direct communication from the companies marketing the individual products. Five different CBMs are currently available for use in spinal fusion surgery. There is a wide variation between the products with regard to the average donor age at harvest, total cellular concentration, percentage of MSCs, shelf life, and cell viability after defrosting. Three retrospective studies evaluating CBMs and fusion have shown fusion rates ranging from 90.2% to 92.3%, and multiple industry-sponsored trials are underway. No independent studies evaluating spinal fusion rates with the use of CBMs exist. All the commercially available CBMs claim to meet the FDA criteria under Section 361, 21 CFR Part 1271, and are not undergoing FDA premarket review. The CBMs claim to provide viable MSCs and are offered at a premium cost. Numerous challenges exist in regard to MSCs' survival, function, osteoblastic potential, and cytokine production once implanted into the intended host. Cellular bone matrices may be a promising bone augmentation technology in spinal fusion surgery

  6. Osteoinductive PolyHIPE Foams as Injectable Bone Grafts.

    Science.gov (United States)

    Robinson, Jennifer L; McEnery, Madison A P; Pearce, Hannah; Whitely, Michael E; Munoz-Pinto, Dany J; Hahn, Mariah S; Li, Huinan; Sears, Nicholas A; Cosgriff-Hernandez, Elizabeth

    2016-03-01

    We have recently fabricated biodegradable polyHIPEs as injectable bone grafts and characterized the mechanical properties, pore architecture, and cure rates. In this study, calcium phosphate nanoparticles and demineralized bone matrix (DBM) particles were incorporated into injectable polyHIPE foams to promote osteoblastic differentiation of mesenchymal stem cells (MSCs). Upon incorporation of each type of particle, stable monoliths were formed with compressive properties comparable to control polyHIPEs. Pore size quantification indicated a negligible effect of all particles on emulsion stability and resulting pore architecture. Alizarin red calcium staining illustrated the incorporation of calcium phosphate particles at the pore surface, while picrosirius red collagen staining illustrated collagen-rich DBM particles within the monoliths. Osteoinductive particles had a negligible effect on the compressive modulus (∼30 MPa), which remained comparable to human cancellous bone values. All polyHIPE compositions promoted human MSC viability (∼90%) through 2 weeks. Furthermore, gene expression analysis indicated the ability of all polyHIPE compositions to promote osteogenic differentiation through the upregulation of bone-specific markers compared to a time zero control. These findings illustrate the potential for these osteoinductive polyHIPEs to promote osteogenesis and validate future in vivo evaluation. Overall, this work demonstrates the ability to incorporate a range of bioactive components into propylene fumarate dimethacrylate-based injectable polyHIPEs to increase cellular interactions and direct specific behavior without compromising scaffold architecture and resulting properties for various tissue engineering applications.

  7. 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...

  8. Eggshell derived hydroxyapatite as bone graft substitute in the healing of maxillary cystic bone defects: a preliminary report.

    Science.gov (United States)

    Kattimani, Vivekanand S; Chakravarthi, P Srinivas; Kanumuru, Narasimha Reddy; Subbarao, Vummidisetti V; Sidharthan, A; Kumar, T S Sampath; Prasad, L Krishna

    2014-06-01

    Since ancient times, use of graft materials to promote healing of defects of bone is wellknown. Traditionally, missing bone is replaced with material from either patient or donor. Multiple sources of bone grafts have been used to graft bone defects to stimulate bone healing. Hydroxyapatite is naturally occurring mineral component of bone, which is osteoconductive. This versatile biomaterial is derived from many sources. The aim of this study is to evaluate the efficacy of eggshell derived hydroxyapatite (EHA) in the bone regeneration of human maxillary cystic bone defects secondary to cystic removal/apicoectomy and compare the material properties of EHA in vitro. A total of eight maxillary bone defects were grafted after cystic enucleation and/or apicoectomy in the year 2008 and completed the study at 1 year. The patients were followed-up 2 weeks after surgery for signs and symptoms of infection or any other complications that may have been related to surgical procedure. Follow-up radiographs were obtained immediately after surgery followed by 1, 2, and 3 months to assess the efficacy of EHA in bone healing. Physicochemical characterization of the EHA was carried out in comparison with synthetic hydroxyapatite (SHA), also compared the biocompatibility of EHA using in vitro cytotoxicity test. By the end of the 8(th) week, the defects grafted with EHA showed complete bone formation. However, bone formation in non-grafted sites was insignificant. The values of density measurements were equal or more than that of surrounding normal bone. These results indicate that the osseous regeneration of the bone defect filled with EHA is significant. EHA showed the superior material properties in comparison with SHA. EHA is a versatile novel bone graft substitute that yielded promising results. Because of its biocompatibility, lack of disease transfer risks, ease of use and unlimited availability, EHA remains a viable choice as regenerative material. EHA is very cost

  9. Synthesis and characterization of Bioglass-based bone grafts with Gelatine substitution for biomedical applications.

    Science.gov (United States)

    Aksakal, B; Demirel, M

    2017-01-01

    Syntesizing alternative bone graft materials are important in biomedical applications. Their morphology, mechanical properties and cell viability plays an important role in tissue engineering. Bioglass (B) based bone grafts with Gelatin (G) substitution were syntesized via the sol-gel method and were compared with various Gelatin and Bioglass concentrations (wt%). Syntesized bone grafts were characterized by Scanning Electron Microscopy (SEM) and X-ray diffraction (XRD) to show the structural and morphological changes of the fabricated B-based bone grafts. It was demonstrated that the concentration of pore size increased with increasing amounts of Gelatin in wt%. The biograft-B40G20 produced the highest flexture strength and hardness. Increasing the pore size caused a decrease in hardness and flexture stress of B-based biografts. Cell viability tests were conducted on the fabricated biografts and it was shown that the cell viability increased in fabricated B-based bone grafts.

  10. Non-Vascularized Autogenous Bone Grafts for Reconstruction of Maxillofacial Osseous Defects.

    Science.gov (United States)

    Ahmed, Waseem; Asim, Muhammad Adil; Ehsan, Afeefa; Abbas, Qalab

    2018-01-01

    To determine the outcomes of non-vascularized bone grafts for reconstruction of maxillofacial defects. Case series. Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi, from January 2013 to December 2015. Descriptive analyses of 30 patients, who underwent maxillofacial reconstruction with non-vascularized bone grafts, were conducted. The demographic information, diagnosis, and type of graft harvested to reconstruct the defect were statistically analyzed. Outcomes of reconstruction with non-vascularized bone grafts were analyzed in terms of mouth opening, success of dental rehabilitation, and postoperative complications, i.e. surgical site infection and hardware loosening. A total of 30 patients ranging from 8 to 60 years (33.57 ±14.74 years) had maxillofacial defects reconstructed mostly due to gunshot injuries, followed by post-resection defects. Overall 15 cases (50%) were reconstructed with iliac crest cortico-cancellous bone graft, 11 cases (36.7%) with rib; while in four cases (13.3%), costochondral graft was used for reconstruction. In 26 cases (86.7%), graft was found to be successful. In three cases, re-operation for onlay bone graft was required to provide optimal dental rehabilitation; while in just one case, postoperative surgical site infection was observed. Non-vascularized bone grafts provide a reasonable and effective modality for reconstruction of maxillofacial defects.

  11. 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.

  12. 3D-CT evaluation of secondary alveolar bone grafts in alveolar clefts

    Energy Technology Data Exchange (ETDEWEB)

    Naitoh, Hiroshi; Nishimura, Yoshihiko [Kyoto Univ. (Japan). Graduate School of Medicine; Yamawaki, Yoshiroh [Kyoto Katsura Hospital (Japan); Morimoto, Naoki [Kobe City General Hospital (Japan)

    2002-07-01

    From 1994 to 2000, we treated 116 patients with cleft alveolus by secondary alveolar bone grafts, and 48 of them were evaluated morphologically with 3D-CT. The frequency of successful bony bridging was significantly higher in the group whose grafts were completely enveloped (including the anterior alveolar ridge) with a mucoperiosteal flap. The frequency was also significantly higher in the group who underwent bone grafts at the age of 13 or less, and canine eruptions did not influence the ratio. Some cases showed such an improved growth pattern of grafted bone that the shape of the affected maxilla resembled that of the normal side, after long-term follow-up observations. The growth increment was remarkable in anterior maxillary height. Orthodontic management guides the canine or incisor into the reconstructed area of the previous cleft. We surmise that the new occlusal position puts pressure on the grafted bone and promotes further osteogenesis. These findings show that it is important to produce sufficient bony bridge to guide the canine or incisor, not the volume of grafted bone, in secondary alveolar bone grafts. Long-term follow-up observation, after more than 2-3 years, is also necessary to evaluate secondary alveolar bone grafts. (author)

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Decellularization and Delipidation Protocols of Bovine Bone and Pericardium for Bone Grafting and Guided Bone Regeneration Procedures.

    Directory of Open Access Journals (Sweden)

    Chiara Gardin

    Full Text Available The combination of bone grafting materials with guided bone regeneration (GBR membranes seems to provide promising results to restore bone defects in dental clinical practice. In the first part of this work, a novel protocol for decellularization and delipidation of bovine bone, based on multiple steps of thermal shock, washes with detergent and dehydration with alcohol, is described. This protocol is more effective in removal of cellular materials, and shows superior biocompatibility compared to other three methods tested in this study. Furthermore, histological and morphological analyses confirm the maintenance of an intact bone extracellular matrix (ECM. In vitro and in vivo experiments evidence osteoinductive and osteoconductive properties of the produced scaffold, respectively. In the second part of this study, two methods of bovine pericardium decellularization are compared. The osmotic shock-based protocol gives better results in terms of removal of cell components, biocompatibility, maintenance of native ECM structure, and host tissue reaction, in respect to the freeze/thaw method. Overall, the results of this study demonstrate the characterization of a novel protocol for the decellularization of bovine bone to be used as bone graft, and the acquisition of a method to produce a pericardium membrane suitable for GBR applications.

  15. Decellularization and Delipidation Protocols of Bovine Bone and Pericardium for Bone Grafting and Guided Bone Regeneration Procedures

    Science.gov (United States)

    Ferroni, Letizia; Guazzo, Riccardo; Sbricoli, Luca; De Benedictis, Giulia; Finotti, Luca; Isola, Maurizio; Bressan, Eriberto; Zavan, Barbara

    2015-01-01

    The combination of bone grafting materials with guided bone regeneration (GBR) membranes seems to provide promising results to restore bone defects in dental clinical practice. In the first part of this work, a novel protocol for decellularization and delipidation of bovine bone, based on multiple steps of thermal shock, washes with detergent and dehydration with alcohol, is described. This protocol is more effective in removal of cellular materials, and shows superior biocompatibility compared to other three methods tested in this study. Furthermore, histological and morphological analyses confirm the maintenance of an intact bone extracellular matrix (ECM). In vitro and in vivo experiments evidence osteoinductive and osteoconductive properties of the produced scaffold, respectively. In the second part of this study, two methods of bovine pericardium decellularization are compared. The osmotic shock-based protocol gives better results in terms of removal of cell components, biocompatibility, maintenance of native ECM structure, and host tissue reaction, in respect to the freeze/thaw method. Overall, the results of this study demonstrate the characterization of a novel protocol for the decellularization of bovine bone to be used as bone graft, and the acquisition of a method to produce a pericardium membrane suitable for GBR applications. PMID:26191793

  16. Vascularized bone graft for oncological reconstruction of the extremities: review of the biological advantages.

    Science.gov (United States)

    Muramatsu, Keiichi; Hashimoto, Takahiro; Tominaga, Yasuhiro; Taguchi, Toshihiko

    2014-06-01

    Vascularized bone graft (VBG) is a form of vascularized bone marrow transplant in which the bone marrow is surgically grafted with its microenvironment intact. Due to the preservation of cellular viability, VBG have significant advantages over non-vascularized bone grafts. Free vascularized fibula grafts have superior material properties and tolerate infection. Bone healing can be accomplished in a shorter period, even in an irradiated bed. In addition to these properties, VBG has other biological advantages that are not always familiar to oncological surgeons. Hypertrophic change can be divided into reactive and adaptive hypertrophy. Early hypertrophy is associated with donor-derived cells, whereas later remodeling is associated with recipient-derived cells. VBG has significant advantages in enhancing neo-revascularization of necrotic bone. We reviewed VBG from a novel viewpoint that stems from our basic research. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  17. Irradiation conditions for fiber laser bonding of HAp-glass ceramics with bovine cortical bone.

    Science.gov (United States)

    Tadano, Shigeru; Yamada, Satoshi; Kanaoka, Masaru

    2014-01-01

    Orthopedic implants are widely used to repair bones and to replace articulating joint surfaces. It is important to develop an instantaneous technique for the direct bonding of bone and implant materials. The aim of this study was to develop a technique for the laser bonding of bone with an implant material like ceramics. Ceramic specimens (10 mm diameter and 1 mm thickness) were sintered with hydroxyapatite and MgO-Al2O3-SiO2 glass powders mixed in 40:60 wt% proportions. A small hole was bored at the center of a ceramic specimen. The ceramic specimen was positioned onto a bovine bone specimen and a 5 mm diameter area of the ceramic specimen was irradiated using a fiber laser beam (1070-1080 nm wavelength). As a result, the bone and the ceramic specimens bonded strongly under the irradiation conditions of a 400 W laser power and a 1.0 s exposure time. The maximum shear strength was 5.3 ± 2.3 N. A bonding substance that penetrated deeply into the bone specimen was generated around the hole in the ceramic specimen. On using the fiber laser, the ceramic specimen instantaneously bonded to the bone specimen. Further, the irradiation conditions required for the bonding were investigated.

  18. Instructive function of surface structure of calcium phosphate ceramics in bone regeneration

    NARCIS (Netherlands)

    Zhang, Jingwei

    2016-01-01

    The incidence of patients which require spinal fusion or bone regeneration in large bone defects caused by trauma, tumors, tumor resection, infections or abnormal skeletal development, is on the rise. Traditionally, in both spinal fusion surgery and other bone regeneration approaches, bone grafts

  19. Development and performance analysis of Si-CaP/fine particulate bone powder combined grafts for bone regeneration.

    Science.gov (United States)

    Sun, Chengli; Tian, Ye; Xu, Wenxiao; Zhou, Changlong; Xie, Huanxin; Wang, Xintao

    2015-05-22

    Although autogenous bone grafts as well as several bone graft substitute material have been used for some time, there is high demand for more efficient and less costly bone-substitute materials. Silicon-substituted calcium phosphates (Si-CaP) and fine particulate bone powder (FPBP) preparations have been previously shown to individually possess many of the required features of a bone graft substitute scaffold. However, when applied individually, these two materials fall short of an ideal substitute material. We investigated a new concept of combining Si-CaP with FPBP for improved performance in bone-repair. We assessed Si-CaP/FPBP combined grafts in vitro, by measuring changes in pH, weight loss, water absorption and compressive strength over time. Si-CaP/FPBP combined grafts was found to produce conditions of alkaline pH levels compared to FPBP, and scaffold surface morphology conducive to bone cell adhesion, proliferation, differentiation, tissue growth and transport of nutrients, while maintaining elasticity and mechanical strength and degradation at a rate closer to osteogenesis. Si-CaP/FPBP combined grafts was found to be superior to any of the two components individually.

  20. Long-term stability of alveolar bone grafts in cleft palate patients.

    Science.gov (United States)

    Toscano, Dominique; Baciliero, Ugo; Gracco, Antonio; Siciliani, Giuseppe

    2012-09-01

    Many authors have examined the surgical bone treatment of cleft palate patients, but no study has emphasized the role of orthodontic therapy. The aims of this study were to evaluate the long-term stability of bone grafts when using an orthodontic-surgical protocol, to determine the success of bone grafts in minor vs severe clefts, and to develop a qualitative method for assessing the success of bone grafting. Forty-nine patients were included in this study. Occlusal x-rays were taken before (T0), immediately after (T1), and at least 1 year after bone grafting (T2). Two radiographic parameters were analyzed adjacent to the cleft side: the vertical bone level (Bergland scale) and the horizontal bone level (Witherow-derived scale). The bone graft success at T2 was 91.84% (95% confidence interval, 84.55-96.41). The severity of the cleft before grafting was not statistically correlated with success at T2 (P cleft, lateral incisor agenesis) were not statistically correlated (P protocol to treat cleft lip and palate patients, prevent postoperative bone resorption, and guarantee correct positioning of the teeth. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  1. Clinical, histologic, and histomorphometric evaluation of mineralized solvent-dehydrated bone allograf (Puros) in human maxillary sinus grafts.

    Science.gov (United States)

    Noumbissi, Sammy S; Lozada, Jaime L; Boyne, Philip J; Rohrer, Michael D; Clem, Donald; Kim, Jay S; Prasad, Hari

    2005-01-01

    Demineralized freeze-dried bone allografts (DFDBA) have been successfully used alone or in composite grafts for many decades. Little research has been done on the effect of retaining the mineral content of bone allografts. This study histologically and histomorphometrically evaluated a new mineralized bone allograft material placed in human atrophic maxillary sinuses. Seven partially edentulous patients requiring sinus grafts before implant placement were selected for this study Their age range was 56 to 81 years (mean 67.7 years). Test grafts consisted of a mineralized solvent-dehydrated cancellous bone allograft, and control grafts were a composite of DFDBA and deproteinized bovine bone xenograft (1:1). Bilateral cases (n = 3) received both test and control grafts on opposite sides, and unilateral cases received either a test (n = 3) or control (n = 1) graft only. At 10 months, core biopsies were taken from each graft site, and dental implants were placed into the augmented bone. All bone grafts resulted in new bone formation and all implants osseointegrated. Test grafts resorbed and were replaced by newly formed bone significantly faster and in greater quantities than were control grafts. No complications with grafts or implants were noted. Both test and control grafts achieved excellent results. The faster bone formation observed with the test graft may be due, in part, to its smaller particle size compared with the bovine portion of the control graft. Test grafts were either replaced by new bone or displayed new bone-to-particle surface contact in higher percentages than did control grafts. No differences in osseointegration or graft stability were noted 2 years after the study.

  2. Sinus lift augmentation using autogenous bone grafts and platelet-rich plasma: radiographic results.

    Science.gov (United States)

    Schaaf, Heidrun; Streckbein, Philipp; Lendeckel, Stefan; Heidinger, Kathrin Sophie; Rehmann, Peter; Boedeker, Rolf-Hasso; Howaldt, Hans-Peter

    2008-11-01

    Autologous bone grafting and sinus floor elevation is a widely accepted method for reconstruction of the atrophic maxilla. The aim of this investigation was to examine the influence of platelet-rich plasma (PRP) on bone grafting in sinus floor augmentation. A prospective, controlled, randomized study including 34 patients undergoing sinus augmentation before implant placement was designed. The intervention group had additional treatment with PRP. Radiographic imaging was performed by computerized tomography (CT) and panoramic radiography 4 months after augmentation and before implant placement. Bone density showed no significant increase when PRP was used in combination with autologous bone grafting compared with autologous bone alone. This study showed no positive effect of PRP on bone density in CT evaluation when used in sinus floor augmentation. Bone density in the CT showed no correlation to histomorphometric evaluation.

  3. 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

  4. Dental implants placed simultaneously with bone grafts in horizontal defects: a clinical retrospective study with 37 patients.

    Science.gov (United States)

    Boronat, Araceli; Carrillo, Celia; Penarrocha, Maria; Pennarocha, Miguel

    2010-01-01

    The aim of this study was to evaluate the 1-year success rate and marginal bone loss for dental implants placed simultaneously with bone grafts. The study sample comprised 37 patients treated with dental implants placed simultaneous with intraoral block bone grafts. The block grafts were harvested from the chin, retromolar area, or maxillary tuberosity. Complications with the bone grafts were categorized as minor or major and, for the graft success rate, the Barone and Covani criteria were used. The definition of implant success was based on the clinical and radiographic criteria of Albrektsson et al. Peri-implant bone loss was measured after 1 year of prosthetic loading. The study involved 39 bone grafts (17 maxillary and 22 mandibular) and 129 implants (73 implants in grafted areas) in 37 patients. No complications were observed at the donor sites. A part of the onlay bone graft was exposed in eight sites; six sites showed spontaneous reepithelialization following chlorhexidine application, but two grafts became infected and had to be removed. Three implants were lost in the grafted areas; the success rate for implants with simultaneous bone grafting was therefore 95.9%. No complications were found at 12 months after prosthesis placement. The mean overall bone loss after 1 year of loading was 0.64 mm. In patients meeting the inclusion criteria, simultaneous placement of bone grafts and implants shortens treatment time without increasing complications or reducing the success rate.

  5. Resorbable bioactive ceramic for treatment of bone infection.

    Science.gov (United States)

    El-Ghannam, Ahmed; Jahed, Kiarash; Govindaswami, Meera

    2010-07-01

    Polymethylmethacrylate (PMMA) beads have been widely used in the treatment of bone infection over the last three decades. Although PMMA does offer a mechanism to quickly and effectively administer a localized dose of antibiotic to the site of infection, its efficacy is limited by its nonresorbability and nonbioactivity. Resorbable bioactive silica-calcium phosphate nanocomposite (SCPC75) was investigated as a novel controlled release carrier of vancomycin for the treatment of osteomyelitis. SCPC75 particles adsorbed significantly higher amount of vancomycin compared with PMMA. Moreover, SCPC75 provided a sustained release kinetics of therapeutic dose of vancomycin up to 35 days. The novel resorbable ceramic was able to release 95.5% of the adsorbed drug in an average dose of 12 microg/mL/day over 480 h (35 days). In conjunction with the sustained drug release, a controlled dissolution rate that led to 40% mass loss of SCPC75 was observed. On the other hand, PMMA provided a sustained release of a therapeutic dose of vancomycin for 14 days after which minimal concentration of the drug was detected. Moreover, PMMA retained 32% of the drug adsorbed onto its surface. The SCPC-vancomycin implant can serve a dual function: provide a sustained therapeutic dose of antibiotic to eradicate infection and stimulate bone cell differentiation and new bone formation. (c) 2010 Wiley Periodicals, Inc. J Biomed Mater Res, 2010.

  6. Proximal Tibia Bone Graft: An alternative Donor Source especially for Foot and Ankle Procedures

    Directory of Open Access Journals (Sweden)

    Jia TY

    2015-03-01

    Full Text Available Among the many donor sites for harvesting autologous bone graft, the iliac crest has been the most commonly used. However, for foot and ankle procedures the proximal tibia has gained popularity as an alternative donor site due to its anatomic proximity to the primary surgical site. In this article we evaluated the possible complications associated with harvesting proximal tibia bone graft. Our study showed the low incidence of morbidity in harvesting proximal tibia bone graft, thereby providing a good alternative donor for foot and ankle procedures.

  7. Favorable survival of acetabular reconstruction with bone impaction grafting in dysplastic hips.

    NARCIS (Netherlands)

    Somford, M.P.; Bolder, S.B.T.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Schreurs, B.W.

    2008-01-01

    Acetabular bone loss hampers implantation of a total hip arthroplasty in patients with developmental dysplasia of the hip. The bone impaction grafting technique in combination with a cemented total hip can restore the bone stock in these patients, but do these reconstructions yield satisfying

  8. Guided bone regeneration : the influence of barrier membranes on bone grafts and bone defects

    NARCIS (Netherlands)

    Gielkens, Pepijn Frans Marie

    2008-01-01

    Guided bone regeneration (GBR) can be described as the use of a barrier membrane to provide a space available for new bone formation in a bony defect. The barrier membrane protects the defect from in-growth of soft tissue cells and allows bone progenitor cells to develop bone within a blood clot

  9. 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.

  10. Histological comparison of an allograft, a xenograft and alloplastic graft as bone substitute materials

    Directory of Open Access Journals (Sweden)

    C.E. Nappe

    2016-11-01

    Full Text Available Aim An allograft, a xenograft and an alloplastic graft, associated to sinus lift or ridge preservation procedures were histologically studied to evaluate their characteristics and to obtain the percentages of bone and remaining graft particles. This may help the clinician to determine, form the histological point of view, if they are viable alternatives to the use of autograft in bone regeneration procedures. Materials and methods Twenty-five samples from 18 subjects were histologically evaluated with respect to newly formed bone and remaining graft particles percentage. Results The three studied grafting materials presented adequate osteoconduction characteristics. Differences in newly formed bone percentage were found between the allograft and the xenograft, whereas no differences were found between the allograft and the alloplastic graft or the xenograft and the alloplastic graft. There were no significant differences in the percentage of residual particles amongst the different types of graft. Conclusions All studied bone substitute materials showed good characteristics for their use in bone regeneration therapies.

  11. 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

  12. Use of allogeneic bone graft in maxillary reconstruction for installation of dental implants.

    Science.gov (United States)

    Gomes, Kelston Ulbricht; Carlini, João Luiz; Biron, Cássia; Rapoport, Abrão; Dedivitis, Rogério A

    2008-11-01

    The aim of this study is to evaluate the efficacy of the application of allogenous bone at the maxillomandibular reconstructions for future rehabilitation with dental implants. The patients were submitted to reconstruction of maxilla, using allogeneic bone grafts, in 3 different techniques: onlay grafts for lateral ridge augmentation, onlay and particulate bone for sinus lift grafting, and particulate alone for sinus lift grafts. Clinical and radiographic control was done at the postoperative phase for at least 8 months, until the patient could be submitted to the installation of dental implants. The results showed success in the majority of the cases, and dental implants could be installed. This can be considered an excellent alternative when compared with the use of autogenous grafts; because handling is easier, there is a great amount of material available and a possibility of using local anesthesia, and consequently there is a reduction of patient morbidity.

  13. Sinus augmentation bone grafts for the provision of dental implants: report of clinical outcome.

    Science.gov (United States)

    McCarthy, Caroline; Patel, Rajesh R; Wragg, Philip F; Brook, Ian M

    2003-01-01

    The aim of this study was to report the outcome of sinus augmentation surgery with autogenous bone grafting in routine dental implant practice. Twenty-seven sinus augmentation procedures were undertaken on 18 consecutive patients (mean age 43.7 years). The mandibular symphysis was used as the donor site for 11 patients. The iliac crest was used as a donor site for 7 bilateral cases. Six patients had implants placed at the time of grafting: the other 13 had a mean bone graft consolidation period of 24.7 weeks (range 9 to 39 weeks) before implants were placed. One patient who had a repeat procedure had both immediate and delayed techniques. A total of 79 Brånemark System Mk II implants were placed in grafted bone (and 2 Mk IV implants were placed in a patient who had to have a repeat procedure) and proceeded to occlusal loading. After a mean follow-up period of 162 weeks (range 76 to 288 weeks), 16 implants failed to integrate in grafted bone, representing an 80.25% survival rate. Fourteen patients proceeded to the planned prosthesis, 3 patients had a compromised treatment plan, and 1 patient was restored conventionally. This represents 94% of patients who were rehabilitated. The sinus augmentation procedure using autogenous bone grafting can Increase bone volume to allow implant placement where there is insufficient bone. The survival of implants in the grafted bone, as measured by integration and successful loading, was reduced compared to implants placed in normal maxillary bone. Infection during the healing of the grafted site reduces the success of subsequent implant osseointegration.

  14. Morphological and histomorphometric evaluation of autogenous bone graft resorption in rabbits treated with alendronate sodium

    Directory of Open Access Journals (Sweden)

    Teo Mario da ROSA

    Full Text Available Abstract Introduction Different rates of resorption are mediated by osteoclasts that may be affected by bisphosphonates during bone graft repair. Bisphosphonates are drugs that act as inhibitors of bone resorption. Objective The aim of the present study was to evaluate the rate of resorption of skullcap grafts in rabbits with and without the use of alendronate sodium. Material and method Thirty two New Zealand rabbits were divided into two groups (control group and alendronate group and divided again into four periods (7, 14, 30 and 60 days. The control group did not receive alendronate, while animals of the experimental group received 4 mg of alendronate sodium weekly after the surgery. An 8 mm diameter bone block was removed from the parietal bone and fixed by screws to the contralateral parietal bone. During the periods of 7, 14, 30 and 60 days, the animals had undergone euthanasia and samples were removed for further analysis. Morphological and histomorphometric tests were used to compare graft thicknesses and to evaluate the newly formed bone at the interface between the graft and receptor site. The Wilcoxon and Mann-Whitney tests were used for statistical analyses. Result All grafts healed and integrated uneventfully and no statistically significant differences in resorption rates or bone deposition were detected after the final incorporation of the graft in both groups. Conclusion Alendronate Sodium did not decrease the bone graft resorption rates, but there was a tendency for better results in the control group regarding the resorption and neoformation in autogenous calvarial bone grafts in rabbits.

  15. Effect of bone graft density on in vitro cell behavior with enamel matrix derivative.

    Science.gov (United States)

    Miron, Richard J; Caluseru, Oana M; Guillemette, Vincent; Zhang, Yufeng; Buser, Daniel; Chandad, Fatiha; Sculean, Anton

    2015-09-01

    Bone replacement grafting materials play an important role in regenerative dentistry. Despite a large array of tested bone-grafting materials, little information is available comparing the effects of bone graft density on in vitro cell behavior. Therefore, the aim of the present study is to compare the effects of cells seeded on bone grafts at low and high density in vitro for osteoblast adhesion, proliferation, and differentiation. The response of osteoblasts to the presence of a growth factor (enamel matrix derivative, (EMD)) in combination with low (8 mg per well) or high (100 mg per well) bone grafts (BG; natural bone mineral, Bio-Oss®) density, was studied and compared for osteoblast cell adhesion, proliferation, and differentiation as assessed by real-time PCR. Standard tissue culture plastic was used as a control with and without EMD. The present study demonstrates that in vitro testing of bone-grafting materials is largely influenced by bone graft seeding density. Osteoblast adhesion was up to 50 % lower when cells were seeded on high-density BG when compared to low-density BG and control tissue culture plastic. Furthermore, proliferation was affected in a similar manner whereby cell proliferation on high-density BG (100 mg/well) was significantly increased when compared to that on low-density BG (8 mg/well). In contrast, cell differentiation was significantly increased on high-density BG as assessed by real-time PCR for markers collagen 1 (Col 1), alkaline phosphatase (ALP), and osteocalcin (OC) as well as alizarin red staining. The effects of EMD on osteoblast adhesion, proliferation, and differentiation further demonstrated that the bone graft seeding density largely controls in vitro results. EMD significantly increased cell attachment only on high-density BG, whereas EMD was able to further stimulate cell proliferation and differentiation of osteoblasts on control culture plastic and low-density BG when compared to high-density BG. The results

  16. Bone Grafts, Substitutes, and Augments in Benign Orthopaedic Conditions Current Concepts.

    Science.gov (United States)

    Blank, Alan; Riesgo, Aldo; Gitelis, Steven; Rapp, Timothy

    2017-04-01

    Musculoskeletal tumors are relatively rare diagnoses made by orthopaedic surgeons. While approximately 2,500 primary bone sarcomas are diagnosed annually in the USA, the number of benign orthopaedic tumors encountered annually is far more difficult to quantify. Some studies have documented between 3% and 10% of the general population having benign bony lesions. Many of these conditions can be simply observed, while others will require surgical intervention. Surgical treatments for benign conditions range from a one-step curettage to extensive resection and reconstruction. With treatment of larger lesions, significant bony defects may need to be addressed surgically. Treatment options have evolved over time with the use of various bone graft and bone void fillers, including methyl methacrylate cement, autograft, allograft bone chips, struts and osteoarticular segments, synthetic bone graft substitutes, and metal augments. This review provides an overview of the present status of bone graft, substitutes, and augment options for the orthopaedic surgeon treating benign musculoskeletal conditions.

  17. Autogenous Partial Bone Chip Grafting on the Exposed Inferior Alveolar Nerve After Cystic Enucleation.

    Science.gov (United States)

    Seo, Mi Hyun; Eo, Mi Young; Cho, Yun Ju; Kim, Soung Min; Lee, Suk Keun

    2017-10-26

    This prospective study evaluated the clinical effectiveness of the new approach of partial autogenous bone chip grafts for the treatment of mandibular cystic lesions related to the inferior alveolar nerve (IAN). A total of 38 patients treated for mandibular cysts or benign tumors were included in this prospective study and subsequently divided into 3 groups depending on the bone grafting method used: cystic enucleation without a bone graft (group 1), partial bone chip graft covering the exposed IAN (group 2), and autogenous bone graft covering the entire defect (group 3). We evaluated the symptoms, clinical signs, and radiographic changes using dental panorama preoperatively, immediate postoperatively, and at 1, 3, 6, and 12 months postoperatively. Radiographic densities were compared using Adobe Photoshop CS5 (Adobe Systems Inc., San Jose, CA). Repeated measures analysis of variance was used for statistical evaluation with SPSS 22.0 (SPSS Inc, Chicago, IL), and P < 0.05 was considered statistically significant.Radiopacities were the most increased at 1 year postoperative in group 3; groups 2 and 3 did not show statistically significant differences, whereas groups 1 and 3 were statistically significant. In terms of radiographic bone healing with clinical regeneration of the exposed IAN, healing occurred in all patients, although the best healing was achieved in group 2.This autogenous partial bone chip grafting procedure to cover the exposed IAN is suggested as a new surgical protocol for the treatment of cystic lesions associated with the IAN.

  18. Changes of mineralization of free autogenous bone grafts used for sinus floor elevation.

    Science.gov (United States)

    Schlegel, Karl Andreas; Schultze-Mosgau, Stefan; Wiltfang, Jörg; Neukam, Friedrich Wilhelm; Rupprecht, Stephan; Thorwarth, Michael

    2006-12-01

    For augmentations before implant placement in areas of minor bone quantity, autogenous bone is considered the reference to all bone substitutes used alternatively. Autogenous bone transplants originate from various donor areas and can be prepared in different ways before augmentation. They may either be used as block grafts or may be milled to granules that can be used solitarily or in combination with a bone substitute. In a prospective study, 61 patients of the Maxillofacial Surgery Department of our University receiving two-stage sinus floor elevation because of insufficient bone supply were randomly selected. At first-stage surgery, the local augmentation procedure, monocortical probes were obtained on the site of bone harvesting. At second-stage surgery, the implant insertion 6 months after the elevation procedure, bone cores were harvested in the areas of implant placement. Donor regions were the following three areas: the posterior (N=28) and anterior pelvic region (N=15) and the chin region (N=18). The implanted bone in all three groups was particulated to granules of 2-3 mm(2) using a bone mill. All biopsies were analyzed by means of microradiography. The anterior pelvic bone grafts showed a mineralized tissue grade of 35.1+/-7.6% before milling and augmentation. The posterior pelvic bone grafts exhibited a mineralization of 30.7+/-9.5% and the chin bone grafts 74.6+/-8.6%. At second-stage surgery after 6 months, the mineralization was 36.1+/-7.59% in the areas where bone grafts from the anterior pelvic crest were used. Probes harvested from sites with posterior pelvic bone augmentations showed a mineralization rate of 34.5+/-6.5%, and sites were chin bone grafts were applied expressed a mineralization of 54+/-8.6% (P=0.003 compared with the pre-operative value). The comparison of the microradiographical results demonstrated significant differences in the mineralization grades depending on the origin of the graft. The origin of the grafts and their

  19. Prospective evaluation of chronic pain associated with posterior autologous iliac crest bone graft harvest and its effect on postoperative outcome

    OpenAIRE

    Wang David A; Kowalski Paulette; Martha Julia F; Schwartz Carolyn E; Bode Rita; Li Ling; Kim David H

    2009-01-01

    Abstract Background Autogenous Iliac Crest Bone Graft (ICBG) has been the "gold standard" for spinal fusion. However, bone graft harvest may lead to complications, such as chronic pain, numbness, and poor cosmesis. The long-term impact of these complications on patient function and well-being has not been established but is critical in determining the value of expensive bone graft substitutes such as recombinant bone morphogenic protein. We thus aimed to investigate the long-term complication...

  20. Guided bone augmentation using ceramic space-maintaining devices: the impact of chemistry

    Directory of Open Access Journals (Sweden)

    Anderud J

    2015-03-01

    Full Text Available Jonas Anderud,1,2 Peter Abrahamsson,2 Ryo Jimbo,1 Sten Isaksson,2 Erik Adolfsson,3 Johan Malmström,2 Yoshihito Naito,4 Ann Wennerberg1 1Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; 2Maxillofacial Unit Halmstad, Region Halland, Halmstad, Sweden; 3Swedish Ceramic Institute, IVF, Mölndal, Sweden; 4Department of Oral and Maxillofacial Prosthodontics and Oral Implantology, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan Abstract: The purpose of the study was to evaluate histologically, whether vertical bone augmentation can be achieved using a hollow ceramic space maintaining device in a rabbit calvaria model. Furthermore, the chemistry of microporous hydroxyapatite and zirconia were tested to determine which of these two ceramics are most suitable for guided bone generation. 24 hollow domes in two different ceramic materials were placed subperiosteal on rabbit skull bone. The rabbits were sacrificed after 12 weeks and the histology results were analyzed regarding bone-to-material contact and volume of newly formed bone. The results suggest that the effect of the microporous structure of hydroxyapatite seems to facilitate for the bone cells to adhere to the material and that zirconia enhance a slightly larger volume of newly formed bone. In conclusion, the results of the current study demonstrated that ceramic space maintaining devices permits new bone formation and osteoconduction within the dome. Keywords: hydroxyapatite, zirconia, guided bone regeneration, GBR, histology, membrane

  1. Effect of Low-Level Laser Therapy on Bone Regeneration During Osseointegration and Bone Graft.

    Science.gov (United States)

    Zein, Randa; Selting, Wayne; Benedicenti, Stefano

    2017-12-01

    The effect of low-level laser therapy (LLLT) on bone regeneration during osseointegration and bone graft is very controversial. Despite many positive reports of in vitro and in vivo studies and more than 50 randomized clinical trials claiming a positive effect of photobiomodulation (PBM), many reports found no significant effect of lasers. The aim of this study was to evaluate studies correlating PBM and bone regeneration and to assesses parameters that produce positive results based on dose and output power used. Four electronic databases were used: PubMed, Springer, Google Scholar, and Cochrane. The research yielded 230 articles. The full texts of all articles were evaluated and scored using eligibility criteria adapted from Cericato et al. After evaluation, only 19 articles met the inclusion criteria. A positive effect of low-level laser energy on bone regeneration within a certain relationship between dose and output power was found. LLLT stimulates cellular metabolism, increasing protein synthesis and subsequent bone regeneration. A high dose combined with low power or a low dose combined with high power appears to produce a positive effect.

  2. Novel Ceramic-Grafted Separator with Highly Thermal Stability for Safe Lithium-Ion Batteries.

    Science.gov (United States)

    Jiang, Xiaoyu; Zhu, Xiaoming; Ai, Xinping; Yang, Hanxi; Cao, Yuliang

    2017-08-09

    The separator is a critical component of lithium-ion batteries (LIBs), which not only allows ionic transport while it prevents electrical contact between electrodes but also plays a key role for thermal safety performance of LIBs. However, commercial separators for LIBs are typically microporous polyolefin membranes that pose challenges for battery safety, due to shrinking and melting at elevated temperature. Here, we demonstrate a strategy to improve the thermal stability and electrolyte affinity of polyethylene (PE) separators. By simply grafting the vinylsilane coupling reagent on the surface of the PE separator by electron beam irradiation method and subsequent hydrolysis reaction into the Al(3+) solution, an ultrathin Al2O3 layer is grafted on the surface of the porous polymer microframework without sacrificing the porous structure and increasing the thickness. The as-synthesized Al2O3 ceramic-grafted separator (Al2O3-CGS) shows almost no shrinkage at 150 °C and decreases the contact angle of the conventional electrolyte compared with the bare PE separator. Notably, the full cells with the Al2O3-CGSs exhibit better cycling performance and rate capability and also provide stable open circuit voltage even at 170 °C, indicating its promising application in LIBs with high safety and energy density.

  3. [Bone-tendon integration of autologous grafts using different diameter tunnels. An experimental study on sheep].

    Science.gov (United States)

    Sánchez Hidalgo, R; Forriol, F

    2012-01-01

    To analyse the bone-ligament integration «ligamentization» of the tendon graft in the reconstruction of anterior cruciate ligament (ACL) performing tunnels of different diameter. We performed the same reconstruction procedure using an autologous tendon graft taken from the superficial tendon of the hoof in 41 adult sheep. In Group A the tibial and femoral tunnels were 5 mm in diameter and in Group B they were 7 mm in diameter. The sheep were sacrificed at 3, 6 and 12 months after the surgery. Histological studies were performed on the graft and the tunnels, as well as a biomechanical analysis of the tibial-femoral complex. In group A we did not observe direct integration of the bone and the tendon graft or any fibres joining both structures, although there was vascularized fibrous tissue. In group B we did not observe any direct binding of the bone and the tendon graft either, although there was abundant fibrous tissue. The tendon graft showed a fascicular structure that increased over time in order to create septa for vascular penetration. Macroscopically the ACL graft had a dense appearance, which was very similar to the original tendon graft. The tendon grafts from group B and with a longer follow up period required a higher strength to produce maximum breakage than the tendon grafts from group A. After one year follow up, the histological study shows that the tendon graft is not transformed into a ligament, and there is no integration of the tendon graft in tunnels regardless of their diameter. Therefore, fixation techniques are essential to maintain the orientation and tension of the tendon graft. Copyright © 2011 SECOT. Published by Elsevier Espana. All rights reserved.

