Peter Schupbach

Publications of Peter Schupbach

• Treatment of combined endodontic-periodontic lesions using guided tissue regeneration: clinical case and histology.

  Authors: Carlo Ghezzi, Mauro Virzi, Peter Schupbach, Alessandro Broccaioli, Massimo Simion

  The International journal of periodontics & restorative dentistry. 08/2012; 32(4):433-9.

  The aim of this case report is to histologically evaluate periapical healing after combined endodontic-periodontic treatment. A maxillary left central incisor was treated with conventional endodonticThe aim of this case report is to histologically evaluate periapical healing after combined endodontic-periodontic treatment. A maxillary left central incisor was treated with conventional endodontic therapy, followed by periodontal surgery. The facial bony defect was filled with a mixture of autologous bone and Bio-Oss. A resorbable membrane was used. Histology showed the presence of new cementum, ligament, and bone around the apex of the treated tooth. This finding was clinically associated with minimal residual probing depth and maximum attachment gain. This histologic report demonstrates the possibility of true regeneration in a case of severe periodontal attachment loss resulting from an endodontic-periodontic lesion.

• Connective Tissue Attachment to Laser-Microgrooved Abutments: A Human Histologic case report.

  Authors: Myron Nevins, Marcelo Camelo, Marc L Nevins, Peter Schupbach, David M Kim

  The International journal of periodontics & restorative dentistry. 08/2012; 32(4):385-92.

  Previous preclinical and clinical studies have demonstrated the effectiveness of precisely configured laser-ablated microgrooves placed on implant collars to allow direct connective tissue attachmentPrevious preclinical and clinical studies have demonstrated the effectiveness of precisely configured laser-ablated microgrooves placed on implant collars to allow direct connective tissue attachment to the implant surface. A recent canine study examining laser-ablated microgrooves placed in a defined healing abutment area demonstrated similar findings. In both instances, direct connective tissue attachment to the implant-abutment surface served as an obstacle to the apical migration of the junctional epithelium, thus preventing crestal bone resorption. The current case report examines the effectiveness of abutment-positioned laser-ablated microgrooves in human subjects. As in the preclinical trial, precisely defined laser-ablated microgrooves allowed direct connective tissue attachment to the altered abutment surface, prevented apical migration of the junctional epithelium, and thus protected the crestal bone from premature resorption.

• Reattachment of connective tissue fibers to a laser-microgrooved abutment surface.

  Authors: Myron Nevins, Marcelo Camelo, Marc L Nevins, Peter Schupbach, David M Kim

  The International journal of periodontics & restorative dentistry. 08/2012; 32(4):e131-4.

  This report presents human evidence of reattachment of the connective tissue when a laser-microgrooved healing abutment was replaced with a laser-microgrooved cylindric definitive abutment. NoThis report presents human evidence of reattachment of the connective tissue when a laser-microgrooved healing abutment was replaced with a laser-microgrooved cylindric definitive abutment. No additional bone loss was noted 15 weeks after placement of the laser-microgrooved cylindric definitive abutment. Dense connective tissue was in intimate contact with the laser-microgrooved surface to the point of the soft tissue separation, and clear evidence of the junctional epithelium ending at the coronal-most position of the laser-microgrooved zone was identified.

• Growth factor-mediated combination therapy to treat large local human alveolar ridge defects.

  Authors: Myron Nevins, Marcelo Camelo, Marc L Nevins, Daniel K Ho, Peter Schupbach, David M Kim

  The International journal of periodontics & restorative dentistry. 06/2012; 32(3):263-71.

  The purpose of this case report is to demonstrate the effectiveness of a matrix consisting of recombinant human platelet-derived growth factor BB (rhPDGF-BB)-hydrated cancellous allogenic block graftThe purpose of this case report is to demonstrate the effectiveness of a matrix consisting of recombinant human platelet-derived growth factor BB (rhPDGF-BB)-hydrated cancellous allogenic block graft in the reconstruction of large local human alveolar ridge defects. The results suggest improved bone regeneration when combining rhPDGF-BB with the allogenic block graft. The clinical and histologic evidence of new bone formation as well as bone remodeling supports the clinical potency of this growth factor-mediated therapy.

• Treatment of gingival recession defects with xenogenic collagen matrix: a histologic report.

