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Sample records for replace bone grafts

  1. Bone grafting: An overview

    Directory of Open Access Journals (Sweden)

    D. O. Joshi

    2010-08-01

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

  2. Bone graft

    Science.gov (United States)

    ... around the area. The bone graft can be held in place with pins, plates, or screws. Why ... Orthopaedic Surgery, San Francosco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...

  3. 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.

  4. The effect of placing a bone replacement graft in the gap at immediately placed implants: a randomized clinical trial.

    Science.gov (United States)

    Sanz, Mariano; Lindhe, Jan; Alcaraz, Jaime; Sanz-Sanchez, Ignacio; Cecchinato, Denis

    2017-08-01

    To assess the added value of using a bone replacement graft in combination with immediate implants in reducing the bone dimensional changes occurring in the residual ridge. Randomized parallel controlled clinical trial to study the efficacy of grafting with demineralized bovine bone mineral with 10% collagen (DBBM-C) in the gap between the implant surface and the inner bone walls when the implants were immediately placed in the anterior maxilla. The changes between implant placement and 16 weeks later in the horizontal and vertical crestal bone changes in relation to the implant were evaluated through direct bone measurements using a periodontal probe. Mean changes were compared between the experimental and control sites using parametric statistics. A total of 86 implant sites in 86 subjects were included in the analysis (43 in the test group and 43 in the control group). The horizontal crest dimension underwent marked changes during healing mainly at the buccal aspect of the alveolar crest where this reduction amounted to 1.1 (29%) in the test group and 1.6 mm (38%) in the control group, being these statistically significant (P = 0.02). This outcome was even more pronounced at sites in the anterior maxilla and with thinner buccal bone plates. In conclusion, the results from this clinical trial demonstrated that placing a DBBM-C bone replacement graft significantly reduced the horizontal bone resorptive changes occurring in the buccal bone after the immediate implantation in fresh extraction sockets. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. 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.

  6. Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotic impregnated bone graft.

    Science.gov (United States)

    Winkler, Heinz

    2009-09-04

    Infection of a total hip replacement (THR) is considered a devastating complication, necessitating its complete removal and thorough debridement of the site. It is undoubted that one stage exchange, if successful, would provide the best benefit both for the patient and the society. Still the fear of re-infection dominates the surgeons decisions and in the majority of cases directs them to multiple stage protocols. However, there is no scientifically based argument for that practice. Successful eradication of infection with two stage procedures is reported to average 80% to 98%. On the other hand a literature review of Jackson and Schmalzried (CORR 2000) summarizing the results of 1,299 infected hip replacements treated with direct exchange (almost exclusively using antibiotic loaded cement), reports of 1,077 (83%) having been successful. The comparable results suggest, that the major factor for a successful outcome with traditional approaches may be found in the quality of surgical debridement and dead space management. Failures in all protocols seem to be caused by small fragments of bacterial colonies remaining after debridement, whereas neither systemic antibiotics nor antibiotic loaded bone cement (PMMA) have been able to improve the situation significantly. Reasons for failure may be found in the limited sensitivity of traditional bacterial culturing and reduced antibiotic susceptibility of involved pathogens, especially considering biofilm formation. Whenever a new prosthesis is implanted into a previously infected site the surgeon must be aware of increased risk of failure, both in single or two stage revisions. Eventual removal therefore should be easy with low risk of additional damage to the bony substance. On the other hand it should also have potential of a good long term result in case of success. Cemented revisions generally show inferior long term results compared to uncemented techniques; the addition of antibiotics to cement reduces its

  7. Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotic impregnated bone graft

    Directory of Open Access Journals (Sweden)

    Heinz Winkler

    2009-01-01

    Full Text Available Infection of a total hip replacement (THR is considered a devastating complication, necessitating its complete removal and thorough debridement of the site. It is undoubted that one stage exchange, if successful, would provide the best benefit both for the patient and the society. Still the fear of re-infection dominates the surgeons´ decisions and in the majority of cases directs them to multiple stage protocols. However, there is no scientifically based argument for that practice. Successful eradication of infection with two stage procedures is reported to average 80% to 98%. On the other hand a literature review of Jackson and Schmalzried (CORR 2000 summarizing the results of 1,299 infected hip replacements treated with direct exchange (almost exclusively using antibiotic loaded cement, reports of 1,077 (83% having been successful. The comparable results suggest, that the major factor for a successful outcome with traditional approaches may be found in the quality of surgical debridement and dead space management. Failures in all protocols seem to be caused by small fragments of bacterial colonies remaining after debridement, whereas neither systemic antibiotics nor antibiotic loaded bone cement (PMMA have been able to improve the situation significantly. Reasons for failure may be found in the limited sensitivity of traditional bacterial culturing and reduced antibiotic susceptibility of involved pathogens, especially considering biofilm formation. Whenever a new prosthesis is implanted into a previously infected site the surgeon must be aware of increased risk of failure, both in single or two stage revisions. Eventual removal therefore should be easy with low risk of additional damage to the bony substance. On the other hand it should also have potential of a good long term result in case of success. Cemented revisions generally show inferior long term results compared to uncemented techniques; the addition of antibiotics to cement

  8. Olecranon bone graft: revisited.

    Science.gov (United States)

    Mersa, Berkan; Ozcelik, Ismail Bulent; Kabakas, Fatih; Sacak, Bulent; Aydin, Atakan

    2010-09-01

    Autogenous bone grafts are frequently in use in the field of reconstructive upper extremity surgery. Cancellous bone grafts are applied to traumatic osseous defects, nonunions, defects after the resection of benign bone tumors, arthrodesis, and osteotomy procedures. Cancellous bone grafts do not only have benefits such as rapid revascularization, but they also have mechanical advantages. Despite the proximity to the primary surgical field, cancellous olecranon grafts have not gained the popularity they deserve in the field of reconstructive hand surgery. In this study, the properties, advantages, and technical details of harvesting cancellous olecranon grafts are discussed.

  9. Alveolar bone grafting

    Directory of Open Access Journals (Sweden)

    Lilja Jan

    2009-10-01

    Full Text Available In patients with cleft lip and palate, bone grafting in the mixed dentition in the residual alveolar cleft has become a well-established procedure. The main advantages can be summarised as follows: stabilisation of the maxillary arch; facilitation of eruption of the canine and sometimes facilitation of the lateral incisor eruption; providing bony support to the teeth adjacent to the cleft; raising the alar base of the nose; facilitation of closure of an oro-nasal fistula; making it possible to insert a titanium fixture in the grafted site and to obtain favourable periodontal conditions of the teeth within and adjacent to the cleft. The timing of the ABG surgery take into consideration not only eruption of the canine but also that of the lateral incisor, if present. The best time for bone grafting surgery is when a thin shell of bone still covers the soon erupting lateral incisor or canine tooth close to the cleft.

  10. The caudal septum replacement graft.

    Science.gov (United States)

    Foda, Hossam M T

    2008-01-01

    To describe a technique for reconstructing the lost tip support in cases involving caudal septal and premaxillary deficiencies. The study included 120 patients with aesthetic and functional nasal problems resulting from the loss of caudal septal and premaxillary support. An external rhinoplasty approach was performed to reconstruct the lost support using a cartilaginous caudal septum replacement graft and premaxillary augmentation with Mersilene mesh. The majority of cases (75%) involved revisions in patients who had previously undergone 1 or more nasal surgical procedures. A caudal septum replacement graft was combined with premaxillary augmentation in 93 patients (77.5%). The mean follow-up period was 3 years (range, 1-12 years). The technique succeeded in correcting the external nasal deformities in all patients and resulted in a significant improvement in breathing in 74 patients (86%) with preoperative nasal obstruction. There were no cases of infection, displacement, or extrusion. The caudal septum replacement graft proved to be very effective in restoring the lost tip support in patients with caudal septal deficiency. Combining the graft with premaxillary augmentation using Mersilene mesh helped increase support and stability over long-term follow-up.

  11. Femoral revision surgery with impaction bone grafting

    NARCIS (Netherlands)

    B.L.E.F. ten Have (Bas); R.W. Brouwer (Reinoud); F.C. van Biezen (Frans); J.A.N. Verhaar (Jan)

    2012-01-01

    textabstractThe purpose of this prospective study was to evaluate the long-term clinical and radiological outcomes of revision of the femoral component of a total hip replacement using impaction bone grafting. Femoral revision with an impacted allograft was performed on 29 patients (31 hips). In all

  12. Bone Grafting: Sourcing, Timing, Strategies, and Alternatives.

    Science.gov (United States)

    Egol, Kenneth A; Nauth, Aaron; Lee, Mark; Pape, Hans-Christoph; Watson, J Tracy; Borrelli, Joseph

    2015-12-01

    Acute fractures, nonunions, and nonunions with bone defects or osteomyelitis often need bone graft to facilitate union. There are several factors to consider when it is determined that a bone graft is needed. These factors include the source of the bone graft (autograft vs. allograft), proper timing for placement of the bone graft, strategies to avoid further complications (particularly in the setting of osteomyelitis), and with the development of a variety of bone graft substitutes, whether alternatives to autograft are available and appropriate for the task at hand. Autograft bone has commonly been referred to as the "gold standard" of bone grafts, against which the efficacy of other grafts has been measured. The best timing for when to place a bone graft or substitute is also somewhat controversial, particularly after an open fracture or a potentially contaminated bed. The treatment of infected nonunions, particularly those that require a graft to facilitate healing, can be quite challenging. Typically, the infection is completely eradicated before placement of a bone graft, but achieving a sterile bed and the timing of a bone graft require strategic thinking and planning. This review outlines the benefits of autografts, the most suitable sites for harvesting bone grafts, the timing of bone graft procedures, the potential risks and benefits of grafting in the face of infection, and the currently available bone graft extenders.

  13. Dynamics of bone graft healing around implants

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

  15. 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.

  16. Bone Graft Substitutes : Developed for Trauma and Orthopaedic Surgery

    NARCIS (Netherlands)

    J. van der Stok (Johan)

    2015-01-01

    markdownabstract__Abstract__ Bone grafting was established in the 19th century and has become a common procedure in which bone defects are filled with bone grafts or bone graft substitutes. Bone defects that require bone grafting are encountered in approximately 10% of trauma and orthopaedic surger

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  18. Vascularized tail bone grafts in rats.

    Science.gov (United States)

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

    1993-03-01

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

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

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA...

  20. Controlling Bone Graft Substitute Microstructure to Improve Bone Augmentation.

    Science.gov (United States)

    Sheikh, Zeeshan; Drager, Justin; Zhang, Yu Ling; Abdallah, Mohamed-Nur; Tamimi, Faleh; Barralet, Jake

    2016-07-01

    Vertical bone augmentation procedures are frequently carried out to allow successful placement of dental implants in otherwise atrophic ridges and represent one of the most common bone grafting procedures currently performed. Onlay autografting is one of the most prevalent and predictable techniques to achieve this; however, there are several well documented complications and drawbacks associated with it and synthetic alternatives are being sought. Monetite is a bioresorbable dicalcium phosphate with osteoconductive and osteoinductive potential that has been previously investigated for onlay bone grafting and it is routinely made by autoclaving brushite to simultaneously sterilize and phase convert. In this study, monetite disc-shaped grafts are produced by both wet and dry heating methods which alter their physical properties such as porosity, surface area, and mechanical strength. Histological observations after 12 weeks of onlay grafting on rabbit calvaria reveal higher bone volume (38%) in autoclaved monetite grafts in comparison with the dry heated monetite grafts (26%). The vertical bone height gained is similar for both the types of monetite grafts (up to 3.2 mm). However, it is observed that the augmented bone height is greater in the lateral than the medial areas of both types of monetite grafts. It is also noted that the higher porosity of autoclaved monetite grafts increases the bioresorbability, whereas the dry heated monetite grafts having lower porosity but higher surface area resorb to a significantly lesser extent. This study provides information regarding two types of monetite onlay grafts prepared with different physical properties that can be further investigated for clinical vertical bone augmentation applications.

  1. Bone Marrow Transplantation (BMT) and Gene Replacement ...

    African Journals Online (AJOL)

    Bone Marrow Transplantation (BMT) and Gene Replacement Therapy (GRT) In Sickle Cell Anemia. ... manifesting clinical disease, while the heterozygoste(AS) are clinically ... medicine, we argue here the case for Bone marrow transplantation

  2. Better primary stability with porous titanium particles than with bone particles in cemented impaction grafting: An in vitro study in synthetic acetabula

    NARCIS (Netherlands)

    Walschot, L.H.B.; Aquarius, R.; Schreurs, B.W.; Buma, P.; Verdonschot, Nicolaas Jacobus Joseph

    2013-01-01

    Aims Impaction bone grafting creates new bone stock after hip joint replacement. Utilizing a synthetic bone substitute instead of bone might increase primary stability and is not associated with graft shortage and pathogen transmission. This study compares the initial stability of a graft layer of p

  3. Bone graft substitutes: past, present, future.

    Directory of Open Access Journals (Sweden)

    Parikh S

    2002-04-01

    Full Text Available Bone grafts are necessary to provide support, fill voids, and enhance biologic repair of skeletal defects. They are used by orthopaedic surgeons, neurosurgeons, craniofacial surgeons, and periodontists. Bone harvested from donor sites is the gold standard for this procedure. It is well documented that there are limitations and complications from the use of autograft, including the limited quantity and associated chronic donor site pain. Despite the increase in the number of procedures that require bone grafts, there has not been a single ideal bone graft substitute Scientists, surgeons, and medical companies, thus, have a tremendous responsibility to develop biologic alternatives that will enhance the functional capabilities of the bone graft substitute, and potentially reduce or eliminate the need for autograft. This article is an attempt to review the past and existing bone graft substitutes, and future directions of research. The historical data was extracted after thorough review of the literature. The data for the current concepts and future directions was compiled from the Internet, and from direct correspondence with medical companies. Since many products are undergoing clinical trials, and are yet not commercially available, their data cannot be found in literature. The main purpose of this article is to give the reader an idea about the existing market products and products likely to be available in near future.

  4. LONG TERM EVOLUTION OF BONE RECONSTRUCTION WITH BONE GRAFT SUBSTITUTES

    Directory of Open Access Journals (Sweden)

    O. V. Martynenko

    2017-06-01

    Full Text Available The review involves clinical and experimental data, constitutive modeling, and computational investigations towards an understanding on how mechanical cyclic loads for long periods of time affect damage evolution in a reconstructed bone, as well as, lifetime reduction of bone graft substitutes after advanced core decompression. The outcome of the integrated model discussed in this paper will be how damage growth in femur after advanced core decompression subjected to mechanical cyclic loading under creep and fatigue conditions may be controlled in order to optimize design and processing of bone graft substitutes, and extend lifetime of bone substitutes.

  5. The use of bone grafts and bone graft substitutes in pediatric orthopaedics: an overview.

    Science.gov (United States)

    Gross, Richard H

    2012-01-01

    Bone graft substitutes have become progressively more widely used, and are currently heavily marketed. To make intelligent decisions, a complete knowledge of autograaft and allograft bone healing is essential, including the definition of "sterile". Differences in donor selection and tissue processing may confound the user not familiar with the implications of these different approaches. Specific products include demineralized bone matrix (DBM), specific growth factors (recombinant BMP's), ceramic grafts, and platelet-rich plasma (PRP). There are a number of useful applications of bone graft substitues for pediatric orthopaedists, but the data base is evolving. This paper describes the current status of these products.

  6. Decellularized bone matrix grafts for calvaria regeneration

    Science.gov (United States)

    Lee, Dong Joon; Diachina, Shannon; Lee, Yan Ting; Zhao, Lixing; Zou, Rui; Tang, Na; Han, Han; Chen, Xin; Ko, Ching-Chang

    2016-01-01

    Decellularization is a promising new method to prepare natural matrices for tissue regeneration. Successful decellularization has been reported using various tissues including skin, tendon, and cartilage, though studies using hard tissue such as bone are lacking. In this study, we aimed to define the optimal experimental parameters to decellularize natural bone matrix using 0.5% sodium dodecyl sulfate and 0.1% NH4OH. Then, the effects of decellularized bone matrix on rat mesenchymal stem cell proliferation, osteogenic gene expression, and osteogenic differentiations in a two-dimensional culture system were investigated. Decellularized bone was also evaluated with regard to cytotoxicity, biochemical, and mechanical characteristics in vitro. Evidence of complete decellularization was shown through hematoxylin and eosin staining and DNA measurements. Decellularized bone matrix displayed a cytocompatible property, conserved structure, mechanical strength, and mineral content comparable to natural bone. To study new bone formation, implantation of decellularized bone matrix particles seeded with rat mesenchymal stem cells was conducted using an orthotopic in vivo model. After 3 months post-implantation into a critical-sized defect in rat calvaria, new bone was formed around decellularized bone matrix particles and also merged with new bone between decellularized bone matrix particles. New bone formation was analyzed with micro computed tomography, mineral apposition rate, and histomorphometry. Decellularized bone matrix stimulated mesenchymal stem cell proliferation and osteogenic differentiation in vitro and in vivo, achieving effective bone regeneration and thereby serving as a promising biological bone graft. PMID:28228929

  7. Decellularized bone matrix grafts for calvaria regeneration

    Directory of Open Access Journals (Sweden)

    Dong Joon Lee

    2016-12-01

    Full Text Available Decellularization is a promising new method to prepare natural matrices for tissue regeneration. Successful decellularization has been reported using various tissues including skin, tendon, and cartilage, though studies using hard tissue such as bone are lacking. In this study, we aimed to define the optimal experimental parameters to decellularize natural bone matrix using 0.5% sodium dodecyl sulfate and 0.1% NH4OH. Then, the effects of decellularized bone matrix on rat mesenchymal stem cell proliferation, osteogenic gene expression, and osteogenic differentiations in a two-dimensional culture system were investigated. Decellularized bone was also evaluated with regard to cytotoxicity, biochemical, and mechanical characteristics in vitro. Evidence of complete decellularization was shown through hematoxylin and eosin staining and DNA measurements. Decellularized bone matrix displayed a cytocompatible property, conserved structure, mechanical strength, and mineral content comparable to natural bone. To study new bone formation, implantation of decellularized bone matrix particles seeded with rat mesenchymal stem cells was conducted using an orthotopic in vivo model. After 3 months post-implantation into a critical-sized defect in rat calvaria, new bone was formed around decellularized bone matrix particles and also merged with new bone between decellularized bone matrix particles. New bone formation was analyzed with micro computed tomography, mineral apposition rate, and histomorphometry. Decellularized bone matrix stimulated mesenchymal stem cell proliferation and osteogenic differentiation in vitro and in vivo, achieving effective bone regeneration and thereby serving as a promising biological bone graft.

  8. [Bovine heterologous bone graft in orbital surgery].

    Science.gov (United States)

    Morax, S; Hurbli, T; Smida, R

    1993-08-01

    Lubboc (T650) is a bovine heterologous bone implant obtained by specific preparation of trabecular of bone. In vitro and in vivo biocompatibility studies have revealed the absence of any cytotoxicity or systemic toxicity. Lubboc has many fields of application, including all bone graft surgical indications. We report our first results concerning the use of this product in orbital surgery either as a filling or contention material or as an apposition material. On all 20 operated patients we did not encounter any intolerance, inflammation or infection. The follow-up is still too short to appreciate the long term integration of this material which has the advantage of being a substitute for autologous bone, avoiding bone graft harvesting.

  9. 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.

  10. Bone regeneration with cultured human bone grafts

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-07-01

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

  11. 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...

  12. A comprehensive clinical review of recombinant human bone morphogenetic protein-2 (INFUSE® Bone Graft)

    Science.gov (United States)

    Peckham, Steven M.; Badura, Jeffrey M.

    2007-01-01

    The combination of recombinant human bone morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge (ACS) carrier has been shown to induce bone formation in a number of preclinical and clinical investigations. In 2002, rhBMP-2/ACS at a 1.5-mg/cc concentration (INFUSE® Bone Graft, Medtronic Spinal and Biologics, Memphis, TN) was FDA-approved as an autograft replacement for certain interbody spinal fusion procedures. In 2004, INFUSE® Bone Graft was approved for open tibial fractures with an intermedullary (IM) nail fixation. Most recently, in March 2007, INFUSE® Bone Graft was approved as an alternative to autogenous bone grafts for sinus augmentations, and for localised alveolar ridge augmentations for defects associated with extraction sockets. The culmination of extensive preclinical and clinical research and three FDA approvals makes rhBMP-2 one of the most studied, published and significant advances in orthopaedics. This review article summarises a number of clinical findings of rhBMP-2/ACS, including the FDA-approved investigational device exemption (IDE) studies used in gaining the aforementioned approvals. PMID:17639384

  13. 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...

  14. 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...

  15. 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 (phealing without provoking any significant inflammatory process. The study also indicates that defects treated with G-Graft attain more density initially and that G-Graft enhances bone healing

  16. Biodegradable, thermoplastic polyurethane grafts for small diameter vascular replacements.

    Science.gov (United States)

    Bergmeister, Helga; Seyidova, Nargiz; Schreiber, Catharina; Strobl, Magdalena; Grasl, Christian; Walter, Ingrid; Messner, Barbara; Baudis, Stefan; Fröhlich, Sophie; Marchetti-Deschmann, Martina; Griesser, Markus; di Franco, Matt; Krssak, Martin; Liska, Robert; Schima, Heinrich

    2015-01-01

    Biodegradable vascular grafts with sufficient in vivo performance would be more advantageous than permanent non-degradable prostheses. These constructs would be continuously replaced by host tissue, leading to an endogenous functional implant which would adapt to the need of the patient and exhibit only limited risk of microbiological graft contamination. Adequate biomechanical strength and a wall structure which promotes rapid host remodeling are prerequisites for biodegradable approaches. Current approaches often reveal limited tensile strength and therefore require thicker or reinforced graft walls. In this study we investigated the in vitro and in vivo biocompatibility of thin host-vessel-matched grafts (n=34) formed from hard-block biodegradable thermoplastic polyurethane (TPU). Expanded polytetrafluoroethylene (ePTFE) conduits (n=34) served as control grafts. Grafts were analyzed by various techniques after retrieval at different time points (1 week; 1, 6, 12 months). TPU grafts showed significantly increased endothelial cell proliferation in vitro (Pbiodegradable vascular implant. Degradable grafts showed equivalent long-term performance characteristics compared to the clinically used, non-degradable material with improvements in intimal hyperplasia and ingrowth of host cells.

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

    Science.gov (United States)

    Babiker, Hassan

    2013-07-01

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

  18. Bone scanning after muscle-pedicle bone graft for femoral neck fracture, (1). Preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, Yutaka; Nabeshima, Kazuo; Okazaki, Takeyuki; Dogo, Akihiko; Kurihara, Makoto; Tsai, Yeong-Nan (Kawasaki Steel Corp., Kobe (Japan))

    1982-04-01

    sup(99m)Tc-MDP bone scintigraphy was performed on patients who received muscle-pedicle bone graft. In each of the bone head and the bone graft, a time-activity curve was obtained. In this muscle-pedicle bone graft, active revascularization and marked osteogenesis, which suggested rapid bone repairing, were observed. The bone scintigraphy was considered to be useful in observing the result of bone grafts, blood circulation, and time of bone fusion, and of value for early detection of secondary changes.

  19. 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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  1. Novel Approaches to Bone Grafting: Porosity, Bone Morphogenetic Proteins, Stem Cells, and the Periosteum

    OpenAIRE

    Petrochenko, Peter; Narayan, Roger J.

    2010-01-01

    The disadvantages involving the use of a patient’s own bone as graft material have led surgeons to search for alternative materials. In this review, several characteristics of a successful bone graft material are discussed. In addition, novel synthetic materials and natural bone graft materials are being considered. Various factors can determine the success of a bone graft substitute. For example, design considerations such as porosity, pore shape, and interconnection play significant roles i...

  2. 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

  3. Estudo comparativo da neoformação óssea utilizando-se o enxerto autógeno e três substitutos: defeitos ósseos em ratos Comparative study of bone neoformation using autologous grafting and three replacements: bone defects in rats

    Directory of Open Access Journals (Sweden)

    Rodrigo Steffen Stein

    2009-01-01

    Full Text Available OBJETIVO: Comparar a percentagem de neoformação óssea promovida pelo enxerto ósseo autógeno e três tipos de materiais de substituição de características distintas em cavidades em fêmures de ratos. MÉTODOS: Foram realizadas duas cavidades de 5,4 x 2,7mm, em cada fêmur (direito e esquerdo, de 14 ratos Wistar isogênicos. Cada um dos quatro defeitos criados foi preenchido com o osso autógeno ou com um dos três materiais testados - hidroxiapatita (HA, Genphos® (HA+ β-TCP e GenMix® (um enxerto ósseo bovino composto. Ao final dos períodos de seis semanas (n = 6 e 12 semanas (n = 8, os animais foram sacrificados. As lâminas (coradas com Picro-Sirius foram analisadas por microscopia óptica normal e software específico. RESULTADOS: Os grupos com o osso autógeno se mostraram muito superiores aos demais nos dois tempos analisados, tendo média de neoformação óssea ± DP de 90,6 ± 10,8% em seis semanas, e 98 ± 9,2% em 12 semanas (p > 0,0001 em ambos os tempos analisados. Em seis semanas, os resultados para os demais grupos foram os seguintes: Genphos®, 46 ± 7,1%; HA, 43,1 ± 8,4%; e GenMix®, 57,3 ± 4,5%. Em 12 semanas: Genphos®, 47,8 ± 11,1%; HA, 39,9 ± 5,4%; GenMix®, 59,7 ± 4,8%, significativa (p = 0,007. CONCLUSÕES: Em ambos os tempos analisados, os três materiais de substituição óssea testados se mostraram inferiores ao osso autógeno quanto à percentagem de neoformação óssea.OBJECTIVE: Compare the percentage of bone neoformation promoted by autologous bone grafting and three kinds of replacement materials with different characteristics in rats' femoral holes. METHODS: Two holes measuring 5.4 x 2.7mm, were produced on each femur (right and left of 14 isogenic Wistar rats. Each of the four defects produced was filled by autologous bone or by one of three tested materials - hydroxyapatite (HA, Genphos® (HA+ β-TCP and GenMix® (a combined bovine bone graft. In the end of the 6-week (n = 6 and 12-week (n = 8

  4. Vestibuloplasty after secondary alveolar bone grafting.

    Science.gov (United States)

    Iino, M; Fukuda, M; Murakami, K; Horiuchi, T; Niitsu, K; Seto, K

    2001-11-01

    This paper introduces a surgical technique for vestibuloplasty after secondary alveolar bone grafting of patients with cleft lip and palate (CLP). This paper also reports on the patients who underwent this modified vestibuloplasty. The vestibuloplasty technique described in this paper consists of: (1) reduction of submucosal scar tissue of the upper lip, (2) V-Y plasty of the superficial mucosa, (3) placement of horizontal mattress sutures between nostril floor skin and freed marginal mucosa, (4) application of artificial skin to cover the exposed periosteal surface, and (5) use of a removable retention splint. This surgical procedure appears to be very useful for patients with CLP. The technique enables the surgeon to obtain an adequate sulcus depth around the graft area. In addition, this technique releases the mucosal scar contraction and improves the shape and mobility of the upper lip.

  5. 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.

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

    Science.gov (United States)

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

    2013-05-01

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

  7. Bone Replacement Materials and Techniques Used for Achieving Vertical Alveolar Bone Augmentation

    Directory of Open Access Journals (Sweden)

    Zeeshan Sheikh

    2015-05-01

    Full Text Available Alveolar bone augmentation in vertical dimension remains the holy grail of periodontal tissue engineering. Successful dental implant placement for restoration of edentulous sites depends on the quality and quantity of alveolar bone available in all spatial dimensions. There are several surgical techniques used alone or in combination with natural or synthetic graft materials to achieve vertical alveolar bone augmentation. While continuously improving surgical techniques combined with the use of auto- or allografts provide the most predictable clinical outcomes, their success often depends on the status of recipient tissues. The morbidity associated with donor sites for auto-grafts makes these techniques less appealing to both patients and clinicians. New developments in material sciences offer a range of synthetic replacements for natural grafts to address the shortcoming of a second surgical site and relatively high resorption rates. This narrative review focuses on existing techniques, natural tissues and synthetic biomaterials commonly used to achieve vertical bone height gain in order to successfully restore edentulous ridges with implant-supported prostheses.

  8. Novel approaches to bone grafting: porosity, bone morphogenetic proteins, stem cells, and the periosteum.

    Science.gov (United States)

    Petrochenko, Peter; Narayan, Roger J

    2010-01-01

    The disadvantages involving the use of a patient's own bone as graft material have led surgeons to search for alternative materials. In this review, several characteristics of a successful bone graft material are discussed. In addition, novel synthetic materials and natural bone graft materials are being considered. Various factors can determine the success of a bone graft substitute. For example, design considerations such as porosity, pore shape, and interconnection play significant roles in determining graft performance. The effective delivery of bone morphogenetic proteins and the ability to restore vascularization also play significant roles in determining the success of a bone graft material. Among current approaches, shorter bone morphogenetic protein sequences, more efficient delivery methods, and periosteal graft supplements have shown significant promise for use in autograft substitutes or autograft extenders.

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

    DEFF Research Database (Denmark)

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

    2001-01-01

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

  10. 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

  11. Periosteal BMP2 activity drives bone graft healing.

    Science.gov (United States)

    Chappuis, Vivianne; Gamer, Laura; Cox, Karen; Lowery, Jonathan W; Bosshardt, Dieter D; Rosen, Vicki

    2012-10-01

    Bone graft incorporation depends on the orchestrated activation of numerous growth factors and cytokines in both the host and the graft. Prominent in this signaling cascade is BMP2. Although BMP2 is dispensable for bone formation, it is required for the initiation of bone repair; thus understanding the cellular mechanisms underlying bone regeneration driven by BMP2 is essential for improving bone graft therapies. In the present study, we assessed the role of Bmp2 in bone graft incorporation using mice in which Bmp2 has been removed from the limb prior to skeletal formation (Bmp2(cKO)). When autograft transplantations were performed in Bmp2cKO mice, callus formation and bone healing were absent. Transplantation of either a vital wild type (WT) bone graft into a Bmp2(cKO) host or a vital Bmp2(cKO) graft into a WT host also resulted in the inhibition of bone graft incorporation. Histological analyses of these transplants show that in the absence of BMP2, periosteal progenitors remain quiescent and healing is not initiated. When we analyzed the expression of Sox9, a marker of chondrogenesis, on the graft surface, we found it significantly reduced when BMP2 was absent in either the graft itself or the host, suggesting that local BMP2 levels drive periosteal cell condensation and subsequent callus cell differentiation. The lack of integrated healing in the absence of BMP2 was not due to the inability of periosteal cells to respond to BMP2. Healing was achieved when grafts were pre-soaked in rhBMP2 protein, indicating that periosteal progenitors remain responsive in the absence of BMP2. In contrast to the requirement for BMP2 in periosteal progenitor activation in vital bone grafts, we found that bone matrix-derived BMP2 does not significantly enhance bone graft incorporation. Taken together, our data show that BMP2 signaling is not essential for the maintenance of periosteal progenitors, but is required for the activation of these progenitors and their subsequent

  12. Coralline hydroxyapatite is a suitable bone graft substitute in an intra-articular goat defect model.

    Science.gov (United States)

    Koëter, S; Tigchelaar, S J; Farla, P; Driessen, L; van Kampen, A; Buma, P

    2009-07-01

    Intra-articular defects can be filled with an autologous bone graft taken from the iliac crest. This can be indicated after trauma or following correcting osteotomy. Patients may encounter donor site morbidity after this procedure. In this in vivo study, we studied if coralline hydroxyapatite (CHA) is a suitable material to replace autologous bone graft to fill a defect in the femoral trochlea of goats. CHA did not evoke any negative reaction in the synovium, and the articular cartilage was comparable to controls. In the bone graft group, we found scattered areas of (enchondral formed) bone. Most bone graft had been resorbed or remodeled, and the scarce remnants were incorporated into new bone. Resorption of CHA was limited or absent and most CHA was surrounded by new bone. In areas with fragmented CHA, close to the joint surface, numerous giant cells were found. The study shows that in this animal model, CHA inserted in a defect that directly communicates with the joint space incorporates into bone. This study did not show any negative effects of CHA in a joint environment.

  13. Alveolar bone grafting with simultaneous cleft lip rhinoplasty.

    Science.gov (United States)

    Kim, Young-Eun; Han, Jihyeon; Baek, Rong-Min; Kim, Baek-Kyu

    2016-11-01

    Optimal timing for cleft lip rhinoplasty is controversial. Definitive rhinoplasty is deferred until facial skeletal growth is completed. Intermediate rhinoplasty is performed after stabilization of the grafted alveolar bone, because the grafted bone tends to be absorbed over several months postoperatively, distorting the nasal profile. Here, we report our experience with simultaneous rhinoplasty during alveolar bone grafting for indicated patients, describe our surgical technique that ensures long-term bone graft survival, and report graft take rates and nasal profile changes. This retrospective chart review included a total of 54 patients; 44 underwent alveolar bone grafting only, and 10 underwent simultaneous cleft lip rhinoplasty. All surgeries were conducted with a judicious mucosal incision for tensionless wound closure. Bone graft take was evaluated with dental radiographs by the Bergland classification. Further, nasal aesthetic outcome was evaluated with medical photographs, based on nostril height and width and alar base width. In total, 96.3% of clefts showed graft success with Type I (66.7%) or Type II (27.8%) classifications; only 3.7% of clefts showed unfavorable results classified as Type III, and no clefts showed Type IV failure. The nasal shape was flatter with a decreased nostril height and increased nostril width after alveolar bone grafting, while nostril height was increased and nostril width was decreased in patients who underwent simultaneous rhinoplasty. With surgical techniques ensuring alveolar bone graft survival, simultaneous cleft lip rhinoplasty can result in nasal aesthetic improvement for patients with severe nasal deformities, decreasing the number of operations. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Bone grafting simultaneous to implant placement. Presentation of a case.

    Science.gov (United States)

    Peñarrocha-Diago, Miguel; Gómez-Adrián, Maria Dolores; García-Mira, Berta; Ivorra-Sais, Mariola

    2005-01-01

    Bone defects at mandibular alveolar crest level complicate the placement of dental implants in the ideal location. Surgical reconstruction using autologous bone grafts allows implant fixation in an esthetic and functional manner. We describe a patient with large mandibular bone loss secondary to periodontal inflammatory processes. Reconstruction of the mandibular alveolar process was carried out using onlay block bone grafts harvested from the mandible. The grafts were stabilized by positioning the dental implants through them--a procedure that moreover afforded good primary implant fixation. After two years of follow-up the clinical and radiological outcome is good. In the lower jaw, where bone regeneration is complicated, we were able to achieve good results in this patient--minimizing the corresponding waiting time by grafting and placing the implants in the same surgical step.

  15. Scaphoid nonunions treated with vascularised bone grafts: MRI assessment

    Energy Technology Data Exchange (ETDEWEB)

    Dailiana, Z.H.; Zachos, V.; Varitimidis, S.; Papanagiotou, P.; Karantanas, A.; Malizos, K.N. E-mail: kmalizos@otenet.gr

    2004-06-01

    Purpose: To assess the value of MR imaging (MRI) with regard to union, graft viability and proximal pole bone marrow status, after use of vascularized bone grafts for treating scaphoid nonunions. Materials and methods: Vascularized bone grafts from the distal radius were used to treat 47 scaphoid nonunions resulting from fractures or enchondromas. Clinical and imaging evaluation was used for the pre- and postoperative assessment of all patients. Apart of conventional radiographs obtained in all cases, 15 patients were also assessed postoperatively with MRI at 3 months. From these 15 patients, eight were assessed preoperatively with MRI whereas nine had serial MRI evaluations at 6 and 12 months. The clinical follow-up time of this subgroup of 15 patients ranged from 6 to 27 months. Results: All patients showed clinical signs of union within 12 weeks form the procedure and at the latest follow-up they experienced complete (10 cases) or almost complete (five cases) relief from pain. Both plain and contrast-enhanced MRI obtained at 3 months showed viability of the bone graft in all cases. At 3 months union was established with plain radiographs in 12 patients at both sides of the graft and in three patients between the graft and proximal pole. At 3 months plain MRI showed nonunion in four patients (two between graft and proximal pole, two between graft and distal pole and one at both sides of the graft) whereas contrast-enhanced MRI revealed only one case of nonunion between graft and proximal pole. Four patients were considered to have osteonecrosis of the proximal pole intraoperatively. Two of them showed necrosis of the proximal pole with preoperative and postoperative plain radiographs and three of them with plain postoperative MRI. Contrast-enhanced MRI at 3 months showed postoperative reversal of necrotic changes in all four scaphoids. MRI also revealed bone marrow oedema of the carpal bones surrounding the scaphoid in 14 cases. Serial MRI at 6 and 12 months

  16. [Surgical Techniques for Patella Replacement in Cases of Deficient Bone Stock in Revision TKA].

    Science.gov (United States)

    Ritschl, P; Machacek, F; Strehn, L; Kloiber, J

    2015-06-01

    The patella replacement in revision surgery is a challenge especially in cases of unsufficient bone stock. Depending on the extent of the bone defect, the following videos demonstrate different approaches: Video 1: bone sparing removal of the patella implant: onlay-type patella implants. Video 2: complete cortical bone rim of the patella, residual thickness between 6 to 10 mm: biconvex patella implant. Video 3 and 4: small defects of the cortical bone rim of the patella, residual thickness 1 to 5 mm (patella shell): gull-wing osteotomy, patella bone grafting techniques. Video 5: partial necrosis/defect of the patella shell with incomplete cortical bone rim: porous tantalum patella prosthesis. On account of the various surgical options for different bone defects of the patella, patellectomy and pure patelloplasty should be avoided to prevent functional shortcomings. Georg Thieme Verlag KG Stuttgart · New York.

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

    Directory of Open Access Journals (Sweden)

    Rubenbauer Bianka

    2009-12-01

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

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

    Science.gov (United States)

    Pieske, Oliver; Wittmann, Alexandra; Zaspel, Johannes; Löffler, Thomas; Rubenbauer, Bianka; Trentzsch, Heiko; Piltz, Stefan

    2009-12-15

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

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

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...... bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA...

  20. 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.

  1. Cortical bone total ossicular replacement prosthesis

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    Manu Malhotra

    2014-01-01

    Full Text Available Objectives: Evaluate an autologous cortical bone total ossicular replacement prosthesis (B TORP made of cortical bone for cost effective and sustainable hearing results. Materials and Methods: A prospective study was undertaken in the patients who underwent tympanoplasty with new B-TORP from January 2011 to December 2011. All patients had an absent superstructure of the stapes and long process of the incus due to chronic otitis media. Totally 40 patients were evaluated. Hearing results were evaluated using four-frequency average pure tone air conduction and air-bone gap (ABG measured at 0.5, 1, 2, and 3 kHz after a period of 12 months. Pre- and post-operative continuous variables were compared using a paired t-test and data from unequal groups were assessed for significant differences using unpaired t-test. Results: Successful rehabilitation of the ABG to 20 dB or less was achieved in 95% of patients. Overall mean improvement in ABG was 25.8 ± 5.6 dB, which was statistically significant (t = 26.8, P 0.5. Conclusion: The new autologous B-TORP provides sustainable hearing improvement and is bio-compatible, stable, and magnetic resonance imaging compatible.

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

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    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.

  3. Improved Accuracy and Safety of Intracorporeal Transpedicular Bone Grafting - using Contrast Impregnated Bone: A Case Report

    Directory of Open Access Journals (Sweden)

    CK Chiu

    2014-11-01

    Full Text Available A method of transpedicular bone grafting using contrast impregnated bone to improve the visualization of bone graft on the image intensifier is reported. A - 36-year old man who had sustained traumatic burst fracture of T12 vertebra, with Load-Sharing Classification (LSC score of 8, was treated with posterior short segment fusion from T11 to L1 with transpedicular bone graft of T12 vertebra. We were able to correct the kyphotic end plate angle (EPA from 19º to 1.4º. Anterior bone graft augmentation was achieved with contrast enhaced transpedicular bone grafts. At six months follow up, CT scan showed good bony integration of the anterior column with EPA of 4.5º and two years later, radiographs showed EPA of 7.6 º.

  4. Autogenous bone graft combined with polylactic polyglycolic acid polymer for treatment of dehiscence around immediate dental implants.

    Science.gov (United States)

    Hassan, Khalid S

    2009-11-01

    The use of composite bone grafts in dehiscence defects around immediate dental implants are aimed at improving the outcome of the regenerative process. The present study was designed to evaluate the efficacy of combinations of autogenous bone graft with a synthetic copolymer polylactic and polyglycolic acid (Fisiograft) on bone healing of buccal dehiscence defects around immediate dental implants. Sixteen adult male patients who each received an immediate implant for a single tooth replacement at a maxillary anterior or premolar site were included in this study. Patients were divided into 2 groups. One group received immediate dental implants augmented with autogenous bone graft combined with Fisiograft. The other group received immediate dental implants augmented with autogenous bone graft alone. The results revealed that both treatment modalities led to significant improvements for the primary outcome regarding bone fill as well as a significant reduction of probing pocket depth and gain of attachment level. Moreover, there were slightly statistically significant differences between the groups. In conclusion, the combination of autogenous bone graft and Fisiograft showed a slight superiority to autogenous bone graft alone, suggesting that it could be an optimum bone substitute for treatment of dehiscence around immediate dental implant.

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

    Directory of Open Access Journals (Sweden)

    Bansal Sanjay

    2009-01-01

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

  6. Repair process of surgical defects filled with autogenous bone grafts in tibiae of diabetic rats

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    Jônatas Caldeira Esteves

    2008-10-01

    Full Text Available From a biological standpoint, the best material for reconstruction of bone defects is the autogenous bone graft. However, as tissue healing is affected under diabetic conditions, major changes might take place in the revascularization, incorporation, replacement and remodeling phases of the grafted area. The purpose of this study was to assess the bone healing process in surgical wounds prepared in tibiae of diabetic rats and filled with autogenous bone. Forty male rats (Rattus norvegicus albinus, Wistar were randomly assigned to receive an endovenous injection (penile vein of either citrate buffer solution (Group 1 - control; n=20 or streptozotocin dissolved in citrate buffer solution (35 mg/kg to induce diabetes (Group 2 - diabetic; n=20. After determination of glycemia, the animals were anesthetized and the anterolateral regions of the tibiae of both limbs were shaved, antisepsis was performed and longitudinal incisions were made in each limb. The tibiae were exposed and two 2mm-diameter surgical cavities were prepared: one in the right limb, filled with particulate autogenous bone and the other in the left limb, filled with blood clot. The animals were euthanized at 10 and 30 postoperative days. The anatomic pieces were obtained, submitted to laboratory processing and sections were stained by hematoxylin and eosin and Masson's Trichrome for histomorphologic and histometric analyses. In both groups, the wounds filled with autogenous bone graft showed better results than those filled with blood clot. The control group showed higher new bone formation in wounds filled with autogenous bone graft at 30 days than the diabetic group, but without statistical significance. It may be concluded that, in general, the new bone formation occurred with autogenous graft was quantitatively similar between control and diabetic groups and qualitatively better in the control group.

  7. 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 compl

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

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    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

  9. Nostril Base Augmentation Effect of Alveolar Bone Graft

    Directory of Open Access Journals (Sweden)

    Woojin Lee

    2013-09-01

    Full Text Available BackgroundThe aims of alveolar bone grafting are closure of the fistula, stabilization of the 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 bone grafting. The purpose of this study was to evaluate the nostril base augmentation effect of secondary alveolar bone grafting in patients with unilateral alveolar cleft.MethodsRecords of 15 children with alveolar clefts who underwent secondary alveolar bone grafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 were reviewed. Preoperative and postoperative worm's-eye view photographs and reconstructed three-dimensional computed tomography (CT scans were used for photogrammetry. The depression of the nostril base and thickness of the philtrum on the cleft side were measured in comparison to the normal side. The depression of the cleft side pyriform aperture was measured in comparison to the normal side on reconstructed three-dimensional CT.ResultsSignificant 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 the pyriform aperture (P<0.001 and the angle (P<0.001.ConclusionsAn alveolar bone graft not only fills the gap in the alveolar process but also augments the nostril base after surgery. In this study, only an alveolar bone graft was performed to prevent bias from other procedures. Nostril base augmentation can be achieved by performing alveolar bone grafts in children, in whom invasive methods are not advised.

