In Situ Tooth Replica Custom Implant: Rationale, Material, and Technique

2010 ◽  
Vol 36 (6) ◽  
pp. 435-450 ◽  
Author(s):  
Wael Aly Ghuneim

Abstract This study introduced a new concept of an in situ, custom-made, tooth replica dental implant. It was obtained by injecting a self-set, nonresorbable polymer type bone graft substitute into the tooth socket after extraction. Based on its cited properties, new composite bone cement Cortoss was suggested. The properties were reviewed and evaluated. The technique of application was described with a simulation model presented that appeared simple. Apparently, immediate duplication of tooth anatomy was achieved; thus, the concept might have the potentials of spontaneous adaptation and stabilization, preservation of alveolar bone, increasing implant-bone surface area, better load distribution, and bone stimulation. Modifications were also described to manage cases of resorbed alveolar bone as well as long-standing extracted teeth. Investigations were still required to assess the performance of the material and if modifications would be needed.

2020 ◽  
Vol 11 (2) ◽  
pp. 167-173 ◽  
Author(s):  
Ashish Kakar ◽  
Kanupriya Kakar ◽  
Minas D. Leventis ◽  
Gaurav Jain

Introduction: Immediate placement of implants in a fresh post-extraction socket is an increasingly popular and established treatment option. However, active infection in the extraction site may adversely affect the outcome of this procedure. This study was designed to assess the clinical results of immediate placement of dental implants in infected extraction sockets using a standardized protocol, which included (a) the use of an Er,Cr:YSGG laser for the decontamination of the infected socket prior to implant insertion, and (b) the utilization of an in situ hardening alloplastic bone graft substitute to augment the gap between the implant surface and the labial plate of bone. Patients and Methods: A retrospective record review was used to identify 68 patients who had implants placed as per the described protocol. A total of 126 implants were placed in 68 patients (65 implants in the maxilla, 61 implants in the mandible). The implants were loaded 136 ± 73 days (mean ± standard deviation; range: 37–400 days) after implant placement. Eight patients (16 implants) were subsequently lost to follow up. Results: 105 of the 110 implants (95.45%) placed immediately in the infected sites using the described protocol survived after prosthetic loading. Conclusion: Immediate implant placement in previously infected sites using the protocols mentioned in our study with laser decontamination of the socket, grafting with an in situ hardening alloplastic bone graft material and non-submerged healing shows a similar survival rate to the published success rates for immediate implants placed in non-infected sites.


2014 ◽  
Vol 1621 ◽  
pp. 53-58
Author(s):  
Didarul Bhuiyan ◽  
John Middleton ◽  
Rina Tannenbaum

ABSTRACTHydroxyapatite (HAP) is a biocompatible bio-ceramic whose structure and composition is similar to bone. However, its lack of strength and toughness have seriously hampered its applications as a bone graft substitute material. Attempts have been made to overcome these mechanical properties deficiencies by combining HAP bioceramic material with absorbable polymers in order to improve its mechanical properties. However, poor interfacial bonding between the HAP and the polymers has limited the benefits of such biocomposite structures. At the other end of the biomaterials spectrum is collagen, which constitutes the most abundant proteins in the body and exhibits properties such as biodegradability, bioadsorbability with low antigenicity, high affinity to water, and the ability to interact with cells through integrin recognition. These favorable properties renders collagen as a natural candidate for the modification and compatibilization of the polymer-HAP biocomposite. In this study, we developed a novel approach to the synthesis of a potential bone graft material, where the HAP moiety acts not only as a bioceramic filler, but also constitutes the initiator surface that promotes the in-situ polymerization of the adsorbable polymer of choice. The synthesis of poly(D,L-lactide-co-glycolide) (PLGA) polymer was catalyzed by nano-hydroxyapatite (nHAP) particles and upon reaction completion, the biocomposite material was tethered with collagen. The synthesis was monitored by 1H NMR and FTIR spectroscopies and the products after each step were characterized by thermal analysis to probe both thermal stability, morphological integrity and mechanical properties.


2005 ◽  
Vol 31 (2) ◽  
pp. 68-76 ◽  
Author(s):  
David D. Hile ◽  
Stephen T. Sonis ◽  
Stephen A. Doherty ◽  
Xiao Yan Tian ◽  
Qing Zhang ◽  
...  

