Incorporation and Remodeling of Bone Block Allografts in the Maxillary Reconstruction: A Randomized Clinical Trial

Deluiz, Daniel; Oliveira, Luciano Santos; Pires, Fábio Ramôa; Reiner, Teresita; Armada, Luciana; Nunes, Marcus Alexandre; Tinoco, Eduardo Muniz Barretto

doi:10.1111/cid.12441

Cited by 22 publications

(20 citation statements)

References 85 publications

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“…The biopsy analyzed in the current investigation showed 15.4% residual graft particles (RG). This finding is in agreement with a recent study of Deluiz et al [45], in which biopsies from ridges augmented with FFB blocks were retrieved four (24.3% RG) and six months (18.4% RG) after grafting. These data, even if they should be interpreted with caution, seem to indicate that the greatest part of graft remodeling and resorption takes place in the first period after the surgical procedure, likely as a consequence of the healing process.…”

Section: Discussionsupporting

confidence: 93%

Fresh Frozen Allogeneic Bone Block in Maxillary Sinus Floor Elevation: Histomorphometric Analysis of a Bone Specimen Retrieved 15 Years after Grafting Procedure

et al. 2019

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Nowadays implant-prosthetic rehabilitations are one of the best solutions for rehabilitating our patients. These allow obtaining rehabilitations with optimal functional and aesthetic performances. Often patients, who undergo implant-prosthetic therapy, have the conditions of edentulias, single or multiple, that have been going on for some time. This, according to the literature, produces resorption of the alveolar bone, a process that is complicated in the posterior area of the upper arch by a pneumatization of the maxillary sinuses. The loss of vertical height, so that the implant fixtures can be inserted, requires a maneuver called maxillary sinus floor elevation. This procedure, now safely performed with piezoelectric instruments, allows increasing bone height through bone grafting. In this study, the tissue obtained from a patient, after 15 years from the intervention, was evaluated by histological and SEM analyses. The bone healing in the patient has led to a perfect integration between the patient’s bone and the fresh frozen allograft used, however still present and detectable after 15 years.

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Section: Discussionsupporting

confidence: 93%

Fresh Frozen Allogeneic Bone Block in Maxillary Sinus Floor Elevation: Histomorphometric Analysis of a Bone Specimen Retrieved 15 Years after Grafting Procedure

et al. 2019

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“…A high incidence of soft tissue dehiscence and implant failures has been reported in patients receiving fresh frozen allogeneic bone grafts for reconstructing severe alveolar atrophies (36.8% incidence of dehiscence and 31.5% incidence of implant loss) [34] and 21% of implant loss [35], respectively. With the use of a different equine bone block, a previous publication reported total removal of the graft in 50% of the patients and in 20% of them the implants failed [36].…”

Section: Discussionmentioning

confidence: 99%

Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement

et al. 2017

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BackgroundThe osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.MethodsIn 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed using CCXBB as bone replacement grafts. Twenty-six weeks postoperatively, a re-entry procedure was performed to evaluate the bone width for adequate implant placement and two histological specimens were retrieved from each patient, one being processed for ground sectioning and the other for decalcified paraffin-included sections. In non-decalcified sections, the relative proportions occupied by bone, biomaterials, and connective tissue present in the biopsies were identified. In de-calcified sections, structures and cells positive for osteopontin (OPN), tartrate-resistant acid phosphatase activity (TRAP), osteocalcin (OSC), and alkaline phosphatase (ALP) were assessed.ResultsSoft tissue dehiscence occurred during the follow-up in 5 out of 15 patients (33.3%). The mean crest width at baseline was 2.78 mm (SD 0.57) and the mean crest width at re-entry was 6.90 mm (SD 1.22), with a mean ridge width increase of 4.12 mm (SD 1.32). Twenty-six bone biopsies were obtained from 13 patients. Histomorphometric analysis showed a mean of 26.90% (SD 12.21) of mineralized vital bone (MVB), 21.37% (SD 7.36) of residual CCXBB, 47.13% (SD 19.15) of non-mineralized tissue, and 0.92% of DBBM. The immunohistochemical analysis revealed a large number of OPN-positive cells 8.12% (SD 4.73), a lower proportion of TRAP positive multinuclear cells 5.09% (SD 4.91), OSC-positive cells 4.09% (SD 4.34), and a limited amount of ALP positive cells 1.63% (SD 2).ConclusionsCCXBB achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. In light of the histological outcomes and implant failures, special attention must be placed to prevent soft tissue dehiscence when CCXBB is used in severe atrophic alveolar crests.

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“…Reasons for excluding 15 studies after full-text assessment were: study could not be excluded before meticulous reading (n = 1) [42], unspecified augmentation procedure (n = 1) [43], unspecified number of implants inserted (n = 1) [44], barrier membrane saturated in platelet-rich plasma (n = 1) [45], immediate implant placement (n = 1) [46], outcome measures could not be identified for HARA in studies involving both horizontal and vertical alveolar ridge augmentation (n = 2) [47,48], observation period after functional loading of six months not fulfilled (n = 3) [49][50][51], or observation period not clearly specified (n = 4) [52][53][54][55][56].…”

Section: Exclusion Of Studiesmentioning

confidence: 99%

Horizontal Alveolar Ridge Augmentation with Allogeneic Bone Block Graft Compared with Autogenous Bone Block Graft: a Systematic Review

Starch‐Jensen¹,

Deluiz²,

Tinoco

2019

JOMR

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Objectives:The objective of the present systematic review was to test the hypothesis of no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block. Material and Methods: A MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted including human studies published in English through March 13, 2019. Comparative and non-comparative studies evaluating horizontal ridge augmentation with allogeneic bone block were included. Cochrane risk of bias tool and Newcastle-Ottawa Scale were used to evaluate risk of bias. Results: One comparative study with high quality and 12 non-comparative studies fulfilled the inclusion criteria. Considerable heterogeneity prevented meta-analysis from being performed. The comparative retrospective short-term study demonstrated no significant difference in implant treatment outcome between the two treatment modalities. Non-comparative long-term studies revealed high implant survival, gain in alveolar ridge width and bone regeneration with allogeneic bone block. However, noncomparative studies disclosed high incidence of complications including dehiscence, exposure of allogeneic bone block and partial or total loss of the grafts. Conclusions: There seemed to be no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block. However, increased risk of complications was frequently reported with allogeneic bone block.

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Incorporation and Remodeling of Bone Block Allografts in the Maxillary Reconstruction: A Randomized Clinical Trial

Cited by 22 publications

References 85 publications

Fresh Frozen Allogeneic Bone Block in Maxillary Sinus Floor Elevation: Histomorphometric Analysis of a Bone Specimen Retrieved 15 Years after Grafting Procedure

Fresh Frozen Allogeneic Bone Block in Maxillary Sinus Floor Elevation: Histomorphometric Analysis of a Bone Specimen Retrieved 15 Years after Grafting Procedure

Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement

Horizontal Alveolar Ridge Augmentation with Allogeneic Bone Block Graft Compared with Autogenous Bone Block Graft: a Systematic Review

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