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Light micrograph of a ground section of a specimen collected 5 months after DCBA placement. The grafted DCBA particles are surrounded by immature woven bone (A) and thus well integrated (B). (C) A smaller area of the specimen consists of bone marrow tissue. The marrow cavity is rich in cells and blood vessels. Scale bar ¼ 200 mm. (H&E staining, Â200 magnification). DCBA, demineralized freeze-dried cortical block allografts; H&E, hematoxylin and eosin.
Source publication
Autogenous bone-block grafts are the "gold standard" for block bone grafting, but have several disadvantages. Allografts have the potential to overcome these disadvantages. The purpose of this study was to evaluate the clinical and histomorphometric features of demineralized freeze-dried cortical block allografts (DCBA) used for ridge augmentation....
Context in source publication
Context 1
... newly formed vital bone, residual cortical block allograft bone, and connective tissue were observed in all specimens (Fig. 5). The residual cortical block allograft bone was distinguished by the existence of empty lacunae and separation lines. The newly formed bone containing viable osteocytes showed close contact with the residual cancellous block allograft. Osteoblasts were present throughout newly formed bone around the residual cortical block allograft. ...
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Background. A decrease in the width and height of the alveolar ridge is inevitable following tooth extraction. This study aimed to histologically evaluate the amount of newly formed bone after using a freeze-dried bone allograft (FDBA) at two different intervals in the tooth socket grafting.
Methods. Forty patients were selected, who required a sin...
Alveolar ridge preservation (ARP) is a method of decreasing bone resorption following tooth extraction and facilitating prosthetically-driven implant placement. An understanding of the physiological responses occurring after extraction and the effects of ARP are important in order to implement clinical procedures. ARP is a predictable way to reduce...
Objectives: Bone remodeling after tooth extraction results in decreased ridge volume and complicates implant placement. Platelet-rich fibrin (PRF) is a rich source of autogenous cytokines and growth factors; it has been proven to effectively improve soft tissue healing and hard tissue regeneration. This study sought to compare the clinical applicat...
Purpose:
Previous studies have solely focused on fresh extraction sockets, whereas in clinical settings, alveolar sockets are commonly associated with chronic inflammation. Because the extent of tissue destruction varies depending on the origin and the severity of inflammation, infected alveolar sockets may display various configurations of their...
Background
The shrinkage of alveolar bone dimensions after tooth extraction is a well-known issue. This clinical phenomenon poses a challenge for clinicians aiming at implant-prosthetic treatment. BonMaker ® ATB is a novel autogenous bone grafting material, produced by the mechanical and chemical processing of natural teeth. This pilot case report...
Citations
... No membranes were used, and all cases were performed with a 2-stage approach (implant placement after 5 months of healing). Clinical analysis showed that the mean gain in horizontal bone was 1.65 ± 0.14 mm, and that the mean percentage of graft resorption was 5.39 ± 2.18% (19). In spite of the good results, allografts have the same problems of the autogenous grafts, since they resorb the same way. ...
Background
Tooth loss and use of a complete denture is still a reality and results in bone loss. Adequate reconstruction of an extremely atrophic edentulous maxilla is a challenge, and different treatment methods have been described for its resolution.
Material and Methods
Patients seeking implant placement in edentulous upper jaw with atrophic maxilla were selected in a private clinic in Porto Alegre, Brazil. The bone graft was performed with bilateral sinus lift and horizontal bone graft in anterior region with 0,25-1mm particles of Bio-Oss (Geistlich) covered with a collagen membrane (Bio-Gide, Geistlich). CBCTs were evaluated to verify the need for bone graft, and 6-8 months after bone graft follow-up, to plan implant placement and assess horizontal bone gain.
Results
124 implants were placed in 19 patients, 76 of those in the sinus region. The survival rate was 95.2%, with six implants lost over a mean implants follow-up time of 47.68 months. The horizontal bone gain ranged from 0.00 to 6.86 mm, a mean gain of 2.85mm. An average of 5.5g of Bio-Oss was used per patient, and in 73.7 % of the cases, a flapless surgery was possible for implant placement, and in 92 implants an immediate loading was possible. Final rehabilitation was accomplished with fixed prosthodontics in 16 patients with a mean follow-up of 38.4 months.
Conclusions
Within the limitations of this study, it is possible to affirm that bone graft with 100% Bio-Oss in atrophic maxilla is a reliable treatment and allow rehabilitation with implants with a high survival rate and the higher the initial bone height, the greater the gain in bone width.
Key words:Bone Regeneration, Dental Implants, Prosthodontics, Dentistry.
