Biocompatibility and effect on bone formation of a native acellular porcine pericardium: Results of in vitro and in vivo / 北京大学学报(医学版)

OBJECTIVE@#To examine the morphology and biocompatibility of a native acellular porcine pericardium (APP) in vitro and to evaluate its barrier function and effects on osteogenesis when used in guided bone regeneration (GBR) in vivo.@*METHODS@#First, the morphology of APP (BonanGenⓇ) was detected using a scanning electron microscope (SEM). Next, for biocompatibility test, proliferation of human bone marrow mesenchymal stem cells (hBMSCs) were determined using cell counting kit-8 (CCK-8) after being seeded 1, 3 and 7 days. Meanwhile, the cells stained with phalloidine and 4, 6-diamidino-2-phenylindole (DAPI) were observed using a confocal laser scanning microscopy (CLSM) to view the morphology of cell adhesion and pattern of cell proliferation on day 5. A 3-Beagle dog model with 18 teeth extraction sockets was used for the further research in vivo. These sites were randomly treated by 3 patterns below: filled with Bio-OssⓇand coverd by APP membrane (APP group), filled with Bio-OssⓇand covered by Bio-GideⓇmembrane (BG group) and natural healing (blank group). Micro-CT and hematoxylin-eosin (HE) were performed after 4 and 12 weeks.@*RESULTS@#A bilayer and three-dimensional porous ultrastructure was identified for APP through SEM. In vitro, APP facilitated proliferation and adhesion of hBMSCs, especially after 7 days (P < 0.05). In vivo, for the analysis of the whole socket healing, no distinct difference of new bone ratio was found between all the three groups after 4 weeks (P>0.05), however significantly more new bone regeneration was detected in APP group and BG group in comparison to blank group after 12 weeks (P < 0.05). The radio of bone formation below the membrane was significantly higher in APP group and BG group than blank group after 4 and 12 weeks (P < 0.05), however, the difference between APP group and BG group was merely significant in 12 weeks (P < 0.05). Besides, less resorption of buccal crest after 4 weeks and 12 weeks was observed in APP group of a significant difference compared in blank group (P < 0.05). The resorption in BG group was slightly lower than blank group (P>0.05).@*CONCLUSION@#APP showed considerable biocompatibility and three-dimentional structure. Performing well as a barrier membrane in the dog alveolar ridge preservation model, APP significantly promoted bone regeneration below it and reduced buccal crest resorption. On the basis of this study, APP is a potential osteoconductive and osteoinductive biomaterial.

Application of absorbable plate in the repairment of orbital Trapdoor fracture in children / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To analyze the treatment of orbital Trapdoor fracture in children and the application of absorbable plate in surgery, so as to accumulate experience for clinical diagnosis and treatment.<p>METHODS: Retrospective analysis of 55 cases(55 eyes)orbital Trapdoor fractures in children. The fracture site was simple orbital floor fracture. All patients were approached by palpebral conjunctiva of lower eyelid. During operations, the embedded extraocular muscles and orbital tissues were returned. A resorbable implant was implanted into the orbit after trimming to proper sizes and shaped according to the fracture defect range. The therapeutic effect was evaluated by preoperative and postoperative ocular examination and orbital CT scan. Repeated measure analysis of variance was used to compare the differences of postoperative outcome evaluation indexes among patients with different operation timing.<p>RESULTS: No serious complications happened during and after surgeries in all patients. The postoperative CT scan showed that the fractures had good anatomical restoration. After the operation, diplopia and limitation of extraocular muscle movement(EOM)recovered obviously. The earlier the operation performed after the injury, the better the postoperative recovery effect was. At the same time, the resorbable implant could repair orbital Trapdoor fracture in children well. It serves as a better material of orbital fracture repairment.<p>CONCLUSION: Operation is an effective method to treat orbital Trapdoor fracture in children, and should be performed as soon as possible after injury. The resorbable implant is a good orbital repair material.