  4. Parathyroid hormone related to bone regeneration in grafted and nongrafted tooth extraction sockets in rats.

    Science.gov (United States)

    Kuroshima, Shinichiro; Al-Salihi, Zeina; Yamashita, Junro

    2013-02-01

    The quality and quantity of bone formed in tooth extraction sockets impact implant therapy. Therefore, the establishment of a new approach to enhance bone formation and to minimize bone resorption is important for the success of implant therapy. In this study, we investigated whether intermittent parathyroid hormone (PTH) therapy enhanced bone formation in grafted sockets. Tooth extractions of the maxillary first molars were performed in rats, and the sockets were grafted with xenograft. Intermittent PTH was administered either for 7 days before extractions, for 14 days after extractions, or both. The effect of PTH therapy on bone formation in the grafted sockets was assessed using microcomputed tomography at 14 days after extractions. PTH therapy for 7 days before extractions was not effective to augment bone fill, whereas PTH therapy for 14 days after operation significantly augmented bone formation in the grafted sockets. Intermittent PTH therapy starting right after tooth extractions significantly enhanced bone fill in the grafted sockets, suggesting that PTH therapy can be a strong asset for the success of the ridge preservation procedure.

  5. Evaluation of osteosynthesis with dual fibular bone grafting for neglected femoral neck fractures.

    Science.gov (United States)

    Jaiswal, Atin; Pruthi, K K; Goyal, R K; Pathak, Vineet; Habib, Masood; Tanwar, Yashwant S; Singh, Satyaprakash; Chaterjee, Rupak

    2013-06-01

    Femoral neck fractures in young adults is an unsolved problem and neglected femoral neck fractures presents more challenge to the orthopaedics surgeon if femoral head salvage is attempted. We reviewed the operative results of neglected femoral neck fractures in young adults with fixation with dual fibular bone grafting Purpose of study was evaluation of epidemiological, clinical, functional, rehabilitative outcome and complications in such patients. Twentyeight patients in age group 18-50 years were operated having fracture neck femur by dual fibular bone grafting in the Department of Orthopaedics, S.N. Medical College, Agra in (May 2005-February 2008) and divided into two groups. Group A: comprised of 8 patients treated by dual fibular bone grafting alone and Group B: comprised of 18 patients treated by dual fibular bone grafting with single cancellous hip screw. All the patients of the present series were having neglected intracapsular fracture, neck femur which were treated by dual fibular bone grafting with or without cancellous hip screw fixation. Majority of the patients had good to fair result according to Larson method with average time of union 16 weeks. All patients had useful range of movement at hip. Satisfactory union was achieved in all patients except two. Double bone grafting is a simple and cost effective modality of treatment for late femoral neck fracture with good results. It is a stable and biological method of fixation with preservation of natural femoral head with fewer complications.

  6. 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

  7. All-Solid-State Lithium-Ion Batteries with Grafted Ceramic Nanoparticles Dispersed in Solid Polymer Electrolytes.

    Science.gov (United States)

    Lago, Nerea; Garcia-Calvo, Oihane; Lopez del Amo, Juan Miguel; Rojo, Teofilo; Armand, Michel

    2015-09-21

    Lithium-based rechargeable batteries offer superior specific energy and power, and have enabled exponential growth in industries focused on small electronic devices. However, further increases in energy density, for example for electric transportation, face the challenge of harnessing the lithium metal as negative electrode instead of limited-capacity graphite and its heavy copper current collector. All-solid-state batteries utilize solid polymer electrolytes (SPEs) to overcome the safety issues of liquid electrolytes. We demonstrate an all-solid-state lithium-ion battery by using plasticized poly(ethylene oxide)-based SPEs comprising anions grafted or co-grafted onto ceramic nanoparticles. This new approach using grafted ceramic nanoparticles enables the development of a new generation of nanohybrid polymer electrolytes with high ionic conductivity as well as high electrochemical and mechanical stability, enabling Li-ion batteries with long cycle life. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Reconstruction of severely atrophied alveolar ridges with calvarial onlay bone grafts and dental implants.

    Science.gov (United States)

    Mertens, Christian; Steveling, Helmut G; Seeberger, Robin; Hoffmann, Jürgen; Freier, Kolja

    2013-10-01

    Severely atrophied alveolar ridges are most commonly reconstructed with free autologous bone grafts from the iliac crest. The use of these grafts, however, is frequently associated with bone resorption as possible late complication after implant surgery and prosthetic loading. Other donor sites, especially intraoral donor sites, show limited availability. The aim of this present study was to evaluate the clinical and radiographical outcome of alveolar ridge reconstruction with bone from the calvarium and subsequent implant rehabilitation. Reconstruction was performed by using calvarial split grafts in case of severe and complex alveolar ridge defects induced by trauma or bone atrophy. Fifteen patients were treated at 19 different intraoral recipient sites (15 sites in the maxilla, four in the mandible). Autologous block grafts were used for combined vertical and horizontal grafting. After a 3-month healing period, patients received dental implants. A total of 99 dental implants (OsseoSpeed™, Astra Tech AB, Mölndal, Sweden) were inserted and left to heal in a submerged position for 3 months before the prosthetic implant-based rehabilitation was performed. No donor site complications occurred during or after surgery. At the intraoral recipient sites two infections occurred, leading to partial loss of the grafts. Implant placement, however, was possible in all cases. Two of 99 implants were lost in two patients prior to prosthetic loading. Patients were followed up clinically and radiographically for an average observation period of 28 months. Implant survival rate and success rates were 97.85 and 95.7%, respectively, and a minimal marginal bone loss was documented. The low morbidity at the donor sites and the good marginal bone stability in the reconstructed regions indicate that calvarial bone grafts represent a viable treatment alternative to grafts from the iliac crest. © 2011 Wiley Periodicals, Inc.

  9. 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

  10. Osteoinductive potential of a novel biphasic calcium phosphate bone graft in comparison with autographs, xenografts, and DFDBA.

    Science.gov (United States)

    Miron, Richard J; Sculean, Anton; Shuang, Yang; Bosshardt, Dieter D; Gruber, Reinhard; Buser, Daniel; Chandad, Fatiha; Zhang, Yufeng

    2016-06-01

    Since the original description of osteoinduction in the early 20th century, the study and development of innovative biomaterials has emerged. Recently, novel synthetic bone grafts have been reported with potential to form ectopic bone in vivo. However, their full characterization in comparison with other leading bone grafts has not been investigated. The aim of this study was to determine the osteoinductive potential of bone grafts by comparing autogenous bone grafts, demineralized freeze-dried bone allografts (DFDBA), a commonly utilized natural bone mineral (NBM) from bovine origin (Bio-Oss), and a newly developed biphasic calcium phosphate (BCP). Grafts were compared in vitro for their ability to stimulate bone marrow stromal cell (BMSC) migration, proliferation, and differentiation as assessed by quantitative real-time PCR for genes coding for bone markers including Runx2, collagen I, and osteocalcin. Furthermore, bone grafts were implanted in the calf muscle of 12 beagle dogs to determine their potential to form ectopic bone in vivo. The in vitro results demonstrate that both autografts and DFDBA show potential for cell recruitment, whereas only autografts and BCP demonstrated the ability to differentiate BMSCs toward the osteoblast lineage. The in vivo ectopic bone model demonstrated that while NBM particles were not osteoinductive and autogenous bone grafts were resorbed quickly in vivo, ectopic bone formation was reported in DFDBA and in synthetic BCP grafts. The modifications in nanotopography and chemical composition of the newly developed BCP bone grafts significantly promoted ectopic bone formation confirming their osteoinductive potential. In conclusion, the results from this study provide evidence that synthetic bone grafts not only serve as a three-dimensional scaffold but are also able to promote osteoinduction. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Comparative evaluation of bovine derived hydroxyapatite and synthetic hydroxyapatite graft in bone regeneration of human maxillary cystic defects: A clinico-radiological study

    OpenAIRE

    Kattimani, Vivekanand. S; Srinivas P Chakravarthi; Naga Neelima Devi, K.; Meka S Sridhar; L Krishna Prasad

    2014-01-01

    Introduction: Bone grafts are frequently used in the treatment of bone defects. Bone harvesting can cause postoperative complications and sometimes does not provide a sufficient quantity of bone. Therefore, synthetic biomaterials have been investigated as an alternative to autogenous bone grafts. Aim and Objectives: The aim of this study was to evaluate and compare bovine derived hydroxyapatite (BHA) and synthetic hydroxyapatite (SHA) graft material as bone graft substitute in maxillary c...

  12. Pilot study of pre-maxilla replacement and bone graft in a patient with lip and palate clefts: transforaminal relationship between upper canines and bone graft

    Directory of Open Access Journals (Sweden)

    João Luis Carlini

    2015-09-01

    Full Text Available Objective: The aim of this study was to assess patients subjected to replacement surgery of the pre maxilla with bone graft, having as donor area the iliac crest and chin, and the relation with upper canines erupted in grafted areas. Materials and Methods: 54 records were evaluated from cleft patients that were under treatment at CAIF - Center of Attention to Clefts in Curitiba, PR, Brazil, both sexes, with unilateral and bilateral lip and palate clefts. Patients younger than fourteen years old, both sexes, that lost the surgical segment or did not continue the treatment at same welcoming institution, were excluded.  The surgical segment average was 5.72 years. Results: Using both descriptive and chi-square statistics, we observed a statistically significant distinction regarding the eruption of upper canines in the region of secondary bone grafts when using iliac crest and chin grafts, which 62.8% of the sample that was treated with chin grafts happened to have an eruption of upper canines, and 37.2% were successful with iliac crest grafts (value-p 0.028. Conclusions: It is necessary to carry out a study with a larger sample size and where the samples are paired in order to confirm the superiority the iliac crest donor area as the gold standard for this surgical procedure.

  13. [Scintigraphic detection of osteoblast activity after implantation of BAS-0 bioactive glass-ceramic material into long bone defects].

    Science.gov (United States)

    Sponer, P; Urban, K; Urbanová, E

    2006-06-01

    recurrence. Two patients had a residual defect. The bioactive glass-ceramic material BAS-0 was completely incorporated in all patients. On three-phase bone scans, radionuclide distribution on the flow phase and soft tissue phase was symmetrical in both limbs of all patients. For the metaphyseal location of implants, the delayed images demonstrated physiological radionuclide distribution in one patient, mildly increased distribution (index up to 1.2) in four, increased uptake (index up to 1.5) in two patients, and highly increased uptake (index above 1.5) in one patient. For the diaphyseal location of implants, the delayed scans demonstrated slightly increased radionuclide distribution in two, markedly increased in two and highly increased uptake in eight patients. The tissue during incorporation of a non-resorbable synthetic material is influenced by stress-shielding. This changes local mechanical signals, which has a negative effect on the adjacent bone tissue. Stress accumulating at the interface of a rigid implant and bone tissue may result in pain, and is detected by scintigraphy as an increased nucleotide uptake, particularly in diaphyseal grafts. This paper presents problems associated with implantation of the non-resorbable bioactive glass-ceramic material BAS-0 in the treatment of diaphyseal defects of long bones. The results show that, for filling of the defects described herein, non-resorbable glass-ceramic materials are not suitable.

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

    Science.gov (United States)

    Klijn, Reinoud J; Meijer, Gert J; Bronkhorst, Ewald M; Jansen, John A

    2010-06-01

    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 April 2009 was carried out. PubMed search engine and the following journals were explored: Clinical Oral Implant Research, International Journal of Oral and Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, and the Journal of Periodontology. Out of 147 titles, according to our criteria, 25 articles were left for analysis. The majority were prospective controlled studies (21) and 2 randomized clinical trials, 1 pilot study and 1 case series. A reference value of 47% for total bone volume (TBV) was found while using iliac bone grafting as a standard. Use of intraoral bone grafts increases the TBV, with 11% for chin bone and 14% for bone grafted from other intraoral sites. Particulation of the bone graft has a negative effect on the TBV of 18%. Surprisingly, no correlation between TBV and the time of graft healing was found. Histological section thickness seemed to be a significant variable, as every micron increase of section thickness leads to an increase of 0.4% of TBV. Bone grafting from the iliac crest resulted in a significantly lower TBV compared with intraoral bone grafting. However, due to the limited availability of intraoral bone to be harvested, iliac grafts still have to be considered the gold standard in augmenting the severely atrophic maxilla.

  15. Corneal grafting and aggressive medication for corneal defects in graft-versus-host disease following bone marrow transplantation.

    Science.gov (United States)

    Tarnawska, D; Wylegała, E

    2007-12-01

    To evaluate the clinical outcomes of corneal grafting for severe dry eye complications in bone marrow transplant recipients. Eleven eyes of nine patients with severe corneal complications of chronic graft-versus-host disease were treated from 2000 to 2005. The subjects underwent penetrating keratoplasty (n=9 eyes; seven for perforation and two for leucoma) or deep anterior lamellar keratoplasty (n=2 eyes) for deep postinflammatory stromal scarring without endothelial abnormalities. Patients were observed for graft survival, visual acuity, and postoperative complications. During the follow-up period (mean=21.6 months), nine grafts (82%) remained clear or almost entirely clear and gained more than two logarithmic units of best-corrected visual acuity. Two regrafts were necessary as the primary grafts became cloudy after 9 and 11 months. Persistent epithelial defects occurred in seven eyes (64%), cataract in six (55%), ocular hypertension in five (45%), corneal calcareous degeneration in two (18%), loss of clarity in two (18%), and sterile ulceration in one (9%). Corneal grafting was effective for restoring corneal clarity and improving visual function in this series of patients. Although the complication ratio was high and some patients required regrafting, there was a clinical improvement in the majority of patients.

  16. Radiopacity of alloplastic bone grafts measured with cone beam computed tomography: An analysis in rabbit calvaria

    Directory of Open Access Journals (Sweden)

    Cristina Bucchi

    2016-02-01

    Full Text Available Availability of adequate bone structure for dental implants is still a problem in dentistry. Alloplastic grafts, which promote bone regeneration, are used as bone substitutes in orthopedic and oral surgical procedures. The aim of this study was to evaluate the radiopacity of three different synthetic bone grafts in rabbit calvaria, over 3 months, using cone beam computed tomography (CBCT. Four critical-size defects were made on the calvaria of 11 rabbits. The lesions were classified into three groups according to the alloplastic grafts they received: Osteon® 70/30, Osteon collagen®, and Osteon II® groups. The fourth group received blood clot, and served as a control. The bone samples were collected and analyzed with CBCT after the 1st, 2nd, and 3rd month. One month after surgery, the lesions that received Osteon® 70/30 and Osteon collagen® grafts showed the highest radiopacity compared to the lesions with Osteon II® and blood clot. After the 2nd month, the radiopacity values between the three groups that received the grafts were more similar compared to the group with blood clot. After the 3rd month, the lesions with Osteon® 70/30 graft showed the highest radiopacity values, followed by Osteon collagen® and Osteon II® groups. The group that received blood clot showed the lowest radiopacity values. In conclusion, the grafts used in this study had higher radiopacity values compared to blood clot. Among the grafts used, the Osteon® 70/30 graft showed the highest radiopacity values in the 3-month period.

  17. Radiopacity of alloplastic bone grafts measured with cone beam computed tomography: An analysis in rabbit calvaria.

    Science.gov (United States)

    Bucchi, Cristina; Borie, Eduardo; Arias, Alain; Dias, Fernando José; Fuentes, Ramón

    2016-02-21

    Availability of adequate bone structure for dental implants is still a problem in dentistry. Alloplastic grafts, which promote bone regeneration, are used as bone substitutes in orthopedic and oral surgical procedures. The aim of this study was to evaluate the radiopacity of three different synthetic bone grafts in rabbit calvaria, over 3 months, using cone beam computed tomography (CBCT). Four critical-size defects were made on the calvaria of 11 rabbits. The lesions were classified into three groups according to the alloplastic grafts they received: Osteon® 70/30, Osteon collagen®, and Osteon II® groups. The fourth group received blood clot, and served as a control. The bone samples were collected and analyzed with CBCT after the 1st, 2nd, and 3rd month. One month after surgery, the lesions that received Osteon® 70/30 and Osteon collagen® grafts showed the highest radiopacity compared to the lesions with Osteon II® and blood clot. After the 2nd month, the radiopacity values between the three groups that received the grafts were more similar compared to the group with blood clot. After the 3rd month, the lesions with Osteon® 70/30 graft showed the highest radiopacity values, followed by Osteon collagen® and Osteon II® groups. The group that received blood clot showed the lowest radiopacity values. In conclusion, the grafts used in this study had higher radiopacity values compared to blood clot. Among the grafts used, the Osteon® 70/30 graft showed the highest radiopacity values in the 3-month period.

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

    Science.gov (United States)

    van Vugt, T A G; Geurts, J; Arts, J J

    2016-01-01

    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.

  19. Four-corner arthrodesis--does the source of graft affect bony union rate? Iliac crest versus distal radius bone graft.

    Science.gov (United States)

    Kitzinger, H B; Karle, B; Prommersberger, K-J; van Schoonhoven, J; Frey, M

    2012-03-01

    Four-corner arthrodesis is an accepted surgical option for treatment of scapholunate advanced collapse, scaphoid non-union advanced collapse and midcarpal instability. A preferred source of bone graft for performing four-corner arthrodesis is the iliac crest. An alternative and more convenient donor site is the distal radius. The aim of this study was to investigate whether the union rate after four-corner arthrodesis is influenced by the source of bone graft, that is, iliac crest or distal radius. In a retrospective analysis, charts and radiographs of 180 patients were identified. In 109 patients, iliac crest bone grafts were used, whereas 71 patients received distal radius bone grafts. In the iliac crest bone graft group, 101 out of 109 patients obtained a solid radiographic union of the arthrodesis at an average of 10 weeks after surgery, and non-union in eight patients (7.3%). In the distal radius bone graft group, X-rays of 66 patients showed bone union after an average of 10 weeks after surgery as well and five patients with non-union (7.0%) respectively. There was no statistical difference in bone union. Our data show that distal radius bone graft compares equally to iliac crest bone graft in performing four-corner arthrodesis. The advantages of the distal radius bone graft include a minor surgical exposure and the avoidance of using a distant anatomic site with associated donor-site morbidity. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. 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 ...

  1. Sinus grafting using recombinant human tissue factor, platelet-rich plasma gel, autologous bone, and anorganic bovine bone mineral xenograft: histologic analysis and case reports.

    Science.gov (United States)

    Philippart, Pierre; Daubie, Valéry; Pochet, Roland

    2005-01-01

    The purpose of this study was to analyze healthy bone formation by means of histology and immunohistochemistry after grafting with a mixture of autologous ground calvarial bone, inorganic xenograft, platelet-rich plasma (PRP), and recombinant human tissue factor (rhTF). Maxillary sinus floor augmentation was performed on 3 patients by grafting with 5 to 10 mL of a paste consisting of autologous powder from calvarial bone (diameter plasma), and about 1 microg rhTF. Six and 10 months after grafting, bone cores were extracted for implant fixation and analyzed. Histology demonstrated a high degree of inorganic xenograft integration and natural bone regeneration. Both the xenograft and newly synthesized bone were colonized with osteocytes and surrounded by osteoblasts. Six-month-old bone cores demonstrated a ratio of synthesized bone to xenograft particles ratio of 0.5, whereas 10-month-old cores demonstrated a ratio of 2. A low degree of inflammation could also be observed using S100A8 immunohistochemistry. Autologous grafting in edentulous patients is a complex procedure; the successful substitution of synthetic analogs for ground bone is a major challenge. In this investigation, it was shown that inorganic xenograft in the harvested bone paste could be safe for patients and had high bone regeneration capacity over time. The sinus graft showed intense bone formation 6 months after grafting and a further increase in bone growth 10 months after grafting.

  2. Use of non-vascularized autologous fibula strut graft in the treatment of segmental bone loss.

    Science.gov (United States)

    Lawal, Y Z; Garba, E S; Ogirima, M O; Dahiru, I L; Maitama, M I; Abubakar, K; Ejagwulu, F S

    2011-01-01

    Fractures resulting in segmental bone loss challenge the orthopedic surgeon. Orthopedic surgeons in developed countries have the option of choosing vascularized bone transfers, bone transport, allogenic bone grafts, bone graft substitutes and several other means to treat such conditions. In developing countries where such facilities or expertise may not be readily available, the surgeon has to rely on other techniques of treatment. Non-vascularized fibula strut graft and cancellous bone grafting provides a reliable means of treating such conditions in developing countries. Over a period of six years all patients with segmental bone loss either from trauma or oncologic resection were included in the study. Data concerning the type of wound, size of gap and skin loss at tumor or fracture were obtained from clinical examination and radiographs. Ten patients satisfied the inclusion criteria for the study. The average length of the fibula strut is 7 cm, the longest being 15 cm and the shortest 3 cm long. The average defect length was 6.5 cm. Five patients had Gustillo III B open tibial fractures. One patient had recurrent giant cell tumor of the distal radius and another had a polyostotic bone cyst of the femur, which was later confirmed to be osteosarcoma. Another had non-union of distal tibial fracture with shortening. One other patient had gunshot injury to the femur and was initially managed by skeletal traction. The tenth patient had a comminuted femoral fracture. All trauma patients had measurement of missing segment, tissue envelope assessment, neurological examination, and debridement under general anesthesia with fracture stabilization with external fixators or casts. Graft incorporation was 80% in all treated patients. Autologous free, non-vascularized fibula and cancellous graft is a useful addition to the armamentarium of orthopedic surgeon in developing countries attempting to manage segmental bone loss, whether created by trauma or excision of tumors.

  3. 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 BackgroundA cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia.MethodsFrom February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework.ResultsThe follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases.ConclusionsOnlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.

  4. Simultaneous maxillary sinus lifting and implant placement with autogenous parietal bone graft: outcome of 17 cases.

    Science.gov (United States)

    Sakka, Salah; Krenkel, Christian

    2011-04-01

    The aim of this study was to retrospectively evaluate the surgical technique of sinus floor elevation with autogenous parietal bone grafting in conjunction with immediate dental implants for the reconstruction of the maxilla in deficient maxillary alveolar ridges. Seventeen patients who underwent sinus floor elevation with bone graft from the parietal bone between 2005 and 2007 were included in the study. Cases of extremely deficient bone level in the alveolar ridgeAnkylos®) with different length and diameter were placed immediately after the graft was placed. Strict oral hygiene was required for the patients. Presurgical and postsurgical panoramic radiographs were taken. A high-quality reconstruction with an increase in lifted sinus bone height was achieved with parietal bone particulates. Seventy-three implants were clinically osseointegrated and four implants were lost giving a success rate 94.8%. No correlation was found between failure and the surgery. The encouraging results of this study suggest that the technique of reconstruction of the sinus floor and the resorbed alveolar ridge using an autogenous parietal bone graft is reliable, giving the surgeon the opportunity to successfully perform immediate implant placement in more difficult and deficient maxillary alveolar bone height. Copyright © 2010. Published by Elsevier Ltd.

  5. The evaluation of the bone graft survival status in titanium cervical ...

    African Journals Online (AJOL)

    ONOS

    2010-08-09

    Aug 9, 2010 ... Key words: Bone graft, titanium cervical cage, radionuclide bone CT. INTRODUCTION. In recent years, cervical interbody cages have gained popularity in the treatment of degenerative spinal dis- orders and satisfactory clinical outcomes have been reported (Hacker, 2002; Profeta et al., 2000). However,.

  6. Maxillary bone grafting for insertion of endosseous implants : results after 12-124 months

    NARCIS (Netherlands)

    Raghoebar, GM; Timmenga, NM; Reintsema, H; Stegenga, B; Vissink, A

    Insertion of endosseous implants in the atrophic maxilla is often complicated because of lack of supporting bone. Augmentation of the floor of the maxillary sinus with autogenous bone graft has been proven to be a reliable treatment modality, at least in the short term. The long-term clinical and

  7. Composite coating of 58S bioglass and hydroxyapatite on a poly (ethylene terepthalate) artificial ligament graft for the graft osseointegration in a bone tunnel

    Energy Technology Data Exchange (ETDEWEB)

    Li Hong; Wu Yang; Ge Yunsheng; Jiang Jia; Gao Kai [Department of Sports Medicine, Huashan Hospital, Shanghai (China); Zhang Pengyun; Wu Lingxiang [Shanghai Research Center of Biomedical Engineering, Shanghai (China); Chen Shiyi, E-mail: cshiyi@163.com [Department of Sports Medicine, Huashan Hospital, Shanghai (China)

    2011-09-01

    The purpose of this study was to determine the effect of the combination of hydroxyapatite (HA) and bioglass (BG) on polyethylene terephthalate (PET) artificial ligament graft osseointegration within the bone tunnel. The results of in vitro culturing of MC3T3-E1 mouse osteoblastic cells proved that this HA/BG composite coating can promote the cell compatibility of grafts. A rabbit extraarticular tendon-to-bone healing model was used to evaluate the effect of this composite coating on PET artificial ligaments in vivo. The final results demonstrated that HA/BG coating improved new bone formation at the graft-bone interface and increased the load-to-failure property of graft in bone tunnel compared to the control group at early time. The study has shown that HA/BG composite coating on the PET artificial ligament surface has a positive effect in the induction of artificial ligament osseointegration within the bone tunnel.

  8. Dental Implantation of Atrophic Jaws Reconstructed with Iliac Bone Graft Crest - Outcome of Seven Cases.

    Science.gov (United States)

    Bllaca, Florian; Toci, Ervin

    2016-12-15

    Iliac bone grafts are used to augment alveolar ridges followed by subsequent dental implants in completely edentulous patients. In Albania the information about these issues is scarce. To describe the procedure of iliac bone grafts augmentation of alveolar ridges and evaluate the survival rate of dental implants in completely edentulous patients in Albania. Seven totally edentulous patients (three males, average age 45.9 years) presenting at Durrës Regional Hospital during 2008-2015 and seeking a solution to their problem through implantation procedures were included in the study. Patients were thoroughly examined, evaluated and the best augmentation procedure, using iliac crest bone grafts, and dental implantation technique was chosen. The number of dental implants placed was recorded and their survival rate was calculated. The most common intervention site was maxillae (in 71.4% of cases). Dental implants were installed six months after augmentation, all fixed on the very stable augmented alveolar ridge. On average between 20%-30% of bone grafts, volume was resorbed. Of 37 implants settled, 36 of them or 97.3% survived. Iliac bone grafts are a suitable augmentation source of bone in a patient suffering from complete edentulism in Albania. The survival rate of dental implants is very satisfactory.

  9. Secondary skull reconstruction with autogenous split calvarial bone grafts versus nonautogenous materials.

    Science.gov (United States)

    Lee, Hee Jong; Choi, Jong Woo; Chung, In Wook

    2014-07-01

    Skull reconstructions, which can be required for various reasons, including decompressive craniectomy, trauma, and tumors, are challenging issues in plastic surgery. Moreover, obtaining a low complication ratio in secondary skull reconstructions is more difficult than in primary skull reconstructions. Because standardized protocols have not been established, we here compare cranioplasty performance using fresh autogenous split calvarial bone grafts and allogenic or alloplastic materials in secondary revisional cases. Surgical correction of skull defects was performed in 25 patients in our center between 2005 and 2012. Only secondary cranioplasty cases were reviewed retrospectively. There were 17 men and 8 women, with ages ranging from 8 to 62 years at the time of surgery. The mean follow-up was 55.6 months. The surgical procedure in each case was a routine cranioplasty. In most of the cases, a 1-piece split calvarial bone graft was used while minimizing the separation of the bone flap into multiple pieces. In comparison with the skull reconstructional approach using nonautogenous materials, the functional and esthetic results of skull reconstruction using autogenous calvarial bone grafts were better and more consistent in secondary revisional cases. The group that received autogenous calvarial bone grafts showed a reconstruction success rate of 80% without esthetic and functional complications. In contrast, the group that received nonautogenous materials had a 30% success rate. Secondary cranial defect reconstructions with autogenous calvarial bone grafts showed better functional and esthetic results than skull reconstructions with nonautogenous materials.

  10. Comparison of autologous and heterologous bone graft stability effects for filling maxillary bone gap after Le Fort I osteotomy.

    Science.gov (United States)

    Eser, Cengiz; Gencel, Eyüphan; Gökdoğan, Mahmut; Kesiktaş, Erol; Yavuz, Metin

    2015-01-01

    The amount of postoperative maxillary relapse of two different bone graft materials after Le Fort I osteotomy were compared in this study. The aim of this study is to compare postoperative maxillary relapse rates using heterologous and autologous graft materials after Le Fort I osteotomy. A total of 80 patients who had developmental malocclusion were analyzed retrospectively in this study. Twenty nine (36.2%) and 51 (63.8%) patients underwent Le Fort I osteotomy, and Le Fort I and bilateral sagittal split ramus osteotomy (two-jaw surgery), respectively. Forty two (52.5%) maxillary bone gaps were filled with heterologous bone grafts (group A) and 38 (47.5%) were filled with autologous bone grafts (group B) after Le Fort I osteotomy. The cephalometric graphics and measurements were taken before (T1), 1 week after (T2), and 1 year after (T3) the surgery. The results were documented and determined by the Dolphin imaging 10.5 (Dolphin Imaging, Chatsworth, Calif.) computer program for skeletal relapse. Whether or not the relationship between group A's and B's maxillary relapse rates was evaluated in the postoperative period. It was observed that both graft materials have positive effects on maxillary relapse rate in the postoperative period. When the groups are compared to each other, the relapse rates were similar between group A (8.3%) and group B (10.8%) (p>0.05). Heterologous bone graft material (Osteoplant®-Flex) is thought to be a good alternative to autologous grafts in decreasing the relapse rates and reducing the morbidity of the donor area of the patients who underwent Le Fort I osteotomy.

  11. [A comparative study of ethylene oxide and ionizing radiation for sterilizing bone grafts].

    Science.gov (United States)

    Sang, H; Hu, Y; Sun, Y

    1996-08-01

    To find a good way for sterilization and disinfection of bone grafts, we compared the sterilization capacity of gaseous ethylene oxide (EO) and cobalt-60 gamma radiation. The bone chips were contaminated with 10(7) bacteria per milliliter of Staphylococcus aureus ATCC 25923, Bacillus subtilis globigii 8017 and Bacillus cereus 4001, then sterilized with various doses of gaseous EO or cobalt- 60 gamma radiation. The sterilization effect of EO was more stronger and faster than that of 60Co gamma radiation. The application of moderate doses of EO for sterilizing particulate bone grafts was recommended.

  12. Silver doped resorbable tricalcium phosphate scaffolds for bone graft applications.

    Science.gov (United States)

    Hoover, Sean; Tarafder, Solaiman; Bandyopadhyay, Amit; Bose, Susmita

    2017-10-01

    Bone graft procedures, in particular maxillofacial repair, account for half of the orthopedic procedures done in the US each year. Infection is a major issue in surgery, and should be of primary concern when engineering biomaterials. Silver is of renewed importance today, as it has the ability to potentiate antibiotics against resistant bacterial strains. In order to reduce long term infection risks, it is necessary for the scaffold to maintain a silver ion release for the length of the healing process. In this study, silver doped porous β-tricalcium phosphate (β-TCP) scaffolds were engineered using liquid porogen based method with the goal of meeting these requirements. Silver was added to the β-TCP at three different dopant levels: 0.5wt% Ag2O, 1wt% Ag2O and 2wt% Ag2O. Immersion in pH5 acetate buffer over a 60day period resulted in a total cumulative ion release between 32 and 54μM for dense control scaffolds, and between 80 and 90μM for porous scaffolds. Porosity increased the dissolution rate of the scaffolds by a factor of 2. Human osteoblast cell lines were grown on the scaffolds to measure cytotoxicity and cell proliferation. Porosity increased osteoconduction by doubling the cell growth, and there was no significant cytotoxic effect even for the 2wt% Ag2O, as cells were observed on all the samples. Our results showed that silver can be released over a long period without compromising the biocompatibility of the scaffolds. Copyright © 2017 Elsevier B.V. All rights reserved.

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

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    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.

  14. Salvage of foot with extensive giant cell tumour with transfer of vascularised fibular bone graft

    Directory of Open Access Journals (Sweden)

    Jose Tharayil

    2011-01-01

    Full Text Available Though giant cell tumor is not uncommon in young adults, simultaneous involvement of multiple mid-foot bones is very uncommon and very difficult to treat. For reconstruction of large segmental bony defects following tumour excision, free vascularized bone graft is an excellent surgical option. We report a case with extensive involvement of all the tarsal bones and metatarsal bases in a young adult. After excision his foot was reconstructed with vascularised bone flap. We were able to save his foot after a wide local excision and reconstruction with free fibula graft. Graft united early and showed excellent remodelling because of good vascularity. We feel that this method deserves consideration as a last attempt to salvage functional foot in disease like this.

  15. 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.

  16. REVERSAL OF GRAFT-VERSUS-HOST DISEASE WITH INFUSION OF AUTOLOGOUS BONE MARROW

    Science.gov (United States)

    Ricordi, Camillo; Tzakis, Anreas G.; Zeevi, Adriana; Rybka, Witold B.; Demetris, Anthony J.; Fontes, Paulo A.C.; Nalesnik, Michael A.; Trucco, Massimo; Ukah, Ferdinand O.; Ball, Edward D.; Mullen, Edward E.; Marino, Ignazio R.; Fung, John J.; Starzl, Thomas E.

    2010-01-01

    Graft-versus-host disease (GVHD) remains a major complication of bone marrow transplantation. This report describes reversal of GVHD by infusion of stored recipient bone marrow following combined liver-bone marrow allotransplantation. Graft-versus-host disease developed at the end of the first postoperative week. The skin involvement progressively spread to approximately 80% of the body surface and was not affected by modification of the immunosuppressive treatment. On the 42nd and 43rd postoperative day 1.23 × 108 and 1.6 × 108 autologous bone marrow cells per kg of recipient body weight were infused. The skin rush began to dramatically improve and resolved within 2 wk from the autologous marrow infusion. Autologous bone marrow storage previous to allogeneic bone marrow transplantation for tolerance induction could constitute a safety net in case of occurrence of GVHD. PMID:8012734

  17. Reverse micelle mediated synthesis, processing, mechanical and biological characterization of hydroxyapatite nanopowders for bone graft application

    Science.gov (United States)

    Banerjee, Ashis

    Hydroxyapatite (HA) is the most widely used bioceramic material in bone graft applications because of its compositional similarity with natural bone. However, synthetic HA does not show similar mechanical and biological properties to the inorganic component of bone. Properties of ceramic material depend on starting materials, processing techniques, densification and microstructure of the final product. The objective of this research was to process HA whisker reinforced HA composite using HA nanopowders and whiskers. HA nanopowders with different length scale and morphology were synthesized by reverse micelle system using NP5 and NP12 as surfactants and cyclohexane as organic solvent. The lowest average aspect ratio was 1.357+/-0.39 with average particle size of 66 nm and the highest average aspect ratio was 7.277+/-3.227 with average length of 150 nm and width of 20 nm, were synthesized. Micron sized HA whiskers with aspect ratio between 20 and 50, average particle length of 15 mum and width of 400 nm was synthesized using urea as a precipitating agent. Desired microstructure was obtained after sintering with spherical HA nanopowder and whiskers along with dopants. Addition of whiskers decreased density of the sintered compacts. However, at 10 wt% whisker content sample showed microhardness and fracture toughness of 3.6 GPa and 1.5 MPa.m1/2, respectively, and a compressive strength of 80 MPa was obtained. Mineralization study in simulated body fluid (SBF) showed formation of apatite layer on the dense HA compacts indicating a good tendency of bond formation with natural bone. Cytotoxicity results showed excellent cell attachment on the HA surface. In the Appendices, 3 journal articles have been attached which describe synthesis, processing and characterization of undoped and doped PZT nanopowders. Free standing and agglomerated PZT nanopowders were synthesized by the sucrose templated method and the citrate nitrate autocombustion method. Particle size in the range

  18. ALVEOLAR BONE REGENERATION AFTER DEMINERALIZED FREEZE DRIED BONE ALOGRAFT (DFDBA BONE GRAFTING

    Directory of Open Access Journals (Sweden)

    Sri Oktawati

    2006-04-01

    Full Text Available Periodontal treatment by conventional way will result in healing repair, which easily cause recurrence. Modification of treatment should be done to get an effective result, that is the regeneration of alveolar bone and to reduce inflammation. The objective of this study is to determine the alveolar bone regeneration after using DFDBA (Demineralized Freeze Dried Bone Allograft. Quasi experimental designs with pre and post test method was used in this study. From 13 patients, 26 defects got conventional or regenerative treatment. The indicator of alveolar bone regenaration in bone height in radiographic appearance and level of osteocalsin in gingival crevicular fluid (GCF were checked before and after the treatment, then the changes that occurred were analyzed. The result of the research showed that alveolar bone regeneration only occurred to the group of regenerative treatment using DFDBA. The conclusion is the effective periodontal tissue regeneration occurred at regenerative treatment by using DFDBA, and the osteocalsin in GCF can be used as indicator of bone growth.

  19. Calvarial Bone Grafting for Three-Dimensional Reconstruction of Severe Maxillary Defects: A Case Series.

    Science.gov (United States)

    Restoy-Lozano, Andres; Dominguez-Mompell, Jose-Luis; Infante-Cossio, Pedro; Lara-Chao, Juan; Lopez-Pizarro, Victor

    2015-01-01

    To evaluate the efficacy, associated morbidity, and results of a three-dimensional reconstruction technique for repairing severe defects of the maxilla using a calvarial autogenous bone graft and a soft tissue double-layered surgical approach in preparation for placing dental implants. Bone defects of the maxilla consecutively reconstructed with calvarial autologous graft in the authors' institution were retrospectively evaluated. Patients with combined maxilla alveolar ridge defects with a width less than 4 mm and a height less than 7 mm (to the level of the maxillary sinus or the nostril), with at least three teeth involved, were included in the study. Calvarial bone blocks were sagittally sectioned in fine layers and fixed three-dimensionally in a boxlike structure with particulate bone inside. The purpose was to obtain an adequate amount of vertical and horizontal alveolar bone to enable restoration with dental implants at least 3.4 mm in diameter and 11 mm in length. Eleven reconstructive procedures were performed in 10 patients. Bone graft integration was successful in all of them. No major complications were observed in the donor cranial site. A mean bone gain of 5.04 mm (range, 3.4 to 7.8 mm) in height was obtained (standard deviation [SD], 1.69). The implant surgery was performed between the 15th and 19th weeks. A total of 28 implants were placed, and the mean follow-up time was 45 months (range, 23 to 65 months; SD, 12). The mean graft vertical resorption was 0.78 mm (range, 0.50-1.50 mm; SD, 0.00) 41 months after implant fixation. Three-dimensional reconstruction technique using calvarial bone grafts to restore severe segmental or crestal bone defects in the maxilla is an effective and predictable procedure that can increase the horizontal and vertical bone volume in preparation for the successful placement of dental implants.

  20. Retrospective evaluation of 211 patients with maxillofacial reconstruction using parietal bone graft for implants insertion.

    Science.gov (United States)

    Depeyre, Arnaud; Touzet-Roumazeille, Sandrine; Lauwers, Ludovic; Raoul, Gwenael; Ferri, Joel

    2016-09-01

    For a century, autologous bone grafts have been used in maxillofacial reconstruction. The ideal bone harvest site and grafting procedure remains a point of contention in regards to obtaining optimal long-term results with sufficient bone quantity and density without serious complications. More recently, confronted with growing patient requests and biomaterials development, maxillofacial surgeons and dentists have been considering these issues as they relate to pre-implant surgery. This study sought to evaluate implant success rate and complications following pre-implant surgery with parietal bone grafting. A retrospective study was carried out on patients who underwent maxillofacial reconstruction of different sites (symphysis, mandibular corpus, maxillary sinus and premaxilla) for the purpose of implant insertion. 311 procedures in 211 patients were included. The implant osseointegration rate was around 95%. Clinical follow-up ranged from 10 months to 11 years. A secondary procedure was performed in 6.1% of cases and we noted no serious complications at the harvest site. With good revascularization and osseointegration of the graft, the use of parietal bone leads to an implant success rate similar to that seen in the literature. Moreover, the use of this material results in few infections and low bone resorption provided there is strict immobilization of the graft and no tension on the soft tissue sutures. Parietal bone grafts technique possess the required qualities for the success of implant surgery, offering results at least as interesting as others using autogenous bone and with no serious complications on donor site. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  1. Bone physiology in human grafted and non-grafted extraction sockets--an immunohistochemical study.