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Bone grafting in four-corner mid-carpal fusion.

    Science.gov (United States)

    McBride, T J; Jewell, D P A; Deshmukh, S C

    2012-01-01

    Four-corner fusion is an accepted surgical treatment for established SLAC and SNAC wrist. We describe a technique of bone grafting to be used in conjunction with any of the standard fusion techniques. A step by step, illustrated approach allows the easy placement of an autograft which is in contact with all surfaces of the bones involved in the fusion.

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

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    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.

  13. Resorption of bone graft after maxillary sinus grafting and simultaneous implant placement

    OpenAIRE

    Kim, Young-Kyun; Kim, Su-Gwan; Kim, Bum-Su; Jeong, Kyung-In

    2014-01-01

    Objectives The purpose of this study was to evaluate the sinus bone graft resorption over 3 years after two-stage implant placement. Materials and Methods The subjects for this study included 30 patients whose maxillary posterior ridges were too atrophic for implants. Bone-added osteotome sinus floor elevation was used in 15 maxillary sinuses, while the bone graft by lateral approach technique was used in 25 maxillary sinuses. The height from the top of the fixture to the sinus floor was esti...

  14. Grafted bone used in acetabular reconstruction: assessment by SPECT scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fujikawa, Yosuke [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Torisu, Takehiko [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Takasita, Mitsuhiro [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Masumi, Shogo [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan)

    1995-08-01

    Single photon emission computed tomography (SPECT) was carried out at the 1st, 6th, and 12th month after the operation and the uptakes on serial SPECT scintigrams were normalized. The horizontal histogram of scintigraphic activity at the level of the central grafted bone in the coronal image was designated the profile curve. Seven patients who had undergone bipolar hip arthroplasty for osteoarthritis of the hip were randomly selected. Five of seven profile curves obtained at the 1st month demonstrated a single peak at the host-graft junction. The profile curve obtained at the 6th month showed two peaks at the host-graft junction and the priphery of the grafted bone in all patients. The profile curve of the 12th month showed slightly increased activity in the center of the grafted bone. This preliminary study demonstrates that comparison of the serial profile curves on SPECT is valuable in evaluating the progress of incorporation of the grafted bone in hip arthroplasty. (orig.)

  15. 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.

  16. 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.

  17. Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction

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    Poissonnet Gilles

    2007-04-01

    Full Text Available Abstract Background Bone scintigraphy was performed to monitor anastomotic patency and bone viability. Methods In this retrospective study, bone scans were carried out during the first three postoperative days in a series of 60 patients who underwent microvascular bone grafting for reconstruction of the mandible or maxilla. Results In our series, early bone scans detected a compromised vascular supply to the bone with high accuracy (p Conclusion When performing bone scintigraphy during the first three postoperative days, it not only helps to detect complications with high accuracy, as described in earlier studies, but it is also an additional reliable monitoring tool to decide whether or not microvascular revision surgery should be performed. Bone scans were especially useful in buried free flaps where early postoperative monitoring depended exclusively on scans. According to our experience, we recommend bone scans as soon as possible after surgery and immediately in cases suspicious of vascularized bone graft failure.

  18. Vascularized fibular graft in infected tibial bone loss

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    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

  19. 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...... of bone implants.   Materials and Methods: Titanium alloy implants were inserted into bilateral femoral condyles of 8 skeletally mature sheep, four in each sheep. The implant has a circumferential gap of 2 mm. The gap was filled with: HA/coll; HA/coll-BMA; autograft or allograft. Allograft was served...

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

    Indian Academy of Sciences (India)

    Gunasekaran Krithiga; Thotapalli P Sastry

    2011-02-01

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

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

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  3. A new view on bone graft in dental implantation: Autogenous bone mixed with titanium granules

    Directory of Open Access Journals (Sweden)

    Yeke Wu

    2013-01-01

    Full Text Available Introduction : Dental implants have been widely applied in clinic for many years. However, the success rate is still challenging mainly because of bone deficiency. An ideal bone graft is traditionally thought to guide and induce new bone regeneration as well as been absorbed completely by human body. The Hypothesis: Autogenous bone mixed with titanium granules might be an ideal bone graft for dental implantation. Evaluation of the Hypothesis: First, we analyzed advantages of grafts of autogenous bone mixed with titanium granules, such as serving as a s scaffold for wound healing and tissue regeneration, creating sui microenvironment for implant-bone integration, shortening the new bone′s creeping distance, etc. Then we creatively hypothesized a novel alternative bone graft with premixed autogenous bone and non-absorbent titanium granules. Apart from repairing bone deficiency, our hypothesis could promote the integration between new bone and titanium implant from the perspective of microenvironment. We believe that the method is promising and worth extension in clinical application.

  4. Sinusfloor elevation and grafting with autogenous iliac crest bone.

    Science.gov (United States)

    van den Bergh, J P; ten Bruggenkate, C M; Krekeler, G; Tuinzing, D B

    1998-12-01

    Insufficient bone height in the posterior area of the maxilla, due to expansion of the maxillary sinus and atrophic reduction of the alveolar process of the maxilla, represents a contra-indication for insertion of dental implants. This anatomic problem can, in many cases, be solved by augmentation of the floor of the maxillary sinus. This surgical technique was introduced by Tatum. The so-called top hinge door method creates a new floor of the maxillary sinus at a more cranial level. Underneath this new floor the existing space is filled with a bone graft. Implantation in the alveolar process with increased bone height allows insertion of dental implants. This sinus grafting technique was used in the present study. In total, 62 sinusfloor elevations were performed with cancellous iliac bone grafts in 42 patients. In those 62 augmented sinuses, 161 ITI screw type implants were inserted. The follow-up was 1-6 years after implantation. In 2 cases infections occurred. One implant needed an extended integration time. No implants were lost. The ITI solid screw implant appears to be a suitable implant following sinusfloor elevation operations, due to its rough surface, its shape and the size of the thread. The sinusfloor elevation procedure with autogenous cancellous bone graft appears to be a valuable and reliable pre-implantological procedure, provided a proper pre-operative investigation and careful surgery are performed. This procedure allows dental implant placement with a high success rate.

  5. 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.

  6. 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

  7. 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.

  8. Treatment of nonunions of the distal phalanx with olecranon bone graft.

    Science.gov (United States)

    Ozçelik, I B; Kabakas, F; Mersa, B; Purisa, H; Sezer, I; Ertürer, E

    2009-10-01

    Distal phalangeal fractures are the most common fractures of the hand but nonunions are unusual in the distal phalanx. Eleven patients were operated on for nonunions of the distal phalanx. The diagnosis of nonunion was made by the presence of the clinical (pain, deformity, instability) and radiological signs of nonunion more than 4 months after the initial injury. Three patients had developed infection and four of them had bone resorption after their initial treatments, which probably caused nonunion. Olecranon bone grafting combined with Kirschner wire fixation was done in all patients. The mean follow up was 7 months (range 5-18 months). There were no major complications at the donor or recipient sites. One patient had a haematoma formation at the donor site. There was complete radiological union of bone-grafted sites in all patients except one. There were no cases of pain, deformity, or instability after the treatment. The olecranon bone graft was found to be safe and easy to harvest. Its strong tubular structure replaced the distal phalanx successfully.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1-24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4...

  10. Piezosurgical osteotomy for harvesting intraoral block bone graft

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    Mahalingam Lakshmiganthan

    2012-01-01

    Full Text Available The use of ultrasonic vibrations for the cutting of bone was first introduced two decades ago. Piezoelectric surgery is a minimally invasive technique that lessens the risk of damage to surrounding soft tissues and important structures such as nerves, vessels, and mucosa. It also reduces damage to osteocytes and permits good survival of bony cells during harvesting of bone. Grafting with intraoral bone blocks is a good way to reconstruct severe horizontal and vertical bone resorption in future implants sites. The piezosurgery system creates an effective osteotomy with minimal or no trauma to soft tissue in contrast to conventional surgical burs or saws and minimizes a patient′s psychological stress and fear during osteotomy under local anesthesia. The purpose of this article is to describe the harvesting of intraoral bone blocks using the piezoelectric surgery device.

  11. Radiological long-term follow-up of grafted xenogeneic bone in patients with bone tumors.

    OpenAIRE

    Ozaki, Toshifumi; Inoue, Hajime; Sugihara, Shinsuke; Sumii, Hiroshi

    1992-01-01

    Radiological findings on the fate of grafted Kiel bone implants for the treatment of bone tumors were evaluated in 25 lesions. The mean follow-up period was 14.8 years, ranging from 5 to 21.8 years. We classified the radiological findings into 4 grades; Excellent (4 lesions), Good (14 lesions), Fair (2 lesions), and Poor (5 lesions). All cases of the Poor grade were polyostotic fibrous dysplasia. The younger the patient at the time of the operation, the more rapidly Kiel bone grafts tended to...

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

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Sandri, Monica

    2012-01-01

    Replacement of extensive local bone loss especially in revision joint arthroplasty and spine fusion is a significant clinical challenge. Allograft and autograft have been considered as gold standards for bone replacement. However, there are several disadvantages such as donor site pain, bacterial...

  13. Autogenous bone grafts in periodontal practice: A literature review

    Directory of Open Access Journals (Sweden)

    Nymphea Pandit

    2016-01-01

    Full Text Available To improve the long-term prognosis of teeth, the treatment of periodontal diseases has evolved from resection to regeneration. Regeneration of the supporting structures of the teeth involves the use of a variety of materials of natural and synthetic origins. The ultimate aim of a true connective tissue attachment to the cementum, however, is difficult to achieve and a few of the materials have shown promising results. Autogenous bone graft obtained from the same individual has always been considered the gold standard because of its high osteogenic potential and virtually nil side effects. The present paper describes the use of autogenous grafts in the periodontal practice. The compilation of the data was done by PubMed search since the first use of the graft in periodontics.

  14. 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)

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

    NARCIS (Netherlands)

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

    2003-01-01

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

  16. Autogenous bone grafts in periodontal practice: A literature review

    OpenAIRE

    Nymphea Pandit; Inder Kumar Pandit

    2016-01-01

    To improve the long-term prognosis of teeth, the treatment of periodontal diseases has evolved from resection to regeneration. Regeneration of the supporting structures of the teeth involves the use of a variety of materials of natural and synthetic origins. The ultimate aim of a true connective tissue attachment to the cementum, however, is difficult to achieve and a few of the materials have shown promising results. Autogenous bone graft obtained from the same individual has always been con...

  17. Pre-implant orthodontics: achieving vertical bone height without osseous grafts.

    Science.gov (United States)

    Biggs, Jeffery; Beagle, Jay R

    2004-01-01

    Traditionally, orthodontic treatment has be involved with implant dentistry to correct malocclusion prior to surgical procedures. Most recently, orthodontics has become an invaluable adjunct to implant dentistry for treatment plans involving tooth replacement for sites diagnosed with localized advanced periodontitis. Loss of vertical bone height as a result of periodontal disease is difficult to overcome with hard tissue grafting. However, in cases where the failing or failed tooth is still present, an alternative method involving pre-implant orthodontics is being utilized to generate vertical bone height. Specifically, orthodontic intrusive and extrusive forces are exerted on the hopeles tooth or teeth to facilitate bone in the future implant site. The author presents a case demonstrating this technique.

  18. Autologous cranial bone graft use for trepanation reconstruction.

    Science.gov (United States)

    Worm, Paulo Valdeci; Ferreira, Nelson Pires; Finger, Guilherme; Collares, Marcus Vinicius Martins

    2015-11-01

    Esthetic deformities in the human skull are a subject of concern among neurosurgical patients and neurosurgeons; they can be disfiguring and harm the patient's social relationships. To access inner structures, neurosurgical operations require skull trepanation, a process that frequently involves loss of bone tissue and leads to esthetic problems. Satisfactory reconstruction is a challenge, and neurosurgeons search for an implant which ideally is organic and low cost and does not cause an immunological or allergic reaction. Therefore, autologous bone tissue remains the gold standard for reconstruction. To develop a technique that allows neurosurgeons to rebuild the trepanation hole with a better esthetic outcome. Craniotomy orifices in 108 patients were closed with a graft obtained from the cranial bone inner layer. In order to remove the graft a specially made trephine was used. No grafts dislocated during follow-up. Cosmetic outcomes and results seen on image examinations were favorable for this new technique when compared with others previously described in medical literature. The authors present a new and feasible trepanation reconstruction technique that allows a better esthetic outcome without increasing the surgical risk for the patient, or making the surgical procedure longer or more expensive. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  20. The adipocyte component of bone marrow in heterotopic bone induced by demineralized incisor grafts The adipocyte component of bone marrow in heterotopic bone induced by demineralized incisor grafts

    Directory of Open Access Journals (Sweden)

    Krzysztof H. Włodarski

    2012-10-01

    Full Text Available The relative proportion of adipocytes to hematopoietic elements in the marrow of heterotopically
    induced bone evaluated 4–42 weeks post implantation of demineralized murine incisors was estimated by histological
    analysis of hematoxylin-eosin stained tissue sections. Using computerized image analysis of microphotographs,
    the proportion of nuclear cells vs. adipocytes was ascertained. The percentage of adipocytes in marrow
    increases over time. Such an effect, the replacement of myelopoietic marrow by adipogenic (yellow marrow
    and the resorption of induced bone, is observed in human osteoporosis. A decline in the non-adipogenic cell
    compartments of bone marrow accompanying induced bone begins in the fourth week of induction, gradually
    progresses until the 26th week, and does not change after that. The luminosity, a parameter used in image analysis
    and proportional to the number of nuclear cells, was 124 ± 3 in hematopoietic femoral bone marrow, and
    that of bone marrow of the induced bone was of a similar value (117 ± 8 in the fourth week. An evident decline
    in luminosity of bone marrow filling the foci of heterotopic bone was observed in samples taken at nine weeks
    (82 ± 20. This process progressed until the 26th week, reaching a luminosity of 70 ± 21. At the 42nd week, the
    luminosity remained at the same level (71 ± 27. This indicates that the replacement of hematopoietic bone
    marrow of heterotopically induced bone by unilocular adipocytes begins relatively early (the fourth week and is
    persistent.The relative proportion of adipocytes to hematopoietic elements in the marrow of heterotopically
    induced bone evaluated 4–42 weeks post implantation of demineralized murine incisors was estimated by histological
    analysis of hematoxylin-eosin stained tissue sections. Using computerized image analysis of microphotographs,
    the proportion of nuclear cells vs

  1. Correlation between Density and Resorption of Fresh-Frozen and Autogenous Bone Grafts

    Directory of Open Access Journals (Sweden)

    Simone Lumetti

    2014-01-01

    Full Text Available Trial Design. This analysis compared the outcome of fresh-frozen versus autologous bone block grafts for horizontal ridge augmentation in patients with Cawood and Howell class IV atrophies. Methods. Seventeen patients received autologous grafts and 21 patients received fresh-frozen bone grafts. Patients underwent CT scans 1 week and 6 months after surgery for graft volume and density analysis. Results. Two autologous and 3 fresh-frozen grafts failed. Autologous and fresh-frozen grafts lost, respectively, 28% and 46% of their initial volume (P=0.028. It is noteworthy that less dense fresh-frozen blocks lost more volume than denser grafts (61% versus 16%. Conclusions. According to these 6-month results, only denser fresh-frozen bone graft may be an acceptable alternative to autologous bone for horizontal ridge augmentation. Further studies are needed to investigate its behaviour at longer time points.

  2. 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.

    1997-01-01

    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 o

  3. Osteonecrosis of the trapezium treated with a vascularized distal radius bone graft.

    Science.gov (United States)

    Zafra, Manuel; Carpintero, Pedro; Cansino, Daniel

    2004-11-01

    A 20-year-old man presented with early stage osteonecrosis of the trapezium, diagnosed by magnetic resonance imaging. A vascularized distal radius bone graft was performed, with good clinical and radiologic results over a 1-year follow-up period. The authors believe that a vascularized distal radius bone graft is an ideal treatment for early stage carpal bone necrosis.

  4. APPLICATION OF A BIODEGRADABLE MATERIAL FOR BONE REPLACEMENT IN TRAUMATOLOGY

    Directory of Open Access Journals (Sweden)

    T. V. Druzhinina

    2014-01-01

    Full Text Available 20 men (medium age (31.5 ± 13.5 years were studied. All patients underwent arthroscopic auditing plastic anterior cruciate ligament of the knee. Osteoregeneration dynamics were determined by biochemical testing of blood serum and X-ray computed tomography (CT of the fracture in 1–4 months after surgery. As a result, an estimation of the bone tissue reparative regeneration according to CT data in 10 patients with a defect of the patella, treated with the material is provided. The obtained results of the clinical study indicate the reparative effect of the biodegradable material for bone replacing on bone regeneration

  5. Comparative study between cortical bone graft versus bone dust for reconstruction of cranial burr holes

    OpenAIRE

    Worm, Paulo Valdeci; Ferreira,Nelson Pires; Faria, Mário de Barros; Ferreira, Marcelo Paglioli; Kraemer,Jorge Luiz; Collares, Marcus Vinicius Martins

    2010-01-01

    Background: As a consequence of the progressive evolution of neurosurgical techniques, there has been increasing concern with the esthetic aspects of burr holes. Therefore, the objective of this study was to compare the use of cortical bone graft and bone dust for correcting cranial deformities caused by neurosurgical trephines. Methods: Twenty-three patients were enrolled for cranial burr hole reconstruction with a 1-year follow-up. A total of 108 burr holes were treated; 36 burr holes were ...

  6. Augmentation of the rat jaw with autogeneic cortico-cancellous bone grafts and guided tissue regeneration.

    Science.gov (United States)

    Donos, Nikolaos; Kostopoulos, Lambros; Karring, Thorkild

    2002-04-01

    The aim of the present study was to evaluate the effect of augmenting the maxillary alveolar ridge and the lateral aspect of the mandible with onlay autogeneic cortico-cancellous bone grafts that were covered with e-PTFE membranes. The experiment was carried out in 51 rats. In 15 rats, the edentulous maxillary jaw between the incisor and the first molar was augmented by means of an autogeneic ischiac bone graft that was fixed with a gold-coated microimplant. In one side, the graft was covered with an e-PTFE membrane, while the other side, which served as control, was treated without a membrane. In the other 36 rats, the lateral aspect of the mandible was augmented in both sides by means of an autogeneic ischiac bone graft that was fixed with a gold-coated or a titanium microimplant. In one side, the augmented area was covered with an e-PTFE membrane, while the contralateral side was treated without a membrane. Histological analysis at 60, 120 and 180 days after augmentation of the maxilla showed that, in the case of the test sites (where most of the membranes were either exposed or lost), the bone grafts presented extensive resorption and there was a lack of bone continuity between the graft and the recipient site. Similar findings were made at the non-membrane-treated control sides. In the case of augmentation of the mandible with membranes, the bone grafts were not resorbed, but were integrated into newly formed bone at the recipient site. In the control sides, the grafts presented varying degrees of resorption and integration into the recipient bone. It is concluded that, in comparison to bone grafting alone, onlay ischiac bone grafting combined with guided tissue regeneration eliminates the risk of bone graft resorption and ensures integration of the graft into newly formed bone at the recipient site, provided that closure of the operated area can be maintained during healing.

  7. 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.)

  8. Characterization of powdered fish heads for bone graft biomaterial applications.

    Science.gov (United States)

    Oteyaka, Mustafa Ozgür; Unal, Hasan Hüseyin; Bilici, Namık; Taşçı, Eda

    2013-01-01

    The aim of this study was to define the chemical composition, morphology and crystallography of powdered fish heads of the species Argyrosomus regius for bone graft biomaterial applications. Two sizes of powder were prepared by different grinding methods; Powder A (coarse, d50=68.5 µm) and Powder B (fine, d50=19.1 µm). Samples were analyzed using X-ray diffraction (XRD), X-ray fluorescence (XRF), scanning electron microscopy (SEM), thermogravimetry (TG), and energy dispersive X-ray spectroscopy (EDS). The powder was mainly composed of aragonite (CaCO3) and calcite (CaCO3). The XRD pattern of Powder A and B matched standard aragonite and calcite patterns. In addition, the calcium oxide (CaO) phase was found after the calcination of Powder A. Thermogravimetry analysis confirmed total mass losses of 43.6% and 47.3% in Powders A and B, respectively. The microstructure of Powder A was mainly composed of different sizes and tubular shape, whereas Powder B showed agglomerated particles. The high quantity of CaO and other oxides resemble the chemical composition of bone. In general, the powder can be considered as bone graft after transformation to hydroxyapatite phase.

  9. 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...

  10. Bone Formation in Maxillary Sinus Lift Using Autogenous Bone Graft at 2 and 6 Months

    Science.gov (United States)

    Netto, Henrique Duque; Miranda Chaves, Maria das Graças Alfonso; Aatrstrup, Beatriz; Guerra, Renata; Olate, Sergio

    2016-01-01

    SUMMARY The aim of this study is to compare the bone formation in maxillary sinus lift with an autogenous bone graft in histological evaluation at 2 or 6 months. A comparative study was designed where 10 patients with missing teeth bilaterally in the posterior zone of the maxilla were selected. Patients received a particulate autogenous bone graft under the same surgical conditions, selecting a site to collect a biopsy and histological study at two months and another at six months postoperatively. Histomorphometry was performed and were used Kolmogorov-Smirnov test, student’s t-test and Spearman’s correlation coefficient, considering a value of p<0.05. Differences were observed in inflammatory infiltrate and vascularization characteristics; however, the group analyzed at two months presented 38.12% ± 6.64 % of mineralized tissue, whereas the group studied at 6 months presented an average of 38.45 ± 9.27 %. There were no statistical differences between the groups. It is concluded that the bone formation may be similar in intrasinus particulate autogenous bone grafts in evaluations at two or six months; under these conditions, early installation of implants is viable. PMID:27867255

  11. Implant placement in the atrophic posterior maxilla with sinus elevation without bone grafting: a 2-year prospective study.

    Science.gov (United States)

    Rajkumar, Garudanahally Chikkalingaiah; Aher, Vinit; Ramaiya, Shashikala; Manjunath, Gavi Siddhaiah; Kumar, Devaraj Veerendra

    2013-01-01

    The purpose of this study was to evaluate changes in alveolar bone height after direct sinus elevation and simultaneous implant placement in the posterior edentulous maxilla. A prospective clinical study was conducted of patients undergoing sinus elevation for implant placement in the posterior maxilla to replace missing teeth. Residual alveolar bone height was between 4 and 7.5 mm. Lateral osteotomy of the maxillary sinus, followed by simultaneous implant placement without bone grafting, was performed under local anesthesia. Prosthetic restoration was completed 9 months later. The changes in alveolar bone height at the sinus floor were assessed radiographically after 1 week and 6, 9, 18, and 28 months after implant placement. Probing depths, implant mobility, and crestal bone loss were assessed at the same intervals. Twenty-eight patients (17 women and 11 men) participated in the study. Forty-five implants were placed and followed after prosthetic rehabilitation. At 18 months after loading of the implants, alveolar bone height in the area of sinus elevation ranged from 7.40 to 11.55 mm. Increases in alveolar bone height at the sinus floor ranged from 2.05 to 5.40 mm at a minimum of 18 months after loading, a statistically significant gain. Crestal bone loss and changes in probing depths were not significant in any patients, and all implants remained clinically stable. The implant success rate was 100% without any complications after 18 to 28 months of follow-up. Placement of endosseous implants in the atrophic posterior maxilla in conjunction with sinus elevation without bone grafting resulted in a significant amount of bone formation around the implants at the sinus floor, resulting in successful restorations and eliminating the need for bone grafting.

  12. 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.

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

    Science.gov (United States)

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

    2002-04-01

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

  14. Modern materials in fabrication of scaffolds for bone defect replacement

    Science.gov (United States)

    Bazlov, V. A.; Mamuladze, T. Z.; Pavlov, V. V.; Kirilova, I. A.; Sadovoy, M. A.

    2016-08-01

    The article defines the requirements for modern scaffold-forming materials and describes the main advantages and disadvantages of various synthetic materials. Osseointegration of synthetic scaffolds approved for use in medical practice is evaluated. Nylon 618 (certification ISO9001 1093-1-2009) is described as the most promising synthetic material used in medical practice. The authors briefly highlight the issues of individual bone grafting with the use of 3D printing technology. An example of contouring pelvis defect after removal of a giant tumor with the use of 3D models is provided.

  15. 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

  16. Allogenous bone grafts improved by bone marrow stem cells and platelet growth factors: clinical case reports.

    Science.gov (United States)

    Filho Cerruti, Humberto; Kerkis, Irina; Kerkis, Alexandre; Tatsui, Nelson Hidekazu; da Costa Neves, Adriana; Bueno, Daniela Franco; da Silva, Marcelo Cavenaghi Pereira

    2007-04-01

    In order to increase the amount of available bone where dental implants must be placed, the present study has associated platelet-rich plasma (PRP) and mononuclear cells (MNCs) from bone marrow aspirate and bone scaffold (BS) in 32 patients aged between 45 and 75 years old. The MNC attainment and the adherence to the BS were confirmed through histology, cell culture, and scanning electron microscopy. The clinical results, analyzed by computed tomography, have showed that the scaffolds were well integrated and adapted to the cortical bone. We can conclude that the process of healing observed in the patients was due to the presence of mesenchymal stem cell in MNC fraction in the bone grafts.

  17. Clinical Effect of Anterior Disc Excision with Bone Graft Fusion and Bryan Artificial Cervical Disc Replacement%颈前路减压植骨融合与Bryan人工颈椎间盘置换疗效比较

    Institute of Scientific and Technical Information of China (English)

    陈昆; 蔡惠民; 陈荣滋

    2014-01-01

    目的:探讨颈椎前路减压植骨融合术( anterior cervical decompression and fusion,ACDF)与Bryan人工颈椎椎间盘置换术( artificial cervical disc replacement,ACDR)两种手术方式用于治疗脊髓型颈椎病及神经根型颈椎病的近期和远期疗效。方法系统分析我院2010年11月至2012年11月70例(70个节段)脊髓型或神经根型颈椎病患者病例资料,将70例(70个节段)脊髓型或神经根型颈椎病患者,通过随机数字表法随机分为ACDF组(35例)及Bryan组(35例)。通过分析术前及术后随访12个月的Odom′s标准评分、活动度( range of motion,ROM)、日本骨科协会( Japa-nese orthopaedic association,JOA)、健康调查简表( the MOS item short from health survey,SF-36)及颈椎残障功能指数( neck disability index,NDI)观察指标的差异,同时对随访12个月的上述各项指标进行两组间比较,比较两者疗效,分析两种术式的优点及他们产生的问题。结果两种手术方式都能取得明确疗效,治疗后患者症状明显缓解( P0.05);JOA评分及SF-36评分两者差异性不显著( P>0.05);而在12个月随访ROM评估及NDI比较有差异,Bryan组数据优于 ACDF组,差异具有统计学意义( P0. 05). JOA score and SF-36 scale had no significant differences(P>0. 05). There was difference between ROM and NDI in the evaluation of 12 month follow-up. Data of Bryan group were better than ACDF group(P<0. 05). Conclusion Bryan artificial cervical disc re-placement(ACDR)is superior to the anterior cervical decompression and fusion(ACDF)in reducing the adjacent segment degeneration of cervical vertebra. Its short-term and mid-term curative effect is superior to the ACDF. But Bryan artificial cervi-cal disc replacement( ACDR)coexist the complications such as incomplete decompression and heterotopic ossification,the long-term curative effect is inferior than ACDF.

  18. 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.

  19. New approaches to graft engineering for haploidentical bone marrow transplantation.

    Science.gov (United States)

    Handgretinger, Rupert

    2012-12-01

    Haploidentical transplantation opens the possibility to offer this treatment to a large number of patients with an otherwise incurable disease, such as some hematologic or oncologic malignancies, inborn or acquired bone marrow failure syndromes, hemoglobinopathies, immunodeficiencies, or other genetic diseases. Initial attempts at haploidentical transplantation using unmanipulated bone marrow were associated with a high transplant-related mortality. However, recent insights into the biology of haploidentical transplantation, the availability of effective in vivo large-scale graft-manipulation technology, and improved supportive care strategies have led to and are still leading to significantly better outcomes compared to previous decades. Methods for the in vitro depletion of T lymphocytes from mobilized peripheral blood stem cells (PBSC) to prevent graft-versus-host disease (GvHD) have facilitated the wider use and acceptance of haploidentical transplantation in children and adult patients. Besides in vitro T-cell depletion techniques, other methods, such as the isolation of alloreactive natural killer (NK) cells, virus-specific T lymphocytes, and other effector or regulatory cells are nowadays available to rapidly rebuild the immune system after haploidentical transplantation for the prevention of severe infections or relapses of the underlying diseases.

  20. Fate of monocortical bone blocks grafted in the human maxilla: a histological and histomorphometric study.

    Science.gov (United States)

    Zerbo, Ilara R; de Lange, Gert L; Joldersma, Manon; Bronckers, Antonius L J J; Burger, Elisabeth H

    2003-12-01

    Local bone defects in the anterior maxilla are commonly grafted with monocortical blocks of autologous bone in order to restore the defect site prior to the placement of dental implants. Increasing evidence suggests that osteocytes are involved in the control of bone remodelling and thus may be important for optimalisation of bone structure around implants, and thus for implant osseointegration. However, it is not well known whether osteocytes will survive when bone blocks are grafted into defects. We grafted 19 patients with monocortical bone blocks derived from the symphysis, to the defect site in the maxillary alveolar process. The bone grafts were left to heal for times varying from 2.5 to 7 months. During implant installation, bone biopsies were removed using a trephine burr, and processed for hard tissue histology. Bone histology and histomorphometry were then carried out in order to gain insight into the density, viability and remodelling of the graft. Clinically, all the bone grafts were successful, with no implant failures, and little resorption was seen. Histologically, bone volume expressed as percentage of tissue volume at the implant site varied from 27% to 57% with an overall average of 41%. Bone fields with empty osteocyte lacunae were observed and measured. The amount of this so-called nonvital bone (NVB) varied between 1% and 34% of the total tissue volume. The amount of NVB decreased significantly with the time of healing. The data suggest that the majority of the osteocytes of the monocortical bone do not survive grafting. The results indicate that the NVB is progressively remodelled into new vital bone 7 months after grafting.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  2. 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

    was evaluated by deposit of 141Ce-labeled microspheres. Both the quantity of cancellous bone (before implantation) and the revascularization (3 weeks postoperatively) were greater in the mandibular and iliac bone grafts than in the calvarial and tibia diaphyseal grafts. The results suggest that the anatomical...

  3. 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 car

  4. Comparative study between cortical bone graft versus bone dust for reconstruction of cranial burr holes.

    Science.gov (United States)

    Worm, Paulo V; Ferreira, Nelson P; Faria, Mario B; Ferreira, Marcelo P; Kraemer, Jorge L; Collares, Marcus V M

    2010-12-22

    As a consequence of the progressive evolution of neurosurgical techniques, there has been increasing concern with the esthetic aspects of burr holes. Therefore, the objective of this study was to compare the use of cortical bone graft and bone dust for correcting cranial deformities caused by neurosurgical trephines. Twenty-three patients were enrolled for cranial burr hole reconstruction with a 1-year follow-up. A total of 108 burr holes were treated; 36 burr holes were reconstructed with autogenous cortical bone discs (33.3%), and the remaining 72 with autogenous wet bone powder (66.6%). A trephine was specifically designed to produce this coin-shaped bone plug of 14 mm in diameter, which fit perfectly over the burr holes. The reconstructions were studied 12 months after the surgical procedure, using three-dimensional quantitative computed tomography. Additionally, general and plastic surgeons blinded for the study evaluated the cosmetic results of those areas, attributing scores from 0 to 10. The mean bone densities were 987.95 ± 186.83 Hounsfield units (HU) for bone fragment and 473.55 ± 220.34 HU for bone dust (P holes because of their lower degree of bone resorption and, consequently, better cosmetic results. The lack of donor site morbidity associated with procedural low cost qualifies the cortical autograft as the first choice for correcting cranial defects created by neurosurgical trephines.

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

    NARCIS (Netherlands)

    Hallman, Mats; Mordenfeld, Arne; Strandkvist, Tomas

    2009-01-01

    Dento-alveolar trauma often leads to a need for reconstruction of the alveolar crest before an implant can be placed. Although autogenous bone grafts is considered the 'gold standard', this may be associated with patient morbidity and graft resorption. Consequently, the use of bone substitutes has i

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

    NARCIS (Netherlands)

    Hallman, Mats; Mordenfeld, Arne; Strandkvist, Tomas

    2009-01-01

    Dento-alveolar trauma often leads to a need for reconstruction of the alveolar crest before an implant can be placed. Although autogenous bone grafts is considered the 'gold standard', this may be associated with patient morbidity and graft resorption. Consequently, the use of bone substitutes has i

  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......, who had secondary alveolar bone grafting of 123 alveolar clefts, were examined. Interalveolar bone height was assessed radiographically a minimum of 10 years after grafting using a 4-point scale (I-IV), where types I and II were considered a success. After an average follow-up of 16 years after SABG...... to the cleft. No significant differences were found with regard to the other parameters investigated. The timing of secondary alveolar bone grafting is critical with regard to the age of the patient and the stage of eruption of the tooth distal to the cleft....

  8. 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

    2017-08-01

    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

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

    Science.gov (United States)

    Hakimi, Mohssen; Grassmann, Jan-Peter; Betsch, Marcel; Schneppendahl, Johannes; Gehrmann, Sebastian; Hakimi, Ahmad-Reza; Kröpil, Patric; Sager, Martin; Herten, Monika; Wild, Michael; Windolf, Joachim; Jungbluth, Pascal

    2014-01-01

    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.

  10. 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.

  11. Selection of allografts for impaction bone grafting for bone defect reconstruction on the acetabular side

    Institute of Scientific and Technical Information of China (English)

    XU Zheng-jian; HE Rong-xin

    2010-01-01

    Objective To review the choices of allografts for bone defect reconstruction in acetabular revision surgery using the technique of impaction bone grafting.Data sources The data cited in this review were mainly obtained from articles listed in PubMed that were published from January 1993 to July 2009. The search terms were "impaction bone grafting", "particle size", "mechanical property"and "biological behavior".Study selection Articles relevant to the choices of allografts and their results for bone defect reconstruction on the acetabular side were selected.Results Different choices of allografts, including the particle size, process of irradiation or fat reduction, composition and particle grade, are made to improve the survival rate of a prosthesis in acetabular revision surgery. This review,which compares both mechanical and biological factors, summarizes the experimental and clinical results for different techniques.Conclusions Fresh frozen cancellous allografts with particle sizes ranging from 7 to 10 mm are a favorable choice for reconstruction of bone defects of American Academy of Orthopedic Surgeons (AAOS) types Ⅱ (cavitary defect) and Ⅲ(combined cavitary and segmental defect) on the acetabular side. A fat-reducing procedure with saline or solvent/detergent is controversial. Adding autologous marrow into irradiated allografts, which provides reliable mechanical stability and biological safety, may be a substitute for fresh frozen allografts. Cortical bone can be a supplementary material in cases of insufficiency of cancellous allografts. Cartilage should be excluded from the graft material. Further research is required to demonstrate the best particle grade, and randomized controlled trials in clinical practice are required to obtain more information about the selection of allografts.

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

    Science.gov (United States)

    Raulo, Y; Baruch, J

    1990-01-01

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

  13. Recent developments in interpositional bone-grafting of the atrophic mandible.

    Science.gov (United States)

    Moloney, F; Stoelinga, P J; Tideman, H; de Koomen, H A

    1985-02-01

    A clinical study on 54 patients, who underwent augmentation of the atrophic mandible by interposed bone-grafts, but in whom routine follow-up vestibuloplasty was deliberately avoided, is presented. The results show a reduced rate of bone resorption in the anterior region and less interference with lip and chin sensibility. An additional study is included concerning the fate of the elevated ridge and associated bone-graft in the body region posterior to the mental foramen. Results suggest that the resorption pattern in this area is very similar to that of a subperiosteal bone-graft. Modification of surgical technique in this regard has produced encouraging results.

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  15. 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)

  16. 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......'s sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26-75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis...

  17. 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.

  18. 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

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

    Science.gov (United States)

    Gardin, Chiara; Ricci, Sara; 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.

  20. 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.

  1. Assessing Donor Site Complications of Iliac Crest Bone Graft in Treatment of Scaphoid Nonunion

    Directory of Open Access Journals (Sweden)

    Davod Jafari

    2016-07-01

    Full Text Available Background Bone grafting is a common surgical technique to augment bone regeneration in orthopedic surgery. Autologous bone graft harvesting is the reliable treatment option and iliac crest is the most common harvesting site for healing bone fractures. However, the results of iliac crest bone graft harvesting are associated with morbidity and a number of complications. Objectives The aim of this study was to assess donor site complications of scaphoid nonunion, to find clinical outcomes and the impact of iliac crest bone graft on age, gender, pain, numbness, itching, nerve injury and scar appearance of patients. Methods In a prospective review of 61 cases of iliac crest bone graft procedures at the Shafa hospital from 2013 to 2014, complications including pain, infection, hematoma, stress fracture, hypertrophic scars, numbness area and itching were assessed clinically. Results Pain identified as the most common complication. The most common complications following postoperative pain at the donor site that reduced after six weeks were: numbness 3.27%, unsatisfactory scar appearance 3.27% and itching discomfort 1.63%. Conclusions Harvesting of iliac crest bone graft can be the ideal way to prepare graft procedures required surgery scaphoid nonunion fractures with minimal complications. Nevertheless, with an adequate preoperative planning and appropriate surgical technique, the prevalence of these complications can be reduced.

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

    Directory of Open Access Journals (Sweden)

    PPY Lui

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gupta Ankit

    2010-01-01

    Full Text Available Background: Beta tricalcium phosphate is commonly used in metaphyseal defects but its use in posterolateral spinal fusion remains controversial. There are very few published animal studies in which use of beta tricalcium phosphate has been evaluated in the posterolateral lumbar arthrodesis model. Hence we conducted a study to evaluate the potential of composite graft of beta tricalcium phosphate and bone marrow aspirate in comparison to autologous bone graft, when used for posterolateral spinal fusion. Materials and Methods: Single level posterolateral lumbar fusion was performed in 40 adult male Indian rabbits, which were assigned randomly into one of the four groups based on graft materials implanted; a 3 gm beta tricalcium phosphate plus 3 ml bone marrow aspirate (Group I; b 3 ml bone marrow aspirate alone (Group II; c 3 gm beta tricalcium phosphate (Group III and d 3 gm autologous bone graft (Group IV. Each group had 10 rabbits. Half of the rabbits were sacrificed by injecting Phenobarbitone intraperitoneally after eight weeks and the remaining after 24 weeks, and were evaluated for fusion by X-rays, computed tomography (CT scans, manual palpation test and histology. Results: Beta tricalcium phosphate used with bone marrow aspirate produced best results when compared to other groups (P =.0001. When beta tricalcium phosphate was used alone, fusion rates were better as compared to fusion achieved with autologous iliac crest bone graft though statistically not significant (P =0.07. Autologous bone graft showed signs of new bone formation. However, the rate of new bone formation was comparatively slow. Conclusion: Composite graft of beta tricalcium phosphate and bone marrow aspirate can be used as an alternative to autologous iliac crest bone graft.

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

    Science.gov (United States)

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

    2010-01-01

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

  5. Referral patterns of general dental practitioners for bone grafting and implant placement.

    Science.gov (United States)

    Gupta, B; Shadbolt, B; Hyam, D

    2017-09-01

    Dental implant rehabilitation is a well-established procedure often conducted in the general dental practise setting. The outcomes for implant placement are reliable when the recipient site is favourable. The goal of this study was to assess the accuracy with which general dental practitioners (GDP) assess the bone volume available for implant placement and their referral patterns for implant sites, which may require bone grafting. Fifty-three GDP were surveyed and asked to assess five different scenarios and cone-beam scans for difficulty (0, 'no difficulty'; 5, 'the most difficult'), and bone grafting requirements ('yes'/'no' and 'who to perform'), prior to implant placement. The GDP assessment of difficulty for the cases was: no graft required, 1.88; aesthetic zone involvement, 3.25; vertical deficiency, 2.8; sinus lift required, 3.68; and horizontal deficiency, 4.4. GDP seemed to have some difficulty identifying which cases required a bone graft, occasionally grafting a site with sufficient bone (12.5%), or not grafting a site with insufficient bone (45-75%). These results show that GDP are accurate in assessing the difficulty of an implant case and conservative when it comes to attempting these complex cases. GDP are less confident when it comes to recognizing cases that require bone grafting, and what options are available. © 2017 Australian Dental Association.

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

    Directory of Open Access Journals (Sweden)

    Xiangdong Duan

    2009-05-01

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

  7. Screw in the aorta: minimally invasive graft replacement for chronic aortic erosion by spinal instrument.

    Science.gov (United States)

    Fukuda, Wakako; Aoki, Chikashi; Daitoku, Kazuyuki; Taniguchi, Satoshi; Fukuda, Ikuo

    2013-01-01

    Intra-and early post-operative aortic injury by pedicle screw is not a rare complication in orthopedic surgery, but aortic penetration by a screw head over a long time period is considered as an uncommon case. There are various surgical management options for thoracic aortic injury caused by malpositioned spinal instruments. We report a case of a patient who underwent minimally invasive graft replacement of the descending thoracic artery for pedicle screw penetration.

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

    DEFF Research Database (Denmark)

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

    2001-01-01

    Bone formation generally depends on adequate blood flow. Failure of bone grafts has been attributed to delayed revascularisation of the graft. We compared the relationship between revascularisation and osteogenesis, evaluated as entrapment of (141)Ce-labelled microspheres and uptake of (85)Sr.......50, p = 0.001), no correlation could be demonstrated in demineralised grafts (r = 0.09, p = 0.6). The results may indicate differences in the mechanisms of vascularisation and osteogenesis in the grafts used fresh or after demineralization but are, at present, difficult to fully explain....

  9. 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

  10. Free vascularized fibula grafts for salvage of failed oncologic long bone reconstruction and pathologic fractures.

    Science.gov (United States)

    Friedrich, Jeffrey B; Moran, Stephen L; Bishop, Allen T; Shin, Alexander Y

    2009-01-01

    Vascularized bone grafts, particularly the free fibula transfer, have incited revolutionary changes in the field of skeletal reconstruction. In no place has this been more evident than in oncologic reconstruction. The free vascularized fibula graft has been used to good effect for primary long-bone reconstruction, long-bone allograft complication salvage, and pathologic fracture salvage of the long bones. Although many of these procedures often entail significant complications, limb salvage has been made possible in a majority of patients using transfers of free vascularized fibula grafts. The purpose of this review is to critically evaluate the technique of onlay free vascularized fibula grafts for salvage of allograft complications and pathologic fractures of the long bones. This will be accomplished by reviewing the problem of allograft complications and pathologic fractures, the current treatment modalities available, the outcomes of these treatments, and future directions of treatment for this particular problem.

  11. A RETROSPECTIVE STUDY OF BILATERAL ALVEOLAR BONE GRAFTING

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

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

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

    Science.gov (United States)

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

    2012-09-01

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

  13. 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 tha

  14. The effect of bone marrow aspirate, bone graft and collagen composites on fixation of bone implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    2007-01-01

    or allograft (control group). The bone marrow was harvested by aspiration from the proximal part of the tibia. Autologous bone graft harvested from the four drill holes in the femoral condyles. A standardised surgical procedure was used. After surgery the sheep were observed at the outdoor facilities...... part of the implant. Specimens are preserving now at - 20°C and wait for the push-out test which is destructive and will be performed on an 858 Bionex MTS hydraulic material testing machine (MTS system cooperation, Minneapolis, Minnesota, USA). The specimens for histological analysis were taken from...