Clinical application of resorbable plate in orbital fracture surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical application of resorbable implants in orbital fracture repair surgery.<p>METHODS: A retrospective analysis of 48 eyes in 48 cases of orbital fracture, all patients were treated with resorbable implants for orbital fracture repair. During operations we exposed fully fracture defect range and returned the tissues that entered the paranasal sinus. A resorbable implant was trimmed to proper sizes according to the fracture defect range and fixed with 2 absorbable screws. The accuracy of plate positioning of the reconstructed orbit and the practicability of clinical use of resorbable implant were judged by the ophthalmic examination and computed tomography(CT)scan before and after operation. <p>RESULTS: All the patients completed the operation successfully and had no serious complications during or after surgery. All the patients had a good anatomical restoration by the postoperative CT scan. One year re-examination after operation, among 18 eyes with limitation of extraocular muscle movement(EOM)before operation 1 eye(6%)with limitation of EOM improved after surgery,17 eyes(94%)with limitation of EOM got cured. Among 30 cases with diplopia before operation 12 cases(40%)with diplopia improved after surgery, 18 cases(60%)with diplopia got cured. Among 32 eyes with enophthalmos before operation 10 eyes(31%)with enophthalmos improved after surgery, 22 eyes(69%)with enophthalmos get cured. Among 40 eyes with suborbital skin numbness before operation 33 eyes(82%)with suborbital skin numbness improved after surgery, 7 eyes(18%)with suborbital skin numbness got cured. Only one eye got lower eyelid entropion after surgery and was resolved by the second correction of entropion.<p>CONCLUSION: The resorbable implant can repair the fractures of orbital wall well. It is a better material of orbital fracture repairment.

Comparison of the removal torque and a histomorphometric evaluation of the RBM treated implants with the RBM followed by laser treated implants: an experimental study in rabbits / 영남의대학술지

BACKGROUND: In the osseointegration of dental implants, the implant surface properties have been reported to be some of the most important critical factors. The effect of implant's surfaces created by resorbable blast media (RBM) followed by laser ablation on bone tissue reactions was examined using the removal torque test and histomorphometric analysis.METHODS: Two types of dental implants, RBM-laser implants (experimental group) and RBM implants (control group) (CSM implant system, Daegu, Korea; L=6 mm, diameter=3.75 mm) were placed into the right and left distal femoral metaphysis of 17 adult rabbits. Six weeks after placement, removal torque was measured and histomorphometric analysis was performed.RESULTS: The mean removal torque was 24.0±10.2 Ncm and 46.6±16.4 Ncm for the control and test specimens, respectively. The experimental RBM-laser implants had significantly higher removal torque values than the control RBM implants (p=0.013). The mean values of total and cortical bone to implant contact (BIC) were respectively 46.3±10.8% and 65.3±12.5% for the experimental group, and 41.9±18.5% and 57.6±10.6% for the control group. The experimental RBM-laser implants showed a higher degree of total and cortical BIC compared with RBM implants, but there was no statistical significance (p=0.482, 0.225).CONCLUSION: The removal torque and BIC of the test group were higher than those of the control group. In this study, the surface treatment created by RBM treatment followed by laser ablation appears to have a potential in improving bone tissue reactions of dental implants.

Orbital wall restoring surgery with resorbable mesh plate

BACKGROUND: Orbital resorbable mesh plates are adequate to use for isolated floor and medial wall fractures with an intact bony buttress, but are not recommended to use for large orbital wall fractures that need load bearing support. The author previously reported an orbital wall restoring surgery that restored the orbital floor to its prior position through the transnasal approach and maintained temporary extraorbital support with a balloon in the maxillary sinus. Extraorbital support could reduce the load applied on the orbital implants in orbital wall restoring surgery and the use of resorbable implants was considered appropriate for the author’s orbital wall restoring technique. METHODS: A retrospective review was conducted of 31 patients with pure unilateral orbital floor fractures between May 2014 and May 2018. The patients underwent transnasal restoration of the orbital floor through insertion of a resorbable mesh plate and maintenance of temporary balloon support. The surgical results were evaluated by the Hertel scale and a comparison of preoperative and postoperative orbital volume ratio (OVR) values. RESULTS: The OVR decreased significantly, by an average of 6.01% (p < 0.05) and the preoperative and postoperative Hertel scale measurements decreased by an average of 0.34 mm with statistical significance (p < 0.05). No complications such as buckling or sagging of the implant occurred among the 31 patients. CONCLUSION: The use of resorbable mesh plate in orbital floor restoration surgery is an effective and safe technique that can reduce implant deformation or complications deriving from the residual permanent implant.

Use of resorbable mesh and fibrin glue for restoration in comminuted fracture of anterior maxillary wall

BACKGROUND: The facial bone has a complex structure compared to other bones, and various types of fractures can occur due to its characteristics. Among them, in comminuted fractures of anterior maxillary wall, multiple depressed and impacted bony segments cannot be reduced easily when performing internal fixation using plates and screws or wires, and inadequate restoration leads to a range of complications. This paper introduces an alternative technique using a resorbable mesh with fibrin glue to restore comminuted fractures of anterior maxillary wall. METHODS: Thirteen patients were diagnosed with comminuted fractures of anterior maxillary wall between March 2017 and February 2018 in the authors’ hospital. All patients with comminuted fractures of anterior maxillary wall underwent restoration using resorbable mesh with fibrin glue. The patients’ demographics, causes of facial trauma, mean operation time, length of hospital stay, follow-up period, and complications were recorded. RESULTS: No major complications and only one hypoesthesia of the skin area was noted. Three months after surgery, the hypoesthesia recovered completely. After surgery (mean, 3.9 months; range, 2–12 months), computed tomography showed that the bone fragments in all patients were fixed successfully in their anatomical places. CONCLUSION: In comminuted fractures of anterior maxillary wall, the use of a resorbable mesh with fibrin glue can be an advantageous and effective method for a successful restoration without complications.