  Authors: Marcelo Camelo, Myron Nevins, Marc L Nevins, Peter Schupbach, David M Kim

  The International journal of periodontics & restorative dentistry. 04/2012; 32(2):167-73.

  The connective tissue graft (CTG) in conjunction with a coronally advanced flap is still regarded as the gold standard treatment for gingival recession defects. Increased surgical morbidity as wellThe connective tissue graft (CTG) in conjunction with a coronally advanced flap is still regarded as the gold standard treatment for gingival recession defects. Increased surgical morbidity as well as limited tissue availability continues to spur interest in alternatives to the CTG. The current case report examines a porcine-derived, double-layer collagen matrix as an alternative to the CTG in managing Miller Class I and II recession defects. A long junctional epithelial attachment as well as connective tissue adhesion were noted when collagen matrix was used in conjunction with a coronally advanced flap in recession treatment protocols. The results suggest that it is possible to obtain root coverage without harvesting connective tissue.

• Soft tissue integration of a porcine collagen membrane: an experimental study in pigs.

  Authors: Isabella Rocchietta, Peter Schupbach, Carlo Ghezzi, Emilio Maschera, Massimo Simion

  The International journal of periodontics & restorative dentistry. 02/2012; 32(1):e34-40.

  Autogenous soft tissue augmentation procedures around natural teeth and dental implants are performed daily by clinicians. However, patient morbidity is often associated with the second surgicalAutogenous soft tissue augmentation procedures around natural teeth and dental implants are performed daily by clinicians. However, patient morbidity is often associated with the second surgical site; hence, research is moving toward an era where matrices may substitute autogenous grafts. The aim of this study was to assess the soft tissue response to a collagen matrix in an animal model. Nine pigs were included in this study. Each animal received four collagen matrices, two for each mandible. Three cohorts were included in the study: group A, where the matrix was applied as an onlay on a partial-thickness flap; group B, where the matrix was inserted under a partial-thickness flap; and group C, where the matrix was inserted in an inverted position under a full-thickness flap. Sacrifice occurred at 7, 15, and 30 days postoperatively for histologic assessment. The collagen matrix was seen in place for the first 2 weeks, and it was completely replaced by healthy connective tissue within 30 days in the inlay cohorts. No inflammatory adverse reactions were noticed in any specimen, resulting in optimal integration of the device. This study showed an optimal integration within 30 days postoperative of the placement of experimental collagen matrix in the soft tissues of an animal model. Its proven safety in this model provides an optimal starting point for further research projects considering its clinical applications.

• Vertical Ridge Augmentation Using an Equine Bone and Collagen Block Infused With Recombinant Human Platelet Derived Growth Factor-BB (rhPDGF-BB): A Randomized Single-Blind Histologic Study in Non-Human Primates.

  Authors: Massimo Simion, Myron Nevins, Khalid Al-Hezaimi, Emilio Maschera, Filippo Fontana, Isabella Rocchietta, Peter Schupbach, Nadeem Karimbux, David M Kim

  Journal of periodontology. 01/2012;

  Background: This study tested the effectiveness of hydroxyapatite and collagen bone blocks of equine origin (eHAC), infused with recombinant platelet derived growth factor-BB (rhPDGF-BB), to augmentBackground: This study tested the effectiveness of hydroxyapatite and collagen bone blocks of equine origin (eHAC), infused with recombinant platelet derived growth factor-BB (rhPDGF-BB), to augment localized posterior mandibular defects in non-human primates (Papio hamadryas). Methods: Bilateral critical-size defects simulating severe atrophy were created at the time of the posterior teeth removal. Test and control blocks (without growth factor) were randomly grafted into the respective sites in each non-human primates. Results: All sites exhibited vertical ridge augmentation, with physiological hard and soft tissue integration of the blocks when clinical and histological examinations were done at four months after the vertical ridge augmentation procedure. There was a clear, though non-significant, tendency to increased regeneration in the test sites. As in the first two preclinical studies in this series using canines, experimental eHAC blocks infused with rhPDGF-BB proved to be a predictable and technically viable method to predictably regenerate bone and soft tissue in-critical size defects. Conclusion: This investigation supplies further evidence that eHAC blocks infused with rhPDGF-BB growth factor is a predictable and technically feasible option for vertical augmentation of severely resorbed ridges.

• Guided bone regeneration around single-tooth implants in the esthetic zone: a case series.