... [24][25][26] Bone block allografts (BBAs) are an alternative that can be used to overcome most of the disadvantages described, especially complications associated with the donor site. 27 Allografts are biomaterials from another individual of the same species, often of cadaveric origin, that are sterilized, processed, and stored in tissue banks. 28 The advantages of this type of graft may include unlimited supply, reduced surgical trauma, no donor site morbidity and extremely low antigenic potential. ...
... This, in turn, enhances both the rate and the quality of bone formation. 27 Nevertheless, like autologous grafts, BBAs require stability and intimate contact with the recipient bed, therefore must be contoured and adapted to maximize the contact surface. This condition facilitates neovascularization and allows integration of the block during the healing phase. ...
Background
Reduced alveolar ridge volume is an often consequence after tooth loss, compromising implant placement and prosthetic rehabilitation. The digital customization of bone block allografts (BBA) is an alternative that incorporates advantages such as intimate contact with the recipient bed, increasing graft stability and reduced surgical time. In addition, enamel matrix derivate (EMD) has attracted interest for its effect on osteogenic gene expression and cell adhesion; few studies have focused on the benefits of bone regeneration with EMD. The aim of this case report is to present the reconstruction of a severely atrophic alveolar ridge defect with a digitally customized bone block allograft (CBBA) in combination with EMD as an adjuvant for bone regeneration and soft tissue healing.
Methods
Initially, the digital planning and manufacture of the BBA was performed based on an initial cone beam computed tomography (CBCT) scan. EMD was applied to the recipient site and to the CBBA before graft fixation. After 6 months, bone biopsies were obtained on re‐entry surgery for prosthetically guided implant placement.
Results
Clinically, bone block showed good integration with the adjacent tissue and no signs of rejection or necrosis were found. On the histological evaluation, new bone was observed in intimate contact with the allograft and showed viable osteocytes and osteoblasts along its entire length. Residual allograft particles were observed to be highly osteoconductive.
Conclusion
According to the clinical and histological results presented, the digital customization of the BBA allows an ideal graft fit to the recipient bed with excellent results in bone regeneration.
... Grafting materials of various origins, such as autografts, allografts, xenografts, or synthetic origins, have been used and studied with or without barrier membranes. (26,27) Due to the absence of cell adhesion signals in synthetic polymers and various drawbacks, the emphasis of current research has switched to natural polymers for uses in bone tissue engineering. (28) Collagen, fibrinogen, and elastin are a few of the natural polymers that make up the extracellular matrix (29). ...
... [19][20][21][22] No vertical graft resorption was observed in either groups. This finding is in contrast with the results by Aslan et al. [23] where they found a mean percentage of vertical graft resorption of 5.4% following the use of a cortical block allograft for augmentation of the alveolar ridge after 5 months of healing. Also Kloss et al. [16] reported the vertical graft shrinkage of about 5.7% ± 5.6% with autogenous while 5.9% ± 6.1% with allogeneic block in ridge augmentation procedures. ...
Background:
The aim of the present study was to evaluate and compare the patient-reported experience and outcome measures (PREMS and PROMS) and three-dimensional augmentation efficacy of the autogenous and allogenic bone block grafts in deficient alveolar ridges through cone beam computed tomography (CBCT).
Materials and methods:
Twenty patients were equally divided into Groups I and II treated with autogenous and allogenic bone block grafts for ridge augmentation, respectively. The radiographic parameters including the apico-coronal defect height (DH) as well as buccolingual defect depth (DD) and mesiodistal defect width (DW) at apical, middle, and cervical zone were measured using CBCT at baseline, 6 months and 1 year. The PREMS and PROMS were evaluated using Visual analogue scale (VAS) scale and questionnaire method.
Results:
The mean DH, apical DD and DW, middle and cervical zone DW were significantly different between two study groups (P < 0.05). The mean apical 11.6 ± 1.91 and middle zone 9.43 ± 0.89 DD were significantly higher (in Group I as compared to Group II, with P values 0.016 and 0.004, respectively). The mean bone gains in apico-coronal DH and mesio-distal DW dimension in the apical and middle zone was significantly higher in Group I (P < 0.0001). The comparison of PROM revealed better patient satisfaction in Group II as depicted by significantly higher VAS score (P < 0.0001).
Conclusion:
Superior bone gain and reduced graft resorption was observed in Group I when compared to Group II. On the contrary, better PROMs and PREMs were obtained with the allogenic bone block augmentation.