Regeneración tisular guiada en paciente diabético: reporte de caso / Guided Tissue Regeneration in a Diabetic Patient: A Case Report

Se presenta el caso clínico del manejo de un defecto intraóseo de dos paredes con un procedimiento de regeneración tisular, guiada mediante el uso de una barrera de membrana reabsorbible de colágeno y aloinjerto óseo en una paciente de 56 años, diabética tipo 2 controlada, que acudió a la clínica de periodoncia de la Universidad Popular Autónoma del estado de Puebla en México. A 2 meses, el posoperatorio mostró una adecuada cicatrización de los tejidos, disminución de la profundidad al sondeo y una evidencia radiográfica de llenado del defecto y formación ósea a los 4 meses. A pesar de la relación bidireccional entre enfermedad periodontal y la diabetes tipo 2, queda demostrado que el tratamiento periodontal de un paciente diabético con buen control metabólico es muy similar a uno sin diabetes, que hace predecible el resultado de la terapia periodontal regenerativa con el uso de barrera de membrana reabsorbible y aloinjerto óseo.

A clinical case of the management of a two-wall intrabony defect with a guided tissue regeneration procedure by using a collagen resorbable barrier membrane and bone allograft in a 56 years old controlled diabetic patient who attended to the clinic periodontics of Popular Autonomous University of Puebla is presented. At 2 months, the postoperative period showed adequate scarring of the tissues, decreased depth of sounding and radiographic evidence of defect filling and bone formation at 4 months. Despite the bi-directional relationship between periodontal disease and type 2 diabetes, it was shown that the periodontal treatment of a diabetic patient with good metabolic control is very similar to one without diabetes, which makes the result of regenerative periodontal therapy predictable with the use of absorbable membrane barrier and bone allograft.

Distracción ósea mandibular con aparatos reabsorbibles: reporte de tres casos / Mandibular distraction osteogenesis with resorbable devices: report of three cases

La micrognatia e hipoplasia unilateral mandibulares son un rasgo característico en algunos síndromes que incluyen defectos faciales, pero también se pueden presentar como secuelas de traumatismo sobre los tejidos duros del complejo maxilofacial. Dichas alteraciones adquiridas o congénitas, ocasionan grandes trastornos estéticosy funcionales. La distracción ósea descrita por Ilizarov como un método de elongación de los huesos largos, aplicado al área maxilofacial en años recientes, ha demostrado ser una técnica eficaz para la corrección de estos defectos. En este artículo se reportan tres casos de corrección de deformidades mandibulares en niños mediante la técnica de distracción ósea utilizando aparatos reabsorbibles, siendouna de sus ventajas el que no se requiere una segunda intervenciónquirúrgica para su retiro. Los pacientes fueron intervenidos en la Unidad Médica de Alta Especialidad (UMAE) No. 71 del Instituto Mexicano del Seguro Social, en donde desde hace 10 años se ha estadoutilizando el método de distracción ósea para manejo de deformidades mandibulares en niños con muy buenos resultados.

Mandibular micrognathia and unilateral mandibular hypoplasia are atypical feature of certain facial deformity syndromes, though can alsoappear as sequelae of maxillofacial hard tissue trauma. Acquired orcongenital alterations of this nature can have a signifi cant aestheticand functional impact. Ilizarov describes distraction osteogenesis as amethod for lengthening long bones, one that in recent years has beenapplied to the maxillofacial region and proved an eff ective technique forcorrecting these defects. This article reports three cases of mandibulardeformity correction in children, carried out using the distraction osteogenesistechnique with resorbable devices. One of the advantagesof using such devices is that the need for a second surgical interventionto remove them is eliminated. All patients were treated at AdvancedSpecialty Medical Unit (UMAE) 71 of the Mexican Institute of SocialSecurity, which, for the last ten years, has been using the distractionosteogenesis method to correct mandibular deformities in children,with optimal results.