    Science.gov (United States)

    Nahles, Susanne; Nack, Claudia; Gratecap, Kerrin; Lage, Hermann; Nelson, John J; Nelson, Katja

    2013-07-01

    The aim of the present immunohistological investigation was to define and compare the osteogenic potential with the vascularization of the provisional matrix in grafted and ungrafted extraction sockets after 4 and 12 weeks of healing. A total of 33 Patients (15 women, 18 men) with 65 extraction sites with a mean age of 54.4 years (30-73 years) participated in this study. After tooth extraction, the sockets were augmented with Bio-Oss collagen or non-augmented. At implant placement after 4 or 12 weeks bone biopsies were obtained. Within the specimens the osteogenic and endothelial potential of mesenchymal cells was analyzed in the provisional matrix using immunohistochemical analysis with three monoclonal antibodies Cbfa1/Runx2, Osteocalcin (OC), and CD31. Statistical analysis was performed using Mann-Whitney U-test, Spearman's rank-order correlation coefficient, and the two-factorial analysis for repeated measurements. Of the 65 extraction sockets, 25 (13 non-augmented, 12 augmented) sites after 4 weeks healing time and 40 (19 non-augmented, 21 augmented) sites after 12 weeks healing time were involved in the study. No signs of acute or chronic inflammation were noted in any specimens. After 4 weeks, a median amount of 56% (10-85%) of Cbfa1 positive cells and a median amount of cells expressing OC of 21% (5-42%) were measured. A median CD31 score of 5 was observed. After 12 weeks, a median amount of 61% (19-90%) positive cells expressed by Cbfa1/Runx2 staining a median amount of OC positive cells of 9% (2-17%) was measured. The results at 12 weeks revealed a median score of CD31 positive cells of 3. Osteoblastic activity in the provisional matrix was highest after 4 weeks of healing period. The active zone of bone formation is found in the apical region of the extraction socket during the early healing phase, shifting to the coronal region after 12 weeks. A peak of osteoblast activity within the first weeks is followed by a reduction in mature

  2. Free bone graft reconstruction of irradiated facial tissue: Experimental effects of basic fibroblast growth factor stimulation

    Energy Technology Data Exchange (ETDEWEB)

    Eppley, B.L.; Connolly, D.T.; Winkelmann, T.; Sadove, A.M.; Heuvelman, D.; Feder, J. (Plastic Surgery Section, Indiana University Medical Center (USA))

    1991-07-01

    A study was undertaken to evaluate the potential utility of basic fibroblast growth factor in the induction of angiogenesis and osseous healing in bone previously exposed to high doses of irradiation. Thirty New Zealand rabbits were evaluated by introducing basic fibroblast growth factor into irradiated mandibular resection sites either prior to or simultaneous with reconstruction by corticocancellous autografts harvested from the ilium. The fate of the free bone grafts was then evaluated at 90 days postoperatively by microangiographic, histologic, and fluorochrome bone-labeling techniques. Sequestration, necrosis, and failure to heal to recipient osseous margins was observed both clinically and histologically in all nontreated irradiated graft sites as well as those receiving simultaneous angiogenic stimulation at the time of graft placement. No fluorescent activity was seen in these graft groups. In the recipient sites pretreated with basic fibroblast growth factor prior to placement of the graft, healing and reestablishment of mandibular contour occurred in nearly 50 percent of the animals. Active bone formation was evident at cortical margins adjacent to the recipient sites but was absent in the more central cancellous regions of the grafts.

  3. Effect of ozone therapy on autogenous bone graft healing in calvarial defects: a histologic and histometric study in rats.

    Science.gov (United States)

    Ozdemir, H; Toker, H; Balcı, H; Ozer, H

    2013-12-01

    The purpose of this study was to analyze histologically the effect of ozone therapy in combination with autogenous bone graft on bone healing in rat calvaria. Critical size defects were created in calvaria of 27 male Wistar rats. The animals were divided into three groups of nine animals each: autogenous bone graft group (n = 9); autogenous bone graft with ozone therapy group (80%, 30 s 3 d for 2 wk, n = 9); non-treatment (control) group (n = 9). Animals were killed after 8 wk. Histomorphometric assessments, using image analysis software, and histological analyses were performed. Primary outcome was total bone area. Secondary outcomes (osteoblast number, new bone formation) were also measured. Histomorphometrically, the total bone area in the autogenous bone graft with ozone therapy group (9.3 ± 2.2) were significantly higher than that of the autogenous bone graft group (5.1 ± 1.8) (p ozone therapy group significantly increased the percentage of total bone area compared to the autogenous bone graft group (p ozone therapy group (58 ± 12.3) compared to the autogenous bone graft group (9.3 ± 3.5) (p ozone therapy group showed significant new bone formation when compared to the autogenous bone graft group (p Ozone therapy enhances new bone formation by autogenous bone graft in the rat calvarial defect model. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Comparison of the human bone matrix gelatin (HBMG with autogenous bone graft in reconstruction of the parietal bone defects in rat: a histological and radiographic study

    Directory of Open Access Journals (Sweden)

    Hossein Shahoon

    2009-06-01

    Full Text Available Background and aims. Autogenous bone graft is commonly used for reconstruction of bone defects in routine surgical procedures. The complexity of producing bone grafts and their application has lead to the use of human bone matrix gelatin (HBMG. The present study was conducted to compare the efficacy of HBMG and autograft on the reconstruction of bone defects in rats. Materials and methods. In this cross-sectional, experimental study, two defects were put on left and right sides of parietal bone of rats. HBMG was placed randomly on defects of one side and autograft in the defects of the other side. All specimens were assessed and compared with each other according to histological and radiographic characteristics. Other assessments included amount and the rate of bone formation, inflammation signs, fibrosis tissue and cartilage formation and also radiographic characteristics of grafts, assessed by digital and film-based methods. Mann-Whitney U test was used for statistical analysis. Results. The results showed a reduction of inflammation and an increase in new bone formation in both groups in 7, 14, 28 and 60 days after surgery. Bone formation with HBMG on day 24 was more than autograft. However, there was no significant difference between the groups on day 60. Superiority of digital method to film-based method of imaging was also observed. Conclusion. Although HBMG has the same efficacy as autograft, the rate of bone reconstruction with HBMG is higher. HBMG also induces focal, rather than peripheral, bone construction in the defect.

  5. Testing of a bioactive, moldable bone graft substitute in an infected, critically sized segmental defect model.

    Science.gov (United States)

    Brown, Matt E; Zou, Yuan; Peyyala, Rebecca; Huja, Sarandeep S; Cunningham, Larry L; Milbrandt, Todd A; Dziubla, Thomas D; Puleo, David A

    2017-09-19

    Large infected bone defects, often resulting from high energy traumas, are difficult to treat due to their variability in complexity and location. Standard treatment for infected bone defects begins with a protocol that includes a series of debridements in conjunction with an extended course of systemic antibiotics. Only after the infection has been eliminated will repair of the defect commence, typically with implantation of autologous bone. To address some of the shortcomings of the standard treatment methods, such as serial procedures, limited grafting material, and the need for a second surgical site for autologous bone, a sequential, dual drug-releasing, moldable, calcium sulfate-based bone graft substitute was developed previously. In the present studies, the effectiveness of the material for treating both the infection with vancomycin and bone defect with simvastatin was evaluated in vivo using a critically sized, infected segmental defect model in rat femurs. Although the infection was not fully eliminated, the local release of vancomycin increased survivorship of infected animals by 464% compared to nontreated controls. Infected animals receiving antimicrobial treatment showed comparable amounts of new bone formation within the defect site when compared to noninfected controls. Incorporating agents capable of disrupting established biofilms into bone graft substitutes may enhance effectiveness in treating a biofilm infection within a bone defect. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017. © 2017 Wiley Periodicals, Inc.

  6. The influence of rifamycin decontamination on incorporation of autologous onlay bone grafts in rats: A histometric and immunohistochemical evaluation.

    Science.gov (United States)

    Taşdemir, Ufuk; Özeç, İlker; Esen, Haci Hasan; Avunduk, M Cihat

    2015-05-01

    Although it has been shown that rifamycin is an effective agent for bone graft decontamination, no information exists on the effects of rifamycin decontamination on bone graft incorporation. The aim of this study was to evaluate the influence of rifamycin decontamination on the incorporation of autologous onlay bone grafts quantitatively. In 30 rats, a standardized 5.0-mm-diameter bone graft was harvested from the right mandibular angle, contaminated with saliva, decontaminated with rifamycin solution, and augmented to the left as an onlay graft. Ten animals were sacrificed at 7, 14, and 21 days after surgery. In the control group (10 rats), the onlay grafts were neither contaminated nor decontaminated, and the rats were sacrificed at 21 days after surgery. Histological slides were prepared from each grafted site for both immunohistochemistry analysis (bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) antibodies) and histometric analysis. Images obtained from the graft incorporation area with the light microscope were transferred to a PC, and they were evaluated using Clemex PE 3.5 image analysis software. The grafts were fully incorporated in all specimens. The results showed that rifamycin decontamination has no detrimental effect on graft incorporation and the findings revealed a tendency for earlier revascularization and osteogenesis in the decontamination group. Data were analyzed using variance analysis and Tukey's test. Rifamycin decontamination has no detrimental effect on autogenous graft incorporation, and it can be used for graft decontamination with confidence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Tantalum is a good bone graft substitute in tibial tubercle advancement

    Science.gov (United States)

    Querales, Virginia; Jakowlew, Alexander; Murcia, Antonio; Ballester, Jorge

    2009-01-01

    Background Porous tantalum is reportedly a good substitute for structural bone graft in several applications. So far, its use has not been reported in tibial tuberosity anteriorization (TTA) for treatment of isolated degenerative chondral lesions of the patellofemoral joint. Questions/Purposes We asked whether the use of this material would produce similar standardized functional scores, pain (VAS), fusion rates, complications, and patient satisfaction to those for bone graft. Patients and Methods We performed a randomized, controlled trial in 101 patients (108 knees) scheduled for TTA comparing a porous tantalum implant (57 knees) with an autologous local tibial bone graft (51 knees). The minimum followup was 5 years (mean, 6.2 years; range, 5–8 years). Results At the last followup, clinical scores, fusion rates, and maintenance of the anteriorization either were better or similar for the TTA using the tantalum implant depending on the respective parameter. The operative technique was easier and shorter with the tantalum device. Complication and failure rates were greater using bone graft. Patient satisfaction was greater using the tantalum implant. Conclusions Porous tantalum provided a reasonable alternative to bone graft in TTA. Level of Evidence Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID:19806411

  8. Horizontal and vertical maxillary osteotomy stability, in cleft lip and palate patients, using allogeneic bone graft

    Directory of Open Access Journals (Sweden)

    Kelston Ulbricht Gomes

    2013-10-01

    Full Text Available OBJECTIVE: This study was carried out to evaluate maxillary stability after orthodontic-surgical treatment of patients with cleft lip and palate. Cephalometric analysis was applied to two different groups, with and without allogeneic bone graft. METHODS: The sample comprised 48 patients with cleft lip and palate. The test group comprised 25 patients who, after correction of maxillary position, received allogeneic bone graft at the gap created by Le Fort I osteotomy. The control group comprised 23 patients and its surgical procedures were similar to those applied to the test group, except for the use of bone graft. Manual cephalometric analysis and comparison between lateral teleradiographs, obtained at the preoperative phase, immediate postoperative phase and after a minimum period of six months, were carried out. RESULTS: An higher horizontal relapse was observed in the control group (p0.05. CONCLUSION: The use of allogeneic bone graft in cleft lip and palate patients submitted to Le Fort I osteotomy contributed to increase postoperative stability when compared to surgeries without bone graft.

  9. Buccal bone plate remodeling after immediate implant placement with and without synthetic bone grafting and flapless surgery: radiographic study in dogs

    National Research Council Canada - National Science Library

    Novaes, Jr, Arthur B; Suaid, Flávia; Queiroz, Adriana C; Muglia, Valdir A; Souza, Sérgio L S; Palioto, Daniela B; Taba, Jr, Mário; Grisi, Márcio F M

    2012-01-01

    .... The use of flapless surgical procedures prior to the installation of immediate implants, as well as the use of synthetic bone graft in the gaps represent viable alternatives to minimize buccal bone...

  10. Bone augmentation using a new injectable bone graft substitute by combining calcium phosphate and bisphosphonate as composite--an animal model.

    Science.gov (United States)

    Schlickewei, Carsten W; Laaff, Georg; Andresen, Anne; Klatte, Till O; Rueger, Johannes M; Ruesing, Johannes; Epple, Matthias; Lehmann, Wolfgang

    2015-07-25

    The aim of this study was to create a new injectable bone graft substitute by combining the features of calcium phosphate and bisphosphonate as a composite bone graft to support bone healing and to evaluate the effect of alendronate to the bone healing process in an animal model. In this study, 24 New Zealand white rabbits were randomly divided into two groups: a calcium phosphate alendronate group and a calcium phosphate control group. A defect was created at the proximal medial tibia and filled with the new created injectable bone graft substitute calcium phosphate alendronate or with calcium phosphate. Healing process was documented by fluoroscopy. To evaluate the potential of the bone graft substitute, the proximal tibia was harvested 2, 4, and 12 weeks after operation. Histomorphological analysis was focused on the evaluation of the dynamic bone parameters using the Osteomeasure system. Radiologically, the bone graft materials were equally absorbed. No fracture was documented. The bones healed normally. After 2 weeks, the histological analysis showed an increased new bone formation for both materials. The osteoid volume per bone volume (OV/BV) was significantly higher for the calcium phosphate group. After 4 weeks, the results were almost equal. The trabecular thickness (Tb.Th) increased in comparison to week 2 in both groups with a slight advantage for the calcium phosphate group. The total mass of the bone graft (KEM.Ar) and the bone graft substitute surface density (KEM.Pm) were consistently decreasing. After 12 weeks, the new bone volume per tissue volume (BV/TV) was still constantly growing. Both bone grafts show a good integration. New bone was formed on the surface of both bone grafts. The calcium phosphate as well as the calcium phosphate alendronate paste had been enclosed by the bone. The trabecular thickness was higher in both groups compared to the first time point. Calcium phosphate proved its good potential as a bone graft substitute

  11. Bone strains around apically free versus grafted implants in the posterior maxilla of human cadavers.

    Science.gov (United States)

    Cehreli, Murat Cavit; Akkocaoglu, Murat; Comert, Ayhan; Tekdemir, Ibrahim; Akca, Kivanc

    2007-04-01

    The objective of this study was to compare the bone strains of apically free versus grafted implants in the posterior maxilla. The experiments were undertaken in four edentulous maxillary posterior regions of fresh human cadavers, having a minimum bone height of 8 mm. In each bone fragment, two Ø 4.1 mm x 12 mm Straumann implants were placed, and insertion torque values (ITV) and implant stability quotients (ISQ) of the implants were quantified to determine implant anchorage. Two splinted crowns were fabricated for each experimental model. Strain gauges were bonded on the buccal and sinus floor cortical bones around apically free and grafted implants. Microstrains were recorded by a data acquisition system and corresponding software at a sample rate of 10 KHz under central and buccally oriented lateral-axial static loads of 100 and 150 N in separate cases. The data were compared by independent T test at a significance level set at PBone tissue strains on the buccal cortical areas adjacent to apically free implants were higher than those of apically grafted implants (Pbone around apically free and grafted implants (PBone strains around anterior implants were higher than those of posterior implants. Microstrains in the sinus floor cortical bone in apically grafted models were slightly higher than apically free models. Bone tissue strains on the buccal cortical areas adjacent to apicallyfree implants are higher than those of apically grafted implants. Sinus lifting, resulting in an enhanced apical support, slightly increases strains at the sinus floor region, but leads to a decrease in bone strains around the collar of supporting implants.

  12. Is hydroxyapatite cement an alternative for allograft bone chips in bone grafting procedures? A mechanical and histological study in a rabbit cancellous bone defect model.

    NARCIS (Netherlands)

    Voor, M.J.; Arts, J.J.C.; Klein, S.A.; Walschot, L.H.B.; Verdonschot, N.J.J.; Buma, P.

    2004-01-01

    To evaluate in vivo performance of hydroxyapatite cement (HAC) as a porous bone graft substitute, HAC was mixed (1:1 ratio) with either porous calcium-phosphate granules (80% tricalcium phosphate, 20% hydroxyapatite) or defatted morsellized cancellous bone (MCB) allograft and implanted bilaterally

  13. Biomechanical Evaluation of Glenoid Reconstruction With an Implant-Free J-Bone Graft for Anterior Glenoid Bone Loss.

    Science.gov (United States)

    Pauzenberger, Leo; Dyrna, Felix; Obopilwe, Elifho; Heuberer, Philipp R; Arciero, Robert A; Anderl, Werner; Mazzocca, Augustus D

    2017-10-01

    The anatomic restoration of glenoid morphology with an implant-free J-shaped iliac crest bone graft offers an alternative to currently widely used glenoid reconstruction techniques. No biomechanical data on the J-bone grafting technique are currently available. To evaluate (1) glenohumeral contact patterns, (2) graft fixation under cyclic loading, and (3) the initial stabilizing effect of anatomic glenoid reconstruction with the implant-free J-bone grafting technique. Controlled laboratory study. Eight fresh-frozen cadaveric shoulders and J-shaped iliac crest bone grafts were used for this study. J-bone grafts were harvested, prepared, and implanted according to a previously described, clinically used technique. Glenohumeral contact patterns were measured using dynamic pressure-sensitive sensors under a compressive load of 440 N with the humerus in (a) 30° of abduction, (b) 30° of abduction and 60° of external rotation, (c) 60° of abduction, and (d) 60° of abduction and 60° of external rotation. Using a custom shoulder-testing system allowing positioning with 6 degrees of freedom, a compressive load of 50 N was applied, and the peak force needed to translate the humeral head 10 mm anteriorly at a rate of 2.0 mm/s was recorded. All tests were performed (1) for the intact glenoid, (2) after the creation of a 30% anterior osseous glenoid defect parallel to the longitudinal axis of the glenoid, and (3) after anatomic glenoid reconstruction with an implant-free J-bone graft. Furthermore, after glenoid reconstruction, each specimen was translated anteriorly for 5 mm at a rate of 4.0 mm/s for a total of 3000 cycles while logging graft protrusion and mediolateral bending motions. Graft micromovements were recorded using 2 high-resolution, linear differential variable reluctance transducer strain gauges placed in line with the long leg of the graft and the mediolateral direction, respectively. The creation of a 30% glenoid defect significantly decreased glenohumeral

  14. Bisphosphonate-adsorbed ceramic nanoparticles increase bone formation in an injectable carrier for bone tissue engineering

    Directory of Open Access Journals (Sweden)

    Tegan L Cheng

    2015-10-01

    Full Text Available Sucrose acetate isobutyrate (SAIB is a sugar-based carrier. We have previously applied SAIB as a minimally invasive system for the co-delivery of recombinant human bone morphogenetic protein-2 (rhBMP-2 and found synergy when co-delivering zoledronic acid (ZA and hydroxyapatite (HA nanoparticles. Alternative bioceramics were investigated in a murine SAIB/rhBMP-2 injection model. Neither beta-tricalcium phosphate (TCP nor Bioglass (BG 45S5 had a significant effect on bone volume (BV alone or in combination with the ZA. 14C-labelled ZA binding assays showed particle size and ceramic composition affected binding with nano-HA > micro-HA > TCP > BG. Micro-HA and nano-HA increased BV in a rat model of rhBMP-2/SAIB injection (+278% and +337%, and BV was further increased with ZA–adsorbed micro-HA and nano-HA (+530% and +889%. These data support the use of ZA–adsorbed nanoparticle-sized HA as an optimal additive for the SAIB/rhBMP-2 injectable system for bone tissue engineering.

  15. Extensive augmentation of the alveolar ridge using autogenous calvarial split bone grafts for dental rehabilitation.

    Science.gov (United States)

    Iizuka, Tateyuki; Smolka, Wenko; Hallermann, Wock; Mericske-Stern, Regina

    2004-10-01

    Free autogenous iliac bone is the most commonly used graft material for an extensive alveolar ridge reconstruction. The application of iliac bone, however, is associated with problems, such as transplant loss resulting from postoperative infection and late bone resorption. A bone-graft material more suitable than iliac bone is therefore still needed. This paper describes a concept for alveolar-ridge reconstruction using calvarial split bone, and the related surgical techniques. Clinical and radiological follow-up examinations were undertaken to evaluate the potential benefit of calvarial split bone in alveolar-ridge reconstruction. Between 1999 and 2002, 13 patients with a mean age of 54 years (range 31-70 years) underwent surgery, seven patients in the maxilla and six in the mandible. In four cases, wound dehiscence occurred postoperatively. In one of these cases, the dehiscence was associated with a local infection. However, no bone transplants were lost. After a mean follow-up time of 19.6 months, bone resorption, measured radiologically, was minimal. Endosseous dental implants were successfully installed and maintained. Satisfactory prosthetic rehabilitation was achieved in all patients. Our preliminary experience suggests that calvarial split bone may be regarded as a promising alternative to autogenous iliac bone in connection with extensive augmentation of the alveolar ridge.

  16. Postradiotherapy Dental Implant Insertion Into Bone Grafts Harvested From Nonirradiated Tissue: Case Reports.

    Science.gov (United States)

    Kimoto, Akira; Shibuya, Yasuyuki; Kobayashi, Masaki; Akashi, Masaya; Hasegawa, Takumi; Suzuki, Hiroaki; Komori, Takahide

    2016-10-01

    Prostheses and dental implants are often used to aid oral rehabilitation after surgery (with/without radiotherapy) for oral cancer. However, some studies have reported that the insertion of dental implants into irradiated bone results in a higher frequency of implant failure than the insertion of such implants in nonirradiated bone. This report describes the cases of 4 patients with oral cancer who underwent surgery and radiotherapy (total dose: 50-86 Gy) and then had dental implants inserted within the irradiated area. In each case, an ilium bone graft or a latissimus dorsi myocutaneous flap containing scapular bone was transferred to the dental implant site before the insertion of the implants. Twenty-three implants were inserted. After loading, 2 implants were lost, and 21 remained stable. In patients who have undergone radiotherapy for oral cancer, transferring bone grafts harvested from nonirradiated tissue to the irradiated site before implant insertion might help to improve dental implant survival rates.

  17. [ITI dental implants immediately placed into vascularized iliac bone grafts for reconstruction of mandibular defect: analysis of 12 consecutive cases].

    Science.gov (United States)

    Wu, Yi-qun; Zhang, Zhi-yong; Zhang, Zhi-yuan; Huang, Wei; Lai, Hong-chang; Hu, Yong-jie; Zhang, Chen-ping

    2005-04-01

    Vascularized iliac bone graft combined implantation has become a routine procedure in the functional reconstruction of mandibular defects. The aim of this study was to assess the clinical outcomes of the implants immediately placed into the vascularized iliac bone grafts. In this study, 12 consecutive patients with 36 ITI dental implants who had reconstruction of mandibular defect between 2000 and 2004 were presented. All implants were inserted immediately after bone grafting and loaded after 3 to 5 months of submerged healing. In general, a primary stability for implants placed in vascularized iliac bone grafts were achieved. After 1 year of observation the mean vertical bone loss was less than 1mm. There was no implant failure in the observation period. The vascularized iliac bone grafts are safe implant-bearing areas and allows a reliable and predictable restoration with dental implants. Implant-supported bridges and overdentures can be used in this procedure.

  18. Tissue-engineered polymer-based periosteal bone grafts for maxillary sinus augmentation: five-year clinical results.

    Science.gov (United States)

    Trautvetter, Wolfram; Kaps, Christian; Schmelzeisen, Rainer; Sauerbier, Sebastian; Sittinger, Michael

    2011-11-01

    Augmentation of the maxillary sinus with allogenic or alloplastic materials, as well as autologous bone grafts, has inherent disadvantages. Therefore, the aim of our study was to evaluate the long-term clinical repair effect of autologous periosteal bone grafts on atrophic maxillary bone. In the present retrospective cohort study, augmentation of the edentulous atrophic posterior maxilla was performed using autologous tissue-engineered periosteal bone grafts based on bioresorbable polymer scaffolds and, in a 1-step procedure, simultaneous insertion of dental implants. The clinical evaluation of 10 patients was performed by radiologic assessment of bone formation, with a follow-up of 5 years. Bone formation was further documented by measuring the bone height and by histologic examination. Excellent clinical and radiologic results were achieved as early as 4 months after transplantation of the periosteal bone grafts. The bone height remained significantly (P bone (median 6.9 mm) during the 5-year observation period. Histologically, the bone biopsy specimens of 2 patients obtained after 6 months showed trabecular bone with osteocytes and active osteoblasts. No signs of bone resorption, formation of connective tissue, or necrosis were seen. Our results suggest that the transplantation of autologous periosteal bone grafts and implantation of dental implants in a 1-step procedure is a reliable procedure that leads to bone formation in the edentulous posterior maxilla, remaining stable in the long term for a period of at least 5 years. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Long Term Follow-Up of Dental Implants Placed in Autologous Onlay Bone Graft.

    Science.gov (United States)

    Schwartz-Arad, Devorah; Ofec, Ronen; Eliyahu, Galit; Ruban, Angela; Sterer, Nir

    2016-06-01

    The aim of this study was to evaluate the efficacy of autologous intraoral onlay bone grafting (OBG) in correlation with long-term survival rates of dental implants placed in the augmented bone. A retrospective study was conducted on 214 patients who received a total of 633 dental implants placed in 224 autologous intraoral block OBG augmentations, combined with Bio-Oss - mixed with platelet-rich plasma (PRP) and covered by platelet-poor plasma (PPP) - as scaffold, with a follow-up time up to 137 months (mean 39.9 ± 30.9 months). A total of 216 OBG cases were successful (96.4%), and most of the augmentations were uneventful (88.4%). Bone graft exposure was moderately associated with bone graft failure (χ(2)  = 3.76, p = .052). The healing period after implant placement was 4-6 months (mean 5.6 ± 2.56). The majority of the 591 implants survived (93.4%). The cumulative survival rate of the implants was 83%. We suggest that augmentation of severely atrophied jaw bone through the placement of horizontal and/or vertical intraoral OBGs in combination with Bio-Oss saturated with PRP and covered by PPP should be considered a reliable, safe, and very effective surgical technique for obtaining high bone graft survival rate and high long-term implant survival rate. © 2014 Wiley Periodicals, Inc.

  20. Clinical and Radiographic Assessment of Secondary Bone Graft Outcomes in Cleft Lip and Palate Patients

    Science.gov (United States)

    Khalil, W.; de Musis, C. R.; Volpato, L. E. R.; Veiga, K. A.; Vieira, E. M. M.; Aranha, A. M.

    2014-01-01

    Purpose. To compare the results of secondary alveolar bone grafts in patients with complete cleft lip and cleft lip and palate using 2 radiographic scales and according to the rate of canine eruption through the newly formed bone. Materials and Methods. We analyzed pre- and postoperative radiographs of 36 patients for the amount of bone in the cleft site according to the Bergland and Chelsea scales. The associations between the variables and the correlation between the scales were measured. Results. A total of 54.2% and 20.8% of cases were classified as type I and type II, respectively, using the Bergland scale, whereas 50% and 22.5% were classified as types A and C, respectively, using the Chelsea scale. A positive correlation between the 2 scales was observed. In 33.3% of males, 58.3% of females, 54.5% of unilateral cleft cases, and 12.5% of bilateral cleft cases, the permanent canines had erupted. Bone grafts performed prior to canine eruption achieved more satisfactory results. Conclusions. Our results suggest that both radiographic scales are important tools for the evaluation of bone grafts. Additionally, longer time periods of evaluation were associated with improved results for patients with secondary alveolar bone grafts. PMID:27351004

  1. Microbiological monitoring of bone grafts: two years' experience at a tissue bank.

    Science.gov (United States)

    Farrington, M; Matthews, I; Foreman, J; Richardson, K M; Caffrey, E

    1998-04-01

    In the first two years of operation of a tissue bank, bone was processed on 63 occasions from 22 cadaveric donors and on 37 occasions from 185 living donors. A standardized protocol for microbiological sampling, culturing and interpretation of the results was developed. Semi-quantitative culture of washings of bone was performed on receipt by the tissue bank, and broth enrichment cultures of bone samples were performed at the end of processing, and again after irradiation. One bone donation was rejected because of heavy contamination with Klebsiella sp. on receipt, and contamination of six donations with Burkholderia cepacia was shown to have come from a water deionizer. Contamination of bone on receipt by the tissue bank decreased during the study period, probably related to increasing experience of staff harvesting bone. Microbiological surveillance of bone grafts protect recipients from infection, and is useful as a quality control of the process of bone banking.

  2. Fracture of the humerus after cancellous bone graft harvesting in a dog.

    Science.gov (United States)

    Ferguson, J F

    1996-05-01

    A five-year-old male Shetland sheepdog underwent calcaneoquartal arthrodesis for instability of the proximal intertarsal joint. A cancellous bone graft was harvested from the proximal humerus and packed around the arthrodesis site. Twenty-four hours postoperatively the dog developed a non-weightbearing forelimb lameness. Clinical and radiographic examination revealed a fracture of the humerus through the hole used to obtain the graft. Surgical repair of the fracture led to an uneventful recovery.

  3. 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.

  4. Role of mechanical compression on bone regeneration around a particulate bone graft material: an experimental study in rabbit calvaria.

    Science.gov (United States)

    Romanos, Georgios E; Delgado-Ruiz, Rafael A; Gómez-Moreno, Gerardo; López-López, Patricia J; Mate Sanchez de Val, Jose E; Calvo-Guirado, Jose Luis

    2015-04-12

    This experimental study was designed to analyze the effect of different compressive forces on the bone regeneration around a particulate bone graft material. Eighty 6-mm-diameter defects were created in the calvaria of 20 New Zealand rabbits (4 defects per rabbit calvaria). All the defects were filled with particles of synthetic bone. Two standardized compressive forces were then applied, 4.1 g to half the defects (Test A) and 8.2 g to the other half (Test B), all for 1 min. The graft sites were allowed to heal for 6 weeks, after which the rabbits were euthanized. The calvarium vault of each animal was extracted, radiographed, and prepared for histomorphometric analysis. The percentage of defect fill, bone density, new bone formation, and residual bone graft material were recorded, and the results were subjected to statistical analysis. Histological evaluation found that defect closure among the Test A (lower compression) group ranged from 38.34 (95% lower CI) to 55.8 (95% upper CI) (mean 47 ± 8.5%), while among the Test B group (higher compression), it ranged from 81.26 (95% lower CI) to 95.32 (mean 88 ± 7.3%). Significantly more closure was achieved for the Test B group (P particulate used to fill small defects created in rabbit calvaria appears to be beneficial. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Mandibular Reconstruction with Lateral Tibial Bone Graft: An Excellent Option for Oral and Maxillofacial Surgery.

    Science.gov (United States)

    Miceli, Ana Lucia Carpi; Pereira, Livia Costa; Torres, Thiago da Silva; Calasans-Maia, Mônica Diuana; Louro, Rafael Seabra

    2017-12-01

    Autogenous bone grafts are the gold standard for reconstruction of atrophic jaws, pseudoarthroses, alveolar clefts, orthognathic surgery, mandibular discontinuity, and augmentation of sinus maxillary. Bone graft can be harvested from iliac bone, calvarium, tibial bone, rib, and intraoral bone. Proximal tibia is a common donor site with few reported problems compared with other sites. The aim of this study was to evaluate the use of proximal tibia as a donor area for maxillofacial reconstructions, focusing on quantifying the volume of cancellous graft harvested by a lateral approach and to assess the complications of this technique. In a retrospective study, we collected data from 31 patients, 18 women and 13 men (mean age: 36 years, range: 19-64), who were referred to the Department of Oral and Maxillofacial Surgery at the Servidores do Estado Federal Hospital. Patients were treated for sequelae of orthognathic surgery, jaw fracture, nonunion, malunion, pathology, and augmentation of bone volume to oral implant. The technique of choice was lateral access of proximal tibia metaphysis for graft removal from Gerdy tubercle under general anesthesia. The mean volume of bone harvested was 13.0 ± 3.7 mL (ranged: 8-23 mL). Only five patients (16%) had minor complications, which included superficial infection, pain, suture dehiscence, and unwanted scar. However, none of these complications decreases the result and resolved completely. We conclude that proximal tibia metaphysis for harvesting cancellous bone graft provides sufficient volume for procedures in oral and maxillofacial surgery with minimal postoperative morbidity.

  6. 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.

  7. Feasibility of fabricating personalized 3D-printed bone grafts guided by high-resolution imaging

    Science.gov (United States)

    Hong, Abigail L.; Newman, Benjamin T.; Khalid, Arbab; Teter, Olivia M.; Kobe, Elizabeth A.; Shukurova, Malika; Shinde, Rohit; Sipzner, Daniel; Pignolo, Robert J.; Udupa, Jayaram K.; Rajapakse, Chamith S.

    2017-03-01

    Current methods of bone graft treatment for critical size bone defects can give way to several clinical complications such as limited available bone for autografts, non-matching bone structure, lack of strength which can compromise a patient's skeletal system, and sterilization processes that can prevent osteogenesis in the case of allografts. We intend to overcome these disadvantages by generating a patient-specific 3D printed bone graft guided by high-resolution medical imaging. Our synthetic model allows us to customize the graft for the patients' macro- and microstructure and correct any structural deficiencies in the re-meshing process. These 3D-printed models can presumptively serve as the scaffolding for human mesenchymal stem cell (hMSC) engraftment in order to facilitate bone growth. We performed highresolution CT imaging of a cadaveric human proximal femur at 0.030-mm isotropic voxels. We used these images to generate a 3D computer model that mimics bone geometry from micro to macro scale represented by STereoLithography (STL) format. These models were then reformatted to a format that can be interpreted by the 3D printer. To assess how much of the microstructure was replicated, 3D-printed models were re-imaged using micro-CT at 0.025-mm isotropic voxels and compared to original high-resolution CT images used to generate the 3D model in 32 sub-regions. We found a strong correlation between 3D-printed bone volume and volume of bone in the original images used for 3D printing (R2 = 0.97). We expect to further refine our approach with additional testing to create a viable synthetic bone graft with clinical functionality.

  8. Buccal bone plate remodeling after immediate implants with or without synthetic bone grafting and flapless surgery: a histomorphometric and fluorescence study in dogs.

    Science.gov (United States)

    Suaid, Flávia A; Novaes, Arthur B; Queiroz, Adriana C; Muglia, Valdir A; Almeida, Adriana L G; Grisi, Márcio F M

    2014-02-01

    The aim of this study was to evaluate the buccal bone plate remodeling after immediate implantation using the flapless approach with or without bone graft into the gap between the implant and the buccal bone. Eight dogs had the mandibular bicuspids extracted without flaps, and four implants were installed on each side, totaling eight implants per animal. Randomly, in one side, the implants were positioned at the bone crest level (equicrestal), and on the opposite side, the implants were positioned 2 mm subcrestal. All the implants were positioned 2.0 mm from the buccal bone plate (gap) and associated or not with grafting material. Therefore, the following treatments were performed: implants subcrestal test (SCTG) with bone graft and control (SCCG) without bone graft, and equicrestal test (ECTG) with bone graft and control (ECCG) without bone graft. One week following the surgeries, metallic prostheses were installed. Bone markers were administered 1, 2, 4, and 12 weeks after implant placement for fluorescence analysis. Ground sections were prepared from 12-week healing biopsies, and histomorphometry was performed. The histomorphometric evaluation presents significant better results for the ECTG in the vertical crestal bone resorption, but the other parameters showed better results for the SCCG. The fluorescence evaluation in adjacent areas showed numerically different results between groups with a small decrease at 12 weeks, except for the SCCG, which was higher at this time. The distant area showed a continuous increase in the marked bone. The equicrestally placed implants presented little or no loss of the buccal bone wall. The subcrestally positioned implants presented loss of buccal bone, regardless of the use of bone graft. However, the buccal bone was always coronal to the implant shoulder. Both the equicrestal and subcrestal groups were benefited in the early stages of bone healing as evidenced by the fluorescence analysis. © 2012 John Wiley & Sons A/S.

  9. 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

  10. Integration of fluoridated implants in onlay autogenous bone grafts - an experimental study in the rabbit tibia.

    Science.gov (United States)

    Dasmah, Amir; Kashani, Hossein; Thor, Andreas; Rasmusson, Lars

    2014-09-01

    Bone augmentation before treatment with endosseous implants is a common procedure for rehabilitation of the edentulous jaw. Both machined and surface modified implants have been used in one-stage and two-stage surgery protocols with varying results and survival rates. The influence of surface modification on the integration of implants has been documented in both non-grafted and grafted bone. The aim of this study was to compare the integration and stability of surface modified fluoridated vs. machined implants when placed simultaneously with an onlay bone graft. Eight rabbits were used in this study. A disc shaped bone graft was harvested from each side of the sagittal suture of the calvarial bone and fixed bi-cortically to the proximal tibial metaphysis by means of a dental implant, 9 mm long and 3.5 mm in diameter with a smooth machined surface as control and a blasted, fluoridated surface as test. Test and control sides were randomised. After a healing time of 8 weeks, the rabbits were sacrificed and the implants were removed en block for light microscopic analysis. Bone to implant contact (BIC) was registered as well as the amount of bone filling a rectangle indicating a region of interest (ROI) in the grafted area. Resonance frequency analysis (RFA) was conducted both at the time of surgery and at the end of the study. Our results showed statistically significant differences in BIC within the grafted area and the total bone to implant contact between the test and control sides in favour of the surface modified implants. The bone area filling the threads within a region of interest showed no statistically significant difference between the test and control sides. RFA showed higher implant stability with significant differences at the time of sacrifice in favour of the fluoridated implants. Surface modified fluoridated implants showed a higher degree of osseointegration and stability in onlay bone grafts compared with control implants with machined surface

  11. Effects of bone graft materials on the microhardness of mineral trioxide aggregate.

    Science.gov (United States)

    Sato, Erick Y; Svec, Timothy; Whitten, Brian; Sedgley, Christine M

    2012-05-01

    Large through-and-through lesions have been reported to heal faster and better when filled with bone graft material at the time of an apicoectomy. It is unknown what effect these have on retrograde filling materials such as white mineral trioxide aggregate (WMTA). In this study, the null hypothesis was tested that the presence of bone graft materials does not affect the microhardness of WMTA. Freshly mixed WMTA was condensed into acrylic cylinders and preincubated aerobically at 37°C for 1 hour. Cylinders were immersed in simulated body fluid in close proximity to graft materials: xenograft (Bio-Oss, n = 60), freeze-dried bone allograft (MinerOss, n = 60), demineralized freeze-dried bone allograft (OraGraft, n = 40), and allograft (Puros, n = 60). Knoop microhardness of half the samples in each group was evaluated after 2 weeks of incubation and the remainder at 4 weeks. The values for each group were then compared with 2-way analysis of variance and Bonferroni post hoc tests. WMTA microhardness values for Bio-Oss, MinerOss, and Puros groups were lower than those for OraGraft and control groups regardless of incubation period (P Microhardness values were higher at 4 weeks compared with 2 weeks for MinerOss (P materials appear to have a differential effect on the microhardness of WMTA. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  12. Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis.

    Science.gov (United States)

    Lee, Hyeong-Geun; Kim, Yong-Deok

    2015-10-01

    The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%±8.4%. Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone.

  13. Structural evaluation and animal implantation of porous eggshell wastederived hydroxyapatite graft as bone substitution

    Directory of Open Access Journals (Sweden)

    Yudha Mathan Sakti Rahadyan Magetsari

    2014-08-01

    Full Text Available The development of hydroxyapatite graft with high economically value is needed for orthopedic practice in developing countries. Eggsell waste is well known as natural substance for calcium resource. It has been used as raw material in producing hydroxyapatite. This study was conducted to synthesize porous hydroxyapatite from eggshell waste and evaluate its activity as bone substitution. The porous hydroxyapatite graft was manufactured from eggshell and sugar as a raw material using hydrothermal process. The porous eggshell waste-derived hydroxyapatite (EW-HAP graft was characterized using X ray difractometer (XRD and analytical scanning electron microscope (SEM and compared with commercial hydroxyapatite (HAP JCPDS 09-432 graft (Bangros® as standard. The porous EW-HAP graft obtained was then implanted on critically sized femoral defects surgically created in the right thigh of male Wistar rats (Rattus norvegicus with Bangros® as control. Radiological examination using XRD and histological examination using hematoxyline-and-eosin staining of the bone femour were performed at 28 days after implantation. The results showed that the XRD pattern for EW-HAP was likely similar with the HAP standard. However, the SEM examination showed that the pasticle size of EW-HAP graft (2.5-3 μm was higher than those HAP standard graft (1.5-2 μm. Radiographs according to the International of Limb Salvage (ISOLS radiological evaluation system between EW-HAP graft (6.1 ± 1.45 and HAP control graft (6.9 ± 2.10 was not significantly different (p>0.05. Moreover, histological examination according to Lane and Shandu scoring system between the both graft (4.0 ± 0.94 versus 4.4 ± 0.92 was also not significantly different (p>0.05. It can be concluded that the structure EW-HAP graft is similar with HAP graft standard. The both grafts have also equal outcome as bone substitution.

  14. 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

      The effect of Hydroxyapatite/collagen I composites, bone marrow aspirate and bone graft on fixation of bone implants IN SHEEP   Ph.D. Student, Hassan Babiker; Associate Professor, Ph.D. Ming Ding; Professor, dr.med., Soren Overgaard. Department of Orthopaedic Surgery, Odense University Hospital......, Odense, Denmark   Background: Hydroxyapatite and collagen composites (HA/coll) have the potential in mimicking and replacing skeletal bones. This study attempted to determine the effect of newly developed HA/coll-composites with and without bone marrow aspirate (BMA) in order to enhance the fixation...

  15. 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

  16. Core decompression or quadratus femoris muscle pedicle bone grafting for nontraumatic osteonecrosis of the femoral head: A randomized control study

    Directory of Open Access Journals (Sweden)

    Deqiang Li

    2016-01-01

    Conclusion: The CD with bone graft could relieve hip pain, improve hip function with much lesser surgical trauma compared to QF-MPBG. Hence, the CD with bone graft should be generally used for the treatment of patients with an early stage (Ficat Stage I or II ONFH.

