Human Histologic Analysis of Mineralized Bone Allograft (Puros) Placement Before Implant Surgery

Abstract

Because clinicians are placing more dental implants, it is becoming more important to maintain bone volume after tooth extraction. This article discusses the various bone-augmentation materials available to the clinician and illustrates a case report of particulate mineralized bone allograft (Puros) placement after extraction. Exposure of the grafted site after 5 months revealed a hard bony structure. Human histologic analysis at the light microscopic level revealed nonvital spicules of mature calcified bone having a highly organized matrix surrounded by viable noncalcified immature bone matrix, or osteoid. It was concluded that mineralized human allograft demonstrated the formation or remodeling of bone histologically and was clinically useful to maintain bone volume for implant placement after extraction. To the authors' knowledge, this is the first publication to demonstrate human histology of particulate mineralized bone allograft (Puros) after placement into an extraction site.

Horizontal and Vertical Reconstruction of the Severely Resorbed Maxillary Jaw Using Subantral Augmentation and a Novel Tenting Technique with Bone from the Lateral Buccal Wall

“…These osteoconductive bone substitutes become integrated into the newly formed bone matrix [20]. In this study, we used MCBA based on encouraging documented reports of new bone formation [21]. Our histological results were consistent with those of Noumbissi et al [22], Froum et al [23] and Schmitt et al [13].…”

Maxillary Sinus Floor Lifting Using Freeze-Dried Homologous Bone And Tibia Autologous Bone: Report On Radiographic And Histological Results

“…[13][14][15] However, the literature is not conclusive on the best material to use as a graft. The studies have reported the use of different materials, including autologous bone, 11,[15][16][17][18][19] homologous bone, [20][21][22][23][24] xenografts, 14,15,19,25 and alloplastic materials. 1,14,25,26 Within these alternative, the autologous bone is the one with the closest to ideal conditions, 2, 27-29 but due to the disadvantage of a second surgical site donor and the morbidity this entails, the exploration of other alternatives was necessary.…”

“…[13][14][15] No obstante, la literatura no es concluyente sobre el tipo de material ideal para utilizar como injerto. Los estudios han reportado el uso de diversos materiales, dentro de los cuales podemos citar el hueso autólogo, 11,[15][16][17][18][19] el hueso homólogo, [20][21][22][23][24] los xenoinjertos 14,15,19,25 y los materiales aloplásticos. 1,14,25,26 Dentro de estas opciones, el hueso autólogo es el que presenta las condiciones más cercanas a las ideales, 2,[27][28][29] pero debido a la desventaja de un segundo sitio quirúr-gico donante y a la morbilidad que esto acarrea, se hizo necesaria la exploración de las otras opciones.…”

“…Los aloinjertos o injertos homólogos 21,40 provienen de individuos de la misma especie que el receptor y se dividen en tres categorías principales: congelado, congelado-seco o liofilizado y congelado-seco desmineralizado. Han sido usados desde la década de los setenta por sus propiedades osteoconductivas.…”

“…Allografts or homologous grafts 21,40 come from individuals of the same species as the receiver and are divided into three main categories: deep-freeze, freeze-dried or lyophilized, and demineralized freeze-dried. They have been used since the 1970s because of their osteoconductive properties.…”