  Authors: Ueli Grunder, Birgit Wenz, Peter Schupbach

  The International journal of periodontics & restorative dentistry. 11/2011; 31(6):613-20.

  The objective of this case series was to evaluate the clinical and histologic outcome of guided bone regeneration around simultaneously placed implants in sites with missing buccal bone walls. EightThe objective of this case series was to evaluate the clinical and histologic outcome of guided bone regeneration around simultaneously placed implants in sites with missing buccal bone walls. Eight weeks after tooth extraction, implants were inserted, and the sites were augmented in both the horizontal and vertical dimensions using a mineralized collagen bone substitute and a nonresorbable titanium-reinforced membrane. Six months later, small hard tissue biopsy specimens were harvested from the buccal bone walls at approximately mid-height of the original defect. The histologies revealed ongoing bone formation. Clinically, an adequate amount of hard and soft tissue volume had formed.

• The Combination of Purified Recombinant Human Platelet-Derived Growth Factor-BB and Equine Particulate Bone Graft for Periodontal Regeneration.

  Authors: Myron Nevins, Marc L Nevins, Nadeem Karimbux, Soo-Woo Kim, Peter Schupbach, David M Kim

  Journal of periodontology. 10/2011;

  Background: The objective of this study was to evaluate the potential for periodontal regeneration of a critical-sized defect with the application of recombinant human platelet-derived growth factorBackground: The objective of this study was to evaluate the potential for periodontal regeneration of a critical-sized defect with the application of recombinant human platelet-derived growth factor (rhPDGF-BB) combined with either a particulate equine or a β-tricalcium phosphate (β-TCP) matrix. Methods: Critical-sized intrabony two-wall defects were created bilaterally on the distal surface of the 2(nd) premolar and the mesial surface of the 1(st) molar in 9 hounds. Twelve defects received rhPDGF-BB/equine treatment, 12 defects received rhPDGF-BB/β-TCP treatment, and remaining 12 sites served as sham-surgery controls. The animals were sacrificed following a 10-week healing period. Results: Clinical healing was uneventful without obvious signs of overt gingival inflammation. Histologic and histomorphometric analyses revealed statistically that there were differences among the three groups in terms of new bone (NB) formation (P <0.001) and for remaining test materials (TM) (P<0.001). The amount of TM for both rhPDGF-BB/equine and rhPDGF-BB/β-TCP groups was comparable, but the amount of newly formed bone was significantly higher (P<0.01) in favor of the rhPDGF-BB/equine group. The amount of new cementum formed for the rhPDGF-BB/equine group (4.8 ± 1.3 mm) was significantly higher (P = 0.001) than the sham-surgery control group (1.7± 1.9 mm). Conclusion: Both rhPDGF-BB/equine and rhPDGF-BB/β-TCP have the potential to support the regeneration of the periodontal attachment apparatus.

• Pilot clinical and histologic evaluations of a two-piece zirconia implant.

  Authors: Myron Nevins, Marcelo Camelo, Marc L Nevins, Peter Schupbach, David M Kim

  The International journal of periodontics & restorative dentistry. 04/2011; 31(2):157-63.

  An investigation was conducted to evaluate the clinical and histologic results of bone and soft tissue healing around a two-piece zirconia dental implant in a human model. A healthy female patientAn investigation was conducted to evaluate the clinical and histologic results of bone and soft tissue healing around a two-piece zirconia dental implant in a human model. A healthy female patient requiring tooth replacement with dental implants received a two-piece zirconia implant together with conventional titanium implants to be implemented in a prosthesis. Clinical and radiographic evaluations at 6 months revealed stable osseointegrated zirconia and titanium dental implants. Light microscopy and backscatter scanning electron microscopic analyses confirmed the biocompatibility and achievement of osseointegration, in addition to maintenance of the crestal bone level. The findings suggest that the bone-to-implant contact with a zirconia implant surface is sufficient to provide clinical and histologic evidence of osseointegration. The biopsied two-piece zirconia dental implant with platform switching demonstrated osseointegration occlusal to the implant-abutment junction, eliminating the significance of the microgap.

• Effects of a calcium phosphate coating on the osseointegration of endosseous implants in a rabbit model.

  Authors: Filippo Fontana, Isabella Rocchietta, Alessandro Addis, Peter Schupbach, Gianfranco Zanotti, Massimo Simion

  Clinical oral implants research. 12/2010; 22(7):760-6.