Preservación de alvéolos mediante fosfato tricálcico beta, con y sin membrana / Socket preservation using beta-tricalcium phosphate with or without membrane

El presente estudio evalúa los resultados de la utilización del fosfato tricálcico beta en la preservación de alvéolos postextracción al emplearlo solo o en conjunto con membranas no reabsorbibles. Se seleccionaron 18 dientes con indicación de extracción y con condiciones favorables para la preservación del alvéolo y posterior colocación de un implante oseointegrado. En 10 alvéolos se utilizó como relleno fosfato tricálcico beta en conjunto con membrana no reabsorbible, y 8 alvéolos fueron tratados solamente con fosfato tricálcico beta. Previo a la cirugía se evaluó el ancho y alto de cada alvéolo, mediante una tomografía computarizada de alta resolución, evaluación que fue repetida 6 meses después de realizada la intervención quirúrgica. Al momento de efectuar la técnica quirúrgica para la instalación de los implantes se tomaron muestras histológicas del sitio de colocación del implante para estudiar las características histológicas del sitio injertado después de 6 meses de realizada la cirugía de extracción dentaria y preservación de alvéolo. El uso de fosfato tricálcico beta, independiente o no del uso de membrana, mantuvo la altura del alvéolo transcurridos 6 meses desde su colocación, mientras que el ancho del alvéolo se mantuvo solo en el grupo sin membrana. Los resultados histológicos demostraron cantidades variables de regeneración ósea.

The present study evaluated the results of the post-extraction socket preservation technique using Beta-Tricalcium Phosphate with and without the use of a non-resorbable membrane. A total of 18 teeth with indication of extraction and socket preservation were selected, with 10 alveoli being treated with Beta-Tricalcium Phosphate combined with a non-resorbable membrane, and the other 8 with Beta-Tricalcium Phosphate only. The width and height of each socket was evaluated using computed tomography, prior to the extraction, and 6 months after the surgery. At the time of performing the surgical technique for installing the implants, histological specimens were taken from the implant site in order to study the graft site 6 months after the dental extraction surgery and alveoli preservation.The use of Beta-Tricalcium Phosphate, whether a membrane is used or not, maintained the alveolar height 6 months after the extraction, while the width of the alveolus only remained in the group without membrane. Histological results showed varying amounts of bone regeneration.

Evaluation of clinical outcomes of implants placed into the maxillary sinus with a perforated sinus membrane: a retrospective study / 대한악안면성형재건외과학회지

BACKGROUND: The aim of this study was to evaluate the clinical outcomes of implants that were placed within the maxillary sinus that has a perforated sinus membrane by the lateral window approach. METHODS: We examined the medical records of the patients who had implants placed within the maxillary sinus that has a perforated sinus membrane by the lateral approach at the Department of Oral and Maxillofacial Surgery of Chonnam National University Dental Hospital from January 2009 to December 2015. There were 41 patients (male:female = 28:13). The mean age of patients was 57.2 ± 7.2 years at the time of operation (range, 20–76 years). The mean follow-up duration was 2.1 years (range, 0.5–5 years) after implant placement. Regarding the method of sinus elevation, only the lateral approach was included in this study. RESULTS: Ninety-nine implants were placed in 41 patients whose sinus membranes were perforated during lateral approach. The perforated sinus membranes were repaired with a resorbable collagen membrane. Simultaneous implant placements with sinus bone grafting were performed in 37 patients, whereas delayed placements were done in four patients. The average residual bone height was 3.4 ± 2.0 mm in cases of simultaneous implant placement and 0.6 ± 0.9 mm in cases of delayed placement. Maxillary bone graft with implant placement, performed on the patients with a perforated maxillary sinus membrane did not fail, and the cumulative implant survival rate was 100%. CONCLUSIONS: In patients with perforations of the sinus mucosa, sinus elevation and implant placement are possible regardless of the location and size of membrane perforation. Repair using resorbable collagen membrane is a predictable and reliable technique.

Evaluation of results of maxillary sinus lifting surgeries using Resorbable synthetic hydroxyapatite

AIM: This study aims to evaluate the results of 10 cases of maxillary sinus lifting using synthetic resorbable hydroxyapatite (osteogen ®) as a filling material. MATERIAL AND METHODS: The surgeries were performed in patients who presented bone resorption in this region. The results were compared radiographically six months after the surgery through initial and final radiographs analysis. RESULTS: The vertical bone height gain was on average 1200.4%, when compared to the initial bone edge. CONCLUSION: The formation of bone tissue in that region had made possible future prosthetic rehabilitation.

