The potential for vertical bone regeneration via maxillary periosteal elevation

Mouraret, Sylvain; Kaeppler, Ericka von; Bardet, Claire; Hunter, Daniel J.; Miller, Catherine; Bouchard, Philippe; Helms, Jill A.

doi:10.1111/jcpe.12310

Cited by 15 publications

(13 citation statements)

References 31 publications

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“…1). This was actually anticipated from previous experiments, where the periosteums of alveolar and long bones were compared (Mouraret et al 2014). Second, relative to type I bone, type III bone exhibited significantly more remodeling activity (Fig.…”

Section: Biological Predictors Of Implant Successsupporting

confidence: 77%

Relationships among Bone Quality, Implant Osseointegration, and Wnt Signaling

Yin

Huang

et al. 2017

J Dent Res

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A variety of clinical classification schemes have been proposed as a means to identify sites in the oral cavity where implant osseointegration is likely to be successful. Most schemes are based on structural characteristics of the bone, for example, the relative proportion of densely compact, homogenous (type I) bone versus more trabeculated, cancellous (type III) bone. None of these schemes, however, consider potential biological characteristics of the bone. Here, we employed multiscale analyses to identify and characterize type I and type III bones in murine jaws. We then combined these analytical tools with in vivo models of osteotomy healing and implant osseointegration to determine if one type of bone healed faster and supported osseointegration better than another. Collectively, these studies revealed a strong positive correlation between bone remodeling rates, mitotic activity, and osteotomy site healing in type III bone and high endogenous Wnt signaling. This positive correlation was strengthened by observations showing that the osteoid matrix that is responsible for implant osseointegration originates from Wnt-responsive cells and their progeny. The potential application of this knowledge to clinical practice is discussed, along with a theory unifying the role that biology and mechanics play in implant osseointegration.

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Section: Biological Predictors Of Implant Successsupporting

confidence: 77%

Relationships among Bone Quality, Implant Osseointegration, and Wnt Signaling

Yin

Huang

et al. 2017

J Dent Res

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“…For example, bone remodeling removes microdamage and ensures a strong osteoid matrix , and for many years the location and types of stem cells that maintain this tissue have been hotly debated. Some place the skeletal stem cells in the marrow cavity , whereas others claim that the periosteum is the primary source . Pinpointing the source(s) of adult stem cells has direct relevance to clinical practice: if the niches that support adult stem cells were characterized, and the mechanisms governing their self‐renewal and proliferation were clear, then care could be taken to preserve these cellular reservoirs.…”

Section: Alveolar Bone Mass Declines With Agementioning

confidence: 99%

From restoration to regeneration: periodontal aging and opportunities for therapeutic intervention

Huang¹,

Salmon²,

Yin³

et al. 2016

Periodontology 2000

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With the march of time our bodies start to wear out: eyesight fades, skin loses its elasticity, teeth and bones become more brittle, and injuries heal more slowly. These universal features of aging can be traced back to our stem cells. Aging has a profound effect on stem cells: DNA mutations naturally accumulate over time and our bodies have evolved highly specialized mechanisms to remove these damaged cells. While obviously beneficial, this repair mechanism also reduces the pool of available stem cells and this, in turn, has a dramatic effect on tissue homeostasis, and our rate of healing. Simply put: fewer stem cells means a decline in tissue function, and slower healing. Despite this seemingly intractable situation, research over the past decade now demonstrates that some of the effects of aging are reversible. Nobel prize-winning research demonstrates that old cells can become young again and lessons learned from these experiments-in-a-dish are now being translated into human therapies. Scientists and clinicians around the world are identifying and characterizing methods to activate stem cells to reinvigorate the body’s natural regenerative process. If this research in dental regenerative medicine pans out, the end result will be tissue homeostasis and healing back to the levels we appreciated when we were young.

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“…Jung et al [17] proposed a hypothesis according to which medial orbital wall remodeling takes place along its periosteum. The ratio of periosteum tissue to bone tissue of the facial bones is much higher than that of bones in the extremities [18]. This might contribute to self-healing of the membranous parts of the facial bones.…”

Section: Discussionmentioning

confidence: 93%

A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts

Chung

Tak

Lim

et al. 2019

Arch Craniofac Surg

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Background: Some parts of a maxillary fracture-for example, the medial and posterior wallsmay remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls. Methods: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated. Results: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p < 0.05). The significant preoperative volume difference between the normal and traumatized sides (p = 0.024) resolved after surgery (p > 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p = 0.002). Conclusion: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.

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The potential for vertical bone regeneration via maxillary periosteal elevation

Abstract: Periosteal response to injury varies with anatomical location, so conclusions from long bone studies should not be extrapolated for craniofacial applications. Murine maxillary periosteum has the osteogenic potential to induce vertical alveolar bone regeneration.

Cited by 15 publications

References 31 publications

Relationships among Bone Quality, Implant Osseointegration, and Wnt Signaling

Relationships among Bone Quality, Implant Osseointegration, and Wnt Signaling

From restoration to regeneration: periodontal aging and opportunities for therapeutic intervention

A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts

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