Stability of Tissue Augmented with Deproteinized Bovine Bone Mineral Particles Associated with Implant Placement in Anterior Maxilla

Abstract

Background Implant placement in defective anterior maxilla poses a great challenge regarding functional and aesthetic outcomes. Therefore, it requires predictable alveolar ridge augmentation. Deproteinized bovine bone mineral (DBBM) particle has commonly been used for bone grafting. However, it is associated with low resorption rates which potentially compromise the outcome of horizontal augmentation in conjunction with implant placement. Aims This study is aimed at evaluating the stability of tissue augmented with DBBM particle associated with implant placement in the anterior maxilla. Materials and Methods The inclusive criteria consist of patients being treated with guided bone regeneration (GBR) incorporating the use of DBBM particles with either a simultaneous or staged approach. The parameters analyzed include the implant survival rate, post-GBR clinical stability based on tissue resorption level, and the tissue stability between simultaneous and staged approaches. Statistical analysis using Mann-Whitney test is performed with significance determined at p value < 0.05. Results Seventeen patients with 23 implant placements satisfy the criteria for this study. Simultaneous approach is adopted in 18 (78.3%) implants and a staged approach in 5 (21.7%) implants. The implant survival rate is 100%. The evaluation of horizontal tissue stability reveals a low resorption level in 19 (82.6%) implants, while moderate and high resorption levels are found in 3 (13.0%) and 1 (4.3%) implants, respectively. The statistical analysis shows that the simultaneous approach produces significantly (p = 0.005) lower resorption level compared to the staged approach. Conclusion Horizontal ridge augmentation using DBBM particles associated with implant placement in the anterior maxilla produces good clinical stability. The stability appears to be higher in the simultaneous approach compared to the staged approach.

Evaluation of regeneration after the application of 2 types of deproteinized bovine bone mineral to alveolar bone defects in adult dogs

“…In a previous study, DBBMs showed a slow degradation rate and relatively low bone regeneration capacity [ 26 ]. Non-mineralized bone substitutes promote osteoblast differentiation by releasing bone morphogenic proteins.…”

In Vivo Analyses of Osteogenic Activity and Bone Regeneration Capacity of Demineralized Freeze-Dried Bovine Bone Xenograft: A Potential Candidate for Alveolar Bone Fillers

“…Osteoclasts could be associated with the resorption of the e quantification of protein expressions showed that osteoblastic markers were significantly higher in the DFDBBX group compared to the DBBM group (p < 0.05), except in ALP in 4 weeks (n � 5); * p < 0.05. 6 International Journal of Dentistry surrounding and the woven bone in the DFDBBX group during the late stage of healing. It is noteworthy, however, that the highest number of osteoclasts was seen in the control group indicating a consistent increase in resorption activities in 2 to 4 weeks.…”

“…eir high osteoconductive activity allows cell migration, attachment, and proliferation, osteoblastic differentiation, and extracellular bone matrix deposition [5]. However, DBBM particles have a slow degradation rate and, consequently, relatively low bone regeneration capacity [6]. Demineralized freeze-dried bovine bone xenograft (DFDBBX) has been developed to overcome DBBM limitations [7].…”

Analyses of Bone Regeneration Capacity of Freeze-Dried Bovine Bone and Combined Deproteinized–Demineralized Bovine Bone Particles in Mandibular Defects: The Potential Application of Biological Forms of Bovine-Bone Filler

“… 14 However, it was associated with very slow degradation that might lower its bone regeneration capacity. 4 In order to overcome DBBM limitation, mineralized FDBX and DFDBXs were developed recapitulating the concept and processing of human FDBA and DFDBA. 15 Despite the concern over the potential xenogeneic response upon its clinical application, this organic forms of xenograft material did not show abnormal immune response in few in vitro 7 16 17 18 and in vivo studies 7 9 19 as well as in a clinical study.…”

“…The DBBM particle is purely inorganic that is considered osteoconductive and exhibits extremely slow degradation which may reduce the bone regeneration capacity and bone-implant contact area. 4 5 Limitation of DBBM particle has made way to the utilization of other forms of bovine bone particles, that is, freeze-dried bovine bone particles (FDBX) and demineralized freeze-dried bovine bone particle (DFDBX) recapitulating the processing in allograft production. 6 Despite concerns over the potential xenogeneic response upon its application, these organic forms of xenograft material is proven to be nontoxic and nonimmunogenic in in vitro and in vivo studies.…”