  15. 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.

  16. 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.

  17. 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

  18. Use of recombinant human bone morphogenetic protein-2 with local bone graft instead of iliac crest bone graft in posterolateral lumbar spine arthrodesis.

    Science.gov (United States)

    Park, Daniel K; Kim, Sung S; Thakur, Nikhil; Boden, Scott D

    2013-05-20

    Prospective clinical study. Compare fusion rates between recombinant human bone morphogenetic protein-2 (rhBMP-2) and iliac crest bone graft (ICBG) with rhBMP-2 and local bone graft (LBG) (±bone graft extenders) in posterolateral fusion. Previous reports have shown higher fusion rates when adding rhBMP-2 to ICBG in lumbar posterolateral fusion, compared with ICBG alone. We compared the fusion success rates between rhBMP-2 delivered with ICBG versus that with LBG. Fusion rates were compared in patients with degenerative spondylolisthesis (1-2 levels) with accompanying lumbar stenosis. RhBMP-2 (INFUSE, Medtronic) was delivered on an absorbable collagen sponge (6 mg/side at 1.5 mg/mL) with ICBG alone or with LBG wrapped inside the sponge. Thin slice computed tomographic scans were assessed at 6, 12, and 24 months. In a consecutive series, 16 patients (30 levels) received ICBG with rhBMP-2 and 35 patients (49 levels) received LBG with rhBMP-2. For the ICBG cohort, 80.0%, 93.4%, 96.7% of levels were fused at 6, 12, and 24 months. In contrast, for the local bone with rhBMP-2 cohort, 87.7%, 98.0%, and 98.0% were fused at 6, 12, and 24 months. There was no statistically significant difference in fusion success rates between the 2 groups at any time point. As for fusion quality, the fusion mass showed superior quality in ICBG group than in the local bone group at each time point. This study validates the high fusion success rates previously reported by adding rhBMP-2 to ICBG and shows that local bone may be safely substituted for ICBG in 1- to 2-level posterolateral fusion. The fusion rates were comparable. The avoidance of ICBG harvest has implications for operative time, blood loss, and morbidity. Lastly, this is the first study that directly compares the fusion success rate and quality using local bone with rhBMP-2 versus ICBG with rhBMP-2 at various times. 4.

  19. Tissue-engineered bone grafts for osteoplasty in patients with cleft alveolus.

    Science.gov (United States)

    Pradel, Winnie; Lauer, Günter

    2012-11-01

    Alveolar bone grafting is an integral part of the treatment concept in cleft palate patients. As an alternative to autogenous bone, tissue-engineered grafts have found some clinical application. The aim of the present study has been to compare ossification in the cleft area using tissue-engineered grafts in a case series of patients with ossification after transplantation of autogenous spongious bone as the gold standard in alveoloplasty. Eight children with complete cleft lips and cleft palates were included in the study. In four children (group A), the cleft defect was filled with tissue-engineered bone (autogenous osteoblasts cultured on demineralized bone matrix Osteovit(®)); as control in another 4 children (group B), the alveoloplasty was performed using spongious iliac bone. Preoperative and 6 months postoperative cone-beam computed tomography was performed, and volumes of the remaining cleft defects were calculated using 3D navigation software. Wound healing was uneventful in both groups. Six months postoperatively the mean volume of the cleft was 0.55±0.24cm(3) after grafting of tissue-engineered bone (group A) and 0.59±0.23cm(3) after transplantation of autogenous spongiosa. In group A, 40.9% of the cleft defect was ossified; in the control group (group B), 36.6%. Tissue-engineered bone is a promising alternative in alveolar bone grafting and no disadvantages were observed in comparison to the gold standard. Copyright © 2012 Elsevier GmbH. All rights reserved.

  20. A Bone Sample Containing a Bone Graft Substitute Analyzed by Correlating Density Information Obtained by X-ray Micro Tomography with Compositional Information Obtained by Raman Microscopy

    Directory of Open Access Journals (Sweden)

    Johann Charwat-Pessler

    2015-06-01

    Full Text Available The ability of bone graft substitutes to promote new bone formation has been increasingly used in the medical field to repair skeletal defects or to replace missing bone in a broad range of applications in dentistry and orthopedics. A common way to assess such materials is via micro computed tomography (µ-CT, through the density information content provided by the absorption of X-rays. Information on the chemical composition of a material can be obtained via Raman spectroscopy. By investigating a bone sample from miniature pigs containing the bone graft substitute Bio Oss®, we pursued the target of assessing to what extent the density information gained by µ-CT imaging matches the chemical information content provided by Raman spectroscopic imaging. Raman images and Raman correlation maps of the investigated sample were used in order to generate a Raman based segmented image by means of an agglomerative, hierarchical cluster analysis. The resulting segments, showing chemically related areas, were subsequently compared with the µ-CT image by means of a one-way ANOVA. We found out that to a certain extent typical gray-level values (and the related histograms in the µ-CT image can be reliably related to specific segments within the image resulting from the cluster analysis.

  1. Reverse engineering of pelvic bone for hip joint replacement.

    Science.gov (United States)

    Popov, I; Onuh, S O

    2009-01-01

    Research into fabrication of hip joint replacements combines knowledge from distinct domains, such as engineering, materials and medical fields. Recent computer assisted technologies have played an important role in the medical field. Unlike the modelling of most of the human bones, the creation of an accurate 3D model of a pelvic bone has been a challenging task. The main source of difficulties in this case has proven to be the complexity of the structure of the pelvis, having basically a free-form shape with a hole in the middle constituting some over-shadowed areas (undercuts), various cavities, areas with high form curvature, variable wall thickness with some very thin sections and inside layers with different mechanical properties. In this research work, a pelvic bone is generated using reverse engineering, rapid prototyping and rapid tooling techniques. The geometric data obtained from reverse engineering through laser scanning are used and manipulated to create accurate 3D CAD representations of these devices. These CAD models can be used for various virtual tests and simulations, as well as for reproduction through rapid manufacturing processes and then used as prototypes in tooling, physical tests and planning of surgical operations.

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

    Science.gov (United States)

    Zein, Randa; Selting, Wayne; Benedicenti, Stefano

    2017-07-21

    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.

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Gui Rak Kim, MD

    2013-11-01

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

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  6. Combined aortic valve replacement and coronary artery bypass grafting for a calcified ascending aorta.

    Science.gov (United States)

    Baba, Hironori; Umesue, Masayoshi; Matsui, Kanzi

    2012-04-01

    Although a severely calcified ascending aorta is encountered infrequently, it presents formidable problems during cardiac surgery. We describe a case of severe aortic valve stenosis and coronary artery disease combined with a severely calcified ascending aorta. The patient was an 80-year-old man with a calcified ascending aorta. He successfully underwent an aortic valve replacement and a single coronary artery bypass graft (CABG) using a saphenous vein graft with the proximal end connected on a Dacron patch, which was used for aortoplasty of the calcified plate along the aortotomy. These procedures were performed under moderate hypothermia with aortic clamping. This patch aortoplasty can be a useful alternative in cases that require aortotomy and proximal anastomoses of a CABG on a calcified ascending aorta.

  7. Use of lymphokine-activated killer cells to prevent bone marrow graft rejection and lethal graft-vs-host disease

    Energy Technology Data Exchange (ETDEWEB)

    Azuma, E.; Yamamoto, H.; Kaplan, J. (Wayne State Univ. School of Medicine, Detroit, MI (USA))

    1989-09-01

    Prompted by our recent finding that lymphokine-activated killer (LAK) cells mediate both veto and natural suppression, we tested the ability of adoptively transferred LAK cells to block two in vivo alloreactions which complicate bone marrow transplantation: resistance to transplanted allogeneic bone marrow cells, and lethal graft-vs-host disease. Adoptive transfer of either donor type B6D2 or recipient-type B6 lymphokine-activated bone marrow cells, cells found to have strong LAK activity, abrogated or inhibited the resistance of irradiated B6 mice to both B6D2 marrow and third party-unrelated C3H marrow as measured by CFU in spleen on day 7. The ability of lymphokine-activated bone marrow cells to abrogate allogeneic resistance was eliminated by C lysis depletion of cells expressing asialo-GM1, NK1.1, and, to a variable degree, Thy-1, but not by depletion of cells expressing Lyt-2, indicating that the responsible cells had a LAK cell phenotype. Similar findings were obtained by using splenic LAK cells generated by 3 to 7 days of culture with rIL-2. Demonstration that allogeneic resistance could be blocked by a cloned LAK cell line provided direct evidence that LAK cells inhibit allogeneic resistance. In addition to inhibiting allogeneic resistance, adoptively transferred recipient-type LAK cells prevented lethal graft-vs-host disease, and permitted long term engraftment of allogeneic marrow. Irradiation prevented LAK cell inhibition of both allogeneic resistance and lethal graft-vs-host disease. These findings suggest that adoptive immunotherapy with LAK cells may prove useful in preventing graft rejection and graft-versus-host disease in human bone marrow transplant recipients.

  8. In Situ Splitting of a Rib Bone Graft for Reconstruction of Orbital Floor and Medial Wall.

    Science.gov (United States)

    Uemura, Tetsuji; Yanai, Tetsu; Yasuta, Masato; Harada, Yoshimi; Morikawa, Aya; Watanabe, Hidetaka; Kurokawa, Masato

    2017-06-01

    In situ splitting of rib bone graft was conducted in 22 patients for the repair of orbital fracture with no other complicating fractures. A bone graft was harvested from the sixth or seventh rib in the right side. The repair of the orbital floor and medial wall was successful in all the cases. Ten patients had bone grafting to the orbital floor, eight had it done onto medial wall, and 4 onto both floor and wall after reduction. The mean length of in situ rib bone graft was 40.9 mm (range, 20-70 mm), the mean width of these was 14.9 mm (range, 8-20 mm). The bone grafting was done by one leaf for 15 cases and two leafs for 7 cases in size of defects. The technique of in situ splitting of a rib bone graft for the repair of the orbital floor and medial wall is a simple and safe procedure, easily taking out the in situ splitting of a rib, and less pain in donor site. It has proved to be an optimal choice in craniofacial reconstruction, especially the defects of orbital floor and medial wall.

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

    Science.gov (United States)

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

    2015-07-01

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

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

    Science.gov (United States)

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

    2013-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Motamedi M

    2003-05-01

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

  12. Aortic valve replacement and concomitant right coronary artery bypass grafting performed via a right minithoracotomy approach.

    Science.gov (United States)

    Mihos, Christos G; Santana, Orlando; Pineda, Andres M; La Pietra, Angelo; Lamelas, Joseph

    2014-01-01

    We present our experience of concomitant right coronary artery bypass grafting (CABG) and aortic valve replacement performed via a right minithoracotomy in patients with coronary lesions not amenable to percutaneous intervention. A total of 17 patients underwent concomitant aortic valve replacement and right CABG between April 2008 and July 2013. A 5- to 6-cm minithoracotomy incision was made over the right second or third intercostal space, and the costochondral cartilage was transected. A saphenous vein bypass to the right coronary artery was then performed, initiating the anastomosis from the toe of the graft. Subsequently, the aortic valve was replaced using standard techniques. There were 6 men and 11 women. The median European System for Cardiac Operative Risk Evaluation II score mortality risk was 5% [interquartile range (IQR), 2%-8%]. The mean (SD) age was 77 (10) years, the left ventricular ejection fraction was 59% (8%), and the New York Heart Association functional class was 2.4 (0.8). One patient had a history of CABG. The mean (SD) cardiopulmonary bypass time was 168 (57) minutes, and the aortic cross-clamp time was 133 (36) minutes. Three patients underwent concomitant mitral valve surgery (replacement, 2; repair, 1). The median intensive care unit and hospital lengths of stay were 47 hours (IQR, 24-90) and 9 days (IQR, 5-13), respectively. There was one reoperation for bleeding, and there was one postoperative stroke. All patients were alive at a mean (SD) follow-up of 2 (1.1) years. Aortic valve replacement with concomitant CABG performed via a right minithoracotomy approach is feasible.

  13. A Retrospective Analysis of Dental Implants Replacing Failed Implants in Grafted Maxillary Sinus: A Case Series.

    Science.gov (United States)

    Manor, Yifat; Chaushu, Gavriel; Lorean, Adi; Mijiritzky, Eithan

    2015-01-01

    To evaluate the survival rate of dental implants replacing failed implants in grafted maxillary sinuses using the lateral approach vs nongrafted posterior maxillae. A retrospective analysis was conducted to study the survival of secondary dental implants inserted in the posterior maxilla in previously failed implant sites between the years 2000 and 2010. The study group consisted of patients who had also undergone maxillary sinus augmentation, and the control group consisted of patients in whom implants in the posterior maxilla had failed. Clinical and demographic data were analyzed using a structured form. Seventy-five patients with a total of 75 replaced implants were included in the study. The study group comprised 40 patients and the control group, 35 patients. None of the replaced implants in the study group failed, resulting in an overall survival of 100%; three replaced implants in the control group failed (92% survival). The main reason for the primary implant removal was lack of osseointegration (35 [87.5%] of 40 study group implants and 23 [65.7%] of 35 control group implants [P = .027]). The difference between the groups with regard to the timing of primary implant failure was statistically significant. The study group had more early failures of the primary implant than did the control group (77% vs 62%; P = .038). Dental implants replaced in the posterior maxilla had a high survival rate. A higher rate of survival was found in augmented maxillary sinus sites. Within the limits of the present study, it can be concluded that previous implant failures in the grafted maxillary sinus should not discourage practitioners from a second attempt.

  14. The accuracy of stereolithography in planning craniofacial bone replacement.

    Science.gov (United States)

    Chang, Peter Shih-Hsin; Parker, Thornwell H; Patrick, Charles W; Miller, Michael J

    2003-03-01

    Stereolithography can be used to produce physical models of the craniofacial skeleton from three-dimensional computed tomography (CT) data. The purpose of this study was to assess its accuracy for modeling osseous defects of the midface. Maxillary resections simulating unilateral maxillectomy (N = 3), bilateral maxillectomy (N = 3), and unilateral orbitomaxillectomy (N = 3) were performed as for sinus tumor resection on nine fresh cadaver skulls. Stereolithographic models (SLMs) were made from the specimen's CT data. The accuracy of SLMs was determined by comparing distances between key landmarks on the skulls and SLMs. Each SLM was grossly accurate with some loss of thin delicate structures. The mean differences in overall dimensions between the SLMs and skull specimens were 1.5 mm (range: 0-5.5 mm) for craniofacial measures, 1.2 mm (range: 0-4.8 mm) for skull base measures, 1.6 (range: 0-5.8 mm) for midface measures, 1.9 mm (range: 0-7.9 mm) for maxilla measures, and 1.5 mm (range: 0-5.7 mm) for orbital measures. The mean differences in defect dimensions were 1.9 mm (range: 0.1-5.7 mm) for unilateral maxillectomy, 0.8 mm (range: 0.2-1.5 mm) for bilateral maxillectomy, and 2.5 mm (range: 0.2-7.0 mm) for orbitomaxillectomy defects. Midface SLMs may be more prone to error than those of other craniofacial regions because of the presence of thin walls and small projections. Thus, one should consider designing midface bone replacements that are larger in critical dimensions than those predicted by preoperative modeling. These findings have important implications for the planning of current surgical methods as well as future applications of tissue-engineered bone replacement.

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

    Directory of Open Access Journals (Sweden)

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

    2010-01-01

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

  16. MR imaging of avascular scaphoid nonunion before and after vascularized bone grafting

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Suzanne E.; Tschering-Vogel, Dechen; Martin, Matthias [University Hospital of Bern, Inselspital, Department of Radiology, Bern (Switzerland); Steinbach, Lynne S. [University of California San Francisco, Department of Radiology, San Francisco, California (United States); Nagy, Ladislav [University Hospital of Bern, Inselspital, Department of Orthopedic Surgery, Bern (Switzerland)

    2005-06-01

    To investigate the magnetic resonance (MR) imaging appearances of chronic nonunion of the scaphoid with proximal pole avascular necrosis before and after insertion of a vascularized bone graft, using computed tomography (CT) as the imaging gold standard. A retrospective study was performed involving MR imaging (n=26), CT scans (n=37) and radiographs (n=52) of 13 men (mean age 29 years, age range 20-38 years) with avascular scaphoid nonunion. Avascular necrosis of the scaphoid proximal pole was confirmed intraoperatively (n=13). MR images were acquired preoperatively and following placement of a vascularized bone graft. Scaphoid MR signal characteristics were assessed for evidence of vascular bone graft incorporation and revascularization of the bone marrow of the proximal pole of the scaphoid and compared with the gold standard of CT. Surgical and clinical notes were reviewed with a minimum 3 year imaging and clinical follow-up in all patients. Graft incorporation with revascularization of the proximal pole of the scaphoid was documented in 9 patients (69%). Graft failure with persistent pseudoarthrosis and avascular necrosis of the scaphoid was seen in 4 patients (31%). MR imaging is useful to determine whether vascularized bone graft incorporation and revascularization of the proximal pole of the scaphoid has occurred in the setting of avascular scaphoid nonunion. (orig.)

  17. [Dislocation of the closing element of the disk mechanical graft at aortic valve replacement].

    Science.gov (United States)

    Korostelev, A N; Kuntsevich, G I; Zotikov, A E; Chernyak, B B; Il'ina, M V; Ter-Khachaturova, I E; Solopova, G V

    2003-01-01

    Presented herein is the first case of dislocation of the closing element of the artificial low-profile aortic valve to the abdominal aorta, which happened during replacement. Toward completion of extracorporeal circulation a 37-year-old man showed the signs of aortic insufficiency because of dislocation of the closing element. After resumption of extracorporeal circulation repeated replacement was accomplished. To detect the site of graft cusp embolism, transesophageal echocardiography and duplex scanning of the abdominal aorta were employed. On the 18th day following the first intervention the patient developed thromboembolism to the distal arterial bed. Emergency thrombectomy from the arteries of the right lower extremity was performed and a foreign body was removed from the abdominal aorta, using left-sided thoracophrenolumbotomy. The patient was discharged from the clinic in a satisfactory condition.

  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. Characterization of the inflammatory response to four commercial bone graft substitutes using a murine biocompatibility model

    Directory of Open Access Journals (Sweden)

    Markel DC

    2012-01-01

    Full Text Available David C Markel1, S Trent Guthrie2, Bin Wu3, Zheng Song4, Paul H Wooley41Department of Orthopaedics, Providence Hospital and Medical Centers, Southfield, MI, 2Henry Ford Hospital, Detroit, MI, 3Department of Biomedical Engineering, Wayne State University, Detroit, MI, 4Orthopaedic Research Institute, Wichita, KS, USAAbstract: Bone grafting is utilized in nearly all orthopedic subspecialties and in most anatomic regions. Bone graft substitutes have the potential to offer similar efficacy as autogenous grafts without the morbidity of harvest. Several studies have noted the efficacy of new-generation bone substitute products, but few studies have evaluated their safety. This study characterizes and quantifies the inflammatory reaction to four different commercially available bone graft substitutes, which were examined using the in vivo murine air pouch biocompatibility model. One coralline hydroxyapatite product was chosen as an example of a purely osteoconductive material. Three demineralized bone matrix products were chosen to represent products that are both osteoconductive and osteoinductive. Samples were implanted in a murine air pouch and harvested after 14 days in situ. Pouch fluid was extracted, mRNA isolated, and reverse transcription polymerase chain reactions carried out to detect interleukin-1 gene expression as a marker for inflammation. In addition, multiple histological characteristics were examined to quantify cellular responses to the implanted materials. All bone graft substitutes induced a significant inflammatory response compared with negative controls. Histology and polymerase chain reaction data indicated that the level of inflammatory reaction was elevated in materials with a higher demineralized bone matrix to carrier proportion. The hydroxyapatite product generated a low inflammatory reaction. In conclusion, this study used an in vivo model of biocompatibility to demonstrate that a significant inflammatory reaction occurs

  20. 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.

  1. Socket grafting with the use of autologous bone: an experimental study in the dog.

    Science.gov (United States)

    Araújo, Mauricio G; Lindhe, Jan

    2011-01-01

    studies in humans and animals have shown that following tooth removal (loss), the alveolar ridge becomes markedly reduced. Attempts made to counteract such ridge diminution by installing implants in the fresh extraction sockets were not successful, while socket grafting with anorganic bovine bone mineral prevented ridge contraction. to examine whether grafting of the alveolar socket with the use of chips of autologous bone may allow ridge preservation following tooth extraction. in five beagle dogs, the distal roots of the third and fourth mandibular premolars were removed. The sockets in the right or the left jaw quadrant were grafted with either anorganic bovine bone or with chips of autologous bone harvested from the buccal bone plate. After 3 months of healing, biopsies of the experimental sites were sampled, prepared for buccal-lingual ground sections and examined with respect to size and composition. it was observed that the majority of the autologous bone chips during healing had been resorbed and that the graft apparently did not interfere with socket healing or processes that resulted in ridge resorption. autologous bone chips placed in the fresh extraction socket will (i) neither stimulate nor retard new bone formation and (ii) not prevent ridge resorption that occurs during healing following tooth extraction.

  2. 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

    2001-01-01

    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 ra

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

    Science.gov (United States)

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

    2016-01-01

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

  4. 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.

  5. SHORT TERM RESULTS OF MUSCLE PEDICLE BONE GRAFT (MPBG IN FRACTURE NECK FEMUR: A CASE SERIES OF 7 CASES

    Directory of Open Access Journals (Sweden)

    Sarabjeet

    2016-03-01

    Full Text Available INTRODUCTION Neglected, untreated and delayed neck femur fractures are commonly encountered fractures and the treatment dilemma arises specially when the patient is physiologically young and osteosynthesis is the preferred option. Past literature creates confusion as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularised fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata (TFL and Quadratus femoris graft and vascularised bone grafting do not have clear lines of indications. We present a series of fracture neck femur cases, each with delayed presentation beyond the vascular emergency period, which were treated with osteosynthesis with MPBG using tensor fascia lata muscle pedicle graft.

  6. Pelvic instability after bone graft harvesting from posterior iliac crest: report of nine patients

    Energy Technology Data Exchange (ETDEWEB)

    Chan, K.; Pathria, M.; Jacobson, J. [Dept. of Radiology, Univ. of California, San Diego, CA (United States); Resnick, D. [Dept. of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States)

    2001-05-01

    Objective. To report the imaging findings in nine patients who developed pelvic instability after bone graft harvest from the posterior aspect of the iliac crest.Design and patients. A retrospective study was performed of the imaging studies of nine patients who developed pelvic pain after autologous bone graft was harvested from the posterior aspect of the ilium for spinal arthrodesis. Plain films, bone scans, and CT and MR examinations of the pelvis were reviewed. Pertinent aspects of the clinical history of these patients were noted, including age, gender and clinical symptoms.Results. The age of the patients ranged from 52 to 77 years (average 69 years) and all were women. The bone graft had been derived from the posterior aspect of the iliac crest about the sacroiliac joint. All patients subsequently developed subluxation of the pubic symphysis. Eight patients had additional insufficiency fractures of the iliac crest adjacent to the bone graft donor site, and five patients also revealed subluxation of the sacroiliac joint. Two had insufficiency fractures of the sacrum and one had an additional fracture of the pubic ramus.Conclusions. Pelvic instability is a potential complication of bone graft harvesting from the posterior aspect of the iliac crest. The pelvic instability is manifested by insufficiency fractures of the ilium and subluxation of the sacroiliac joints and pubic symphysis. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-01-15

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

  8. Bone transplantation and tissue engineering. Part II: bone graft and osteogenesis in the seventeenth, eighteenth and nineteenth centuries (Duhamel, Haller, Ollier and MacEwen).

    Science.gov (United States)

    Hernigou, Philippe

    2015-01-01

    In the 18th century, the fate of allografts and their role in bone formation became of interest to many orthopaedic surgeons. A controversy over the science of osteogenesis, the formation of bone, had emerged following the opposing views of Duhamel and von Haller. Duhamel noted that the periosteum had a deep osteogenic layer, which he termed the "cambium layer". However, von Haller claimed the opposite: the periosteum was not osteogenic. In the 19th century, Ollier performed comprehensive studies on the periosteum. Ollier's experiments were published in two volumes entitled "Traite Experimental et clinique de la regeneration des os" in 1867. His conclusion was that transplanted periosteum and bone survived and could become osteogenic under proper conditions. The controversy was furthered by MacEwen who believed, contrary to Duhamel and Ollier, that the periosteum had no osteogenetic power and was purely a limiting membrane giving direction to bone growth but taking no active part in it. This manuscript describes this period of controversies about the osteogenesis of the transplanted bone, marrow and periosteum that would eventually die or not and be replaced by surrounding tissue or be active for osteogenesis. Whether bone grafts are a form of passive scaffolding or active in osteogenesis was the main question about auto and allografts in the 18th and 19th centuries. In response to this challenge, many papers were written to defend each side of the argument.

  9. 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.

  10. Assessment of bone healing in rabbit calvaria grafted with three different biomaterials.

    Science.gov (United States)

    Takauti, Carlos Alberto Yoshihiro; Futema, Fabio; Brito Junior, Rui Barbosa de; Abrahão, Aline Corrêa; Costa, Claudio; Queiroz, Celso Silva

    2014-01-01

    This study evaluated the bone regeneration process in rabbit calvaria induced by three types of biomaterials: two xenogenous, consisting of deproteinized bovine bone, while the other was alloplastic, based on biphasic calcium phosphate. Five New Zealand white rabbits weighing between 2,900 and 3,500 g were submitted to four standard 8 mm-diameter perforations at the parietal bone. Three perforations were filled with three grafts and biomaterials, two of them received bovine Bio-Oss® and Endobon® Xenograft Granules, and the other consisted of fully alloplastic Straumann® Bone Ceramic. The fourth remaining cavity was used as control with coagulum. After eight weeks, the animals were sacrificed, and the samples were prepared for morphometric and qualitative analysis. The cavities filled with alloplastic biomaterials showed higher percentages of newly formed bone (pbiomaterials showed higher amount of residual graft (pbiomaterial for bone induction process.

  11. Quantitation of mandibular symphysis volume as a source of bone grafting.

    Science.gov (United States)

    Verdugo, Fernando; Simonian, Krikor; Smith McDonald, Roberto; Nowzari, Hessam

    2010-06-01

    Autogenous intramembranous bone graft present several advantages such as minimal resorption and high concentration of bone morphogenetic proteins. A method for measuring the amount of bone that can be harvested from the symphysis area has not been reported in real patients. The aim of the present study was to intrasurgically quantitate the volume of the symphysis bone graft that can be safely harvested in live patients and compare it with AutoCAD (version 16.0, Autodesk, Inc., San Rafael, CA, USA) tomographic calculations. AutoCAD software program quantitated symphysis bone graft in 40 patients using computerized tomographies. Direct intrasurgical measurements were recorded thereafter and compared with AutoCAD data. The bone volume was measured at the recipient sites of a subgroup of 10 patients, 6 months post sinus augmentation. The volume of bone graft measured by AutoCAD averaged 1.4 mL (SD 0.6 mL, range: 0.5-2.7 mL). The volume of bone graft measured intrasurgically averaged 2.3 mL (SD 0.4 mL, range 1.7-2.8 mL). The statistical difference between the two measurement methods was significant. The bone volume measured at the recipient sites 6 months post sinus augmentation averaged 1.9 mL (SD 0.3 mL, range 1.3-2.6 mL) with a mean loss of 0.4 mL. AutoCAD did not overestimate the volume of bone that can be safely harvested from the mandibular symphysis. The use of the design software program may improve surgical treatment planning prior to sinus augmentation.

  12. Quantitation of mandibular ramus volume as a source of bone grafting.

    Science.gov (United States)

    Verdugo, Fernando; Simonian, Krikor; Smith McDonald, Roberto; Nowzari, Hessam

    2009-10-01

    When alveolar atrophy impairs dental implant placement, ridge augmentation using mandibular ramus graft may be considered. In live patients, however, an accurate calculation of the amount of bone that can be safely harvested from the ramus has not been reported. The use of a software program to perform these calculations can aid in preventing surgical complications. The aim of the present study was to intra-surgically quantify the volume of the ramus bone graft that can be safely harvested in live patients, and compare it to presurgical computerized tomographic calculations. The AutoCAD software program quantified ramus bone graft in 40 consecutive patients from computerized tomographies. Direct intra-surgical measurements were recorded thereafter and compared to software data (n = 10). In these 10 patients, the bone volume was also measured at the recipient sites 6 months post-sinus augmentation. The mandibular second and third molar areas provided the thickest cortical graft averaging 2.8 +/- 0.6 mm. The thinnest bone was immediately posterior to the third molar (1.9 +/- 0.3 mm). The volume of ramus bone graft measured by AutoCAD averaged 0.8 mL (standard deviation [SD] 0.2 mL, range: 0.4-1.2 mL). The volume of bone graft measured intra-surgically averaged 2.5 mL (SD 0.4 mL, range: 1.8-3.0 mL). The difference between the two measurement methods was significant (p AutoCAD software program did not overestimate the volume of bone that can be safely harvested from the mandibular ramus.

  13. Histologic and radiographic evaluation of different bone grafts in ridge preservation procedures

    OpenAIRE

    Barallat Sendagorta, Lucía

    2016-01-01

    The main goal of this PhD project was to better understand how different types of bone grafts behave in ridge preservation procedures. There is clear evidence that, after tooth removal, a healing process takes place in which the blood clot that fills the socket is gradually substituted with new bone. This process is accompanied by a reduction in height and width of the alveolar ridge. These events may result in limited bone availability, which may compromise an adequate implant pl...

  14. Novel ceramic bone replacement material CeraBall seeded with human mesenchymal stem cells.

    NARCIS (Netherlands)

    Douglas, T.E.L.; Liu, Q.; Humpe, A.; Wiltfang, J.; Sivananthan, S.; Warnke, P.H.

    2010-01-01

    OBJECTIVES: Hydroxyapatite (HA) and tricalcium phosphate (TCP) are two very common ceramic materials for bone replacement. A recently developed material for bone replacement is CeraBall, which is a mixed HA-TCP scaffold available as porous spherical scaffolds of diameter 4 and 6 mm. Before their use

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

    Directory of Open Access Journals (Sweden)

    Fotios TZERMPOS

    2013-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  18. Evaluation of Volumetric Changes of Augmented Maxillary Sinus With Different Bone Grafting Biomaterials.

    Science.gov (United States)

    Gultekin, B Alper; Cansiz, Erol; Borahan, Oguz; Mangano, Carlo; Kolerman, Roni; Mijiritsky, Eitan; Yalcin, Serdar

    2016-03-01

    Extensive alveolar bone resorption because of pneumatized maxillary sinus is a common problem that limits dental implant placement. Maxillary sinus floor augmentation (MSFA) is an accepted treatment protocol that provides sufficient bone volume. The aim of this study was to evaluate the percentage of graft volume reduction following MSFA using cone beam computed tomography. In this retrospective study, cone beam computed tomography scans of MSFA were measured to evaluate the volume of the grafted sinus with deproteinized bovine bone (DBB), mineralized allograft (MA), or a mixture of MA and demineralized allograft as a composite. The volumetric changes in sinus augmentation between 2 weeks (T-I) and 6 months (T-II) after operation were analyzed. Thirty-nine patients were included in this study. The average percent volume reduction was 8.14 ± 3.76%, 19.38 ± 9.22%, and 24.66 ± 4.68% for DBB, MA, and composite graft, respectively. A significant graft volume reduction was found between T-I and T-II for all groups (P Biomaterials can influence the bone graft volume change before implant placement. Deproteinized bovine bone may offer greater volume stability during healing than mineralized and composite allografts.

  19. Fiber glass-bioactive glass composite for bone replacing and bone anchoring implants.

    Science.gov (United States)

    Vallittu, Pekka K; Närhi, Timo O; Hupa, Leena

    2015-04-01

    Although metal implants have successfully been used for decades, devices made out of metals do not meet all clinical requirements, for example, metal objects may interfere with some new medical imaging systems, while their stiffness also differs from natural bone and may cause stress-shielding and over-loading of bone. Peer-review articles and other scientific literature were reviewed for providing up-dated information how fiber-reinforced composites and bioactive glass can be utilized in implantology. There has been a lot of development in the field of composite material research, which has focused to a large extent on biodegradable composites. However, it has become evident that biostable composites may also have several clinical benefits. Fiber reinforced composites containing bioactive glasses are relatively new types of biomaterials in the field of implantology. Biostable glass fibers are responsible for the load-bearing capacity of the implant, while the dissolution of the bioactive glass particles supports bone bonding and provides antimicrobial properties for the implant. These kinds of combination materials have been used clinically in cranioplasty implants and they have been investigated also as oral and orthopedic implants. The present knowledge suggests that by combining glass fiber-reinforced composite with particles of bioactive glass can be used in cranial implants and that the combination of materials may have potential use also as other types of bone replacing and repairing implants. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  20. "Lytic" lesions in autologous bone grafts: demonstration of medullary air pockets on post mortem computed tomography.

    Science.gov (United States)

    Rotman, A; Hamilton, K; O'Donnell, C

    2007-12-01

    Donor bone grafts are an important aspect of orthopaedic surgery. The use of plain film as a pathological screening tool before donor bone dispatch has revealed "lytic" lesions in proximal humeri. Donor demographics did not support the diagnosis of myeloma and subsequent computed tomography (CT) scans of these bones identified the lesions as air, not pathology. In total, 27 long bones were scanned and 100% (27/27 cases) exhibited air within the trabecular bone. Three distinct patterns were found: ovoid, linear/branching, and broad channel. A longitudinal course of CT scans was performed to identify at which stage air appeared within the bone. Pre-retrieval, preprocessing, and postprocessing scans revealed that air originated between the retrieval and preprocessing stages of donor bone preparation. There may be multiple aetiology of this phenomenon, including bone retrieval and natural decomposition.

  1. Bioactive Glass versus Autogenous Iliac Crest Bone Graft in Adolescent Idiopathic Scoliosis Surgery

    Directory of Open Access Journals (Sweden)

    Ameri Ebrahim

    2009-10-01

    Full Text Available Surgery on the skeleton frequently requires harvesting of autogenous bone graft from the pelvis, but this procedure often is complicated by problems. The purpose of this retrospective, comparative descriptive study was to compare the efficacy of metal-derived bioactive glass (Novabone versus autogenous iliac crest bone graft in adolescent idiopathic scoliosis surgery. The study was carried out on forty cases (aged 14-20 years with 55 total curves fused for AIS. Posterior spinal fusion was performed using local bone grafts combined with autogenous iliac crest bone graft in 20 patients (group 1, and combined with Novabone in another twenty ones (group 2. The patients were observed for a minimum of 24 months after surgery, with a mean postoperative observation time of 34.7 months. The results were assessed clinically and radiologically. In group 1, average preoperative curve was 66° with immediate correction to 24.2° (59.7% and final follow-up of 27.4° (54.3%, but in group 2 the calculated numbers included 63.8°, 25.8° (59.6% and 28.4° (55.5 % respectively. There were 5 indeterminate fusions (3 cases in group 1 and 2 in the other group, 1 acute infection, and 1 hook dislodgement in the synthetic group. These results justify and favor the use of bone substitutes for instrumented posterior spinal fusion in AIS. Potentially hazardous harvesting of pelvic bone is no longer necessary for such operations.

  2. Bioactive Glass versus Autogenous Iliac Crest Bone Graft in Adolescent Idiopathic Scoliosis Surgery

    Directory of Open Access Journals (Sweden)

    Ameri E

    2009-04-01

    Full Text Available Surgery on the skeleton frequently requires harvesting of autogenous bone graft from the pelvis, but this procedure is complicated by problems. The purpose of this retrospective, comparative descriptive study was to compare the efficacy of metal-derived bioactive glass (Novabone versus autogenous iliac crest bone graft in adolescent idiopathic scoliosis surgery. The study was carried out on forty cases (aged 14-20 years with 55 total curves fused for AIS. Posterior spinal fusion was performed using local bone grafts combined with autogenous iliac crest bone graft in 20 patients (group 1, and combined with Novabone in another twenty ones (group 2. The patients were observed for a minimum of 24 months after surgery, with a mean postoperative observation time of 34.7 months. The results were assessed clinically and radiologically. In group 1, average preoperative curve was 66° with immediate correction to 24.2° (59.7% and final follow-up of 27.4° (54.3%, but in group 2 the calculated numbers included 63.8°, 25.8° (59.6% and 28.4° (55.5 % respectively. There were 5 indeterminate fusions (3 cases in group 1 and 2 in the other group, 1 acute infection, and 1 hook dislodgement in the synthetic group. These results justify and favor the use of bone substitutes for instrumented posterior spinal fusion in AIS. Potentially hazardous harvesting of pelvic bone is no longer necessary for such operations.

  3. Traumatic Periprosthetic Acetabular Fracture Treated with One-Stage Exchange and Bone Reconstruction Using a Synthetic Bone Graft Substitute

    Directory of Open Access Journals (Sweden)

    Jan Svacina

    2016-01-01

    Full Text Available A case of a traumatic periprosthetic acetabular fracture in an elderly patient, which was treated by one-stage hip exchange with implantation of an antiprotrusio cage and reconstruction of the acetabular bone loss with an injectable calcium sulphate/hydroxyapatite bone graft substitute, is reported. The paste-like bone graft substitute was injected through the holes of the antiprotrusio cage. After a setting time of 15 minutes, a low-profile cup was cemented onto the cage using polymethylmethacrylate and a new stem was inserted. The patient was encouraged to ambulate three days postoperatively weight-bearing as tolerated. At the one-year follow-up visit the patient was ambulatory and full weight-bearing without any walking aids. The follow-up radiographs demonstrated stable position and articulation of the revision hip arthroplasty with no signs of loosening of the antiprotrusio cage. However, the most interesting finding was that the bone graft substitute had remodelled to a great extent into bone. This calcium sulphate/hydroxyapatite composite shows high osteoconductive potential and can be used to regenerate bone stock in revision arthroplasty.

  4. Traumatic Periprosthetic Acetabular Fracture Treated with One-Stage Exchange and Bone Reconstruction Using a Synthetic Bone Graft Substitute.

    Science.gov (United States)

    Svacina, Jan

    2016-01-01

    A case of a traumatic periprosthetic acetabular fracture in an elderly patient, which was treated by one-stage hip exchange with implantation of an antiprotrusio cage and reconstruction of the acetabular bone loss with an injectable calcium sulphate/hydroxyapatite bone graft substitute, is reported. The paste-like bone graft substitute was injected through the holes of the antiprotrusio cage. After a setting time of 15 minutes, a low-profile cup was cemented onto the cage using polymethylmethacrylate and a new stem was inserted. The patient was encouraged to ambulate three days postoperatively weight-bearing as tolerated. At the one-year follow-up visit the patient was ambulatory and full weight-bearing without any walking aids. The follow-up radiographs demonstrated stable position and articulation of the revision hip arthroplasty with no signs of loosening of the antiprotrusio cage. However, the most interesting finding was that the bone graft substitute had remodelled to a great extent into bone. This calcium sulphate/hydroxyapatite composite shows high osteoconductive potential and can be used to regenerate bone stock in revision arthroplasty.

  5. Traumatic Periprosthetic Acetabular Fracture Treated with One-Stage Exchange and Bone Reconstruction Using a Synthetic Bone Graft Substitute

    Science.gov (United States)

    2016-01-01

    A case of a traumatic periprosthetic acetabular fracture in an elderly patient, which was treated by one-stage hip exchange with implantation of an antiprotrusio cage and reconstruction of the acetabular bone loss with an injectable calcium sulphate/hydroxyapatite bone graft substitute, is reported. The paste-like bone graft substitute was injected through the holes of the antiprotrusio cage. After a setting time of 15 minutes, a low-profile cup was cemented onto the cage using polymethylmethacrylate and a new stem was inserted. The patient was encouraged to ambulate three days postoperatively weight-bearing as tolerated. At the one-year follow-up visit the patient was ambulatory and full weight-bearing without any walking aids. The follow-up radiographs demonstrated stable position and articulation of the revision hip arthroplasty with no signs of loosening of the antiprotrusio cage. However, the most interesting finding was that the bone graft substitute had remodelled to a great extent into bone. This calcium sulphate/hydroxyapatite composite shows high osteoconductive potential and can be used to regenerate bone stock in revision arthroplasty. PMID:27446621

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  8. Treatment of Periradicular Bone Defect by Periosteal Pedicle Graft as a Barrier Membrane and Demineralized Freeze-Dried Bone Allograft

    Science.gov (United States)

    Saxena, Anurag

    2017-01-01

    The purpose of this case report is to describe the usefulness of Periosteal Pedicle Graft (PPG) as a barrier membrane and Demineralized Freeze-Dried Bone Allograft (DFDBA) for bone regeneration in periradicular bone defect. A patient with intraoral discharging sinus due to carious exposed pulp involvement was treated by PPG and DFDBA. Clinical and radiological evaluations were done immediately prior to surgery, three months, six months and one year after surgery. Patient was treated using split-thickness flap, PPG, apicoectomy, defect fill with DFDBA and lateral displacement along with suturing of the PPG prior to suturing the flap, in order to close the communication between the oral and the periapical surroundings through sinus tract opening. After one year, successful healing of periradicular bone defect was achieved. Thus, PPG as a barrier membrane and DFDBA have been shown to have the potential to stimulate bone formation when used in periradicular bone defect. PMID:28274066

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

    Science.gov (United States)

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

    2016-06-01

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

  10. Bone grafting from a restorative perspective--are we winning the space race?

    Science.gov (United States)

    Hanlin, S M

    2000-10-01

    The edentulous maxilla presents diverse and complex rehabilitation problems for the clinician that are often not addressed with a conventional removable appliance. Implant therapy, although revolutionizing the management of the edentulous mandible, has yielded less than favourable treatment outcomes in the maxilla. Poor bone quality and small bone volume in the maxilla, at the time of implant surgery has been associated with more implant and prosthesis failure. Bone grafting appears to improve the survival rate of implants in the atrophic maxilla and many studies have been published outlining techniques in which various types of implants have been used in conjunction with grafting materials. It is as yet not clear from the studies of maxillary grafting, whether various grafting materials are equally capable of supporting implants. The small number of patients and implants evaluated in many studies makes it difficult to predict specific outcomes for a single patient. The occurrence and frequency of complications with endosseous implant placement and with bone grafting is generally poorly defined. In the year 2000, our patients, third party insurers, the legal system and the scientific community are expecting more evidence to support the effectiveness of dental health care strategies. Evidence-based practice has become the catch cry for therapeutic intervention and yet the dental literature reveals a wide range of treatment modalities for which research can be at best considered weak. Studies to date into patient-based assessment of implant therapy provides little scientific evidence of substantially more benefit to edentulous patients with severe alveolar loss from implant therapy than was gained from alternative forms of treatment. Bone grafting and bone regenerative procedures do hold promise for the rehabilitation of the edentulous maxilla, however the Space Race is far from won.

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

    Directory of Open Access Journals (Sweden)

    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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2012-09-01

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

  14. 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.

  15. Localized ridge augmentation using autogenous block bone graft followed by dental implant placement

    Directory of Open Access Journals (Sweden)

    K V Prabhakara Rao

    2012-01-01

    Full Text Available The placement of endosseous dental implants is often hampered by unfavourable anatomy of the alveolar bone. Most frequently patients lose their teeth due to alveolar bone loss, tooth extraction; trauma and long term use of removable appliances tend to lose the bone making it difficult for the placement of implant in an optimal prosthetic position. The loss of width of the residual alveolar ridge necessitated measures which could refurbish the lost dimensions. Here we report the successful management of such a condition wherein placement of implant was made possible by placement of autogenous bone block graft obtained from the mandibular symphysis region and predictable osseointegration thus achieved.

