ABSTRACT
Autogenous soft tissue augmentation procedures around natural teeth and dental implants are performed daily by clinicians. However, patient morbidity is often associated with the second surgical site; hence, research is moving toward an era where matrices may substitute autogenous grafts. The aim of this study was to assess the soft tissue response to a collagen matrix in an animal model. Nine pigs were included in this study. Each animal received four collagen matrices, two for each mandible. Three cohorts were included in the study: group A, where the matrix was applied as an onlay on a partial-thickness flap; group B, where the matrix was inserted under a partial-thickness flap; and group C, where the matrix was inserted in an inverted position under a full-thickness flap. Sacrifice occurred at 7, 15, and 30 days postoperatively for histologic assessment. The collagen matrix was seen in place for the first 2 weeks, and it was completely replaced by healthy connective tissue within 30 days in the inlay cohorts. No inflammatory adverse reactions were noticed in any specimen, resulting in optimal integration of the device. This study showed an optimal integration within 30 days postoperative of the placement of experimental collagen matrix in the soft tissues of an animal model. Its proven safety in this model provides an optimal starting point for further research projects considering its clinical applications.
Subject(s)
Absorbable Implants , Collagen/metabolism , Membranes, Artificial , Mouth Mucosa/surgery , Oral Surgical Procedures/methods , Animals , Connective Tissue/metabolism , Implants, Experimental , Mandible , Models, Animal , Mouth Mucosa/metabolism , Surgical Flaps , Sus scrofaABSTRACT
The goal of classifying complications in guided bone regeneration procedures with nonresorbable membranes is to provide the clinician with an instrument for easier identification of both the problem and treatment modality. A standardized terminology represents a key point for proper communication among clinicians and provides guidelines for managing these drawbacks.
Subject(s)
Bone Regeneration , Guided Tissue Regeneration, Periodontal/methods , Membranes, Artificial , Postoperative Complications/classification , Glucosyltransferases , Humans , Terminology as TopicABSTRACT
This preclinical study evaluated the efficacy of purified recombinant human platelet-derived growth factor (rhPDGF-BB), combined with a novel equine hydroxyapatite and collagen (eHAC) bone block, in providing vertical bone regeneration in critical-size defects simulating localized mandibular alveolar bone atrophy. In addition, the impact of barrier membrane placement in growth factor-mediated bone regeneration was also studied. Bilateral posterior mandibular defects simulating severe localized bony atrophy were created in 12 adult foxhounds following removal of all four mandibular premolars. Three months later, the defects were grafted as follows: group A: eHAC block alone; group B: eHAC block + collagen membrane; group C: eHAC block + rhPDGF-BB; group D: eHAC block + rhPDGF-BB + membrane. The animals were sacrificed after 5 months and the grafted areas were examined histologically, radiographically, and clinically. Groups A and B (controls) exhibited little to no vertical bone regeneration. Group C demonstrated significant vertical bone regeneration, with dense, well-vascularized bone, high bone-to-implant contact, and accelerated replacement of graft particles with newly formed bone. In group D, with the imposition of a barrier membrane, robust bone regeneration was less evident when compared to group C. As in the first study in this series, the importance of the periosteum as a source of osteoprogenitor cells in growth factor-mediated regenerative procedures is examined.
Subject(s)
Alveolar Ridge Augmentation/methods , Angiogenesis Inducing Agents/therapeutic use , Bone Substitutes/therapeutic use , Collagen/therapeutic use , Durapatite/therapeutic use , Platelet-Derived Growth Factor/therapeutic use , Alveolar Bone Loss/surgery , Alveolar Process/blood supply , Animals , Becaplermin , Biocompatible Materials , Bone Regeneration/drug effects , Bone Regeneration/physiology , Dental Implants , Disease Models, Animal , Dogs , Horses , Humans , Mandible/blood supply , Mandible/surgery , Membranes, Artificial , Osseointegration/physiology , Osteogenesis/drug effects , Osteogenesis/physiology , Proto-Oncogene Proteins c-sis , Random Allocation , Recombinant ProteinsABSTRACT
A report of a patient who presented with severe disfigurement of the maxillary left lateral incisor and canine area following oncologic surgery is presented. The bone defect extended 20 mm from the cervical line of adjacent teeth up to and including the nasal cavity. Treatment was performed with a 1:1 ratio of autogenous bone graft (harvested from the retromolar region) and deproteinized bovine bone particles. The composite graft was hydrolyzed with recombinant human platelet-derived growth factor BB and covered with a titanium-reinforced nonresorbable membrane. Second-stage surgery was performed at 6 months, at which point the membrane was removed and two titanium dental implants were successfully placed. The elapsed time from initial surgery to definitive prosthesis placement was 14 months.