  The aim of the present study was to evaluate a Ca-P coated implant surface in a rabbit model. The Ca-P surface (test) was compared to the titanium porous oxide surface (control) in terms ofThe aim of the present study was to evaluate a Ca-P coated implant surface in a rabbit model. The Ca-P surface (test) was compared to the titanium porous oxide surface (control) in terms of bone-to-implant contact (BIC) and removal torque value. Two hundred and sixteen dental implants were inserted in the tibia and in the femur of 36 rabbits. One hundred and eight were represented by Ca-P oxidized surface implant and other 108 were titanium porous oxide surface modified implants. Each rabbit received six implants. Animals were sacrificed after 2, 4 and 9 weeks of healing. Each group included 12 rabbits. The femoral implant and the proximal implant of the tibia of each animal were subjected to the histologic analysis and the distal implants of the tibia underwent removal torque test (RTQ). Histological analysis in terms of BIC and RTQ did not revealed any significant difference between the Ca-P oxidized surface and the oxidized surface at 2 and 4 weeks. At 9 weeks, the oxidized surface demonstrated better results in terms of RTQ in the tibia. In conclusion, findings from the present study suggested that the Ca-P coating had no beneficial effect in improving bonding strength at the bone-implant interface either at 2, 4 and 9 weeks.

• Human histologic evaluation of anorganic bovine bone mineral combined with recombinant human platelet-derived growth factor BB in maxillary sinus augmentation: case series study.

  Authors: Myron Nevins, David Garber, James J Hanratty, Bradley S McAllister, Marc L Nevins, Maurice Salama, Peter Schupbach, Steven Wallace, Simon M Bernstein, David M Kim

  The International journal of periodontics & restorative dentistry. 12/2009; 29(6):583-91.

  The objective of this proof-of-principle study was to examine the potential for improved bone regenerative outcomes in maxillary sinus augmentation procedures when recombinant human platelet-derivedThe objective of this proof-of-principle study was to examine the potential for improved bone regenerative outcomes in maxillary sinus augmentation procedures when recombinant human platelet-derived growth factor BB (0.3 mg/mL) is combined with particulate anorganic bovine bone mineral. The surgical outcomes in all treated sites were uneventful at 6 to 8 months, with sufficient regenerated bone present to allow successful placement of maxillary posterior implants. Large areas of dense, well-formed lamellar bone were seen throughout the intact core specimens in more than half of the grafted sites. Abundant numbers of osteoblasts were noted in concert with significant osteoid in all sites, indicating ongoing osteogenesis. A number of cores demonstrated efficient replacement of the normally slowly resorbing anorganic bovine bone mineral matrix particles with newly formed bone when the matrix was saturated with recombinant human platelet-derived growth factor BB.

• Surface-modified zirconia implants: tissue response in rabbits.

  Authors: Isabella Rocchietta, Filippo Fontana, Alessandro Addis, Peter Schupbach, Massimo Simion

  Clinical oral implants research. 09/2009; 20(8):844-50.

  AIM: To evaluate the bone tissue response to zirconia implants with three different surface modifications in comparison with the oxidized titanium surface with the goal to optimize osseointegrationAIM: To evaluate the bone tissue response to zirconia implants with three different surface modifications in comparison with the oxidized titanium surface with the goal to optimize osseointegration in terms of strength and speed. MATERIALS AND METHODS: A total of 18 rabbits with 143 implants were used. One hundred and twenty-three were threaded zirconia ceramic implants with three different surface topographies and 20 modified titanium oxide implants were controls. Each rabbit received eight implants and sacrificed after 3 weeks. The removal torque test (RTQ) and histology were performed. RESULTS: Sixteen out of 18 rabbits completed the study with a total of 110 implants. No statistical significance was observed between the chemical modification implants compared with the topographically modified zirconia implant in terms of interfacial shear strength proven by the RTQ applied. No statistical significance was also observed in the bone-to-implant contact between the zirconia implants and the control oxidized implants. CONCLUSIONS: The findings suggest that additional specific chemical modifications of the topographically modified zirconia implants do not seem to enhance the bone-to-implant contact and appear not to increase the interfacial shear strength.

• Vertical ridge augmentation using an equine block infused with recombinant human platelet-derived growth factor-BB: a histologic study in a canine model.