Desarrollo de sitio periimplantario mediante regeneración ósea guiada e injerto conectivo en el sector anterior / Peri-implant Site Development using Guided Bone Regeneration and Connective Tissue Graft in the Anterior Region

Condiciones desfavorables del reborde alveolar debido a atrofia, enfermedad periodontal o traumatismos pueden generar deficiencias de volumen óseo, produciendo como consecuencia una relación corona/implante inadecuada y un aspecto estético desfavorable. La presente serie de casos propone el uso de la técnica asociada a un injerto de tejido conectivo como método de desarrollo de sitio periimplantario, con el fin de corregir deficiencias del reborde alveolar, para permitir la posterior instalación de un implante óseo integrado. Ocho pacientes con indicación de extracción de una pieza anterior, asociada a ausencia de la tabla vestibular y a una pérdida de tejidos duros y blandos, fueron sometidos a un procedimiento de regeneración ósea guiada mediante el uso de una mezcla de xenoinjerto y hueso autólogo en conjunto con una membrana reabsorbible e injerto conectivo autólogo. A los 6 meses postratamiento, fue colocado el implante, y provisionalizado inmediatamente. En todos los casos se logró una mejora y una equiparación de los contornos periimplantarios con las piezas vecinas. No existieron complicaciones posoperatorias, la regeneración de tejidos fue exitosa en todos los casos intervenidos, y todos los implantes se integraron correctamente. La regeneración ósea guiada en conjunto con un injerto de tejido conectivo fue un método efectivo para el desarrollo de sitio periimplantario previo a la colocación de implantes en el sector anterior del maxilar.

Unfavorable conditions of the alveolar ridge, due to atrophy, periodontal disease or trauma, can lead to osseous volume deficiencies, producing an inadequate crown / implant relationship and an unfavorable esthetic appearance. The present case series proposes the use of guided bone regeneration (GBR) associated with a connective tissue graft, as a method for peri-implant site development, to correct alveolar ridge deficiencies, and to allow the subsequent placement of an osseointegrated implant. Eight patients with the indication of an anterior tooth extraction, associated with a loss of the vestibular plate and a hard and soft tissue deficiency, were treated with a GBR procedure using a mixture of xenograft-autogenous bone in conjunction with a resorbable membrane and an autogenous connective tissue graft. At 6 months post-treatment, the implant was installed and immediately provisionalized. In all the cases, an improvement and matching of the tissue contours with the neighboring teeth was achieved. There were no postoperative complications. The tissue regeneration was successful in all the cases, and all the implants achieved a correct integration. GBR, in conjunction with a connective tissue graft, was an effective method to perform a peri-implant site development prior to the implant installation in the maxillary anterior region.

Técnica de preservación del volumen alveolar post-extracción utilizando hueso liofilizado y lámina ósea cortical / Preservation techniques of alveolar post-extraction volume using liophilisate bone and cortical bone sheets

Se evaluó la eficacia del hueso liofilizado humano (Matriz Ósea UNC en Polvo) injertado en cavidades alveolares post-extracción, recubierto por una lámina ósea cortical (Matriz Ósea UNC en membrana), en el tratamiento de preservación del perfil volumétrico del reborde alveolar.La metodología de trabajo se fundamentó en: 1) El estudio de una casuística de 27 casos clínicos en pacientes de ambos sexos que poseían elementos dentarios unirradiculares con indicación de extracción. Se injertó en las cavidades óseas resultantes hueso liofilizado, contenido in situ mediante una lámina ósea cortical parcialmente desmineralizada. Los pacientes fueron evaluados clínica y radiográficamente, mediante modelos de estudio, Rx convencional y radiovisiografía que permitieron mensurar las modificaciones producidas por resorción durante un año. Se realizaron controles pre y post-operatorios, a los 7, 15, 30, 60, 90, 120, 180 y 360 días. A los modelos de yeso preliminares y a los obtenidos a los 120 y 360 días se les efectuaron cortes transversales en las zonas de estudio y se los escaneó. Las imágenes obtenidas se procesaron mediante un analizador de imágenes (Image Pro-Plus). Los datos se analizaron estadísticamente con software específico (SPSS). El estudio demostró que las mayores modificaciones dimensionales del reborde se observaron sobre el área superficial del alvéolo y en los primeros 4 meses post-extracción. La lámina cortical presentó características físicas, estructurales y biológicas que le permitieron actuar como barrera física oclusiva, minimizando los fenómenos de inhibición celular heterotípica y favoreciendo los procesos osteogénicos por el mecanismo de osteopromoción...

