Bone regeneration at extraction sockets filled with leukocyte-platelet-rich fibrin: An experimental pre-clinical study.

BACKGROUND: We aimed to histomorphometrically evaluate the effects of Leucocyte-Platelet-Rich Fibrin (L-PRF), with and without the combination of a bone grafting material, for alveolar ridge preservation using an in vivo canine model. MATERIAL AND METHODS: Seven dogs (Female Beagles, ~18-month-old) were acquired for the study. L-PRF was prepared from each individual animal by drawing venous blood and spinning them through a centrifuge at 408 RCF-clot (IntrasSpin, Intra-Lock, Boca Raton, FL). L-PRF membranes were obtained from XPression fabrication kit (Biohorizons Implant Systems, Inc., AL, USA). A split mouth approach was adopted with the first molar mesial and distal socket defects treated in an interpolated fashion of the following study groups: 1) Empty socket (negative control); 2) OSS filled defect 3) L-PRF membrane; and 4) Mix of Bio-Oss® with L-PRF. After six weeks, samples were harvested, histologically processed, and evaluated for bone area fraction occupancy (BAFO), vertical/horizontal ridge dimensions (VRD and HRD, respectively), and area of coronal soft tissue infiltration. RESULTS: BAFO was statistically lower for the control group in comparison to all treatment groups. Defects treated with Bio-Oss® were not statistically different then defects treated solely with L-PRF. Collapsed across all groups, L-PRF exhibited higher degrees of BAFO than groups without L-PRF. Defects filled with Bio-Oss® and Bio-Oss® with L-PRF demonstrated greater maintenance of VRD relative to the control group. Collapsed across all groups, Bio-Oss® maintained the VRD and resulted in less area of coronal soft tissue infiltration compared to the empty defect. Soft tissue infiltration observed at the coronal area was not statistically different among defects filled with L-PRF, Bio-Oss®, and Bio-Oss® with L-PRF. CONCLUSIONS: Inclusion of L-PRF to particulate xenograft did not promote additional bone heading at 6 weeks in vivo. However, we noted that L-PRF alone promoted alveolar socket regeneration to levels comparable to particulate xenografts, suggesting its potential utilization for socket preservation.

Osteogenic parameters surrounding trabecular tantalum metal implants in osteotomies prepared via osseodensification drilling.

BACKGROUND: Surgical fixation of implants into bone for the correction of bone deformities or defects is a traditional approach for skeletal stabilization. Important measures of efficacy of implants include implant stability and osseointegration-the direct interaction between living bone and an implant. Osseointegration depends on successful implant placement and subsequent bone remodeling. This study utilized osseodensification drilling (OD) in a low bone density model using trabecular metal (TM) implants. MATERIAL AND METHODS: Three osteotomy sites, Regular, OD-CW (clockwise), and OD-CCW (counterclockwise), were prepared in each ilium of three female sheep. Drilling was performed at 1100rpm with saline irrigation. Trabecular metal (TM) (Zimmer, Parsippany, NJ, USA) implants measuring 3.7mm in diameter x 10mm length were placed into respective osteotomies. A three-week period post-surgery was given to allow for healing to take place after which all three sheep were euthanized and the ilia were collected. Samples were prepared, qualitatively and quantitatively analyzed using histology micrographs and image analysis software (ImageJ, NIH, Bethesda, MD). Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were quantified to evaluate the osseointegration parameters. RESULTS: All implants exhibit successful bone formation in the peri-implant environment as well as within the open spaces of the trabecular network. Osseointegration within the TM (quantified by %BIC) as a function of drilling technique was more pronounced in OD samples(p>0.05). The %BAFO however shows a significant difference (p=0.036) between the CCW and R samples. Greater bone volume and frequency of bone chips are observed in OD samples. CONCLUSION: The utilization of OD as a design for improved fixation of hardware was supported by increased levels of stability, both primary and secondary. Histological data with OD provided notably different results from those of the regular drilling method.

Evaluation of neurosensory disturbances of the inferior alveolar nerve after intraoral verticosagittal ramus osteotomy.

PURPOSE: To assess the incidence of neurosensory disturbances (NSD) of the inferior alveolar nerve (IAN) after Intraoral verticosagittal ramus osteotomy (IVSRO). MATERIALS AND METHODS: The sensibility of the chin and lower lip of ten consecutive patients undergoing IVSRO was assessed. Evaluations were performed at 7 days preoperatively, 7 days, one month and six months postoperatively. The chin was divided into four quadrants, which were tested separately. The tests used were: two-point discrimination (2-P), brush stroke direction discrimination (BSD) and thermal stimuli (TH). Postoperatively, patients also answered a questionnaire. RESULTS: The values for 2-P showed statistically significant difference when compared to preoperative measurements (P>0.05) in all quadrants, with exception to quadrant D. There was no statistically significant difference among preoperative values and 7 days, 1 month and 6 months postoperative values. For BSD and TH tests, no differences were found among time points. None of the 10 patients reported complete numbness after 1 week. After 6 months, complete recovery of the chin sensibility was reported in all 10 cases. CONCLUSION: This study showed, objectively and subjectively, a low incidence of NSD after IVSRO. Further studies with larger samples are necessary to confirm these results.

Estimation in vivo of the body and carcass chemical composition of growing lambs by real-time ultrasonography.

The relationship between ultrasound measurements and empty body and carcass chemical composition was investigated. A 500-V real-time ultrasound with a 7.5-MHz probe combined with image analysis was used to make in vivo measurements to predict the empty body and carcass chemical composition of 31 female lambs of two genotypes, ranging in BW from 18.2 to 48.9 kg. Eleven ultrasound measurements of s.c. fat, muscle, and tissue depth were taken at four different sites (over the 13th thoracic vertebra, between the 3rd and 4th lumbar vertebrae, at the 3rd sternebra of the sternum, and over the 11th rib, 16 cm from the dorsal midline). The single best predictor of empty body fat quantity and energy value was the s.c. fat depth over the 13th thoracic vertebra (r(2) = 0.904 and 0.912; P <0.01, respectively). Body weight was used with ultrasound measurements in multiple regression equations to establish the best independent variables combination for predicting chemical composition. Results showed that BW and two of the three ultrasound measurements (s.c. fat depth over the 13th thoracic vertebra, between the 3rd and 4th lumbar vertebrae, and tissue depth over the 11th rib, 16 cm from the dorsal midline), explained 94.7 to 98.7% (P < 0.01) of the quantity of water and fat and the energy value variation in the empty body and carcass. Body weight per se was the best predictor of the quantity of protein, accounting for 97.5 and 96.8% (P < 0.01) of the variation observed in the empty body and carcass, respectively. The results of this study suggest that BW and some ultrasound measurements combined with image analysis, particularly subcutaneous fat depth over the 13th thoracic vertebra, allow accurate prediction of empty body and carcass chemical composition in lambs.