Clinical use of allogeneic bone granulates to reconstruct maxillary and mandibular alveolar processes.

INTRODUCTION: Lack of adequate mass of a patient's own bone is still a clinical problem in dental implantology; it precludes dental embedment. Surgical widening of an atrophied alveolar process with the use of an allogeneic bone granulate to fill the bone defect constitutes a first-line method to prepare for implant-prosthetic treatment. Transplantation of allogeneic material allows reconstruction of optimal height, thickness, and width of the alveolar process facilitating a procedure with a good long-term outcome. The study assessed outcomes following augmentation of atrophied alveolar processes before intraosseous implantation. MATERIALS AND METHODS: Filling bone defects in the maxilla and mandible as an introductory measure for implant-prosthetic treatment was performed in 59 patients (24 females and 35 males of age range 22-65 years). Bone granulate was used for maxillary sinus floor elevation (n=29), augmentation of the postextraction alveoli (n=12), and filling of defects in the outer table of the compact bone formed following inflammatory conditions (n=18). The bone grafts were covered with plasma-rich fibrin (PRF) obtained from the patient's blood to accelerate the formation of synostoses and prevent epithelial penetration between the patients' own bone and the bone graft. RESULTS: In all of the patients normal union was observed, as confirmed by radiological images as well as intraprocedural assessment. Sufficient height and width as well as thickness of the alveolar process was obtained, which allowed embedment. CONCLUSIONS: Allogeneic bone granulate constitutes a good material to reconstruct maxillary and mandibular alveolar processes in out-patient care.

Application of frozen and radiation-sterilised bone allografts for treatment of bone cysts.

Between 1981 and 1998 frozen and radiation sterilized bone allografts were transplanted into 1376 patients at the Institute of Traumatology, Orthopaedic and Neurosurgery of the Military School of Medicine in Warsaw. Of these 179 (13%) required treatment due to benign tumours. Incidence of solitary cysts was highest (127 cases, 71%), mainly occurring in children (84%). During surgery bone cysts were excised and filled by bone grafts. Results were evaluated several years after surgery (2-10 yrs) using x-rays and clinical examination. Rebuilding of allografts was one of the most important prognostic factors. Within the period of observation time 83% of transplanted allografts were rebuilt and substituted by own patients bone.