  Authors: Massimo Simion, Myron Nevins, Isabella Rocchietta, Filippo Fontana, Emilio Maschera, Peter Schupbach, David M Kim

  The International journal of periodontics & restorative dentistry. 07/2009; 29(3):245-55.

  This preclinical study evaluated the efficacy of purified recombinant human platelet-derived growth factor (rhPDGF-BB), combined with a novel equine hydroxyapatite and collagen (eHAC) bone block, inThis preclinical study evaluated the efficacy of purified recombinant human platelet-derived growth factor (rhPDGF-BB), combined with a novel equine hydroxyapatite and collagen (eHAC) bone block, in providing vertical bone regeneration in critical-size defects simulating localized mandibular alveolar bone atrophy. In addition, the impact of barrier membrane placement in growth factor-mediated bone regeneration was also studied. Bilateral posterior mandibular defects simulating severe localized bony atrophy were created in 12 adult foxhounds following removal of all four mandibular premolars. Three months later, the defects were grafted as follows: group A: eHAC block alone; group B: eHAC block + collagen membrane; group C: eHAC block + rhPDGF-BB; group D: eHAC block + rhPDGF-BB + membrane. The animals were sacrificed after 5 months and the grafted areas were examined histologically, radiographically, and clinically. Groups A and B (controls) exhibited little to no vertical bone regeneration. Group C demonstrated significant vertical bone regeneration, with dense, well-vascularized bone, high bone-to-implant contact, and accelerated replacement of graft particles with newly formed bone. In group D, with the imposition of a barrier membrane, robust bone regeneration was less evident when compared to group C. As in the first study in this series, the importance of the periosteum as a source of osteoprogenitor cells in growth factor-mediated regenerative procedures is examined.

• Growth factor-mediated treatment of recession defects: a randomized controlled trial and histologic and microcomputed tomography examination.

  Authors: Michael K McGuire, E Todd Scheyer, Peter Schupbach

  Journal of periodontology. 05/2009; 80(4):550-64.

  Background: The primary aims of this two-part prospective study were: 1) to compare the safety and efficacy of beta-tricalcium phosphate (beta-TCP) + 0.3 mg/ml recombinant human platelet-derivedBackground: The primary aims of this two-part prospective study were: 1) to compare the safety and efficacy of beta-tricalcium phosphate (beta-TCP) + 0.3 mg/ml recombinant human platelet-derived growth factor-BB (rhPDGF-BB) with a bioabsorbable collagen wound-healing dressing and a coronally advanced flap (CAF) to a subepithelial connective tissue graft (CTG) in combination with a CAF in subjects with gingival recession defects using a randomized, controlled, split-mouth design; and 2) to compare, through histologic and microcomputed tomography (micro-CT) examination, the periodontal regenerative potential of these two therapies in surgically created gingival recession defects in restoring missing cementum, periodontal ligament (PDL), and supporting alveolar bone. Methods: In the randomized controlled trial (RCT), 30 patients with Miller Class II buccal gingival recession, >/=3 mm deep and >/=3 mm wide in contralateral quadrants of the same jaw were treated and followed for 6 months. Using a split-mouth design with similar bilateral recession defects, test sites were treated with 0.3 mg/ml rhPDGF-BB + beta-TCP + bioabsorbable collagen wound-healing dressing; contralateral control sites were treated with a CTG, each in combination with a CAF. In the histologic/micro-CT study segment, recession defects were created in six teeth, each requiring extraction for orthodontic therapy. These defects were created with a recession depth >/=3 mm, the osseous crest 2 to 3 mm apical to the gingival margin, and with 2 to 3 mm of keratinized tissue. The defects were treated with a CTG (control) or rhPDGF-BB + beta-TCP + wound-healing dressing (test), plus CAF. Nine months after surgical correction, en bloc resections were obtained and examined histologically and with micro-CT. Results: In the RCT, test and control treatments demonstrated clinically significant improvements from baseline through month 6. Statistically significant results favoring the CTG were found in recession depth reduction (-2.9 + 0.5 mm, test; -3.3 + 0.6 mm, control; P = 0.009), root coverage (90.8%, test; 98.6%, control; P = 0.013), and -3.9 +/- 0.7 mm, control, -3.3 +/- 1.3 mm, test, recession width reduction (P = 0.035), whereas mid-buccal probing depth (PD) and PD reduction (PDR) reduction favored the test group (1.4 +/- 0.4 mm, test; 1.8 +/- 0.1 mm, control; P < 0.001 PD and -0.0 mm test; +0.4 mm control PDR). For all other parameters, the two treatments were statistically equivalent, including increases in keratinized tissue, esthetic results, and subject satisfaction. In the histologic/micro-CT portion, all four sites treated with rhPDGF-BB + beta-TCP showed evidence of regeneration of cementum, PDL with inserting connective tissue fibers, and supporting alveolar bone, whereas neither CTG-treated site exhibited any signs of periodontal regeneration. Conclusions: CTG and rhPDGF-BB + beta-TCP + wound-healing dressing are effective treatment modalities for clinically correcting gingival recession defects. In addition, the current study demonstrated that regeneration of the periodontium in gingival recession defects was possible through a growth factor-mediated approach.

