Radiographic Comparison of Bovine Bone Substitute Alone Versus Bovine Bone Substitute and Simvastatin for Human Maxillary Sinus Augmentation.

OBJECTIVES: The aim of this study was to compare the efficacy of bovine bone substitute (Compact Bone B. ®) alone versus bovine bone substitute and simvastatin for human maxillary sinus augmentation. MATERIALS AND METHODS: This study was conducted on 16 sinuses in eight patients. Radiographic assessments were done preoperatively (T0), immediately (T1) and at nine months after sinus grafting (T2). Alveolar bone height and density were assessed on cone beam computed tomography (CBCT) scans using Planmeca Romexis™ Imaging Software 2.2. RESULTS: The change in alveolar bone height and density between T0, T1 and T2 was significant in both groups. Alveolar bone height (h0, h1, h2) and vertical height of the grafted bone (g1, g2) in three lines (anterior, middle and posterior) were not significantly different between groups. The grafted bone height shrinkage (%) in the anterior, middle and posterior limits of the augmented area were not significantly different between groups. The existing alveolar and grafted bone density increased significantly in both groups between T1 and T2, except for the existing alveolar bone density in the control group. There were no statistically significant differences between the alveolar bone density values obtained in TI and T2 between groups, except for the existing alveolar bone density at T1. CONCLUSIONS: This study did not show any significant positive effect for simvastatin in maxillary sinus augmentation based on radiographic examination.

Modified Pedicle Grafting: A Novel Noninvasive Technique for Soft Tissue Augmentation Around Maxillary Dental Implants.

OBJECTIVES: This study sought to assess the efficacy of modified pedicle grafting as a noninvasive technique for soft tissue augmentation around maxillary dental implants. MATERIALS AND METHODS: This descriptive study was conducted on eight patients who met the inclusion criteria. Prior to the second-stage surgery for exposing the implants, the buccal keratinized mucosa width, vestibular depth, and mucosal thickness around the implants were measured. The same parameters were measured six months after the second-stage surgery and were compared with the baseline values. Also, the color match of the graft with the adjacent gingival and mucosal tissues was evaluated. RESULTS: Forty-seven maxillary implants were evaluated. The minimum and maximum gains of keratinized mucosal width were respectively equal to 0mm and 7mm, with a mean of 4.31±1.19mm. The mean vestibular depth around the implants was 9.47±1.75mm (ranging from 5mm to 12mm) six months after the surgery. At the beginning of the study, a thin mucosa surrounded the implants, but after six months, the peri-implant keratinized mucosa width increased. The color match of the graft with the adjacent gingival and mucosal tissues was excellent based on the periodontists' opinion. CONCLUSIONS: Modified pedicle grafting is a safe and predictable technique for soft tissue augmentation around maxillary implants. This technique is reliable for increasing the width of keratinized mucosa in fully and partially edentulous patients with a shallow vestibular depth. The stability of the pedicle flap is achieved by fixing the flap to the tissue around the healing abutment.

Outcomes of Alveolar Ridge Preservation With Recombinant Human Bone Morphogenetic Protein-2: A Systematic Review.

PURPOSE: The main focused question of this systematic review was as follows: Does the application of recombinant human bone morphogenetic protein-2 (rhBMP-2) placed in extraction sockets reduce the alveolar ridge changes? METHODS: A systematic literature search was performed up to February 2017. Clinical studies published in English were included. Outcome variables of interest were as follows: changes in alveolar ridge width and height, the quality of new bone, patient's safety, adverse events, and postoperative complications. RESULTS: Seven articles were included. Because of the vast heterogeneity and high risk of bias among the studies, performing a meta-analysis deemed not feasible. Application of rhBMP-2 in the extraction socket was more effective in the reduction of ridge width compared with that of ridge height. The superiority of 1.5 mg/mL rhBMP-2/absorbable collagen sponge over the carrier alone on alveolar ridge width/height remodeling was more significant when it was applied in the sockets with ≥50% buccal bone dehiscence. The limited available data showed that rhBMP-2 did not improve the quality of new bone. Antibodies against rhBMP-2 were detected in the serum in 1 trial. CONCLUSIONS: Within the limits of this review, 1.5 mg/mL rhBMP-2 might be beneficial for preserving the alveolar ridge width within extraction sockets given as to whether the cost-effectiveness is justifiable. Studies with lower risk of bias should be performed to confirm the above findings.

Assessment of Surface Markers Derived from Human Periodontal Ligament Stem Cells: An In Vitro Study.

OBJECTIVES: Periodontal tissue regeneration for treatment of periodontal disease has not yet been mastered in tissue engineering. Stem cells, scaffold, and growth factors are the three main basic components of tissue engineering. Periodontal ligament (PDL) contains stem cells; however, the number, potency and features of these cells have not yet been understood. This study aimed to isolate and characterize the properties of PDL stem cells. MATERIALS AND METHODS: In this experimental study, samples were isolated from the PDL of extracted teeth of five patients and then stained immunohistochemically for detection of cell surface markers. Cells were then examined by immuno-flow cytometry for mesenchymal markers as well as for osteogenic and adipogenic differentiation. RESULTS: The isolated cell population had fibroblast-like morphology and flow cytometry revealed that the mesenchymal surface markers were (means): CD90 (84.55), CD31 (39.97), CD166 (33.77), CD105 (31.19), CD45 (32/44), CD44 (462.11), CD34 (227.33), CD38 (86.94), CD13 (34.52) and CD73 (50.39). The PDL stem cells also differentiated into osteoblasts and adipocytes in osteogenic and adipogenic media, respectively. CONCLUSIONS: PDL stem cells expressed mesenchymal stem cell (MSC) markers and differentiated into osteoblasts and adipocytes in osteogenic and adipogenic media, respectively.