  16. 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.

  17. 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.

  18. Intraosseous epidermoid cyst of the distal phalanx reconstructed with synthetic bone graft.

    Science.gov (United States)

    Sasaki, Hiromi; Nagano, Satoshi; Shimada, Hirofumi; Nakashima, Takayuki; Yokouchi, Masahiro; Ishidou, Yasuhiro; Setoguchi, Takao; Komiya, Setsuro

    2017-01-01

    Intraosseous epidermoid cysts are exceedingly rare. Known as pseudotumors, not true neoplasms, intraosseous epidermoid cysts usually involve the phalanges, the skull, and the toes. Intraosseous epidermoid cysts typically present as destructive osteolytic lesions on X-ray, mimicking malignant bone tumors. Here, we present two cases of an intraosseous epidermoid cyst in the distal phalanx treated with curettage and synthetic bone graft, followed by a review of the relevant literature. In both cases, the patient presented with a painful enlargement of the fingertip following a minor trauma. Magnetic resonance imaging demonstrated lesions involving the distal phalanx that had a low signal on T1-weighted imaging (WI) and a high intensity on T2-WI. In both cases, the lesions were not enhanced by gadolinium. Good remodeling and functional recoveries were obtained. For physically active patients with substantial bone defects, synthetic bone graft may be recommended.

  19. 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...

  20. 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.

  1. Supercritical carbon dioxide-processed resorbable polymer nanocomposites for bone graft substitute applications

    Science.gov (United States)

    Baker, Kevin C.

    Numerous clinical situations necessitate the use of bone graft materials to enhance bone formation. While autologous and allogenic materials are considered the gold standards in the setting of fracture healing and spine fusion, their disadvantages, which include donor site morbidity and finite supply have stimulated research and development of novel bone graft substitute materials. Among the most promising candidate materials are resorbable polymers, composed of lactic and/or glycolic acid. While the characteristics of these materials, such as predictable degradation kinetics and biocompatibility, make them an excellent choice for bone graft substitute applications, they lack mechanical strength when synthesized with the requisite porous morphology. As such, porous resorbable polymers are often reinforced with filler materials. In the presented work, we describe the use of supercritical carbon dioxide (scCO2) processing to create porous resorbable polymeric constructs reinforced by nanostructured, organically modified Montmorillonite clay (nanoclay). scCO2 processing simultaneously disperses the nanoclay throughout the polymeric matrix, while imparting a porous morphology to the construct conducive to facilitating cellular infiltration and neoangiogenesis, which are necessary components of bone growth. With the addition of as little as 2.5wt% of nanoclay, the compressive strength of the constructs nearly doubles putting them on par with human cortico-cancellous bone. Rheological measurements indicate that the dominant mode of reinforcement of the nanocomposite constructs is the restriction of polymer chain mobility. This restriction is a function of the positive interaction between polymer chains and the nanoclay. In vivo inflammation studies indicate biocompatibility of the constructs. Ectopic osteogenesis assays have determined that the scCO2-processed nanocomposites are capable of supporting growth-factor induced bone formation. scCO 2-processed resorbable

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

    Science.gov (United States)

    2016-01-01

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

  3. Cranioplasty with subcutaneously preserved autologous bone grafts in abdominal wall—Experience with 75 cases in a post-war country Kosova

    Science.gov (United States)

    Morina, Arsim; Kelmendi, Fatos; Morina, Qamile; Dragusha, Shefki; Ahmeti, Feti; Morina, Dukagjin; Gashi, Kushtrim

    2011-01-01

    Background: The study is to show the advantages of preservation of a calvarial bone flap in the abdominal pocket after decompressive craniotomy. Decompressive craniectomy is an option in the surgical management of refractory hypertension when maximal medical treatment (sedation, drainage of cerebrospinal fluid, moderate cooling, etc) has failed to control refractory high intracranial pressure. Methods: We have prospectively analyzed 82 consecutively operated cases decompressive craniotomies done at the University Neurosurgical Clinic in Prishtina/KOSOVA over a period of eight years (June 1999 to Aug 2008). Of the 75 who had their grafts replaced (7 patient died before replacement of bone graft), 62 patients had hemicraniectomy (fronto-parieto-temporal) 7 of them were bilateral. Results In 66 out of 75 patients was achieved a satisfactory and cosmetically reconstruction, in 9 cases was required augmentation with methyl methacrylate to achieve cosmetic needs. Two patients had infection and the bone was removed; 6 months later these patients had cranioplasty with methyl methacrylate. The duration of storage of calvarial bone in abdominal pouch before reimplantation was 14 – 232 days (range 56 days). Conclusion: We think that storage of the patients own bone flap in the abdominal pocket is a safe, easy, cheap, sterile, histocompatible, and better cosmetic results. PMID:21697987

  4. The effects of replacing collagen fibers with carbon nanotubes on the rate of bone remodeling process.

    Science.gov (United States)

    Jamilpour, Nima; Fereidoon, Abdolhosein; Rouhi, Gholamreza

    2011-08-01

    Application of carbon nanotubes (CNTs) instead of collagen fibers (CFs) in bone tissue is one of the proposed avenues for the enhancement of bone's mechanical properties. The mechanical behavior improvement caused by such a replacement is somehow guaranteed because of the superior mechanical properties of CNTs compared to those of CFs. But on the other side, bone is a very active and dynamic tissue, which is maintained through a lifelong coupled process of resorption and formation in order to reach an optimal configuration. Hence, the well accepted fact of the bone remodeling dependency on mechanical stimuli besides the differences in mechanical behavior of CNTs and CFs under loading can encourage one to hypothesize that such a replacement would cause an imbalance in the normal rate of bone remodeling process. Results of our finite element analysis indicate that the application of CNTs instead of CFs can cause a significant reduction in strain energy density, assumed here as the mechanical stimulus to initiate the bone remodeling process. Our results also show that this replacement may change the strain energy distribution within the bone. Based on a semi-mechanistic bone remodeling theory, it is speculated that this alteration in strain energy distribution in artificial bone can destabilize normal bone remodeling process, and therefore it is likely to cause some abnormalities in bone's mechanical and biological functions.

  5. Harvesting bone graft from the olecranon: a quantitative and biomechanical comparison of proximal and dorsal cortical windows.

    Science.gov (United States)

    Anderson, Matthew C; Chong, Alexander C M; Lucas, George L; Czuwala, Peter J; Wooley, Paul H

    2014-07-01

    We conducted a study to compare 2 techniques of harvesting ulna bone graft from the olecranon, one using a proximal cortical window (PCW), the other using a dorsal cortical window (DCW), in terms of cancellous bone graft quantity and ulna fracture strength after graft harvest. Cancellous bone was harvested from 8 pairs of embalmed cadaver proximal ulna. Each side of a matched pair was randomly assigned to graft harvest using either a PCW or a DCW approach. Packed bone volume (PBV) was determined by placing the harvested bone into a 3-mL syringe and compacting it with a quasi-static 25-N load. Biomechanical cantilever bending was performed on each elbow to determine load at failure (LF). Paired Student t tests were used to compare PBV and LF between the experimental and control groups. The graft PBV obtained from the matched-pair specimens was not statistically different between the PCW and DCW approaches. Ulnas subjected to proximal bone harvest exhibited higher LF than ulnas subjected to dorsal bone harvest, though the difference was not statistically significant. Compared with bone graft harvest using the traditional DCW approach, harvest using a PCW approach provides similar cancellous graft amounts and exhibits similar fracture resistance.

  6. Comparison of platelet rich plasma and synthetic graft material for bone regeneration after third molar extraction

    Science.gov (United States)

    Nathani, Dipesh B.; Sequeira, Joyce; Rao, B. H. Sripathi

    2015-01-01

    Aims: To compare the efficacy of Platelet rich plasma and synthetic graft material for bone regeneration after bilateral third molar extraction. Material and Methods: This study was conducted in 10 patients visiting the outpatient department of Oral & Maxillofacial Surgery, Yenepoya Dental College & Hospital. Patients requiring extraction of bilateral mandibular third molars were taken for the study. Following extraction, PRP (Platelet Rich Plasma) was placed in one extraction socket and synthetic graft material in form granules [combination of Hydroxyapatite (HA) and Bioactive glass (BG)] in another extraction socket. The patients were assessed for postoperative pain and soft tissue healing. Radiological assessment of the extraction site was done at 8, 12 and 16 weeks interval to compare the change in bone density in both the sockets. Results: Pain was less on PRP site when compared to HA site. Soft tissue evaluation done using gingival healing index given by Landry et al showed better healing on PRP site when compared to HA site. The evaluation of bone density by radiological assessment showed the grey level values calculated at 4 months at the PRP site were comparatively higher than HA site. Conclusion: The study showed that the platelet rich plasma is a better graft material than synthetic graft material in terms of soft tissue and bone healing. However a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of both the materials. PMID:26981473

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  8. FIBULA AND ILIAC BONE GRAFTING WITH INTERNAL FIXATION FOR GAINT CELL TUMOUR OF PROXIMAL TIBIA

    Directory of Open Access Journals (Sweden)

    Nishant Gaonkar

    2015-02-01

    Full Text Available Middle aged old female with swelling in left knee suggestive of giant cell tumour was treated with excisional biopsy with curettage, phenol cauterisation , bone graft and proximal tibia locking plate fixation. Sample sent for histopathology was consistent with diagnosis of giant cell tumour. No recurrence has been seen after 1 year of follow up.

  9. Use of Three-Dimensional Computed Tomography to Classify Filling of Alveolar Bone Grafting

    Directory of Open Access Journals (Sweden)

    Antonio Jorge V. Forte

    2012-01-01

    Full Text Available Several authors have proposed classifications to analyze the quality over time of secondary alveolar bone grafting. However, little discussion has been held to quantitatively measure the secondary bone grafting for correction of nasal deformity associated to cleft palate and lip. Twenty patients with unilateral alveolar cleft, who underwent secondary alveolar bone grafting, were studied with 3D computer tomography. The height between the inferior portion of the pyriform aperture and the incisal border of the unaffected side (height A and the affected side (height B was measured using a software Mirror. A percentage was then obtained dividing the height B by the height A and classified into grades I, II, and III if the value was greater than 67%, between 34% and 66%, or less than 33%. Age, time of followup, initial operation, and age of canine eruption were also recorded. All patients presented appropriate occlusion and function. Mean time of followup was 7 years, and mean initial age for operation was 10 years old. 16 patients were rated as grade I and 4 patients as grade II. No cases had grade III. We present a new grading system that can be used to assess the success of secondary bone grafting in patients who underwent alveolar cleft repair.

  10. Experimental evaluation of the effects of Ankaferd Blood Stopper and collagenated heterologous bone graft on bone healing in sinus floor augmentation.

    Science.gov (United States)

    Cakir, Merve; Karaca, İnci Rana; Firat, Ayşegül; Kaymaz, Figen; Bozkaya, Suleyman

    2015-01-01

    The aim of this study was to evaluate the effect of collagenated heterologous bone graft (CHBG) and Ankaferd Blood Stopper (ABS), a plant extract, on bone healing after sinus floor augmentation. Thirty-six New Zealand rabbits were used. Bilateral sinus augmentation was performed, and 72 bone defects were created. The maxillary sinuses were grafted with four different biomaterials: blood clot (control group), CHBG (Apatos Mix, OsteoBiol, Tecnoss) (graft group), ABS (ABS group), and ABS + CHBG (ABS+graft group). The rabbits were sacrificed at 1, 4, and 8 weeks after surgery. Histochemical and immunohistochemical examinations were performed on all samples. Staining with hematoxylin-eosin and Masson trichrome was performed, and bone marker activity was evaluated. Lymphocyte infiltration was high at the first week in all groups and decreased from 1 to 8 weeks. All materials were biocompatible. Osteoclast numbers increased in the control group from 1 to 8 weeks and decreased in the other groups. There was no new bone formation in week 1 in all groups. New bone formation increased in all groups from 1 to 8 weeks, and at the fourth week, new bone formation was greater in the ABS and ABS+graft groups than in the other groups. There were osteoclasts around the bone graft materials, but degeneration of the graft was seen only in the ABS+graft group at week 8. ABS accelerates bone healing in sinus augmentation procedures and can be used alone or with CHBG. CHBG has osteoconductive properties, and ABS can accelerate bone graft degeneration.

  11. 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.

  12. The use of platelet-rich fibrin (PRF) and PRF-mixed particulated autogenous bone graft in the treatment of bone defects: An experimental and histomorphometrical study.

    Science.gov (United States)

    Kökdere, Nesligül Niyaz; Baykul, Timuçin; Findik, Yavuz

    2015-01-01

    Various materials and techniques have been developed to facilitate bone healing process and reduce its healing period. In recent studies, it is pointed out that, platelet-rich fibrin (PRF) which is derived autogenously from the own blood of the individuals, increase regeneration and accelerate the healing of the wound, due to the consisting various growing factors. The aim of the experimental study is to evaluate the efficiency of PRF and PRF/autogenous graft combination on bone healing in different time intervals. A total of 24 skeletally mature New Zealand rabbits were used. Animals were divided randomly into two groups. Two bone defects with a diameter 3, 3 mm were created on the right and left tibia in all group animals. Only particulate autogeneous bone graft, only PRF, combination of PRF and autogeneous bone graft and empty bone cavity, were performed to all animals. The animals in the first experimental group were sacrificed after 30 days. The animals in the second experimental group were sacrificed after 60 days from the operation. Histomorphometrical and statistical analysis was performed. The data were analyzed using Tukey test (P PRF used alone or used in conjuction with autogenous bone graft, PRF accelerated the healing of the bone defects. There were statistically significant differences in osteoblast, osteoblast and new bone area values in PRF alone and autogenous graft with PRF than the other groups. Our preliminary result demonstrated that PRF increase new bone formation and has a positive effect on early bone healing.

  13. Block bone graft fixation (onlay): a modification of the surgical technique.

    Science.gov (United States)

    Gealh, Walter Cristiano; dos Santos, Pâmela Letícia; Pereira, Cassiano Costa Silva; Okamoto, Tetuo; Antoniali, Cristina; Okamoto, Roberta

    2014-03-01

    Several reconstructive methods of the alveolar ridge have been reported to make possible future rehabilitations with implants. Many of these methods come from studies done in animals, mainly rats. With this clinical practice based on scientific evidence, any experimental procedure that can be undertaken in real life is fundamental. Thus, any research that emulates as closely as possible those techniques used in humans are important. This study describes the modification of the technique for block bone graft fixation (onlay) in rats using the "lag screw"-type technique, normally used in clinical procedures for grafts in humans. The conclusion was that the execution of the described procedures minimizes interference of blood flow in the area because of the maintenance of the muscle insertion in the buckle aspect of the most anterior region of the mandible, providing better stability to the graft and better contact interface of the graft and receptor bed.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  15. Photoencapsulation of bone morphogenetic protein-2 and periosteal progenitor cells improve tendon graft healing in a bone tunnel.

    Science.gov (United States)

    Chen, Chih-Hwa; Liu, Hsia-Wei; Tsai, Ching-Lin; Yu, Chung-Ming; Lin, I-Hsuan; Hsiue, Ging-Ho

    2008-03-01

    Tissue-engineered solutions for promoting the tendon graft incorporation within the bone tunnel appear to be promising. To determine the feasibility that conjugation of hyaluronic acid-tethered bone morphogenetic protein-2 can be used to stimulate periosteal progenitor cells direct fibrocartilagenous attachment and new bone formation in an extra-articular tendon-bone healing model. Controlled laboratory study. A total of 42 mature New Zealand White rabbits were used. The long digitorum extensor tendon was transplanted into a bone tunnel of the proximal tibia. The tendon was pulled through a drill hole in the proximal tibia and attached to the medial aspect of the tibia. Photopolymerizable hydrogel based on poly (ethylene glycol) diacrylate with hyaluronic acid-tethered bone morphogenetic protein-2 was injected and photogelated in a bone tunnel. Histological and biomechanical examination of the tendon-bone interface was evaluated at postoperative weeks 3 and 6. Histological analysis showed an interface fibrocartilage and new bone formed by photoencapsulation of bone morphogenetic protein-2 and periosteal progenitor cells at 6 weeks. Biomechanical testing revealed higher maximum pullout strength and stiffness in experimental groups with a statistically significant difference at 3 and 6 weeks after tendon transplantation. The healing tendon-bone interface undergoes a gradual remodeling process; it appears that photoencapsulation of bone morphogenetic protein-2 and periosteal progenitor cells possesses a powerful inductive ability between the tendon and the bone to incorporate the healing in a rabbit model. Novel technologies, such as those described in this study, including photopolymerization and tissue engineering, may provide minimally invasive therapeutic procedures via arthroscopy to enhance biological healing after reconstruction of the anterior cruciate ligament.

  16. 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

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

    Science.gov (United States)

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

    2004-09-01

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

  18. 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.

  19. 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.

  20. 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

  1. Comparative biomechanical and microstructural analysis of native versus peracetic acid-ethanol treated cancellous bone graft.

    Science.gov (United States)

    Rauh, Juliane; Despang, Florian; Baas, Jorgen; Liebers, Cornelia; Pruss, Axel; Gelinsky, Michael; Günther, Klaus-Peter; Stiehler, Maik

    2014-01-01

    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.

  2. 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.

  3. Analysis of the inorganic component of autogenous tooth bone graft material.

    Science.gov (United States)

    Kim, Young-Kyun; Kim, Su-Gwan; Oh, Ji-Su; Jin, Seung-Chan; Son, Jun-Sik; Kim, Suk-Young; Lim, Soo-Young

    2011-08-01

    This study was performed to identify the calcium phosphate minerals, chemical element and Ca/P ratio and to examine the surface structure of autogenous tooth bone grafting material (AutoBT) which recently developed and applied clinically as a bone graft materials. The analytical results showed that AutoBT is composed of low-crystalline hydroxyapatite (HA) and possibly other calcium phosphate minerals, which is similar to the minerals of human bone tissues. And the dental crown portion was composed of high-crystalline calcium phosphate minerals (mainly HA) with higher Ca/P ratio while the root portion was mainly composed of low-crystalline calcium phosphates with relatively low Ca/P ratio.

  4. Interaction of platelet-rich concentrate with bone graft materials: an in vitro study.

    Science.gov (United States)

    Butcher, Andrew; Milner, Richard; Ellis, Keith; Watson, J Tracy; Horner, Alan

    2009-03-01

    Platelet-rich concentrate (PRC) is in routine use for orthopaedic and maxilofacial surgery and is frequently combined with bone graft materials to fill bony defects and enhance healing. Numerous studies have been performed investigating the efficacy of PRC to enhance bone healing in which a variety of graft materials have been combined with varying degrees of success. Here, we sought to determine the effect of combining PRC with different graft materials on human bone marrow stromal cell (hBMSC) proliferation, osteoblastic differentiation, and bone formation. Our central hypothesis is that PRC is not a true osteogenic agent but rather is osteopromotive, with cell fate determination being dependent on additional signals derived from the microenvironment. Experiments were performed with low passage (maximum 3) hBMSCs that were maintained in the presence of ascorbic acid-2-phosphate and beta-glycerol phosphate. Dexamethasone was excluded from these studies. PRC and graft materials were retained within well inserts and clotted by addition of bovine thrombin. Cell proliferation was determined by DNA content, osteoblastic commitment, and differentiation by alkaline phosphatase activity and matrix mineralization. Combining PRC with the graft materials increased proliferation above that seen with the graft materials alone; however, only demineralized bone matrix (DBM) and allograft were capable of increasing proliferation above that seen with PRC alone. The increased proliferation observed in the presence of PRC coincided with decreased normalized alkaline phosphatase activity, suggesting decreased osteoblastic differentiation. However, at later time points, PRC increased mineralization compared with DBM, collagen, or beta tricalcium phosphate alone. When compared with PRC alone, addition of DBM or allograft decreased mineralization. Collagen gave rise to a small increase in mineralization, whereas beta tricalcium phosphate yielded the same level of mineralization as PRC

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

    Science.gov (United States)

    Marsell, Richard; Hailer, Nils P

    2014-08-01

    We present the case of a 27-year-old female with subcortical osteonecrosis of the humeral capitulum. Percutaneous retrograde drilling of the lesion and application of recombinant human bone morphogenetic protein (BMP)-7 were combined with autologous bone grafting. At follow-up the patient was almost pain-free, had normalized her range of motion, and radiography showed consolidation of the lesion without any heterotopic bone formation. By timing surgery prior to subchondral collapse, biomechanical stability of the subchondral bone was maintained. To our knowledge, this is the first report on the treatment of an osteonecrosis in this location with a BMP, and this strategy could potentially be applied in other locations with juxta-articular osteonecrosis.

  6. Clinical and radiographic evaluation of bone grafting in corticotomy-facilitated orthodontics in adults.

    Science.gov (United States)

    Shoreibah, Eatemad A; Ibrahim, Samir A; Attia, Mai S; Diab, May M Nabil

    2012-10-01

    To evaluate the effect of bone grafting in corticotomy-facilitated orthodontics in adults, using a further modified conventional corticotomy technique. Twenty adult orthodontic patients with moderate crowding of the lower anterior teeth were equally divided into two groups and treated with either a modified corticotomy-faciIitated orthodontic tooth movement alone (Group I) or modified corticotomy-facilitated orthodontic tooth movement combined with bone grafting (Group II). Total treatment time was calculated in weeks from the time of activation of the orthodontic appliance immediately following the corticotomy procedure to the time of debracketing. Clinical periodontal parameters and standardized periapical radiographs were recorded at baseline, post-orthodontic treatment (debracketing time) and six months post-operatively. The primary radiographic variables were root length and bone density. Treatment duration for patients in both groups ranged from 14-20 weeks. There was no statistically significant difference between the two groups in clinical parameters at each time interval. The net percentage of change that occurred to bone density from baseline to six months post-orthodontic treatment was statistically significantly different between the two groups. Group I demonstrated a net decrease in bone density of -17.59%, while Group II demonstrated a net increase in bone density of 25.85%. Group I demonstrated an average net decrease in root length of -0.056 mm +/- 0.025, while Group II demonstrated an average net decrease in root length of -0.050 mm +/- 0.026, which was not statistically significantly different. The results of the current study suggest that corticotomy-facilitated orthodontic tooth movement significantly reduces the total time of treatment. In addition, the incidence of apical root resorption and periodontal problems associated with orthodontic tooth movement were reduced. The incorporation of bone graft material significantly increased the

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

    Science.gov (United States)

    Hallman, Mats; Mordenfeld, Arne; Strandkvist, Tomas

    2009-02-01

    Dento-alveolar trauma often leads to a need for reconstruction of the alveolar crest before an implant can be placed. Although autogenous bone grafts is considered the 'gold standard', this may be associated with patient morbidity and graft resorption. Consequently, the use of bone substitutes has increased. Today, a substantial number of biomaterials are available on the market, but only a few are well documented. The user should be aware that these biomaterials have different properties: resorbable or non-resorbable, time of resorption and resorption mechanism. The purpose of this review is to describe the function of various bone substitutes and indications for their use in reconstructive implant surgery and to give an overview of the current situation.

  8. Complete resection and immediate reconstruction with costochondral graft for recurrent aneurysmal bone cyst of the mandibular condyle.

    Science.gov (United States)

    Ziang, Zhuo; Chi, Yang; Minjie, Chen; Yating, Qiu; Xieyi, Cai

    2013-11-01

    Aneurysmal bone cyst is a non-neoplastic expansile lesion characterized by replacement with fibro-osseous tissue and blood-filled cavernous spaces. Involvement of the condyle is rare, and only 11 cases have been reported in English-language literature to date. Its common treatment modalities are lesion excision or condylar resection, but recurrence is high in patients treated with the former. The authors reported a 19-year-old female patient with swelling of the right preauricular region, who had a surgical curettage history in another hospital. The lesion was completely resected and the jaw was immediately reconstructed with costochondral graft with the help of SurgiCase software. The patient has been symptom-free for 6 months postoperatively.

  9. Early Bone Formation at a Femur Defect Using CGF and PRF Grafts in Adult Dogs: A Comparative Study.

    Science.gov (United States)

    Park, Hyun-Chun; Kim, Su-Gwan; Oh, Ji-Su; You, Jae-Seek; Kim, Jae-Sung; Lim, Sung-Chul; Jeong, Mi-Ae; Kim, Jin-Son; Jung, Chan; Kwon, Young-Sun; Ji, Hyeok

    2016-06-01

    The purpose of this study was to compare the predictability of new bone formation using an autologous concentrated growth factor (CGF) graft alone and platelet graft alone. Four bony defects of 8 mm were formed, and 3.7- × 10-mm implants were placed in the right femur. The platelet-rich fibrin (PRF), CGF, and synthetic bone were grafted to the bone defect area. Enzyme linked immunosorbent assay quantitative analysis and microscopic analysis of the fibrinogen structure were performed. At 4 weeks, the comparisons of each experimental group showed a significant difference between the CGF group and the synthetic bone graft group. When comparing the CGF and allograft material groups, the allograft group showed significantly more new bone formation. In the case of vascular endothelial growth factor, CGF had 1.5 times more than PRF. CGF showed a fibrinogen structure with a constant diameter. When applied to a clinical case, CGF is predicted to show better results than PRF.

  10. Stabilization of premaxilla repositioned during secondary bone grafting in complete bilateral cleft lip and palate patients.

    Science.gov (United States)

    Behnia, Hossein; Mesgarzadeh, Abolhasan; Tehranchi, Azita; Morad, Golnaz; Samieerad, Sahand; Younessian, Farnaz

    2014-07-01

    Secondary bone grafting simultaneous to premaxillary repositioning is a well-recognized surgical procedure for the management of bilateral cleft lip and palate patients. Proper stabilization of the repositioned premaxilla is considered as a key factor for the success of secondary bone grafting because the mobility of the premaxillary segment jeopardizes graft integration. This case series reports a reliable method of premaxillary stabilization that incorporated the intrasurgical application of resin bone cement to cover and reinforce the arch bars or orthodontic brackets applied on the maxillary teeth. Occlusal loads were reduced by application of posterior bite blocks on the mandibular teeth. The stabilization method was performed on 7 patients (5 women and 2 men) with a mean age of 12.4 years. During postsurgery follow-ups, the repositioned premaxillary segments did not show mobility in any of the patients. The palatal fistulae were completely closed. Panoramic radiographies taken 2 months after surgery demonstrated acceptable graft integration. The patients have now been followed up to 5 years. No evidence of relapse has been observed. This technique seemed to be undemanding, included minimal laboratory procedure, and maintained the labial mucosa overlying the repositioned segment intact.

  11. 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.

  12. Arthroscopic autologous bone graft with arthroscopic Bankart repair for a large bony defect lesion caused by recurrent shoulder dislocation.

    Science.gov (United States)

    Mochizuki, Yu; Hachisuka, Hiroki; Kashiwagi, Kenji; Oomae, Hiromichi; Yokoya, Shin; Ochi, Mitsuo

    2007-06-01

    Many clinicians believe that a large bony defect of the glenoid must be treated with bone grafting when a Bankart procedure is performed. Various types of bone graft, such as open bone graft, Eden-Hybinnette, J-bone graft, coracoid transfer, and Latarjet, have been used. These require open procedures that are difficult to perform arthroscopically. We performed an arthroscopic autologous bone graft and an arthroscopic Bankart repair at the same time to treat a patient with recurrent dislocation of the shoulder joint and a large bony Bankart lesion. We harvested from the lateral site of the acromion 2 bones that were 2.7 mm in cylindrical diameter. We transplanted these bones to the large bony defect of the anteroinferior area of the glenoid and placed anchors between the 2 plugs. During the 30 months since the surgery was performed, the patient has not experienced dislocation or apprehension about the shoulder. A 3-dimensional computed tomography scan showed enlargement of the glenoid surface. Our surgical procedure offers promise for treatment of patients with recurrent dislocation of the shoulder joint and a large bony Bankart lesion because it allows the surgeon to alter the size and the grafted site of the cylindrical bone according to the size of the defect.

  13. 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.

  14. Autogenous bone graft and ePTFE membrane in the treatment of peri-implantitis. II. Stereologic and histologic observations in cynomolgus monkeys

    DEFF Research Database (Denmark)

    Schou, Søren; Holmstrup, Palle; Skovgaard, Lene Theil

    2003-01-01

    autogenous bone graft; guided bone regeneration; histology; membrane; non-human primates; oral implants; osseointegration; pathalogy; peri-implantitis; stereology; treatment......autogenous bone graft; guided bone regeneration; histology; membrane; non-human primates; oral implants; osseointegration; pathalogy; peri-implantitis; stereology; treatment...

  15. Managment of frontal sinus fracture: obliteration sinus with cancellous bone graft.

    Science.gov (United States)

    Muminagic, Sahib; Masic, Tarik; Babajic, Emina; Asotic, Mithat

    2011-01-01

    Frontal sinus fractures make up about 2-15% of all facial fractures.This is relatively low frequency of occurrence, but it has a large potential of complication and may involve not only the frontal sinuse but more importantly the brain and the eyes. The management depends of the complexity. If anterior wall is fractured with grossly involved nasofrontal duct (NFD) in the injury it is paramount to occlude NFD. Very often, sinus obliteration is done at the same time. In our expirience autogenous cancellous bone graft is considered to be the best grafting material. It has the less short - or long-term complications and the donor site morbidity is insignificant.

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

    Directory of Open Access Journals (Sweden)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

    Stravinskas, M; Horstmann, P; Ferguson, J;

    2016-01-01

    in patients treated surgically for chronic corticomedullary osteomyelitis. RESULTS: The release pattern in vitro was comparable with the obtained release in the patient studies. No recurrence was detected in the osteomyelitis group at latest follow-up (minimum 1.5 years). CONCLUSIONS: This new biphasic bone...

  18. Dual-Purpose Bone Grafts Improve Healing and Reduce Infection

    Science.gov (United States)

    2011-08-01

    and PUR+BMP (High) (n = 14) groups. Two-thirds of the animals were used to assess bone formation, and the remainder was used to assess bacterial ...stabilized segmental defect in the rat femur. J Orthopaedic Res. 2005;23:816–823. 14. Anglen JO. Comparison of soap and antibiotic solutions for irrigation of

  19. 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

  20. 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

  1. 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

    2015-05-01

    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.

  2. 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

  3. Distraction arthrodesis of the subtalar joint using allogeneic bone graft: a review of 15 cases.

    Science.gov (United States)

    Lee, Michael S; Tallerico, Valerie

    2010-01-01

    Distraction arthrodesis of the subtalar joint is often used for the correction of neglected calcaneal fractures. Although different techniques have been advocated, there remains some debate as to the optimal type of bone graft for this purpose. This study retrospectively reviewed one surgeon's results for distraction arthrodesis of the talocalcaneal joint for 15 consecutive feet in 15 patients using 12 frozen femoral head and 3 freeze-dried iliac crest allografts. Indications for distraction arthrodesis in this series included neglected calcaneal fracture (n = 10), failed open reduction with internal fixation (n = 3), malunion after ankle fusion (n = 1), and subtalar joint arthritis with deformity (n = 1). The mean patient age was 47.5 (range 29 to 66) years, and the mean duration of follow-up was 20.6 (range 13 to 31) months. Complete union was achieved in 14 (93.33%) feet. Orthobiological agents were used in every case, including 7 (46.67%) platelet-rich plasma, 5 (33.33%) demineralized bone matrix combined with platelet-rich plasma, 2 (13.33%) platelet-rich plasma combined with an implantable electrical bone growth stimulator, and 1 (6.67%) demineralized bone matrix only. One (6.67%) patient developed a nonunion with collapse of the allogeneic graft, requiring revision with autogenous iliac crest bone graft. There were 8 (53.33%) minor complications, including 4 (26.66%) cases with inferior heel irritation, 2 (13.33%) with sural nerve paresthesia, and 2 (13.33%) with wound dehiscence. In conclusion, the use of allograft for subtalar joint distraction arthrodesis results in similar union rates as autogenous iliac crest grafting previously reported in the literature. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

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

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

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    D D Baksi

    2016-01-01

    Full Text Available Background: 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. Materials and Methods: 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

  6. Massive allograft replacement in management of bone tumors%冷冻异体骨移植治疗骨肿瘤切除后骨缺损

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Niu; Lin Hao; Qing Zhang; Yi Ding

    2008-01-01

    Objective: To evaluate the functional outcome and complications of allograft replacement in management of bone tumors. Methods: Between March 1992 and September 2002, 164 patients underwent bone tumor resection and massive allograft reconstruction of bone defects. The length of the resected part ranged from 5-35 cm. The resections were dassified as marginal or wide resections of the tumor on the basis of the Musculoskeletal Tumor Society staging system. Fresh-frozen allografts were employed as osteoarticular grafts (n = 95), hemi-condylar (n = 15), massive (n = 23), allograft-prosthesis composite (n=12), intercalary grafts (n=15) or hemi-pelvic grafts (n=4). Most of the lesions were osteosarcoma and giant cell tumor of bone and located in proximal and distal femur, proximal tibia and humerus. Results: At a median follow-up of 47 months (range, 12 to 168 months) after the operation, 154 of the patients in the study were free of disease and 10 died of disease. Twenty-one (12.8%) patients had local recurrence and 38 (23.2%) nonunion. Late complications included 11 (6.7%)fractures of the allograft and 18 (11.0%) infections of the graft. Instability of the joint in the form of subluxation was noted in 13 (7.9%) patients. Ten extremities were amputated due to local recurrence or severe infection. Conclusion: Allografts can be used for reconstruction of bony defects after tumor resection. Allograft has nearly similar shape, strength, osteo-inductivity and osteo-conductivity with host bone. Allograft implantation is a high complication reconstruction method, and the risk of recurrence increases when less surgical margin achieves.

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

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    Sydney X Lu

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

  8. Dehydrothermally Cross-Linked Collagen Membrane with a Bone Graft Improves Bone Regeneration in a Rat Calvarial Defect Model.

    Science.gov (United States)

    An, Yin-Zhe; Heo, Young-Ku; Lee, Jung-Seok; Jung, Ui-Won; Choi, Seong-Ho

    2017-08-10

    In this study, the bone regeneration efficacy of dehydrothermally (DHT) cross-linked collagen membrane with or without a bone graft (BG) material was evaluated in a critical-sized rat model. An 8-mm-diameter defect was created in the calvaria of 40 rats, which were randomized into four groups: (1) control; (2) DHT; (3) BG; and, (4) DHT + BG. Evaluations were made at 2 and 8 weeks after surgery using micro-computed tomographic (micro-CT), histological, and histomorphometric analyses. Micro-CT analysis showed an increase in the new bone volume (NBV) of the BG and DHT + BG groups at 2 weeks after surgery, representing a significant difference (p DHT + BG groups, and a significant difference was no longer observed between the two groups. Histologic analysis demonstrated that the graft materials sustained the center of the defect in the BG and DHT + BG groups, which was shown in histomorphometric analysis as well. These results suggest that DHT membrane is a safe biomaterial with adequate tissue integration, and has a positive effect on new bone formation. Moreover, the best effects were achieved when DHT was used in conjunction with BG materials.

  9. Expanding the utility of modified vascularized femoral periosteal bone-flaps: An analysis of its form and a comparison with a conventional-bone-graft

    Science.gov (United States)

    Hamada, Yoshitaka; Hibino, Naohito; Kobayashi, Anna

    2014-01-01

    Background Vascularized medial femoral condyle (MFC) corticoperiosteal bone-flap is a well-accepted technique when dealing with tissue defects or infection. Its role in refractory conditions and in the possible use for options concerning modifications of this bone-flap compared to a conventional iliac bone graft (conventional-graft) are rarely discussed. Methods We reviewed 21 consecutive cases concerning alternatives with some modifications of original MFC bone-flap surgery used to treat refractory conditions with bone defects, necrosis, or infection in the extremities. We present our devised approaches for this boneflap, and especially modifications of the grafted bone (including strut bone, perforator to the vastus medialis muscle, and the use of one vascular pedicle for some bone flaps) as well as the combined use of artificial bone as hybrid bone transplantation. We also compared the clinical results of 21 cases that received a conventional-graft. Results and Conclusions Following flap placement, 100% of the nonunion sites healed in an average of 2 months, which was significantly shorter than 5.5 months for the conventional-graft. The results showed the expanding possibility for options with regard to the form and options of this bone-flap as well as the shortening the duration of treatment, especially at the site of an infected distal tibia, insertion of the Achilles tendon on the posterior aspect of calcaneal osteomyelitis, distal end of the clavicle, clavicle or forearm with a bone defect, small bones with refractory conditions, and a femur without implant failure. However, it was not efficient for treating a forearm without bone defect. PMID:25983463

  10. A novel porous bioceramics scaffold by accumulating hydroxyapatite spherulites for large bone tissue engineering in vivo. II. Construct large volume of bone grafts.

    Science.gov (United States)

    Zhi, Wei; Zhang, Cong; Duan, Ke; Li, Xiaohong; Qu, Shuxin; Wang, Jianxin; Zhu, Zhuoli; Huang, Peng; Xia, Tian; Liao, Ga; Weng, Jie

    2014-08-01

    In vivo engineering of bone autografts using bioceramic scaffolds with appropriate porous structures is a potential approach to prepare autologous bone grafts for the repair of critical-sized bone defects. This study investigated the evolutionary process of osteogenesis, angiogenesis, and compressive strength of bioceramic scaffolds implanted in two non-osseous sites of dogs: the abdominal cavity and the dorsal muscle. Hydroxyapatite (HA) sphere-accumulated scaffolds with controlled porous structures were prepared and placed in the two sites for up to 6 months. Analyses of retrieved scaffolds found that osteogenesis and angiogenesis were faster in scaffolds implanted in dorsal muscles compared with those placed in abdominal cavities. The abdominal cavity, however, can accommodate larger bone grafts with designed shape. Analyses of scaffolds implanted in abdominal cavities [an environment of a low mesenchymal stem cell (MSC) density] further demonstrated that angiogenesis play critical roles during osteogenesis in the scaffolds, presumably by supplying progenitor cells and/or MSCs as seed cells. This study also examined the relationship between the volume of bone grafts and the physiological environment of in vivo bioreactor. These results provide basic information for the selection of appropriate implanting sites and culture time required to engineer autologous bone grafts for the clinical bone defect repair. Based on these positive results, a pilot study has applied the grafts constructed in canine abdominal cavity to repair segmental bone defect in load-bearing sites (limbs).

  11. Clinical comparison of guided tissue regeneration, with collagen membrane and bone graft, versus connective tissue graft in the treatment of gingival recessions

    OpenAIRE

    Haghighati F; Akbari S

    2006-01-01

    Background and Aim: Increasing patient demands for esthetic, put the root coverage procedures in particular attention. Periodontal regeneration with GTR based root coverage methods is the most common treatment used. The purpose of this study was to compare guided tissue regeneration (GTR) with collagen membrane and a bone graft, with sub-epithelial connective tissue graft (SCTG), in treatment of gingival recession. Materials and Methods: In this randomized clinical trial study, eleven healthy...

  12. Treatment of distal radius fractures with external fixation, limited open reduction and dorsal autologous cancellous onlay bone grafting

    Directory of Open Access Journals (Sweden)

    Mordechai Vigler

    2012-04-01

    Conclusion: Compared to current published results of distal radial fractures treated with external fixation supplemented with packed intramedullary autologous cancellous iliac crest graft, our dorsal on- lay technique is as effective a treatment modality. Additionally, there are several advantages including less bone graft to be harvested and associated morbidity. [Hand Microsurg 2012; 1(1.000: 10-16

  13. Bio-mimetic hollow scaffolds for long bone replacement

    Science.gov (United States)

    Müller, Bert; Deyhle, Hans; Fierz, Fabienne C.; Irsen, Stephan H.; Yoon, Jin Y.; Mushkolaj, Shpend; Boss, Oliver; Vorndran, Elke; Gburek, Uwe; Degistirici, Özer; Thie, Michael; Leukers, Barbara; Beckmann, Felix; Witte, Frank

    2009-08-01

    The tissue engineering focuses on synthesis or regeneration of tissues and organs. The hierarchical structure of nearly all porous scaffolds on the macro, micro- and nanometer scales resembles that of engineering foams dedicated for technical applications, but differ from the complex architecture of long bone. A major obstacle of scaffold architecture in tissue regeneration is the limited cell infiltration as the result of the engineering approaches. The biological cells seeded on the three-dimensional constructs are finally only located on the scaffold's periphery. This paper reports on the successful realization of calcium phosphate scaffolds with an anatomical architecture similar to long bones. Two base materials, namely nano-porous spray-dried hydroxyapatite hollow spheres and tri-calcium phosphate powder, were used to manufacture cylindrically shaped, 3D-printed scaffolds with micro-passages and one central macro-canal following the general architecture of long bones. The macro-canal is built for the surgical placement of nerves or larger blood vessels. The micro-passages allow for cell migration and capillary formation through the entire scaffold. Finally, the nanoporosity is essential for the molecule transport crucial for signaling, any cell nutrition and waste removal.

  14. Treatment of Radial Nonunion with Corticocancellous Bone Graft and Fascia of Anterolateral Thigh Free Flap: The Wrap Technique

    Science.gov (United States)

    Ronga, Mario; Sallam, Davide; Fagetti, Alessandro; Valdatta, Luigi; Cherubino, Paolo

    2016-01-01

    Summary: The management of nonunion of the forearm bones is a challenging task. Multiple factors have been associated with the establishment of forearm nonunion, such as the fracture position and complexity, general condition of the patient, and the previously utilized surgical technique. The optimal surgical treatment of a bone gap remains a subject of discussion. Autogenous corticocancellous bone grafts and vascularized bone flaps have been used with differing results. The authors describe a technique for the treatment of posttraumatic nonunion of the radius with a 5-cm bone gap using the free anterolateral thigh fascial flap wrapped around a tricortical iliac bone graft. The fracture healed after 5 weeks. The use of a vascularized tissue wrapped around the bone graft resulted in a well-healed bone and no signs of resorption after 2 years of follow-up. A bone graft wrapped by a fascial flap could magnify the restorative effect on the bone defect because of its dual role of constructing vascularization and inducing tissue regeneration.

  15. A 6-DOF parallel bone-grinding robot for cervical disc replacement surgery.

    Science.gov (United States)

    Tian, Heqiang; Wang, Chenchen; Dang, Xiaoqing; Sun, Lining

    2017-05-24

    Artificial cervical disc replacement surgery has become an effective and main treatment method for cervical disease, which has become a more common and serious problem for people with sedentary work. To improve cervical disc replacement surgery significantly, a 6-DOF parallel bone-grinding robot is developed for cervical bone-grinding by image navigation and surgical plan. The bone-grinding robot including mechanical design and low level control is designed. The bone-grinding robot navigation is realized by optical positioning with spatial registration coordinate system defined. And a parametric robot bone-grinding plan and high level control have been developed for plane grinding for cervical top endplate and tail endplate grinding by a cylindrical grinding drill and spherical grinding for two articular surfaces of bones by a ball grinding drill. Finally, the surgical flow for a robot-assisted cervical disc replacement surgery procedure is present. The final experiments results verified the key technologies and performance of the robot-assisted surgery system concept excellently, which points out a promising clinical application with higher operability. Finally, study innovations, study limitations, and future works of this present study are discussed, and conclusions of this paper are also summarized further. This bone-grinding robot is still in the initial stage, and there are many problems to be solved from a clinical point of view. Moreover, the technique is promising and can give a good support for surgeons in future clinical work.

  16. [Renal transplantation without maintenance immunosuppression. Identical twins and kidney transplantation following a successful bone marrow graft].

    Science.gov (United States)

    Hadi, Riad Abdel; Thomé, Gustavo Gomes; Ribeiro, Adriana Reginato; Manfro, Roberto Ceratti

    2015-01-01

    Renal transplantation without maintenance immunosuppression has been sporadically reported in the literature. The cases include non-adherent patients who discontinued their immunosuppressive medications, transplantation between identical twins, kidney transplantation after a successful bone marrow graft from the same donor and simultaneous bone marrow and kidney transplantation for the treatment of multiple myeloma with associated renal failure. There are also ongoing clinical trials designed to induce donor specific transplant tolerance with infusion of hematopoietic cells from the same kidney donor. Here we describe two cases of renal transplantation without immunosuppression as examples of situations described above.

