Stability of Implants Supported By Three Types of Bone Grafting Materials in Dogs

Background: This study was conducted to assess the stability of implants placed in a simultaneous procedure with different grafting materials (autogenous, xenogenous, and synthetic) in experimentally induced bone defects in dogs.Methods: Thirteen dogs were included and divided into three groups according to the time of sacrificing. Oversized osteotomies were prepared in the sternum, and the implants were placed in bone defects. A total of 3 to 5 implants were placed per animal. Each group of animals contained 3 subgroups according to the grafting material utilized. In subgroup 1, autograft was applied, whereas in subgroups 2 and 3, bovine bone mineral (Cerabone) and a synthetic calcium phosphate substitute (Osteon II) were employed. At the end of the specified healing periods (2 months, 4 months, or 6 months), the animals were sacrificed and the implant stability was determined through measuring the resonance frequency.Results: Forty-five integrated implants were obtained from this study and nine were lost (failure rate 17%). The two-way analysis of variance revealed no significant difference in ISQ measurements either between the bone graft materials (autogenous, xenogenous, and synthetic; P=0.950) or between the healing intervals (2 months, 4 months, and 6 months; P=0.769)Conclusions: The stability of implants augmented with autogenous, xenogenous (Cerabone) or synthetic (Osteon II) graft materials was comparable at 2, 4 and 6 months after placement. This indicates that both Cerabone and Osteon II could be considered as suitable substitutes for regeneration of bone defects to overcome the limitations of autografts.

Rehabilitation of severely atrophic mandible: A 3-year Follow Up Protocol.

Severe bone atrophies are considered a challenge in the rehabilitation process. In clinical situations involving excessive vertical bone deficiency in edentulous mandibles, there is risk of fracture and frequently the need for an approach that involves highly complex procedures. In this context, simultaneous three-dimensional bone reconstruction associated with rigid fixation is a viable alternative to optimize longevity and avoid failures in these cases. This clinical case report presents a technique for reconstruction of severely atrophic mandibles in an elderly female patient to allow the implant-supported prosthesis protocol. The placement of immediate implants was possible by using an intraoral approach for fixation of a titanium plate, followed by guided bone regeneration in association with rhBMP-2, deproteinized bovine bone mineral and titanium mesh in a one-stage surgical procedure. There are no reports in the literature with this approach for treating of severely atrophic mandibles. These association of techniques was shown to be predictable after three years of follow-up. Therefore, this protocol provides safe supported-implant prosthesis rehabilitation for patients with severely atrophic mandible.

Osteoconductivity of Bovine Xenograft Granules of Different Sizes in Sinus Lift: A Histomorphometric Study in Rabbits

Background: Due to the lack of data on bone-to-graft contact (BGC) over time in the various regions within the subantral space of the augmented sinus floor, the present study aimed to evaluate the osteoconductivity of deproteinized bovine bone mineral (DBBM) with granules of different sizes applied in maxillary sinus floor elevation. Methods: A maxillary sinus augmentation was performed bilaterally in 18 rabbits using DBBM with particle dimensions of either 0.125–1.0 mm or 1–2 mm. The antrostomy was covered using a collagen barrier. The animals were euthanized in groups of six after 2, 4, and 8 weeks of healing. MicroCT and histological analyses were performed. Results: After 2 weeks of healing, BGC was 10.9% and 11.9% for the small and large granule sites, respectively. After 8 weeks of healing, the BGC increased to 65% and 62% at the small and large granule sites, respectively. The highest values were located close to the bony walls and the bony window. New bone content developed between 2 and 8 weeks from 7.0% to 27.6% and from 6.1% to 27.6% at the small and large granule sites, respectively. Conclusions: Similar outcomes in osteoconductivity and bone formation were found at both small and large DBBM granule sites.

Healing of Experimental Periodontal Defects Following Treatment with Fibroblast Growth Factor-2 and Deproteinized Bovine Bone Mineral

The aim of this study was to investigate the effects of fibroblast growth factor (FGF)-2 used in combination with deproteinized bovine bone mineral (DBBM) on the healing of experimental periodontal defects. Periodontal defects created in rats were treated by FGF-2, DBBM, FGF-2 + DBBM, or left unfilled. Microcomputed tomography, histological, and immunohistochemical examinations were used to evaluate healing. In vitro cell viability/proliferation on DBBM with/without FGF-2 was assessed by WST-1. Cell behavior was analyzed using scanning electron and confocal laser scanning microscopy. Osteogenic differentiation was evaluated by staining with alkaline phosphatase and alizarin red. Bone volume fraction was significantly greater in FGF-2 and FGF-2 + DBBM groups than in other groups at 2 and 4 weeks postoperatively. In histological assessment, newly formed bone in FGF-2 and FGF-2 + DBBM groups appeared to be greater than other groups. Significantly greater levels of proliferating cell nuclear antigen-, vascular endothelial growth factor-, and osterix-positive cells were observed in FGF-2 and FGF-2 + DBBM groups compared to Unfilled group. In vitro, addition of FGF-2 to DBBM promoted cell viability/proliferation, attachment/spreading, and osteogenic differentiation. The combination therapy using FGF-2 and DBBM was similarly effective as FGF-2 alone in the healing of experimental periodontal defects. In certain bone defect configurations, the combined use of FGF-2 and DBBM may enhance healing via promotion of cell proliferation, angiogenesis, and osteogenic differentiation.