  17. 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.

  18. Reconstruction of the moderately atrophic edentulous maxilla with mandibular bone grafts.

    Science.gov (United States)

    Cordaro, Luca; Boghi, Ferdinando; Mirisola di Torresanto, Vincenzo; Torsello, Ferruccio

    2013-11-01

    Mandibular bone grafts are used for alveolar reconstruction in partially edentulous patients. Few reports describe the use of mandibular bone for total maxillary reconstruction. To describe indications to the use of extensive mandibular bone grafts for maxillary reconstructions in edentulous patients. A retrospective evaluation of a group of patients with edentulous resorbed maxillae reconstructed with mandibular bone grafts in preparation for implant placement was performed. The studied cohort consisted of 15 patients who were treated with mandibular onlay blocks and sinus augmentation with mandibular bone in an outpatient setting under local anesthesia (MG). This approach was chosen when residual bone height in the anterior maxilla was at least 8 mm combined with posterior vertical deficiency and anterior horizontal defects. Success and survival rates of the implants and prostheses together with the achievement of the planned prosthetic plan were recorded. Patients also performed an evaluation of the outcome with the aid of Visual Analog Scales. Mean follow-up time was 19 months after prosthesis delivery. No major surgical complications occurred at recipient or donor sites. A total of 81 implants were inserted, and survival and success rates were 97.6% and 93%, respectively. Planned prostheses could be delivered to all patients (eight overdentures and seven fixed dental prostheses). With the limitations of the present clinical study, it can be stated that edentulous maxillae with a moderate atrophy may be successfully augmented with mandibular bone grafts in an outpatient setting under local anesthesia and e.v. sedation. This is the case when posterior maxillary deficiency is combined with horizontal defects, but with a residual height of 8 mm or more in the anterior maxilla. When the residual anterior bone height is less than 8 mm, or when the inter-arch discrepancy needs to be corrected with an osteotomy, extraoral bone harvesting needs to be considered.

  19. Sandcastle Worm-Inspired Blood-Resistant Bone Graft Binder Using a Sticky Mussel Protein for Augmented In Vivo Bone Regeneration.

    Science.gov (United States)

    Kim, Hyo Jeong; Choi, Bong-Hyuk; Jun, Sang Ho; Cha, Hyung Joon

    2016-12-01

    Xenogenic bone substitutes are commonly used during orthopedic reconstructive procedures to assist bone regeneration. However, huge amounts of blood accompanied with massive bone loss usually increase the difficulty of placing the xenograft into the bony defect. Additionally, the lack of an organic matrix leads to a decrease in the mechanical strength of the bone-grafted site. For effective bone grafting, this study aims at developing a mussel adhesion-employed bone graft binder with great blood-resistance and enhanced mechanical properties. The distinguishing water (or blood) resistance of the binder originates from sandcastle worm-inspired complex coacervation using negatively charged hyaluronic acid (HA) and a positively charged recombinant mussel adhesive protein (rMAP) containing tyrosine residues. The rMAP/HA coacervate stabilizes the agglomerated bone graft in the presence of blood. Moreover, the rMAP/HA composite binder enhances the mechanical and hemostatic properties of the bone graft agglomerate. These outstanding features improve the osteoconductivity of the agglomerate and subsequently promote in vivo bone regeneration. Thus, the blood-resistant coacervated mussel protein glue is a promising binding material for effective bone grafting and can be successfully expanded to general bone tissue engineering. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Virtual planning and construction of prototyped surgical guide in implant surgery with maxillary sinus bone graft.

    Science.gov (United States)

    Martins, Renato Jahjah Cunha; Lederman, Henrique Manoel

    2013-09-01

    To evaluate the efficacy of associating techniques of bone grafting in the maxillary sinus with the use of a prototyped surgical guide for planning and positioning dental implants in total edentulous maxillae, rehabilitated after six months. Eight patients consecutives with totally edentulous maxilla presenting few remaining bone in the posterior alveolar ridge, associated with pneumatization of the maxillary sinus were selected. Twenty eight Brånemark RP 10mm implants were installed in 14 maxillary sinuses. The surgical planning for the implant installation was performed with the DentalSlice software by means of a computerized tomography. The obtained images were used for building a surgical guide that, placed over the maxilla, showed the exact position for the implants installation (prototyped surgical guide). The portion of the implants that went into the maxillary sinus was covered by an autogenous bone graft. The patients were re-evaluated six months after the surgery and a 100% success rate was achieved. All of the implants presented no mobility or symptoms, permitting an oral rehabilitation with total fixed screw-retained prosthesis over the implants. The technique of associating implants and bone graft in the maxillary sinus aided by a prototyped guide planned on DentalSlice has showed itself efficient for positioning implants and for quantifying and locating the bone graft.

  1. Bone morphogenetic protein Smads signaling in mesenchymal stem cells affected by osteoinductive calcium phosphate ceramics.

    Science.gov (United States)

    Tang, Zhurong; Wang, Zhe; Qing, Fangzhu; Ni, Yilu; Fan, Yujiang; Tan, Yanfei; Zhang, Xingdong

    2015-03-01

    Porous calcium phosphate ceramics (CaP ceramics) could induce ectopic bone formation which was regulated by various signal molecules. In this work, bone marrow mesenchymal stem cells (MSCs) were cultured on the surface of osteoinductive hydroxyapatite (HA) and biphasic calcium phosphate (BCP) ceramics in comparison with control (culture plate) for up to 14 days to detect the signal molecules which might be affected by the CaP ceramics. Without adding osteogenic factors, MSCs cultured on HA and BCP both expressed higher Runx2, Osterix, collagen type I, osteopontin, bone sialoprotein, and osteocalcin at various stages compared with control, thus confirmed the osteoblastic differentiation of MSCs. Later study demonstrated the messenger RNA level of bone morphogenetic protein 2 (BMP2) and BMP4 were also significantly enhanced by HA and BCP. Furthermore, Smad1, 4, 5, and Dlx5, the main molecules in the BMP/Smads signaling pathway, were upregulated by HA and BCP. Moreover, the higher expression of Smads and BMP2, 4 in BCP over HA, corresponded to the better performance of BCP in stimulating in vitro osteoblastic differentiation of MSCs. This was in accordance with the better osteoinductivity of BCP over HA in vivo. Altogether, these results implied that the CaP ceramics may initiate the osteoblastic differentiation of MSCs by influencing the expression of molecules in BMP/Smads pathway. © 2014 Wiley Periodicals, Inc.

  2. Guided bone regeneration with autogenous graft of Chin

    OpenAIRE

    Ramos Perfecto, Donald; Estudiantes de la Segunda Especialidad en Periodoncia. Facultad Odontología UNMSM. Lima - Perú.; García Olivera, John; Estudiantes de la Segunda Especialidad en Periodoncia. Facultad Odontología UNMSM. Lima - Perú.; Sueldo Gálvez, Luis; Estudiantes de la Segunda Especialidad en Periodoncia. Facultad Odontología UNMSM. Lima - Perú.

    2014-01-01

    The deficiencies of bone quality in the patient, either of wide or height, make the clinician take decisions to improve these conditions, with the purpose of placing implants or improving faulty edges that can support a prosthetics frame. For this, the procedures of guided bone regeneration with ones own chin bone (autogenous implant), are the ones with the best forecast for resolving the problem. In this clinical case we show the diagnosis, the surgical technique, the advantages and pharmaco...

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

    Science.gov (United States)

    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 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. Conclusion: Hydroxyapatite

  4. THE RESULT OF INTRAMEDULLARY NAILING WITH BONE GRAFTING OF TIBIA'S PATHOLOGIC FRACTURE

    Directory of Open Access Journals (Sweden)

    V. M. Shapovalov

    2010-01-01

    Full Text Available The authors give the clinical case of successful surgical treatment of patient with tibia's pathologic fracture by intramedullary nailing with bone grafting. The disadvantages of such patients' treatment by plaster immobilization and by some invasive methods like vascular autografting by Ilizarov's method and bone plating were also discussed. The obvious benefits of proposed surgical treatment technique of observed patient category are shown.

  5. High Hydrostatic Pressure for Disinfection of Bone Grafts and Biomaterials: An Experimental Study

    OpenAIRE

    Gollwitzer, Hans; Mittelmeier, Wolfram; Brendle, Monika; Weber, Patrick; Miethke, Thomas; Hofmann, Gunther O; Gerdesmeyer, Ludger; Schauwecker, Johannes; Diehl, Peter

    2009-01-01

    Background: Autoclaving, heat, irradiation or chemical detergents are used to disinfect autografts, allografts and biomaterials for tissue reconstruction. These methods are often associated with deterioration of mechanical, physical, and biological properties of the bone grafts and synthetic implants. High hydrostatic pressure has been proposed as a novel method preserving biomechanical and biological properties of bone, tendon and cartilage. This is the first study to assess the inactivation...

  6. Autogenous Corticocancellous Iliac Bone Graft in Reconstruction of ...

    African Journals Online (AJOL)

    The surgical reconstruction of the defect is a major challenge in maxillofacial surgery. Lack of ... Graft site infection was the most complication with overall incidence of 27.0 percent. Most of the infections were superficial and responded to antibiotic use and local wound care. Donor site complications were few in the study.

  7. Bone tissue engineering with periosteal-free graft and pedicle omentum.

    Science.gov (United States)

    Bigham-Sadegh, Amin; Oryan, Ahmad; Mirshokraei, Pezhman; Shadkhast, Mohamad; Basiri, Ehsan

    2013-04-01

    The histological characteristics of periosteum make it a specific tissue with a unique capacity to be engineered. Higher flexibility of the greater omentum is useful for reconstructive surgery as it facilitates not only filling of the site of infections such as myelitis, but also is effective in filling complicated defects of the soft and hard tissues, and these criteria make it suitable for tissue engineering. The present study was designed to evaluate bone tissue engineering with periosteal-free graft concurrent with pedicle omentum and compare it with subcuticular periosteal grafting in a dog model. This is the first report in which periosteum-free graft has been used as bone tissue engineering. Eight young female indigenous dogs were used in this experiment. In omental group (n = 4), end of omentum was wrapped by periosteum of the radial bone in the abdomen of each dog, while in the subcutaneous group (n = 4), the harvested periosteum was sutured on the subcutaneous layer. Lateral view radiographs were taken from the abdominal cavity post-operatively at 2, 4, 6 and 8 weeks post surgery. Eight weeks after operation, the dogs were re-anaesthetized and the omental or subcutical grafted periosteom was found and removed for histopathological evaluation. Radiological, gross and histopathological evaluations revealed a superior bone formation in the wrapped omentum with periosteum compared with that of the subcuticular periosteal grafting. This is a novel and efficient technique in producing mature trabecular bone and could be used as a potential source of bone tissue engineering for autotransplantation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  8. Treatment of screw hole defects using bone graft materials: a histologic and biomechanic study.

    Science.gov (United States)

    York, M J; Hutton, W C

    1996-01-01

    We surgically applied compression plates, secured with cortical screws, to the anterolateral surface of each radius in 20 dogs. Five weeks later, the plates and screws were removed. The dogs were then divided into four groups of 5, and each group had the screw holes in the left radii filled with a different form of bone graft material. The screw holes in the right radii received no graft material and served as controls. Five weeks later the dogs were euthanized, and the radii were removed and torqued to failure. All bones failed through a previous screw hole. An analysis of variance comparing all grafted radii to the ungrafted controls revealed no significant difference in torque to failure. This suggests that both grafted and ungrafted screw holes still increase stress at 5 weeks, and any period of protection after plate removal should be longer than 5 weeks. However, histology revealed that the holes filled with graft material had, in every case, more bone in the screw holes than did the holes in the ungrafted controls.

  9. Solid variant of aneurysmal bone cyst in the tibia treated with simple curettage without bone graft: a case report

    Directory of Open Access Journals (Sweden)

    Takechi Rumi

    2012-02-01

    Full Text Available Abstract The solid variant of aneurysmal bone cyst (solid ABC is rarely encountered in long bones and appropriate treatment for this disease remains unclear. We experienced a 13-year-old boy suffering from pain in his left knee caused by solid ABC. Simple curettage of the bone lesion without any adjuvant therapy and a bone graft gave immediate pain relief. Histological examination of the surgical specimen showed typical features of solid ABC, and cycloxygenase-2 (COX-2 expression was confirmed in giant cells with a background of spindle cells by immunohistochemistry. Magnetic resonance imaging showed that soft tissue edema surrounding the lesion was improved two months after surgery and there was no indication of recurrence two years after surgery. If COX-2 secreted from the tumor induces soft tissue edema, simple curettage of the bone lesion seems to be a reasonable treatment for solid ABC and is able to minimize invasive treatment of the patients.

  10. Solid variant of aneurysmal bone cyst in the tibia treated with simple curettage without bone graft: a case report.

    Science.gov (United States)

    Takechi, Rumi; Yanagawa, Takashi; Shinozaki, Tetsuya; Fukuda, Toshio; Takagishi, Kenji

    2012-02-20

    The solid variant of aneurysmal bone cyst (solid ABC) is rarely encountered in long bones and appropriate treatment for this disease remains unclear. We experienced a 13-year-old boy suffering from pain in his left knee caused by solid ABC. Simple curettage of the bone lesion without any adjuvant therapy and a bone graft gave immediate pain relief. Histological examination of the surgical specimen showed typical features of solid ABC, and cycloxygenase-2 (COX-2) expression was confirmed in giant cells with a background of spindle cells by immunohistochemistry. Magnetic resonance imaging showed that soft tissue edema surrounding the lesion was improved two months after surgery and there was no indication of recurrence two years after surgery. If COX-2 secreted from the tumor induces soft tissue edema, simple curettage of the bone lesion seems to be a reasonable treatment for solid ABC and is able to minimize invasive treatment of the patients.

  11. [Clinical anatomy of iliac bone grafts used for mandibular reconstruction and dental implantation].

    Science.gov (United States)

    Dong, Gang; Xu, Xin; Zheng, Jian-jin; Wu, Hong; Lu, Shu-lai

    2013-02-01

    To investigate the anatomical features of iliac bone grafts used for mandibular reconstruction and dental implantation. Sixteen cadavers were dissected. The length, width, height and cortical thickness of the iliac bone were measured with respect to points determined by the relative dimensions of the bone. The length of iliac bone graft was (77.2 ± 6.1) mm. The height was from (38.2 ± 4.2) mm to (41.9 ± 4.7) mm. The width decreased from iliac crest to base line. The least width 10 mm and 15 mm away from iliac crest were (8.4 ± 2.2) mm and (6.5 ± 2.1) mm respectively. The greatest mean cross-sectional cortical thickness at the intermediate line of the iliac crest was (3.4 ± 0.8) mm. Anatomical features of iliac bone are suitable for designing bone grafts for mandibular reconstruction followed by dental implantation.

  12. Porous biomorphic silicon carbide ceramics coated with hydroxyapatite as prospective materials for bone implants.

    Science.gov (United States)

    Gryshkov, Oleksandr; Klyui, Nickolai I; Temchenko, Volodymyr P; Kyselov, Vitalii S; Chatterjee, Anamika; Belyaev, Alexander E; Lauterboeck, Lothar; Iarmolenko, Dmytro; Glasmacher, Birgit

    2016-11-01

    Porous and cytocompatible silicon carbide (SiC) ceramics derived from wood precursors and coated with bioactive hydroxyapatite (HA) and HA-zirconium dioxide (HA/ZrO2) composite are materials with promising application in engineering of bone implants due to their excellent mechanical and structural properties. Biomorphic SiC ceramics have been synthesized from wood (Hornbeam, Sapele, Tilia and Pear) using a forced impregnation method. The SiC ceramics have been coated with bioactive HA and HA/ZrO2 using effective gas detonation deposition approach (GDD). The surface morphology and cytotoxicity of SiC ceramics as well as phase composition and crystallinity of deposited coatings were analyzed. It has been shown that the porosity and pore size of SiC ceramics depend on initial wood source. The XRD and FTIR studies revealed the preservation of crystal structure and phase composition of in the HA coating, while addition of ZrO2 to the initial HA powder resulted in significant decomposition of the final HA/ZrO2 coating and formation of other calcium phosphate phases. In turn, NIH 3T3 cells cultured in medium exposed to coated and uncoated SiC ceramics showed high re-cultivation efficiency as well as metabolic activity. The recultivation efficiency of cells was the highest for HA-coated ceramics, whereas HA/ZrO2 coating improved the recultivation efficiency of cells as compared to uncoated SiC ceramics. The GDD method allowed generating homogeneous HA coatings with no change in calcium to phosphorus ratio. In summary, porous and cytocompatible bio-SiC ceramics with bioactive coatings show a great promise in construction of light, robust, inexpensive and patient-specific bone implants for clinical application. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Treatment of displaced intraarticular calcaneal fractures with or without bone grafts: A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Yunfeng Yang

    2012-01-01

    Full Text Available Background: The necessity of bone grafts in the treatment of intraarticular calcaneal fractures continues to be one of the most debated topics in foot and ankle surgery. The purpose of this study was to determine whether there are sufficient objective cumulative data in the literature to compare the two methods and if the bone graft was needed in surgical treatment of intraarticular calcaneal fractures. Materials and Methods: A comprehensive search of all relevant articles from 1990 to 2010 was conducted. Two reviewers evaluated each study to determine its suitability for inclusion and collected the data of interest. Meta-analytic pooling of group results across studies was performed for the two treatment methods. Results: The systematic review identified 32 primary studies with 1281 fractures, which contained 4 comparative studies, 13 with bone grafts, and 15 without bone grafts in treatment methods. The infection rate in bone graft group was higher through statistically insignificant than in non-graft group (8.3% vs. 6.3% No significant difference was found between good reduction rate, postoperative osteoarthritis rate, and subtalar fusion rate. The average full weight-bearing time in bone graft group was significantly lower (5.4 months than in non-graft group (10.5 months. The mean postoperative Böhler′s angle was significantly higher in bone graft group (lose due to collapse was significancy less. For the efficacy outcomes, the bone graft group had a lower American Orthopaedic Foot and Ankle Society Score (AOFAS (71.4 points vs. 80.5 points but a higher Creighton score (89.9 points vs. 81.0 points compared with non-graft group. Pooled mean results showed 35% of the patients in bone graft group had an excellent result, 40% had a good result, 21% had a fair result, and 4% had a poor result. In the non-graft group, the corresponding values were 34, 42, 14, and 10%, respectively. Conclusions: The operative treatment of intraarticular

  14. Reconstruction of interdental papilla using autogenous bone and connective tissue grafts

    Directory of Open Access Journals (Sweden)

    Santhanakrishnan Muthukumar

    2016-01-01

    Full Text Available Previous studies have reported the management of Class I and II papillary defects, but knowledge on Class III defects, estimated to have a poor periodontal prognosis, remains minimal. In this case report, a Class III papillary defect reconstruction was attempted mainly since the patient reported with difficulty in phonetics. In Stage I, autogenous bone graft from the maxillary tuberosity and subepithelial connective tissue graft was augmented to decrease the distance between the interdental bone crest and contact point, simultaneously achieving a switch in the periodontal biotype. In Stage II, subepithelial connective tissue graft was augmented to achieve papillary fill. To avoid manual errors associated with quantifying the posttreatment outcomes, image data processing ImageJ software was used to assess the length, perimeter, and surface area of papillary loss using the preoperative images.

  15. Treatment of midshaft clavicular nonunion with plate fixation and autologous bone grafting

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Vaesel, M T; Søjbjerg, Jens Ole

    1995-01-01

    , and one had a failure. Thirteen of 16 patients were satisfied with the cosmetic outcome, assessing their cosmetic result as either good or excellent. Rigid plate fixation and restoration of clavicular length with autologous cancellous bone graft is recommended for the treatment of symptomatic clavicular...

  16. The evaluation of the bone graft survival status in titanium cervical ...

    African Journals Online (AJOL)

    To find a better way to evaluate the bone graft survival status in cervical cages, forty-one patients suffering from one-level cervical spondylosis were enrolled in this study. All underwent anterior cervical decompression and fusion with titanium cage and plate. When followed up, another 21 patients were confirmed as ...

  17. Alpha-1-antitrypsin monotherapy reduces graft-versus-host disease after experimental allogeneic bone marrow transplantation

    NARCIS (Netherlands)

    Tawara, I.; Sun, Y.; Lewis, E.C.; Toubai, T.; Evers, R.; Nieves, E.; Azam, T.; Dinarello, C.A.; Reddy, P.

    2012-01-01

    Acute graft-versus-host disease (GvHD) is a major complication that prevents successful outcomes after allogeneic bone marrow transplantation (BMT), an effective therapy for hematological malignancies. Several studies demonstrate that donor T cells and host antigen-presenting cells along with

  18. Mechanical testing of impaction bone grafting in the tibia: initial stability and design of the stem.

    NARCIS (Netherlands)

    Toms, A.D.; McClelland, D.; Chua, L.; Waal Malefijt, M.C. de; Verdonschot, N.J.J.; Jones, R.; Kuiper, J.H.

    2005-01-01

    Clinical experience of impaction bone grafting for revision knee arthroplasty is limited, with initial stability of the tibial tray emerging as a major concern. The length of the stem and its diameter have been altered to improve stability. Our aim was to investigate the effect of the type of stem,

  19. Interest of Mineralized Plasmatic Matrix in Secondary Autogenous Bone Graft for the Treatment of Alveolar Clefts.

    Science.gov (United States)

    Nadon, Florian; Chaput, Benoit; Périssé, Jean; de Bérail, Ambre; Lauwers, Frédéric; Lopez, Raphaël

    2015-10-01

    The authors describe a new material termed mineralized plasmatic matrix (MPM), a combination of platelets, fibrin concentrate, and autogenous bone to repair alveolar cleft defects. Autogenous cancellous bone is widely used to this end because such bone affords the functionalities (osteogenesis, osteoinduction, and osteoconduction) required for successful outcomes. To optimize these features, autologous blood products high in platelet concentrations have recently been developed. On the basis of our experience with PRP (platelet-rich plasma) and PRF (platelet-rich fibrin), we developed MPM, which contains platelets and fibrin concentrate in a liquid state; these materials can become bound to bone particles. The filling material is easy to shape and a PRF-type membrane is also generated. Ten patients with cleft lips and alveoli, with or without cleft palates (median, or uni- or bilateral) benefited from secondary bone grafts placed using our new material. We transferred autogenous bone from the iliac crest, an abundant source of cancellous bone associated with a high success rate. The 6-month outcomes of all patients were excellent in terms of both bone graft stability and closure of the oronasal fistulae. The preparation procedure is simple and the technical requirements minimal. Upon further optimization, MPM may serve as a third-generation platelet concentrate with potential applications in various fields.

  20. 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

  1. Unprotected autogenous bone block grafts in anterior maxilla: Resorption rates and clinical outcomes

    Directory of Open Access Journals (Sweden)

    Kosanić Ivan

    2017-01-01

    Full Text Available Background/Aim. The use of autogenous bone grafts for augmentation of the resorbed alveolar ridge is still considered the gold standard in implant dentistry. The aim of this study was to analyze the resorption rate of autogenous bone block grafts from the retromolar region placed in the frontal segment of the upper jaw unprotected by barrier membranes, to assess the stability of implants placed into the grafted bone, as well as to monitor its changes during the healing period. Methods. The study included 18 patients with a total of 20 grafted sites. The residual alveolar ridge was measured before and after the augmentation and prior to implant placement. All implants were restored with provisional crowns within 48 hours after the placement. Implant stability was assessed using resonance frequency analysis. Results. The average period from ridge augmentation to reentry was 5.4 months (range 4–6 months. At reentry the healed alveolar ridge had a mean width of 6.1 ± 1.27 mm. The mean calculated width gain was 3.04 ± 1.22 mm. The overall surface resorption of block grafts was 0.68 ± 0.69 mm (18.85%. At the time of implant placement the mean value of implant stability quotient (ISQ was 71.25 ± 5.77. The lowest ISQ values were noted after three weeks of healing, followed by a gradual increase until week 12. After 12 weeks implants showed significantly higher ISQ values compared to primary stability (p < 0.05 Wilcoxon signed ranks test. During the 3-years followup period no cases of implant loss were recorded. Conclusion. Despite a significant resorption of bone grafts, it was possible to place implants in all the cases and to use the immediate loading protocol without affecting implant survival rate. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no.175021

  2. 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.

  3. Variability in Particle Degradation of Four Commonly Employed Dental Bone Grafts.

    Science.gov (United States)

    Yang, Shuang; Lan, Liao; Miron, Richard J; Wei, Lingfei; Zhang, Meng; Zhang, Yufeng

    2015-10-01

    Replacement bone grafting materials are used clinically for a variety of clinical procedures to augment and replace lost or missing bone. Little information is available regarding their degradation properties. The aim of the present study was to investigate the degradation rate and modes of degradation of four commonly used bone grafting materials. A natural bone mineral (NBM) of bovine origin, NBM in combination with enamel matrix derivative (EMD), LifeNet demineralized freeze-dried bone allograft (DFDBA), and Osteotech DFDBA were analyzed for particle degradation over time in 3 mm femur defects created in female Wistar rats. At 2, 4, and 8 weeks postimplantation, femur defects were assigned to histological analysis. Hematoxylin and eosin, Safranin O, tartrate-resistant acid phosphatase (TRAP), receptor activator of nuclear factor kappa B ligand (RANKL), and matrix metalloproteinase-2 (MMP-2) staining were performed to determine the rate of particle degradation, number of osteoclasts around particles, and intensity and localization of TRAP, RANKL, and MMP-2 staining. In the present study, NBM particles demonstrated little signs of degradation. The combination of NBM with EMD significantly increased the number of osteoclasts around NBM particles and increased expression of RANKL and MMP-2 specifically around particle surface. Only minor resorption was observed. Both DFDBA particles showed much faster degradation of particles. Interestingly, fewer osteoclasts were found on their surface when compared with NBM particles, specifically on Osteotech DFDBA particles, suggesting an alternative mode of degradation. Osteotech DFDBA particles demonstrated significantly faster degradation when compared with all other bone grafts. No obvious increase in TRAP, RANKL, or MMP2 was observed to validate this fast rate of degradation. The results from the present study demonstrate a wide range of particle degradation between various commonly commercially available bone grafts

  4. Successful disinfection of femoral head bone graft using high hydrostatic pressure.

    Science.gov (United States)

    van de Sande, Michiel A J; Bovée, Judith V M G; van Domselaar, Mark; van Wijk, Marja J; Sanders, Ingrid; Kuijper, Ed

    2017-12-20

    The current standard for sterilization of potentially infected bone graft by gamma irradiation and thermal or chemical inactivation potentially deteriorates the biomechanical properties of the graft. We performed an in vitro experiment to evaluate the use of high hydrostatic pressure (HHP); which is widely used as a disinfection process in the food processing industry, to sterilize bone grafts. Four femoral heads were divided into five parts each, of which 16 were contaminated (in duplicate) with 10 5 -10 7  CFU/ml of Staphylococcus epidermidis, Bacillus cereus, or Pseudomonas aeruginosa or Candida albicans, respectively. Of each duplicate, one sample was untreated and stored similarly as the treated sample. The remaining four parts were included as sterile control and non-infected control. The 16 parts underwent HHP at the high-pressure value of 600 MPa. After HHP, serial dilutions were made and cultured on selective media and into enrichment media to recover low amounts of microorganism and spores. Three additional complete femoral heads were treated with 0, 300 and 600 MPa HHP respectively for histological evaluation. None of the negative-control bone fragments contained microorganisms. The measured colony counts in the positive-control samples correlated excellent with the expected colony count. None of the HHP treated bone fragments grew on culture plates or enrichment media. Histological examination of three untreated femoral heads showed that the bone structure remained unchanged after HHP. Sterilizing bone grafts by high hydrostatic pressure was successful and is a promising technique with the possible advantage of retaining biomechanical properties of bone tissue.

  5. Bone regeneration: molecular and cellular interactions with calcium phospate ceramics

    NARCIS (Netherlands)

    Barrère, F.; van Blitterswijk, Clemens; de Groot, K.

    2006-01-01

    Calcium phosphate bioceramics are widely used in orthopedic and dental applications and porous scaffolds made of them are serious candidates in the field of bone tissue engineering. They have superior properties for the stimulation of bone formation and bone bonding, both related to the specific

  6. 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

  7. Histologic evaluation of the bone-ceramic interface of an alumina ceramic cup arthroplasty retrieved after 25 years in vivo

    Directory of Open Access Journals (Sweden)

    Fuminori Higuchi, MD

    2016-09-01

    Full Text Available A 47-year-old man underwent ceramic cup arthroplasty when he was 22 years old. Revision total hip arthroplasty was performed 25 years later because of limited range of motion without implant loosening. Histologic examination revealed that the femoral head and ceramic implant were well fixed through a thin fibrous membrane. The energy-dispersive X-ray analysis indicated that calcium and phosphorus were detected in the same peak pattern as cancellous bone in the bone-ceramic interface.

  8. 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.

  9. Rehabilitation of atrophic maxilla using the combination of autogenous and allogeneic bone grafts followed by protocol-type prosthesis.

    Science.gov (United States)

    Margonar, Rogério; dos Santos, Pâmela Letícia; Queiroz, Thallita Pereira; Marcantonio, Elcio

    2010-11-01

    Currently, there are several techniques for the rehabilitation of atrophic maxillary ridges in literature. The grafting procedure using autogenous bone is considered ideal by many researchers, as it shows osteogenic capability and causes no antigenic reaction. However, this type of bone graft has some shortcomings, mainly the restricted availability of donor sites. In recent years, several alternatives have been investigated to supply the disadvantages of autogenous bone grafts. In such studies, allogeneic bone grafts, which are obtained from individuals with different genetic load, but from the same species, have been extensively used. They can be indicated in cases of arthroplasty, surgical knee reconstruction, large bone defects, and in oral and maxillofacial reconstruction. Besides showing great applicability and biocompatibility, this type of bone is available in unlimited quantities. On the other hand, allogeneic bone may have the disadvantage of transmitting infectious diseases. Atrophic maxillae can be treated with bone grafts followed by osseointegrated implants to obtain aesthetic and functional oral rehabilitation. This study aimed to show the viability of allogeneic bone grafting in an atrophic maxilla, followed by oral rehabilitation with dental implant and protocol-type prosthesis within a 3-year follow-up period by means of a clinical case report.

  10. 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

  11. 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.

  12. Comparative Biomechanical and Microstructural Analysis of Native versus Peracetic Acid-Ethanol Treated Cancellous Bone Graft

    Directory of Open Access Journals (Sweden)

    Juliane Rauh

    2014-01-01

    Full Text Available Bone transplantation is frequently used for the treatment of large osseous defects. The availability of autologous bone grafts as the current biological gold standard is limited and there is a risk of donor site morbidity. Allogenic bone grafts are an appealing alternative, but disinfection should be considered to reduce transmission of infection disorders. Peracetic acid-ethanol (PE treatment has been proven reliable and effective for disinfection of human bone allografts. The purpose of this study was to evaluate the effects of PE treatment on the biomechanical properties and microstructure of cancellous bone grafts (CBG. Forty-eight human CBG cylinders were either treated by PE or frozen at −20°C and subjected to compression testing and histological and scanning electron microscopy (SEM analysis. The levels of compressive strength, stiffness (Young’s modulus, and fracture energy were significantly decreased upon PE treatment by 54%, 59%, and 36%, respectively. Furthermore, PE-treated CBG demonstrated a 42% increase in ultimate strain. SEM revealed a modified microstructure of CBG with an exposed collagen fiber network after PE treatment. We conclude that the observed reduced compressive strength and reduced stiffness may be beneficial during tissue remodeling thereby explaining the excellent clinical performance of PE-treated CBG.

  13. Orthodontic reconstruction with autotransplantation and bone grafting after a traffic accident.

    Science.gov (United States)

    Mimura, Hiroshi; Fukuyo, Shinho

    2012-04-01

    This case report describes the orthodontic treatment with autotransplantation and bone grafting of the lost maxillary alveolus for a patient injured in a traffic accident. This patient had a severe skeletal Class III relationship because of the loss of 6 maxillary teeth and the adjacent alveolar bone. Autotransplantation of mandibular first premolars and bone grafting of the deficient alveolus were carried out to improve the occlusion and the profile. After orthodontic treatment, the transplanted premolars were reshaped and restored with composite as central incisors. Good occlusion and cosmetic improvement were obtained. Orthodontic treatment is useful for occlusal reconstruction after a traumatic injury, and autotransplantation is an effective option for these patients. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  14. [Orthodontic reconstruction with autotransplantation and bone grafting after a traffic accident].

    Science.gov (United States)

    Mimura, Hiroshi; Fukuyo, Shinho

    2013-06-01

    This case report describes the orthodontic treatment with autotransplantation and bone grafting of the lost maxillary alveolus for a patient injured in a traffic accident. This patient had a severe skeletal Class III relationship because of the loss of six maxillary teeth and the adjacent alveolar bone. Autotransplantation of mandibular first premolars and bone grafting of the deficient alveolus were carried out to improve the occlusion and the profile. After orthodontic treatment, the transplanted premolars were reshaped and restored with composite as central incisors. Good occlusion and cosmetic improvement were obtained. Orthodontic treatment is useful for occlusal reconstruction after a traumatic injury, and autotransplantation is an effective option for these patients. © EDP Sciences, SFODF, 2013.

  15. The use of allograft as a bone graft substitute in patients with congenital spine deformities.

    Science.gov (United States)

    Hedequist, Daniel; Yeon, Howard; Emans, John

    2007-09-01

    The purpose of this study was to determine the safety and efficacy of using allograft bone as a substitute for iliac crest bone graft when treating pediatric patients with congenital spine deformities. We performed a retrospective review of 107 pediatric patients who underwent instrumentation and arthrodesis using allograft for congenital spine deformity between 1995 and 2002. Pseudoarthrosis was defined as implant failure, a clear radiographic pseudoarthrosis, or any loss of correction more than 10 degrees from the immediate postoperative radiographs to the final follow-up radiographs. The pseudoarthrosis rate in this series was 2.8%, and the infection rate was 0.9%. We conclude that freeze-dried corticocancellous allograft is a safe and effective alternative to iliac crest bone graft in this patient population.

  16. The split calvarial bone graft donor site: the effects of surgicel and hydroxyapatite impregnated with collagen.

    Science.gov (United States)

    Thaller, S R; Kim, S; Tesluk, H; Kawamoto, H

    1990-12-01

    Surgicel, which is commonly used as a hemostatic agent in clinical practice, is basically composed of oxidized regenerated cellulose. Skoog followed by Thilander and Stenstrom are credited with initially describing the use of Surgicel as a subperiosteal implant that could stimulate new bone formation in the closure of secondary palatal fistulae. Encouraged by these previous studies, we decided to investigate the effect of Surgicel and a new implant material, hydroxyapatite impregnated with collagen, on the split calvarial bone graft donor site. To do this, we used adult New Zealand White rabbits as our experimental model. Our study demonstrated histological evidence of both an increased quantity and earlier bony reformation, eventually reconstituting the surgical defect in the split calvarial bone graft donor site treated with Surgicel. Additionally, we found that this alloplastic implant material has potential in the reconstruction of the donor defect in selected patients.

  17. Effect of coating Straumann Bone Ceramic with Emdogain on mesenchymal stromal cell hard tissue formation.

    Science.gov (United States)

    Mrozik, Krzysztof Marek; Gronthos, Stan; Menicanin, Danijela; Marino, Victor; Bartold, P Mark

    2012-06-01

    Periodontal tissue engineering requires a suitable biocompatible scaffold, cells with regenerative capacity, and instructional molecules. In this study, we investigated the capacity of Straumann Bone Ceramic coated with Straumann Emdogain, a clinical preparation of enamel matrix protein (EMP), to aid in hard tissue formation by post-natal mesenchymal stromal cells (MSCs) including bone marrow stromal cells (BMSCs) and periodontal ligament fibroblasts (PDLFs). MSCs were isolated and ex vivo-expanded from human bone marrow and periodontal ligament and, in culture, allowed to attach to Bone Ceramic in the presence or absence of Emdogain. Gene expression of bone-related proteins was investigated by real time RT-PCR for 72 h, and ectopic bone formation was assessed histologically in subcutaneous implants of Bone Ceramic containing MSCs with or without Emdogain in NOD/SCID mice. Alkaline phosphatase activity was also assessed in vitro, in the presence or absence of Emdogain. Collagen-I mRNA was up-regulated in both MSC populations over the 72-h time course with Emdogain. Expression of BMP-2 and the osteogenic transcription factor Cbfa-1 showed early stimulation in both MSC types after 24 h. In contrast, expression of BMP-4 was consistently down-regulated in both MSC types with Emdogain. Up-regulation of osteopontin and periostin mRNA was restricted to BMSCs, while higher levels of bone sialoprotein-II were observed in PDLFs with Emdogain. Furthermore, alkaline phosphatase activity levels were reduced in both BMSCs and PDLFs in the presence of Emdogain. Very little evidence was found for ectopic bone formation following subcutaneous implantation of MSCs with Emdogain-coated or -uncoated Bone Ceramic in NOD/SCID mice. The early up-regulation of several important bone-related genes suggests that Emdogain may have a significant stimulatory effect in the commitment of mesenchymal cells to osteogenic differentiation in vitro. While Emdogain inhibited AP activity and appeared

  18. EFFICACY OF GBR USING COMPOSITE BONE GRAFT AND RESORBABLE COLLAGEN MEMBRANE IN SEIBERT'S CLASS I RIDGE DEFECTS- RADIOLOGICAL EVALUATION.

    Science.gov (United States)

    Pushparajan, Saravanan; Ramakrishnan, T; Ambalavanan, N; Emmadi, Pamela

    2012-04-26

    Abstract The purpose of the study was to radiologically evaluate the efficacy of Guided Bone Regeneration (GBR) using Composite Bone Graft (Autogenous Bone graft & 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 computed tomography at 0 day and at 180th day at 2mm, 4mm, and 6mm from the crest.There was a statistically significant increase in bone width between 0 day and 180th day at 2mm, 4mm and 6mm from the crest. The results of the study demonstrated an increase in bone width of Seibert's class I ridge defects in maxilla in the study patients.

  19. Three-Dimensional Finite Element Analysis of Maxillary Sinus Floor Augmentation with Optimal Positioning of a Bone Graft Block

    Directory of Open Access Journals (Sweden)

    Peter Schuller-Götzburg

    2018-01-01

    Full Text Available Purpose: the aim of the computational 3D-finite element study is to evaluate the influence of an augmented sinus lift with additional inserted bone grafting. The bone graft block stabilizes the implant in conjunction with conventional bone augmentation. Two finite element models were applied: the real geometry based bone models and the simplified geometry models. The bone graft block was placed in three different positions. The implants were loaded first with an axial force and then with forces simulating laterotrusion and protrusion. This study examines whether the calculated stress behavior is symmetrical for both models. Having established a symmetry between the primary axis, the laterotrusion and protrusion behavior reduces calculation efforts, by simplifying the model. Material and Methods: a simplified U-shaped 3D finite element model of the molar region of the upper jaw and a more complex anatomical model of the left maxilla with less cortical bone were created. The bone graft block was placed in the maxillary sinus. Then the von Mises stress distribution was calculated and analyzed at three block positions: at contact with the sinus floor, in the middle of the implant helix and in the upper third of the implant. The two finite element models were then compared to simplify the modelling. Results: the position of the bone graft block significantly influences the magnitude of stress distribution. A bone graft block positioned in the upper third or middle of the implant reduces the quantity of stress compared to the reference model without a bone graft block. The low bone graft block position is clearly associated with lower stress distribution in compact bone. We registered no significant differences in stress in compact bone with regard to laterotrusion or protrusion. Conclusions: maximum values of von Mises stresses in compact bone can be reduced significantly by using a bone graft block. The reduction of stress is nearly the same for

  20. Survival of Dental Implants Placed in Grafted and Nongrafted Bone: A Retrospective Study in a University Setting.

    Science.gov (United States)

    Tran, Duong T; Gay, Isabel C; Diaz-Rodriguez, Janice; Parthasarathy, Kavitha; Weltman, Robin; Friedman, Lawrence

    2016-01-01

    To compare dental implant survival rates when placed in native bone and grafted sites. Additionally, risk factors associated with dental implant loss were identified. This study was based on the hypothesis that bone grafting has no effect on implant survival rates. A retrospective chart review was conducted for patients receiving dental implants at the University of Texas, School of Dentistry from 1985 to 2012. Exclusion criteria included patients with genetic diseases, radiation and chemotherapy, or an age less than 18 years. To avoid misclassification bias, implants were excluded if bone grafts were only done at the same time of placement. Data on age, sex, tobacco use, diabetes, osteoporosis, anatomical location of the implant, implant length and width, bone graft, and professional maintenance were collected for analysis. A total of 1,222 patients with 2,729 implants were included. The cumulative survival rates at 5 and 10 years were 92% and 87% for implants placed in native bone and 90% and 79% for implants placed in grafted bone, respectively. The results from multivariate analysis (Cox regression) indicated no significant difference in survival between the two groups; having maintenance therapy after implant placement reduced the failure rate by 80% (P dental implant survival rate when implants were placed in native bone or bone-grafted sites. Smoking and lack of professional maintenance were significantly related to increased implant loss.