  17. Total Humeral Endoprosthetic Replacement following Excision of Malignant Bone Tumors

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    Suhel Kotwal

    2016-01-01

    Full Text Available Humerus is a common site for malignant tumors. Advances in adjuvant therapies and reconstructive methods provide salvage of the upper limb with improved outcomes. Reports of limb salvage with total humeral replacement in extensive humeral tumors are sparse. We undertook a retrospective study of 20 patients who underwent total humeral endoprosthetic replacement as limb salvage following excision of extensile malignant tumor from 1990 to 2011. With an average followup of 42.9, functional and oncological outcomes were analyzed. Ten patients were still alive at the time of review. Mean estimated blood loss was 1131 mL and duration of surgery was 314 minutes. Deep infection was encountered in one patient requiring debridement while mechanical loosening of ulnar component was identified in one patient. Subluxation of prosthetic humeral head was noted in 3 patients. Mean active shoulder abduction was 12.5° and active flexion was 15°. Incompetence of abduction mechanism was the major determinant of poor active functional outcome. Mean elbow flexion was 103.5° with 30.5° flexion contracture in 10 patients with good and useful hand function. Average MSTS score was 71.5%. Total humeral replacement is a reliable treatment option in restoring mechanical stability and reasonable functional results without compromising patient survival, with low complication rate.

  18. Immunohistochemical characterization of wound healing at two different bone graft substitutes.

    Science.gov (United States)

    Sager, M; Ferrari, D; Wieland, M; Dard, M; Becker, J; Schwarz, F

    2012-05-01

    The immunohistochemical characteristics of wound healing following application of a biphasic calcium phosphate or a collagen coated natural bone combined with a native collagen membrane in a dog model was assessed. Standardized buccal dehiscence-type defects were surgically created following implant bed preparation in 6 dogs. Following implant placement, defects were randomly filled with a collagen coated natural bone mineral (GBO), or a biphasic hydroxyapatite/beta tricalcium phosphate (SBC), and covered with a native collagen membrane. After 1, 4, and 9 weeks' submerged healing, dissected blocks were processed for immunohistochemical (collagen type I (CI), osteocalcin (OC), angiogenesis (TG)) analysis. At 1 week, GBO and SBC granules were homogeneously surrounded by a well vascularized, non-mineralized tissue (NMT). CI and OC antigen reactivity was commonly observed adjacent to both bone graft substitutes. At 4 and 9 weeks, SBC and GBO granules were completely integrated into a secondly formed network of spongiosa. At 9 weeks, dissolution of some granules was observed in the SBC group. Adjacent to these granules, NMT was significantly increased and revealed a pronounced CI, OC and TG antigen reactivity. The initial pattern of bone regeneration and graft integration was comparable in both groups; bone remodelling was more pronounced with SBC.

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

    Science.gov (United States)

    Tommasi, Giacomo; Perni, Stefano

    2016-01-01

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

  20. Hybrid Matrix Grafts to Favor Tissue Regeneration in Rabbit Femur Bone Lesions

    Science.gov (United States)

    Goy, Dante Pascual; Gorosito, Emmanuel; Costa, Hermes S; Mortarino, Pablo; Pedemonte, Noelia Acosta; Toledo, Javier; Mansur, Herman S; Pereira, Marivalda M; Battaglino, Ricardo; Feldman, Sara

    2012-01-01

    At present, typical approaches employed to repair fractures and other bone lesions tend to use matrix grafts to promote tissue regeneration. These grafts act as templates, which promote cellular adhesion, growth and proliferation, osteoconduction, and even osteoinduction, which commonly results in de novo osteogenesis. The present work aimed to study the bone-repairing ability of hybrid matrixes (HM) prepared with polyvinyl alcohol (PVA) and bioactive glass in an experimental rabbit model. The HM were prepared by combining 30% bioactive glass (nominal composition of 58% SiO2 -33 % CaO - 9% P2O5) and 70% PVA. New Zealand rabbits were randomly divided into the control group (C group) and two groups with bone lesions, in which one received a matrix implant HM (Implant group), while the other did not (no Implant group). Clinical monitoring showed no altered parameters from either the Implant or the no Implant groups as compared to the control group, for the variables of diet grades, day and night temperatures and hemograms. In the Implant group, radiologic and tomographic studies showed implanted areas with clean edges in femoral non-articular direction, and radio-dense images that suggest incipient integration. Minimum signs of phlogosis could be observed, whereas no signs of rejection at this imaging level could be identified. Histological analysis showed evidence of osteo-integration, with the formation of a trabecular bone within the implant. Together, these results show that implants of hybrid matrixes of bioactive glass are capable of promoting bone regeneration. PMID:22848334

  1. 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.

  2. Comparison of platelet rich plasma and synthetic graft material for bone regeneration after third molar extraction

    OpenAIRE

    Nathani, Dipesh B.; Sequeira, Joyce; Rao, B. H. Sripathi

    2015-01-01

    Aims: To compare the efficacy of Platelet rich plasma and synthetic graft material for bone regeneration after bilateral third molar extraction. Material and Methods: This study was conducted in 10 patients visiting the outpatient department of Oral & Maxillofacial Surgery, Yenepoya Dental College & Hospital. Patients requiring extraction of bilateral mandibular third molars were taken for the study. Following extraction, PRP (Platelet Rich Plasma) was placed in one extraction socket and synt...

  3. Femoral impaction bone grafting in revision hip arthroplasty: 705 cases from the originating centre.

    Science.gov (United States)

    Wilson, M J; Hook, S; Whitehouse, S L; Timperley, A J; Gie, G A

    2016-12-01

    Femoral impaction bone grafting was first developed in 1987 using morselised cancellous bone graft impacted into the femoral canal in combination with a cemented, tapered, polished stem. We describe the evolution of this technique and instrumentation since that time. Between 1987 and 2005, 705 revision total hip arthroplasties (56 bilateral) were performed with femoral impaction grafting using a cemented femoral stem. All surviving patients were prospectively followed for a mean of 14.7 years (9.8 to 28.3) with no loss to follow-up. By the time of the final review, 404 patients had died. There were 76 further revisions (10.8%) involving the stem; seven for aseptic loosening, 23 for periprosthetic fracture, 24 for infection, one for malposition, one for fracture of the stem and 19 cement-in-cement exchanges of the stem during acetabular revision. The 20-year survival rate for the entire series was 98.8% (95% confidence interval (CI) 97.8 to 99.8) with aseptic loosening as the endpoint, and 87.7% (95% CI 82.8 to 92.6) for revision for any reason. Survival improved with the evolution of the technique, although this was not statistically significant due to the overall low rate of further revision. This is the largest series of revision total hip arthroplasties with femoral impaction grafting, and the results support the continued use of this technique. Cite this article: Bone Joint J 2016;98-B:1611-19. ©2016 The British Editorial Society of Bone & Joint Surgery.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    . The superficial part was used for mechanical testing and micro-CT scanning, and the profound part for histomorphometry. Push-out tests were performed on an 858 Bionix MTS hydraulic materials testing machine (MTS Systems Corporation, USA). Shear mechanical properties between implant and newly generated bone were......: No significant differences regarding failure energy (kJ/m2, p=0.44) or ultimate shear strength (MPa, p=0.17) could be seen. Shear stiffness (MPa) was significantly higher for the allograft group (p=0.04). Group 2: No significant differences regarding failure energy (p=0.11) or shear stiffness (p=0.52) could...

  5. Meralgia paresthetica occurring 40 years after iliac bone graft harvesting: case report.

    Science.gov (United States)

    Yamamoto, T; Nagira, K; Kurosaka, M

    2001-12-01

    Meralgia paresthetica is an entrapment neuropathy involving the lateral femoral cutaneous nerve. We describe an unusual case in which meralgia paresthetica occurred many years after iliac bone graft harvesting. An 81-year-old man presented with a 1-year history of pain, dysesthesia, and hypesthesia in the anterolateral aspect of the right thigh. This patient had undergone iliac bone grafting when he sustained a calcaneal fracture 40 years previously. Radiographs and computed tomographic scans of the pelvis revealed a bony excrescence in the anterosuperior iliac spine. The patient underwent neurolysis of the lateral femoral cutaneous nerve and excision of the bony excrescence. At surgery, the nerve was densely adherent to the bony excrescence. The etiology of meralgia paresthetica in this patient is considered to be heterotopic ossification on the anterosuperior iliac spine and pubic symphysis degeneration. A significant relationship between pubic symphysis degeneration with increasing age and meralgia paresthetica has been reported. One should be aware of meralgia paresthetica as a late complication of iliac bone graft harvesting.

  6. Composition dependent mechanical behaviour of S53P4 bioactive glass putty for bone defect grafting.

    Science.gov (United States)

    van Gestel, N A P; Hulsen, D J W; Geurts, J; Hofmann, S; Ito, K; Arts, J J; van Rietbergen, B

    2017-05-01

    To improve the handling properties of S53P4 bioactive glass granules for clinical applications, bioactive glass putty formulations were developed. These formulations contain both granules and a synthetic binder to form an injectable material that is easy to shape. To explore its applicability in load-bearing bone defect grafting, the relation between the putty composition and its mechanical behaviour was assessed in this study. Five putty formulations with variations in synthetic binder and granule content were mechanically tested in confined compression. The results showed that the impaction strains significantly decreased and the residual strains significantly increased with an increasing binder content. The stiffness of all tested formulations was found to be in the same range as the reported stiffness of cancellous bone. The measured creep strains were low and no significant differences between formulations were observed. The stiffness significantly increased when the samples were subjected to a second loading stage. The residual strains calculated from this second loading stage were also significantly different from the first loading stage, showing an increasing difference with an increasing binder content. Since residual strains are detrimental for graft layer stability in load-bearing defects, putty compositions with a low binder content would be most beneficial for confined, load-bearing bone defect grafting.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

  8. 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.

  9. Application of bone scintigrams in total knee replacement (Okayama MK-II type)

    Energy Technology Data Exchange (ETDEWEB)

    Umeda, T.; Inoue, S.; Matsui, N.; Moriya, H. (Chiba Univ. (Japan). School of Medicine)

    1982-02-01

    Eighteen patients with 21 total knee replacements (OKAYAMA MK-II type) were examined by radionuclide imaging in order to assess the prosthetic complaints such as loosening, infection, fracture and lasting pain. The following results and conclusions were obtained. 1) Bone imaging can reveal the condition of the attachment of bone and prosthesis. 2) Diffuse uptake gradually diminished until 18 months after surgery. 3) In front view on bone imaging, tibial uptake corresponded highly with the part of the weight area. 4) In cases of high uptake of posterior femoral component in lateral view, the range of knee flexion was mostly restricted. 5) Long-period persistent local uptake suggested loosening of the prosthesis or fracture of the tibial plateau. 6) Patello-femoral uptake showed no relation to the patellofemoral complaints. Radionuclide bone imaging is considered to represent one of the most valuable diagnostic procedures for assessing the clinical results after total knee replacement.

  10. Evaluation of periprosthetic bone cysts in patients with a scandinavian total ankle replacement

    DEFF Research Database (Denmark)

    Jensen, Janni; Frøkjær, Johnny; Gerke, Oke;

    2014-01-01

    OBJECTIVE. Periprosthetic bone cysts are a known finding after total ankle replacement (TAR). The significance of cysts is uncertain, but they may threaten the long-term survival of the implant. The aim of this prospective study was to evaluate the diagnostic accuracy of weight-bearing digital...... radiography compared with 3D weight-bearing multiplanar reconstructed (MPR) fluoroscopic imaging when diagnosing periprosthetic bone cysts in patients who have undergone TAR. SUBJECTS AND METHODS. Forty-two consecutive patients with a Scandinavian Total Ankle Replacement (STAR) were consecutively enrolled...

  11. Demineralized Bone Matrix (DBM) as a Bone Void Filler in Lumbar Interbody Fusion: A Prospective Pilot Study of Simultaneous DBM and Autologous Bone Grafts

    Science.gov (United States)

    Kim, Bum-Joon; Kim, Se-Hoon; Lee, Haebin; Lee, Seung-Hwan; Kim, Won-Hyung; Jin, Sung-Won

    2017-01-01

    Objective Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32–71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (posteoporosis. PMID:28264244

  12. Avoiding graft-tunnel length mismatch in anterior cruciate ligament reconstruction: the single-bone plug technique.

    Science.gov (United States)

    Grawe, Brian; Smerina, Amber; Allen, Answorth

    2014-06-01

    Anterior cruciate ligament reconstruction, using autogenous bone-patellar tendon-bone (BTB) as a graft material, is commonly performed in the setting of anterior cruciate ligament insufficiency. Although bone-patellar tendon-bone autograft has an extensive track record, showing excellent clinical results, donor-site morbidity and graft-tunnel mismatch can still be problematic for a subset of patients. In the setting of a tendon graft that is too long, adequate interference screw fixation cannot be obtained, typically resulting in a tibial-sided bone plug that achieves less than 15 to 20 mm of bone in the distal tibial tunnel. We present an easy and effective technique for avoiding the graft-tunnel mismatch problems that commonly occur in patients who have an excessively long patellar tendons. This technique involves a simple preoperative planning algorithm that ultimately results in a single tibial-sided plug harvest. Bony interference fixation is then obtained on the femoral side and soft-tissue fixation on the tibial side. This technique allows for satisfactory graft fixation while avoiding the donor-site morbidity associated with patellar bone plug harvest.

  13. 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

  14. Use of Renal Replacement Therapy May Influence Graft Outcomes following Liver Transplantation for Acute Liver Failure: A Propensity-Score Matched Population-Based Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Stephen R Knight

    Full Text Available Acute kidney injury is associated with a poor prognosis in acute liver failure but little is known of outcomes in patients undergoing transplantation for acute liver failure who require renal replacement therapy.A retrospective analysis of the United Kingdom Transplant Registry was performed (1 January 2001-31 December 2011 with patient and graft survival determined using Kaplan-Meier methods. Cox proportional hazards models were used together with propensity-score based full matching on renal replacement therapy use.Three-year patient and graft survival for patients receiving renal replacement therapy were 77.7% and 72.6% compared with 85.1% and 79.4% for those not requiring renal replacement therapy (P<0.001 and P = 0.009 respectively, n = 725. In a Cox proportional hazards model, renal replacement therapy was a predictor of both patient death (hazard ratio (HR 1.59, 95% CI 1.01-2.50, P = 0.044 but not graft loss (HR 1.39, 95% CI 0.92-2.10, P = 0.114. In groups fully matched on baseline covariates, those not receiving renal replacement therapy with a serum creatinine greater than 175 μmol/L had a significantly worse risk of graft failure than those receiving renal replacement therapy.In patients being transplanted for acute liver failure, use of renal replacement therapy is a strong predictor of patient death and graft loss. Those not receiving renal replacement therapy with an elevated serum creatinine may be at greater risk of early graft failure than those receiving renal replacement therapy. A low threshold for instituting renal replacement therapy may therefore be beneficial.

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

    Directory of Open Access Journals (Sweden)

    Kye-Bok Lee

    2014-01-01

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

  16. Impact of body mass index on outcome in patients undergoing coronary artery bypass grafting and/or valve replacement surgery

    Science.gov (United States)

    Costa, Vinícius Eduardo Araújo; Ferolla, Silvia Marinho; dos Reis, Tâmara Oliveira; Rabello, Renato Rocha; Rocha, Eduardo Augusto Victor; Couto, Célia Maria Ferreira; Couto, José Carlos Ferreira; Bento, Alduir

    2015-01-01

    Objective This study aimed to analyze the impact of body mass index on outcomes of 101 patients undergoing coronary artery bypass grafting, valve replacement, or combined valve/ coronary artery bypass grafting surgery in a private hospital in Belo Horizonte, Brazil. Methods This was a prospective cross-sectional study of patients undergoing cardiac surgery from May 2009 to December 2012. All patients were followed up from the first day of admission until discharge or death. Patients were divided into three groups according to BMI: normal weight, overweight, and obese. The main outcome measure was the association between BMI and postoperative morbidities and mortality. Results Multivariate analysis identified obesity as an independent predictor of increased risk of surgical reintervention (odds ratio [OR] 13.6; 95%CI 1.1 - 162.9; P=0.046) and reduced risk of bleeding (OR 0.05; 95% CI 0.09 - 0.69; P=0.025). Univariate analysis showed that obesity was associated with increased frequency of wound dehiscence (P=0.021). There was no association between BMI and other complications or mortality in univariate analysis. There was also no association between body mass index and duration of cardiopulmonary bypass, aortic clamping, mechanical ventilation, and intensive care unit or hospital stay. Conclusion Obese individuals undergoing coronary artery bypass grafting, valve replacement, or combined surgery have a higher postoperative risk of surgical reintervention and lower chances of bleeding. PMID:26313724

  17. Long-term clinical outcomes following the use of synthetic hydroxyapatite and bone graft in impaction in revision hip arthroplasty.

    Science.gov (United States)

    Aulakh, Tajeshwar S; Jayasekera, Narlaka; Kuiper, Jan-Herman; Richardson, James B

    2009-03-01

    Impaction grafting using morsellised allograft bone restores bone stock, but carries the potential for transmission of infection. Synthetic bone graft substitutes can eliminate this risk but may, however, influence outcome. In this study we tested the hypothesis that a 50/50 mix of hydroxyapatite and allograft does not affect long-term function, survival or radiological outcome. Sixty-five patients had revision hip arthroplasty using impaction grafting with either pure allograft (42 patients) or a 50/50 mixture of allograft and solid particulate hydroxyapatite. Harris hip scores were assessed pre-operatively and annual intervals thereafter. Function was analyzed using multilevel modeling, the Kaplan-Meier method used for survival analysis and graft incorporation was assessed radiologically. The hip score improved in both groups but showed a small annual decline (average 1.2/year, plong-term prosthesis survival and function following revision arthroplasty with a 50/50 mixture of allograft and hydroxyapatite are comparable to allograft alone.

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

    Science.gov (United States)

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

    2016-01-01

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

  19. 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.

  20. Multiscale Homogenization Theory: An Analysis Tool for Revealing Mechanical Design Principles in Bone and Bone Replacement Materials

    Science.gov (United States)

    Hellmich, Christian; Fritsch, Andreas; Dormieux, Luc

    Biomimetics deals with the application of nature-made "design solutions" to the realm of engineering. In the quest to understand mechanical implications of structural hierarchies found in biological materials, multiscale mechanics may hold the key to understand "building plans" inherent to entire material classes, here bone and bone replacement materials. Analyzing a multitude of biophysical hierarchical and biomechanical experiments through homogenization theories for upscaling stiffness and strength properties reveals the following design principles: The elementary component "collagen" induces, right at the nanolevel, the mechanical anisotropy of bone materials, which is amplified by fibrillar collagen-based structures at the 100-nm scale, and by pores in the micrometer-to-millimeter regime. Hydroxyapatite minerals are poorly organized, and provide stiffness and strength in a quasi-brittle manner. Water layers between hydroxyapatite crystals govern the inelastic behavior of the nanocomposite, unless the "collagen reinforcement" breaks. Bone replacement materials should mimic these "microstructural mechanics" features as closely as possible if an imitation of the natural form of bone is desired (Gebeshuber et al., Adv Mater Res 74:265-268, 2009).

  1. 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.

  2. Instrumental and laboratory assessment of stressful remodelling processes in bone tissue at total hip replacement

    Directory of Open Access Journals (Sweden)

    E.V. Karjakina

    2010-06-01

    Full Text Available Research objective is to estimate stressful remodelling features of bone tissue according to the densitometry data and to the level of biochemical markers of bone resorption and formation in total hip replacement (THR. Bone tissue mineral density (BTMD, condition of calcium-phosphoric metabolism and biochemical markers of bone formation (osteocalcin and bone isoenzyme of alkaline phosphatase and resorption (С-terminal bodypeptide of the I type collagen have been determined in 52 patients with coxarthrosis of ll-lll stages with marked joint dysfunction before and after THR. The control group included 24 donors. The data were considered to be reliable when the probability index was р<0,05. The reliable (р<0,05 change of BTMD was determined only in 3-6 months after the operation, whereas the change of biochemical markers of remodeling had already been done after 1,5-3 months, allowing to define the group of patients with obvious negative bone balance: strong predominance of resorption processes without compensation of the subsequent adequate osteogenesis, that subsequently could lead to significant bone tissue deficiency in the area adjacent to the endoprosthesis. Changes of indices of calcium-phosphoric metabolism were not certain during the investigation term. ln conclusion it is to state that biochemical markers of remodeling in comparison with BTMD allow to estimate objectively features of adaptive bone tissue remodeling after THR in earlier periods and to define group of patients with sharp intensification of metabolism and obvious negative bone balance

  3. Development and validation of technique for in-vivo 3D analysis of cranial bone graft survival

    Science.gov (United States)

    Bernstein, Mark P.; Caldwell, Curtis B.; Antonyshyn, Oleh M.; Ma, Karen; Cooper, Perry W.; Ehrlich, Lisa E.

    1997-05-01

    Bone autografts are routinely employed in the reconstruction of facial deformities resulting from trauma, tumor ablation or congenital malformations. The combined use of post- operative 3D CT and SPECT imaging provides a means for quantitative in vivo evaluation of bone graft volume and osteoblastic activity. The specific objectives of this study were: (1) Determine the reliability and accuracy of interactive computer-assisted analysis of bone graft volumes based on 3D CT scans; (2) Determine the error in CT/SPECT multimodality image registration; (3) Determine the error in SPECT/SPECT image registration; and (4) Determine the reliability and accuracy of CT-guided SPECT uptake measurements in cranial bone grafts. Five human cadaver heads served as anthropomorphic models for all experiments. Four cranial defects were created in each specimen with inlay and onlay split skull bone grafts and reconstructed to skull and malar recipient sites. To acquire all images, each specimen was CT scanned and coated with Technetium doped paint. For purposes of validation, skulls were landmarked with 1/16-inch ball-bearings and Indium. This study provides a new technique relating anatomy and physiology for the analysis of cranial bone graft survival.

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

    Science.gov (United States)

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

    2014-12-01

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

  5. BMP 2--Genetics Institute/ Medtronic-Sofamor Danek/Integra. Bone morphogenetic protein 2--Genetics Institute/ Medtronic-Sofamor Danek/Integra, INFUSE Bone Graft, recombinant human bone morphogenetic protein 2--Genetics Institute/Medtronic-Sofamor Danek/Integra, RhBMP 2--Genetics Institute/Medtronic-Sofamor Danek/Integra.

    Science.gov (United States)

    2002-01-01

    Genetics Institute (Wyeth) is collaborating with Medtronic-Sofamor Danek (which specialises in spinal reconstruction) and Integra Life Sciences to develop a BMP 2 product [INFUSE Bone Graft] for use in spinal reconstruction in North America. The INFUSE Bone Graft product has been approved for use in lumbar interbody spinal fusion procedures in the USA and is in phase III trials for use in lumbar posterolateral spinal fusion procedures. During the procedure, damaged disc is replaced with a collagen sponge (Integra's Absorbable Collagen Sponge) soaked with BMP 2, which is held in place within an implanted cage device (LT-CAGE Lumbar Tapered Fusion Devise); the fusion process subsequently requires several months to complete. However, the patient is able to leave hospital the day after the operation, whereas in conventional spinal surgery a longer recovery time is required. The procedure supersedes the use of autograft bone as it uses a recombinant human bone morphogenic protein, rhBMP-2, which induces the body to grow its own bone where required. Genetics Institute has cloned and expressed bone morphogenic proteins 1-7 and established manufacturing processes by recombinant DNA technology. Bone morphogenic proteins may be useful in the treatment of osteoporosis and orthopaedic trauma. BMP 2 is also being developed for bone regeneration as an implanted device and as an injectable formulation. Genetics Institute is also collaborating with Integra LifeSciences to develop a formulation of BMP 2 with Integra's absorbable collagen-based structures for fracture treatment, which is awaiting approval in the USA.

  6. Patient and implant survival following joint replacement because of metastatic bone disease

    DEFF Research Database (Denmark)

    Sørensen, Michala S; Gregersen, Kristine G; Grum-Schwensen, Tomas

    2013-01-01

    Patients suffering from a pathological fracture or painful bony lesion because of metastatic bone disease often benefit from a total joint replacement. However, these are large operations in patients who are often weak. We examined the patient survival and complication rates after total joint...

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

    Directory of Open Access Journals (Sweden)

    Kaveh Bashti

    2015-01-01

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

  8. 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.

  9. 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

    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. 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. 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. 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). 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.

  10. Efficacy of Autologous Bone Marrow Concentrate for Knee Osteoarthritis with and without Adipose Graft

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    Christopher Centeno

    2014-01-01

    Full Text Available Introduction. We investigated the use of autologous bone marrow concentrate (BMC with and without an adipose graft, for treatment of knee osteoarthritis (OA. Methods. Treatment registry data for patients who underwent BMC procedures with and without an adipose graft were analyzed. Pre- and posttreatment outcomes of interest included the lower extremity functional scale (LEFS, the numerical pain scale (NPS, and a subjective percentage improvement rating. Multivariate analyses were performed to examine the effects of treatment type adjusting for potential confounding factors. The frequency and type of adverse events (AE were also examined. Results. 840 procedures were performed, 616 without and 224 with adipose graft. The mean LEFS score increased by 7.9 and 9.8 in the two groups (out of 80, respectively, and the mean NPS score decreased from 4 to 2.6 and from 4.3 to 3 in the two groups, respectively. AE rates were 6% and 8.9% in the two groups, respectively. Although pre- and posttreatment improvements were statistically significant, the differences between the groups were not. Conclusion. BMC injections for knee OA showed encouraging outcomes and a low rate of AEs. Addition of an adipose graft to the BMC did not provide a detectible benefit over BMC alone.

  11. Efficacy of autologous bone marrow concentrate for knee osteoarthritis with and without adipose graft.

    Science.gov (United States)

    Centeno, Christopher; Pitts, John; Al-Sayegh, Hasan; Freeman, Michael

    2014-01-01

    We investigated the use of autologous bone marrow concentrate (BMC) with and without an adipose graft, for treatment of knee osteoarthritis (OA). Treatment registry data for patients who underwent BMC procedures with and without an adipose graft were analyzed. Pre- and posttreatment outcomes of interest included the lower extremity functional scale (LEFS), the numerical pain scale (NPS), and a subjective percentage improvement rating. Multivariate analyses were performed to examine the effects of treatment type adjusting for potential confounding factors. The frequency and type of adverse events (AE) were also examined. 840 procedures were performed, 616 without and 224 with adipose graft. The mean LEFS score increased by 7.9 and 9.8 in the two groups (out of 80), respectively, and the mean NPS score decreased from 4 to 2.6 and from 4.3 to 3 in the two groups, respectively. AE rates were 6% and 8.9% in the two groups, respectively. Although pre- and posttreatment improvements were statistically significant, the differences between the groups were not. BMC injections for knee OA showed encouraging outcomes and a low rate of AEs. Addition of an adipose graft to the BMC did not provide a detectible benefit over BMC alone.

  12. Flexural performance of foam concrete containing pulverized bone as partial replacement of cement

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    Efe Ikponmwosa

    2014-01-01

    Full Text Available This paper presents the results of a study conducted to investigate the flexural behaviour of foam concrete containing pulverised bone as partial replacement of cement. A total of sixty reinforced beams (150×150×750 mm were used to investigate the flexural behaviour of the specimens. For reinforcement of the beams, hot-rolled, deformed 10-mm-diameter bars with yield and ultimate stresses of 478.10 N/mm2 and 710.81 N/mm2 respectively were used. The cement constituent of the mix was partly replaced with up to 20% of pulverised bone. The flexural parameters investigated are crack formation and its pattern, failure mode, ul timate load, theoretical and experimental ultimate moments, deflection and stiffness. From the results of this investigation, it is concluded that the provision of the design standard in relation to shear and flexural design of beams can be considered as adequate for the design of reinforced foam concrete. It is further concluded that the stiffness is not affected by the inclusion of pulverised bone in the mix at up to 15% cement replacement level , and neither is the deflection pattern of the uncracked sections of the specimens affected by the inclusion of pulverised bone. The bending moments of the specimens,however, decreased with increase in pulverised bone.

  13. Maxillary reconstruction with particulate bone graft and titanium mesh: a treatment option for large complex odontoma of the maxilla.

    Science.gov (United States)

    Utumi, Estevam Rubens; Cremonini, Caio Cesar; Pedron, Irineu Gregnanin; Zambon, Camila Eduarda; Cavalcanti, Marcelo Gusmão Paraíso; Ceccheti, Marcelo Minharro

    2011-07-01

    Odontomas are the most common type of odontogenic tumor and are generally asymptomatic. The purpose of this paper was to describe the case of a complex odontoma in a patient who had asymptomatic swelling in the central maxillary region, along with unerupted central and lateral incisors. In this case, surgical excision of the lesion was performed and an iliac bone graft was introduced into the defect area with a titanium mesh covering up the grafted harvesting bone. After 2 years of followup, no recurrence was identified. Patient followup is still in progress to evaluate bone graft resorption, and the patient awaits complete bone development. Oral rehabilitation with an osseointegrated titanium implant is expected in the future. An option of the large complex odontoma treatment is discussed.

  14. Bone morphogenetic protein-2-encapsulated grafted-poly-lactic acid-polycaprolactone nanoparticles promote bone repair.

    Science.gov (United States)

    Xu, Xiaojun; Yang, Jun; Ding, Lifeng; Li, Jianjun

    2015-01-01

    The aim of this study is to test the efficacy of a novel tissue-engineered bone in repairing bone defects, using poly-lactic-acid-polycaprolactone (PLA-PCL) scaffolding seeded with PEG-bone morphogenetic protein-2 (BMP-2)-transfected rBMSCs (rabbit bone marrow stromal cells). The rBMSCs were transfected with PEG/BMP-2 or liposome/BMP-2, and then implanted into a PLA-PCL tissue-engineered bone. The protein level of BMP-2 was assessed by Western blot analysis and immunohistochemistry. ELISA was used to measure the amount of BMP-2 secreted in the culture media. The mRNA level of BMP-2 and osteocalcin was assayed quantitatively by real-time PCR. The middle portion of the bilateral radius in New Zealand rabbits was excised and implanted with tissue-engineered bone, and the modified areas were monitored by X-ray, hematoxylin-eosin staining, and immunohistochemistry staining of BMP-2. PEG-BMP-2 nanoparticles (NPs) and BMP-2-loaded PEG-PLA-PCL tissue-engineered bones were successfully constructed. The novel PEG-PLA-PCL NPs/DNA complex was a superior option for transfecting BMP-2 in rBMSCs compared to normal liposomes Moreover, the mRNA level of osteocalcin and alkaline phosphatase activity was also elevated upon transfection of BMP-2-encapsulated NPs. In vivo implants with BMP-2-carried tissue-engineered bone exhibited dramatic augmentation of BMP-2 and effective bone formation in the rabbit ectopic model. The PEG-PLA-PCL NPs/BMP-2 complex had an advantageous effect on bone repair, which provided an important theoretic basis for potential clinical treatments.

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

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    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.

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

    Science.gov (United States)

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

    2016-04-20

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

  17. Ipsilateral Femoral Fracture Non-Union and Delayed Union Treated By Hybrid Plate Nail Fixation and Vascularized Fibula Bone Grafting: A Case Report

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    CK Chan

    2013-07-01

    Full Text Available Non-union is a well recognized complication of femoral neck fractures. The decision whether to attempt fracture fixation or to resort to hip replacement is particularly difficult in patients in the borderline age group in whom complex attempts at gaining union may fail and later present a difficult revision. On the other hand the patient may be young enough that arthroplasty best be avoided . Besides, presence of ipsilateral femoral shaft fracture with delayed union in addition to the femoral neck non-union will pose major problems at operation. We share our experience in treating a femoral neck fracture non-union with ipsilateral femoral shaft delayed union in the shaft and in the distal femur in a fifty years old patient. The fracture was treated with an angle blade plate and supracondylar nail supplemented with a free vascularised fibular bone grafting and autologous cancellous graft. There was radiological union at fourth month. At sixth months, the patient was free of pain and able to walk without support. Thus, we would like to suggest that vascularised fibula bone grafting with supracondylar nailing is a viable option for this pattern of fracture.

  18. Maxillary Sinus Floor Augmentation Surgery with Autogenous Bone Grafts as Ceiling: A Pilot Study and Test of Principle

    OpenAIRE

    Raghoebar, Gerry M.; Meijer, Henny J A; Telleman, Gerdien; Vissink, Arjan

    2013-01-01

    Background: 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. Purpose: 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...

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

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    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

  20. 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

  1. 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.

  2. Effects of short-term testosterone replacement on areal bone mineral density and bone turnover in young hypogonadal males

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    Prasun Deb

    2012-01-01

    Full Text Available Context: Effect of parenteral testosterone esters administration on bone-mineral density (BMD and bone turnover in young age onset male hypogonadism is not studied in Indian subjects. Aims: To prospectively study the effect of short-term (6 months replacement therapy with parenteral testosterone enanthate-propionate combination on BMD and bone turnover markers in hypogonadal adult patients. Settings and Design: Prospective, tertiary care academic center. Materials and Methods: Thirteen young, otherwise healthy hypogonadal males (age 25.5 ± 4.9 yrs, serum testosterone 2.56 ± 4.29 nmol/l were subjected to BMD measurements (DXA and estimation of urinary Crosslaps™ and serum osteocalcin at baseline. Twelve healthy age and BMI-matched males served as controls for BMD measurements. The hypogonadal patients were administered parenteral testosterone esters (as mixed enanthate and propionate 250 mg i.m. every 2-3 weeks, and prospectively followed for 6 months. BMD and bone markers were studied at the end of 6 months. Statistical Analysis Used: Mann-Whitney nonparametric test, paired t-test and Pearson′s test of two-tail significance. Results: At baseline, BMD was significantly lower in hypogonadal males as compared to that in controls. With testosterone replacement, there was significant improvement in BMD, both at trabecular and cortical sites, There was a decline in bone turnover with treatment (Ur Crosslaps™:creatinine ratio: pretreatment 72.8 ± 40.4, post-treatment 35.5 ± 23.8 μg/mmol, P = 0.098; serum osteocalcin: pre-treatment 41.0 ± 16.8, post-treatment 31.7 ± 2.1 ng/ml, P = 0.393. Conclusions: Short-term parenteral testosterone replacement significantly improves BMD at the hip, lumbar spine and forearm in hypogonadal young males.

  3. Experimental research of injectable calcium sulfate-based bone graft in the sheep femur bone defects%可注射硫酸钙基人工骨在羊股骨缺损植骨中的实验研究

    Institute of Scientific and Technical Information of China (English)

    王逢贤; 尹本敬; 俞兴; 曹旭; 徐林

    2012-01-01

    [目的]通过可注射性植骨材料在羊股骨缺损的骨内植入,评价可注射硫酸钙基植骨材料的骨修复能力.[方法]建立绵羊单侧股骨缺损模型,将可注射硫酸钙基人工骨植入骨缺损内,于术后4、8、12周行大体观察及X线片检查缺损区骨痂生长情况.[结果]术后4周时材料大部分降解吸收,可见新生骨小梁结构,缺损区有部分骨痂形成;8周时可见大量新生骨小梁结构,部分形成成熟骨单位,可见骨母细胞,新生骨与宿主骨界面模糊,完成断端间的骨性桥接;12周时材料完全降解,形成的新生骨小梁部分出现重塑形成正常骨结构,缺损区被新骨完全替代,骨痂开始塑形,髓腔再通.[结论]可注射硫酸钙基人工骨作为骨移植替代材料,具有良好的骨传导性和骨诱导性,用于修复骨缺损可以取得良好的效果.%[Objective]To evaluate the osteogenetic ability of injectable calcium sulfate-based bone graft substitute by applying injectable bone graft material in the sheep femur bone defects. [ Method] The sheep unilateral femoral defect model was established, and the injectable calcium sulfate-based bone graft substitute was implanted into the bone defect. The callus growth was investigated at 4,8 and 12 weeks after surgery by gross observation and X-ray examination. [ Result] At 4 weeks after operation the majority of material was degraded and absorbed. New trabecular bone structure and some defect of callus formation were noted. At 8 weeks after operation a large number of new trabecular bone structure could be seen. Part of mature bone unit were formed, osteoblasts were noted, new bone was blurred at the host bone interface, and bone bridging was completed between the ends. At 12 weeks after operation material was degraded completely, the new bone grew into normal structure,and the defect was completely replaced by new bone. [ Conclusion ] Injectable calcium sulfate-based bone as a bone graft substitute

  4. Influence of Material Properties on Rate of Resorption of Two Bone Graft Materials after Sinus Lift Using Radiographic Assessment

    Directory of Open Access Journals (Sweden)

    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.

  5. The perioperative cost of Infuse bone graft in posterolateral lumbar spine fusion.

    Science.gov (United States)

    Glassman, Steven D; Carreon, Leah Y; Campbell, Mitchell J; Johnson, John R; Puno, Rolando M; Djurasovic, Mladen; Dimar, John R

    2008-01-01

    There is mounting evidence supporting the efficacy of bone morphogenetic protein (BMP) for both anterior interbody and posterolateral lumbar fusion. However, the relative cost of BMP remains an important concern for physicians, hospitals, and payers. The purpose of this study is to report on the perioperative costs for patients treated with rhBMP-2 as compared with an iliac crest bone graft (ICBG) supplemented with graft extenders. A prospective randomized controlled trial of rhBMP-2/ACS (Infuse Bone Graft; Medtronic Sofamor Danek, Memphis, TN) versus ICBG+/-graft extender for lumbar spine fusion in patients over 60 years old. One hundred two patients over 60 years old who required a posterolateral lumbar spine fusion randomized between receiving rhBMP-2/ACS or ICBG. All health-care costs over the first 3 months after surgery. As part of a prospective randomized trial of rhBMP-2/ACS versus ICBG+/-graft extender for lumbar spine fusion, all costs over the first 3 months after surgery were directly recorded by a dedicated coder funded by Norton Healthcare, Louisville, KY. A dedicated research nurse also followed all patients throughout their hospital stay and posthospitalization recovery to identify any adverse events or additional outpatient medical care. Fifty patients received rhBMP-2/ACS and 52 underwent ICBG harvest. The mean hospital cost for the index admission was $24,736 for the rhBMP-2/ACS group and $21,138 for the ICBG group. Mean inpatient physician costs were $5,082 in the rhBMP-2/ACS group and $5,316 in the ICBG group. Costs associated with posthospital rehabilitation averaged $4,906 in the rhBMP-2/ACS group versus $6,820 in the ICBG group. Total payer expenditure for the 3-month perioperative period averaged $33,860 in the rhBMP-2/ACS group and $37,227 in the ICBG group. The hospital carries the cost burden associated with the utilization of rhBMP-2/ACS. In contrast, the payer in a Diagnosis-Related Group (DRG) model achieves a net savings, based

  6. Attributes of Bio-Oss(®) and Moa-Bone(®) graft materials in a pilot study using the sheep maxillary sinus model.

    Science.gov (United States)

    Smith, M M; Duncan, W J; Coates, D E

    2017-09-04

    The aim of this pilot study was to characterize surface morphology and to evaluate resorption and osseous healing of two deproteinated bovine bone graft materials after sinus grafting in a large animal model. Surfaces of a novel particulate bovine bone graft, Moa-Bone(®) were compared with Bio-Oss(®) using scanning electron microscopy. Six sheep then had maxillary sinus grafting bilaterally, covered with BioGide(®) . Grafted maxillae were harvested after 4, 6 and 12 weeks. Healing was described for half of each site using resin-embedded ground sections. For the other half, paraffin-embedded sections were examined using tartrate resistant acid phosphatase staining for osteoclast activity, runt-related transcription factor2 immunohistochemistry for pre-osteoblasts and osteoblasts and proliferating cell nuclear antigen for proliferative cells. Moa-Bone(®) had a smoother, more porous fibrous structure with minimal globular particles compared with Bio-Oss(®) . After 4 weeks, woven bone formed on both grafts and the Moa-Bone(®) particles also showed signs of resorption. After 12 weeks, Moa-Bone(®) continued to be resorbed, however Bio-Oss(®) did not; both grafts were surrounded by maturing lamellar bone. Moa-Bone(®) was associated with earlier evidence of runt-related transcription factor 2-positive cells. Moa-Bone(®) but not Bio-Oss(®) was associated with strong tartrate resistant acid phosphatase-positive osteoclasts on the graft surface within resorption lacunae at both 4 and 6 weeks post-grafting. Both materials supported osseous healing and maturation without inflammation. Moa-Bone(®) showed marked osteoclast activity after 4 and 6 weeks and demonstrated positive attributes for grafting, if complete remodeling of the graft within the site is desired. Further optimization of Moa-Bone(®) for maxillofacial applications is warranted. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. [Lengthening of residual digit by gradual traction and bone grafting (a report of 143 cases)].

    Science.gov (United States)

    Hou, C L

    1992-06-01

    Since 1985, a device for gradual traction was used for lengthening of 143 residual digits in 75 patients. The average lengthening was 2.2 cm. This method is simple, safe, and effective. The advantages of this method over the previously exercised tubed bone graft and other digital lengthening methods are that the digit reconstructed by the gradual traction-lengthening method has the normal cutaneous structure, good sensation function, and better contour. Multiple digits can be reconstructed simultaneously. Because the periosteum at the osteotomy site is kept intact, the long term results are consistent.

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

    Directory of Open Access Journals (Sweden)

    Omer Ersen

    2014-12-01

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

  9. Is There a Difference in Graft Motion for Bone-Tendon-Bone and Hamstring Autograft ACL Reconstruction at 6 Weeks and 1 Year?

    Science.gov (United States)

    Irvine, James N; Arner, Justin W; Thorhauer, Eric; Abebe, Ermias S; D'Auria, Jennifer; Schreiber, Verena M; Harner, Christopher D; Tashman, Scott

    2016-10-01

    Bone-patellar tendon-bone (BTB) grafts are generally believed to heal more quickly than soft tissue grafts after anterior cruciate ligament (ACL) reconstruction, but little is known about the time course of healing or motion of the grafts within the bone tunnels. Graft-tunnel motion will be greater in hamstring (HS) grafts compared with BTB grafts and will be less at 1 year than at 6 weeks. Controlled laboratory study. Twelve patients underwent anatomic single-bundle ACL reconstruction using HS or BTB autografts (6 per group) with six 0.8-mm tantalum beads embedded in each graft. Dynamic stereo x-ray images were collected at 6 weeks and 1 year during treadmill walking and stair descent and at 1 year during treadmill running. Tibiofemoral kinematics and bead positions were evaluated. Graft-tunnel motion was based on bead range of motion during the loading response phase (first 10%) of the gait cycle. During treadmill walking, there was no difference in femoral tunnel or tibial tunnel motion between BTB or HS grafts at 6 weeks (BTB vs HS: 2.00 ± 1.05 vs 1.25 ± 0.67 mm [femoral tunnel]; 1.20 ± 0.63 vs 1.27 ± 0.71 mm [tibial tunnel]), or 1 year (BTB vs HS: 1.62 ± 0.76 vs 1.08 ± 0.26 mm [femoral tunnel]; 1.58 ± 0.75 vs 1.68 ± 0.53 mm [tibial tunnel]). During stair descent, there was no difference in femoral or tibial tunnel motion between BTB and HS grafts at 6 weeks or 1 year. With running, there was no difference between graft types at 1 year. For all results, P values were > .05. Knee kinematics were consistent with the literature. During walking and stair descent, ACL reconstruction using suspensory fixation yielded no difference between graft types in femoral or tibial tunnel motion at 6 weeks or 1 year. All subjects were asymptomatic with knee kinematics similar to that of the literature. The significance of persistent, small (1 to 3 mm) movements at 1 year for healing or graft performance is unknown. These study results may have significant implications

  10. 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 tooth movement without fenestrations and accelerated new bone formation on the pressure side.