Human efficacy lyophilized bone (UNC Bone Matrix Powder) grafted post-extraction alveolar sacs, covered by a cortical bone plate (UNC Bone Matrix membrane), in the treatment volume preservation ridge profile was evaluated. The working methodology was based on: 1) The study of a case series of 27 clinical cases in patients of both sexes who had single-rooted tooth elements indicating extraction. It was grafted bone cavities in the resulting lyophilized bone content in situ by a partially demineralized cortical bone plate. Patients were evaluated clinically and radiographically, using study models, and conventional Rx radiovisiography that allowed mensurar resorption induced changes for a year. Pre and post-operative controls at 7, 15, 30, 60, 90, 120, 180 and 360 days were performed. A preliminary plaster models and those obtained at 120 and 360 days transects were conducted in the study areas and were scanned. The images obtained were processed by an image analyzer (Image Pro-Plus). The data were statistically analyzed with software (SPSS) .The study showed that older flange dimensional changes were observed on the surface area of the alveoli and in the first 4 months post-extraction. The cortical sheet submitted physical, structural, and biological characteristics that allowed him to act as occlusive physical barrier, minimizing heterotypic cellular inhibition phenomena and processes favoring osteogenic mechanism osteopromoción...

Comparison of resorbable plates and titanium plates for fixation stability of combined mandibular symphysis and angle fractures

OBJECTIVES: We compared resorbable plates with titanium plates for treatment of combined mandibular angle and symphyseal fractures. MATERIALS AND METHODS: Patients with mandibular angle and symphysis fractures were divided into two groups. The control (T) group received titanium plates while the experimental (R) group received resorbable plates. All procedures were carried out under general anesthesia using standard surgical techniques. We compared the frequency of wound dehiscence, development of infection, malocclusion, malunion, screw breakage, and any other technical difficulties between the two groups. RESULTS: Thirteen patients were included in the R group, where 39 resorbable plates were applied. The T group consisted of 16 patients who received 48 titanium plates. The mean age in the R and T groups was 28.29 and 24.23 years, respectively. Primary healing of the fractured mandible was obtained in all patients in both groups. Postoperative complications were minor and transient. Moreover, there were no significant differences in the rates of various complications between the two groups. Breakage of 3 screws during the perioperative period was seen in the R group, while no screws or plates were broken in the T group. CONCLUSION: Resorbable plates can be used to stabilize combined mandibular angle and symphysis fractures.

Comparative Study of the Early Loading of Resorbable Blasting Media and Sandblasting with Large-grit and Acid-etching Surface Implants: A Retrospective Cohort Study / 대한악안면성형재건외과학회지

PURPOSE: This study compares the prognosis (the survival rate and marginal bone loss) of resorbable blasting media (RBM) surface implants and sandblasting with large-grit and acid-etching (SLA) surface implants in the early loading. METHODS: This study targeted 123 patients treated by implants installation from January 2008 to March 2010. The loading was initiated in the maxilla within three to four months and in the mandible within one to two months. The types of restoration were single crown and fixed partial prosthesis. Those functioned over one year. The implants were classified by the surface of implants as Group 1: RBM surface (GS III; OSSTEM, Busan, Korea) and, Group 2: SLA surface (Superline; Dentium, Seoul, Korea). The groups were categorized by maxilla and mandible and compared by survival rate, marginal bone loss through clinical records evaluation, and radiographic measurements. RESULTS: The marginal bone loss in the maxilla was 0.14+/-0.34 mm (Group 1) and 0.30+/-0.37 mm (Group 2), a statistically significant difference (P 0.05). There was no significant difference of marginal bone loss between maxilla and mandible by groups. During observation there was no implant failure, a survival rate of 100%. CONCLUSION: Both surfaces showed an excellent survival rate, and the marginal bone loss was not substantial.

Effect of implant surface microtopography by hydroxyapatite grit-blasting on adhesion, proliferation, and differentiation of osteoblast-like cell line, MG-63

OBJECTIVE: This study examined the potential of the in vitro osteogenesis of microtopographically modified surfaces, RBM (resorbable blasting media) surfaces, which generate hydroxyapatite grit-blasting. METHODS: RBM surfaces were modified hydroxyapatite grit-blasting to produce microtopographically modified surfaces and the surface morphology, roughness or elements were examined. To investigate the potential of the in vitro osteogenesis, the osteoblastic cell adhesion, proliferation, and differentiation were examined using the human osteoblast-like cell line, MG-63 cells. Osteoblastic cell proliferation was examined as a function of time. In addition, osteoblastic cell differentiation was verified using four different methods of an ALP activity assay, a mineralization assay using alizarin red-s staining, and gene expression of osteoblastic differentiation marker using RT-PCR or ELISA. RESULTS: Osteoblastic cell adhesion, proliferation and ALP activity was elevated on the RBM surfaces compared to the machined group. The cells exhibited a high level of gene expression of the osteoblastic differentiation makers (osteonectin, type I collagen, Runx-2, osterix). imilar data was represented in the ELISA produced similar results in that the RBM surface increased the level of osteocalcin, osteopontin, TGF-beta1 and PGE2 secretion, which was known to stimulate the osteogenesis. Moreover, alizarin red-s staining revealed significantly more mineralized nodules on the RBM surfaces than the machined discs. CONCLUSION: RBM surfaces modified with hydroxyapatite grit-blasting stimulate the in vitro osteogenesis of MG-63 cells and may accelerate bone formation and increase bone-implant contact.

