Evaluation of the Safety and Clinical Efficacy of Allogeneic Bone Grafts in the Reconstruction of the Maxilla and Mandible.

INTRODUCTION: Loss of teeth caused by inflammatory processes or trauma is one of the causes of bone atrophy of the maxilla alveolar process and the alveolar part of the mandible. Often, restoring these deficiencies with dental implants requires additional reconstructive procedures. Methods using autogenous, allogeneic, xenogeneic, or synthetic bone grafts are commonly used. MATERIALS AND METHODS: Patients who had bone atrophy of the maxilla or mandible were qualified for deep-frozen transplantation, radiation-sterilized allogeneic bone from the Bank of Tissues in the form of cortico-spongy bone blocks and spongy bone granules. Bone blocks were stabilized with titanium screws, and the free spaces were additionally supplemented with chips from autogenous bone and covered with allogeneic pericardial transplants and platelet-rich fibrin (PRF). Four months after the bone reconstruction, titanium implants were placed, and then after the osseointegration period prosthetic restoration was performed. Clinical safety and efficacy were determined by analyzing the quantity and quality of the reconstructed bone tissue and the degree of resorption was assessed. RESULTS: The surgical procedures performed confirmed the safety and efficacy of biological material in the reconstruction of the jaw. In two cases, the treatment was not effective and the transplant was removed. In the remaining cases, titanium implants were successfully placed and loaded with prosthetic works. DISCUSSION: Implanting deeply frozen, radiation-sterilized bone is a safe and effective surgical procedure. As an appropriate technique for fixing the allogeneic bone block, additional use of autogenous bone chips and PRF allows one to obtain a good, long-lasting clinical result.

Frequency of Human Papilloma Virus Occurrence Among Pathological Changes of the Oral Cavity in Kidney Allotransplant Recipients Undergoing Long-Term Pharmacological Immunosuppressive Therapy.

Recipients of allotransplants are more susceptible to viral infections, among which the human papilloma virus infection is an independent factor inducing precancerous lesions and cancers of both the anogenital and the cervicocephalic region. MATERIALS AND METHODS: The study included a group of 69 allogenic kidney transplantation recipients aged 20 to 70, who were treated with cyclosporine, azathioprine, and prednisone. The patients in whom the macroscopic examination of the oral mucosa revealed lesions were qualified for a biopsy. The infection with human papilloma virus (HPV) was confirmed by a histopathological examination and genotyping with the use of polymerase chain reaction (PCR) and Hybrid Capture II test. RESULTS: Papillomatous lesions in the oral cavity occurred in 36.1% of the research group participants. The HPV16 virus was the most common genotype in this group of patients (25%). The pathologic changes in the oral cavity were predominantly situated on the gingivae. In the group of transplant recipients, clinical changes resulting from HPV infection occurred within a period of 2 years following the transplantation. Cyclosporine used in the immunosuppression scheme has correlated in as many as 53.7% of cases of allogenic kidney transplant recipients with the appearance of clinical signs and symptoms of HPV infection. In 50% of cases there was a correlation with acute kidney transplant rejection. When induction therapy (anti-thymocyte globulin [ATG] and muromonab-CD3 [OKT3]) was applied, at least 1 oral cavity lesion in each case of allogenic transplant recipients was reported. CONCLUSIONS: Typing of HPV with the use of molecular methods should be a standard diagnostic technique.