  11. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Coen Pramono D

    2006-09-01

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

  14. Evaluation of impact of steroid replacement treatment on bone health in children with 21-hydroxylase deficiency.

    Science.gov (United States)

    Delvecchio, M; Soldano, L; Lonero, A; Ventura, A; Giordano, P; Cavallo, L; Grano, M; Brunetti, G; Faienza, M F

    2015-04-01

    There are conflicting data regarding the potential impact of chronic glucocorticoid (GC) therapy on the bone mineral density of patients with congenital adrenal hyperplasia (CAH). Previous studies performed by dual-energy X-ray absorptiometry reported conflicting results. The purpose of this study was to assess the impact of chronic GC replacement treatment in children with classical and non classical CAH due to 21-hydroxylase deficiency (21-OHD) by quantitative ultrasonometry (QUS), an easy, cheap, and radiation-free technique. The study population consisted of nineteen 21-OHD patients (nine males) on lifelong GC treatment. Anthropometric, hormonal, and treatment data were recorded for each patient, and bone quality was assessed by QUS measurements. QUS findings (amplitude-dependent speed of sound and bone transmission time) were normal in 21-OHD patients and did not correlate with duration of treatment, daily, total, and yearly hydrocortisone dose. Furthermore, no significant correlation was found between QUS findings and 17α-hydroxy progesterone, Δ4-androstenedione, and testosterone levels. In conclusion, our results provide reassurance that currently used replacement doses of GC do not have a major impact on bone in patients with CAH. QUS seems to be a reliable tool for screening of bone health in children with 21-OHD.

  15. Efficacy of xenogeneic bone grafting with guided tissue regeneration in the management of bone defects after surgical endodontics.

    Science.gov (United States)

    Taschieri, Silvio; Del Fabbro, Massimo; Testori, Tiziano; Weinstein, Roberto

    2007-06-01

    The purpose of this prospective clinical trial was to monitor the outcomes of periradicular surgery in large periapical lesions with or without guided tissue regeneration (GTR) and anorganic bovine bone. All teeth in the study revealed a periradicular lesion measuring at least 10 mm. A total of 63 teeth in 44 patients were included according to specific selection criteria. In the test group, after root end filling was completed, the defect was filled with anorganic bovine bone and was covered with a resorbable collagen membrane. In the control group, neither graft nor membrane was used. A total of 59 teeth in 41 patients were evaluable at 1-year follow-up. Of these, 24 teeth belonged to the test group and 35 to the control group. Overall, 46 teeth (78%) had successfully healed, 10 (16.9%) demonstrated uncertain healing, and 3 exhibited treatment failure. Investigators found no statistically significant differences in outcome between test and control groups. The present study showed that the use of GTR in association with anorganic bovine bone in the treatment of patients with large periradicular lesions of strictly endodontic origin has no beneficial effect on outcome.

  16. [Effectiveness of in situ subtalar arthrodesis with bone graft for subtalar traumatic arthritis and gait analysis].

    Science.gov (United States)

    Wu, Zhanpo; Chen, Wei; Zhang, Qi; Yin, Bing; Li, Ming; Wang, Haili; Zhang, Yingze

    2011-10-01

    To evaluate the effects of in situ subtalar arthrodesis with bone graft for subtalar traumatic arthritis, and to analyse the plantar pressure distribution so as to provide the evidence for effectiveness evaluation. Between March 2004 and December 2008, 26 patients with unilateral subtalar arthrodesis undergoing bone graft fusion were enrolled (test group). After operation, the imageology diversity and the effect of subtalar arthrodesis on adjacent joint were observed. American Orthopaedic Foot and Ankel Society (AOFAS) ankle and hindfoot score and radiographs were used to assess the foot function before and after operation. Twenty-six normal subjects served as controls. Foot scan system was used to test the distribution of maximum plantar pressure and the change of gravity center curve. No significant difference was found in gender, age, height, and weight between 2 groups (P > 0.05). All patients were followed up 18.2 months on average (range, 14-71 months). The mean subtalar arthrodesis time was 5.6 months (range, 4 months and 15 days to 11 months). The mean AOFAS ankle and hindfoot score improved from 35.18 +/- 8.16 preoperatively to 76.36 +/- 6.90 postoperatively (t = -13.910, P = 0.000). Nine (34.6%) patients had satisfactory functional effects, and 13 (50.0%) patients basically satisfactory. The talocalcaneal height, talocalcaneal angle, talar declination angle, and calcaneus patch angle were 87.04% +/- 6.17%, 76.73% +/- 5.13%, 65.86% +/- 7.01%, and 70.19% +/- 8.33% of the contralateral side, respectively. Osteoarthritis of the adjacent joints occurred in 7 cases. The maximum plantar pressure increased in the third to fifth metatarsal bones and decreased in the first to second metatarsal bones, showing significant differences when compared with normal controls (P 0.05). The plantar pressure was well distributed in patient who was satisfied with the effect, but it was still different from normal controls. In patients who had high plantar pressure in middle

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

    Directory of Open Access Journals (Sweden)

    CH Evans

    2009-12-01

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

  18. [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.

  19. Indirect MR-arthrography in osteochondral autograft and crushed bone graft with a collagen membrane-Correlation with histology

    Energy Technology Data Exchange (ETDEWEB)

    Streitparth, F. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany)], E-mail: florian.streitparth@charite.de; Schoettle, P.; Schell, H. [Center for Musculoskeletal Surgery, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany); Lehmkuhl, L.; Madej, T.; Wieners, G. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany); Duda, G.N. [Center for Musculoskeletal Surgery, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany); Schroeder, R.J. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany)

    2009-04-15

    Objective: To analyze the spectrum of findings in indirect MR-arthrography following osteochondral autograft transfer system (OATS) and crushed bone graft using a magnetic resonance imaging (MRI) scoring and grading system in relation to histology as the standard of reference. Materials and methods: Iatrogenic lesions were set at ovine condylar facets (n = 6/group), treated with OATS or crushed bone graft. 1.5 T MRI was performed 6 months after surgery using PD-weighted (w fat saturated (fs) fast spin echo (FSE), T1-w 2D, and 3D fs gradient echo (GE) sequences 30 min. after i.v. Gd-DTPA administration and passive joint exercise. The repair tissue was evaluated by two independent radiologists. The MR findings were compared to histology. Results: In all cases, MRI and histologic grading correlated well and showed significant superior repair in OATS at 6 months (p < 0.05), reproducing the original articular contour and a good subchondral restoration. FsT1-w3DGE proved most appropriate identifying characteristic post-operative findings: the OATS group demonstrated bone marrow edema at the donor site and the graft/host interface showed significant enhancement in indirect MR-arthrography, indicating fibrocartilage. After crushed bone graft, we found an irregular structure and significant contrast uptake, consistent with remnants of bone grafts surrounded by inflammatory tissue. Conclusion: Indirect MR-arthrography is an accurate, non-invasive monitoring tool following OATS and crushed bone graft as the MRI scoring and grading system allows a reliable evaluation of normal and pathological osteochondral repair with a high histologic correlation.

  20. Osseointegrated implants in maxillary sinus-lift and bone graft areas

    Directory of Open Access Journals (Sweden)

    Camila Daher Cozac

    Full Text Available Objectives: To assess the satisfaction index of such treatment; provide statistical data about this index and explain to the dental community, the possible satisfaction expressed by the group assisted, with regard to the intervention performed. Methods: After applying the questionnaire, the the values of the analysis obtained were tabulated and statistical calculation was then applied(Fisher Exact test and Chi-Square test with a significance level of 5% (p <0.05. Results: According to the data obtained, it was found that the degree of satisfaction of nonsmoker patients was significantly higher than that of the group of smokers, irrespective of their economic condition. As regards gender, the satisfaction index of women showed a higher percentage than that of men. In this study, the need for additional surgery, the loss of bone graft and repetition of the surgical procedure did not occur frequently. All patients were satisfied with the surgery performed, and the majority did not need additional surgery. Conclusion: In view of the factors evaluated in this study, it could be concluded that a significant portion of patients attended by the Improvement and Specialization Courses in Implant Dentistry at the Faculty of Dentistry, Federal University of Goiás, as from the year 2004, reported that the osseointegrated implant placement techniques and bone graft procedures are considered traumatic, but nevertheless they experienced a significant improvement in their quality of life after treatment.

  1. 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.

  2. Feasibility and tailoring of bioactive glass-ceramic scaffolds with gradient of porosity for bone grafting.

    Science.gov (United States)

    Vitale-Brovarone, Chiara; Baino, Francesco; Verné, Enrica

    2010-05-01

    The aim of this research study is the preparation and characterization of graded glass-ceramic scaffolds that are able to mimic the structure of the natural bone tissue, formed by cortical and cancellous bone. The material chosen for the scaffolds preparation is a glass belonging to the system SiO( 2)-P(2)O(5)-CaO-MgO-Na( 2)O-K(2)O (CEL2). The glass was synthesized by a conventional melting-quenching route, ground, and sieved to obtain powders of specific size. The scaffolds were fabricated using different methods: polyethylene burn-off, sponge replication, a glazing-like technique, and combinations of these methods. The scaffolds were characterized through morphological observations, density measurements, volumetric shrinkage, mechanical tests, and in vitro bioactivity tests. The features of the scaffolds prepared using the different methods were compared in terms of morphological structure, pores content, and mechanical strength. The proposed scaffolds effectively mimic the cancellous/cortical bone system in terms of structure, porosity, and mechanical strength, and they exhibit a highly bioactive behavior. Therefore, these graded grafts have a great potential for biomedical applications and can be successfully proposed for the substitution of load-bearing bone portions.

  3. A Novel Surgical Technique for Augmented Corticotomy-Assisted Orthodontics: Bone Grafting With Periosteum.

    Science.gov (United States)

    Ma, Zhi-Gui; Yang, Chi; Xie, Qian-Yang; Xi, Qian-Yang; Ye, Zhou-Xi; Ye, Zhou-Xie; Zhang, Shan-Yong; Abdelrehem, Ahmed

    2016-01-01

    To introduce grafting fixed with the periosteum (dumpling technique) as an alternative surgical technique for augmented corticotomy-assisted orthodontics in the lower anterior region and evaluate the preliminary outcomes. Eleven patients (9 women, 2 men; mean age, 21.4 yr) with a thin alveolus or alveolar defect in the lower anterior region by clinical and radiographic examination underwent an augmented corticotomy using the new dumpling technique. Cone-beam computerized tomography was used to evaluate morphologic changes of the lower anterior ridge before treatment (T0) and 1 week (T1) and 6 months (T2) after the bone-augmentation procedure. Repeated-measures analysis of variance with Bonferroni multiple-comparison test was used to compare variables at each time point. No severe postsurgical complications occurred in any patient. The mean alveolar bone thickness of the labial plate increased from T0 to T1 (P .05). No significant differences were found in root length of the lower anterior teeth at these 3 time points (P > .05). In this preliminary study, the dumpling technique for augmented corticotomy-assisted surgical orthodontics showed alveolar bone augmentation by increasing the vertical alveolar height and the horizontal bone thickness in the labial aspect of the anterior mandibular area. However, long-term follow-up is necessary. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. 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

  5. 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 ...

  6. Does LED phototherapy influence the repair of bone defects grafted with MTA, bone morphogenetic proteins, and guided bone regeneration? A description of the repair process on rodents.

    Science.gov (United States)

    Pinheiro, Antonio L B; Soares, Luiz G P; Barbosa, Artur F S; Ramalho, Luciana M P; dos Santos, Jean N

    2012-09-01

    This work carried out a histological analysis on bone defects grafted (MTA) treated or not with LED, BMPs, and membrane (GBR). Benefits of their isolated or combined usage on bone repair were reported, but not their association. Ninety rats were divided into ten groups and each subdivided into three. Defects on G II and I were filled with the blood clot. G II was further LED irradiated. G III and IV were filled with MTA; G IV was further LED irradiated. In G V and VI, the defects were filled with MTA and covered with a membrane (GBR). G VI was further LED irradiated. In G VII and VIII, BMPs were added to the MTA and group VIII was further LED irradiated. In G IX and X, the MTA + BMP graft was covered with a membrane (GBR). G X was further LED irradiated. LED was applied over the defect at 48-h intervals and repeated for 15 days. Specimens were processed, cut, and stained with H&E and Sirius red and underwent histological analysis. The use of LED light alone dramatically reduced inflammation. However, its use on MTA associated with BMP and/or GBR increased the severity of the inflammatory reaction. Regarding bone reabsorption, the poorest result was seen when the LED light was associated with the MTA + BMP graft. In the groups Clot and MTA + GBR, no bone reabsorption was detectable. Increased collagen deposition was observed when the LED light was associated with the use of the MTA associated with BMP and/or GBR. Increased new bone formation was observed when the LED light was used alone or associated with the use of MTA + GBR, MTA + BMP, on association of MTA + BMP + GBR and when BMP was added to the MTA. Our results indicate that the use of LED light alone or in association with MTA, MTA + BMP, MTA + GBR, and MTA + BMP + GBR caused less inflammation, and an increase of both collagen deposition and bone deposition as seen on both histological and morphometric analysis.

  7. Kinetic study of the replacement of porcine small intestinal submucosa grafts and the regeneration of meniscal-like tissue in large avascular meniscal defects in dogs.

    Science.gov (United States)

    Cook, J L; Tomlinson, J L; Arnoczky, S P; Fox, D B; Reeves Cook, C; Kreeger, J M

    2001-06-01

    Porcine small intestinal submucosa (SIS) was used to replace large, avascular defects in the medial menisci of dogs. Twelve dogs received SIS grafts and 3 dogs were left untreated as controls. Dogs were evaluated at 4, 8, and 12 weeks by means of lameness scoring and ultrasonography. Dogs were sacrificed at 1, 6, or 12 weeks after implantation, and the tissue at the site of meniscal resection was evaluated for gross and histologic appearance, cross-sectional and surface area, and collagen types I and II. The femoral and tibial condyles were assessed for articular cartilage damage. Control dogs were significantly more lame than grafted dogs 8 and 12 weeks after instrumentation. Grafted dogs' replacement tissue appeared meniscal-like when evaluated grossly and ultrasonographically 12 weeks after instrumentation. The amount of replacement tissue was significantly greater in both cross-sectional and surface area for grafted dogs than for controls at all time points. Histologically, the SIS biomaterial could be identified in all grafted dogs at 1 week post-implantation, but in none at 6 weeks post-implantation. Subjectively, grafted dogs' replacement tissue was histologically superior to that of controls with respect to tissue type, organization, and architecture. Collagen types I and II immunoreactivity in grafted menisci were similar to that of normal menisci. Control dogs had significantly more articular cartilage damage than grafted dogs. SIS appears to induce regeneration of meniscal-like tissue in large, avascular meniscal defects in dogs, resulting in superior clinical function and articular cartilage protection compared to ungrafted controls.

  8. Anterior decompression, structural bone grafting, and Caspar plate stabilization for unstable cervical spine fractures and/or dislocations.

    Science.gov (United States)

    Garvey, T A; Eismont, F J; Roberti, L J

    1992-10-01

    Fourteen patients who sustained acute cervical spine fractures and/or dislocations with associated posterior ligamentous disruption had anterior decompressions, structural bone grafting, and anterior Caspar plate stabilization. With an average 30-month follow-up, no patient has had loss of fixation. Despite criticism raised from biomechanical testing, the Caspar anterior plate system (Aesculape, Tuttlingen, Germany) may be added to structural bone grafting of unstable cervical fractures and/or dislocations, yielding an in vivo solid construct, which obviates the need for simultaneous posterior stabilization.

  9. 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.

  10. 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.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  12. Radiation-Associated Fracture Nonunion of the Clavicle Treated with Locking Plate Fixation and Autologous Bone Grafting

    Directory of Open Access Journals (Sweden)

    Takahiro Niikura

    2012-01-01

    Full Text Available We describe a case of radiation-associated fracture nonunion of the clavicle, which was treated by locking plate fixation and autologous bone grafting. The patient was a 67-year old man who received 70 Gy radiation therapy to treat nasopharyngeal carcinoma. Eight years later, he suffered a pathological fracture of the right clavicle. One year after the fracture, surgical treatment was performed due to persistent pain and weakness. Radiographs demonstrated atrophic nonunion. Bone scan demonstrated hot uptake at both ends of the fractured bone. MRI demonstrated a formation of pseudoarthrosis with fluid collection and suggested bone marrow edema at both ends of the fracture fragments. In surgery, fibrous pseudoarthrosis tissue was excised and both ends of the fracture fragments were refreshed to identify bleeding. Open reduction and internal fixation using a 7-hole locking plate and autologous bone grafting were performed. Successful bony union was obtained 1 year postoperatively, and no adverse events were observed up to 52 months after the operation. Our case suggests that a locking plate provides sufficient fixation and autologous bone grafting is effective in enhancing bone healing in a radiation-associated fracture nonunion of the clavicle in which it is difficult to achieve bony union.

  13. The Influence of Partial Knee Replacement Designs on Tensile Strain at Implant-Bone Interface

    Directory of Open Access Journals (Sweden)

    He Wang

    2012-01-01

    Full Text Available Partial knee replacement (PKR results in fast recovery and good knee mechanics and is ideal to treat medial knee osteoarthritis. Cementless PKR depends on bone growing into the implant surface for long-term fixation. Implant loosening may occur due to high tensile strain resulted from large mechanical loads during rehab exercises. The purpose of this study is to investigate whether external fixations such as superior screw and frontal flange could reduce the tensile strain at the implant-bone interface. Three medial PKRs were designed. The first PKR had no external fixations. A superior screw and a frontal flange were then added to the first PKR to form the second and third PKR designs, respectively. Finite element analysis was performed to examine the tensile strain at the implant-bone interface during weight-bearing exercises. The PKR with no external fixations exhibited high tensile strain at the anterior implant-bone interface. Both the screwed and flanged PKRs effectively reduced the tensile strain at the anterior implant-bone interface. Furthermore, the flanged PKR resulted in a more uniform reduction of the tensile strain than the screwed PKR. In conclusion, external fixations are necessary to alleviate tensile strain at the implant-bone interface during knee rehab exercises.

  14. Comparative Study of New Autologous Material, Bone-Cartilage Composite Graft (BCCG), for Ossiculoplasty with Polycel(®) and Titanium.

    Science.gov (United States)

    Kong, Ji Sun; Jeong, Chang Yeong; Shim, Myung Joo; Kim, Woo Jin; Yeo, Sang Won; Park, Shi Nae

    2017-09-25

    Ossiculoplasty is a surgical procedure that recreates sound transmission of the middle ear in conductive hearing loss. Various materials have been used for ossicular reconstruction, but the most ideal material for ossiculoplasty remains controversial. The purpose of this study is to introduce a novel method of autologous ossiculoplasty, bone-cartilage composite graft (BCCG), and to compare its surgical results with different types of ossiculoplastic prostheses. A retrospective study was performed in a tertiary referral center. Data of 275 patients who received ossiculoplasty using the three different materials of BCCG, Polycel(®) , and titanium were analyzed according to type of ossiculoplasty: partial or total ossicular replacement prosthesis (PORP or TORP). Hearing results, complication rates, and clinical parameters including age, sex, past history, preoperative diagnosis, and surgery type were compared among different groups. Ossiculoplasty with BCCG showed satisfactory hearing outcomes and the lowest complication rate among the three different materials. In particular, its extrusion rate was 0%. We propose that the BCCG technique is a useful alternative method for ossiculoplasty, with proper patient selection. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  15. Transcatheter Aortic Valve Replacement: The New Standard in Patients With Previous Coronary Bypass Grafting?

    Science.gov (United States)

    Reinöhl, Jochen; Kaier, Klaus; Reinecke, Holger; Frankenstein, Lutz; Zirlik, Andreas; Zehender, Manfred; von Zur Mühlen, Constantin; Bode, Christoph; Stachon, Peter

    2016-10-24

    The aim of this study was to assess how the introduction of transcatheter aortic valve replacement (TAVR) has changed clinical practice and outcome in patients who have previously undergone coronary artery bypass grafting (CABG). A significant proportion of patients admitted for aortic valve replacement have previously undergone CABG and are therefore at increased operative risk in case of redo surgery. In-hospital outcome data were analyzed from patients with or without previous CABG undergoing isolated surgical aortic valve replacement or TAVR in Germany from 2007 to 2013. In total, 32,581 TAVR and 55,992 surgical aortic valve replacement procedures were performed in patients with (n = 6,221) or without (n = 82,352) previous CABG. TAVR increased markedly in patients with previous CABG, from 18 procedures in 2007 to 1,191 in 2013, while surgical aortic valve replacement decreased in these patients from 471 to 179 procedures. In 2013, TAVR was the preferred therapy in almost 90% of patients with previous CABG. In-hospital mortality was increased in patients with previous CABG compared with those without (7.6% vs. 6.3% for TAVR and 7.2% vs. 2.6% for surgical aortic valve replacement). Bleeding and stroke rates were also increased with redo surgical aortic valve replacement procedures (with vs. without previous CABG: stroke, 3.2% vs. 1.8%; relevant bleeding, 29.6% vs. 13.4%; acute kidney injury, 4.2% vs. 2.9%), whereas this was not the case with TAVR (stroke, 2.1% vs. 2.6%; relevant bleeding, 7.3% vs. 8.3%; acute kidney injury, 6.3% vs. 5.4% respectively). A similar influence was seen in resource utilization (discharge destination home: TAVR after CABG, 51%; surgical aortic valve replacement after CABG, 31%). Since its introduction in 2007, TAVR has been increasingly used in Germany in patients with previous CABG, and in-hospital outcome data support the trend away from redo surgery. Copyright © 2016 American College of Cardiology Foundation. Published by

  16. Immunomodulation with dendritic cells and donor lymphocyte infusion converge to induce graft vs neuroblastoma reactions without GVHD after allogeneic bone marrow transplantation

    OpenAIRE

    Ash, S.; Stein, J.; Askenasy, N; Yaniv, I.

    2010-01-01

    Background: Mounting evidence points to the efficacy of donor lymphocyte infusion (DLI) and immunisation with tumour-pulsed dendritic cells (DC) in generating graft vs leukaemia reactions after allogeneic bone marrow transplantation (BMT). We assessed the efficacy of DLI and DC in generating potent graft vs neuroblastoma tumour (GVT) reactions following allogeneic BMT. Methods: Mice bearing congenic (H2Ka) Neuro-2a tumours were grafted with allogeneic (H2Kb) T-cell-depleted bone marrow cells....

  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. Improvement in nerve regeneration through a decellularized nerve graft by supplementation with bone marrow stromal cells in fibrin.

    Science.gov (United States)

    Zhao, Zhe; Wang, Yu; Peng, Jiang; Ren, Zhiwu; Zhang, Li; Guo, Quanyi; Xu, Wenjing; Lu, Shibi

    2014-01-01

    Acellular nerve grafting is often inferior as well as an inadequate alternative to autografting for the repair of long gaps in peripheral nerves. Moreover, the injection method is not perfect. During the injection of cells, the syringe can destroy the acellular nerve structure and the limited accumulation of seed cells. To resolve this problem, we constructed a nerve graft by acellular nerve grafting. Bone marrow-mesenchymal stromal cells (BM-MSCs) were affixed with fibrin glue and injected inside or around the graft, which was then used to repair a 15-mm nerve defect in rats. The acellular nerve graft maintained its structure and composition, and its tensile strength was decreased, as determined by two-photon microscopy and a tensile testing device. In vitro, MSCs embedded in fibrin glue survived and secreted growth factors such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF). We repaired 15-mm Sprague-Dawley rat sciatic nerve defects using this nerve graft construction, and MSCs injected around the graft helped improve nerve regeneration and functional recovery of peripheral nerve lesions as determined by functional analysis and histology. Therefore, we conclude that supplying MSCs in fibrin glue around acellular nerves is successful in maintaining the nerve structure and can support nerve regeneration similar to the direct injection of MSCs into the acellular nerve for long nerve defects but may avoid destroying the nerve graft. The technique is simple and is another option for stem cell transplantation.

  19. Guided Bone Regeneration in Long-Bone Defects with a Structural Hydroxyapatite Graft and Collagen Membrane

    Science.gov (United States)

    2013-01-01

    is currently limited by high costs and associated complications, including life-threatening cervical swelling4 and ectopic bone formation.5...fibrous ver- sus collagen zones. Biomechanical evaluation Immediately after euthanasia, eight excised radii and ul- nae per group (seven for the wrap group...serve as controls for the biomechanical evaluation. The specimens were tested to flexural failure in a 4-point bending configuration with 10- mm spacing

  20. 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.

  1. Biomimetic nanocomposites of carboxymethyl cellulose-hydroxyapatite: novel three dimensional load bearing bone grafts.

    Science.gov (United States)

    Garai, Subhadra; Sinha, Arvind

    2014-03-01

    An innovative biomimetic synthesis of novel three dimensional micro/macro porous carboxymethyl cellulose (CMC)-hydroxyapatite (HA) nanocomposites having four systematically different compositions has been established for its possible application as a load bearing synthetic bone graft. Our process, being in situ, involves a simple and cost effective route akin to a matrix mediated biomineralization process. Developed synthesis route not only controls the size of HA particles in the range of 15-50 nm, embedded in CMC matrix, but also assists in the formation of a mechanically strong three dimensional nanocomposite structures due to physical cross linking of HA impregnated CMC matrix. The process does not involve any toxic cross linker and works at near ambient conditions. The nanocomposites are systematically structurally and mechanically characterized using various techniques like scanning electron microscopy (SEM), atomic force microscopy (AFM), transmission electron microscopy (TEM), X-ray diffraction (XRD), Fourier transform IR (FTIR), solid state (13)C nuclear magnetic resonance ((13)C NMR), thermo-gravimetric analysis (TGA) and Universal mechanical test. It reveals that the ionic/polar or electrostatic interactions are the main driving force for formation of load bearing three dimensional nanocomposites via a process similar to matrix mediated biomineralization. Compressive strength and compressive modulus of nanocomposites, being in the range of 1.74-12 MPa and 157-330 MPa, respectively, meet the desired range of compressive strength for the synthetic grafts used in cancellous bone. An increase in the compressive strength with increase in the porosity has been an interesting observation in the present study. In vitro cytotoxicity of the synthesized nanocomposites has been evaluated using bone marrow mesenchymal stem cells (BMSC) isolated from Wistar rat.

  2. 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...

  3. Guided Bone Regeneration with Collagen Membranes and Particulate Graft Materials: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Wessing, Bastian; Lettner, Stefan; Zechner, Werner

    2017-09-22

    The aim of this meta-analysis was to evaluate different methods for guided bone regeneration using collagen membranes and particulate grafting materials in implant dentistry. An electronic database search and hand search were performed for all relevant articles dealing with guided bone regeneration in implant dentistry published between 1980 and 2014. Only randomized clinical trials and prospective controlled studies were included. The primary outcomes of interest were survival rates, membrane exposure rates, bone gain/defect reduction, and vertical bone loss at follow-up. A meta-analysis was performed to determine the effects of presence of membrane cross-linking, timing of implant placement, membrane fixation, and decortication. Twenty studies met the inclusion criteria. Implant survival rates were similar between simultaneous and subsequent implant placement. The membrane exposure rate of cross-linked membranes was approximately 30% higher than that of non-cross-linked membranes. The use of anorganic bovine bone mineral led to sufficient newly regenerated bone and high implant survival rates. Membrane fixation was weakly associated with increased vertical bone gain, and decortication led to higher horizontal bone gain (defect depth). Guided bone regeneration with particulate graft materials and resorbable collagen membranes is an effective technique for lateral alveolar ridge augmentation. Because implant survival rates for simultaneous and subsequent implant placement were similar, simultaneous implant placement is recommended when possible. Additional techniques like membrane fixation and decortication may represent beneficial implications for the practice.

  4. 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.

  5. Preclinical investigation of an innovative magnesium-based bone graft substitute for potential orthopaedic applications

    Directory of Open Access Journals (Sweden)

    Chen Liu

    2014-07-01

    Full Text Available Degradable or corrosive biometal is an attractive research and development (R&D area in clinical orthopaedics. This study was designed to investigate biomechanical and biological properties of magnesium (Mg and strontium (Sr with a focus on Mg-based metals, including pure Mg and Mg–xwt% Sr (x = 0.25, x = 1.0, x = 1.5, x = 2.5 alloys, as potential bone graft substitutes in respect to their mechanical strength, corrosion resistance, and cytocompatibility for further optimization and establishing indications for relevant in vivo applications. Our data showed that the tensile and compressive strength increased with addition of Sr because of the Mg17Sr2 precipitation strengthen. Compared with commercially used bone graft substitutes, the mechanical properties of Mg–Sr alloys were close to those of cortical bone, and the compressive strength could reach 300 MPa, suggesting its potential application for load-bearing bone as bone defect filler. The corrosion rates of Mg–xwt% Sr alloys were controlled in the range of 0.05–0.07 mm/y, indicating feasibility of bone grafting and the in situ bone repair process. Moreover, Mg–Sr alloys also exhibit good cytocompatibility and antibacterial properties. Our innovation presented in this work supported in vivo clinical indication-based assessment of biodegradable Mg-based metals that could be potential candidates for bone graft substitutes for future orthopaedic applications.

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

    Directory of Open Access Journals (Sweden)

    Aravind Buddula

    2011-01-01

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

  7. 自体牙本质片修复骨缺损的实验研究%Pilot study of autogenous tooth dentin graft to repair bone defect

    Institute of Scientific and Technical Information of China (English)

    秦旭; 石玮; 马博; 许译文; 陈卫民; 周彬

    2014-01-01

    Objective:To investigate the feasibility of autogenous dentin block to repair the bone defect. Method:Autogenous grafts from freshly extracted teeth were rigidly fixed to the mandibular defects in eighteen rabbits using titanium screws in order to achieve good primary stability. Every six rabbits were stochastically sacrificed at 1,3 and 6 months after implantation respectively. For all specimens,radiographical and histological measurements were performed. Result:The boundaries of the grafts were distinctly visible in the implanted area during the first and third month. However,the teeth grafts were fully covered by new bone after sixth month. The radiograph demonstrated the progressive change in the bone and grafted tooth interface from radiolucency to radiopacity. Histologically,vascularization led to a temporary fibrous-integration in the graft-bone interface and grafts were gradually resorbed and replaced by new bone. Conclusion:Rigid fixation of auto-genous tooth dentin could serve as a novel approach for bone regeneration and to repair of bone defect.%目的:探讨自体牙本质片修复骨缺损的临床效果。方法:选取18只2.5~3 kg新西兰兔,随机分为3组,拔取自体下切牙,制备成牙本质片,在同侧下颌骨下缘制备骨缺损,用钛钉坚固内固定牙本质片于缺损区。分别在术后1、3、6个月取材进行影像学和组织学检查。结果:术后1、3个月仍可见牙本质片与骨组织存在分界,但6个月时牙本质片完全被骨组织覆盖。放射学检查提示牙本质片与骨组织间的低密度投射影随着植入时间延长而逐渐消失,高密度影逐渐形成。组织学显示牙本质片与骨组织界面血管化,牙本质片逐渐被吸收,新骨形成。结论:坚固内固定的自体牙本质片能作为骨缺损修复材料恢复骨缺损。

  8. 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.

  9. Modification of bone graft by blending with lecithin to improve hydrophilicity and biocompatibility

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Y; Cui, F Z; Jiao, Y P; Hu, K [Biomaterials Laboratory, Department of Materials Science and Engineering, Tsinghua University, Beijing 100084 (China); Fan, D D [Department of Chemical Engineering, Northwest University, Xi' an 710069 (China)], E-mail: cuifz@mail.tsinghua.edu.cn

    2008-03-01

    Lecithin was blended to improve the hydrophilicity and biocompatibility of bone graft containing poly(l-lactic acid) (PLLA). Solution blending and freeze drying were used to fabricate symmetrical scaffolds containing different percentages of lecithin (lecithin: PLLA = 0, 5, 10 wt%). Scanning electron microscopy showed that the scaffolds maintained the three-dimensional porous structure. A water uptake experiment proved the significant improvement of hydrophilicity of the blend scaffold. With the addition of lecithin, the compressive strength and compressive modulus decreased. When the weight ratio of lecithin to PLLA was up to 10%, the compressive strength was still more than the lower limit of natural cancellous bone. To test the biocompatibility of the scaffolds, cell culture in vitro and subcutaneous implantation in vivo were performed. MC3T3-E1 preosteoblastic cells were cultured on the scaffolds for 7 days. Methylthiazol tetrazolium assay and laser scanning confocal microscopy were used to exhibit proliferation and morphology of the cells. The subcutaneous implantation in rats tested inflammatory response to the scaffolds. The results proved the better biocompatibility and milder inflammatory reactions of the blend scaffold (lecithin: PLLA = 5%) compared with the scaffold without lecithin. The modified scaffold containing lecithin is promising for bone tissue engineering.

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

    Science.gov (United States)

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

    2010-06-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  14. Does platelet-rich plasma promote remodeling of autologous bone grafts used for augmentation of the maxillary sinus floor?

    NARCIS (Netherlands)

    Raghoebar, GM; Schortinghuis, J; Liem, RSB; Ruben, JL; van der Wal, JE; Vissink, A

    2005-01-01

    The aim of this study was to evaluate the effect of platelet-rich plasma (PRP) on remodeling of autologous bone grafts used for augmentation of the floor of the maxillary sinus. In five edentulous patients suffering from insufficient retention of their upper denture related to a severely resorbed ma

  15. Orthodontic treatment results following grafting autologous mandibular bone to the alveolar cleft in patients with a complete unilateral cleft.

    NARCIS (Netherlands)

    Ruiter, A. de; Bilt, A. van der; Meijer, G.J.; Koole, R.

    2010-01-01

    OBJECTIVE: To analyze orthodontic treatment results following mandibular symphysis bone grafting and postoperative orthodontic treatment. DESIGN: Randomized selection of 75 patients out of 308 with unilateral cleft of lip, alveolus, and palate, operated upon according to protocol between 1990 and 20

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

    Institute of Scientific and Technical Information of China (English)

    WU Shui-pei

    2008-01-01

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

  17. The Effect of Locally Administered Pamidronate on Autogenous Bone Graft in Maxillofacial Reconstruction: A Randomized Clinical Trial

    Science.gov (United States)

    Bayat, M.; Garajei, A.; Afshari Pour, E.; Hasheminasab, M.; Ghorbani, Y.; Kalantar Motamedi, M. H.; Bahrami, N.

    2017-01-01

    Background: Although bone grafts are commonly used in reconstructive surgeries, they are sensitive to local perfusion and are thus prone to severe resorption. Biphosphonates can inactivate osteoclasts and can be used to control the undesirable bone resorption. Objective: To assess the effect of administration of biphosphonates on bone resorption. Methods: 20 patients with bony defects who were candidates for free autogenous grafts were randomized into “pamidronate” and “control” groups. Bone segments were soaked in either pamidronate solution or normal saline and were inserted into the area of the surgery. Bone densities were measured post-surgery and in 6-month follow-up. Data were obtained via Digora software and analyzed. Results: The mean±SD bone density in pamidronate group changed from 93.4±14.6 to 93.6±17.5 (p<0.05); in the control group the density decreased from 89.7±13.2 to 78.9±11.4 (p<0.05). The mean difference of bone density in anterior areas of the jaws showed higher DXA in comparison to posterior regions (p=0.002). Conclusion: Locally administered pamidronate affects reduction in bone resorption.

  18. Radioscapholunate arthrodesis with distal excision of the distal scaphoid pole: Intraoperative measurement of range of motion and bone graft coming from a radial cortical flap

    Directory of Open Access Journals (Sweden)

    Cindy Bouvet

    2017-08-01

    Conclusions: Radioscapholunate arthrodesis in the case of radiocarpal arthritis with the use of a bone graft coming from the distal radius demonstrated robust results in terms of pain. The perioperative benefit on mobility was not found during postoperative period. A bone graft using a cortical cover from the distal radius yielded favorable results with regards to bone healing. [Hand Microsurg 2017; 6(2.000: 62-67

  19. Supplementation of autogenous bone graft with coralline hydroxyapatite in posterior spine fusion for idiopathic adolescent scoliosis.

    Science.gov (United States)

    Mashoof, A Allen; Siddiqui, Saqib A; Otero, Marilyn; Tucci, James J

    2002-10-01

    Twenty-seven consecutive patients with adolescent idiopathic scoliosis underwent posterior spinal fusion with pediatric Texas Scottish Rite Hospital instrumentation. Coralline hydroxyapatite (Interpore, Irvine, Calif) was mixed with limited autograft from posterior iliac crest (an approximate 70/30 ratio of coralline hydroxyapatite to autograft). Patient evaluation was based on clinical and radiographic findings. On initial radiographic evaluation, a "snowstorm" appearance consistent with the exoskeleton of the coralline hydroxyapatite was observed. After two years, the fusion mass had a "marble-like" appearance with distinct decreased visibility of the disk spaces in the fusion mass. This latter stage of "marbilization correlated with solid fusion clinically. All patients achieved solid fusion at an average follow-up of 27 months. Coralline hydroxyapatite is safe, biocompatible, and effective in augmenting autogenous bone graft in the treatment of idiopathic adolescent scoliosis with posterior spinal fusion. In addition to decreased donor site morbidity, this may be invaluable in cases where there is insufficient autograft available.

  20. Combined endodontic therapy and periapical surgery with MTA and bone graft in treating palatogingival groove.

    Science.gov (United States)

    Mittal, Mudit; Vashisth, Pallavi; Arora, Rachita; Dwivedi, Swati

    2013-04-18

    A 37-year-old male patient reported to our department with chief complaint of pain and pus discharge from the labial marginal gingiva in the maxillary right lateral incisor region since last 4 months. Clinically, the tooth was hypersensitive to percussion and palpation but failed to respond to pulp sensitivity testing. After periodontal probing, a palatal groove was observed which started at the cingulum and travelled apically and laterally, associated with a pocket depth of 8 mm. Occlusal radiograph showed circumscribed radiolucency measuring 5 mm×7 mm in diameter at the apex of the tooth. A clinical diagnosis of chronic apical abscess was established. The case was treated with a combination of mineral trioxide aggregate and bone graft. At the 6-month follow-up visit, the tooth showed progressive healing without sinus track and sulcular bleeding.

  1. Graft-versus-Host Disease-Associated Vulvovaginal Symptoms after Bone Marrow Transplantation.

    Science.gov (United States)

    Chung, Christopher P; Sargent, Rachel E; Chung, Nadia T; Lacey, James V; Wakabayashi, Mark T

    2016-02-01

    We conducted a retrospective review to assess the prevalence of graft-versus-host disease (GVHD)-associated gynecologic conditions among bone marrow transplantation (BMT) patients at City of Hope Medical Center. We calculated the associations among the estimated risks of various gynecologic complications, including vaginal stenosis, by performing chi-square tests and t-test statistics. Between 2010 and 2014, 180 patients were referred to the gynecologic clinic after their BMT. One hundred twenty-four patients (69%) had GVHD; among these patients, 51 (41%) experienced dyspareunia and 43 (35%) had vaginal stenosis. GVHD patients were significantly more likely to have vaginal stenosis (P vulvovaginal symptoms, such as dyspareunia and pelvic pain. Patients with GVHD are at high risk for vaginal stenosis requiring the use of a vaginal dilator. However, they are at low risk for developing UI and POP.

  2. Non-Invasive Monitoring of Temporal and Spatial Blood Flow during Bone Graft Healing Using Diffuse Correlation Spectroscopy.

    Directory of Open Access Journals (Sweden)

    Songfeng Han

    Full Text Available Vascular infiltration and associated alterations in microvascular blood flow are critical for complete bone graft healing. Therefore, real-time, longitudinal measurement of blood flow has the potential to successfully predict graft healing outcomes. Herein, we non-invasively measure longitudinal blood flow changes in bone autografts and allografts using diffuse correlation spectroscopy in a murine femoral segmental defect model. Blood flow was measured at several positions proximal and distal to the graft site before implantation and every week post-implantation for a total of 9 weeks (autograft n = 7 and allograft n = 10. Measurements of the ipsilateral leg with the graft were compared with those of the intact contralateral control leg. Both autografts and allografts exhibited an initial increase in blood flow followed by a gradual return to baseline levels. Blood flow elevation lasted up to 2 weeks in autografts, but this duration varied from 2 to 6 weeks in allografts depending on the spatial location of the measurement. Intact contralateral control leg blood flow remained at baseline levels throughout the 9 weeks in the autograft group; however, in the allograft group, blood flow followed a similar trend to the graft leg. Blood flow difference between the graft and contralateral legs (ΔrBF, a parameter defined to estimate graft-specific changes, was elevated at 1-2 weeks for the autograft group, and at 2-4 weeks for the allograft group at the proximal and the central locations. However, distal to the graft, the allograft group exhibited significantly greater ΔrBF than the autograft group at 3 weeks post-surgery (p < 0.05. These spatial and temporal differences in blood flow supports established trends of delayed healing in allografts versus autografts.

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

    Science.gov (United States)

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

    2014-04-14

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

  4. Replacement

    Directory of Open Access Journals (Sweden)

    S. Radhakrishnan

    2014-03-01

    Full Text Available The fishmeal replaced with Spirulina platensis, Chlorella vulgaris and Azolla pinnata and the formulated diet fed to Macrobrachium rosenbergii postlarvae to assess the enhancement ability of non-enzymatic antioxidants (vitamin C and E, enzymatic antioxidants (superoxide dismutase (SOD and catalase (CAT and lipid peroxidation (LPx were analysed. In the present study, the S. platensis, C. vulgaris and A. pinnata inclusion diet fed groups had significant (P < 0.05 improvement in the levels of vitamins C and E in the hepatopancreas and muscle tissue. Among all the diets, the replacement materials in 50% incorporated feed fed groups showed better performance when compared with the control group in non-enzymatic antioxidant activity. The 50% fishmeal replacement (best performance diet fed groups taken for enzymatic antioxidant study, in SOD, CAT and LPx showed no significant increases when compared with the control group. Hence, the present results revealed that the formulated feed enhanced the vitamins C and E, the result of decreased level of enzymatic antioxidants (SOD, CAT and LPx revealed that these feeds are non-toxic and do not produce any stress to postlarvae. These ingredients can be used as an alternative protein source for sustainable Macrobrachium culture.

  5. Implant prosthetic rehabilitation with a free fibula flap and interpositional bone grafting after a mandibulectomy: a clinical report.

    Science.gov (United States)

    Garcia Blanco, M; Ostrosky, M A

    2013-06-01

    This clinical report describes the multidisciplinary treatment of a 16-year-old girl diagnosed with cemento-ossifying fibroma in the mandible. The resection of the lesion and reconstruction with a free osseous fibula flap with microvascular anastomosis was performed. Four months later, interpositional bone grafting of iliac spongy bone was used to gain bone height at the treated site. Twenty-four months later, 5 dental implants were placed. After a 6-month osseointegration period, a partial screw-retained fixed dental prosthesis was fabricated. Prosthodontic planning and treatment considerations are discussed.

  6. Effect of Low-Level Laser on Bone Defects Treated with Bovine or Autogenous Bone Grafts: In Vivo Study in Rat Calvaria

    Directory of Open Access Journals (Sweden)

    Mércia J. S. Cunha

    2014-01-01

    Full Text Available Objective. The purpose of this study was to histologically evaluate the effect of low-level laser (LLL on the healing of critical size defects (CSD in rat calvaria, filled with autogenous or inorganic bovine bone grafts. Methods. Sixty rats were divided into 6 groups (n=10: C (control—filled with blood clot, LLL (low-level laser—GaAlAs, λ 780 nm, 100 mW, 210 J/cm2, Φ 0.05 cm2; 6 J/point, AB (autogenous bone, ABL (autogenous bone + low-level laser, OB (inorganic bovine bone, and OBL (inorganic bovine bone + LLL. Material and Methods. The animals were killed after 30 days. Histological and histometric analyses were performed by light microscopy. Results. The groups irradiated with laser, LLL (47.67% ± 8.66%, ABL (39.15% ± 16.72%, and OBL (48.57% ± 28.22%, presented greater area of new bone formation than groups C (9.96% ± 4.50%, AB (30.98% ± 16.59%, and OB (11.36% ± 7.89%, which were not irradiated. Moreover, they were significantly better than group C (Kruskal-Wallis test followed by Dunn test, P<0.05. Conclusion. The laser accelerated the healing of bone defects and the resorption of particles of the graft material.