Avaliação da biocompatibilidade de um sistema para fixação interna baseado em polímero reabsorvível: estudo histológico em coelhos / Biocompatibility evaluation of a system for internal fixation based on a resorbable polymer: a histological study in rabbits

Algumas características indesejáveis dos materiais de fixação metálicos instigaram pesquisadores no desenvolvimento de um sistema para fixação interna reabsorvível, necessitando, dessa forma, de estudos para avaliar o seu comportamento principalmente em relação à biocompatibilidade. Sendo assim, o objetivo do presente estudo foi o de avaliar histologicamente, de forma comparativa, a reação do tecido ósseo local ao emprego de um sistema de fixação interna reabsorvível, baseado no polímero poli (L-co-D,L ácido lático) 70:30, utilizando como controle um sistema de fixação interna baseado em uma liga de titânio (Ti-6Al-4V/Grau V) de mesmas dimensões. Para isso, foram selecionados 15 coelhos adultos, albinos, da raça Nova Zelândia, fêmeas, com idade aproximada de 06 meses e peso variando entre 3,8 e 4,5 kg no momento do procedimento cirúrgico. Cada animal recebeu, ao mesmo tempo, o sistema reabsorvível e o metálico, sendo sacrificados aleatoriamente com 3, 8 e 16 semanas pós-operatórias. Como resultado histológico, observou-se que o sistema de fixação baseado em polímero apresentou um comportamento histológico bastante semelhante ao sistema metálico. Em nenhum período dos sacrifícios de ambos os grupos, notou-se a presença de reação tecidual exacerbada. Dessa forma, conclui-se que o sistema de fixação baseado no reabsorvível apresentou biocompatibilidade satisfatória com o leito receptor.

Some undesirable characteristics of metal fixation materials prompted researchers to develop a system for resorbable internal fixation, thus requiring studies to evaluate their behavior, particularly with regard to their biocompatibility. The aim of this study was to make a comparative histological evaluation of the reaction of bone tissue to a local internal fixation system based on resorbable poly (L-co-D, L-lactic acid) 70:30, using an internal fixation system with the same dimensions based on a titanium alloy (Ti-6Al-4V/Grau V) as a control. For this purpose we selected 15 female albino New Zealand rabbits, aged approximately 6 months and weighing between 3.8 and 4.5 kg at the time of surgery. Each animal received both the absorbable and metallic systems, with the animals being randomly sacrificed postoperatively at 3, 8 and 16 weeks. No exacerbated reaction of this tissue was observed at the time of sacrifice in either group. We thus conclude that the fixation system based on resorbable material displayed a satisfactory biocompatibility with the recipient bed.

Biocompatibility evaluation of a new bioresorbable pin for membrane fixation

The aim of this study was to morphometrically analyze the tissue response to a customized pin obtained from devitalized bovine cortical bone (DBCB-pin) implanted in the subcutaneous tissue of rats, as well as to assess its microstructural aspect by scanning electron microscopy (SEM). The pins were implanted in the subcutaneous tissue of 20 rats, which were killed at 7, 14, 28 and 60 days (5 rats/period) after implantation. In the subcutaneous tissue, DBCB-pin promoted the formation of a fibrous capsule. At 7 days, capsule showed thickness of 70 ± 3.2 µm with higher density of newly formed capillaries and smaller density of collagen fibers. Between 14 and 60 days, more organized fibrous capsule exhibited smaller thickness (53 ± 5.5 µm) with higher density of fibroblasts and collagen fibers. In this period, a small and slow bioresorption of the DBCB-pin by macrophages and rare multinucleated giant cells without tissue damage was observed. The thickness of DBCB-pin resorbed was in mean only of 9.3 µm. During all experimental periods not occurred presence of immune reaction cells as lymphocytes and plasma cells. It was concluded that the pin derived from cortical bovine bone was well tolerated by subcutaneous tissue of rats and slowly resorbed could be an alternative material for membrane fixation in the guided tissue regeneration procedures.