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

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    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-out test and analyzed histologically qualitatively and quantitatively. Study II investigates the effect of DBM alone...... and the histological analysis by using the profound part of the implant. The implants in this study were inserted in the proximal humerus and only allograft was used in the peri-implant gap. In study I, the mechanical testing showed failure by the preloading in the composite group with and without BMA. There were...... with CB or allograft showed no significant differences on the mechanical testing and histological analysis to the control group, whereas DBM alone showed significant low mechanical fixation, low bone ongrowth and low bone formation. Study III showed no significant difference between the sampling methods...

  2. 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.

  3. Perforated sigmoid diverticulitis in a lumbar hernia after iliac crest bone graft--a case report.

    Science.gov (United States)

    Frueh, Florian S; Vuille-dit-Bille, Raphael N; Raptis, Dimitri A; Notter, Hanspeter; Muff, Brigitte S

    2014-07-22

    The combination of perforated diverticulitis in a lumbar hernia constitutes an extremely rare condition. We report a case of a 66 year old Caucasian woman presenting with perforated sigmoid diverticulitis localized in a lumbar hernia following iliac crest bone graft performed 18 years ago. Emergency treatment consisted of laparoscopic peritoneal lavage. Elective sigmoid resection was scheduled four months later. At the same time a laparoscopic hernia repair with a biologic mesh graft was performed. This case shows a very seldom clinical presentation of lumbar hernia. Secondary colonic resection and concurrent hernia repair with a biologic implant have proven useful in treating this rare condition.

  4. Experimental study of fat grafting under negative pressure for wounds with exposed bone.

    Science.gov (United States)

    Kao, H-K; Hsu, H-H; Chuang, W-Y; Chang, K-P; Chen, B; Guo, L

    2015-07-01

    The combination of fat grafting and negative pressure (VAC) therapy represents a synergistic interaction of all essential components for wound healing. The aim of this experimental study was to determine whether it could promote healing of wounds with exposed bone. Full-thickness wounds with denuded bone in Sprague-Dawley rats were treated with either polyurethane foam dressing, fat grafting alone, polyurethane foam dressing with VAC, or polyurethane foam dressing with VAC combined with a single, or two administrations of fat graft. Wound healing kinetics, tissue growth, cell proliferation (Ki-67) and angiogenesis (platelet endothelial cell adhesion molecule 1 and α-smooth muscle actin) were investigated. Messenger RNA levels related to angiogenesis (vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b-FGF)), profibrosis (platelet-derived growth factor A and transforming growth factor β), adipocyte expression (fatty acid-binding protein (FABP) 4 and peroxisome proliferator activated receptor γ), and extracellular matrix remodelling (collagen I) were measured in wound tissues. Wounds treated by VAC combined with fat grafting were characterized by cell proliferation, neoangiogenesis and maturation of functional blood vessels; they showed accelerated granulation tissue growth over the denuded bone compared with VAC- or foam dressing-treated wounds. Fat grafting alone over denuded bone resulted in complete necrosis. Expression of angiogenesis markers (VEGF and b-FGF) and adipocyte expression factors (FABP-4) was upregulated in wounds treated with VAC combined with fat grafting. Fat grafting with VAC therapy may represent a simple but effective clinical solution for a number of complex tissue defects, and warrants testing in clinical models. The combination of fat grafting and vacuum therapy represents a synergistic interaction of regenerative cells, hospitable wound matrix and stimulating micromechanical forces. It could accelerate complex

  5. Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts - a prospective study of two cohorts.

    Science.gov (United States)

    Wiltfang, Jörg; Jätschmann, Nadine; Hedderich, Jürgen; Neukam, Friedrich W; Schlegel, Karl Andreas; Gierloff, Matthias

    2014-02-01

    The augmentation of the alveolar ridge using iliac cortico-spongeous bone grafts is routinely used. However, bone grafts show a substantial degree of resorption, which may negatively affect the long-term success of dental implants in the augmented area. The aim of this study was to evaluate the effect of a deproteinized bovine bone matrix coverage on the resorption of iliac bone grafts. Two cohorts consisting of 40 patients who received a vertical augmentation of the alveolar ridge with onlay grafts from the iliac crest were prospectively investigated over a period of 2 years. In half of the patients (n = 40), the grafts were covered by a thin layer of deproteinized bovine bone matrix (DBBM cohort). The other 40 patients received the identical surgical procedure without a DBBM coverage (non-DBBM cohort). The graft height/resorption was radiographically determined immediately after surgery, 6 months, 1 year, and 2 years postoperatively. The height of the bone graft 6 months after surgery accounted 92.15% of the initial value in the DBBM cohort and 87.76% in the non-DBBM cohort. One year after augmentation, the height reduced to 83.95% in the DBBM cohort and 72.92% in the non-DBBM cohort. Two years after surgery, the resorption slowed down and the height of the grafts accounted 81.27% in the DBBM cohort and 71.43% in the non-DBBM cohort. The difference was statistically significant. Deproteinized bovine bone matrix reduces the postoperative resorption of iliac bone block grafts and may therefore enhance the long-term implant prognosis in the augmented area. © 2012 John Wiley & Sons A/S.

  6. High hydrostatic pressure for disinfection of bone grafts and biomaterials: an experimental study.

    Science.gov (United States)

    Gollwitzer, Hans; Mittelmeier, Wolfram; Brendle, Monika; Weber, Patrick; Miethke, Thomas; Hofmann, Gunther O; Gerdesmeyer, Ludger; Schauwecker, Johannes; Diehl, Peter

    2009-01-29

    Autoclaving, heat, irradiation or chemical detergents are used to disinfect autografts, allografts and biomaterials for tissue reconstruction. These methods are often associated with deterioration of mechanical, physical, and biological properties of the bone grafts and synthetic implants. High hydrostatic pressure has been proposed as a novel method preserving biomechanical and biological properties of bone, tendon and cartilage. This is the first study to assess the inactivation of clinically relevant bacteria on biomaterials and human bone by high hydrostatic pressure. Bacterial suspensions of Staphylococcus aureus, Pseudomonas aeruginosa and Enterococcus faecium, implants covered with infected blood, human bone infected in vitro, and biopsies of patients with chronic osteomyelitis were subjected to different protocols of high hydrostatic pressure up to 600 MPa. Bacterial survival after high hydrostatic pressure treatment was determined and compared with bacterial growth in untreated controls. S. aureus and P. aeruginosa in suspension were completely inactivated by high hydrostatic pressure (> 5log levels), whereas E. faecium showed barotolerance up to 600 MPa. Blood and adherence to metal implants did not significantly alter inactivation of bacteria, and complete disinfection was achieved with barotolerant bacteria (S. aureus and P. aeruginosa). However, osteoarthritic bone demonstrated a non-homogeneous baroprotective effect, with single bone samples resistant to treatment resulting in unaltered bacterial growth, and complete disinfection of artificially infected bone specimens was achieved in 66% for S. aureus, 60% for P. aeruginosa and 0% for E. faecium. Human bone samples of patients with chronic osteomyelitis could be completely disinfected in 2 of 37 cases. High hydrostatic pressure offers new perspectives for disinfection of sensitive biomaterials and bone grafts, and contamination by blood did not significantly affect bacterial inactivation rates

  7. Autologous Bone Grafts Use in Orthopaedic Practice in Abuja ...

    African Journals Online (AJOL)

    Materials and Methods: This is a retrospective case series of patients operated on between January 1st, 2005 and December 31st, 2008 for various orthopaedic pathologies at the University of Abuja Teaching Hospital (UATH), Gwagwalada. All patients ... The main indication was nonunion of long bones following fractures.

  8. The concentration of antibiotic in fresh-frozen bone graft.

    Science.gov (United States)

    Chang, Y; Shih, H-N; Chen, D W; Lee, M S; Ueng, S W; Hsieh, P-H

    2010-10-01

    We investigated the antibiotic concentration in fresh-frozen femoral head allografts harvested from two groups of living donors. Ten samples were collected from patients with osteoarthritis of the hip and ten from those with a fracture of the neck of the femur scheduled for primary arthroplasty. Cefazolin (1 g) was administered as a pre-operative prophylactic antibiotic. After storage at -80 degrees C for two weeks the pattern of release of cefazolin from morsellised femoral heads was evaluated by an in vitro broth elution assay using high-performance liquid chromatography. The bioactivity of the bone was further determined with an agar disc diffusion and standardised tube dilution bioassay. The results indicated that the fresh-frozen femoral heads contained cefazolin. The morsellised bone released cefazolin for up to four days. The concentration of cefazolin was significantly higher in the heads from patients with osteoarthritis of the hip than in those with a fracture.Also, in bioassays the bone showed inhibitory effects against bacteria.We concluded that allografts of morsellised bone from the femoral head harvested from patients undergoing arthroplasty of the hip contained cefazolin, which had been administered pre-operatively and they exhibited inhibitory effects against bacteria in vitro.

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

    Energy Technology Data Exchange (ETDEWEB)

    Fântânariu, Mircea, E-mail: mfantanariu@uaiasi.ro [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Veterinary Medicine, Str. Aleea M. Sadoveanu, no. 8, 700489, Iasi (Romania); Trincă, Lucia Carmen, E-mail: lctrinca@uaiasi.ro [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Horticulture, Str. Aleea M. Sadoveanu, no. 3, 700490, Iasi (Romania); Solcan, Carmen, E-mail: csolcan@yahoo.com [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Veterinary Medicine, Str. Aleea M. Sadoveanu, no. 8, 700489, Iasi (Romania); Trofin, Alina, E-mail: aetrofin@yahoo.com [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Horticulture, Str. Aleea M. Sadoveanu, no. 3, 700490, Iasi (Romania); Strungaru, Ştefan, E-mail: strungaru_stefan@yahoo.com [“Alexandru Ioan Cuza” University, Faculty of Biology, Bulevardul Carol I, Nr.11, 700506, Iasi (Romania); Şindilar, Eusebiu Viorel, E-mail: esindilar@uaiasi.ro [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Veterinary Medicine, Str. Aleea M. Sadoveanu, no. 8, 700489, Iasi (Romania); Plăvan, Gabriel, E-mail: gabriel.plavan@uaic.ro [“Alexandru Ioan Cuza” University, Faculty of Biology, Bulevardul Carol I, Nr.11, 700506, Iasi (Romania); and others

    2015-10-15

    Highlights: • A Fe–Mn–Si alloy was obtained as alloplastic graft material for bone implants. • Fe–Mn–Si alloy degradation rate was preliminary evaluate with SEM and EDAX techniques. • Biochemical, histological, RX and CT investigations were done in rats with subcutaneous and tibiae implants. • Fe–Mn–Si alloy assured an ideal compromise between degradation and mechanical integrity during bone regeneration. - Abstract: 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

  10. Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection.

    Science.gov (United States)

    Brembilla, Carlo; Lanterna, Luigi Andrea; Risso, Andrea; Bonaldi, Giuseppe; Gritti, Paolo; Resmini, Bruno; Viscone, Andrea

    2014-01-01

    Candida osteomyelitis in the current literature is an emerging infection. The factors contributing to its emergence include a growing population of immunosuppressed patients, invasive surgeries, broad-spectrum antibiotics, injection drug users, and alcohol abuse. The diagnosis requires a high degree of suspicion. The insidious progression of infection and the nonspecificity of laboratory and radiologic findings may contribute to a delay in diagnosis. The current case concerns a 27-year-old man with a spinal cord injury who, after undergoing anterior cervical fixation and fusion surgery, developed postoperative systemic bacterial infection and required long-term antibiotic therapy. After six months, a CT scan demonstrated an almost complete anterior dislocation of the implants caused by massive bone destruction and reabsorption in Candida albicans infection. The patient underwent a second intervention consisting firstly of a posterior approach with C4-C7 fixation and fusion, followed by a second anterior approach with a corpectomy of C5 and C6, a tricortical bone grafting from the iliac crest, and C4-C7 plating. The antifungal therapy with fluconazole was effective without surgical debridement of the bone graft, despite the fact that signs of the bone graft being infected were seen from the first cervical CT scans carried out after one month.

  11. Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection

    Directory of Open Access Journals (Sweden)

    Carlo Brembilla

    2014-01-01

    Full Text Available Candida osteomyelitis in the current literature is an emerging infection. The factors contributing to its emergence include a growing population of immunosuppressed patients, invasive surgeries, broad-spectrum antibiotics, injection drug users, and alcohol abuse. The diagnosis requires a high degree of suspicion. The insidious progression of infection and the nonspecificity of laboratory and radiologic findings may contribute to a delay in diagnosis. The current case concerns a 27-year-old man with a spinal cord injury who, after undergoing anterior cervical fixation and fusion surgery, developed postoperative systemic bacterial infection and required long-term antibiotic therapy. After six months, a CT scan demonstrated an almost complete anterior dislocation of the implants caused by massive bone destruction and reabsorption in Candida albicans infection. The patient underwent a second intervention consisting firstly of a posterior approach with C4–C7 fixation and fusion, followed by a second anterior approach with a corpectomy of C5 and C6, a tricortical bone grafting from the iliac crest, and C4–C7 plating. The antifungal therapy with fluconazole was effective without surgical debridement of the bone graft, despite the fact that signs of the bone graft being infected were seen from the first cervical CT scans carried out after one month.

  12. Silver nanoparticle based antibacterial methacrylate hydrogels potential for bone graft applications

    Science.gov (United States)

    González-Sánchez, M. Isabel; Perni, Stefano; Tommasi, Giacomo; Morris, Nathanael Glyn; Hawkins, Karl; López-Cabarcos, Enrique; Prokopovich, Polina

    2015-01-01

    Infections are frequent and very undesired occurrences after orthopedic procedures; furthermore, the growing concern caused by the rise in antibiotic resistance is progressively dwindling the efficacy of such drugs. Artificial bone graft materials could solve some of the problems associated with the gold standard use of natural bone graft such as limited bone material, pain at the donor site and rejections if donor tissue is used. We have previously described new acrylate base nanocomposite hydrogels as bone graft materials. In the present paper, we describe the integration of silver nanoparticles in the polymeric mineralized biomaterial to provide non-antibiotic antibacterial activity against Staphylococcus epidermidis and Methicillin-resistant Staphylococcus aureus. Two different crosslinking degrees were tested and the silver nanoparticles were integrated into the composite matrix by means of three different methods: entrapment in the polymeric hydrogel before the mineralization; diffusion during the process of calcium phosphate crystallization and adsorption post-mineralization. The latter being generally the most effective method of encapsulation; however, the adsorption of silver nanoparticles inside the pores of the biomaterial led to a decreasing antibacterial activity for adsorption time longer than 2 days. PMID:25746278

  13. Enamel matrix derivative in combination with bone grafts: A review of the literature.

    Science.gov (United States)

    Miron, Richard J; Guillemette, Vincent; Zhang, Yufeng; Chandad, Fatiha; Sculean, Anton

    2014-06-01

    Over 15 years have passed since an enamel matrix derivative (EMD) was introduced as a biologic agent capable of periodontal regeneration. Histologic and controlled clinical studies have provided evidence for periodontal regeneration and substantial clinical improvements following its use. The purpose of this review article was to perform a systematic review comparing the eff ect of EMD when used alone or in combination with various types of bone grafting material. A literature search was conducted on several medical databases including Medline, EMBASE, LILACS, and CENTRAL. For study inclusion, all studies that used EMD in combination with a bone graft were included. In the initial search, a total of 820 articles were found, 71 of which were selected for this review article. Studies were divided into in vitro, in vivo, and clinical studies. The clinical studies were subdivided into four subgroups to determine the eff ect of EMD in combination with autogenous bone, allografts, xenografts, and alloplasts. The analysis from the present study demonstrates that while EMD in combination with certain bone grafts is able to improve the regeneration of periodontal intrabony and furcation defects, direct evidence supporting the combination approach is still missing. Further controlled clinical trials are required to explain the large variability that exists amongst the conducted studies.

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

    Science.gov (United States)

    Buma, Pieter; Arts, J J Chris; Gardeniers, Jean W M; Verdonschot, Nico; Schreurs, B Willem

    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 accelerate the incorporation of MCB and prevents the formation of a soft tissue interface after remodeling of the MCB. A large loaded defect in the acetabulum of goats was reconstructed with a wire mesh and with MCB or MCB mixed with OP-1. After 6 weeks, no differences were found in the revascularization process, in the number of osteoclasts resorbing the MCB, and in the thickness and appearance of the fibrous interface between MCB with or without OP-1. After 6 weeks, enchondral bone had formed in the bone graft layer and on the periosteal anterior and superior rim in the OP-1 group only. More periosteal bone and more bone in the holes of the mesh had been formed in most OP-1 goats. Most MCB was replaced by new lamellar bone after 15 weeks in both groups. We speculate that during or directly after impaction most of the OP-1 is released from the carrier inducing an early effect outside the reconstructive layer at the periosteal side of the acetabulum. Probably most OP-1 has left the reconstruction by the time new vessels and progenitors reached the bone graft. These results do not support the use of OP-1 in impaction bone grafting in patients.

  15. Bacteriological evaluation of bone grafts stored by cryogenic freezing at –24°C from a canine (Canis familiaris bone bank

    Directory of Open Access Journals (Sweden)

    Jaqueline França dos Santos

    2015-12-01

    Full Text Available The scientific basis of bone transplantation was established during the mid-nineteenth century, when the osteogenic properties of the bone and periosteum, beneficial influence of cold preservation of bones, and first conventional attempt to store bones for elective use, were described. A bone bank has several advantages, such as the immediate availability of grafts in large quantities, and different shapes and sizes, and maintenance of osteoinductive activity in grafts. In addition, it reduces patient blood loss, surgical time, and quantity of anesthetics required. Clinical applications include the correction of comminuted fractures, treatment of non-union bones, and replacement of bone loss due to infections or malignancies. The success of these procedures depends on the preservation and integrity of the graft. This study aimed to evaluate the feasibility of maintaining a canine bone bank (Canis familiaris by quantifying the bacterial contamination of bone grafts preserved at –24°C. The samples were evaluated through a monthly assessment of bacteriological cultures over a period of 6 months. The harvest method was efficient and sterile, reducing the risk of contamination. We conclude that the techniques chosen for the implementation of a bone bank were effective and feasible (use of a common freezer reaching a temperature below –24°C. The viability of the bones was attested during a 6-month period, and the samples demonstrated a 100% sterility rate.

  16. A Biphasic Calcium Sulphate/Hydroxyapatite Carrier Containing Bone Morphogenic Protein-2 and Zoledronic Acid Generates Bone

    DEFF Research Database (Denmark)

    Raina, Deepak Bushan; Isaksson, Hanna; Hettwer, Werner

    2016-01-01

    -the-shelf osteoinductive bone substitutes that can replace bone grafts are required. We tested the carrier properties of a biphasic, calcium sulphate and hydroxyapatite ceramic material, containing a combination of recombinant human bone morphogenic protein-2 (rhBMP-2) to induce bone, and zoledronic acid (ZA) to delay...

  17. Man as a Living Bioreactor: Prefabrication of a Custom Vascularized Bone Graft in the Gastrocolic Omentum.

    Science.gov (United States)

    Wiltfang, Jörg; Rohnen, Michael; Egberts, Jan-Hendrik; Lützen, Ulf; Wieker, Henning; Açil, Yahya; Naujokat, Hendrik

    2016-08-01

    Reconstruction of critical-size jaw defects still remains challenging. The standard treatment today is transplantation of autologous bone grafts, which is associated with high donor-site morbidity and unsatisfactory outcomes. We aimed to reconstruct a mandibular discontinuity defect after ablative surgery using the gastrocolic omentum as a bioreactor for heterotopic ossification. Three-dimensional computed tomography data were used to produce an ideal virtual replacement for the mandibular defect. A titanium mesh cage was filled with bone mineral blocks, infiltrated with 12 mg of recombinant human bone morphogenetic protein 2, and enriched with bone marrow aspirate. The scaffold was implanted into the gastrocolic omentum, and 3 months later, a free flap was harvested to reconstruct the mandibular defect. In vivo single photon emission computed tomography/computed tomography revealed bone remodeling and mineralization inside the mandibular transplant during prefabrication and after transplantation. Reconstruction was possible without any further modifications of the graft. A histological evaluation revealed that large sections of the Bio-Oss material were covered with osteoid matrix 3 months after transplantation. The quality of life of the patient significantly increased with acquisition of the ability to masticate and the improvement in pronunciation and aesthetics. Heterotopic bone induction to form a mandibular replacement inside the gastrocolic omentum is possible in human subjects. Heterotopic prefabrication is associated with many advantages, like allowing a reduced operative burden compared with conventional techniques and good three-dimensional outcomes.

  18. Alveolar bone morphology of maxillary central incisors near grafted alveolar clefts after orthodontic treatment.

    Science.gov (United States)

    Yatabe, Marilia; Natsumeda, Gabriela Manami; Miranda, Felicia; Janson, Guilherme; Garib, Daniela

    2017-10-01

    The aim of this study was to evaluate the thickness and the height of the maxillary central incisors' alveolar bone near the grafted alveolar cleft area, after comprehensive orthodontic treatment. The sample comprised 30 patients with unilateral alveolar cleft with a mean age of 20.5 years (range, 17-25.8 years). High-resolution cone-beam computed tomography images of the maxilla were obtained 6 to 24 months after the comprehensive orthodontic treatment. The contralateral maxillary central incisor was used as a comparison group. Axial sections at the level of the central incisor root were used to measure the labial and lingual alveolar bone thicknesses. Cross sections were used to measure the bone crest heights using the cementoenamel junction as the reference. Paired t and Wilcoxon tests were used to compare the cleft and noncleft sides. The labial and lingual bone thicknesses of the maxillary central incisors' alveolar bone were significantly thinner (0.16 and 0.39 mm, respectively), and the labial alveolar crest height distance was significantly greater on the cleft side compared with the noncleft side (-1.2 mm). In patients with unilateral cleft lip and palate, the maxillary central incisors adjacent to the grafted alveolar cleft had thinner labial and lingual alveolar bones and an apically displaced labial alveolar crest level than the controls. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  19. 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

  20. 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

  1. Osteoconductivity of modified fluorcanasite glass-ceramics for bone tissue augmentation and repair.

    Science.gov (United States)

    Bandyopadhyay-Ghosh, S; Faria, P E P; Johnson, A; Felipucci, D N B; Reaney, I M; Salata, L A; Brook, I M; Hatton, P V

    2010-09-01

    Modified fluorcanasite glasses were fabricated by either altering the molar ratios of Na(2)O and CaO or by adding P(2)O(5) to the parent stoichiometric glass compositions. Glasses were converted to glass-ceramics by a controlled two-stage heat treatment process. Rods (2 mm x 4 mm) were produced using the conventional lost-wax casting technique. Osteoconductive 45S5 bioglass was used as a reference material. Biocompatibility and osteoconductivity were investigated by implantation into healing defects (2 mm) in the midshaft of rabbit femora. Tissue response was investigated using conventional histology and scanning electron microscopy. Histological and histomorphometric evaluation of specimens after 12 weeks implantation showed significantly more bone contact with the surface of 45S5 bioglass implants when compared with other test materials. When the bone contact for each material was compared between experimental time points, the Glass-Ceramic 2 (CaO rich) group showed significant difference (p = 0.027) at 4 weeks, but no direct contact at 12 weeks. Histology and backscattered electron photomicrographs showed that modified fluorcanasite glass-ceramic implants had greater osteoconductivity than the parent stoichiometric composition. Of the new materials, fluorcanasite glass-ceramic implants modified by the addition of P(2)O(5) showed the greatest stimulation of new mineralized bone tissue formation adjacent to the implants after 4 and 12 weeks implantation. (c) 2010 Wiley Periodicals, Inc.

  2. New bioactive glass-ceramic: synthesis and application in PMMA bone cement composites.

    Science.gov (United States)

    Abd Samad, Hamizah; Jaafar, Mariatti; Othman, Radzali; Kawashita, Masakazu; Abdul Razak, Noor Hayati

    2011-01-01

    In present study, a new composition of glass-ceramic was synthesized based on the Na2O-CaO-SiO2-P2O5 glass system. Heat treatment of glass powder was carried out in 2 stages: 600 °C as the nucleation temperature and different temperature on crystallization at 850, 950 and 1000 °C. The glass-ceramic heat-treated at 950 °C was selected as bioactive filler in commercial PMMA bone cement; (PALACOS® LV) due to its ability to form 2 high crystallization phases in comparison with 850 and 1000 °C. The results of this newly glass-ceramic filled PMMA bone cement at 0-16 wt% of filler loading were compared with those of hydroxyapatite (HA). The effect of different filler loading on the setting properties was evaluated. The peak temperature during the polymerization of bone cement decreased when the liquid to powder (L/P) ratio was reduced. The setting time, however, did not show any trend when filler loading was increased. In contrast, dough time was observed to decrease with increased filler loading. Apatite morphology was observed on the surface of the glass-ceramic and selected cement after bioactivity test.

  3. Apical and marginal bone alterations around implants in maxillary sinus augmentation grafted with autogenous bone or bovine bone material and simultaneous or delayed dental implant positioning.

    Science.gov (United States)

    Sbordone, Ludovico; Levin, Liran; Guidetti, Franco; Sbordone, Carolina; Glikman, Ari; Schwartz-Arad, Devorah

    2011-05-01

    A re-pneumatization phenomenon was recorded in sinuses grafted with different materials. The specific aims of this paper were to assess the dental implant survival rate and the behavior of marginal and apical bone remodeling around dental implants placed following sinus augmentation. A retrospective study was conducted on consecutive patients treated in two surgical centers. Different surgical techniques were adopted for sinus augmentation: simultaneous or delayed dental implant insertion with bovine bone-material augmentation or autologous bone grafting (chin and iliac crest). Survival rates were recorded for the overall number of implants (patients of group A). Apical and marginal bone levels (ABL and MBL, respectively) were radiographically measured, and statistical analysis was performed in implants of a subgroup of patients (group B). A total of 282 dental implants were positioned. Recorded cumulative survival rates (CSRs) were 95.6% and 100% for autogenous and bovine bone material, respectively, while CSRs at 2-year follow-up for immediate and delayed procedures were 99.3% and 96.5%. For the subgroup B, 57 sinus augmentation procedures were performed in 39 patients, with the positioning of 154 implants. Generally, the apical- and marginal-bone resorption of the bovine bone-material group was less than that of the autogenous group. The differences between the ABL values of the bovine bone-material and iliac-crest groups were statistically significant at 1 year, whereas this significance disappeared at the 2-year follow-up; tests showed that a statistical difference was recorded in the bovine bone-material group between the 1- and 2-year follow-ups. With regard to MBL comparisons between simultaneous and delayed implantation, the differences maintained their significance at the 2-year follow-up also. Differences regarding apical bone alteration between autogenous bone from the iliac crest and bovine bone material at the 1- and 2-year follow-ups, as well as in

  4. EFFECT OF LOCATION AND BONE GRAFT REMODELING ON RESULTS OF BRISTOW-LATARJET PROCEDURE

    Directory of Open Access Journals (Sweden)

    D. A. Malanin

    2016-01-01

    Full Text Available Introduction. Operation Bristow-Latarjet proved itself as one of the most effective and predictable surgical treatments. despite its widespread use, there are various complications associated with improper installation of the bone block and the violation of its remodeling.Objective: To obtain new data on the effect of location and remodeling of bone graft block on functional outcome and stability of the shoulder joint in patients with recurrent anterior instability after the operation Bristow-latarjet.Material and methods. The material for the study served as the analysis of results of treatment of 64 patients with posttraumatic recurrent anterior shoulder dislocation who underwent Bristow-latarjet operation. postoperatively, assessed a provision and the degree of bone remodeling unit according to computed tomography in the sagittal, axial slices, and through 3d modeling. To evaluate the functional outcome scale were used western Ontario Shoulder Index (wOSI and Rowe scale.Results. At the level of the articular surface (congruent or flattening in the axial plane were 89% bone blocks, too medially or laterally arranged 9% and 2% grafts, respectively. On sagittal cT images in the middle third of the articular surface of the scapula was located 28% of the bone blocks at the bottom 60%, in the upper third of 12%. Analysis of the dependence of the results of treatment of graft positioning showed that patients with excellent and good summary on the scale WOSI and Rowe, had a correct location of the bone block in the middle and lower third of the articular process of the blade. It can be assumed that excessive lateralized or medialized bone block position in the axial plane of a more profound effect on the outcome than cranial displacement of the latter with the sagittal plane. Bony union of the graft was found by CT in 74% of cases, soft tissue 26%, the degree of resorption of the graft revealed 0-1 84% 2-3 degree in 26% of cases. In the last periods

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

    Directory of Open Access Journals (Sweden)

    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

  6. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting.

    Science.gov (United States)

    Baksi, D D; Pal, A K; Baksi, D P

    2016-01-01

    Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8-30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN) of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG) were excluded. Thus, out of 244 patients, 208 (85.3%) untreated nonunion and 36 (14.7%) following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN) femoral head was found histologically in 135 (54.3%) and radiologically in 48 (19.7%) patients. The patients were operated by open reduction of fracture, cannulated hip screw fixation, iliac crest bone

  7. Remodeling of Autogenous Bone Grafts after Osteotome Sinus Floor Elevation Assessed by Limited Cone Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    Tetsuya Nishida

    2013-01-01

    Full Text Available This study assessed the radiographic appearance of bone graft domes longitudinally after osteotome sinus floor elevation using cone beam computed tomography (CBCT. This study presents the radiological findings of a 6-month follow-up CBCT study in maxillary osteotome sinus floor elevation. We examined 52 patients with a crestal bone height of less than 8 mm in the posterior maxilla who required sinus augmentation. Implants ( were subsequently placed in regenerated bone following osteotome sinus floor elevation; autogenous bone was used as the augmentation material. In all cases, the grafted augmentation material tended to be absorbed, but at least 1 mm of grafted augmentation material was recognized around the implant fixtures on CBCT at the second implant operation. The border between the grafted augmentation material and the existing bone was indistinct. The grafted area apical to the implants undergoes shrinkage and remodeling. It was suggested that sufficient grafted autogenous bone changes into bone to support an implant.

  8. Outcome of plating, bone grafting and shortening of non-union humeral diaphyseal fracture.

    Science.gov (United States)

    Khan, Mohammad Shoaib; Sahibzada, Ahmed Sohail; Khan, Mohammad Ayaz; Sultan, Shahid; Younas, Mohammed; Khan, Alam Zeb

    2005-01-01

    Humeral diaphyseal fracture usually heals with closed methods but when non union develops then it needs surgical intervention in the form of plating and bone grafting, intramedulary nailing (open or closed simple or interlocking nails) and external fixators (circular or one plane fixator). In our unit we treated non union humeral diaphyseal fracture with plating and bone grafting and shortening of fracture ends up to 4 to 5 cm when needed. This study was conducted at Orthopaedic Department of Ayub Teaching Hospital Abbottabad from January 2002 till December 2003. We included 15 cases with atrophic non-union in 9 (60%) and hypertrophic non-union in 6 (40%) patients. All atrophic non-union were treated with plating, bone shortening by transverse osteotomy and bone grafting, while hypertrophic non-union were treated with decortications of non-union ends and fixation with compression plates, with bone grafting in old age. Follow up measures were based on clinical (range of joints motion) and radiological (healing) findings. Follow up was done for up to 6 months. Out of 15 patients the age range was 20-80 years, 12 (80%) were male and 03 (20%) female. Right humerus involved in 5 (33.33%) while left humerus in 10 (66.66%) patients. In 9 (60%) patients with atrophic non union bone shortening by transverse cut osteotomy was done while in remaining patients with hypertrophic non-union plating was done in 2 (13.33%) cases and plating with bone grafting in 4 (26.66%) patients. Union was achieved in all patients after 16 to 20 weeks of surgery. In one patient (6.66%) of 75 years age with hypertrophic non-union implant was loosened after 03 months of surgery. At that time healing (Union) was evident on X-rays and humeral brace was applied for further 03 months. Two patients (13.33%) got neuropraxia of radial nerve which resolved with in 3 months time. 02 patients (13.33%) developed shoulder stiffness which resolved after exercise. In Non Union of Humerus shortening by

  9. Hollow-bone-graft dynamic hip screw can fix and promote bone union after femoral neck fracture: an experimental research.

    Science.gov (United States)

    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

    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. 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. Testing of specifically designed fixation devices in a pig animal model. 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. 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 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.

  10. Hydroxyapatite grafted carbon nanotubes and graphene nanosheets: promising bone implant materials.

    Science.gov (United States)

    Oyefusi, Adebola; Olanipekun, Opeyemi; Neelgund, Gururaj M; Peterson, Deforest; Stone, Julia M; Williams, Ebonee; Carson, Laura; Regisford, Gloria; Oki, Aderemi

    2014-11-11

    In the present study, hydroxyapatite (HA) was successfully grafted to carboxylated carbon nanotubes (CNTs) and graphene nanosheets. The HA grafted CNTs and HA-graphene nanosheets were characterized using FT-IR, TGA, SEM and X-ray diffraction. The HA grafted CNTs and graphene nanosheets (CNTs-HA and Gr-HA) were further used to examine the proliferation and differentiation rate of temperature-sensitive human fetal osteoblastic cell line (hFOB 1.19). Total protein assays and western blot analysis of osteocalcin expression were used as indicators of cell proliferation and differentiation. Results indicated that hFOB 1.19 cells proliferate and differentiate well in treatment media containing CNTs-HA and graphene-HA. Both CNTs-HA and graphene-HA could be promising nanomaterials for use as scaffolds in bone tissue engineering. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Cells responding to surface structure of calcium phosphate ceramics for bone regeneration.

    Science.gov (United States)

    Zhang, Jingwei; Sun, Lanying; Luo, Xiaoman; Barbieri, Davide; de Bruijn, Joost D; van Blitterswijk, Clemens A; Moroni, Lorenzo; Yuan, Huipin

    2017-11-01

    Surface structure largely affects the inductive bone-forming potential of calcium phosphate (CaP) ceramics in ectopic sites and bone regeneration in critical-sized bone defects. Surface-dependent osteogenic differentiation of bone marrow stromal cells (BMSCs) partially explained the improved bone-forming ability of submicron surface structured CaP ceramics. In this study, we investigated the possible influence of surface structure on different bone-related cells, which may potentially participate in the process of improved bone formation in CaP ceramics. Besides BMSCs, the response of human brain vascular pericytes (HBVP), C2C12 (osteogenic inducible cells), MC3T3-E1 (osteogenic precursors), SV-HFO (pre-osteoblasts), MG63 (osteoblasts) and SAOS-2 (mature osteoblasts) to the surface structure was evaluated in terms of cell proliferation, osteogenic differentiation and gene expression. The cells were cultured on tricalcium phosphate (TCP) ceramics with either micron-scaled surface structure (TCP-B) or submicron-scaled surface structure (TCP-S) for up to 14 days, followed by DNA, alkaline phosphatase (ALP) and quantitative polymerase chain reaction gene assays. HBVP were not sensitive to surface structure with respect to cell proliferation and osteogenic differentiation, but had downregulated angiogenesis-related gene expression (i.e. vascular endothelial growth factor) on TCP-S. Without additional osteogenic inducing factors, submicron-scaled surface structure enhanced ALP activity and osteocalcin gene expression of human (h)BMSCs and C2C12 cells, favoured the proliferation of MC3T3-E1, MG63 and SAOS-2, and increased ALP activity of MC3T3-E1 and SV-HFO. The results herein indicate that cells with osteogenic potency (either osteogenic inducible cells or osteogenic cells) could be sensitive to surface structure and responded to osteoinductive submicron-structured CaP ceramics in cell proliferation, ALP production or osteogenic gene expression, which favour bone

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

    National Research Council Canada - National Science Library

    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...

  13. Rapid Maxillary Expansion After Alveolar Bone Grafting With rhBMP-2 in UCLP Evaluated by Means of CBCT

    NARCIS (Netherlands)

    Garib, D.; Miranda, F.; Sathler, R.; Kuijpers-Jagtman, A.M.; Aiello, C.A.

    2017-01-01

    OBJECTIVE: To demonstrate the feasibility of rapid maxillary expansion (RME) after alveolar bone grafting (ABG) in complete unilateral cleft lip, alveolus and palate (UCLP) without damage to the grafted area. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of Sao

  14. 8-10 year follow-up survival of dental implants in maxillae with or without autogenous bone graft reconstruction

    OpenAIRE

    de Moraes, Paulo H; Olate, Sergio; Lauria, Andrezza; Asprino, Luciana; de Moraes, Márcio; de Albergaria-Barbosa, José Ricardo

    2015-01-01

    The aim of this research was to ascertain the survival of implants installed in the atrophic maxillae of patients treated with or without autogenous bone graft at 8 to 10 years of follow-up. A retrospective study was conducted using clinical and imaging analysis. 42 adult patients were selected, treated with osseointegrated implants in a fixed maxillary prosthesis model with suprastructure using 6 to 8 implants; of these, 22 underwent reconstruction with a bone graft taken from the anterior i...

  15. Patients' perception about dental implant and bone graft surgery: A questionnaire-based survey

    Directory of Open Access Journals (Sweden)

    Neha Agrawal

    2017-01-01

    Full Text Available Introduction: The decision toward dental implant – an elective procedure in most cases depends on patients' preferences, values, as well as cost considerations. Patients' participation and codetermination, as well as realistic patient expectations, have been associated with improved subjective treatment outcomes, and health professionals are increasingly encouraged to involve their patients in treatment decisions. However, scientific data on patient expectations and motivation to choose or refuse dental implants are scarce. Aim: The aim of this study is to assess perception about the dental implant and bone graft surgery among patients seeking dental implants. Materials and Methods: A cross-sectional questionnaire study was carried out in OPD of Dental College, Aligarh. One hundred and twenty patients participated in this study. The patients were asked to answer a questionnaire on implant and bone graft surgery including cost and time concerns and second-opinion behavior. Descriptive statistics were calculated for the different variables, and absolute frequencies and percentages were evaluated. A value of P< 0.05 was selected as the threshold for statistical significance. Results: The highest priority was given to treatment predictability and avoidance of the removable dentures by the patients. On an average, the total treatment time was estimated to be 6 months. Patients' opinion regarding 10-year implant success rate was 81%. Autologous bone grafts was accepted by 61% of interviewees (the majority preferring the retromolar area. Young patients, especially males showed higher second opinion-seeking behavior. Conclusions: There is a growing interest in patients' perspectives and expectations of dental implants and bone graft surgeries. Patient expectations on implant success and predictability were found to be high.

  16. Anconeus Muscle-Pedicle Bone Graft With Periosteal Coverage for Osteochondritis Dissecans of the Humeral Capitellum

    OpenAIRE

    Shimada, Kozo; Temporin, Ko; Oura, Keiichiro; Tanaka, Hiroyuki; Noguchi, Ryosuke

    2017-01-01

    Background: Treatment of advanced osteochondritis dissecans (OCD) of the capitellum is controversial, especially in moderate-sized lesions. Purpose: To establish a treatment algorithm for capitellum OCD, we tried to determine the utility of and problems associated with anconeus muscle-pedicle bone graft with periosteal coverage (ABGP) for the treatment of moderate-sized articular OCD defects of the capitellum. Study Design: Case series; Level of evidence, 4. Methods: According to our protocol...

  17. Revision hip arthroplasty as a treatment of Vancouver B3 periprosthetic femoral fractures without bone grafting.

    Science.gov (United States)

    Wang, Jia-Qi; Gao, You-Shui; Mei, Jiong; Rao, Zhi-Tao; Wang, Shu-Qing

    2013-09-01

    It is conventionally considered that bone grafting is mandatory for Vancouver B3 periprosthetic femoral fractures (PFF) although few clinical studies have challenged the concept previously. The aim of the current study was to investigate the radiographic and functional results of Vancouver B3 PFF treated by revision total hip or hemiarthroplasty (HA) in combination with appropriate internal fixation without bone grafting. 12 patients with Vancouver B3 PFF were treated by revision THA/HA without bone grafting between March 2004 and May 2008. There were nine females and three males, with an average age of 76 years. PFFs were following primary THA/HA in nine patients and following revision THA/HA in three. Postoperative followup was 5.5 years on average (range, 3.5-6.5 years). At the final followup, radiographic results were evaluated with Beals and Tower's criteria and functional outcomes were evaluated using the Merle d'Aubigné scoring system. All fractures healed within an average of 20 weeks (range, 12-28 weeks). There was no significant deformity and shortening of the affected limb and the implant was stable. The average Merle d'Aubigné score was 15.8. Walking ability was regained in 10 patients without additional assistance, while 2 patients had to use crutches. There were 2 patients with numbness of lateral thigh, possibly due to injury to the lateral femoral cutaneous nerve. There were no implant failures, dislocation and refractures. Revision THA/HA in combination with appropriate internal fixation without bone grafting is a good option for treatment of Vancouver B3 periprosthetic femoral fractures in the elderly.

  18. Modified sacrospinalis muscle pedicle bone graft for fusion of isthmic spondylolisthesis

    OpenAIRE

    Adam, Faisal F.

    2001-01-01

    We treated 20 patients with symptomatic L4–5 isthmic spondylolisthesis (ten grade I, nine grade II and one grade III) surgically. All patients complained of low back pain and nine had additional radicular pain. Bilateral posterolateral fusion using the sacrospinalis muscle as a muscle pedicle bone graft was carried out in all patients. Decompression was added in patients with radiculopathy. Follow-up ranged from 12 to 28 months. Pain relief was graded as excellent in 18 patients, radiographic...