  7. The RANK/ RANKL/ OPG interaction in the repair of autogenous bone grafts in female rats with estrogen deficiency

    Directory of Open Access Journals (Sweden)

    Tábata de Mello TERA

    2014-01-01

    Full Text Available The aim of this study was to evaluate the resorption process during the repair of autogenous bone grafts with or without coverage by an expanded polytetrafluoroethylene (e-PTFE membrane in female rats with estrogen deficiency using the immunohistochemical technique. Eighty female rats were randomly divided into two groups (OVX and SHAM. The 40 female rats in the OVX group were subjected to ovariectomy, and the 40 female rats in the SHAM group were subjected to simulated ovariectomy. The two groups were further divided in subgroup E, which was subjected to surgery for placement of autogenous bone graft (ABG, and subgroup ME, in which the ABG was covered with an e-PTFE membrane. The animals were killed at 0, 7, 21, 45 and 60 days. The specimens were analyzed using immunohistochemistry for the bone resorption markers RANK, RANK-L and Osteoprotegerin (OPG. A higher remodeling rate was observed at 7 and 21 days after the autogenous bone grafts, when the markers were more intensely expressed. At the final time point, the specimens presented similar characteristics to those observed at the initial time point. The expression of immunohistochemical markers was not altered by the estrogen deficiency. The presence of the e-PTFE membrane delayed the bone resorption process, influencing the immunohistochemical expression of markers.

  8. Low-dose hydrocortisone (HC) replacement therapy is associated with improved bone remodeling balance in hypopituitary subjects

    LENUS (Irish Health Repository)

    Behan, L A

    2011-06-01

    The effect of commonly used glucocorticoid replacement regimens on bone health in hypopituitary subjects is not well known. We aimed to assess the effect of 3 hydrocortisone (HC) replacement dose regimens on bone turnover in this group.10 hypopituitary men with severe ACTH deficiency were randomised in a crossover design to 3 HC dose regimens, Dose A (20mg mane, 10mg tarde), Dose B (10mg twice daily) and Dose C (10mg mane, 5mg tarde). Following 6 weeks of each regimen participants underwent fasting sampling of bone turnover markers.Data from matched controls were used to produce a Z score for subject bone formation and resorption markers and to calculate the bone remodeling balance (formation Z score-resorption Z score) and turnover index ((formation Z + resorption Z)\\/2). A positive bone remodeling balance with increased turnover is consistent with a favourable bone cycle. Data are expressed as median (range).The Pro Collagen Type 1 Peptide (PINP) bone formation Z-score was significantly increased in Dose C, (1.805 (-0.6-10.24)) compared to Dose A (0.035 (-1.0-8.1)) p<0.05 while there was no difference in the C-terminal crosslinking telopeptide (CTx) resorption Z score. The bone remodeling balance was significantly lower for dose A -0.02 (-1.05-4.12) compared to dose C 1.13 (0.13-6.4) (p<0.05). Although there was a trend to an increased bone turnover index with the lower dose regimen, this was not statistically significant.Low dose HC replacement (10mg mane\\/5 mg tarde) was associated with increased bone formation and improved bone remodeling balance which is associated with a more favourable bone cycle. This may have a long term beneficial effect on bone health.

  9. Changes in bone mineral density of the acetabulum, femoral neck and femoral shaft, after hip resurfacing and total hip replacement

    DEFF Research Database (Denmark)

    Penny, J O; Brixen, K; Varmarken, J E;

    2012-01-01

    It is accepted that resurfacing hip replacement preserves the bone mineral density (BMD) of the femur better than total hip replacement (THR). However, no studies have investigated any possible difference on the acetabular side. Between April 2007 and March 2009, 39 patients were randomised into ...

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

    Institute of Scientific and Technical Information of China (English)

    韶青华; 陈振琦

    2013-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  12. Long circulating enzyme replacement therapy rescues bone pathology in mucopolysaccharidosis VII murine model.

    Science.gov (United States)

    Rowan, Daniel J; Tomatsu, Shunji; Grubb, Jeffrey H; Haupt, Bisong; Montaño, Adriana M; Oikawa, Hirotaka; Sosa, Angela C; Chen, Anping; Sly, William S

    2012-09-01

    Mucopolysaccharidosis (MPS) type VII is a lysosomal storage disease caused by deficiency of the lysosomal enzyme β-glucuronidase (GUS), leading to accumulation of glycosaminoglycans (GAGs). Enzyme replacement therapy (ERT) effectively clears GAG storage in the viscera. Recent studies showed that a chemically modified form of GUS (PerT-GUS), which escaped clearance by mannose 6-phosphate and mannose receptors and showed prolonged circulation, reduced CNS storage more effectively than native GUS. Clearance of storage in bone has been limited due to the avascularity of the growth plate. To evaluate the effectiveness of long-circulating PerT-GUS in reducing the skeletal pathology, we treated MPS VII mice for 12 weeks beginning at 5 weeks of age with PerT-GUS or native GUS and used micro-CT, radiographs, and quantitative histopathological analysis for assessment of bones. Micro-CT findings showed PerT-GUS treated mice had a significantly lower BMD. Histopathological analysis also showed reduced storage material and a more organized growth plate in PerT-GUS treated mice compared with native GUS treated mice. Long term treatment with PerT-GUS from birth up to 57 weeks also significantly improved bone lesions demonstrated by micro-CT, radiographs and quantitative histopathological assay. In conclusion, long-circulating PerT-GUS provides a significant impact to rescue of bone lesions and CNS involvement.

  13. Effect of testosterone replacement therapy on bone mineral density in patients with Klinefelter syndrome.

    Science.gov (United States)

    Jo, Dae Gi; Lee, Hyo Serk; Joo, Young Min; Seo, Ju Tae

    2013-11-01

    Klinefelter syndrome (KS) is related to testicular insufficiency, which causes low testosterone levels in serum. Generally, sex hormone levels and bone mineral density (BMD) are lower in patients with KS than normal. We investigated the effects of testosterone replacement on serum testosterone levels and BMD in KS patients. From December 2005 to March 2008, 18 KS patients with a 47, XXY karyotype were treated with initial intramuscular injections of long-acting testosterone undecanoate (Nebido®, 1000 mg/4 mL) at baseline and second injections after six weeks. An additional four injections were administered at intervals of 12 weeks after the second injection. BMD was measured at the lumbar spine (L2-4), the left femoral neck and Ward's triangle, using dual energy X-ray absorptiometry. Medical histories, physical examinations and prostate specific antigen, hematology and serum chemistry were conducted for each patient. In addition, total testosterone and sex hormone-binding globulin levels were measured. Following testosterone replacement, mean serum total testosterone increased significantly from baseline (0.90 vs. 4.51 ng/mL, ptestosterone rose to normal levels after replacement in all patients. The mean BMD of the lumbar spine increased significantly (0.91 vs. 0.97 g/cm², ptestosterone replacement therapy may be effective in treating BMD deficiency in men with testosterone deficiency, especially those with Klinefelter syndrome.

  14. Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation.

    Science.gov (United States)

    Giacomo, Giovanni Di; Costantini, Alberto; de Gasperis, Nicola; De Vita, Andrea; Lin, Bernard K H; Francone, Marco; Beccaglia, Mario A Rojas; Mastantuono, Marco

    2013-01-01

    One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P Latarjet procedure. Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level 4. Prospective case series, Treatment study.

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

    Directory of Open Access Journals (Sweden)

    Priyank

    2015-08-01

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

  16. Manipulating the anabolic and catabolic response in bone graft remodeling: synergism by a combination of local BMP-7 and a single systemic dosis of zoledronate.

    Science.gov (United States)

    Harding, Anna Kajsa; Aspenberg, Per; Kataoka, Masashi; Bylski, David; Tägil, Magnus

    2008-09-01

    Remodeling of a bone graft can be influenced both by anabolic substances, such as a bone morphogenic protein (BMP) and by anticatabolic substances, such as the bisphosphonates. BMPs are potent bone anabolic substances, but also boost catabolism and cause resorption. Bisphosphonates inhibit osteoclast function and can be used to postpone resorption. In the present study a combination of both drugs was explored in a rat bone chamber model. Cancellous bone grafts were treated with either BMP-7 or saline and placed in a bone chamber implanted in the proximal tibia. After 2 weeks, an injection of either zoledronate 0.1 mg/kg or saline was given subcutaneously. The rats were killed after 6 weeks, and bone ingrowth distance into the graft and graft resorption were measured by histomorphometry. BMP-7 significantly (p = 0.007) increased new bone ingrowth distance into the graft from 2.0 mm (SD = 0.98 mm) in the controls to 3.1 mm (SD = 0.93 mm). If bisphosphonate was not given, most of the newly formed and old graft bone was resorbed. A single injection of zoledronate significantly (p < 0.001) increased the trabecular volume/total volume to 40% (SD = 9%) compared to 14% (SD = 10%) in the nonbisphosphonate treated. In total, the net amount of bone increased by 400% when BMP-7 and zoledronate combined was compared to saline. A bone graft can be treated with BMP-7 to increase new bone formation and at the same time be protected against premature catabolism by a single dose of a bisphosphonate. This combination might be useful in various conditions in orthopedic reconstruction. (c) 2008 Orthopaedic Research Society

  17. Impaction grafting with morsellised allograft and tricalcium phosphate-hydroxyapatite: incorporation within ovine metaphyseal bone defects.

    Science.gov (United States)

    Pratt, J N J; Griffon, D J; Dunlop, D G; Smith, N; Howie, C R

    2002-08-01

    An ovine model was used to investigate the in vivo properties of impacted tricalcium phosphate-hydroxyapatite (TCP-HA) aggregates, varying in chemical composition (ratio of TCP to HA) and particle size distribution (8 versus 3 particle size ranges). All pellets were impacted to a standard compactive effort. Eight sheep underwent implantation of pellets in 4 metaphyseal defects in both rear limbs. Treatment groups consisted of: (1) allograft (clinical control). (2) 50/50 allograft/80% HA/20% TCP in 8 particle size ranges, (3) 50/50 allograft/80% TCP/20% HA in 8 sizes and (4) 50/50 allograft/80% HA/20% TCP in only 3 sizes of particles. Healing of defects was evaluated at 14 weeks with computed tomography, histology and histomorphometry. The computer tomography (CT) density measured in all defects containing synthetic agents was higher than in defects filled with allograft alone (p<0.01). Defects containing 8 sizes of 80% HA/ 20% TCP granules (group 2) achieved lower histological scores and contained less bone than the clinical control (p<0.05), whereas groups 3 and 4 did not differ from the control. Although all synthetic agents were osteoconductive, our results suggest that increasing the ratio of TCP over HA and limiting the number of particle size ranges to 3 instead of 8 improve the performance of impacted aggregates as graft expanders. Evaluation under loading conditions of morsellised allograft expanded with 80% TCP/20% HA (BoneSave) in 3 particle size ranges is warranted.

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

    Science.gov (United States)

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

    2016-04-01

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

  19. Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation

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    Giovanni Di Giacomo

    2013-01-01

    Full Text Available Aims: One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. Materials and Methods: A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. Results: The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P < 0.01. Discussion: To our knowledge, there are no studies in literature that show the causes of coracoid bone graft osteolysis after Latarjet procedure. Conclusion: Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level of Evidence: Level 4. Clinical Relevance: Prospective case series, Treatment study.

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

    NARCIS (Netherlands)

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

    2002-01-01

    In revision surgery of the acetabulum bone defects can be filled with impacted human morsellized bone grafts. Because of a worldwide limited availability of human bone, alternatives are being considered. In this study we compared the initial stability of acetabular cups after reconstructing a cavita

  1. Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion

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    Kleiner JB

    2016-05-01

    Full Text Available Jeffrey B Kleiner, Hannah M Kleiner, E John Grimberg Jr, Stefanie J Throlson The Spine Center of Innovation, The Medical Center of Aurora, Aurora, CO, USA Study design: Disk material removed (DMR during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF surgery was compared to the corresponding bone graft (BG volumes inserted at the time of fusion. A novel BG delivery tool (BGDT was used to apply the BG. In order to establish the percentage of DMR during T-LIF, it was compared to DMR during anterior diskectomy (AD. This study was performed prospectively. Summary of background data: Minimal information is available as to the volume of DMR during a T-LIF procedure, and the relationship between DMR and BG delivered is unknown. BG insertion has been empiric and technically challenging. Since the volume of BG applied to the prepared disk space likely impacts the probability of arthrodesis, an investigation is justified. Methods: A total of 65 patients with pathology at L4-5 and/or L5-S1 necessitating fusion were treated with a minimally invasive T-LIF procedure. DMR was volumetrically measured during disk space preparation. BG material consisting of local autograft, BG extender, and bone marrow aspirate were mixed to form a slurry. BG slurry was injected into the disk space using a novel BGDT and measured volumetrically. An additional 29 patients who were treated with L5-S1 AD were compared to L5-S1 T-LIF DMR to determine the percent of T-LIF DMR relative to AD. Results: DMR volumes averaged 3.6±2.2 mL. This represented 34% of the disk space relative to AD. The amount of BG delivered to the disk spaces was 9.3±3.2 mL, which is 2.6±2.2 times the amount of DMR. The BGDT allowed uncomplicated filling of the disk space in <1 minute. Conclusion: The volume of DMR during T-LIF allows for a predictable volume of BG delivery. The BGDT allowed complete filling of the entire prepared disk space. The T-LIF diskectomy debrides 34% of the disk

  2. Clinical comparison of guided tissue regeneration, with collagen membrane and bone graft, versus connective tissue graft in the treatment of gingival recessions

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    Haghighati F

    2006-06-01

    Full Text Available Background and Aim: Increasing patient demands for esthetic, put the root coverage procedures in particular attention. Periodontal regeneration with GTR based root coverage methods is the most common treatment used. The purpose of this study was to compare guided tissue regeneration (GTR with collagen membrane and a bone graft, with sub-epithelial connective tissue graft (SCTG, in treatment of gingival recession. Materials and Methods: In this randomized clinical trial study, eleven healthy patients with no systemic diseases who had miller’s class I or II recession defects (gingival recession  2mm were treated with SCTG or GTR using a collagen membrane and a bone graft. Clinical measurements were obtained at baseline and 6 months after surgery. These clinical measurements included recession depth (RD, recession width (RW, probing depth (PD, and clinical attachment level (CAL. Data were analyzed using independent t test with p<0.05 as the limit of significance. Results: Both treatment methods resulted in a statistically significant reduction of recession depth (SCTG=2.3mm, GTR=2.1mm; P<0.0001. CAL gain after 6 months was also improved in both groups (SCG= 2.5mm, GTR=2.1mm, compared to baseline (P<0.0001. No statistical differences were observed in RD, RW, CAL between test and control groups. Root coverage was similar in both methods (SCTG= 74.2%, GTR= 62.6%, P=0.87. Conclusion: Based on the results of this study, the two techniques are clinically comparable. Therefore the use of collagen membrane and a bovine derived xenograft may alleviate the need for connective tissue graft.

  3. Proximal Tibia Chondroblastoma Treated With Curettage and Bone Graft and Cement Use.

    Science.gov (United States)

    Cho, Hwan Seong; Park, Yeong Kyoon; Oh, Joo Han; Lee, Jung Hyun; Han, Ilkyu; Kim, Han-Soo

    2016-01-01

    Chondroblastoma has a predilection for the epiphyses or apophyses of long tubular bones. Management of lesions in the proximal tibia is challenging because it is difficult to gain access to intraepiphyseal lesions for completion of curettage. From October 2007 to December 2011, 9 patients with de novo chondroblastoma of the proximal tibia underwent surgery at the authors' institution. All patients initially presented with pain, and 5 patients had limitation of range of motion of the ipsilateral knee. Four lesions abutted the tibial attachment sites of the cruciate ligaments. Surgical procedures included intralesional tumor curettage, additional burring, and packing of the defect with bone graft and/or bone cement. The extra-articular approach was used according to tumor location. The medial or lateral parapatellar approach was used when the tumor was located in the anterior two-thirds of the horizontal plane. When a lesion was located in the posterior third, the posteromedial or posterolateral approach was used as the lesion was cornered. Mean duration of follow-up was 47.2 months (range, 27-80 months). No local recurrence or pulmonary metastasis was noted at latest follow-up. Mean functional score was 29.3 points (range, 28-30 points). All patients fully recovered range of motion in the affected knee. No avulsion fracture or anteroposterior instability of the knee joint was detected. Results of the current study suggest that intralesion curettage followed by additional burring with an extra-articular approach is a successful treatment option for chondroblastoma of the proximal tibia.

  4. Bone graft options for spinal fusion following resection of spinal column tumors: systematic review and meta-analysis.

    Science.gov (United States)

    Elder, Benjamin D; Ishida, Wataru; Goodwin, C Rory; Bydon, Ali; Gokaslan, Ziya L; Sciubba, Daniel M; Wolinsky, Jean-Paul; Witham, Timothy F

    2017-01-01

    OBJECTIVE With the advent of new adjunctive therapy, the overall survival of patients harboring spinal column tumors has improved. However, there is limited knowledge regarding the optimal bone graft options following resection of spinal column tumors, due to their relative rarity and because fusion outcomes in this cohort are affected by various factors, such as radiation therapy (RT) and chemotherapy. Furthermore, bone graft options are often limited following tumor resection because the use of local bone grafts and bone morphogenetic proteins (BMPs) are usually avoided in light of microscopic infiltration of tumors into local bone and potential carcinogenicity of BMP. The objective of this study was to review and meta-analyze the relevant clinical literature to provide further clinical insight regarding bone graft options. METHODS A web-based MEDLINE search was conducted in accordance with preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines, which yielded 27 articles with 383 patients. Information on baseline characteristics, tumor histology, adjunctive treatments, reconstruction methods, bone graft options, fusion rates, and time to fusion were collected. Pooled fusion rates (PFRs) and I(2) values were calculated in meta-analysis. Meta-regression analyses were also performed if each variable appeared to affect fusion outcomes. Furthermore, data on 272 individual patients were available, which were additionally reviewed and statistically analyzed. RESULTS Overall, fusion rates varied widely from 36.0% to 100.0% due to both inter- and intrastudy heterogeneity, with a PFR of 85.7% (I(2) = 36.4). The studies in which cages were filled with morselized iliac crest autogenic bone graft (ICABG) and/or other bone graft options were used for anterior fusion showed a significantly higher PFR of 92.8, compared with the other studies (83.3%, p = 0.04). In per-patient analysis, anterior plus posterior fusion resulted in a higher fusion rate

  5. Safety of recombinant human platelet-derived growth factor-BB in Augment® Bone Graft

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    Luis A Solchaga

    2012-12-01

    Full Text Available This article discusses nonclinical and clinical data regarding the safety of recombinant human platelet-derived growth factor-BB as a component of the Augment® Bone Graft (Augment. Augment is a bone graft substitute intended to be used as an alternative to autologous bone graft in the fusion of hindfoot and ankle joints. Nonclinical studies included assessment of the pharmacokinetic profile of intravenously administered recombinant human platelet-derived growth factor-BB in rat and dog, effects of intravenous administration of recombinant human platelet-derived growth factor-BB in a reproductive and development toxicity study in rats, and chronic toxicity and carcinogenicity of Augment in a 12-month implantation model. These studies showed that systemic exposure was brief and clearance was rapid. No signs of toxicity, carcinogenicity, or tumor promotion were observed even with doses far exceeding the maximum clinical dose. Results of clinical trials (605 participants and commercial use of recombinant human platelet-derived growth factor-BB containing products indicate that these products are not associated with increased incidence of adverse events or cancer. The safety data presented provide evidence that recombinant human platelet-derived growth factor-BB is a safe therapeutic when used in combination products as a single administration during surgical procedures for bone repair and fusion. There is no evidence associating use of recombinant human platelet-derived growth factor-BB in Augment with chronic toxicity, carcinogenicity, or tumor promotion.

  6. Chemical Preparation of Beta Calcium Sulfate Hemihydrate Granules with a Special Particle Size as Bone Graft Material

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    Naser Sargolzaie

    2014-09-01

    Full Text Available Introduction: Beta calcium sulfate hemihydrate (BCSH, which is commonly known as “Gypsum plaster” has long been used as bone graft material because of its excellent biocompatibility and the ability for bone regeneration. Several methods have been used for the preparation of BCSH, including heat treatment of calcium sulfate dihydrate with water, application of inorganic acids or condensed inorganic salt solutions under high or atmospheric pressure. As a bone graft, it is preferred that the BCSH powder has a granular form for the purpose of manipulation, bio-mechanical properties and ease of injection. Methods: For this study granules of BCSH in the size of 500 to 700 micrometers were manufactured and sterilized using gamma ray. For assessing the regeneration of thismaterial, six rabbits were selected and granules were injected in the bone defects that were made using diamond bur in their skull under general anesthesia. Biopsies for histological evaluations were done 3, 6, 9, 12, 14 and 16 months following surgery. Results: At the third month time-point, remodeling of the BCSH was evident, and complete newly formed bone was seen in the region of the defect. Conclusion: The results of this study demonstrated that BCSH had a good biocompatibility without inducing an inflammatory response and promoted bone healing.

  7. Methodological approach for the evaluation of homologous bone graft use in post-extractive atrophic alveolar ridges

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    B. Musante

    2013-01-01

    Full Text Available The aim of this study is to investigate the in vivo efficacy of Puros® cancellous particulate allograft bone in the regeneration of post-extractive sites. Twelve molar or premolar sites were selected. Seven days after minimally invasive tooth extraction, Puros® cancellous particulate allografts were inserted into the elected sites. TC Cone-Beam investigation and at 4 months from surgery; bone height and width were evaluated. Five months after surgery, biopsy samples of the regenerated sites were taken and histologically analyzed to qualitatively evaluate bone regeneration. TC analysis showed, a mean bone gain of 4.1 mm in height and 2.02 mm in width. The histological analysis of the samples showed intense bone metabolic activity with active osteoblasts on the implant surface, at the level of the native bone-graft interface and in the grafted area. The radiographic and histological analyses demonstrate an optimal bonen regeneration, both in terms of quality and quantity using Puros®.

  8. Graft-versus-leukemia effects from donor lymphocyte infusion after nonmyeloablative allogeneic bone marrow transplantation in mice

    Institute of Scientific and Technical Information of China (English)

    DU Bing; LI De-peng; XU Kai-lin; PAN Xiu-ying

    2005-01-01

    Background Nonmyeloablative allogeneic bone marrow transplantation has been used since the 1990s as a new hematological stem cell transplantation strategy for treating hematological diseases. The purpose of this study was to explore the graft-versus-leukemia (GVL) effects of donor lymphocyte infusions (DLIs) after nonmyeloablative allogeneic bone marrow transplantations, while assessing the declines in treatment-associated morbidity, mortality, and graft-versus-host disease (GVHD).Methods A total of 615 (H-2k) mice were injected with L615 tumor cells and received 500 cGy (60Coγ-ray) irradiation three days later, followed by an allogeneic bone marrow transplantation (allo-BMT). The allo-grafts consisted of 3×107 bone marrow cells and 1×107 spleen cells from BALB/C (H-2d) donor mice. Two days after the allo-BMT, the recipient mice were given 200 mg/kg of cyclophosphamide. Subsequently, recipient mice were infused with either donor spleen cells (2×107) on day 14 or 21, or donor spleen cells (5×107) pretreated with hydrocortisone and cyclosporin A (CsA) in vitro on day 14 post-BMT.Results The median survival time of mice that received DLI on day 21 and pretreated DLI on day 14 post-BMT was longer than that of controls and the day 14 DLI group (P<0.01). No evidence of severe GVHD was observed in the day 21 DLI group nor in the day 14 treated DLI group. Mixed chimerism was confirmed in the day 14 DLI group, the day 14 treated DLI group, and the day 21 DLI group on the thirteenth day post-transplantation; full donor chimerism was observed two weeks after DLI.Conclusion Donor lymphocyte infusion after nonmyeloablative bone marrow transplantation may reduce transplantation-associated morbidity and mortality while strengthening graft-versus-leukemia effects.

  9. Morphology of autogenous bone graft and castor oil polyurethane in the infraorbital rim of rabbits: a comparative study

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    Mendonça José Carlos Garcia de

    2006-01-01

    Full Text Available PURPOSE: Morphological study comparing castor oil polyurethane and autogenous bone graft to repair bone defect in zygomatic bone of rabbits. METHODS: Twenty-four adult, male New Zealand rabbits were randomly distributed between two groups of twelve. Bone defects of 5mm in diameter were cut through the zygomatic bone and filled with polyurethane discs in the experimental group or autogenous bone harvested from the tibia in the control group. Animals were sacrificed after 30, 60 or 90 days, and the zygomatic bones were macro- and microscopically analyzed. Student's, Fisher's, chi-squared and McNemar's tests were used for statistical analysis. RESULTS: Both the castor oil polyurethane and the autograft adapted well to the defect, with no need for fixation. Fibrous connective tissue encapsulated the polyurethane, but no inflammation or giant cell reaction was observed. Acidophilic and basophilic areas were observed inside the micropores of the polyurethane, suggesting cell nuclei. After 90 days, bone repair with a lamellar pattern of organization was observed in the control group. CONCLUSION: The castor oil polyurethane was biocompatible and did not cause inflammation. It may be considered an alternative to fill bone defects.

  10. Acellular allogeneic nerve grafting combined with bone marrow mesenchymal stem cell transplantation for the repair of long-segment sciatic nerve defects: biomechanics and validation of mathematical models

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    Ya-jun Li

    2016-01-01

    Full Text Available We hypothesized that a chemically extracted acellular allogeneic nerve graft used in combination with bone marrow mesenchymal stem cell transplantation would be an effective treatment for long-segment sciatic nerve defects. To test this, we established rabbit models of 30 mm sciatic nerve defects, and treated them using either an autograft or a chemically decellularized allogeneic nerve graft with or without simultaneous transplantation of bone marrow mesenchymal stem cells. We compared the tensile properties, electrophysiological function and morphology of the damaged nerve in each group. Sciatic nerves repaired by the allogeneic nerve graft combined with stem cell transplantation showed better recovery than those repaired by the acellular allogeneic nerve graft alone, and produced similar results to those observed with the autograft. These findings confirm that a chemically extracted acellular allogeneic nerve graft combined with transplantation of bone marrow mesenchymal stem cells is an effective method of repairing long-segment sciatic nerve defects.

  11. A Distinct Subpopulation of Bone Marrow Mesenchymal Stem Cells, Muse Cells, Directly Commit to the Replacement of Liver Components.

    Science.gov (United States)

    Katagiri, H; Kushida, Y; Nojima, M; Kuroda, Y; Wakao, S; Ishida, K; Endo, F; Kume, K; Takahara, T; Nitta, H; Tsuda, H; Dezawa, M; Nishizuka, S S

    2016-02-01

    Genotyping graft livers by short tandem repeats after human living-donor liver transplantation (n = 20) revealed the presence of recipient or chimeric genotype cases in hepatocytes (6 of 17, 35.3%), sinusoidal cells (18 of 18, 100%), cholangiocytes (15 of 17, 88.2%) and cells in the periportal areas (7 of 8, 87.5%), suggesting extrahepatic cell involvement in liver regeneration. Regarding extrahepatic origin, bone marrow mesenchymal stem cells (BM-MSCs) have been suggested to contribute to liver regeneration but compose a heterogeneous population. We focused on a more specific subpopulation (1-2% of BM-MSCs), called multilineage-differentiating stress-enduring (Muse) cells, for their ability to differentiate into liver-lineage cells and repair tissue. We generated a physical partial hepatectomy model in immunodeficient mice and injected green fluorescent protein (GFP)-labeled human BM-MSC Muse cells intravenously (n = 20). Immunohistochemistry, fluorescence in situ hybridization and species-specific polymerase chain reaction revealed that they integrated into regenerating areas and expressed liver progenitor markers during the early phase and then differentiated spontaneously into major liver components, including hepatocytes (≈74.3% of GFP-positive integrated Muse cells), cholangiocytes (≈17.7%), sinusoidal endothelial cells (≈2.0%), and Kupffer cells (≈6.0%). In contrast, the remaining cells in the BM-MSCs were not detected in the liver for up to 4 weeks. These results suggest that Muse cells are the predominant population of BM-MSCs that are capable of replacing major liver components during liver regeneration.

  12. Histomorhological and clinical evaluation of maxillary alveolar ridge reconstruction after craniofacial trauma by applying combination of allogeneic and autogenous bone graft.

    Science.gov (United States)

    De Ponte, Francesco Saverio; Falzea, Roberto; Runci, Michele; Siniscalchi, Enrico Nastro; Lauritano, Floriana; Bramanti, Ennio; Cervino, Gabriele; Cicciu, Marco

    2017-02-01

    A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is considered ideal by many researchers and it still remains the most predictable and documented method. The aim of this report is to underline the effectiveness of using allogeneic bone graft for managing maxillofacial trauma. A case of a 30-year-old male with severely atrophic maxillary ridge as a consequence of complex craniofacial injury is presented here. Augmentation procedure in two stages was performed using allogeneic and autogenous bone grafts in different areas of the osseous defect. Four months after grafting, during the implants placement surgery, samples of both sectors were withdrawn and submitted to histological evaluation. On the examination of the specimens, treated by hematoxylin and eosin staining, the morphology of integrated allogeneic bone grafts was revealed to be similar to the autologous bone. Our clinical experience shows how the allogeneic bone graft presented normal bone tissue architecture and is highly vascularized, and it can be used for reconstruction of severe trauma of the maxilla.

  13. Histomorhological and clinical evaluation of maxillary alveolar ridge reconstruction after craniofacial trauma by applying combination of allogeneic and autogenous bone graft

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    Francesco Saverio De Ponte

    2017-02-01

    Full Text Available A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is considered ideal by many researchers and it still remains the most predictable and documented method. The aim of this report is to underline the effectiveness of using allogeneic bone graft for managing maxillofacial trauma. A case of a 30-year-old male with severely atrophic maxillary ridge as a consequence of complex craniofacial injury is presented here. Augmentation procedure in two stages was performed using allogeneic and autogenous bone grafts in different areas of the osseous defect. Four months after grafting, during the implants placement surgery, samples of both sectors were withdrawn and submitted to histological evaluation. On the examination of the specimens, treated by hematoxylin and eosin staining, the morphology of integrated allogeneic bone grafts was revealed to be similar to the autologous bone. Our clinical experience shows how the allogeneic bone graft presented normal bone tissue architecture and is highly vascularized, and it can be used for reconstruction of severe trauma of the maxilla.

  14. Application of modern computer-aided technologies in the production of individual bone graft: A case report

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    Mirković Siniša

    2015-01-01

    Full Text Available Introduction. An autologous bone (bone derived from the patient himself is considered to be a “golden standard” in the treatment of bone defects and partial atrophic alveolar ridge. However, large defects and bone losses are difficult to restore in this manner, because extraction of large amounts of autologous tissue can cause donor-site problems. Alternatively, data from computed tomographic (CT scan can be used to shape a precise 3D homologous bone block using a computer-aided design-computer-aided manufacturing (CAD-CAM system. Case report. A 63-year old male patient referred to the Clinic of Dentistry of Vojvodina in Novi Sad, because of teeth loss in the right lateral region of the lower jaw. Clinical examination revealed a pronounced resorption of the residual ridge of the lower jaw in the aforementioned region, both horizontal and vertical. After clinical examination, the patient was referred for 3D cone beam (CBCT scan that enables visualization of bony structures and accurate measurement of dimensions of the residual alveolar ridge. Considering the large extent of bone resorption, the required ridge augmentation was more than 3 mm in height and 2 mm in width along the length of some 2 cm, thus the use of granular material was excluded. After consulting prosthodontists and engineers from the Faculty of Technical Sciences in Novi Sad we decided to fabricate an individual (custom bovine-derived bone graft designed according to the obtained 3D CBCT scan. Conclusion. Application of 3D CBCT images, computer-aided systems and software in manufacturing custom bone grafts represents the most recent method of guided bone regeneration. This method substantially reduces time of recovery and carries minimum risk of postoperative complications, yet the results fully satisfy the requirements of both the patient and the therapist.

  15. Application of modern computer-aided technologies in the production of individual bone graft: A case report.

    Science.gov (United States)

    Mirković, Sinisa; Budak, Igor; Puskar, Tatjana; Tadić, Ana; Sokac, Mario; Santosi, Zeljko; Djurdjević-Mirković, Tatjana

    2015-12-01

    An autologous bone (bone derived from the patient himself) is considered to be a "golden standard" in the treatment of bone defects and partial atrophic alveolar ridge. However, large defects and bone losses are difficult to restore in this manner, because extraction of large amounts of autologous tissue can cause donor-site problems. Alternatively, data from computed tomographic (CT) scan can be used to shape a precise 3D homologous bone block using a computer-aided design-computer-aided manufacturing (CAD-CAM) system. A 63-year old male patient referred to the Clinic of Dentistry of Vojvodina in Novi Sad, because of teeth loss in the right lateral region of the lower jaw. Clinical examination revealed a pronounced resorption of the residual ridge of the lower jaw in the aforementioned region, both horizontal and vertical. After clinical examination, the patient was referred for 3D cone beam (CB)CT scan that enables visualization of bony structures and accurate measurement of dimensions of the residual alveolar ridge. Considering the large extent of bone resorption, the required ridge augmentation was more than 3 mm in height and 2 mm in width along the length of some 2 cm, thus the use of granular material was excluded. After consulting prosthodontists and engineers from the Faculty of Technical Sciences in Novi Sad we decided to fabricate an individual (custom) bovine-derived bone graft designed according to the obtained-3D CBCT scan. Application of 3D CBCT images, computer-aided systems and software in manufacturing custom bone grafts represents the most recent method of guided bone regeneration. This method substantially reduces time of recovery and carries minimum risk of postoperative complications, yet the results fully satisfy the requirements of both the patient and the therapist.

  16. Use of a graft of demineralized bone matrix along with TGF-β1 leads to an early bone repair in dogs.

    Science.gov (United States)

    Servin-Trujillo, Miguel Angel; Reyes-Esparza, Jorge Alberto; Garrido-Fariña, German; Flores-Gazca, Enrique; Osuna-Martinez, Ulises; Rodriguez-Fragoso, Lourdes

    2011-09-01

    Tibia fractures are common in small animal practice. Over the past decade, improvements to animal internal fracture fixation have been developed. TGF-β1 has been shown to be crucial in the development, induction and repair of bone. In present study, we investigate the effect of local application of a graft demineralized bone matrix (DBM) along with TGF-β1 in a model of open osteotomy induced experimentally in dogs. Tibia fracture was brought about by using an open osteotomy model in young male dogs. Fracture repair was evaluated by a histological and biochemical analysis. Collagen content, proteolytic activity and urokinase-type plasminogen activator (uPA) expression were analyzed at the end of the study. Radiographic analysis, alkaline phosphatase and hematological evaluation were performed weekly. At the fifth week, there was an improvement and restoration of bone architecture in animals treated with a graft containing TGF-β1 (5 ng/ml) compared with the control and graft groups, as was evidenced by the presence of an early formation of wide callus and bone regeneration. In addition, local application of TGF-β1 led to an increase in collagen and proteolytic activity. More immunopositive osteoclast and mesenchymal cells were found in bone tissue from animals treated with TGF-β1 as compared with the control group. No changes in alkaline phosphatase, hematological and clinical parameters were observed. This study shows that the combined use of DBM along with TGF-β1 is able to improve and accelerate the bone repair.

  17. Platelet-rich plasma-induced bone marrow mesenchymal stem cells versus autologous nerve grafting for sciatic nerve repair

    Institute of Scientific and Technical Information of China (English)

    Changsuo Xia; Yajuan Li; Wen Cao; Zhaohua Yu

    2010-01-01

    Autologous nerve grafting is the gold standard of peripheral nerve repair.We previously showed that autologous platelet-rich plasma(PRP)contains high concentrations of growth factors and can induce in vitro cultured bone marrow mesenchymal stem cells(BMSCs)to differentiate into Schwann cells.Here we used PRP-induced BMSCs combined with chemically extracted acellular nerves to repair sciatic nerve defects and compared the effect with autologous nerve grafting.The BMSCs and chemically extracted acellular nerve promoted target muscle wet weight restoration,motor nerve conduction velocity,and axonal and myelin sheath regeneration,with similar effectiveness to autologous nerve grafting.This finding suggests that PRP induced BMSCs can be used to repair peripheral nerve defects.

  18. The safety and efficacy of combined autologous concentrated bone marrow grafting and low-intensity pulsed ultrasound in the treatment of osteonecrosis of the femoral head.

    Science.gov (United States)

    Mishima, Hajime; Sugaya, Hisashi; Yoshioka, Tomokazu; Aoto, Katsuya; Wada, Hiroshi; Akaogi, Hiroshi; Ochiai, Naoyuki

    2016-04-01

    Osteonecrosis of the femoral head (ONFH) is commonly treated with total hip arthroplasty; however, the disadvantages of this form of treatment, especially in young patients, include the need for revision arthroplasty. Here we describe a novel, combined approach to the treatment of ONFH based on autologous concentrated bone marrow grafting and low-intensity pulsed ultrasound (LIPUS). The 7 male and 7 female patients (mean age: 40 years; 22 hips) underwent autologous concentrated bone marrow grafting followed by 6 months of continuous LIPUS. The mean follow-up period was 26 months. We evaluated site-specific bacterial infection of the grafted bone marrow concentrate microbiologically and site-specific cancer by magnetic resonance imaging 24 months after grafting. All patients were assessed using the visual analogue scale (VAS) for pain and the Japanese Orthopedic Association (JOA) hip score. Clinical and plain radiographic evaluations were performed before grafting and at the most recent follow-up. Computed tomography (CT) scans were obtained before and 12 months after grafting. None of the grafted bone marrow concentrates were infected, and none of the patients developed a tumor at the treatment site. The VAS and JOA scores improved in all patients. Collapse progressed in 8 of the 22 hips, but none required total hip arthroplasty. The mean volume of new bone formation 12 months post-grafting as seen on CT was 1256 mm(3). New bone formation was observed in all patients. Our study demonstrates the safety and efficacy of autologous concentrated bone marrow grafting and LIPUS as a joint-preserving procedure for patients with ONFH.

  19. STUDY OF AN ASSESSMENT OF THE FATE OF CALCIUM HYDROXY APATITE BLOCK WITH CORTICO CANCELLOUS BONE GRAFT USED IN COMMUNITED FRACTURES OF LONG BONE OF LOWER LIMB

    Directory of Open Access Journals (Sweden)

    Ahmad

    2015-03-01

    Full Text Available INTRODUCTION: In recent years there has been an increasing interest in biologically active calcium phosphate ceramic materials for orthopaedic application. A number of materials from human, animal or non - biological sources have been used to fill defects with or without additional autogenus bone. It would be ideal to have bone substitute w hich is easily fabricated and preserved, is biocompatible with bone, and is biodegradable. The calcium phosphate system, and in particular hydroxyappatite (HA, has long been the subject of intensive investigation. MATERIAL AND METHODS: This observational two year study was undertaken at S.N. Medical College and Hospital, Agra (U.P.. The patients having the comminuted fracture of the long bone of lower limbs were treated with autogenus bone graft and calcium hydroxy Apatite bone block. Functional results w ere presented according to Klemm and Borner (1986 criteria. RESULTS: The total cases studied were 25 out of which 21 cases had fracture of both bones of leg and 4 were of fracture femur. The patients were aged between 15 to 70 years. Most of the patients were males and the common mode of injury was road traffic accident. An excellent result were seen in the majority 9(36% of patients while 8(32% patients showed a good result and 6(24% showed a fair result. 17(68% patients had compound fracture while 8( 32% patients were having closed fracture. CONCLUSION: Calcium Hydroxy Apatite is a suitable alternative to bone graft. There was no evidence of any foreign body reaction and infection at the Calcium Hydroxy Apatite implanted site. There was satisfactory h ealing of all the comminuted fractures. The movement of adjacent joints was nearly normal. No refracture was observed on follow up.

  20. Clinical observation of particulate cancellous bone impaction grafting in combination with total hip arthroplasty for acetabular reconstruction

    Institute of Scientific and Technical Information of China (English)

    LIU Xian-zhe; YANG Shu-hua; XU Wei-hua; LIU Guo-hui; YANG Cao; LI Jin; YE Zhe-wei; LIU Yong; ZHANG Yu-kun

    2008-01-01

    Objective: To investigate the effect of particulate cancellous bone impaction grafting in combination with total hip arthroplasty (THA) for acetabular reconstruction in patients with posttraumatic arthritis and bone loss afteracetabular fractures.Methods: Totally 15 consecutive cases with unilateral acetabular fracture were treated with bone impaction grafting in combination with THA in our department.There were 10 males and 5 females with mean age of 48.2 years (ranging from 36 to 73 years).Eight cases had the fracture at left hips,7 at right hips.The average age at injury was 28 years (ranging from 18 to 68 years).The mean follow-up period was 4.3 years (ranging from 2 to 7 years).Results: Compared with mean 42 points (ranging from 10 to 62) of the preoperative Harris score,the survival cases at the final follow-up had mean 84 points (ranging from 58 to 98).One patient had mild pain in the hip.No revision of the acetabular or femoral component was undertaken during the follow-up.Normal rotational centre of most hips was recovered except 2 cases in which it was 0.8 mm higher than that in opposite side.All of them had a stable radiographic appearance.Progressive radiolucent fines were observed in I,III zones in 2 cases.One patient had a nonprogressive radiolucent fine in zone III.The cup prosthesis was obviously displaced (6 mm) in one patient,but had not been revised.Conclusion: Particulate cancellous bone impaction grafting in combination with THA as a biological solution is an attractive procedure for acetabular reconstruction in patients with posttraumatic arthritis and bone loss after acetabular fracture,which can not only restore acetabular bone stock but also repair normal hip anatomy and its function.