O objetivo deste estudo foi analisar morfometricamente a resposta tecidual a um pino obtido a partir de osso bovino desvitalizado cortical (DBCB pinos) implantado no tecido subcutâneo de ratos, bem como para avaliar o seu aspecto microestrutural por microscopia eletrônica de varredura (MEV). Os pinos foram implantados no tecido subcutâneo de 20 ratos, que foram sacrificados aos 7, 14, 28 e 60 dias (5 animais / período) após a implantação. No tecido subcutâneo, o pino DBCB promoveu a formação de uma cápsula fibrosa. Aos 7 dias, a cápsula apresentou espessura de 70 ± 3,2 μm com maior densidade de capilares neoformados e menor densidade de fibras colágenas. Entre 14 e 60 dias, a cápsula fibrosa apresentava-se mais organizada e exibiram menor espessura (53 ± 5,5 μm) com maior densidade de fibroblastos e fibras colágenas. Nesse período, foi observada uma bioreabsorção pequena e lenta dos pinos DBCB por macrófagos e raras células gigantes multinucleadas, sem dano tecidual. A espessura dos pinos DBCB reabsorvidos foi em média de apenas 9,3 µm. Durante todos os períodos experimentais não ocorreu presença de células como linfócitos e células plasmáticas. Concluiu-se que o pino derivado de osso bovino cortical foi bem tolerado pelo tecido subcutâneo de ratos e reabsorvido lentamente, sendo um potencial material alternativo para fixação da membrana nos procedimentos de regeneração tecidual guiada.

Guided bone regeneration using two types of non-resorbable barrier membranes

INTRODUCTION: Guided bone regeneration (GBR) is a common procedure for the treatment of bone defects and bone augmentation. The non-resorbable barriers are well-documented barriers for GBR because of their stability and malleability. However, few GBR studies have focused on the different types of non-resorbable barriers. Therefore, this study examined the clinical results of different non-resorbable barriers for GBR; expanded polytetrafluoroethylene (e-PTFE) (TR-Gore Tex, Flagstaff, AZ, USA), and high-density polytetrafluoroethylene (d-PTFE) (Cytoplast membrane, Oraltronics, Bremen, Germany). MATERIALS AND METHODS: The analysis was performed on patients treated with GBR and implant placement from January 2007 to October 2007 in the department of the Seoul National University Bundang Hospital. The patients were divided into two groups based on the type of non-resorbable barrier used, and the amount of bone regeneration, marginal bone resorption after prosthetics, implant survival rate and surgical complication in both groups were evaluated. RESULTS: The implants in both groups showed high survival rates, and the implant-supported prostheses functioned stably during the follow-up period. During the second surgery of the implant, all horizontal defects were filled with new bone, and there was no significant difference in the amount of vertical bone defect. CONCLUSION: In bone defect areas, GBR with non-resorbable barriers can produce favorable results with adequate postoperative management. There was no significant difference in bone regeneration between e-PTFE and d-PTFE.

Tratamiento quirúrgico de Fracturas mandibulares en pacientes pediátricos: Revisión Bibliográfica / Surgical treatment of mandibular fractures in pediatric patients

Las fracturas faciales en niños muestran características importantes en lo que respecta a su prevalencia, diagnóstico y tratamiento, las cuales las diferencian de las fracturas en adultos. Por estas razones, el trauma infantil debe ser objeto de especial atención ya que presentan particulares características anatómicas, fisiológicas y psicológicas propias de la edad del paciente. Las fracturas mandibulares infantiles que presenten pequeños desplazamientos pueden ser tratadas conservadoramente, mientras que, aquellas que presenten desplazamientos mayores y que interfieran con la función deben ser tratadas de manera semejante a la de los adultos, esto es con reducción cruenta y estabilización, la misma que puede ser obtenida por medio de dispositivos como placas, alambres de acero, tornillos, tornillos y placas de titanio o mediante sistemas de osteosíntesis resorbibles. Estos diferentes sistemas presentan indicaciones, ventajas y desventajas, las cuales deben ser consideradas a fin de elegir la opción de tratamiento más adecuada.

The facial fractures in children show important characteristics about their prevalence, diagnosis and treatment, which differentiate them from fractures in adults. For these reasons, children trauma should be a subject of special attention to due the anatomical, physiological and psychological considerations of the patient´s age. The children jaw fractures that show little displacements can be treat in a conservative way, while those that show greater displacements and interfering with the function should be treated similarly to that in adults, this is with open reduction and stabilization, using some devices such as plaques, steel wires, screws and titanium plaques or through resorbable osteosynthesis systems. These different systems show indications, advantages and disadvantages, which must be considered in order to choose the most suitable treatment.