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Tensile behaviors of three-dimensionally free-formable titanium mesh plates for bone graft applications

    Science.gov (United States)

    He, Jianmei

    2017-11-01

    Present metal artificial bones for bone grafts have the problems like too heavy and excessive elastic modulus compared with natural bones. In this study, three-dimensionally (3D) free-formable titanium mesh plates for bone graft applications was introduced to improve these problems. Fundamental mesh shapes and patterns were designed under different base shapes and design parameters through three dimensional CAD tools from higher flexibility and strength points of view. Based on the designed mesh shape and patterns, sample specimens of titanium mesh plates with different base shapes and design variables were manufactured through laser processing. Tensile properties of the sample titanium mesh plates like volume density, tensile elastic modulus were experimentally and analytically evaluated. Experimental results showed that such titanium mesh plates had much higher flexibility and their mechanical properties could be controlled to close to the natural bones. More details on the mechanical properties of titanium mesh plates including compression, bending, torsion and durability will be carried out in future study.

  1. Presence of Cells in Fresh-Frozen Allogeneic Bone Grafts from Different Tissue Banks.

    Science.gov (United States)

    Coutinho, Libério França; Amaral, Juliano Batista do; Santos, Érico Brito Dos; Martinez, Elizabeth Ferreira; Montalli, Victor Angelo M; Junqueira, José Luiz Cintra; Araújo, Vera Cavalcanti de; Napimoga, Marcelo Henrique

    2017-01-01

    Bone replacement materials have been widely used to reconstruct atrophic jawbones. Based on previous reports demonstrating the presence of viable cells in bone blocks even after processing by musculoskeletal tissue banks for orthopedic use, the aim of this study was to evaluate the presence of cells in bone blocks from three Brazilian tissue banks for maxillary reconstructions. All samples were processed by the respective tissue banks, according to the guidelines of the Brazilian National Sanitary Surveillance Agency. Three samples were removed from each block for subsequent histological processing and stained using hematoxylin & eosin. Further evaluation included section staining by the Feulgen method and ultrastructural analysis using scanning electron microscopy (SEM). Light microscopy images from all bone samples showed presence of osteocyte-like cells in all groups and intense Feulgen staining, demonstrating presence of DNA in bone even after tissue processing. The ultrastructural analysis showed red blood cells in lacunae within the bone tissue. In conclusion, despite bone tissue processing by the musculoskeletal tissue banks, cells may be found within the bone used for allogeneic grafts.

  2. Reconstruction of the Shallow Acetabulum With a Combination of Autologous Bulk and Impaction Bone Grafting Fixed by Cement.

    Science.gov (United States)

    Maruyama, Masaaki; Wakabayashi, Shinji; Ota, Hiroshi; Tensho, Keiji

    2017-02-01

    Acetabular bone deficiency, especially proximal and lateral deficiency, is a difficult technical problem during primary total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH). We report a new reconstruction method using a medial-reduced cemented socket and additional bulk bone in conjunction with impaction morselized bone grafting (additional bulk bone grafting method). In a population of patients with acetabular dysplasia undergoing THA using a medial-reduced cemented socket and additional bulk bone with impacted morselized bone grafting, we evaluated (1) the radiographic appearance of bone graft; (2) the proportion of cups that developed loosening and subsequent revision; and (3) clinical results (outcome scores and complications). Forty percent of 330 THAs for DDH performed at one center between 1999 and 2009 were defined as shallow dysplastic hips. The additional bulk bone grafting method was performed on 102 THAs with shallow acetabulum (31% for DDH) at one center between 1999 and 2009. We used this approach and technique for shallow acetabuli when a cup protruded from the lateral acetabular edge in preoperative templating. The other 132 dysplastic hips without bone grafting had THA performed at the same periods and served as a control. Acetabuli were defined as shallow when the depth was less than or equal to one-fifth of the pelvic height (cranial-caudal length on radiograph). The additional bulk bone grafting technique was as follows: the resected femoral head was sectioned at 1 to 2 cm thickness, and a suitable size of the bulk bone graft was placed on the lateral iliac cortex and fixed by poly-L-lactate absorbable screws. Autologous impaction morselized bone grafting, with or without hydroxyapatite granules, was performed along with the implantation of a medial-reduced cemented socket. We defined an "incorporated" graft as remodeling and trabeculation including rounding off of the protruding edge of a graft beyond the socket

  3. Buccal bone plate remodeling after immediate implant placement with and without synthetic bone grafting and flapless surgery: radiographic study in dogs.

    Science.gov (United States)

    Novaes, Arthur B; Suaid, Flávia; Queiroz, Adriana C; Muglia, Valdir A; Souza, Sérgio L S; Palioto, Daniela B; Taba, Mário; Grisi, Márcio F M

    2012-12-01

    Recent studies in animals have shown pronounced resorption of the buccal bone plate after immediate implantation. The use of flapless surgical procedures prior to the installation of immediate implants, as well as the use of synthetic bone graft in the gaps represent viable alternatives to minimize buccal bone resorption and to favor osseointegration. The aim of this study was to evaluate the healing of the buccal bone plate following immediate implantation using the flapless approach, and to compare this process with sites in which a synthetic bone graft was or was not inserted into the gap between the implant and the buccal bone plate. Lower bicuspids from 8 dogs were bilaterally extracted without the use of flaps, and 4 implants were installed in the alveoli in each side of the mandible and were positioned 2.0 mm from the buccal bone plate (gap). Four groups were devised: 2.0-mm subcrestal implants (3.3 × 8 mm) using bone grafts (SCTG), 2.0-mm subcrestal implants without bone grafts (SCCG), equicrestal implants (3.3 × 10 mm) with bone grafts (ECTG), and equicrestal implants without bone grafts (ECCG). One week following the surgical procedures, metallic prostheses were installed, and within 12 weeks the dogs were sacrificed. The blocks containing the individual implants were turned sideways, and radiographic imaging was obtained to analyze the remodeling of the buccal bone plate. In the analysis of the resulting distance between the implant shoulder and the bone crest, statistically significant differences were found in the SCTG when compared to the ECTG (P = .02) and ECCG (P = .03). For mean value comparison of the resulting linear distance between the implant surface and the buccal plate, no statistically significant difference was found among all groups (P > .05). The same result was observed in the parameter for presence or absence of tissue formation between the implant surface and buccal plate. Equicrestally placed implants, in this methodology

  4. Bone bonding ability of some borate bio-glasses and their corresponding glass-ceramic derivatives

    Directory of Open Access Journals (Sweden)

    Fatma H. Margha

    2012-12-01

    Full Text Available Ternary borate glasses from the system Na2O·CaO·B2O3 together with soda-lime-borate samples containing 5 wt.% of MgO, Al2O3, SiO2 or P2O5 were prepared. The obtained glasses were converted to their glass-ceramic derivatives by controlled heat treatment. X-ray diffraction was employed to investigate the separated crystalline phases in glass-ceramics after heat treatment of the glassy samples. The glasses and corresponding glass-ceramics after immersion in water or diluted phosphate solution for extended times were characterized by the grain method (adopted by several authors and recommended by ASTM and Fourier-transform infrared spectra to justify the formation of hydroxyapatite as an indication of the bone bonding ability. The influence of glass composition on bioactivity potential was discussed too.

  5. Does the presence of glenoid bone loss influence coracoid bone graft osteolysis after the Latarjet procedure? A computed tomography scan study in 2 groups of patients with and without glenoid bone loss.

    Science.gov (United States)

    Di Giacomo, Giovanni; de Gasperis, Nicola; Costantini, Alberto; De Vita, Andrea; Beccaglia, Mario A Rojas; Pouliart, Nicole

    2014-04-01

    Coracoid bone graft osteolysis and fibrous union are the principal causes of failure in patients treated with the Latarjet procedure. This study aims to investigate the hypothesis that coracoid bone graft osteolysis is more pronounced in cases without glenoid bone loss, which may be due to a diminished mechanotransduction effect at the bone healing site. We prospectively followed up 34 patients, treated with a mini-plate Latarjet procedure, divided into 2 groups (group A patients had glenoid bone loss >15% and group B patients had no glenoid bone loss). A computed tomography scan evaluation with 3-dimensional reconstruction was then performed on all patients to evaluate coracoid bone graft osteolysis according to our coracoid bone graft osteolysis classification. The computed tomography scan analysis showed a different distribution of osteolysis between group A and group B. The statistical analysis showed a significant difference (P 15%) than in those without it. Because factors of blood supply, compression, and surgical technique were the same for both groups, we believe that the mechanotransduction effect from the humeral head on the graft influences its remodeling. The results of this study suggest that the bone graft part of the Latarjet procedure plays a role in patients with significant coracoid bone loss but much less so when there is no bone loss. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  6. Sinus augmentation with intra- vs extraorally harvested bone grafts for the provision of dental implants: clinical long-term results.

    Science.gov (United States)

    Deppe, Herbert; Mücke, Thomas; Wagenpfeil, Stefan; Hölzle, Frank

    2012-06-01

    To report the long-term outcome of sinus augmentation with intra- vs extraorally harvested autogenous bone grafts. Between January 1993 and August 2009, 146 patients (86 women and 60 men) were consecutively treated with sinus elevation procedures. In February 2010, 127 patients were re-evaluated. Bone grafts were harvested from the iliac crest (54 patients, group 1) and from the mandibular symphysis (73 patients, group 2). A total of 179 sinus augmentation procedures were performed (105 in group 1 and 74 in group 2). All patients received fixed prostheses. A total of 456 Frialit II implants were placed in the 127 patients: 244 implants in extraorally harvested bone (group 1) and 212 in intraorally harvested bone (group 2). Patients had a mean bone graft consolidation period of 5.8 months in group 1 and of 5.2 months in group 2. During a minimum 3-month healing phase following implant placement, 35 of 456 implants failed (12.0% of group 1 and 4.5% of group 2) to become integrated in grafted bone. A total of 421 implants proceeded to occlusal loading with a fixed prosthesis. After a mean follow-up period of 110.2 months (range, 6 to 204 months), 34 implants were lost (25 in group 1 and 9 in group 2, for a total of 387 implants (91.9%) still functioning. Sinus augmentation procedures using intra- and extraorally harvested bone grafts can provide implant stability in the long term. However, major preoperative discomfort and more bone loss was seen when bone was harvested from the iliac crest. If autogenous bone is mandatory in sinus elevation procedures, extraorally harvested bone grafts can still be recommended, especially when bilateral procedures are indicated.

  7. Dental implants placed into alveolar clefts reconstructed with tongue flaps and bone grafts.

    Science.gov (United States)

    Sándor, George K B; Carmichael, Robert P; Brkovic, Bozidar M B

    2010-02-01

    The aim of this study was to describe a case series using surgical and prosthodontic modifications of tongue flaps necessary to adapt them for use in the reconstruction of large cleft deformities refractory to customary measures using dental implants and to study their outcomes in patients with complex cleft lip and palate deformities. Five patients were treated with iliac crest bone grafts and covered by anteriorly based tongue flaps divided at either 3 or 4 weeks after surgery. The patients were followed clinically and radiographically for 3-12 years after placement of their dental implants to monitor implant survival and success. One of the 5 patients suffered a partial tongue flap detachment, graft dehiscence, and recurrence of an oronasal fistula, which was successfully treated by shifting the tongue flap tissue from its new location in the palate. A total of 18 dental implants were placed into bone-grafted tissue covered by the tongue flaps. There was 1 implant failure. There were no cases of periimplantitis or bone loss in the 17 surviving implants. Tongue flaps are rarely used clinical entities with a very narrow range of indications. Tongue flaps are useful in the preprosthetic reconstruction of select cases with large residual oronasal fistulae with soft tissue deficits due to scarring from previously failed surgery. Tongue flaps are extremely stressful procedures for patients to endure. Patient selection is of the utmost importance. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  8. DHS osteosynthesis with internal bone grafting in unstable delayed presented intracapsular neck femur fractures.

    Science.gov (United States)

    Gadegone, Wasudeo M; Chandak, R M; Lokhande, Vijayanand R

    2017-08-01

    The aim of this study was to assess fracture union and complications following use of dynamic hip screw (DHS) with internal bone grafting in treatment of unstable delayed presented intracapsular neck femur fractures in patients younger than 65 years of age. Thirty two patients with displaced intracapsular neck femur fractures(Garden III and IV, Pauwels III, with comminution) with delayed presentation (15-60 days) in the 45-65 year age group (mean 54.4±10.2 years) were included in this study. All patients were treated with dynamic sliding hip screw with closed cancellous bone grafting through a tunnel of a triple reamer. The average time to union was 3.8 months (3-5 months). Satisfactory union was achieved in all patients except two. One case developed avascular necrosis of the femoral head. Other complications were coxa vara in two, shortening of less than 10mm in three cases but there were no cases of infection or implant failure. Excellent results were achieved in 27, good/fair in 4 and poor in 1 patient. Osteosynthesis with DHS and primary cancellous bone grafting in indicated cases is a simple, providing biological stimulation for early union. Failure in a particular case can be treated with any appropriate second procedure. © 2017 Elsevier Ltd. All rights reserved.

  9. Keratinized Gingiva Height Increases After Alveolar Corticotomy and Augmentation Bone Grafting.

    Science.gov (United States)

    Wilcko, M Thomas; Ferguson, Donald J; Makki, Laith; Wilcko, William M

    2015-10-01

    The aim of the present study is to compare the keratinized gingival tissue (KT) height labial to the mandibular incisors after active orthodontic treatment (AOT) with and without alveolar corticotomy and bone grafting. Two orthodontically treated groups of 35 patients each, with (Cort) and without (Conv) alveolar decortication and augmentation bone grafting, are matched in this case-control study for sample size, sex, mandibular premolar extractions, pretreatment age, post-treatment observation period, and pretreatment KT height. Standardized digital frontal occlusion photographs taken before and at least 1 year after AOT were adjusted to 96 dots per inch and measured with image analysis software for vertical KT height labial to each mandibular incisor. An average of 1.5 years after completion of AOT, KT height had increased significantly by 0.78 mm (P evidence-based studies, the value-added protection of KT height increase after decortication and augmentation bone grafting offsets the concerns of orthodontic proclination or expanding mandibular incisors facially.

  10. Morphological and mechanical characterization of chitosan-calcium phosphate composites for potential application as bone-graft substitutes

    Directory of Open Access Journals (Sweden)

    Guilherme Maia Mulder van de Graaf

    Full Text Available Introduction: Bone diseases, aging and traumas can cause bone loss and lead to bone defects. Treatment of bone defects is challenging, requiring chirurgical procedures. Bone grafts are widely used for bone replacement, but they are limited and expensive. Due to bone graft limitations, natural, semi-synthetic, synthetic and composite materials have been studied as potential bone-graft substitutes. Desirable characteristics of bone-graft substitutes are high osteoinductive and angiogenic potentials, biological safety, biodegradability, bone-like mechanical properties, and reasonable cost. Herein, we prepared and characterized potential bone-graft substitutes composed of calcium phosphate (CP - a component of natural bone, and chitosan (CS - a biocompatible biopolymer. Methods CP-CS composites were synthetized, molded, dried and characterized. The effect of drying temperatures (38 and 60 °C on the morphology, porosity and chemical composition of the composites was evaluated. As well, the effects of drying temperature and period of drying (3, 24, 48 and 72 hours on the mechanical properties - compressive strength, modulus of elasticity and relative deformation-of the demolded samples were investigated. Results Scanning electron microscopy and gas adsorption-desorption analyses of the CS-CP composites showed interconnected pores, indicating that the drying temperature played an important role on pores size and distribution. In addition, drying temperature have altered the color (brownish at 60 °C due to Maillard reaction and the chemical composition of the samples, confirmed by FTIR. Conclusion Particularly, prolonged period of drying have improved mechanical properties of the CS-CP composites dried at 38 °C, which can be designed according to the mechanical needs of the replaceable bone.

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

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    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. Clinical Results of Localized Alveolar Ridge Augmentation with Bone Grafts Harvested from Symphysis in Comparison with Ramus

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    Reza Pourabbas

    2007-06-01

    Full Text Available

    Background and aims. Autogenous onlay bone grafting is a common procedure for alveolar ridge augmentation. It has been suggested that the amount of healed bone after this technique would be significantly less than the initial quantity. The aim of this study was to determine the relationship between the various parameters influencing the outcome of ridge augmentation procedures.

    Materials and methods. Thirty-two patients, 17 males and 15 females (mean age 40 ± 8.66, requiring lateral ridge augmentation in the anterior maxilla were recruited. Bone grafts obtained from either the mandibular ramus or symphysis were grafted on the recipient site and the buccolingual dimensions of the edentulous ridge before and six months after the procedure were measured and the difference between them was considered as ridge augmentation (RA. Parameters including graft thickness (GT, graft area (GA and donor site (DS were also recorded.

    Results. Onlay bone grafts, taken from mandibular and symphysis areas, significantly increased the buccolingual dimension of the alveolar ridge (mean 1.98 ± 1.22 mm, p < 0.001. However, the mean RA by symphysis grafts was significantly greater than ramus grafts (2.49 mm vs. 1.48 mm. There was also a significant correlation between graft thickness, surface area and the amount of bone augmentation.

    Conclusion. Symphysis area provides thicker and larger grafts, which may result in a better clinical outcome in alveolar ridge augmentation.

  13. Chemical and physicochemical characterization of porous hydroxyapatite ceramics made of natural bone.

    Science.gov (United States)

    Joschek, S; Nies, B; Krotz, R; Göferich, A

    2000-08-01

    The properties of a porous hydroxyapatite ceramic produced by sintering of bovine bone were investigated by using a number of physicochemical methods such as scanning electron microscopy (SEM), SEM in combination with energy dispersive X-ray spectroscopy (SEM-EDX), mercury intrusion porosimetry, krypton-adsorption, contact angle measurements, wide angle X-ray diffraction. Fourier transform infrared spectroscopy, thermal analysis, inductively coupled plasma optical atom emissions spectroscopy and flame atomic absorption spectroscopy. The results indicate that there are considerable differences between the ceramic and native bone. However, the most important properties with respect to the use of such ceramics as a biomaterial for filling bone defects namely the high porosity (> or = 57 +/- 2%) and the interconnecting pore system are maintained. While macropores with an average diameter of approx. 300 microm contribute 97% to porosity, micropores with an average diameter of 1.3 microm account for only 3% of the total porosity. The surface area was found to be approx. 0.1 m2/g. The contact angles of water (44.6 +/- 15.4 degrees, n = 5) and tetrahydrofurane (10 degrees) allow the processing of the ceramic to a drug carrier by incubation with aqueous or organic drug solutions. The ceramic is highly crystalline with crystal sizes of 1-7 microm and contains crystal bridges. The investigation of its chemical composition revealed small amounts of other inorganic compounds such as Ca4O(PO4)2, NaCaPO4, Ca3(PO4)2, CaO, and MgO. Besides trace amounts of aluminum, iron, magnesium, potassium, silica, sodium, vanadium and zinc it contains probably carbonated apatite.

  14. Preparation and characterization of calcium phosphate ceramics and composites as bone substitutes

    Science.gov (United States)

    Zhang, Xing

    Marine CaCO3 skeletons have tailored architectures created by nature, which give them structural support and other functions. For example, seashells have dense lamellar structures, while coral, cuttlebone and sea urchin spines have interconnected porous structures. In our experiments, seashells, coral and cuttlebone were hydrothermally converted to hydroxyapatite (HAP), and sea urchin spines were converted to Mg-substituted tricalcium phosphate (beta-TCMP), while maintaining their original structures. Partially converted shell samples have mechanical strength, which is close to that of compact human bone. After implantation of converted shell and spine samples in rat femoral defects for 6 weeks, there was newly formed bone growth up to and around the implants. Some new bone was found to migrate through the pores of converted spine samples and grow inward. These results show good bioactivity and osteoconductivity of the implants, indicating the converted shell and spine samples can be used as bone defect fillers. Calcium phosphate powders were prepared through different synthesis methods. Micro-size HAP rods were synthesized by hydrothermal method through a nucleation-growth mechanism. On the other hand, HAP particles, which have good crystallinity, were prepared by wet precipitation with further hydrothermal treatment. beta-TCP or beta-TCMP powders were prepared by a two-step process: wet precipitation of apatitic tricalcium phosphate ('precursor') and calcination of the precursor at 800°C for 3 hours. beta-TCMP or beta-TCP powders were also prepared by solid-state reactions from CaHPO4 and CaCO 3 with/without MgO. Biphasic calcium phosphate, which is mixture of HAP and beta-TCP, can be prepared though mechanical mixing of HAP and beta-TCP powders synthesized as above. Dense beta-TCP and beta-TCMP ceramics can be produced by pressing green bodies at 100MPa and further sintering above 1100°C for 2 hours. beta-TCMP ceramics ˜99.4% relative dense were prepared by

  15. Skoog Primary Periosteoplasty versus Secondary Alveolar Bone Grafting in Unilateral Cleft Lip and Alveolus: Long-Term Effects on Alveolar Bone Formation and Maxillary Growth.

    Science.gov (United States)

    Jabbari, Fatima; Hakelius, Malin M; Thor, Andreas L I; Reiser, Erika A; Skoog, Valdemar T; Nowinski, Daniel J

    2017-01-01

    Clefts involving the alveolus are treated using one of two strategies: primary periosteoplasty at the time of lip repair or secondary alveolar bone grafting at mixed dentition. Most teams favor secondary alveolar bone grafting because of its high success rate, and concerns have been raised that primary periosteoplasty may interfere with maxillary growth. However, primary periosteoplasty may obviate the need for future bone grafting and is still practiced in some centers. Few studies compare the long-term outcomes of these two strategies. Fifty-seven consecutive patients born with unilateral cleft lip and alveolus were studied retrospectively. All patients underwent primary lip repair using Skoog's method; 28 patients underwent primary periosteoplasty at the time of lip repair and the remaining 29 underwent secondary alveolar bone grafting at mixed dentition. Occlusal radiographs obtained at ages 10 and 16 years were analyzed for alveolar bone height. Cephalometric analysis assessed growth at ages 5, 10, and 18 years. Seventeen of 28 patients treated using primary periosteoplasty required later secondary bone grafting, and the bone height at age 16 years was lower in the primary periosteoplasty group (p < 0.0001). There was a more pronounced decrease in maxillary protrusion from ages 5 to 10 years in the primary periosteoplasty group (p < 0.03). However, at age 18 there was no significant difference in maxillary growth between the two groups. Primary periosteoplasty did not seem to inhibit long-term maxillary growth but was ineffective as a method of reconstructing the alveolar cleft. Therapeutic, III.

  16. An in vivo swine study for xeno-grafts of calcium sulfate-based bone grafts with human dental pulp stem cells (hDPSCs).

    Science.gov (United States)

    Kuo, Tzong-fu; Lee, Sheng-Yang; Wu, Hong-Da; Poma, Malosi; Wu, Yu-Wei; Yang, Jen-Chang

    2015-05-01

    The purpose of this in vivo study was to evaluate the effect of human dental pulp stem cells (hDPSCs) on various resorbable calcium sulfate/calcium phosphate bone grafts in bone regeneration. Granular particles of calcium sulfate dehydrate (CSD), α-calcium sulfate hemihydrate/amorphous calcium phosphate (α-CSH/ACP), and CSD/β-tricalcium phosphates (β-TCP) were prepared for in vitro dissolution and implantation test. The chemical compositions of specimen residues after dissolution test were characterized by XRD. The ratios of new bone formation for implanted grafts/hDPSCs were evaluated using mandible bony defect model of Lanyu pig. All the graft systems exhibited a similar two-stage dissolution behavior and phase transformation of poor crystalline HAp. Eight weeks post-operation, the addition of hDPSCs to various graft systems showed statistically significant increasing in the ratio of new bone formation (pbone regeneration was rejected. The results suggest that the addition of hDPSCs to calcium sulfate based xenografts could enhance the bone regeneration in the bony defect. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Stem cells in bone grafting: Trinity allograft with stem cells and collagen/beta-tricalcium phosphate with concentrated bone marrow aspirate.

    Science.gov (United States)

    Guyton, Gregory P; Miller, Stuart D

    2010-12-01

    The orthopedic foot and ankle surgeon needs bone grafts in the clinical situation of fracture healing and in bone-fusion procedures. This article briefly outlines thought processes and techniques for 2 recent options for the surgeon. The Trinity product is a unique combination of allograft bone and allograft stem cells. The beta-tricalcium phosphate and collagen materials provide an excellent scaffold for bone growth; when combined with concentrated bone marrow aspirate, they also offer osteoconductive and osteoinductive as well as osteogenerative sources for new bone formation. Copyright © 2010. Published by Elsevier Inc.

  18. 8-10 year follow-up survival of dental implants in maxillae with or without autogenous bone graft reconstruction.

    Science.gov (United States)

    de Moraes, Paulo H; Olate, Sergio; Lauria, Andrezza; Asprino, Luciana; de Moraes, Márcio; de Albergaria-Barbosa, José Ricardo

    2015-01-01

    The aim of this research was to ascertain the survival of implants installed in the atrophic maxillae of patients treated with or without autogenous bone graft at 8 to 10 years of follow-up. A retrospective study was conducted using clinical and imaging analysis. 42 adult patients were selected, treated with osseointegrated implants in a fixed maxillary prosthesis model with suprastructure using 6 to 8 implants; of these, 22 underwent reconstruction with a bone graft taken from the anterior iliac crest and 20 were treated without any type of bone graft. The sequence of removal, installation and management of the grafts followed routine patterns, and the implant installation and prosthesis preparation also followed parameters established in previous publications. Variables of implant survival, stage of loss and bone stability of the implants were analyzed with the Wilcoxon signed-rank test, considering a value of Pbone graft group, where 8.0% of implants were lost in the pre-loading stage, 3.7% in the post-loading stage and 88.7% had complete survival. In the group without bone graft, 6.17% were lost in the pre-loading stage, 1.85% in the post-loading stage and 90.97% had complete survival. There was no significant difference in the survival of the implants between the two groups (P=0.082). Cervical bone loss between the groups showed no significant differences either (P=0.241). The implants in grafted maxillae with cases of severe maxillary atrophy are just as efficient as implants installed in maxillae without bone graft.

  19. Two-stage reconstruction of the severely deficient alveolar ridge: bone graft followed by alveolar distraction osteogenesis.

    Science.gov (United States)

    Rachmiel, A; Emodi, O; Aizenbud, D; Rachmiel, D; Shilo, D

    2018-01-01

    Distraction osteogenesis for the augmentation of severe alveolar bone deficiency has gained popularity during the past two decades. In cases where the vertical bone height is not sufficient to create a stable transport segment, performing alveolar distraction osteogenesis (ADO) is not possible. In these severe cases, a two-stage treatment protocol is suggested: onlay bone grafting followed by ADO. An iliac crest onlay bone graft followed by ADO was performed in 13 patients: seven in the mandible and six in the maxilla. Following ADO, endosseous implants and prosthetic restorations were placed. In all cases, the onlay bone graft resulted in inadequate height for implant placement, but allowed ADO to be performed. ADO was performed to a mean total vertical augmentation of 13.7mm. Fifty-two endosseous implants were placed. During a mean follow-up of 4.85 years, two implants failed, both during the first 6 months; the survival rate was 96.15%. In severe cases lacking the required bone for ADO, using an onlay bone graft as a first stage treatment increases the bone height thus allowing ADO to be performed. This article describes a safe and stable two-stage treatment modality for severely atrophic cases, resulting in sufficient bone for implant placement and correction of the inter-maxillary vertical relationship. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite as a potential bone graft substitute material

    Science.gov (United States)

    Florschutz, Anthony Vatroslav

    Utilization of bone grafts for the treatment of skeletal pathology is a common practice in orthopaedic, craniomaxillofacial, dental, and plastic surgery. Autogenous bone graft is the established archetype but has disadvantages including donor site morbidity, limited supply, and prolonging operative time. In order to avoid these and other issues, bone graft substitute materials are becoming increasingly prevalent among surgeons for reconstructing skeletal defects and arthrodesis applications. Bone graft substitutes are biomaterials, biologics, and guided tissue/bone regenerative devices that can be used alone or in combinations as supplements or alternatives to autogenous bone graft. There is a growing interest and trend to specialize graft substitutes for specific indications and although there is good rationale for this indication-specific approach, the development and utility of a more universal bone graft substitute may provide a better answer for patients and surgeons. The aim of the present research focuses on the design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite composites for potential use as a bone graft substitutes. After initial establishment of rational material design, gelatinhydroxyapatite scaffolds were fabricated with different gelatin:hydroxyapatite ratios and crosslinking concentrations. The synthesized scaffolds were subsequently evaluated on the basis of their swelling behavior, porosity, density, percent composition, mechanical properties, and morphology and further assessed with respect to cell-biomaterial interaction and biomineralization in vitro. Although none of the materials achieved mechanical properties suitable for structural graft applications, a reproducible material design and synthesis was achieved with properties recognized to facilitate bone formation. Select scaffold formulations as well as a subset of scaffolds loaded with recombinant human bone morphogenetic protein-2 were

  1. [Resection of an aneurysmal bone cyst in the proximal humerus with a non-vascularized fibular graft. Case report].

    Science.gov (United States)

    Lima-Ramírez, P G; Chavarría-Jacinto, J; Martínez-Asención, P; Montiel-Jarquín, A J; Barragán-Hervella, R G; Salvatori-Rubí, J J; Domínguez-Cid, M I

    2015-01-01

    An aneurysmal bone cyst is a benign lesion involving the marrow of long bones; it accounts for 6% of primary bone lesions and may occur as a secondary lesion with other benign or malignant bone tumors. We describe herein the case of a seven year-old female with an aneurysmal bone cyst which was diagnosed clinically, radiographically and with a CAT scan, and confirmed with histopathology. Resection was performed using the eggshell technique and a non-vascularized left fibular bone graft. The patient did well up to the fourth postoperative year, which is consistent with what has been reported in world literature.

  2. Correction of mandibular nonunion and malocclusion by plate fixation and autogenous cortical bone grafts in two dogs.

    Science.gov (United States)

    Boudrieau, R J; Tidwell, A S; Ullman, S L; Gores, B R

    1994-03-01

    Two dogs were treated for severe malocclusion secondary to segmental defects in the mandibular bodies as a result of nonhealing mandibular fractures. The problems of fibrous nonunions with large fracture gaps, the potential for infection, and the severe malocclusion were addressed in considering definitive surgical correction. The segmental defects in both dogs were spanned by use of autogenous cortical grafts (full-thickness rib segments or full cortical diaphyseal ulnar segments), supplemented with autogenous cancellous graft, and were stabilized with screw-and-plate fixation. Radiographic evaluation of bone healing and graft incorporation was difficult because of the implants, which obscured full observation of the bone graft sites. Successful graft revascularization, determined by 99mradiophosphate localization, was shown in both dogs; fairly uniform isotope uptake was observed throughout the graft sites and was continuous with the recipient bone. Mildly increased uptake was observed at 6 months and at 1 year after surgery and was considered consistent with remodeling associated with fracture healing. Observation of complete graft revascularization within 1 year provided ample evidence that the autografts were incorporated, with sufficient remodeling to characterize bone union.

  3. 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.

  4. Anterior Cruciate Ligament-Derived Stem Cells Transduced With BMP2 Accelerate Graft-Bone Integration After ACL Reconstruction.

    Science.gov (United States)

    Kawakami, Yohei; Takayama, Koji; Matsumoto, Tomoyuki; Tang, Ying; Wang, Bing; Mifune, Yutaka; Cummins, James H; Warth, Ryan J; Kuroda, Ryosuke; Kurosaka, Masahiro; Fu, Freddie H; Huard, Johnny

    2017-03-01

    Strong graft-bone integration is a prerequisite for successful graft remodeling after reconstruction of the anterior cruciate ligament (ACL) using soft tissue grafts. Novel strategies to accelerate soft tissue graft-bone integration are needed to reduce the need for bone-tendon-bone graft harvest, reduce patient convalescence, facilitate rehabilitation, and reduce total recovery time after ACL reconstruction. The application of ACL-derived stem cells with enhanced expression of bone morphogenetic protein 2 (BMP2) onto soft tissue grafts in the form of cell sheets will both accelerate and improve the quality of graft-bone integration after ACL reconstruction in a rat model. Controlled laboratory study. ACL-derived CD34+ cells were isolated from remnant human ACL tissues, virally transduced to express BMP2, and embedded within cell sheets. In a rat model of ACL injury, bilateral single-bundle ACL reconstructions were performed, in which cell sheets were wrapped around tendon autografts before reconstruction. Four groups containing a total of 48 rats (96 knees) were established (n = 12 rats; 24 knees per group): CD34+BMP2 (100%), CD34+BMP2 (25%), CD34+ (untransduced), and a control group containing no cells. Six rats from each group were euthanized 2 and 4 weeks after surgery, and each graft was harvested for immunohistochemical and histological analyses. The remaining 6 rats in each group were euthanized at 4 and 8 weeks to evaluate in situ tensile load to failure in each femur-graft-tibia complex. In vitro, BMP2 transduction promoted the osteogenic differentiation of ACL-derived CD34+ cells while retaining their intrinsic multipotent capabilities. Osteoblast densities were greatest in the BMP2 (100%) and BMP2 (25%) groups. Bone tunnels in the CD34+BMP2 (100%) and CD34+BMP2 (25%) groups had the smallest cross-sectional areas according to micro-computed tomography analyses. Graft-bone integration occurred most rapidly in the CD34+BMP2 (25%) group. Tensile load to

  5. Directly auto-transplanted mesenchymal stem cells induce bone formation in a ceramic bone substitute in an ectopic sheep model

    Science.gov (United States)

    Boos, Anja M; Loew, Johanna S; Deschler, Gloria; Arkudas, Andreas; Bleiziffer, Oliver; Gulle, Heinz; Dragu, Adrian; Kneser, Ulrich; Horch, Raymund E; Beier, Justus P

    2011-01-01

    Abstract Bone tissue engineering approaches increasingly focus on the use of mesenchymal stem cells (MSC). In most animal transplantation models MSC are isolated and expanded before auto cell transplantation which might be critical for clinical application in the future. Hence this study compares the potential of directly auto-transplanted versus in vitro expanded MSC with or without bone morphogenetic protein-2 (BMP-2) to induce bone formation in a large volume ceramic bone substitute in the sheep model. MSC were isolated from bone marrow aspirates and directly auto-transplanted or expanded in vitro and characterized using fluorescence activated cell sorting (FACS) and RT-PCR analysis before subcutaneous implantation in combination with BMP-2 and β-tricalcium phosphate/hydroxyapatite (β-TCP/HA) granules. Constructs were explanted after 1 to 12 weeks followed by histological and RT-PCR evaluation. Sheep MSC were CD29+, CD44+ and CD166+ after selection by Ficoll gradient centrifugation, while directly auto-transplanted MSC-populations expressed CD29 and CD166 at lower levels. Both, directly auto-transplanted and expanded MSC, were constantly proliferating and had a decreasing apoptosis over time in vivo. Directly auto-transplanted MSC led to de novo bone formation in a heterotopic sheep model using a β-TCP/HA matrix comparable to the application of 60 μg/ml BMP-2 only or implantation of expanded MSC. Bone matrix proteins were up-regulated in constructs following direct auto-transplantation and in expanded MSC as well as in BMP-2 constructs. Up-regulation was detected using immunohistology methods and RT-PCR. Dense vascularization was demonstrated by CD31 immunohistology staining in all three groups. Ectopic bone could be generated using directly auto-transplanted or expanded MSC with β-TCP/HA granules alone. Hence BMP-2 stimulation might become dispensable in the future, thus providing an attractive, clinically feasible approach to bone tissue engineering. PMID

  6. Comparative evaluation of bovine derived hydroxyapatite and synthetic hydroxyapatite graft in bone regeneration of human maxillary cystic defects: A clinico-radiological study

    Directory of Open Access Journals (Sweden)

    Vivekanand S Kattimani

    2014-01-01

    Conclusion: Both BHA and SHA graft materials are biocompatible for filling bone defects, showing less resorption and enhanced bone formation with similar efficacy. Our study showed maximum bone healing within 12 weeks of grafting of defects. The BHA is economical; however, price difference between the two is very nominal.

  7. Controlling surface microstructure of calcium phosphate ceramic from random to custom-design

    NARCIS (Netherlands)

    Wang, Liao; Luo, Xiaoman; Barbieri, D.; Bao, Chongyun; Yuan, Huipin

    2014-01-01

    Calcium phosphate ceramics have long been studied as bone graft substitutes due to their similarity with the mineral constitute of bone and teeth, excellent biocompatibility and bioactivity. Chemical composition, macrostructure and surface microstructure are believed to be important for the bone

  8. Treatment of a large aneurysmal bone cyst in a 15-year-old boy using a corticospongial bone graft and a 12-year follow-up after operation.

    Science.gov (United States)

    von Kieseritzky, Johanna; Widenfalk, Bertil

    2012-04-01

    We report the case of a 15-year-old boy with a large aneurysmal bone cyst in the third metacarpal, which was operated on radically with excision of the bone and grafting from the distal radius. At 12-year follow-up the patient had good cosmetic results and a perfectly functioning hand.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Engineering vascularized bone grafts by integrating a biomimetic periosteum and β-TCP scaffold.

    Science.gov (United States)

    Kang, Yunqing; Ren, Liling; Yang, Yunzhi

    2014-06-25

    Treatment of large bone defects using synthetic scaffolds remain a challenge mainly due to insufficient vascularization. This study is to engineer a vascularized bone graft by integrating a vascularized biomimetic cell-sheet-engineered periosteum (CSEP) and a biodegradable macroporous beta-tricalcium phosphate (β-TCP) scaffold. We first cultured human mesenchymal stem cells (hMSCs) to form cell sheet and human umbilical vascular endothelial cells (HUVECs) were then seeded on the undifferentiated hMSCs sheet to form vascularized cell sheet for mimicking the fibrous layer of native periosteum. A mineralized hMSCs sheet was cultured to mimic the cambium layer of native periosteum. This mineralized hMSCs sheet was first wrapped onto a cylindrical β-TCP scaffold followed by wrapping the vascularized HUVEC/hMSC sheet, thus generating a biomimetic CSEP on the β-TCP scaffold. A nonperiosteum structural cell sheets-covered β-TCP and plain β-TCP were used as controls. In vitro studies indicate that the undifferentiated hMSCs sheet facilitated HUVECs to form rich capillary-like networks. In vivo studies indicate that the biomimetic CSEP enhanced angiogenesis and functional anastomosis between the in vitro preformed human capillary networks and the mouse host vasculature. MicroCT analysis and osteocalcin staining show that the biomimetic CSEP/β-TCP graft formed more bone matrix compared to the other groups. These results suggest that the CSEP that mimics the cellular components and spatial configuration of periosteum plays a critical role in vascularization and osteogenesis. Our studies suggest that a biomimetic periosteum-covered β-TCP graft is a promising approach for bone regeneration.

  11. Nonunion of the femur treated with conventional osteosynthesis combined with autogenous and strut allogeneic bone grafts.

    Science.gov (United States)

    Weng, Lin-Hsiu; Wang, Jun-Wen

    2004-04-01

    In this study, we reviewed the results of conventional osteosynthesis combined with strut onlay allografts and autogenous bone grafts as the treatment for nonunion of the femur. We conducted a retrospective study of 18 patients with nonunion of the femur treated with internal fixation (eight 95 degree fixed-angled blade plates, 7 intramedullary nails, 2 dynamic hip compression plates and screws, and 1 condylar buttress plate) and autogenous bone grafts and cortical strut allografts. There were 1.8 operations on average before surgery. The average time from the initial treatment of the fracture or osteotomy to surgery was 32.5 months. The average follow-up was 32.2 months. All 18 nonunions had healed by the time of follow-up. Positive intraoperative cultures (Staphylococcus epidermidis) in 2 patients were resolved by parenteral antibiotics with no additional treatment. Removal of implants was required in 5 patients because of screw irritation or bony union. One concomitant quadricepsplasty as well as 2 excisions of a protruding graft were required because of restricted knee motion or impingement. For difficult nonunions of the femur in the current study, strict adherence to the principles of the treatment of nonunion and the addition of strut allografts to enhance stability and repair potential proved to be a good alternative.

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

    Science.gov (United States)

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

    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 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. PMID:25692166

  13. 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.

  14. Bone graft in the treatment of nonunion of the scaphoid with necrosis of the proximal pole: a literature review.

    Science.gov (United States)

    Severo, Antônio Lourenço; Lemos, Marcelo Barreto; Lech, Osvandré Luiz Canfield; Barreto Filho, Danilo; Strack, Daniel Paulo; Candido, Larissa Knapp

    2017-01-01

    Scaphoid fractures are the most common fractures of the carpal bones, corresponding to 60%. Of these, 10% progress to nonunion; moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized and non-vascularized bone grafts. To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different surgical techniques. The authors conducted a review of the literature using the following databases: PubMed and BIREME/LILACS, where 13 case series were selected (ten with use of vascularized bone grafts and three of non-vascularized bone grafts), according to inclusion and exclusion criteria. In most cases VBGs were used, especially those based on the 1,2 intercompartmental supraretinacular artery, due to greater reproducibility in performing the surgical technique.

