Levantamento de seio maxilar com utilização de enxerto homógeno / Elevation of maxilar sinus with the use of homogenous bone

A implantodontia moderna tem buscado cada vez mais novas técnicas para resolver situações adversas com relação às áreas de ausência de tecido ósseo, causadas por perdas dentais precoces. Este artigo consiste na apresentação de um relato de caso clínico, no qual foi utilizado o enxerto homógeno obtido do Banco de Tecidos Músculo Esquelético do HC-UFPR. Essa modalidade terapêutica mostrou-se satisfatória por apresentar menor tempo clínico operatório, menor desconforto ao paciente e quantidade óssea necessária independente da extensão da área receptora.

The modern dental implant has increasingly sought new techniques for adverse situations in areas without bone tissue due to premature bone loss. This article presents a clinical case using a homogeneous bone graft from the Skeletal Muscle Tissue Bank of HC-UFPR (Brazil). This type of therapy has been successful due to its faster clinical surgery, less discomfort for the patient and the amount of bone needed regardless of the extent of the receiving area.

Comparação entre enxerto ósseo autólogo, homólogo congelado e homólogo liofilizado em modelo experimental de cranioplastia / Comparison between autogenous, deep-frozen homologous, and lyophilized homologous bone grafts in an experimental model of cranioplasty

Objetivo: O objetivo deste experimento é comparar, em um modelo experimental de cirurgia craniomaxilofacial, o comportamento de ossos processados e armazenados pelos métodos de liofilização e a congelação profunda, com o enxerto autólogo. Método: Trinta ratos Wistar adultos foram divididos em três grupos submetidos a cranioplastia com reconstrução com enxerto ósseo. O grupo 1 recebeu homoenxertos congelados, o grupo 2 recebeu homoenxertos liofilizados e o grupo 3 foi reconstruído com enxertos autólogos frescos. Os animais foram sacrificados na 6ª e na 15ª semana. Os resultados foram avaliados por parâmetros macroscópicos e histopatológicos. Resultados: Na primeira avaliação, os grupos 1 e 3 apresentavam resultados semelhantes, enquanto o grupo 2 mostrava resultados significativamente piores em vários parâmetros avaliados. Na avaliação tardia, enquanto o grupo 1 mostrou uma diminuição na neoformação óssea e na atividade osteoblástica, o grupo 2 apresentou índices significativamente maiores para estes parâmetros. O grupo 3 manteve sua proporção de osso neoformado inalterada, com uma diminuição da atividade dos osteoblastos. Conclusão: Conclui-se que o enxerto autólogo fresco permanece como primeira opção na reparação do esqueleto facial. Embora os enxertos homólogos tenham apresentado resultados satisfatórios, com capacidade de osteoindução e osteocondução, os enxertos homólogos liofilizados parecem ter um melhor comportamento em longo prazo.

Objective: This experiment was designed to compare, in an experimental model of craniomaxillofacial surgery, the behavior of processed and banked bones through lyophilization with autoclave or deep-freezing with autogeneic grafts. Method: Thirty Wistar rats were divided in three groups and submitted to cranioplasty with reconstruction using bone graft. Group 1 received deepfrozen allografts, group 2 received lyophilized allografts, and group 3 was reconstructed with fresh autografts. Four animals of each group were sacrificed at week 6. The remaining 6 were sacrificed at week 15. Results: Results were evaluated by macroscopic and histopathologic parameters. In the first evaluation, groups 1 and 3 showed similar results, while group 2 showed significantly worse results in several parameters. In the late evaluation, group 1 showed diminished bone neoformation and osteoblastic activity, whereas group 2 showed significantly higher indexes in these parameters. Group 3 kept its proportion of neoformed bone unchanged, with a decrease in osteoblastic activity. Conclusion: It is concluded that fresh autografts remain as the first choice in repairing the facial skeleton. Although allografts presented satisfactory results, with osteoinductive and osteoconductive properties, lyophilized allografts appear to show a better behavior in the follow up.

Standard operating procedures of hard tissues such as femoral head, allografts obtained from living donors

Progress in medical science and cell biology has resulted in the transplantation of human cells and tissues from on human into another, facilitating reproduction and the restoration of form and function, as well as enhancing the quality of life. For more than 40 years, society has recognized the medical and humanitarian value of donation and transplanting organs and tissues. The standard operating procedures of hard tissues reflect the collective expertise and conscientious efforts of tissue bank professionals to provide a foundation for the guidance of tissue banking activities. Procurement of allograft tissues from surgical bone donors is a part of tissue banking. During the past decades the use of bone allografts has become widely accepted for the filling of skelectal defects in a variety of surgical procedures. In particular in the field of orthopaedic and oral and maxillofacial surgery the demand for allografts obtained from either living or post-mortem donors has increased. Hospital-based tissue banks mainly retrieve allografts from living donors undergoing primary total hip replacement for osteoarthritis or hemi arthroplasty for hip fractures and orthgnatic surgery such as angle reduction. Although bone banks have existed for many years, the elements of organized and maintaining a hospital bone bank have not been well documented. The experience with a tissue bank at Korea Tissue Bank(KTB) between 2001 and 2004 provides a model of procurement, storage, processing, sterilization and documentation associated with such a facility. The following report describes the standard operating procedures of hard tissues such as femoral head obtained from living donors.

The Use of Refrigerated Autogenous Bone Flaps for Cranioplasty

Authors made a clinical analysis on 17 patients who were reconstructed with autogenous cranioplasty using refrigerated bone flap at the Department of Neurosurgery, Yonsei University College of Medicine from March 1982 to April 1984, and the results were summarized as follows; 1) The use of refrigerated autogenous bone flap for cranioplasty provided best cosmetic appearance due to natural contour and early operation within 3 months. 2) This procedure was simple with reduction of operating time. No infection nor foreign body reactions were found. 3) There were psychological benefits due to use of autogenous bone flap and radiodensity was appropriate for diagnosis and treatment. Cranioplasty using refrigerated bone flap was thought to be safe and ideal procedure.