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

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 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.

The clinical efficacy of DynaMatrix extracellular membrane in augmenting keratinized tissue.

This study was conducted to compare the efficacy and feasibility of an extracellular matrix membrane (DynaMatrix) with that of an autogenous gingival graft in increasing the width of attached keratinized tissue. Six patients with an inadequate amount of attached keratinized gingiva on the bilateral facial aspect of the mandibular posterior teeth were recruited for this study. The defect sites were randomly subjected to receive either test (DynaMatrix membrane) or control (autogenous gingival graft) treatment. Both test and control sites achieved a clinically significant increase in the amount of keratinized gingiva, and the DynaMatrix membrane-treated sites blended well with the surrounding tissue, with a better appearance when compared to the autogenous gingival grafted sites. The biopsy specimens of both test and control sites appeared to be similar histologically, with mature connective tissue covered by keratinized epithelium. The results of both clinical and histologic evaluations have suggested a potential application of an extracellular matrix membrane in achieving gingival augmentation.

Minimally invasive alveolar ridge augmentation procedure (tunneling technique) using rhPDGF-BB in combination with three matrices: a case series.

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 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.

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

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 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.

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.

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 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.