... Increasing awareness of the use of bone grafting materials for the treatment of periodontal osseous defects has resulted in the dissemination and proliferation of a diverse range of donor/implant materials. An ideal graft material should be biocompatible enough to allow for graft integration or remodelling, as well as provide a highly osteoconductive scaffold for osteogenic cells (1).Due to their superior osteogenicity, osteoinduction, osteoconductivity, and biocompatibility, autogenous bone grafts are regarded as the gold standard (2). Despite the fact that allogenic bone, alloplasts, xenogeneic bone, and bone substitutes have shown some promise in the past, they do not transplant any osteocompetent cells (3). ...
Equinox (Group 3). Osteotomy drilling for collection of bone particles was performed on each lateral portion of the mandibles. Thus a total of 6 osteotomies were done for each group. The bone particles stuck to the flutes of the drills were collected by scraping into a small container. The bone particles were sieved serially using two sieves of size 500 μm and 850 μm. The particles were divided into three categories based on particle sizes; <500 μm, 500-850 μm, and >850 μm. Then, the wet volume of each category was measured. After drying for 72 hours at room temperature, the total and categorical dry volumes were also measured. RESULTS: The wet volume of >850μm sized bone particles were greater than that of bone particles with sizes 500-850μm and <500μm in all three groups. The total volume of bone collected was highest in Group A followed by Group B and Group C. The difference in the total wet and dry volume between the groups was statistically significant (P<0.05). The percentage of wet volume of bone particles >850μm in size was 82% in Group A and 68% in Group C. The dry weight of bone particles in all three groups had a similar pattern of wet volume. The weight of bone particles >850μm was significantly greater than that of 500-850μm and <500μm. CONCLUSION:The amount of total bone particles collected was statistically greater in Group A, followed by Group B and Group C. , Larger particle size bone chips in both wet and dry volumes (>850μm) were harvested in greater amounts than <500μm and 500-850μm. Particle size of >850μm was higher in Group A drills.
... A total of 54 abstracts were reviewed and full-text analysis included 28 articles. Finally, one comparative [29], and 12 non-comparative studies were included [30][31][32][33][34][35][36][37][38][39][40][41]. ...
... Studies included in the present systematic review consisted of one comparative retrospective radiographic evaluation [29], and 12 non-comparative case-series [30][31][32][33][34][35][36][37][38][39][40][41]. Partial and totally edentulous patients with horizontal alveolar ridge deficiencies of the maxilla and mandible were enrolled. ...
... Age and gender distribution as well as inclusion criteria and exclusion criteria were specified in all included studies. Alveolar deficiency was defined according to ITItreatment guide categories [29], Cawood and Howell classification [33,37], Kennedy classification [41], or not specified [30][31][32][34][35][36][38][39][40]. Preoperative width of the alveolar ridge was specified in six noncomparative studies [31][32][33][34]38,39]. ...
... Allogeneic bone blocks offer a viable alternative to autologous bone, as they can be obtained in unlimited quantities from a human tissue bank, are of limited antigenicity, and present a low risk of disease transmission thanks to a complex process of delipidization, oxidation, dehydration, and gamma irradiation (1,10,11). Although, the allogeneic bone block graft technique is simpler, this technique, does not present identical behavior to autologous grafts and to date scientific evidence in support of its use is relatively scarce (11,12). Due the lack of studies and standardized protocols, with firmly inclusion criteria and medium-and long-term follow-up, we deem justified to carry out a systematic review. ...
... (4,17), while another study measured resorption of the original bone block as a percentage, with a mean of 5.39±2.18% (12). ...
... -Histologic and histomorphometric findings Newly formed bone, residual bone graft, and soft tissue were evaluated in only four of the articles reviewed. In three works concerning allogeneic bone blocks, newly formed bone ranged between 31% and 42% on average; residual bone graft varied from 14% to 40%, while marrow and connective tissue ranged between 19.3 and 53.7% (12,16,17). ...
Background:
This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis.
Material and methods:
An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates.
Results:
Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts.
Conclusions:
Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings.
... In addition, it has been reported that freeze-dried sperm maintains its fertilization function (Kaneko & Serikawa, 2012;Keskintepe & Eroglu, 2015). For bone regeneration, especially reconstruction of the jaw bone in dentistry, demineralized freeze-dried bone is applied in the clinic (Aslan et al., 2016;Innes & Myint, 2010;Lytle, 1994). Thus, freeze drying is able to preserve protein functions. ...