  1. The effect of polystyrene sodium sulfonate grafting on polyethylene terephthalate artificial ligaments on in vitro mineralisation and in vivo bone tissue integration

    Science.gov (United States)

    Vaquette, Cédryck; Viateau, Véronique; Guérard, Sandra; Anagnostou, Fani; Manassero, Mathieu; Castner, David G.; Migonney, Véronique

    2013-01-01

    This study investigates the impact of polystyrene sodium sulfonate (PolyNaSS) grafting onto the osseointegration of a polyethylene terephthalate artificial ligament (Ligament Advanced Reinforcement System, LARS™) used for Anterior Cruciate Ligament (ACL). The performance of grafted and non-grafted ligaments was assessed in vitro by culturing human osteoblasts under osteogenic induction and this demonstrated that the surface modification was capable of up-regulating the secretion of ALP and induced higher level of mineralisation as measured 6 weeks post-seeding by Micro-Computed Tomography. Grafted and non-grafted LARS™ were subsequently implanted in an ovine model for ACL reconstruction and the ligament-to-bone interface was evaluated by histology and biomechanical testing 3 and 12 months post-implantation. The grafted ligaments exhibited more frequent direct ligament-to-bone contact and bone formation in the core of the ligament at the later time point than the nongrafted specimens, the grafting also significantly reduced the fibrous encapsulation of the ligament 12 months post-implantation. However, this improved osseo-integration was not translated into a significant increase in the biomechanical pull-out loads. These results provide evidences that PolyNaSS grafting improved the osseo-integration of the artificial ligament within the bone tunnels. This might positively influence the outcome of the surgical reconstructions, as higher ligament stability is believed to limit micro-movement and therefore permits earlier and enhanced healing. PMID:23790438

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

    Directory of Open Access Journals (Sweden)

    Anshul Jain

    2016-01-01

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

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

    Science.gov (United States)

    Jain, Anshul; Baliga, Shridhar

    2015-07-01

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

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

    Science.gov (United States)

    Baliga, Shridhar

    2015-01-01

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

  5. Enzyme replacement therapy in newborn mucopolysaccharidosis IVA mice: early treatment rescues bone lesions?

    Science.gov (United States)

    Tomatsu, Shunji; Montaño, Adriana M; Oikawa, Hirotaka; Dung, Vu Chi; Hashimoto, Amiko; Oguma, Toshihiro; Gutiérrez, Monica L; Takahashi, Tatsuo; Shimada, Tsutomu; Orii, Tadao; Sly, William S

    2015-02-01

    We treated mucopolysaccharidosis IVA (MPS IVA) mice to assess the effects of long-term enzyme replacement therapy (ERT) initiated at birth, since adult mice treated by ERT showed little improvement in bone pathology [1]. To conduct ERT in newborn mice, we used recombinant human N-acetylgalactosamine-6-sulfate sulfatase (GALNS) produced in a CHO cell line. First, to observe the tissue distribution pattern, a dose of 250units/g body weight was administered intravenously in MPS IVA mice at day 2 or 3. The infused enzyme was primarily recovered in the liver and spleen, with detectable activity in the bone and brain. Second, newborn ERT was conducted after a tissue distribution study. The first injection of newborn ERT was performed intravenously, the second to fourth weekly injections were intraperitoneal, and the remaining injections from 5th to 14th weeks were intravenous into the tail vein. MPS IVA mice treated with GALNS showed clearance of lysosomal storage in the liver and spleen, and sinus lining cells in bone marrow. The column structure of the growth plate was organized better than that in adult mice treated with ERT; however, hyaline and fibrous cartilage cells in the femur, spine, ligaments, discs, synovium, and periosteum still had storage materials to some extent. Heart valves were refractory to the treatment. Levels of serum keratan sulfate were kept normal in newborn ERT mice. In conclusion, the enzyme, which enters the cartilage before the cartilage cell layer becomes mature, prevents disorganization of column structure. Early treatment from birth leads to partial remission of bone pathology in MPS IVA mice. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Comparison of Cranial and Iliac Autologus Bone Grafts and Their Effects on the Success Rates of Subsequent Osseointegrated Intra/Extraoral Implant Application in the Miniature Swine

    Science.gov (United States)

    1992-10-31

    SUBSEQUENT OSSEOINTEGRATED INTRA/EXTRAORAL IMPLANT APPLICATION IN THE MINIATURE SWINE SUBTITLE: Autologous Calvarial and Iliac Onlay Bone Grafts in...DATE: October 31, 1992 S ELECTE TYPE OF REPORT: Final Report WMAR03 1993U PREPARED FOR: U.S. ARMY MEDICAL RESEARCH AND DEVELOPMENT COMMAND Fort Detrick...and Iliac Onlay Bone Grafts in Miniature Swine To be published in the Journal of Oral and Maxillofacial Surgery. 12a_ DISTRIBUTION AVAILABILITY

  7. Evaluation of analgesic effect of local administration of morphine after iliac crest bone graft harvesting: A double blind study

    Directory of Open Access Journals (Sweden)

    Devinder Singh

    2013-01-01

    Full Text Available Background and Objective: Pain is a complex process influenced by both physiological and psychological factors. In spite of an armamentarium of analgesic drugs and techniques available to combat post-operative pain, appropriate selection, and effective management for relief of post-operative pain still poses unique challenges. The discovery of peripheral opioid receptors has led to growing interest in the use of locally applied opioids (intra-articular, intra-pleural, intra-peritoneal, and perineural for managing acute pain. As bone graft harvesting is associated with significant post-operative pain and there is a paucity of literature on the use of peripheral opioids at the iliac crest bone harvesting site, the present study was planned to evaluate the analgesic efficacy of local administration of morphine after iliac crest bone graft harvesting. Materials and Methods: A total of 60 patients, 20-50 years of age scheduled to undergo elective surgery for delayed and non-union fracture both bone leg with bone grafting under general anaesthesia (GA were randomly assigned to one of the four groups of 15 patients each: group 1: 2.5 ml normal saline (NS +2.5 ml NS infiltrated into the harvest site at 2 sites + 1 ml NS intramuscularly (i/m; Group 2: 2.5 ml NS + 2.5 ml NS infiltrated into the harvest site at 2 sites + 5 mg morphine in 1 ml i/m.; Group 3: 2.5 mg (2.5 ml morphine + 2.5 mg (2.5 ml morphine infiltrated into the harvest site at 2 sites + 1 ml NS i/m; Group 4: 0.5 mg naloxone (2.5 ml +5 mg (2.5 ml morphine infiltrated into the harvest site at 2 sites + 1 ml NS i/m. Pain from the bone graft site and operative site was assessed for 24 h post-operatively. Results: The patients who had received morphine infiltration (Group 3 had significantly less pain scores at the graft site at 4, 6, and 10 post-operative hours. They also had significantly less morphine consumption and overall better pain relief as compared to the other groups. Conclusions

  8. Bone grafting of alveolar socket and ovate seat pontic preparation for natural emergence profile for anterior bridge - A case report

    Directory of Open Access Journals (Sweden)

    Vijay Deshmukh

    2009-01-01

    Full Text Available Alveolar atrophy following tooth extraction remains a challenge for future prosthetic restorations. Immediate implant placement and postextraction alveolar bone grafting are two methods that are used to prevent significant postextraction bone loss. Grafting is one of the most common methods of socket preservation widely used to prevent the collapse of oral tissues following extraction so that an excellent esthetic prosthesis can be provided particularly in the anterior maxillary region. The present report describes the management of a maxillary tooth extraction socket using a socket preservation technique involving placement of an osteoconductive slowly resorbable grafting material & resorbable collagen membrane in the extraction socket also called as Bio-Col socket preservation technique followed by a provisional restoration to preserve the tissues & interdental papilla for the placement of future final ovate pontic anterior bridge to give the illusion of the tooth emerging from the gums. This technique resulted in a successful prevention of alveolar bone loss following tooth extraction & maintainence of tissue contour & density which provided a good tissue base for the fabrication of Ovate pontic giving excellent esthetic results.

  9. [Timing of alveolar bone graft and sequences of canine eruption in cases of cleft lip and palate: a systematic review].

    Science.gov (United States)

    Elhaddaoui, Rajae; Bahije, Loubna; Zaoui, Fatima; Rerhrhaye, Wiam

    2017-06-01

    The alveolar bone graft (ABG) is an important phase in the surgical treatment of cleft lip and palate (CLP). The purpose of alveolar bone grafting is to eliminate oronasal fistulas, restore the continuity of the maxilla and provide optimal periodontal support for spontaneous eruption of permanent canines adjacent to the cleft. The purpose of this systematic review was to determine the ideal timing of the ABG that would achieve these goals. Databases consulted were MEDLINE, Embase et EBSCOhost, using keywords present in the MeSH: [cleft lip and palate] and [alveolar bone graft] and [tooth eruption]. Selection criteria included retrospective studies, prospective studies and meta-analyzes dating from January 2005, with available full text. Among 105 references, 9 articles met our selection criteria. ABG carried out before or just after the eruption of permanent canines adjacent to the cleft, between 8 and 12 years old, has the best success rate of the transplant (71% to 89%) and the lowest risk of canine inclusion (5% to 19%). According to literature data, the optimal timing of ABG that provide best results is located between 8 and 12 years, before or just after the eruption of permanent canines adjacent to the cleft. However, this timing could be modified by the multidisciplinary team according priorities, particularly aesthetic, defined for each child. © EDP Sciences, SFODF, 2017.

  10. Ability of bone graft substitutes to support the osteoprogenitor cells: An in-vitro study

    Institute of Scientific and Technical Information of China (English)

    Ziad; Dahabreh; Michalis; Panteli; Ippokratis; Pountos; Mark; Howard; Peter; Campbell; Peter; V; Giannoudis

    2014-01-01

    AIM: To compare seven commercially available bone graft substitutes(BGS) in terms of these properties and without using any additional biological growth factors.METHODS: Porcine osteoprogenitor cells were loaded on seven commercially available BGS and allowed to proliferate for one week followed by osteogenic induction. Staining for live/dead cells as well as scanning electron microscopy(SEM) was carried out to determine viability and cellular binding. Further outcome measures included alkaline phosphatase(ALP) assays with normalisation for DNA content to quantify osteogenic potential. Negative and positive control experiments were carried out in parallel to validate the results.RESULTS: Live/dead and SEM imaging showed higher viability and attachment with β-tricalcium phosphate(β-TCP) than with other BGS(P < 0.05). The average ALP activity in nmol/mL(normalised value for DNA content in nmol/μg DNA) per sample was 657.58(132.03) for β-TCP, 36.22(unable to normalise) for calcium sulphate, 19.93(11.39) for the Hydroxyapatite/Tricalcium Phosphate composite, 14.79(18.53) for polygraft, 13.98(8.15) for the highly porous β-Tricalcium Phosphate, 5.56(10.0) for polymers, and 3.82(3.8) for Hydroxyapatite.CONCLUSION: Under the above experimental conditions, β-TCP was able to maintain better the viability of osteoprogenitor cells and allow proliferation and differentiation(P < 0.05).

  11. Newly forming bone graft: a novel surgical approach to the treatment of denuded roots

    Directory of Open Access Journals (Sweden)

    Adriana Campos Passanezi Sant'Ana

    2012-06-01

    Full Text Available Many techniques have been proposed for root coverage. However, none of them presents predictable results in deep and wide recessions. OBJECTIVES: The aim of this case series report is to describe an alternative technique for root coverage at sites showing deep recessions and attachment loss >4 mm at buccal sites. MATERIAL AND METHODS: Four patients presenting deep recession defects at buccal sites (>4 mm were treated by the newly forming bone graft technique, which consists in the creation of an alveolar socket at edentulous ridge and transferring of granulation tissue present in this socket to the recession defect after 21 days. Clinical periodontal parameters, including recession depth (RD, probing depth (PD, clinical attachment level (CAL, bleeding on probing (BOP, plaque index (PI and keratinized gingiva width (KGW were evaluated by a single examiner immediately before surgery and at 1, 3, 6 and 9 months postoperatively. RESULTS: All cases showed reduction in RD and PD, along with CAL gain, although no increase in KGW could be observed. These findings suggest that the technique could favor periodontal regeneration along with root coverage, especially in areas showing deep recessions and attachment loss.

  12. Silica xerogel-chitosan nano-hybrids for use as drug eluting bone replacement.

    Science.gov (United States)

    Lee, Eun-Jung; Jun, Shin-Hee; Kim, Hyoun-Ee; Kim, Hae-Won; Koh, Young-Hag; Jang, Jun-Hyeog

    2010-01-01

    Silica xerogel-chitosan hybrids containing vancomycin were fabricated by the sol-gel process at room temperature and their potential as a drug eluting bone replacement was evaluated in terms of their mechanical properties and drug release behaviors. Regardless of the content of chitosan, all of the prepared hybrids had a uniform mesoporous structure, which would allow the effectual loading of vancomycin. As the content of chitosan was increased, the strength, strain to failure, and work of fracture of the hybrids were significantly enhanced, while the elastic modulus was decreased. These changes in the mechanical properties were mainly attributed to the mitigation of the brittleness of the silica xerogel through its hybridization with the flexible chitosan phase. In addition, the initial burst-effect was remarkably reduced by increasing the content of chitosan. The hybrids with more than 30% chitosan could release the vancomycin for an extended period of time in a controlled manner.

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

    DEFF Research Database (Denmark)

    Jensen, Thomas; Schou, S; Stavropoulos, A

    2012-01-01

    of the graft improved significantly with increased proportion of Bio-Oss. Bone regeneration, bone-to-implant contact (BIC), biomechanical implant test values, and biodegradation of Bio-Oss after MSFA with Bio-Oss or Bio-Oss mixed with autogenous bone have never been compared within the same study in animals......The objective of the present systematic review was to test the hypothesis of no differences between the use of Bio-Oss or Bio-Oss mixed with autogenous bone as graft for maxillary sinus floor augmentation (MSFA) applying the lateral window technique, as evaluated in animals. A MEDLINE (Pub....... Thus, the hypothesis of no differences between the use of Bio-Oss and Bio-Oss mixed with autogenous bone as graft for MSFA could neither be confirmed nor rejected based on existing animal studies....

  14. The effect of composition on ion release from Ca-Sr-Na-Zn-Si glass bone grafts.

    Science.gov (United States)

    Murphy, S; Boyd, D; Moane, S; Bennett, M

    2009-11-01

    Controlled delivery of active ions from biomaterials has become critical in bone regeneration. Some silica-based materials, in particular bioactive glasses, have received much attention due to the ability of their dissolution products to promote cell proliferation, cell differentiation and activate gene expression. However, many of these materials offer little therapeutic potential for diseased tissue. Incorporating trace elements, such as zinc and strontium, known to have beneficial and therapeutic effects on bone may provide a more viable bone graft option for those suffering from metabolic bone diseases such as osteoporosis. Rational compositional design may also allow for controlled release of these active ions at desirable dose levels in order to enhance therapeutic efficacy. In this study, six differing compositions of calcium-strontium-sodium-zinc-silicate (Ca-Sr-Na-Zn-Si) glass bone grafts were immersed in pH 7.4 and pH 3 solutions to study the effect of glass composition on zinc and strontium release in a normal and extreme physiological environment. The zinc release levels over 30 days for all zinc-containing glasses in the pH 7.4 solution were 3.0-7.65 ppm. In the more acidic pH 3 environment, the zinc levels were higher (89-750 ppm) than those reported to be beneficial and may produce cytotoxic or negative effects on bone tissue. Strontium levels released from all examined glasses in both pH environments similarly fell within apparent beneficial ranges--7.5-3500 ppm. Glass compositions with identical SrO content but lower ZnO:Na(2)O ratios, showed higher levels of Sr(2+) release. Whereas, zinc release from zinc-containing glasses appeared related to ZnO compositional content. Sustainable strontium and zinc release was seen in the pH 7.4 environment up to day 7. These results indicate that the examined Ca-Sr-Na-Zn-Si glass compositions show good potential as therapeutic bone grafts, and that the graft composition can be tailored to allow therapeutic

  15. Predictors of inotrope use in patients undergoing concomitant coronary artery bypass graft (CABG and aortic valve replacement (AVR surgeries at separation from cardiopulmonary bypass (CPB

    Directory of Open Access Journals (Sweden)

    Nelson William B

    2009-06-01

    Full Text Available Abstract Background Left ventricular dysfunction is common after coronary artery bypass graft and valve replacement surgeries and is often treated with inotropic drugs to maintain adequate hemodynamic status. In this study, we aimed to identify the demographic, clinical, laboratory, echocardiographic and hemodynamic factors that are associated with use of inotropic drugs in patients undergoing concomitant coronary artery bypass graft and aortic valve replacement surgery. Methods The study included 97 patients who had undergone concomitant coronary artery bypass graft and aortic valve replacement at Regions Hospital, University of Minnesota Medical School from January 2006 to December 2008. All data were collected retrospectively after reviewing electronic medical records. Inotropic support was defined as the use of dopamine [greater than or equal to] 5 ug/kg/min; any dose of epinephrine, norepinephrine, dobutamine, and milrinone at the separation from cardiopulmonary bypass. Results Inotropic support was used in a total of 50 patients (52% at the separation from cardiopulmonary bypass. Average age of the patients requiring inotropic support was 72.2 +/- 8.8 years. The study identified four significant, independent predictors of inotrope use: (1 Cardiac index [less than or equal to]2.5 L/min/m2, (2 LVEDP [greater than or equal to] 20 mm Hg, (3 LVEF [less than or equal to]40%, and (4 CKD stage 3 to 5. Conclusion We identified four independent risk factors for postoperative use of inotropic support in patients undergoing concomitant coronary artery bypass graft and arotic valve replacement surgery at the separation from cardiopulmonary bypass. The study results will be helpful to prospectively identify patients who will likely to require inotropic support at the separation from cardiopulmonary bypass.

  16. Prosthesis, bone graft and internal fixation and bone cement filling for treatment of giant cell tumor of bone%假体置换、植骨内固定及骨水泥填充治疗骨巨细胞瘤

    Institute of Scientific and Technical Information of China (English)

    广东; 王亚军; 赵凡

    2011-01-01

    BACKGROUND: Artificial joint replacement or allogeneic bone fixation and bone substitute materials filling are common ways torepair bone defects in giant cell tumor of bone after curettage, so which one is more ideal?OBJECTIVE: To understand the staging standard of giant cell tumors through access to Chinese and English literature abouttreatment for giant cell tumor of bone, and to compare different therapies, bone graft, bone cement filling and prosthesis.METHODS: A computer based search of CNKI using keywords of “tumor-type prosthesis, giant cell tumor of bone, bone graft,bone cement” and Elsevier Science and Pringer-Link using keywords of “giant cell tumor of bone, therapy, tumor-type prosthesis”were performed to retrieve relevant articles. Totally 346 articles were retrieved, and finally 26 were included in result analysis.RESULTS AND CONCLUSION: The traditional treatments for giant cell tumor have a higher recurrence rate. The bone graft maynot be able to fill the entire bone cavity, bone cement materials cannot be easy to be fused with the host. Tumor-type prosthesisshows a good effect on giant cell tumor of bone, but it is still inadequate. However, special prosthesis joints can repair bone defectsfollowing giant cell tumor of bone according to individualized treatment needs, which is an effective and reliable surgical method aswell as the main research direction for the future treatment of giant cell tumor of bone.%背景:人工关节置换或同种异体骨内固定及骨组织替代材料填充是修复骨巨细胞瘤刮除后骨缺损的常见方式,那么哪一种更理想呢?目的:通过查阅关于骨巨细胞瘤治疗方面的中英文文献,了解骨巨细胞瘤的分期标准并比较以植骨内固定、骨水泥填充及假体置换为主的治疗方法.方法:中国知网数据库输入中文检索词"肿瘤型假体,骨巨细胞瘤,植骨内固定,骨水泥",Elesvier Science和Springer-Link 数据库输入英文检索词"giant cell

  17. Posterior maxillary sandwich osteotomy combined with sinus grafting with bone morphogenetic protein-2 for alveolar reconstruction for dental implants: report of four cases.

    Science.gov (United States)

    Jensen, Ole T; Cottam, Jared

    2013-01-01

    Four patients underwent posterior sandwich osteotomy combined with sinus floor grafting using bone morphogenetic protein-2 and other grafting materials. The patients were treated over a period of 4 years. Two to four implants were placed in each site subsequently. Of the 12 implants placed, none failed. Alveolar crest bone levels appeared to be stable over time, with an average vertical gain of about 5 mm. Overall vertical gain, including the sinus graft, exceeded 13 mm in all patients. The procedure appears to hold promise for combined vertical alveolar defects and prominent pneumatization of the posterior maxilla.

  18. Human mandible bone defect repair by the grafting of dental pulp stem/progenitor cells and collagen sponge biocomplexes

    Directory of Open Access Journals (Sweden)

    R d’Aquino

    2009-11-01

    Full Text Available In this study we used a biocomplex constructed from dental pulp stem/progenitor cells (DPCs and a collagen sponge scaffold for oro-maxillo-facial (OMF bone tissue repair in patients requiring extraction of their third molars. The experiments were carried out according to our Internal Ethical Committee Guidelines and written informed consent was obtained from the patients. The patients presented with bilateral bone reabsorption of the alveolar ridge distal to the second molar secondary to impaction of the third molar on the cortical alveolar lamina, producing a defect without walls, of at least 1.5 cm in height. This clinical condition does not permit spontaneous bone repair after extraction of the third molar, and eventually leads to loss also of the adjacent second molar. Maxillary third molars were extracted first for DPC isolation and expansion. The cells were then seeded onto a collagen sponge scaffold and the obtained biocomplex was used to fill in the injury site left by extraction of the mandibular third molars. Three months after autologous DPC grafting, alveolar bone of patients had optimal vertical repair and complete restoration of periodontal tissue back to the second molars, as assessed by clinical probing and X-rays. Histological observations clearly demonstrated the complete regeneration of bone at the injury site. Optimal bone regeneration was evident one year after grafting. This clinical study demonstrates that a DPC/collagen sponge biocomplex can completely restore human mandible bone defects and indicates that this cell population could be used for the repair and/or regeneration of tissues and organs.

  19. Effects of Growth Hormone Replacement Therapy on Bone Mineral Density in Growth Hormone Deficient Adults: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Peng Xue

    2013-01-01

    Full Text Available Objectives. Growth hormone deficiency patients exhibited reduced bone mineral density compared with healthy controls, but previous researches demonstrated uncertainty about the effect of growth hormone replacement therapy on bone in growth hormone deficient adults. The aim of this study was to determine whether the growth hormone replacement therapy could elevate bone mineral density in growth hormone deficient adults. Methods. In this meta-analysis, searches of Medline, Embase, and The Cochrane Library were undertaken to identify studies in humans of the association between growth hormone treatment and bone mineral density in growth hormone deficient adults. Random effects model was used for this meta-analysis. Results. A total of 20 studies (including one outlier study with 936 subjects were included in our research. We detected significant overall association of growth hormone treatment with increased bone mineral density of spine, femoral neck, and total body, but some results of subgroup analyses were not consistent with the overall analyses. Conclusions. Our meta-analysis suggested that growth hormone replacement therapy could have beneficial influence on bone mineral density in growth hormone deficient adults, but, in some subject populations, the influence was not evident.

  20. Microstructure, cytotoxicity and corrosion of powder-metallurgical iron alloys for biodegradable bone replacement materials

    Energy Technology Data Exchange (ETDEWEB)

    Wegener, Bernd; Sievers, Birte; Utzschneider, Sandra; Mueller, Peter; Jansson, Volkmar [Department of Orthopedic Surgery, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377 Muenchen (Germany); Roessler, Sophie; Nies, Berthold [InnoTERE GmbH, Tatzberg 47, 01307 Dresden (Germany); Stephani, Guenter; Kieback, Bernd [Fraunhofer Institute for Manufacturing Technology and Advanced Materials (IFAM), Dresden Branch Lab, Winterbergstrasse 28, 01277 Dresden (Germany); Quadbeck, Peter, E-mail: peter.quadbeck@ifam-dd.fraunhofer.de [Fraunhofer Institute for Manufacturing Technology and Advanced Materials (IFAM), Dresden Branch Lab, Winterbergstrasse 28, 01277 Dresden (Germany)

    2011-12-15

    Up to now biodegradable bone implants with the ability of bearing high loads for the temporary replacement of bones or as osteosynthesis material are not available. Iron and iron based alloys have been identified as appropriate materials, since they combine high strength at medium corrosion rates. Thus, the aim of the present study is the development of a degradable iron based alloy with the perspective of using them as matrix material of cellular structures with biomechanical tailored properties. A powder metallurgical approach has been used to manufacture Fe-C, Fe-0.6P, Fe-1.6P, Fe-B and Fe-Ag samples, which have been tested with respect to their microstructure, their cytotoxicity, and their degradation rate. In order to determine the cytotoxicity of the material a monolayer culture of fibroblast and a perfusion chamber system has been chosen, which was recommended by the ISO 10993-5:1999 for biological testing of medical devices. It has been found, that in particular phosphorus features beneficial properties, since density and thus the strength of the material are increased. No corrosion inhibiting effects of phosphorus on the degradation rate have been found.

  1. Long-term implant-bone fixation of the femoral component in total knee replacement.

    Science.gov (United States)

    Cristofolini, L; Affatato, S; Erani, P; Leardini, W; Tigani, D; Viceconti, M

    2008-04-01

    Success of total knee replacement (TKR) depends on the prosthetic design. Aseptic loosening of the femoral component is a significant failure mode that has received little attention. Despite the clinical relevance of failures, no protocol is available to test long-term implant-bone fixation of TKR in vitro. The scope of this work was to develop and validate a protocol to assess pre-clinically the fixation of TKR femoral components. An in vitro protocol was designed to apply a simplified but relevant loading profile using a 6-degrees-of-freedom knee simulator for 1,000000 cycles. Implant-bone inducible micromotions and permanent migrations were measured at three locations throughout the test. After test completion, fatigue damage in the cement was quantified. The developed protocol was successfully applied to a commercial TKR. Additional tests were performed to exclude artefacts due to swelling or creep of the composite femur models. The components migrated distally; they tilted towards valgus in the frontal plane and in extension in the sagittal plane. The migration patterns were consistent with clinical roentgen-stereophotogrammetric recordings with TKR. Additional indicators were proposed that could quantify the tendency to loosen/stabilize. The type and amount of damage found in the cement, as well as the migration patterns, were consistent with clinical experience with the specific TKR investigated. The proposed pre-clinical test yielded repeatable results, which were consistent with the clinical literature. Therefore, its relevance and reliability was proved.

  2. The economics of using prophylactic antibiotic-loaded bone cement in total knee replacement.

    Science.gov (United States)

    Gutowski, C J; Zmistowski, B M; Clyde, C T; Parvizi, J

    2014-01-01

    The rate of peri-prosthetic infection following total joint replacement continues to rise, and attempts to curb this trend have included the use of antibiotic-loaded bone cement at the time of primary surgery. We have investigated the clinical- and cost-effectiveness of the use of antibiotic-loaded cement for primary total knee replacement (TKR) by comparing the rate of infection in 3048 TKRs performed without loaded cement over a three-year period versus the incidence of infection after 4830 TKRs performed with tobramycin-loaded cement over a later period of time of a similar duration. In order to adjust for confounding factors, the rate of infection in 3347 and 4702 uncemented total hip replacements (THR) performed during the same time periods, respectively, was also examined. There were no significant differences in the characteristics of the patients in the different cohorts. The absolute rate of infection increased when antibiotic-loaded cement was used in TKR. However, this rate of increase was less than the rate of increase in infection following uncemented THR during the same period. If the rise in the rate of infection observed in THR were extrapolated to the TKR cohort, 18 additional cases of infection would have been expected to occur in the cohort receiving antibiotic-loaded cement, compared with the number observed. Depending on the type of antibiotic-loaded cement that is used, its cost in all primary TKRs ranges between USD $2112.72 and USD $112 606.67 per case of infection that is prevented.

  3. Reconstruction of Orbital Floor Fractures with Autogenous Bone Graft Application from Anterior Wall of Maxillary Sinus: A Retrospective Study.

    Science.gov (United States)

    Bande, Chandrashekhar R; Daware, Surendra; Lambade, Pravin; Patle, Bhaskar

    2015-09-01

    Orbital wall fracture implies a situation where disruptions of the walls or floor have occurred. It is a blowout type fracture where bone fragments with torn periosteum are pushed outside of the original bony orbit. There is no intact bone even near the defect area except the thin bone rim surrounding the blowout fracture. The purpose of this defect repair is to support orbital contents, free entrapped tissue, and, especially, restore the original orbital volume. Ten patients (seven males and three females) who underwent repair of orbital floor factures with maxillary sinus bone grafts were included in this study. Surgical procedure for harvesting graft and its fixation was almost same in all operated cases. The collection in the maxillary sinus due to fracture of floor of orbit, blood and bony fragments collected in the maxillary sinus can be easily drained and removed after removal of anterior wall of maxillary sinus and through the same approach you can reduce the floor of orbit manually to the proper position which helps to decease the orbital floor defect.

  4. Staphylococcal biofilm formation on the surface of three different calcium phosphate bone grafts: a qualitative and quantitative in vivo analysis.

    Science.gov (United States)

    Furustrand Tafin, Ulrika; Betrisey, Bertrand; Bohner, Marc; Ilchmann, Thomas; Trampuz, Andrej; Clauss, Martin

    2015-03-01

    Differences in physico-chemical characteristics of bone grafts to fill bone defects have been demonstrated to influence in vitro bacterial biofilm formation. Aim of the study was to investigate in vivo staphylococcal biofilm formation on different calcium phosphate bone substitutes. A foreign-body guinea-pig infection model was used. Teflon cages prefilled with β-tricalcium phosphate, calcium-deficient hydroxyapatite, or dicalcium phosphate (DCP) scaffold were implanted subcutaneously. Scaffolds were infected with 2 × 10(3) colony-forming unit of Staphylococcus aureus (two strains) or S. epidermidis and explanted after 3, 24 or 72 h of biofilm formation. Quantitative and qualitative biofilm analysis was performed by sonication followed by viable counts, and microcalorimetry, respectively. Independently of the material, S. aureus formed increasing amounts of biofilm on the surface of all scaffolds over time as determined by both methods. For S. epidermidis, the biofilm amount decreased over time, and no biofilm was detected by microcalorimetry on the DCP scaffolds after 72 h of infection. However, when using a higher S. epidermidis inoculum, increasing amounts of biofilm were formed on all scaffolds as determined by microcalorimetry. No significant variation in staphylococcal in vivo biofilm formation was observed between the different materials tested. This study highlights the importance of in vivo studies, in addition to in vitro studies, when investigating biofilm formation of bone grafts.

  5. The efficacy of the use of IR laser phototherapy (LPT) on bone defect grafted with biphasic ceramic on rats with iron deficiency anemia: Raman spectroscopy analysis.

    Science.gov (United States)

    Rosa, Cristiane Becher; de Castro, Isabele Cardoso Vieira; Júnior, João Alves Reis; Aragão, Juliana Silveira; Barbosa, Artur Felipe Santos; Silveira, Landulfo; Pinheiro, Antonio L B

    2014-05-01

    The aim of this study was to evaluate bone repair in anemic and non-anemic rats submitted or not to laser phototherapy and hydroxyapatite graft. Animals were divided in eight groups of five animals: Clot; Laser; Graft; Graft + Laser; iron deficiency anemia (IDA) + Clot; IDA + Laser; IDA + graft; IDA + graft + Laser. When appropriate irradiation with infrared laser was done during 15 days at a 48-h interval. Animals were killed at day 30; samples were analyzed by Raman spectroscopy. Three shifts were studied and statistically analyzed: ~960, ~1,070, and ~1,454 cm(-1). Graft + laser showed highest ~960 peak was statistically different from all other healthy groups. No statistical difference was found between Clot and IDA + Clot in any shift. The IDA + Graft and IDA + Graft + Laser groups had low mean peak values for shifts ~960, ~1,070, and ~1,454 cm(-1). The results in this study indicate that using hydroxyapatite (HA) and laser irradiation in healthy subjects is favorable to mineral deposition and bone maturation, this being of importance for some groups at risk, such as astronauts. In iron deficiency anemia cases, the use of graft, associated or not to laser irradiation, resulted in low collagen and low carbonate and phosphate HA.

  6. The role of angiogenesis in implant dentistry part II: The effect of bone-grafting and barrier membrane materials on angiogenesis

    Science.gov (United States)

    Asatourian, Armen; Garcia-Godoy, Franklin; Sheibani, Nader

    2016-01-01

    Background In implant dentistry, bone substitute materials and barrier membranes are used in different treatments including guided bone regeneration (GBR), socket preservation, alveolar ridge augmentation, maxillary sinus elevation, and filling bony defects around the inserted dental implant. One of the most important factors in prognosis of treatments using these materials is the growth of new blood vessels in applied areas. Present review was performed to evaluate the effect of the bone-grafting and barrier membrane materials on angiogenesis events. Material and Methods An electronic search was performed in PubMed, MEDLINE, and EMBASE databases via OVID using the keywords mentioned in the PubMed and MeSH headings regarding the role of angiogenesis in implant dentistry from January 2000-April 2014. Results Of the 5,622 articles identified in our initial search results, only 33 met the inclusion criteria set for this review. Among bone substitute materials the autogenous bone-grafts, and among the barrier membranes the collagenous membranes, had the highest angiogenic potentials. Other bone-grafting materials or membranes were mostly used with pro-angiogenic factors to enhance their angiogenic properties. Conclusions Angiogenesis is one of the key factors, which plays a critical role in success rate of GBR technique and is seriously considered in manufacturing bone-grafting and barrier membrane materials. However, there is still lack of clinical and in-vivo studies addressing the effect of angiogenesis in treatments using bone-grafting and barrier membrane materials. Key words:Angiogenesis, bone-grafting materials, GBR, ridge augmentation, sinus elevation, socket preservation. PMID:27031074

  7. Case report of the free vascularized iliac bone graft with groin flap for the pseudoarthrosis of the tibia caused by irradiation osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Moriyama, Masatoshi; Ohkubo, Koichi; Asanuma, Kazuo; Murota, Kagehisa

    1987-04-01

    In a 35-year-old man, bone fracture occurred 6 years after radiotherapy with a total dose of 130 Gy for osteosarcoma of the middle end of the right tibia. The patient developed osteomyelitis and was dignosed as having pseudoarthrosis in the irradiated field. Satisfactory synostosis was attained by performing free vascularized iliac bone graft with groin flap. (Namekawa, K.).

  8. Composite graft including bone tissue: a case report of successful reattachment of multiple fingertip oblique amputation.

    Science.gov (United States)

    Lee, Kyung Suk; Lim, Yun sub; Choi, Jaehoon; Kim, Nam Gyun; Kim, Jun Sik

    2013-02-01

    A composite graft for reattachment of an amputated fingertip is a very controversial and challenging procedure. An osteocutaneous composite graft is rarely conducted and has a low success rate following fingertip amputation. A 21-year-old male patient was referred to our emergency clinic with dorsal oblique amputation of the middle, ring and small fingers of the left hand through the distal interphalangeal joint and middle phalanx. The amputated parts of the middle and ring fingers were reattached with osteocutaneous composite grafts. The amputated part of the small finger was revascularised to the ulnar palmar digital artery of the small finger. The composite grafts of the middle and ring fingers and the revascularised small finger survived completely. We suggest that careful patient selection will allow an osteocutaneous composite graft to become an acceptable method for the treatment of fingertip amputation. A large-scale study of osteocutaneous graft of amputated fingertips is required to improve the survival rate.

  9. Surgical Outcomes of Anterior Cervical Fusion Using Deminaralized Bone Matrix as Stand-Alone Graft Material: Single Arm, Pilot Study.

    Science.gov (United States)

    Chung, Ho-Jung; Hur, Jung-Woo; Ryu, Kyeong-Sik; Kim, Jin-Sung; Seong, Ji-Hoon

    2016-09-01

    To investigate the safety and efficacy of demineralized bone matrix (DBM) as a bone graft substitute for anterior cervical discectomy and fusion (ACDF) surgery. Twenty consecutive patients treated with ACDF using stand-alone polyestheretherketone (PEEK) cages (Zero-P) with DBM(CGDBM100) were prospectively evaluated with a minimum of 6 months of follow-up. Radiologic efficacy was evaluated with a 6-point scoring method for osseous fusion using plain radiograph and computed tomogrpahy scans. Clinical efficacy was evaluated using the visual analogue scale (VAS), Owestry disability index (ODI), and short-form health questionnaire-36. The safety of the bone graft substitute was assessed with vital sign monitoring and a survey measuring complications at each follow-up visit. There were significant improvements in VAS and ODI scores at a mean 6-month follow-up. Six months after surgery, solid fusion was achieved in all patients. Mean score on the 6-point scoring system was 5.1, and bony formation was found to score at least 4 points in all patients. There was no case with implant-related complications such as cage failure or migration, and no complications associated with the use of CGDBM100. ACDF using CGDBM100 demonstrated good clinical and radiologic outcomes. The fusion rate was comparable with the published results of traditional ACDF. Therefore, the results of this study suggest that the use of a PEEK cage packed with DBM for ACDF is a safe and effective alternative to the gold standard of autologous iliac bone graft.

  10. Determination of orthodontic tooth movement and tissue reaction following demineralized freeze-dried bone allograft grafting intervention

    Directory of Open Access Journals (Sweden)

    Massoud Seifi

    2012-01-01

    Full Text Available Background: Socket preservation after tooth extraction is one of the indications of bone grafting to enhance preorthodontic condition. The aim of this study is to determine the effects of socket preservation on the immediate tooth movement, alveolar ridge height preservation and orthodontic root resorption. Materials and Methods: In a split-mouth technique, twelve sites in three dogs were investigated as an experimental study. Crushed demineralized freeze-dried bone allograft (DFDBA (CenoBone® was used as the graft material. The defects were made by the extraction of 3 rd premolar. On one side of each jaw, the defects were preserved by DFDBA and defects of the other side left opened as the control group. Simultaneously the teeth adjacent to the defects were pulled together by a NiTi coil spring. After eight weeks, the amount of (OTM, alveolar height, and root resorption were measured. Analysis of variance was used for purpose of comparison. Results: There was a slight increase in OTM at grafted sites as they were compared to the control sites (P<0.05. Also a significant bone resorption in control site and successful socket preservation in experimental site were observed. Reduction of root resorption at the augmented site was significant compared to the normal healing site (P<0.05. Conclusion: Using socket preservation, tooth movement can be immediately started without waiting for the healing of the recipient site. This can provide some advantages like enhanced rate of OTM, its approved effects on ridge preservation that reduces the chance of dehiscence and the reduction of root resorption.

  11. Grafting of iliac bone flap with deep iliac circumflex vessel in treatment of femoral head ischemic necrosis and long dated hip joint function observation%旋髂深血管髂骨瓣移植治疗中青年股骨头缺血性坏死远期髋关节功能观察

    Institute of Scientific and Technical Information of China (English)

    奉成斌; 杜全印

    2002-01-01

    Objective To retrospect the long dated curative effect of grafting of iliac bone flap with deep iliac circumflex vessel in treatment of femoral head ischemic necrosis.Methods 79 cases of femoral head ischemic necrosis treated by promoted Smith Petersen incision, neck of femur notch, focus cleaning decompression,grafting of iliac bone flap with deep iliac circumflex vessel and screw fixation. 13 cases treated by transplanting granular bone after decompression. Results Grafting of iliac bone flap with deep iliac circumflex vessel treatment group were followed up from 3 to 9 years,the planting bone healed 3 to 6 months averagely.Two cases suffered femoral head ischemic necrosis continuously.Other cases received good results.Transplanting granular bone after decompression group were followed up 3 to 9 years, 3 cases suffered femoral head ischemic necrosis continuously, hip joint function was limited,patients received hip replacement finally. Conclusion Place of iliac bone flap with deep iliac circumflex vessel is fixed, curative effects are credible, which can become the first choice therapy to femoral head ischemic necrosis of middle age and young people (Ficat I~ III stage).

  12. Modelling Gaucher disease progression: long-term enzyme replacement therapy reduces the incidence of splenectomy and bone complications.

    Science.gov (United States)

    van Dussen, Laura; Biegstraaten, Marieke; Dijkgraaf, Marcel Gw; Hollak, Carla Em

    2014-07-24

    Long-term complications and associated conditions of type 1 Gaucher Disease (GD) can include splenectomy, bone complications, pulmonary hypertension, Parkinson disease and malignancies. Enzyme replacement therapy (ERT) reverses cytopenia and reduces organomegaly. To study the effects of ERT on long-term complications and associated conditions, the course of Gaucher disease was modelled.

  13. Acute renal graft-versus-host disease in a murine model of allogeneic bone marrow transplantation.

    Science.gov (United States)

    Schmid, Peter M; Bouazzaoui, Abdellatif; Schmid, Karin; Birner, Christoph; Schach, Christian; Maier, Lars S; Holler, Ernst; Endemann, Dierk H

    2017-03-23

    Acute kidney injury (AKI) is a very common complication after allogeneic bone marrow transplantation (BMT) and associated with poor prognosis. Generally kidneys are assumed to be no direct target of Graft-versus-Host Disease (GvHD), and renal impairment is often attributed to several other factors occurring in the early phase after BMT. Our study aimed to prove the existence of renal GvHD in a fully MHC-mismatched model of BALB/c mice conditioned and transplanted according to two different intensity protocols. Syngeneically transplanted and untreated animals served as controls. 4 weeks after transplantation, allogeneic animals developed acute GvHD that was more pronounced in the high-intensity protocol (HIP) group than in the low-intensity protocol (LIP) group. Urea and creatinine as classic serum markers of renal function could not verify renal impairment 4 weeks after BMT. Creatinine levels were even reduced as a result of catabolic metabolism and loss of muscle mass due to acute GvHD. Proteinuria, albuminuria, and urinary N-acetyl-beta-Dglucosaminidase (NAG) levels were measured as additional renal markers before and after transplantation. Albuminuria and NAG were only significantly increased after allogeneic transplantation, correlating with disease severity between HIP and LIP animals. Histological investigations of the kidneys showed renal infiltration of T-cells and macrophages with endarteriitis, interstitial nephritis, tubulitis, and glomerulitis. T-cells consisted of CD4+, CD8+, and FoxP3+ cells. Renal expression analysis of allogeneic animals showed increases in indoleamine-2,3 dioxygenase (IDO), different cytokines (TNFα, IFN-γ, IL-1α, IL2, IL-6, and IL-10), and adhesion molecules (ICAM-1 and VCAM-1), resembling findings from other tissues in acute GvHD. In summary, our study supports the entity of renal GvHD with histological features suggestive of cell-mediated renal injury. Albuminuria and urinary NAG levels may serve as early markers of renal

  14. Effects of LED phototherapy on bone defects grafted with MTA, bone morphogenetic proteins, and guided bone regeneration in a rodent model: a description of the bone repair by light microscopy

    Science.gov (United States)

    Pinheiro, Antonio Luiz B.; Aciole, Gilberth T. S.; Soares, Luiz G. P.; Correia, Neandder A.; N. dos Santos, Jean

    2011-03-01

    We carried out a histological analysis on surgical bone defects grafted or not with MTA, treated or not with LED, BMPs and GBR. We have used several models to assess the effects of laser on bone. Benefits of the isolated or combined use them on bone healing has been suggested. There is no previous report on their association with LED light. 90 rats were divided into 10 groups. On Groups II and I the defect were filled with the clot. On Group II, were further irradiated. On groups III-VI, defect was filled with MTA + Collagen gel (III); animals of group IV were further irradiated. On groups V and VI, the defects filled with the MTA were covered with a membrane. Animals of Group VI were further irradiated. On Groups VII and VIII a pool of BMPs was added to the MTA and was further irradiated. On groups IX and X, the MTA + BMP graft was covered with a membrane. On group X, the defect was further irradiated. LED (λ850 +/- 10nm, 150mW, A= 0.5cm2, 54s, 0.3W/cm2, 16 J/cm2) was applied at 48 h intervals during 15 days. Specimens were taken, processed, cut and stained with H&E and Sirius red and underwent histological analysis. The results showed that MTA seemed not being affected by LED light. However, its use positively affected healing around the graft. It is concluded that MTA is not affected by the LED light due to it characteristics, but beneficial results with LED usage was found.

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

    DEFF Research Database (Denmark)

    Jensen, Thomas; Schou, Søren; Stavropoulos, Andreas

    2012-01-01

    Aims: The objective of the present systematic review was to test the hypothesis of no differences in the implant treatment outcome when Bio-Oss or Bio-Oss mixed with autogenous bone is used as graft for the maxillary sinus floor augmentation (MSFA) applying the lateral window technique. Material...... was compared in one study demonstrating no statistically significant difference. The implant survival was 96% with Bio-Oss and 94% with a mixture of 80% Bio-Oss and 20% autogenous mandibular bone. Addition of a limited amount of autogenous bone to Bio-Oss seemed not to increase the amount of new bone formation...... and bone-to-implant contact compared with Bio-Oss. Conclusions: Therefore, the hypothesis of no differences between the use of Bio-Oss or Bio-Oss mixed with autogenous bone as graft for MSFA could neither be confirmed nor rejected. To cite this article: Jensen T, Schou S, Stavropoulos A, Terheyden H...

  16. Segmental intercalary diaphyseal endoprosthetic replacement for malignant diaphyseal bone tumors MAO%节段型骨干肿瘤假体置换治疗骨干恶性肿瘤

    Institute of Scientific and Technical Information of China (English)

    毛震扬; 郝永强

    2013-01-01

    Radical excision of tumor se