• Human histologic evaluation of mineralized collagen bone substitute and recombinant platelet-derived growth factor-BB to create bone for implant placement in extraction socket defects at 4 and 6 months: a case series.

  Authors: Marc L Nevins, Marcelo Camelo, Peter Schupbach, David M Kim, Joao Marcelo Borges Camelo, Myron Nevins

  The International journal of periodontics & restorative dentistry. 05/2009; 29(2):129-39.

  The objective of this pilot study was to assess whether mineralized collagen bone substitute (MCBS) combined with recombinant human platelet-derived growth factor-BB (0.3 mg/mL) would generateThe objective of this pilot study was to assess whether mineralized collagen bone substitute (MCBS) combined with recombinant human platelet-derived growth factor-BB (0.3 mg/mL) would generate adequate viable bone in buccal wall extraction defects to accommodate implant placement. The primary outcome variable was bone quality, as measured by microcomputed tomography and histologic evaluation. This was successfully accomplished in all eight specimens obtained from seven patients. The secondary outcome variables were bone quality and quantity as observed clinically, radiographically, and by the primary stability of implants at the time of placement. Soft tissue healing was excellent, and there were no unanticipated adverse events. Robust bone formation accompanied by MCBS resorption was evident in all 4- and 6-month specimens. This was accomplished without barrier membranes.

• Evaluation of human recession defects treated with coronally advanced flaps and either purified recombinant human platelet-derived growth factor-BB with beta tricalcium phosphate or connective tissue: a histologic and microcomputed tomographic examination.

  Authors: Michael K McGuire, Todd Scheyer, Myron Nevins, Peter Schupbach

  The International journal of periodontics & restorative dentistry. 03/2009; 29(1):7-21.

  The current study examined the histologic and microcomputed tomographic (micro CT) outcomes of the treatment of gingival recession defects with either a subepithelial connective tissue graft (CTG) orThe current study examined the histologic and microcomputed tomographic (micro CT) outcomes of the treatment of gingival recession defects with either a subepithelial connective tissue graft (CTG) or 0.3 mg/mL recombinant human platelet-derived growth factor (rhPDGF-BB) on a beta tricalcium phosphate (beta-TCP) matrix. Gingival recession defects were surgically created in six premolar teeth with no more than 3 mm of keratinized marginal tissue, an osseous crest 2 to 3 mm apical to the newly created gingival margin, and recession depth of at least 3 mm. The defects were left untouched for 2 months; then, four defects were grafted with rhPDGF-BB + beta-TCP + a wound healing dressing, and two defects received CTGs. A coronally advanced flap covered each grafted site. Nine months later, sections were obtained for examination. All four sites treated with rhPDGF-BB + beta-TCP showed connective tissue fibers (Sharpey fibers) perpendicularly inserting into newly formed cementum and alveolar bone. In the two sites treated with CTGs, a long junctional epithelium was seen coronal to the osseous crest and connective tissue fibers ran parallel to the adjacent root surfaces, with no evidence of insertion into cementum or bone. There was no evidence of regeneration of cementum, inserting connective tissue fibers, or supporting alveolar bone. Regeneration of the periodontium in gingival recession defects is possible through growth factor-mediated therapy.

• The efficacy of demineralized bone matrix and cancellous bone chips for maxillary sinus augmentation.

  Authors: David M Kim, Marc L Nevins, Marcelo Camelo, Joao Marcelo Borges Camelo, Peter Schupbach, James J Hanratty, N Guzin Uzel, Myron Nevins

  The International journal of periodontics & restorative dentistry. 29(4):415-23.