Freeze‐dry processing improves the operability and stability of cell‐based biomaterials and facilitates sterilization for clinical application. However, there is no established freeze‐drying protocol for engineered tissues. Recently, we reported that biomimetic bone tissues can be fabricated using scaffold‐free three‐dimensional (3D) cell constructs with potential applications as bone graft materials. The purpose of this study was to assess the influence of freeze drying on the morphology and components of 3D cell constructs. Cell constructs freeze dried in phosphate buffered saline (PBS) maintained organic and inorganic components; whereas sodium citrate buffer (SCB)‐treated constructs had significantly lower amounts of calcium and bone‐related proteins. Alkaline phosphatase (ALP) activity in cell constructs was maintained by freeze drying in 10% sucrose‐containing PBS, whereas cell constructs treated with PBS without sucrose or with sucrose‐containing SCB showed significant reductions of ALP activity. In this study, we found that sucrose‐containing phosphate buffer was suitable for freeze drying to maintain minerals and protein functions within 3D cell constructs, whereas citrate buffer was inappropriate. The insights gained by this study may facilitate the development of novel cell‐based biomaterials fabricated by tissue engineering approaches and bone graft biomaterials.
... An ideal grafting material for ridge augmentation should be easy to handle and apply, should have excellent biocompatibility in order to enable graft integration or remodeling and be a supply highly osteoconductive scaffold for osteogenic cells (Aslan et al., 2016). Bone allografts have been demonstrated to excel other grafting materials with respect to the aforementioned criteria. ...
... Aslan and colleagues reported a mean percentage of vertical graft resorption of 5.4% following the use of a cortical block allograft for augmentation of the alveolar ridge after 5 months of healing (Aslan et al., 2016). This percentage is nearly exactly the same value as found in our analysis for vertical graft shrinkage. ...
Objectives
The aim of this study was to compare three‐dimensional alterations following the use of autogenous versus allogeneic onlay grafts for augmentation at single tooth defects.
Materials and methods
Alveolar bone width at specific implant sites were assessed using sagittal and cross‐sectional CBCT images prior grafting and at three subsequent time points. 21 patients received autogenous bone blocks harvested from the retromolar region and another 21 patients received freeze‐dried cancellous allogeneic bone blocks.
Results
The vertical and horizontal dimensions did not significantly differ between autogenous and allogeneic bone grafts at any time point. In addition, there were no statistically significant differences in graft remodeling rates between autogenous (mean shrinkage rate after 12 months: 12.5 ± 7.8 %) and allogeneic onlay grafts (mean shrinkage rate after 12 months: 14.4 ± 9.8 %).
Conclusions
Freeze‐dried cancellous allogeneic bone blocks showed equivalent volumetric shrinkage rates as autogenous bone blocks when used for treating circumscribed bone defects classified as Type‐II to Type‐IV according to the ITI‐treatment guide categories. Therefore, it is not necessary to over‐contour the alveolar ridge when using allogeneic blocks for treating single tooth defects, but to apply the same procedure as when using autogenous blocks.
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... The bone remodeling after allogeneic graft occurs by means of newly-formed bone and blood vessels spread through the grafted material [14]. This regenerative and remodeling process of in-block grafts is influenced by many factors, as allogeneic bone origin, surgical technique, bone volume available before the surgery, healing time, and different receptor sites [17]. These are important points to be considered during the patients' evaluations. ...
... In another study on animal and human model, the allogeneic bone showed inadequate revascularization, decrease of the mineral deposition, while the autogeneic bone revealed small differences between the residual and grafted bone [16]. An in vivo study with autogenous and allogenous bone showed signs of delayed remodeling of the latter, seven months after the grafting, with small amounts of remodeling bone [15] All this aforementioned discussion on the outcomes of allogeneic grafts may explain the presence of the bone fistula, at the allogeneic graft area, in this case report [16,17]. ...
p> ABSTRACT
The high dental implant success rate is directly linked to the presence of adequate bone volume, which enables and maintains the osseointegration of dental implants. This study aimed to report a clinical case of a female with agenesis of the right maxillary lateral incisor (#12), due to cleft lip and palate.Because the bone and mucosal defects of the area, the treatment planning comprised guided bone regeneration with the association of autogenous bone, platelet rich plasm (PRP), and expanded polytetrafluoroethylene membrane (e-PTFE,Gore-Tex), performed in 2005. After nine months, a new evaluation was carried out and revealed that the area was still not suitable for implant placement. Thus, an allogenous bone graft was planned. Elapsed another nine months, the implant was placed. After six months, the implant was reopened and a metal-ceramic crown was installed. The 5-year following-up appointment showed the presence of fistula with purulent secretion at the buccal cortical plate. We attempted to control the fistula with antibiotics and follow-up clinically and radiographically. The examinations suggested a communication with the right nasal cavity, which decreased until nowadays. The osseointegrated dental implant was in function, without symptomatology. The autogenous bone graft is still more effective than allogenous bone graft. Further studies are necessary to achieve better evaluations.
Keywords
Bone graft; Dental implant; Osseointegration.</p