  15. Ununited diaphyseal forearm fractures with segmental defects: plate fixation and autogenous cancellous bone-grafting.

    Science.gov (United States)

    Ring, David; Allende, Christian; Jafarnia, Koroush; Allende, Bartolome T; Jupiter, Jesse B

    2004-11-01

    With current techniques of plate-and-screw fixation, diaphyseal nonunions of the radius and ulna are unusual. The few reports that have been published have discussed the use of structural corticocancellous bone grafts for the treatment of atrophic nonunions that are associated with osseous defects. We reviewed the rate of union and the functional results in association with the use of plate-and-screw fixation and autogenous cancellous (nonstructural) bone grafts. Thirty-five patients with an atrophic ununited diaphyseal fracture of the forearm were treated with 3.5-mm plate-and-screw fixation and autogenous cancellous bone-grafting. A segmental osseous defect with an average size of 2.2 cm (range, 1 to 6 cm) was present in each patient. Twenty of the original fractures had been open. Eleven patients had had treatment of a deep infection before referral to us. The nonunion involved both forearm bones in eight patients, the radius alone in sixteen patients, and the ulna alone in eleven patients. The atrophic nonunion was associated with an open fracture in twenty patients, suboptimal fixation in twenty-two, a fracture-dislocation of the forearm in nine, and infection in eleven. All fractures healed without additional intervention within six months. Two patients had a subsequent Darrach resection of the distal part of the ulna for the treatment of arthrosis of the distal radioulnar joint. After an average duration of follow-up of forty-three months, the final arc of motion averaged 121 degrees in the forearm, 131 degrees at the elbow, and 137 degrees at the wrist, with an average grip strength of 83% compared with that of the contralateral limb. According to the system of Anderson and colleagues, five patients had an excellent result, eighteen had a satisfactory result, eleven had an unsatisfactory result (because of elbow stiffness related to associated elbow injuries in three and because of wrist stiffness in eight), and one had a poor result (because of malunion

  16. The use of freeze-dried bone allograft as an alternative to autogenous bone graft in the atrophic maxilla: a 3-year clinical follow-up.

    Science.gov (United States)

    Bianchini, Marco Aurélio; Buttendorf, André R; Benfatti, César A M; Bez, Leonardo Vieira; Ferreira, Cimara Fortes; de Andrade, Rafael Fonseca

    2009-12-01

    Freeze-dried bone allograft is an interesting treatment alternative to autogenous bone grafts. This clinical report presents a 3-year follow-up of an atrophic maxilla treated with freeze-dried bone allograft. Ridge augmentation was conducted with freeze-dried tibial allografts. Eight implants were used to support a full-arch prosthesis. Three years later, clinical and radiographic follow-up showed bone surrounding the dental implants. Histologic sections showed the presence of biologically active bone. This clinical case supports the use of freeze-dried allograft as an alternative for the reconstruction of the atrophic maxilla.

  17. Perforated sigmoid diverticulitis in a lumbar hernia after iliac crest bone graft - a case report

    Science.gov (United States)

    2014-01-01

    Background The combination of perforated diverticulitis in a lumbar hernia constitutes an extremely rare condition. Case presentation We report a case of a 66 year old Caucasian woman presenting with perforated sigmoid diverticulitis localized in a lumbar hernia following iliac crest bone graft performed 18 years ago. Emergency treatment consisted of laparoscopic peritoneal lavage. Elective sigmoid resection was scheduled four months later. At the same time a laparoscopic hernia repair with a biologic mesh graft was performed. Conclusion This case shows a very seldom clinical presentation of lumbar hernia. Secondary colonic resection and concurrent hernia repair with a biologic implant have proven useful in treating this rare condition. PMID:25051974

  18. Polymer-ceramic nanocomposites for applications in the bone surgery

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    Stodolak, E; Gadomska, K [AGH - University of Science and Technology, Faculty of Materials Science and Ceramics, Department of Biomaterials, al. Mickiewicza 30, 30-059 Krakow (Poland); Lacz, A [AGH - University of Science and Technology, Faculty of Materials Science and Ceramics, Department of Inorganic Chemistry, al. Mickiewicza 30, 30-059 Krakow (Poland); Bogun, M [Technical University of Lodz, Faculty of Textile Engineering and Marketing, Department of Man-Made Fibres, 50-952 Lodz (Poland)], E-mail: stodolak@agh.edu.pl

    2009-01-01

    The subject of this work was preparation and investigation of properties of a nanocomposite material based on polymer matrix modified with nanometric silica particles (SiO{sub 2}). The composite matrix consisted of resorbable P(L/DL)LA polymer with certified biocompatibility. Nanometric silica was introduced into the matrix by means of ultrasonic homogenisation and/or mechanical stirring. The silica was introduced directly e.g. as nanoparticles or inside calcium alginate fibres which contained 3 wt.% of amorphous SiO{sub 2}. Proper dispersion of nano-filliers was confirmed by means of thermal analysis (TG/DTA, DSC). It was observed, that the presence of inorganic nanoparticles influenced several surface parameters of the nanocomposites i.e. hydrophility (a decrease of surface energy) and topography (both in micro- and nano-scale). Additionally, the nanocomposites exhibited enhanced mechanical properties (Young's modulus, tensile strength) compared to the pure polymer. The nanocomposites were bioactive materials (SBF/3 days/37 deg. C). Biological tests (MTT test) showed a good viability of human osteoblasts (hFOB 1.19) in contact with the nanocomposites surface. Results of preliminary biological tests carried out with the use of mother cells extracted from human bone marrow showed that the nanocomposites may provide differenation of bone cells.

  19. Polymer-ceramic nanocomposites for applications in the bone surgery

    Science.gov (United States)

    Stodolak, E.; Gadomska, K.; Lacz, A.; Bogun, M.

    2009-01-01

    The subject of this work was preparation and investigation of properties of a nanocomposite material based on polymer matrix modified with nanometric silica particles (SiO2). The composite matrix consisted of resorbable P(L/DL)LA polymer with certified biocompatibility. Nanometric silica was introduced into the matrix by means of ultrasonic homogenisation and/or mechanical stirring. The silica was introduced directly e.g. as nanoparticles or inside calcium alginate fibres which contained 3 wt.% of amorphous SiO2. Proper dispersion of nano-filliers was confirmed by means of thermal analysis (TG/DTA, DSC). It was observed, that the presence of inorganic nanoparticles influenced several surface parameters of the nanocomposites i.e. hydrophility (a decrease of surface energy) and topography (both in micro- and nano-scale). Additionally, the nanocomposites exhibited enhanced mechanical properties (Young's modulus, tensile strength) compared to the pure polymer. The nanocomposites were bioactive materials (SBF/3 days/37oC). Biological tests (MTT test) showed a good viability of human osteoblasts (hFOB 1.19) in contact with the nanocomposites surface. Results of preliminary biological tests carried out with the use of mother cells extracted from human bone marrow showed that the nanocomposites may provide differenation of bone cells.

  20. 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.

  1. Clinical and 3-Dimensional Radiographic Evaluation of Autogenous Iliac Block Bone Grafting and Guided Bone Regeneration in Patients With Atrophic Maxilla.

    Science.gov (United States)

    Gultekin, B Alper; Cansiz, Erol; Borahan, M Oguz

    2017-04-01

    To evaluate the rate of graft resorption in autogenous iliac bone grafting (IBG) and guided bone regeneration (GBR) in patients with atrophic maxillae. We performed a retrospective study involving patients requiring implant placement who underwent IBG or GBR. Volumetric changes of the graft sites were evaluated by imaging studies. The primary predictor and outcome variables were augmentation technique and rate of volumetric resorption, respectively. Secondary outcome variables included bone gain, success of grafting, insertion torque of implants, and requirement for vestibuloplasty. The sample comprised 39 patients (21 with GBR and 18 with IBG). One patient in the IBG group had temporary sensory disturbance at the donor site, and one patient in the GBR group had late exposure of the nonresorbable membrane. The average values of percent volume reduction in the GBR and IBG groups were 12.26% ± 2.35% and 35.94% ± 7.94%, respectively, after healing and 15.87% ± 1.99% and 41.62% ± 6.97%, respectively, at last follow-up. The IBG group exhibited a significantly higher reduction in bone volume than the GBR group at both time points (P = .001). The mean values of horizontal and vertical bone gain after healing in the IBG group were significantly higher than those in the GBR group (P = .006 and P = .001, respectively). The mean implant torque during implant placement in the GBR group was significantly higher than that in the IBG group (P = .024). There was no significant difference in the requirement for vestibuloplasty between the two groups (P > .05). Although both hard tissue augmentation approaches provide an adequate volume of bone graft for implant insertion, IBG results in greater graft resorption at maxillary augmented sites than GBR. Clinicians should consider the differences in the extent of graft resorption between the two methods while choosing the treatment approach. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published

  2. Injectable bone-graft substitutes: current products, their characteristics and indications, and new developments.

    Science.gov (United States)

    Larsson, Sune; Hannink, Gerjon

    2011-09-01

    More than a decade has passed since the first injectable bone substitutes were introduced for use in orthopaedic trauma, and over recent years the number of commercial products has increased dramatically. Despite the fact that these bone substitutes have been on the market for many years, knowledge amongst potential users on how and when they might be useful is still fairly limited. Most injectable bone substitutes belong to one of two major groups: by far the largest group contains products based on various calcium phosphate (CP) mixtures, whilst the smaller group consists of calcium sulphate (CS) compounds. Following mixing, the CP or CS paste can be injected into--for instance--a fracture space for augmentation as an alternative to bone graft, or around a screw for augmentation if the bone is weak. Within minutes an in situ process makes the substitute hard; the mechanical strength in compression resembles that of cancellous bone, whereas the strength in bending and shear is lower. Over time, CP products undergo remodelling through a cell-mediated process that seems to mimic the normal bone remodelling, whilst CS products are dissolved through a faster process that is not cell-mediated. For CP, a number of clinical studies have shown that it can be useful for augmentation of metaphyseal fractures when a space is present. Randomised studies have verified that CP works especially well in tibial plateau fractures when compared with conventional bone grafting. So far the number of clinical studies on CS products is very low. Development at present seems to be heading towards premixed or directly mixed products as well as new compounds that contain fibres or other components to enhance bending and shear strength. Products that are based on combinations of CP and CS are also being developed to combine the fast-dissolving CS with the stronger and more slowly remodelling CP. Injectable bone substitutes, and especially CS, have also been targeted as potentially good

  3. [Graft integration in the lumbar spine of bovine cancellous bone compared to autologous iliac crest in a sheep model].

    Science.gov (United States)

    Strohm, P C; Kubosch, D C; Sprecher, C M; Schmal, H; Südkamp, N P; Milz, S

    2010-12-01

    Spinal injuries are common and a standard procedure for the stabilisation of spinal injuries is ventral spondylodesis with an autograft from the iliac crest. Because of the high incidence of harvesting complications there is a need to search for alternative materials. The aim of our study was to evaluate graft integration in the lumbar spine of bovine cancellous bone compared to autologous iliac crest material. Two groups of eight female adult sheep (median age 3 years, range 2.4-3.8 years) received surgical treatment in the form of anterior monosegmental spondylodesis. The spondylodesis was performed in all animals in the motion segment L3/4 through a lateral approach with the animals lying on their right sides. To produce serial sections, the explanted vertebral segments were implanted in methyl methacrylate. On one side the histological preparation was examined qualitatively and in addition we analysed the quantity of the bone structure with special software. The bone structure in both groups did not differ significantly and demonstrated integration of the grafts in the adjacent vertebral bodies. Fractures and lysis occurred in the region of the intervertebral disc and were more frequent in the group with the bovine graft. The bony integration of the grafts of both groups was not significantly different and showed good results. Almost all of the bovine grafts fractured or presented regions of lysis. In our opinion bovine cancellous bone graft is not a good alternative to autologous iliac crest. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Treatment of alveolar cleft performing a pyramidal pocket and an autologous bone grafting.

    Science.gov (United States)

    Morselli, Paolo Giovanni; Giuliani, Renzo; Pinto, Valentina; Oranges, Carlo Maria; Negosanti, Luca; Tavaniello, Beatrice; Morellini, Andrea

    2009-09-01

    Alveolar cleft repair is a debate topic in cleft lip and palate treatment.The aim of this article is to analyze the outcomes and the advantages of the autologous bone grafting performed during the period between 1981 and 2006. In our plastic surgery unit, 468 patients with alveolar clefts have been treated. According to our protocol, the timing for the closure of the alveolar cleft ranged from 7 to 11 years (mean, 9.4 years). Autologous bone was taken from the skull in the 45% of patients, from the iliac crest in 35% of cases, and from the chin in 20% of cases. The surgical technique of creating a pyramidal pocket to secure the bone graft was central to achieving a good result. The postoperative evaluation of the results, using clinical criteria and endoral radiography, orthopantomography, and teleradiography at 3, 6, 12 months after surgery, and more recently, in the last 82 cases by a three-dimensional computed tomography, allows us to assert that we obtained optimal results in 50% of treated cases, good results in 40%, sufficient in 4%, partial failure in 5.4%, and complete failure in 0.6%.

  5. CT appearances of unilateral cleft palate 20 years after bone graft surgery.

    Science.gov (United States)

    Kolbenstvedt, A; Aaløkken, T M; Arctander, K; Johannessen, S

    2002-11-01

    To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Although adherence to the present treatment protocol is considered to give satisfactory functional and cosmetic results, certain abnormalities persist. A knowledge of these is a prerequisite for a complete and final evaluation of the surgical and orthodontic regimen.

  6. Sacrospinalis muscle-pedicle bone graft in posterolateral fusion for spondylolisthesis.

    Science.gov (United States)

    Baksi, D P

    1998-01-01

    Twenty three patients with lumbar spondylolisthesis (6 Grade I, 14 Grade II and 3 Grade III) with low back pain, and radicular pain in 14, were treated surgically when they failed to respond to conservative treatment. Their average age was 33.2 years. Bilateral posterolateral spinal fusions with autologous iliac bone chips, supplemented by a sacrospinalis muscle-pedicle bone graft on the left side, were undertaken after laminectomy and foraminotomy in all except in two adolescents, where laminectomy and foraminotomy were avoided. The period of follow-up varied from 26 to 126 months (average 65.3 months). The results in 11 (48%) patients were excellent, 9 (39%) were good, 2 (9%) fair and one (4%) poor. There was a higher incidence (87%) of good quality of osseous fusion on the left side, where the sacrospinalis muscle-pedicle bone graft was used, compared to the right, where 70% of fusions were satisfactory. Function improved in 91% of the patients. Neither scoliosis nor weakness of the extensor muscles of the back developed due to reanchorage of the sacrospinalis muscle to the lumbosacral spines.

  7. CT appearances of unilateral cleft palate 20 years after bone graft surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kolbenstvedt, A.; Aaloekken, T.M. [Rikshospitalet, Oslo (Norway). Dept. of Radiology; Arctander, K. [Rikshospitalet, Oslo (Norway). Dept. of Plastic Surgery; Johannessen, S. [Inst. of Clinical Dentistry, Oslo (Norway)

    2002-11-01

    Purpose: To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Material and Methods: Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Results: Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Conclusion: Although adherence to the present treatment protocol is considered to give satisfactory functional and cosmetic results, certain abnormalities persist. A knowledge of these is a prerequisite for a complete and final evaluation of the surgical and orthodontic regimen. Cleft palate nasal cavity abnormalities CT.

  8. 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

  9. Optimal microvessel density from composite graft of autogenous maxillary cortical bone and anorganic bovine bone in sinus augmentation: influence of clinical variables.

    Science.gov (United States)

    Galindo-Moreno, Pablo; Padial-Molina, Miguel; Fernández-Barbero, Juan Emilio; Mesa, Francisco; Rodríguez-Martínez, Dolores; O'Valle, Francisco

    2010-02-01

    The objectives of this study were to assess the microvessel density (MVD) of intra-sinus grafts after 6 months of wound healing and to study the relationship between revascularization processes and patient clinical variables and habits. We performed 45 maxillary sinus augmentations with different implant placements in 25 consecutive patients, obtaining bone cores of the grafted area for histological, histomorphometric and immunohistochemical study. Biopsies were also taken from pristine bone in the posterior maxilla (control). All implants survived at 24 months. Biopsies of sinus augmentation areas showed significantly greater remodeling activity vs. pristine bone, with significantly more osteoid lines. The morphometry study revealed 34.88+/-15.2% vital bone, 32.02+/-15.1% non-mineralized tissue and 33.08+/-25.4% remnant anorganic bovine bone particles. The number of CD34-positive vessels was 86.28+/-55.52/mm(2) in graft tissue vs. 31.52+/-13.69/mm(2) in native tissue (P=0.002, Mann-Whitney U=46). The larger amount of non-mineralized tissue in grafts was directly correlated with a higher MVD (r=0.482, P=0.0001, Pearson's test). MVD was affected by the presence of periodontitis or tobacco and alcohol consumption. The angiogenesis and revascularization obtained by this type of graft achieve adequate tissue remodeling for osseointegration and are influenced by periodontal disease and tobacco or alcohol consumption.

  10. Composite bone cements loaded with a bioactive and ferrimagnetic glass-ceramic: Leaching, bioactivity and cytocompatibility.

    Science.gov (United States)

    Verné, Enrica; Bruno, Matteo; Miola, Marta; Maina, Giovanni; Bianco, Carlotta; Cochis, Andrea; Rimondini, Lia

    2015-08-01

    In this work, composite bone cements, based on a commercial polymethylmethacrylate matrix (Palamed®) loaded with ferrimagnetic bioactive glass-ceramic particles (SC45), were produced and characterized in vitro. The ferrimagnetic bioactive glass-ceramic belongs to the system SiO2-Na2O-CaO-P2O5-FeO-Fe2O3 and contains magnetite (Fe3O4) crystals into a residual amorphous bioactive phase. Three different formulations (containing 10, 15 and 20 wt.% of glass-ceramic particles respectively) have been investigated. These materials are intended to be applied as bone fillers for the hyperthermic treatment of bone tumors. The morphological, compositional, calorimetric and mechanical properties of each formulation have been already discussed in a previous paper. The in vitro properties of the composite bone cements described in the present paper are related to iron ion leaching test (by graphite furnace atomic absorption spectrometer), bioactivity (i.e. the ability to stimulate the formation of a hydroxyapatite - HAp - layer on their surface after soaking in simulated body fluid SBF) and cytocompatibility toward human osteosarcoma cells (ATCC CRL-1427, Mg63). Morphological and chemical characterizations by scanning electron microscopy and energy dispersion spectrometry have been performed on the composite samples after each test. The iron release was negligible and all the tested samples showed the growth of HAp on their surface after 28 days of immersion in a simulated body fluid (SBF). Cells showed good viability, morphology, adhesion, density and the ability to develop bridge-like structures on all investigated samples. A synergistic effect between bioactivity and cell mineralization was also evidenced. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Influence of Material Properties on Rate of Resorption of Two Bone Graft Materials after Sinus Lift Using Radiographic Assessment

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    Fawzi Riachi

    2012-01-01

    Full Text Available Purpose. The aim of this study was to investigate the influence of chemical and physical properties of two graft materials on the rate of resorption. Materials and Methods. Direct sinus graft procedure was performed on 22 patients intended for implant placement. Two types of graft materials were used (Bio-Oss and Cerabone and after 8 months healing time the implants were inserted. Radiographic assessment was performed over the period of four years. Particle size, rate of calcium release, and size and type of crystal structure of each graft were evaluated. Results. The average particle size of Bio-Oss (1 mm was much smaller compared to Cerabone (2.7 mm. The amount of calcium release due to dissolution of material in water was much higher for Bio-oss compared to Cerabone. X-ray image analysis revealed that Bio-Oss demonstrated significantly higher volumetric loss (33.4 ± 3.1% of initial graft size compared to Cerabone (23.4 ± 3.6%. The greatest amount of vertical loss of graft material volume was observed after one year of surgery. Conclusion. The chemical and physical properties of bone graft material significantly influence resorption rate of bone graft materials used for sinus augmentation.

  12. Mechanical evaluation of a porous bone graft substitute based on poly(propylene glycol-co-fumaric acid).

    Science.gov (United States)

    Hile, David D; Kirker-Head, Carl; Doherty, Stephen A; Kowaleski, Michael P; McCool, John; Wise, Donald L; Trantolo, Debra J

    2003-07-15

    A porous, resorbable polymer composite based on poly(propylene glycol-co-fumaric acid) (PPF) was mechanically evaluated in vitro for use as a bone graft substitute and fracture fixative. The test material created a dynamic system capable of initially providing mechanical integrity to bony voids and a degradative mechanism for ingrowth by native bone. The unsaturated polymer, PPF, was crosslinked in the presence of effervescent agents to yield a porous microstructure upon curing. An in vitro degradation study first assessed the temporal mechanical properties of the test material. This research was followed by an ex vivo study using a long-bone osteotomy model to characterize the mechanics of fixation. Results showed the initial compressive strength of the cross-linked PPF system was comparable to cancellous bone. The rate of strength loss was commensurate with the predicted mechanical recovery of healing bone with analogous results in a composite that comprised also 25% (by weight) autograft. Mechanical testing in the long-bone model demonstrated that PPF-based bone-graft substitute increased the flexural strength of K-wire stabilized osteotomies. These results suggest that this type of bone graft substitute may have clinical utility in the stabilization of complex tubular bone fractures. Copyright 2003 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 66B: 311-317, 2003

  13. The effects of microporosity on osteoinduction of calcium phosphate bone graft substitute biomaterials.

    Science.gov (United States)

    Chan, O; Coathup, M J; Nesbitt, A; Ho, C-Y; Hing, K A; Buckland, T; Campion, C; Blunn, G W

    2012-07-01

    The effect of increasing strut porosity on the osteoinductive ability of silicate substituted calcium phosphate (SiCaP) biomaterials was investigated in an ectopic ovine model. Implants with strut porosities of 22.5%, 32.0% and 46.0% were inserted into the parapsinalis muscle. At 8, 12 and 24 weeks histological sections were prepared. Sections were examined using backscattered scanning electron microscopy and un-decalcified histology. Bone area, implant area and bone-implant contact were quantified. At 8 weeks there was no significant difference between the groups in terms of bone area and implant area. However at 12 weeks, the amount of bone formation observed was significantly greater in SiCaP-46 (6.17 ± 1.51%) when compared with SiCaP-22.5 (1.33 ± 0.84%) p=0.035. Results also showed significantly increased amounts of bone-implant contact to the SiCaP-46 scaffold (3.30 ± 1.17%) compared with SiCaP-22.5 (0.67 ± 0.52%, p=0.043) at 8 weeks and 12 weeks; (SiCaP-46 (21.82 ± 5.59%) vs SiCaP-22.5 (3.06 ± 1.89%), p=0.012). At 24 weeks, bone formation and graft resorption had significantly increased in all groups so that the level of bone formation in the SiCaP-46 group had increased 75-fold to 30.05 ± 8.38%. Bone formation was observed in pores osteoinductive. Copyright © 2012 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  14. Decreased migration with locally administered bisphosphonate in cemented cup revisions using impaction bone grafting technique.

    Science.gov (United States)

    Zampelis, Vasileios; Belfrage, Ola; Tägil, Magnus; Sundberg, Martin; Flivik, Gunnar

    2017-09-12

    Background and purpose - Impaction bone grafting (IBG) in revision hip surgery is an established method in restoring bone stock deficiencies. We hypothesized that local treatment of the morsellized allograft with a bisphosphonate in cemented revision would, in addition to increased bone density, also reduce the early migration of the cup as measured by radiostereometry (RSA). Patients and methods - 20 patients with aseptic cup loosening underwent revision using the IBG technique. The patients were randomized to either clodronate (10 patients) or saline (10 patients, control group) as local adjunct to the morsellized bone. The outcome was evaluated by dual-energy X-ray absorptiometry (DXA) during the first year regarding periacetabular bone density and with radiostereometric analysis (RSA) for the first 2 years regarding cup migration. Results - 2 patients were lost to follow-up: 9 patients remained in the clodronate and 9 in the control group. Less proximal migration was found in the clodronate group compared with the controls, measured both over time (mixed-models analysis, p = 0.02) as well as at the specified time points up to 2 years (0.22 mm and 0.59 mm respectively, p = 0.02). Both groups seemed to have stabilized at 1 year. We found similar bone mineral density measured by DXA, and similar RSA migration in the other directions. No cups were re-revised. Interpretation - Local treatment of the allograft bone with clodronate reduced early proximal migration of the revised cup but without any measurable difference in periacetabular bone density.

  15. A novel technique to reconstruct a boxlike bone defect in the mandible and support dental implants with In vivo tissue-engineered bone.

    Science.gov (United States)

    Yao, Jinfeng; Li, Xiaoyu; Bao, Chongyun; Fan, Hongsong; Zhang, Xingdong; Chen, Zhiqing

    2009-11-01

    The purpose of this study was to investigate the feasibility of using in vivo tissue-engineered (TE) bone to repair boxlike mandibular defect and support dental implant, and then provide experimental evidence for the future application of the novel technique in the clinical setting. The TE bone graft was constructed in vivo by implanting osteoinductive calcium phosphate (Ca-P) ceramics in the femoral muscles of dog for 8 weeks, then was transplanted to repair the autogeneic boxlike bone defect site created in one side of the mandible and simultaneously support a dental implant, while in the opposite side of the mandibular defect, the same ceramic was used directly as control. 8 weeks after transplantation, samples were harvested for analysis. The results demonstrated that the technique of in vivo tissue engineering improved the mechanical and biologic properties of ceramics significantly. After transplantation, the in vivo TE ceramic-bone grafts were involved in bone metabolism of the host and fused well with the host bone. The dental implants were stable and had been integrated with both TE bone grafts and autologous bone. Therefore, it is feasible to construct a live bone graft with osteoinductive Ca-P ceramics in vivo, then repair a mandibular bone defect, and support a dental implant. In conclusion, in vivo TE bone is a promising technique for bone repair.

  16. The Need for Lateral Piriform Rim Augmentation in Patients with Unilateral Cleft Lip/Palate During Alveolar Cleft Bone Grafting.

    Science.gov (United States)

    Rahpeyma, Amin; Khajehahmadi, Saeedeh

    2015-09-01

    Alveolar bone grafting in unilateral cleft lip/palate (CLP) patients can improve nasal symmetry and facial esthetic. In some cases lateral piriform hypoplasia cannot be compensated by soft tissue thickness of the face, necessitating onlay bone grafting. This study was designed to estimate the proportion of patients among unilateral CLP patients requiring this procedure. In a retrospective study, unilateral CLP patients with severe paranasal deficiency, who were managed by paranasal augmentation with cortico-cancellous bone graft during the alveolar cleft bone grafting, were included. From 85 unilateral CLP patients treated from 2005 to 2011 in the Oral and Maxillofacial Surgery Department, Mashhad University of Medical Sciences, fourteen patients were treated with lateral piriform augmentation technique. Mean age of the patients at the time of operation was 16 ± 4.8 years. Follow-up period was 2-6 years. Concomitant alveolar bone grafting and lateral piriform augmentation is needed at least in 16.5 % of unilateral CLP patients.

  17. Effect of the interleukin-1 genotype on outcomes of regenerative periodontal therapy with bone replacement grafts.

    Science.gov (United States)

    Weiss, Oren I; Caton, Jack; Blieden, Timothy; Fisher, Susan G; Trafton, Sarah; Hart, Thomas C

    2004-10-01

    Previous studies have shown an association between a specific genotype for the inflammatory cytokine interleukin (IL)-1 and the severity of periodontal disease. The purpose of this study was to evaluate the effect of the IL-1 genotype on the outcomes of periodontal surgical regenerative treatment with bone replacement grafts. Forty-four patients with interproximal intrabony defects were treated with bone replacement grafts. Probing depths (PD) and clinical attachment levels (CAL) were measured before treatment and at least 9 months post-treatment. Whole-mouth plaque index (WMPI) and bleeding index (WMBI) were recorded as well. All patients were tested for the IL-1 genotype. Thirteen (29.55%) of the patients were IL-1 genotype positive. There was no statistically significant difference between the genotype-positive and genotype-negative groups regarding age, smoking status, gender, WMPI, and WMBI. There was no significant difference in PD or CAL between the genotype-positive and genotype-negative groups at baseline. Genotype-positive patients had a smaller reduction in probing depth (1.86 mm versus 2.13 mm) and a greater gain of clinical attachment (1.20 mm versus 0.65 mm). These differences were not statistically significant (P = 0.70, P = 0.40). Multivariate regression analysis showed that presurgical PD significantly influenced post-surgical PD and CAL, and only WMPI significantly influenced CAL. In this study, there was no evidence that the IL-1 genotype influences the clinical treatment outcomes of regenerative periodontal therapy with bone replacement grafts.

  18. The use of particulate bone grafts from the mandible for maxillary sinus floor augmentation before placement of surface-modified implants: results from bone grafting to delivery of the final fixed prosthesis.

    Science.gov (United States)

    Becktor, Jonas P; Hallström, Hadar; Isaksson, Sten; Sennerby, Lars

    2008-04-01

    This prospective study followed 61 patients who were partially dentulous and considered to have insufficient bone volume for routine implant treatment and consequently underwent sinus inlay bone grafting. The patients were treated with maxillary sinus floor augmentation with particulated autogenous bone from the mandibular ramus/corpus. After a healing period, dental implants (n = 180) were installed. Radiographic examination revealed average residual vertical bone heights of 6.5 mm in the first premolar region, 3.8 mm in the second premolar region, 3.5 mm in the first molar region, and 2.6 mm in the second molar region. The average implant lengths were 12 mm in the first premolar region and 11 mm in the second premolar, first, and second molar regions. All patients received a fixed partial prosthesis. All bone grafts were stable, and the implant survival rate was 98.9%. There were few cases of minor complications postoperatively and no record of any injured teeth, heavy bruising, bleeding, or swelling in either the donor site or the recipient site. The present clinical study demonstrated a low failure rate of surface-modified dental implants when placed into the maxillary sinus an average of 7 months after augmentation with particulate mandibular bone grafts and followed up to delivery of the final fixed prosthesis. The findings indicate that treatment with endosseous implants may be as predictable in patients with inadequate bone who underwent sinus floor augmentation as in patients with adequate bone volume.

  19. Correlation of fractal dimension with histomorphometry in maxillary sinus lifting using autogenous bone graft.

    Science.gov (United States)

    de Molon, Rafael Scaf; de Paula, Wagner Nunes; Spin-Neto, Rubens; Verzola, Mario Henrique Arruda; Tosoni, Guilherme Monteiro; Lia, Raphael Carlos Comelli; Scaf, Gulnara; Marcantonio, Elcio

    2015-01-01

    The aim of this study was to determine the pattern of bone remodeling after maxillary sinus lifting in humans by means of fractal dimension (FD) and histomorphometric analysis. Therefore, the correlation between FD and the histomorphometric findings was evaluated. Sixteen patients with posterior edentulous maxilla were enrolled in this study. Maxillary sinus lifting was performed using autogenous bone grafted from the mandibular retromolar area. Three direct digital panoramic radiographs were obtained: before surgery (Group 1), immediately postoperatively (Group 2) and after 6 months of healing (Group 3) for FD analysis. Biopsies were taken after 6 months, processed and submitted to histological and histomorphometric analysis. Data were analyzed by Shapiro-Wilk test and ANOVA test followed by a Tukey test (a = 0.05). The bone volume fraction of newly trabecular bone (TB) and medullary area (MA) was measured as 62.75% ± 17.16% and 37.25 ± 17.16%, respectively. Significant difference in FD analysis was measured between Group 1 and Group 3. No significant difference was found in the correlation between FD and histomorphometric analysis for TB and MA (p = 0.84). In conclusion, all performed analyses were effective in assessing the bone-remodeling pattern in the maxillary sinus, offering complementary information about healing and predictable outcomes. There were no correlations between FD and histomorphometric analysis.

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

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    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.

  1. Modified sacrospinalis muscle pedicle bone graft for fusion of isthmic spondylolisthesis.

    Science.gov (United States)

    Adam, F F

    2001-01-01

    We treated 20 patients with symptomatic L4-5 isthmic spondylolisthesis (ten grade I, nine grade II and one grade III) surgically. All patients complained of low back pain and nine had additional radicular pain. Bilateral posterolateral fusion using the sacrospinalis muscle as a muscle pedicle bone graft was carried out in all patients. Decompression was added in patients with radiculopathy. Follow-up ranged from 12 to 28 months. Pain relief was graded as excellent in 18 patients, radiographic fusion as excellent in 17 patients and functional outcome as excellent in 19 patients.

  2. Maxillary sinus floor augmentation surgery with autogenous bone grafts as ceiling: a pilot study and test of principle.

    Science.gov (United States)

    Raghoebar, Gerry M; Meijer, Henny J A; Telleman, Gerdien; Vissink, Arjan

    2013-08-01

    Studies have pointed out that the mere elevation of the maxillary sinus membrane might suffice to allow for bone formation indicating the additional use of augmentation materials to be redundant. The purpose of this study was to assess whether elevation of the sinus mucosal lining combined with applying an autologous bone graft as a ceiling and placement of a short implant would allow for bone formation around the implant thus surpassing the need for applying augmentation materials around the installed implants. Fourteen consecutive patients were subjected to maxillary sinus floor elevation surgery and simultaneous placement of an implant. Using the lateral bone-wall window technique, the membrane was exposed and elevated. Next, a bone graft taken from the zygomatic rim was placed as a ceiling above the inserted implant to ensure that the sinus membrane would not collapsed around a significant part of the implant. Finally, the bone window was returned in place. After connecting the healing abutment, the wound was closed. All implants were stable and no implants were lost. There were no complications after harvesting the bone graft. Radiographic evaluation showed a bone gain of 3.2 ± 0.9 mm after 3 months and 3.6 ± 0.9 mm after 1 year. Less than 6% of the implant was not covered by bone after 1 year. Maxillary sinus membrane elevation and simultaneous placement of short endosseous implants with a bone graft as a ceiling on top of the implant result in predictable bone formation around the implant and good osseointegration on radiographs. © 2011 Wiley Periodicals, Inc.

  3. 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 materials facilitated tooth movement without fenestrations and accelerated new bone formation on the pressure side.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft.

    Science.gov (United States)

    Di Stefano, Danilo Alessio; Greco, Gian Battista; Cinci, Lorenzo; Pieri, Laura

    2015-02-01

    The present work describes a horizontal ridge augmentation in which a titanium mesh was preshaped by adapting it to a stereolithographic model of the patient's jaw that was fabricated from CT scans. Guided bone regeneration (GBR) involves covering the augmentation site with a long-lasting barrier to protect it from the invasion of surrounding soft tissues. Among barriers, titanium meshes may provide a successful outcome, but the intraoperatory time needed to shape them is a disadvantage. The 54-year-old patient, missing the right mandibular second bicuspid, first molar, and second molar, had her atrophic ridge augmented with a 30:70 mixture of autogenous bone and equine, enzyme-deantigenic collagen-preserved bone substitute. Two conical implants were inserted concomitantly in the second bicuspid and first molar positions, and the site was protected with the preshaped mesh. Four months later, the titanium mesh was retrieved, a bone sample was collected, and histological and histomorphometric analyses were performed. Provisional and definitive prostheses were then delivered, and follow-up controls were performed for up to 24 months. Preshaping the mesh on a model of the patient's mandible shortened the surgical time and enabled faster mesh placement. Two years after surgery, the implants were perfectly functional, and the bone width was stable over time as shown by radiographic controls. Histological analysis of the bone sample showed the heterologous biomaterial to be biocompatible and undergoing advanced remodeling and replacement with newly formed bone. Preshaping a titanium mesh over a stereolithographic model of the patient's jaw allowed for a significant reduction of the intraoperative time and may be therefore, advisable in routine practice.

  6. A 5-Year Implant Follow-Up in Maxillary and Mandibular Horizontal Osseous Onlay Grafts and Native Bone.

    Science.gov (United States)

    Sbordone, Carolina; Toti, Paolo; Martuscelli, Ranieri; Guidetti, Franco; Sbordone, Ludovico; Ramaglia, Luca

    2015-10-01

    The purpose of this study is to analyze marginal bone levels (MBLs) around dental implants positioned in the upper and lower jaw with or without horizontal onlay grafting procedures, and to survey implant survival with a follow-up of 5 years. Seventeen patients were surveyed in the present retrospective chart review. A total of 27 dental implants positioned in pristine bone and 21 in horizontally grafted bone were enrolled. MBLs were recorded for 4 aspects during a radiologic survey of 5 years. Significant differences were searched for among times and surgical procedures with paired and unpaired comparison tests, respectively, and survival rates were calculated for the 2 groups. In the maxilla, no statistically-significant differences between pristine and augmented groups were obtained; the time comparisons for pristine implants showed an affection of palatal, mesial, and distal sides, whereas the resorption around implants placed into horizontally grafted bone of anterior maxilla seemed to be limited just to buccal and distal aspects. Comparisons with the pristine horizontal procedure revealed that just the buccal sides were involved. The analysis of time comparisons attested to a continuous alveolar bone remodeling during the entire time of the survey for the pristine group. Given the extremely unfavorable resorption at the buccal aspect of the augmented areas, clinicians should reserve dental implant positioning into horizontal bone graft to selected patients, in whom it may represent one of the last opportunities of rehabilitation with a fixed prosthesis.

  7. UV Photofunctionalization Effect on Bone Graft in Critical One-Wall Defect around Implant: A Pilot Study in Beagle Dogs

    Science.gov (United States)

    Kim, Min-Young; Lee, Jae-Hoon; Kim, Jee-Hwan; Jung, Han-Sung; Park, Young-Bum

    2016-01-01

    The purpose of this study was to compare and evaluate, through histomorphometric and radiological analysis, the effects of UV photofunctionalization on an implant placed over a critical defect area with and without a bone graft. Four female beagle dogs were first divided into control and bone graft groups. Each group was then subdivided into UV-treated and UV-untreated groups. The mandibular premolars in each dog were extracted. 12 weeks after extraction, implants were placed according to the condition of each group. Four and 12 weeks after implantation on left and right mandible, the dogs were sacrificed. The specimens were prepared for histomorphometric and micro-computed tomographic analysis. In both 4-week and 12-week groups, UV-treated implant surfaces showed better osseointegration than SA implant surfaces. Also, with implant surfaces placed over the critical defect with bone graft, UV photofunctionalization increased bone-to-implant contact (BIC) and new bone formation at the initial stage (4 weeks). Based on the results of this study, it can be suggested that UV photofunctionalization on the surface of implants placed over large critical defects with bone graft aids initial osseointegration and osteogenesis. PMID:28116296

  8. UV Photofunctionalization Effect on Bone Graft in Critical One-Wall Defect around Implant: A Pilot Study in Beagle Dogs

    Directory of Open Access Journals (Sweden)

    Min-Young Kim

    2016-01-01

    Full Text Available The purpose of this study was to compare and evaluate, through histomorphometric and radiological analysis, the effects of UV photofunctionalization on an implant placed over a critical defect area with and without a bone graft. Four female beagle dogs were first divided into control and bone graft groups. Each group was then subdivided into UV-treated and UV-untreated groups. The mandibular premolars in each dog were extracted. 12 weeks after extraction, implants were placed according to the condition of each group. Four and 12 weeks after implantation on left and right mandible, the dogs were sacrificed. The specimens were prepared for histomorphometric and micro-computed tomographic analysis. In both 4-week and 12-week groups, UV-treated implant surfaces showed better osseointegration than SA implant surfaces. Also, with implant surfaces placed over the critical defect with bone graft, UV photofunctionalization increased bone-to-implant contact (BIC and new bone formation at the initial stage (4 weeks. Based on the results of this study, it can be suggested that UV photofunctionalization on the surface of implants placed over large critical defects with bone graft aids initial osseointegration and osteogenesis.

  9. Limitation of the antibiotic-eluting bone graft substitute: An example of gentamycin-impregnated calcium sulfate.

    Science.gov (United States)

    Wu, Chang-Chin; Huang, Yang-Kai; Chang, Wei-Jen; Wu, Yun-Ching; Wang, Chen-Chie; Yang, Kai-Chiang

    2016-11-18

    Patients with inadequate volume of alveolar processes or bone defects commonly require graft substitutes in oral, maxillofacial or orthopedic surgery. Ridge augmentation and reconstruction of facial bony defects with bone graft materials achieve better outcomes in functional and aesthetic rehabilitation. The injectable calcium sulfate filler is used widely in intra-operative applications. Calcium sulfate bone filler has been shown to upregulate bone formation-related mRNA genes in vitro and improve osseointegration in vivo. In addition, the bone graft substitute can be used as a drug delivery system for antibiotics to treat or prevent infections based on the clinical experiences. However, the influences of antibiotics addition on the calcium sulfate are not fully understood. In this study, calcium sulfate impregnated with gentamycin in different weight ratios was characterized. The results showed that gentamycin prolonged the hydration process and extended initial/final setting times of calcium sulfate. The addition of gentamycin slowed the conversion from calcium sulfate hemihydrate to dihydrate and changed the crystalline phase and microstructure. Higher amounts of gentamycin added resulted in faster degradation and lower mechanical strength of calcium sulfate. This study reveals that the extended setting time, decreased compressive strength, and the accelerated degradation of the gentamycin-impregnated calcium sulfate bone graft substitutes should be considered during intra-operative applications. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2016. © 2016 Wiley Periodicals, Inc.