  Demineralized bone matrix and cancellous bone chips in a reverse-phase medium carrier (DynaBlast, Keystone Dental) were used to augment the maxillary sinuses in 8 patients requiring 10 sinusDemineralized bone matrix and cancellous bone chips in a reverse-phase medium carrier (DynaBlast, Keystone Dental) were used to augment the maxillary sinuses in 8 patients requiring 10 sinus augmentations. Clinical reentry after 6 to 7 months (mean, 6.2 months) and computed tomographic scan evaluation at 5 months demonstrated new bone formation as well as sufficient radiopaque volume to place implants in all sites. Microcomputed tomographic evaluation and histomorphometric analysis of sinus core biopsies confirmed the formation of new bone and demonstrated three distinctive mineralization patterns that have been previously described. DynaBlast can be considered a viable alternative to the use of autogenous bone or other types of grafting materials. (Int J Periodontics Restorative Dent 2009;29:415-423.).

• Minimally Invasive Alveolar Ridge Augmentation Procedure (Tunneling Technique) Using rhPDGF-BB in Combination with Three Matrices: A Case Series.

  Authors: Marc L Nevins, Marcelo Camelo, Myron Nevins, Peter Schupbach, Bernard Friedland, Joao Marcelo Borges Camelo, David M Kim

  The International journal of periodontics & restorative dentistry. 29(4):371-83.

  This study investigated a minimally invasive surgical procedure for alveolar ridge augmentation that combined recombinant human platelet-derived growth factor BB (rhPDGF-BB) and three differentThis study investigated a minimally invasive surgical procedure for alveolar ridge augmentation that combined recombinant human platelet-derived growth factor BB (rhPDGF-BB) and three different matrices. The minimally invasive tunneling ridge augmentation procedure was applied to 12 patients randomized into three groups: rhPDGF-BB (0.3 mg/mL) was combined with freeze-dried bone allograft (FDBA; group A), anorganic bovine bone graft (ABBG; group B), or anorganic bovine bone graft/mineralized collagen bone substitute (ABBG/MCBS; group C). Computed tomography (CT) scans were obtained presurgically and prior to 14-week re-entry surgery. Clinical reentry revealed adequate bone volume to place implants in all patients in groups A and B and two of four patients in group C. Trephine core biopsies were obtained and evaluated by microCT, backscatter scanning electron microscopy (BE-SEM), and light microscopy. New bone formation was consistently observed with BE-SEM and histologic analysis for group A and B specimens. Newly formed woven and lamellar bone were in close contact with graft particles. The ABBG/MCBS specimens (group C) had more variable results, with fibrous encapsulation of graft particles and limited histologic evidence of new bone formation. Within the limits of this study, the FDBA and ABBG carriers appear to be appropriate scaffolds to deliver rhPDGF-BB for ridge augmentation via minimally invasive surgical techniques. (Int J Periodontics Restorative Dent 2009;29:371-383.).

• The feasibility of demineralized bone matrix and cancellous bone chips in conjunction with an extracellular matrix membrane for alveolar ridge preservation: a case series.

  Authors: David M Kim, Myron Nevins, Marcelo Camelo, Peter Schupbach, Soo-Woo Kim, Joao Marcelo Borges Camelo, Khalid Al Hezaimi, Marc L Nevins

  The International journal of periodontics & restorative dentistry. 31(1):39-47.

  An investigation was conducted to test the feasibility of demineralized bone matrix and cancellous bone chips in a reverse-phase medium carrier (DynaBlast) in concert with an extracellular matrixAn investigation was conducted to test the feasibility of demineralized bone matrix and cancellous bone chips in a reverse-phase medium carrier (DynaBlast) in concert with an extracellular matrix membrane (DynaMatrix) to provide hard and soft tissue regeneration for the purpose of a ridge preservation procedure. Nine patients requiring extraction of 30 maxillary teeth were grafted with DynaBlast and DynaMatrix. Twenty sites attained primary flap closure over the grafted area (primary healing intention group), while 10 sites were assigned randomly to the secondary healing intention group, in which primary flap closure over the membrane was not achieved. Clinical and radiographic evaluations at 6 months revealed comparable bone formation for both groups. Histologic analyses of 21 harvested soft and hard tissue core biopsies revealed absence of the remnant membrane and consistent patterns of new bone formation. The efficacy and safety of DynaBlast and DynaMatrix have been validated clinically and histologically to preserve the dimensions of the alveolar process.