Abstract This study evaluated reconstruction of the alveolar ridge after molar extraction in rats with bioabsorbable bone repair scaffolds. The material was prepared from the unsaturated polyester poly(propylene glycol-co-fumaric acid) (PPF), which may be cured in situ to form a porous scaffold. The intention is to use this material either as a stand-alone bone graft substitute or as an extender to autograft harvested from mandibular reconstruction sites. The bioactivity of the graft substitute was investigated in a rat residual ridge resorption model. PPF bone repair material was injected into the defect site, where it cross-linked in situ in the presence of a hydroxyapatite (HA) filler and effervescent agents. The PPF-based material develops porosity during an in situ cure by generating carbon dioxide during the effervescent reaction of citric acid and sodium bicarbonate. The incorporation of HA promotes osteoconduction within the bone repair scaffold. In this study, bioactivity of the porous scaffold was evaluated as a function of HA particle size (micrometer-sized vs nanometer-sized particles). The maxillary or mandibular molars on the right side were extracted from 96 adult Sprague-Dawley rats. A 2-mm round bur was used to create a uniform trench defect measuring 2 mm in diameter, 2 mm in depth, and 4 mm in length at each extraction site. The defect site was (1) treated with PPF bone repair material containing nanometer-sized HA, (2) treated with PPF material containing micrometer-sized HA, (3) treated with demineralized freeze-dried bone allograft , or (4) left untreated. Rats were sacrificed at 2, 4, 7, and 12 weeks postoperative. Resorption of the residual alveolar ridge was assessed by radiographic outcomes. Bone ingrowth through the defect site was measured by histomorphometric outcomes. Mandibular and maxillary ridge heights increased for all treatments used in this study. There were no clinical indications that addition of either of the PPF bone repair materials retarded hard- or soft-tissue healing of the extraction sites. Although not statistically significant, the mandibular defects treated with PPF containing nanometer-sized HA healed at a faster rate as determined by ridge height and new bone formation measurements when compared with the other treatments. These findings suggest the feasibility of using PPF bone graft substitutes for oral-maxillofacial applications.


2013 ◽  
Vol 3 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Chandan Gupta ◽  
Divya Mehrotra ◽  
Shadab Mohammad ◽  
Vaibhav Khanna ◽  
Gulshan Kumar Singh ◽  
...  

Author(s):  
Niketa Chauhan ◽  
Nilay Lakhkar ◽  
Amol Chaudhari

AbstractThe process of bone regeneration in bone grafting procedures is greatly influenced by the physicochemical properties of the bone graft substitute. In this study, porous phosphate glass (PPG) morsels were developed and their physicochemical properties such as degradation, crystallinity, organic content, surface topography, particle size and porosity were evaluated using various analytical methods. The in vitro cytotoxicity of the PPG morsels was assessed and the interaction of the PPG morsels with Dental Pulp Stem Cells (DPSCs) was studied by measuring cell proliferation and cell penetration depth. The cell-material interactions between PPG morsels and a commercially available xenograft (XG) were compared. The PPG morsels were observed to be amorphous, biocompatible and highly porous (porosity = 58.45%). From in vitro experiments, PPG morsels were observed to be non-cytotoxic and showed better cell proliferation. The internal surface of PPG was easily accessible to the cells compared to XG.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Aljawadi ◽  
I Madhi ◽  
T Naylor ◽  
M Elmajee ◽  
A Islam ◽  
...  

Abstract Background Management of traumatic bone void associated with Gustilo IIIB open fractures is challenging. Gentamicin eluting synthetic bone graft substitute (Cerament-G) had been recently utilised for the management of patients with these injuries. This study aims to assess radiological signs of Cerament-G remodelling. Method Retrospective data analysis of all patients admitted to our unit with IIIB open fractures who had Cerament-G applied as avoid filler. Postoperative radiographic images of the fracture site at 6-weeks, 3-months, 6-months and at the last follow-up were reviewed. The radiological signs of Cerament-G integration, percent of void healing, and bone cortical thickness at the final follow-up were assessed. Results 34 patients met our inclusion criteria, mean age: 42 years. Mean follow-up time was 20 months. 59% of patients had excellent (>90%) void filling, 26.4% of patients had 50-90% void filling, and 14.6% had < 50% void filling. Normal bone cortical thickness was restored on AP and Lateral views in 55.8% of patients. No residual Cerement-G was seen on X-rays at the final follow-up in any of the patients. Conclusions Our results showed successful integration of Cerament-G with excellent void filling and normal cortical thickness achieved in more than half of the patients.


2021 ◽  
pp. 105566562110076
Author(s):  
Caroline Dissaux ◽  
Laetitia Ruffenach ◽  
Catherine Bruant-Rodier ◽  
Daniel George ◽  
Frédéric Bodin ◽  
...  

Introduction: Since the early stages of alveolar bone grafting development, multiple types of materials have been used. Iliac cancellous bone graft (ICBG) remains the gold standard. Design/Methods: A review of literature is conducted in order to describe the different bone filling possibilities, autologous or not, and to assess their effectiveness compared to ICBG. This review focused on studies reporting volumetric assessment of the alveolar cleft graft result (by computed tomography scan or cone beam computed tomography). Results: Grafting materials fall into 3 types: autologous bone grafts, ICBG supplementary material, and bone substitutes. Among autologous materials, no study showed the superiority of any other bone origin over iliac cancellous bone. Yet ICBG gives inconsistent results and presents donor site morbidity. Concerning supplementary material, only 3 studies could show a benefit of adding platelet-rich fibrin (1 study) or platelet-rich plasma (2 studies) to ICBG, which remains controversial in most studies. There is a lack of 3-dimensional (3D) assessment in most articles concerning the use of scaffolds. Only one study showed graft improvement when adding acellular dermal matrix to ICBG. Looking at bone substitutes highlights failures among bioceramics alone, side-effects with bone morphogenetic protein-2 composite materials, and difficulties in cell therapy setup. Studies assessing cell therapy–based substitutes show comparable efficacy with ICBG but remain too few. Conclusion: This review highlights the lack of 3D assessments in the alveolar bone graft materials field. Nothing dethroned ICBG from its position as the gold standard treatment at this time.


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