  10. Cell response of calcium phosphate based ceramics, a bone substitute material

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    Juliana Marchi

    2013-01-01

    Full Text Available The aim of this study was to characterize calcium phosphate ceramics with different Ca/P ratios and evaluate cell response of these materials for use as a bone substitute. Bioceramics consisting of mixtures of hydroxyapatite (HAp and β-tricalcium phosphate (β-TCP powders in different proportions were pressed and sintered. The physical and chemical properties of these bioceramics were then characterized. Characterization of the biological properties of these materials was based on analysis of cell response using cultured fibroblasts. The number of cells attached to the samples was counted from SEM images of samples exposed to cell culture solution for different periods. These data were compared by analysis of variance (ANOVA complemented by the Tukey's test. The TCP sample had higher surface roughness and lower density. The adherence and growth of FMM1 cells on samples from all groups was studied. Even though the different calcium based ceramics exhibited properties which made them suitable as bone substitutes, those with higher levels of β-TCP revealed improved cell growth on their surfaces. These observations indicated two-phase calcium phosphate based materials with a β-TCP surface layer to be a promising bone substitute.

  11. Influence of low-level laser therapy on the healing process of autogenous bone block grafts in the jaws of systemically nicotine-modified rats: A histomorphometric study.

    Science.gov (United States)

    de Almeida, Juliano Milanezi; de Moraes, Ricardo Oliveira; Gusman, David Jonathan Rodrigues; Faleiros, Paula Lazilha; Nagata, Maria José Hitomi; Garcia, Valdir Gouveia; Theodoro, Letícia Helena; Bosco, Alvaro Francisco

    2017-03-01

    To analyze the influence of low-level laser therapy (LLLT) on the bone healing process of autogenous bone block grafts installed in nicotine systemically modified rats. Seventy-two rats (Wistar) were randomly assigned into 4 groups (n=18). SS-BG: saline application+bone graft. SS-BG/LLLT: saline application+bone graft+LLLT. NIC-BG: nicotine application+bone graft. NIC-BG/LLLT: nicotine application+bone graft+LLLT. After 30days of application of solutions, all animals received autogenous bone block graft in the jaw, with the donation from the parietal bone's calvarial area. Treatment with LLLT was in bed-graft interface, after accommodation of the graft. The animals in each group were sacrificed at 7, 14, and 28days after graft surgery. The histologic analyses of NIC-BG group depicted a delay of osteogenic activity in the recipient bed-graft interface and the irradiation of tissue with LLLT provided better bone healing. The histometric analysis revealed that SS-BG/LLLT and NIC-BG/LLLT groups showed increased bone formation compared to BG-SS and NIC-BG groups, after 14days (SS-BG 24.94%±13.06% versus SS-BG/LLLT 27.53%±19.07% and NIC-BG 14.27%±2.22% versus NIC-BG/LLLT 24.37%±11.93%) and 28days (SS-BG 50.31%±2.69% versus SS-BG/LLLT 58 19%±12.32% and NIC-BG 36.89%±8.40% versus NIC-BG/LLLT 45.81%±6.03%). Nicotine harms bone formation in the bed-graft interface and LLLT action can mitigate this. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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    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.

  13. A Prospective Study to Compare the Functional and Aesthetic Outcomes with and without Primary Bone Grafting in Facial Fractures

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    Narayanamurthy Sundaramurthy

    2017-10-01

    Full Text Available Introduction: Open Reduction and Internal Fixation (ORIF has been the gold standard in treatment of facial fractures. Bone grafts have been used to correct bone defects in face. Many studies assessing outcomes of ORIF and primary bone grafting separately have been published in literature. Aim: A prospective study to compare the functional and aesthetic outcomes with and without primary bone grafting in facial fractures. Materials and Methods: Thirty patients, admitted between January 2012 and December 2013, were divided into two groups. Group 1 patients underwent ORIF with primary bone grafting and in group 2, only ORIF was done. Clinical and functional, photographic and radiological assessments were done after one month and three months. Results: Mean value of vertical dystopia in groups 1 and 2 after three months postoperatively were 1.25mm and 0.67mm. Mean value of enophthalmos in groups 1 and 2 after three months postoperatively were 0.5mm and 1mm. Thus, vertical dystopia was corrected better without bone grafts and enophthalmos corrected better with bone grafts. Photographic assessment revealed no statistical difference between the two groups. Postoperatively, in upper face fractures, both groups had similar number of patients in grades 1 and 2. Only one patient from group 2 of midface fractures ended up with grade 3 asymmetry. Radiologically, in upper face fractures, group 2 had more mean projection, height and breadth deficits (1.28mm, 2.57mm and 2.42mm when compared to group 1 (0.67mm, 1.50mm and 0.50mm. The mean projection and height deficits were statistically better in group 1. In midface fractures, mean zygomatic complex projection and height deficits were more in group 2 (1.88mm and 0.63mm than group 1 (0.78mm and 0.44mm. The mean zygomatic complex projection was statistically better in group1. Postoperative complications were lesser with the bone graft group. Conclusion: Judicious use of bone grafts in comminuted facial and orbital

  14. HLA-typing analysis following allogeneic bone grafting for sinus lifting.

    Science.gov (United States)

    Piaia, Marcelo; Bub, Carolina Bonet; Succi, Guilherme de Menezes; Torres, Margareth; Costa, Thiago Henrique; Pinheiro, Fabricio Costa; Napimoga, Marcelo Henrique

    2017-03-01

    According to the Brazilian Association of Organ Transplants, in 2015, 19,408 bone transplants were performed in Brazil, over 90% by Dental Surgeons. The surgical technique itself has a respectable number of reports regarding its clinical efficacy, as measured by long-term survival of dental implants in grafted areas. Uncertainty remains, however, as to whether fresh frozen grafts from human bone donors remain immunologically innocuous in the body of the host. Six male with no previous medical history of note, including systemic diseases, surgery or blood transfusion were selected. These patients underwent reconstructive procedures (sinus lifting) using fresh frozen human bone from a tissue bank. All patients had venous blood samples collected prior to surgery and 6 months after the procedure. Anti-HLA analysis for the detection of HLA (human leukocyte antigen) antibodies was performed using methods such as the LABScreen PRA Class I and Class II, LABScreen Single Antigen Class I and Class II, Luminex Platform. Reactive individuals to the screening tests (LABScreen PRA) were further investigated to determine the specificity of the antibodies detected (LABScreen Single Antigen) with a cutoff value of median fluorescence intensity ≥500. As a result, it was observed that two patients (33%) were positive in screening tests, one presenting with anti-HLA Class I and II sensitization and the other with anti-HLA class II. The specificity analysis showed that the patients sensitized to HLA class II presented 4 specificities, 3 of which immunologically relevant. In the second individual, 23 specificities were identified, 6 of which immunologically important for HLA class I and 4 specificities for HLA class II, 3 of these were immunologically important. All specificities detected had average fluorescence. These findings are suggestive that sinus-lifting procedures with allogeneic bone can induce immunological sensitization.

  15. [Is local bone graft sufficient to maintain the surgical correction in adolescent idiopathic scoliosis curves?].

    Science.gov (United States)

    Mardomingo, A; Sánchez-Mariscal, F; Alvarez, P; Pizones, J; Zúñica, L; Izquierdo, E

    2013-01-01

    The purpose of this study was to compare postoperative clinical and radiological results in adolescent idiopathic scoliosis curves treated by posterior arthrodesis using autogenous bone graft from iliac crest (CI) versus only local autograft bone (HL). A retrospective matched cohort study was conducted on 73 patients (CI n=37 and HL n=36) diagnosed with adolescent idiopathic scoliosis and treated surgically by posterior arthrodesis. The mean post-operative follow-up was 126 months in the CI group vs. 66 months in the HL group. The radiographic data collected consisted of preoperative, postoperative, and final follow-up antero-posterior and lateral full-length radiographs. Loss of correction and quality of arthrodesis were evaluated by comparing the scores obtained from the Spanish version of the SRS-22 questionnaire. There were significant differences in the post-operative results as regards the correction of the Cobb angle of the main curve (HL 61 ± 15% vs. CI 51 ± 14%, P<.004), however a greater loss of correction was found in the local bone group (CI 4.5 ± 7.3° vs. HL 8.5 ± 6.3°, P=.02). There were no significant differences as regards the correction of the Cobb angle of the main curve at the end of follow-up. There were no clinical differences between the two groups in the SRS-22 scores. At 5 years of follow-up, there was a statistically significant greater loss of radiographic correction at the end of final follow-up in the local bone graft group. However clinical differences were not observed as regards the SRS-22 scores. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  16. Composite bone cements loaded with a bioactive and ferrimagnetic glass-ceramic: Leaching, bioactivity and cytocompatibility

    Energy Technology Data Exchange (ETDEWEB)

    Verné, Enrica, E-mail: enrica.verne@polito.it [Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, C. so Duca degli Abruzzi 24, 10129 Torino (Italy); Bruno, Matteo [Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, C. so Duca degli Abruzzi 24, 10129 Torino (Italy); Miola, Marta [Institute of Materials Physics and Engineering, Applied Science and Technology Department, Politecnico di Torino, C. so Duca degli Abruzzi 24, 10129 Torino (Italy); Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, Via Solaroli 17, 28100 Novara (Italy); Maina, Giovanni; Bianco, Carlotta [Traumatology Orthopedics and Occupational Medicine Dept., Università di Torino, Via G. Zuretti 29, 10126 Torino (Italy); Cochis, Andrea [Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, Via Solaroli 17, 28100 Novara (Italy); Rimondini, Lia [Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, Via Solaroli 17, 28100 Novara (Italy); Consorzio Interuniversitario Nazionale per la Scienza e Tecnologia dei Materiali, Via G. Giusti, 9, 50121 Firenze (Italy)

    2015-08-01

    In this work, composite bone cements, based on a commercial polymethylmethacrylate matrix (Palamed®) loaded with ferrimagnetic bioactive glass-ceramic particles (SC45), were produced and characterized in vitro. The ferrimagnetic bioactive glass-ceramic belongs to the system SiO{sub 2}–Na{sub 2}O–CaO–P{sub 2}O{sub 5}–FeO–Fe{sub 2}O{sub 3} and contains magnetite (Fe{sub 3}O{sub 4}) crystals into a residual amorphous bioactive phase. Three different formulations (containing 10, 15 and 20 wt.% of glass-ceramic particles respectively) have been investigated. These materials are intended to be applied as bone fillers for the hyperthermic treatment of bone tumors. The morphological, compositional, calorimetric and mechanical properties of each formulation have been already discussed in a previous paper. The in vitro properties of the composite bone cements described in the present paper are related to iron ion leaching test (by graphite furnace atomic absorption spectrometer), bioactivity (i.e. the ability to stimulate the formation of a hydroxyapatite – HAp – layer on their surface after soaking in simulated body fluid SBF) and cytocompatibility toward human osteosarcoma cells (ATCC CRL-1427, Mg63). Morphological and chemical characterizations by scanning electron microscopy and energy dispersion spectrometry have been performed on the composite samples after each test. The iron release was negligible and all the tested samples showed the growth of HAp on their surface after 28 days of immersion in a simulated body fluid (SBF). Cells showed good viability, morphology, adhesion, density and the ability to develop bridge-like structures on all investigated samples. A synergistic effect between bioactivity and cell mineralization was also evidenced. - Highlights: • An in vitro biological characterization was carried out on ferromagnetic and bioactive composite cements. • No release of iron was revealed in the physiological solution. • Bioactivity tests

  17. Combined two foot flaps with iliac bone graft for reconstruction of the thumb.

    Science.gov (United States)

    Zhang, G; Ju, J; Li, L; Jin, G; Li, X; Hou, R

    2016-09-01

    The purpose of this report was to retrospectively review the results of reconstruction of the thumb by use of combined two foot flaps with an iliac bone graft. From 2009 to 2014, nine patients with traumatic amputation of the thumb had their thumbs reconstructed. The two flaps were based on one pedicle. All flaps survived completely. Patients were followed for a mean of 15.6 months (range, 6-35 months). The appearance of the reconstructed thumb was comparable to a normal one, except for one thumb which required debulking. The appearance of the nail was satisfactory without deformity. The range of joint motion was satisfactory. The two point discrimination of the pulp ranged from 6 mm to >15 mm. The Michigan Hand Questionnaire outcome score was a mean of 76.2 ± 11.3 points and the Maryland foot rating score a mean of 94.8 ± 3.4 points. The combined two foot flaps with iliac bone graft might provide an option for the reconstruction of the thumb. III. © The Author(s) 2016.

  18. Evaluation of unilateral cleft lip and palate using anthropometry measurements post-alveolar bone grafting

    Science.gov (United States)

    Simorangkir, H. J.; Hak, M. S.; Tofani, I.

    2017-08-01

    Rehabilitation of patients with unilateral cleft lip and palate (UCLP) requires multiple steps and coordination of multidisciplinary sciences to produce optimal results. Alveolar bone-grafting (ABG) is an important procedure in the treatment of such patients because it influences the eruption of teeth and stabilizes the maxilla. To evaluate the effect and suitability of alveolar bone grafting procedure at Cleft Center Harapan Kita Maternal and Child Hospital on nasal deformity from anthropometry with photogrammetry and aesthetic proportional in patients with unilateral cleft lip and palate with UCLP. Patients with UCLP were evaluated post-ABG using anthropometry and photogrammetry to investigate the results anteriorly, laterally, and basally. Anthropometric measurements taken photogrammetrically used 14 points and 11 distance items. Evaluations were made of upper lip length, upper lip projection, and nostril sill elevation for both the cleft and non-cleft sides of patients’ faces. A t-test showed that the values for upper lip length and projection were significantly increased, and a correction test using a Fisher exam gave a value of 1. The ABG treatment protocol for patients with UCLP at the Cleft Lip and Palate Unit at Harapan Kita Maternal and Child Hospital is suitable to be performed; it aesthetically satisfies patients and their families.

  19. A facile magnesium-containing calcium carbonate biomaterial as potential bone graft.

    Science.gov (United States)

    He, Fupo; Zhang, Jing; Tian, Xiumei; Wu, Shanghua; Chen, Xiaoming

    2015-12-01

    The calcium carbonate is the main composition of coral which has been widely used as bone graft in clinic. Herein, we readily prepared novel magnesium-containing calcium carbonate biomaterials (MCCs) under the low-temperature conditions based on the dissolution-recrystallization reaction between unstable amorphous calcium carbonate (ACC) and metastable vaterite-type calcium carbonate with water involved. The content of magnesium in MCCs was tailored by adjusting the proportion of ACC starting material that was prepared using magnesium as stabilizer. The phase composition of MCCs with various amounts of magnesium was composed of one, two or three kinds of calcium carbonates (calcite, aragonite, and/or magnesian calcite). The different MCCs differed in topography. The in vitro degradation of MCCs accelerated with increasing amount of introduced magnesium. The MCCs with a certain amount of magnesium not only acquired higher compressive strength, but also promoted in vitro cell proliferation and osteogenic differentiation. Taken together, the facile MCCs shed light on their potential as bone graft. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Comparative ultrasound evaluation of human trabecular bone graft properties after treatment with different sterilization procedures.

    Science.gov (United States)

    Vastel, L; Masse, C; Mesnil, P; Crozier, E; Padilla, F; Laugier, P; Mitton, D; Courpied, J P

    2009-07-01

    New sterilization methods for human bone are likely to affect the mechanical properties of human cancellous grafts. These mechanical properties dictate the short- and mid-term results of the orthopedic procedure. The aim of this study was to compare the effects on bone mechanical properties, as assessed by ultrasound velocity, of different sterilization methods used under similar conditions: bleach and sublimation, humid heat, successive baths of physiological saline with osmotic detersion, and CO(2) in the supercritical phase. Alterations in mechanical properties were small with CO(2) (velocity change: -2%) and humid heat (-2.5%). Osmotic detersion had a significant but moderate effect (-4.7%). The -9% change with the protocol involving bleach suggested a greater than 30% decrease in load to failure, based on earlier studies. Gamma irradiation of defatted trabecular allografts, in a dose of 10 or 25 KGy, produced no significant changes in ultrasound velocity. Powerful protein denaturants used in sterilization protocols substantially alter the mechanical resistance of the grafts, which may jeopardize the orthopedic procedure. (c) 2009 Wiley Periodicals, Inc.

  1. Biomechanical effects on maxillary protraction of the craniofacial skeleton with cleft lip and palate after alveolar bone graft.

    Science.gov (United States)

    Chen, Zhengxi; Pan, Xiaogang; Shao, Qinghua; Chen, Zhenqi

    2013-03-01

    To explore the biomechanical effects of maxillary protraction on the craniofacial skeleton in patients with unilateral cleft lip and palate (UCLP) after alveolar bone graft (ABG) and resorption of ABG, thus to provide theoretical basis for the clinical application of maxillary protraction, which can improve the facial deformity of the UCLP patients. A finite element model of a UCLP patient's skull was generated using data from spiral computed tomographic (CT) scans. Based on this finite element model, another 6 ABG finite element models were constructed to simulate ABG and resorption of ABG, respectively (nonresorption model, upper one-third resorption of the grafted bone model, upper two-thirds resorption of the grafted bone model, lower one-third resorption of the grafted bone model, lower two-thirds resorption of the grafted bone model, upper one-third and lower one-third resorption of the grafted bone model). Two additional models were developed to simulate maxillary protraction with expansion and maxillary protraction alone. All models were loaded with orthopedic force (30 degrees downward and forward to the occlusal plane, 500 g per side) on the region of alveolar of maxillary canine. Before ABG, the cleft side showed larger displacement than the noncleft side, when it came to the stress distribution in the craniofacial suture, it showed an asymmetric pattern as well. After ABG, the displacement difference between the cleft side and the noncleft side decreased, and the stress distribution in the craniofacial suture showed more symmetric than that before ABG. The pterygopalatine suture obtained the largest value, followed by zygomaticotemporal, zygomaticomaxillary, and zygomaticofrontal sutures among the observed sutures. Higher stresses and pronounced forward displacement were generated in the craniofacial sutures after maxillary protraction with expansion. Maxillary protraction after ABG performed a more favorable outcome. Among the ABG models, nonresorption

  2. A Bilateral Pediculated Palatal Periosteal Connective Tissue Flap for Coverage of Large Bone Grafts in the Anterior Maxillary Region

    Directory of Open Access Journals (Sweden)

    Amin Rahpeyma

    2012-03-01

    Full Text Available Introduction: Coverage of bone grafts is very important in reconstructive surgery. In edentulous alveolar ridges this coverage is particularly important for supporting dental prostheses. Here we present the case of a patient with a large deficient maxillary anterior region that was reconstructed with a bilateral palatal submucosal periosteal connective tissue flap: a soft tissue reserve for upper jaw reconstructive surgeries. The bilateral pediculated palatal periosteal connective tissue flap was used for coverage of a large bone graft in the anterior maxillary region.  Conclusion: Palatal submucosa can be used as a soft tissue reserve in upper jaw reconstructions.

  3. No effect of ketoprofen and meloxicam on bone graft ingrowth: a bone chamber study in goats.

    NARCIS (Netherlands)

    Heide, H.J. van der; Hannink, G.; Buma, P.; Schreurs, B.W.

    2008-01-01

    BACKGROUND AND PURPOSE: There is increasing awareness that non-steroidal anti-inflammatory drugs (NSAIDs), and especially the cyclooxygenase-2 (COX-2) selective ones, may retard bone healing. We have used NSAIDs (indomethacin for at least 7 days) to prevent heterotopic ossification after acetabular

  4. Effect of nanostructure on osteoinduction of porous biphasic calcium phosphate ceramics.

    Science.gov (United States)

    Li, Bo; Liao, Xiaoling; Zheng, Li; Zhu, Xiangdong; Wang, Zhe; Fan, Hongsong; Zhang, Xingdong

    2012-10-01

    In order to evaluate the effect of the nanostructure of calcium phosphate ceramics on osteoinductive potential, porous biphasic calcium phosphate (BCP) ceramics with a nano- or submicron structure were prepared via microwave sintering and compared to conventional BCP ceramics. The selective protein adsorption of bovine serum albumin and lysozyme (LSZ) and the osteogenic differentiation of human mesenchymal stem cells in vitro was investigated. Porous BCP nanoceramics showed higher ability to adsorb proteins, especially low molecular weight protein of LSZ, than conventional BCP ceramics, and the BCP nanoceramics promoted bone sialoprotein expression more than conventional BCP did. Further in vivo study to investigate ectopic bone formation and bone repair efficiency proved the highly osteoinductive potential of nanostructured BCP ceramics. The results suggest that nanostructured BCP ceramics have the potential to become a new generation of bioceramics for bone tissue engineering grafts. Copyright © 2012 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  5. 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.

  6. 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.

  7. A clinical study of the outcomes and complications associated with zygomatic buttress block bone graft for limited preimplant augmentation procedures.

    Science.gov (United States)

    Sakkas, Andreas; Schramm, Alexander; Karsten, Winter; Gellrich, Nils-Claudius; Wilde, Frank

    2016-03-01

    The aim of this study was to evaluate the possibility of using the zygomatic buttress as an intraoral bone harvesting donor site and determine the safety of this harvesting procedure for later optimal positioning of dental implants in accordance with prosthodontic and functional principles. A consecutive retrospective study was conducted on patients who had been treated at the Department of Oral and Maxillofacial Surgery of Ulm military and academic hospital, over a 3-year period (January 2008 to December 2010). Medical history, smoking status, area of surgery, and complications were recorded. The need for bone grafting was defined by the impossibility of installing implants of adequate length or diameter to fulfill prosthetic requirements, or for esthetic reasons. The patients were treated using a 2-stage technique. During the first operation, bone blocks harvested from the zygomatic buttress region were placed as lateral onlay grafts and fixed with titanium osteosynthesis screws after exposure of the deficient alveolar ridge. After 3-6 months of healing, the flap was reopened, the screws removed and the implants placed. A total of 113 zygomatic buttress bone block grafts in 112 patients were performed. Graft loss and graft removal were defined as failure; swelling, wound dehiscence, infection with pus, temporary paresthesia, and perforations of the maxillary sinus membrane were defined as complications. According to our criteria, 4 (3.5%) of the patients presented postoperative complications of the donor site and 20 (17.8%) of the recipient site. Throughout, 93 (82.3%) of the bone grafts were successful and 20 (17.6%) had complications, regardless of the final success of the implant procedure. Smoking was associated with a high rate of complications and graft failure. Early graft exposure appeared to compromise the results, whereas pain and swelling were comparable to usual dentoalveolar procedures. However, in 1.7% of all cases, concerning 2 patients, the final

  8. 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 the 0.75 cc gap surrounding the implant. After 3 weeks, the OP-1 device enhanced implant fixation by 800% (p...

  9. Guided Bone Regeneration in Long-Bone Defects with a Structural Hydroxyapatite Graft and Collagen Membrane

    Science.gov (United States)

    2013-01-01

    at San Antonio, San Antonio, Texas. 3College of Dentistry , Chosun University, Gwangju, Republic of Korea. 4Institute for Biomaterials Research...guide was not included in this study, because previous investigations in the mandible defects of beagle dogs have shown no difference in the bone...membranes: an experimental study in dogs . Clin Oral Implants Res 19, 402, 2008. 13. Schwarz, F., Herten, M., Ferrari, D., Wieland, M., Schmitz, L

  10. 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.

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

    DEFF Research Database (Denmark)

    Pinholt, Else M

    2003-01-01

    and the patients were followed between 20 and 67 months post implantation. The bone graft was transplanted to add bony volume in the maxillary sinus, the anterior floor of the nose and/or the alveolar ridge. After a healing period of 4(1/2) months, dental implants were inserted and left for healing for 8 months......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...... either Brånemark- or ITI-fixures. In 25 patients (18 females, seven males) the severely atrophied maxilla was reconstructed with autogenous iliac or mandibular bone and either Brånemark or ITI implants. Seventy-eight Brånemark implants and 80 SLA-ITI implants were inserted in the augmented bone...

  12. Reverse shoulder arthroplasty with glenoid bone grafting for anterior glenoid rim fracture associated with glenohumeral dislocation and proximal humerus fracture.

    Science.gov (United States)

    Garofalo, R; Brody, F; Castagna, A; Ceccarelli, E; Krishnan, S G

    2016-12-01

    Large fractures of the anterior glenoid rim can result in persisting instability and osteoarthritis of the glenohumeral joint When this fracture is associated with a glenohumeral dislocation and proximal humerus fracture could be a concern. The goal of this paper was to evaluate the clinical and radiological outcomes and complications of reverse shoulder arthroplasty (RSA) and glenoid bone graft in cases with a significant anterior glenoid fracture associated with a proximal humerus fracture. RSA and step bone graft harvested from proximal humeral head could be a viable option in the treatment of this complex injury. Retrospective case series. Twenty-six patients underwent RSA and glenoid bone graft in a single stage procedure were evaluated at an average 32 months postoperatively. There were 18 women and 8 men with a mean age of 68.5 years (range 63-75 years). Reverse shoulder arthroplasty with a contoured glenoid bone graft placed underneath the baseplate using humeral head autograft was utilized in all cases. Clinical outcomes were evaluated with range of motion, Constant score and self-reported subjective outcome rated as excellent, good, fair or poor. Radiographic evaluation was performed to evaluate for baseplate displacement or loosening, bone graft union, resorption or collapse. At final follow-up, average active elevation was 135° (range 110°-145°), abduction 122° (range 60°-160°), and external rotation 30° (range 0 to 45°). The mean Constant score was 68.2 (range 54-83). The clinical results were rated as excellent by 15 patients, good by 9, and fair by 2. Radiographic evaluation showed the disc of cancellous bone graft healed without any signs of graft resorption or migration in all 26 cases. No reoperation was performed on any patient in this series. RSA with glenoid bone grafting produces satisfactory short-term outcomes with acceptable complication rates for treatment of patients greater than 60 years old with proximal humerus fractures

  13. Bone engineering-vitalisation of alloplastic and allogenic bone grafts by human osteoblast-like cells.

    Science.gov (United States)

    Hinze, Marc Christian; Wiedmann-Al-Ahmad, Margit; Glaum, Ricarda; Gutwald, Ralf; Schmelzeisen, Rainer; Sauerbier, Sebastian

    2010-07-01

    Human osteoblasts on non-sintered hydroxyapatite and demineralised bone matrix (DBX) were analysed in vitro to find out whether they would be suitable for reconstruction of bones in oral surgery. Human osteoblasts were isolated from the jaw during routine dental operations and seeded onto the two biomaterials. Cells were characterised by assay of alkaline phosphatase, detection of type 1 collagen, and production of osteocalcin. After 21 days of cultivation, the cell/biomaterial constructs were examined by scanning electron microscopy, thin sections, and propidium iodide/fluorescein diacetate staining. The osteoblasts formed a vital multiple cell layer on DBX within 3 weeks of cultivation. On hydroxyapatite, the cells showed no tendency to proliferate or migrate onto the synthetic biomaterial, or to form well-spread and viable cell constructs. These findings suggest that surface morphology or the presence of osteoinductive factors may have an important role in the adhesion and proliferation of osteoblasts. Human DBX can be colonised by human osteoblast-like cells in vitro, indicating the potential of allogeneic carriers for future procedures in bone engineering. Copyright 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Do Porous Titanium Granule Grafts Affect Bone Microarchitecture at Augmented Maxillary Sinus Sites? A Pilot Split-Mouth Human Study.

    Science.gov (United States)

    Dursun, Erhan; Dursun, Ceyda Kanli; Eratalay, Kenan; Orhan, Kaan; Celik, Hakan Hamdi; Tözüm, Tolga Fikret

    2015-08-01

    The aim of this randomized controlled clinical study was to analyze the bone microarchitecture at augmented maxillary sinus sites by using different materials in patients to compare the effect of porous titanium granules as a sinus augmentation material with bone microstructural features. Eight subjects with bilateral atrophic posterior maxilla of residual bone height Dental) and xenograft (1 g) + porous titanium (1 g) granules (Natix; Tigran Technologies AB). Sixteen human bone biopsy samples were taken from patients receiving two-stage sinus augmentation therapy during implant installation and analyzed using microcomputerized tomography. Three-dimensional bone structural parameters were analyzed in details: tissue volume, bone volume, percentage of bone volume, bone surface and bone surface density, bone specific surface, trabecular thickness trabecular separation, trabecular number, trabecular pattern factor, structural model index, fractal dimension, and bone mineral density. No statistically significant differences were found between groups according to bone structural parameters. Porous titanium grafts may ensure a space for new bone formation in the granules, which may be a clinical advantage for long-term success.

  15. Tomographic evaluation of iliac crest bone grafting and the use of immediate temporary implants to the atrophic maxilla.

    Science.gov (United States)

    Castagna, L; Polido, W D; Soares, L G; Tinoco, E M B

    2013-09-01

    Sixteen consecutive patients with atrophic maxillae, who had been referred for bone augmentation using iliac bone grafting before the placement of dental implants, received a full clinical examination and underwent a CT scan before and after surgery. Linear vertical and horizontal measurements were made before and 6 months after surgery. Differences in mean bone gain or loss for each area were compared between a group that received an immediate total provisional prosthesis on temporary immediate implants (test group, 12 patients) and a control group (four patients). Both groups showed significant horizontal bone gain in all regions and vertical bone augmentation in the posterior regions. The test group showed no significant difference for bone gain compared to the control group, but half the test group had problems during treatment. Bone augmentation of the atrophic maxilla with iliac crest bone grafting resulted in sufficient vertical and horizontal bone augmentation to install six or eight implants in all patients and successfully rehabilitate them. The results suggest that the use of total provisional prostheses on temporary immediate implants meets the aesthetic demands required, but should be used with care and in special cases. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Structural properties of a bone-ceramic composite as a promising material in spinal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kirilova, I. A., E-mail: IKirilova@mail.ru; Sadovoy, M. A.; Podorozhnaya, V. T., E-mail: VPodorognaya@niito.ru; Taranov, O. S. [Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan, Novosibirsk (Russian Federation); Klinkov, S. V.; Kosarev, V. F. [Christianovich Institute of Theoretical and Applied Mechanics, SB RAS, Novosibirsk (Russian Federation); Shatskaya, S. S. [Institute of Solid State Chemistry and Mechanochemistry, SB RAS, Novosibirsk (Russian Federation)

    2015-11-17

    The paper describes the results of in vitro tests of composite bone-ceramic implants and procedures for modifying implant surfaces to enhance osteogenesis. Analysis of CBCI ESs demonstrated that they have a porous structure with the mean longitudinal pore size of 70 µm and the mean transverse pore size of 46 µm; surface pores are open, while inner pores are closed. Elemental analysis of the CBCI surface demonstrates that CBCIs are composed of aluminum and zirconium oxides and contain HA inclusions. Profilometry of the CBCI ES surface revealed the following deviations: the maximum deviation of the profile in the sample center is 15 µm and 16 µm on the periphery, while the arithmetical mean and mean square deviations of the profile are 2.65 and 3.4 µm, respectively. In addition, CBCI biodegradation products were pre-examined; a 0.9% NaCl solution was used as a comparison group. Potentially toxic and tissue accumulated elements, such as cadmium, cobalt, mercury, and lead, are present only in trace amounts and have no statistically significant differences with the comparison group, which precludes their potential toxic effects on the macroorganism. Ceramic-based CBCI may be effective and useful in medicine for restoration of the anatomic integrity and functions of the bone tissue.

  17. 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.

  18. Bone transplantation and tissue engineering, part III: allografts, bone grafting and bone banking in the twentieth century.

    Science.gov (United States)

    Hernigou, Philippe

    2015-03-01

    During the 20th century, allograft implantation waned in popularity as a clinical activity. Reports appeared in the literature describing several small series of patients in whom bone was obtained from amputation specimens or recently deceased individuals. The concept of bone banking became a reality during and after World War II when the National Naval Tissue Bank was established in Bethesda and a number of small banks sprang up in hospitals throughout the world. Small fragments, either of cortical or medullary bone, from these banks were used heterotopically to augment spinal fusions, to implant into cyst cavities, or to serve as a scaffolding for repair of non- or delayed union of fractures of the long bones.

  19. Definitive CAD/CAM-guided prosthesis for immediate loading of bone-grafted maxilla: a case report.

    Science.gov (United States)

    Kupeyan, Herman K; Shaffner, Matt; Armstrong, Joseph

    2006-01-01

    The reconstruction of a functional occlusion in the presence of severe residual ridge resorption remains a significant challenge for maxillofacial surgeons and prosthodontists. Removable appliances are unsuccessful in severely resorbed cases and the advanced degree of bone loss precludes conventional implant-retained prostehesis. In recent years, bone graft reconstruction of the maxilla and the mandible has been advocated to reverse the debilitating effects of alveolar ridge resorption. The surgical objective was the reconstruction of the osseous platform of the jaws, thereby allowing implant-retained definitive prosthetic rehabilitation utilizing the Teeth-in-an-Hour concept within 4 months. A completely edentulous patient received bone grafts from the posterior iliac crest to augment both the maxillary and mandibular alveolar ridges. The manmandible was augmented using Marx's "soft issue matrix expansion procedure" and was restored in the conventional manor using an impression and a milled framework. The maxilla underwent "inlay/onlay" bone graft augmentation of the right and left maxilla at the same time as the mandiblular procedure. Implant placement was at 4 months post-bone graft reconstruction. Immediate loading of implants into a bone graft using Nobel Biocare's Teeth-in-an-Hour protocol prelaunch was implemented. This included CT-based implant planning, simultaneous CAD/CAM fabrication of a surgical guide, a CNC-milled framework, flapless surgical placement of the implants, and immediate placement of a pre-fabricated definitive prosthesis. This approach reduced the time necessary for an edentulous patient to transform from severely atrophic alveolar support to implant-retained maxillary and mandibular prosthetic restorations. Immediate loading with an implant retained definitive prosthesis using a bone graft-reconstructed osseous platform was also performed. The Teeth-in-an-Hour concept was utilized to restore bone grafted augmentation of the maxilla with

  20. Type of bone graft or substitute does not affect outcome of spine fusion with instrumentation for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Theologis, Alexander A; Tabaraee, Ehsan; Lin, Tracy; Lubicky, John; Diab, Mohammad

    2015-09-01

    Retrospective cohort analysis. To compare clinical outcomes after spine instrumentation and fusion using 3 different bone grafts in children with adolescent idiopathic scoliosis (AIS). Autogenous iliac crest bone graft (AIC) is the "gold standard" to promote fusion in posterior AIS operations, although the morbidity of harvest is a concern. There is limited data comparing outcomes after AIS surgery based on types of bone grafts. Children (10-18 yr) with AIS who underwent deformity correction via a posterior approach were identified in the Spinal Deformity Study Group database. All had a minimum of 2-year follow-up. Patients were subdivided into 3 groups based on bone graft used: AIC, allograft, and bone substitute (BS). Clinical data included patient demographics, operative details, postoperative analgesic use, and perioperative complications. Lenke curve type and curve magnitude changes were radiographically analyzed. The Scoliosis Research Society-30 questionnaire was used to assess clinical outcomes. 461 patients met inclusion criteria (girls: 381, boys: 80; average age 14.7 ± 1.7) and consisted of 152 AIC patients (124 girls, 28 boys), 199 allograft patients (167 girls, 32 boys), and 110 BS patients (90 girls, 20 boys). There was no difference in age (P = 0.41) or gender (P = 0.82). The BS group had significantly smaller preoperative curves and shorter operative times. Postoperatively, patients who received BS had significantly longer hospital stays, used higher quantities of patient-controlled intravenous analgesia and used epidurals longer. The AIC group used patient-controlled intravenous analgesia significantly longer. There were no differences between the groups in regards to curve type, number of levels fused, postoperative infections, pseudarthrosis, reoperations for any indication, and Scoliosis Research Society-30 scores at the latest follow-up. Outcomes after primary posterior spinal fusion with instrumentation are not influenced by type of bone

  1. Comparison of collagen membrane and bone substitute as a carrier for rhBMP-2 in lateral onlay graft.

    Science.gov (United States)

    Chang, Yun-Young; Lee, Jung-Seok; Kim, Min-Soo; Choi, Seong-Ho; Chai, Jung-Kiu; Jung, Ui-Won

    2015-01-01

    To evaluate the bone regenerative effect of bioresorbable collagen membrane (CM) as a carrier for recombinant human bone morphogenetic protein-2 (rhBMP-2) when performing lateral onlay grafts using bovine hydroxyapatite incorporated with collagen matrix (BHC) in combination with CM in dogs. A guided bone regeneration (GBR) was performed at the buccal aspect of edentulous maxillary alveolar ridges in dogs (n = 5): (1) BHC group, in which rhBMP-2-loaded BHC was covered by a CM, and (2) CM group, in which BHC was covered by an rhBMP-2-loaded CM. A histologic and histometric analysis was performed after 8 weeks of healing. Both the BHC and CM groups exhibited substantial newly formed bone (NB). More NB was found in the CM group than in the BHC group without statistical significance. Most of the NB was in direct contact with the residual bone substitute in the BHC group, whereas the projections and islands of NB were observed in the spaces between the residual bone substitute clusters in the CM group. The bone-to-residual bone substitute contact ratio was significantly lower in the CM group than in the BHC group (P = 0.043). Within the limitations of this study, it can be concluded that rhBMP-2-loaded CM performed lateral onlay grafts as effectively as rhBMP-2-loaded BHC while showing less bone-residual bone substitute contact ratio in dogs. The loading of CMs with rhBMP-2 might therefore be a recommendable treatment option for facilitating lateral onlay graft combined with rhBMP-2. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. 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

  3. 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.

  4. One versus two titanium screw fixation of autologous onlay bone grafts in the anterior maxilla: a randomised histological pilot study

    NARCIS (Netherlands)

    Burger, Evita A. C.; Meshkini, Hamid; Lindeboom, Jerome A. H.

    2011-01-01

    The aim of this study was to compare the histological presentation of local mandibular bone grafts fixed with one screw or two screws in buccal anterior maxillary augmentation procedures. Local buccal defects of the anterior maxilla were reconstructed in 12 patients (mean age 47 ± 17 years, range 18

  5. The use of beta-tricalcium phosphate bone graft substitute in dorsally plated, comminuted distal radius fractures

    Directory of Open Access Journals (Sweden)

    Jakubietz Rafael G

    2011-05-01

    Full Text Available Abstract Background Intraarticular distal radius fractures can be treated with many methods. While internal fixation with angle stable implants has become increasingly popular, the use of bone graft substitutes has also been recommended to address comminution zones and thus increase stability. Whether a combination of both methods will improve clinical outcomes was the purpose of the study Methods The study was thus conducted as a prospective randomized clinical trial. 39 patients with unilateral, intraarticular fractures of the distal radius were included and randomized to 2 groups, one being treated with internal fixation only, while the second group received an additional bone graft substitute. Results There was no statistical significance between both groups in functional and radiological results. The occurrence of complications did also not show statistical significance. Conclusions No advantage of additional granular bone graft substitutes could be seen in this study. Granular bone graft substitutes do not seem to provide extra stability if dorsal angle stable implants are used. Dorsal plates have considerable complication rates such as extensor tendon ruptures and development of CRPS.

  6. Usage of Bone Replacement Grafts in Periodontics and Oral Implantology and Their Current Levels of Clinical Evidence - A Systematic Assessment.

    Science.gov (United States)

    Salem, Daliah; Natto, Zuhair; Elangovan, Satheesh; Karimbux, Nadeem

    2016-08-01

    The aim of this review is to evaluate the levels of clinical evidence for bone replacement grafts available in the United States for periodontics and oral implantology purposes. A search was performed using PubMed, the Cochrane Library, and Google Scholar for articles relating to the use of bone replacement grafts in implant and/or periodontics by two independent reviewers. Articles unrelated to the topic, not involving patients, not including abstracts, or in languages other than English were excluded. Selected articles were graded according to "levels of evidence" based on guidelines originally introduced by Wright et al. (2003). There was limited published peer-reviewed clinical literature available regarding US commercially available bone replacement grafts in periodontics and oral implantology. Of 144 bone replacement grafts available in the United States according to Avila-Ortiz et al. (2013), only 52 met the inclusion criteria. The majority of materials used were allografts (26 of 93 available in the United States), followed by alloplasts (15 of 30) and xenografts (11 of 21). Dental providers should be aware of the limited evidence that qualified for a strong rating supporting the clinical efficacy of these materials for periodontics and oral implantology purposes using the inclusion criteria selected in this study.

  7. Influence analysis of cleft type and supernumerary teeth eruption in the prognosis of bone graft in patients with cleft palate.

    Science.gov (United States)

    Gaujac, Cristiano; de Souza Faco, Eduardo Francisco; Shinohara, Elio Hitoshi; de Souza Faco, Renato Andre; Pereira, Flávia Priscila; Assunção, Wirley Gonçalves

    2014-09-01

    The aim of this study was to investigate the influence of cleft type and supernumerary tooth eruption on the treatment of palatal clefts with alveolar bone grafts. In this article, medical records of 40 patients with palatal clefts and associated supernumerary teeth who were treated with alveolar bone grafting in the Hospital for Craniofacial Anomalies Rehabilitation were assessed. The patients were studied to assess the influence of supernumerary teeth and the cleft severity on the prognosis of the alveolar bone graft. Forty medical records were included in the assessment. When the teeth in the cleft had an anatomic shape close to canine, we called them precanine. When they were very small or malfor