186 resultados para BONE GRAFT


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Piezosurgery is a new and modern technique of bone surgery in implantology. Selective cutting is possible for different ultrasonic frequencies acting only in hard tissues (mineralized), saving vital anatomical structures. With the piezoelectric osteotomy technique, receptor site preparation for implants, autogenous bone graft acquistition (particles and blocks), osteotomy for alveolar bone crest expansion, maxillary sinus lifting, and dental implant removal can be performed accurately and safely, providing excellent clinical and biological results, especially for osteocyte viability. The aim of this review was, through literature review, to present clinical applications of piezosurgery in implant dentistry and outline their advantages and disadvantages over conventional surgical systems. Moreover, this study addressed the biological aspects related to piezosurgery that differentiate it from those of bone tissue approaches. Overall, piezosurgery enables critical operations in simple and fully executable procedures; and effectively, areas that are difficult to access have less risk of soft tissue and neurovascular tissue damage via piezosurgery.

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Abstract : The objective of this study was to evaluate quantitatively and to describe qualitatively the process of bone repair in the interface of receptor bed and graft autogenous bone block with or without a e-PTFE membrane, in osteopenia induced rats. To this end, we used forty-eight Wistar rats weighing about 300g, in which, with the aid of 4.1 mm trephine a graft was removed from the parietal bone and fixed to the surface of the left mandibular ramus. The animals were randomly divided into four experimental groups: Group 1 (n=12): SHAM operated and autogenous bone graft only; Group 2 (n=12): SHAM and autogenous bone graft covered by e-PTFE membrane; Group 3 (n=12): ovariectomized rats (OVX) and autogenous bone graft only; Group 4 (n=12): OVX and autogenous bone graft covered by e-PTFE membrane. The animals in each group were sacrificed at three time periods: 21, 45 and 60 days, each time with 4 animals per group. The specimens were decalcified and included, the sections were stained with HE and subjected to histological and histomorphometric analysis in light microscopy. The results of the ANOVA showed that the variables on the condition (OVZ and SHAM), and the time (21, 45 and 60 days) were statistically significant, and can be established with the Tukey test (5%) that the period 21-day differs significantly from the periods of 45 and 60 days, which did not differ among themselves. The descriptive histological analysis showed integration of the graft in all animals. It was concluded that the initial integration of the graft bed was negatively affected in the presence of induced osteopenia, and that the use or not of a e-PTFE membrane did not interfere in the process of integration

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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The early tooth loss and periodontal disease often leave inadequate bone volume for installation of osseointegrated implants. The autogenous bone graft is considered the gold standard for reconstruction of residual bone defects. Some surgical techniques can be performed, including extra or intraoral donor sites depending on the degree of bone loss, depending on surgical-prosthetic planning and general condition of the patient. The intraoral bone grafts offer a safe option to rebuilt bone volume in smaller rehabilitations, with low morbidity and minimal postoperative discomfort. Among the possible donor sites, the mandibular ramus and body, which offer predominantly cortical bone, and the chin area, which offers corticomedullary bone tissue, can be harvested. The graft will be suitable both in quantity and quality, preserving the capacity of osteogenesis, osteoinduction and osteoconduction, which differentiate autogenous grafts from other biomaterials. The aim of this study was to report a clinical case in which the mandibular ramus graft was used for total reconstruction of an edentulous maxilla, showing that even large areas can be reconstructed with grafts from intraoral origin. All the steps that allowed the complete reconstruction of the maxilla done by an intraoral donor area are listed in the text, culminating in an extremely satisfactory clinical result.

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The bone resorption in the anterior maxilla, due to its aesthetic importance, can be considered one of the challenges in implant dentistry. Autogenous bone graft is the most indicated bone augmentation procedure, aiming an implant supported rehabilitation.. Alternatively, some other graft procedures can be done with homogenous and xenogenous bone graft, biomaterials and different associations. Additionally to the mentioned biomaterials, the bone morphogenetic protein (BMP), specially the rhBMP-2, which was characterized as a bone osteoinductor, and consecutively, a potential autogenous graft substitute, with previsibility and no necessity of association to other biomaterial. The objective of this study is to present a single case using the rhBMP-2 for bone augmentation.

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Purpose: The aim of this systematic review was to evaluate clinical and safety data for recombinant human bone morpho-genetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier when used for alveolar ridge/maxillary sinusaugmentation in humans.Materials and Methods: Clinical studies/case ser ies published 1980 through June 2012 using rhBMP-2/ACS were searched.Studies meeting the following criteria were considered eligible for inclusion: >10 subjects at baseline and maxillary sinus oralveolar ridge augmentation not concomitant with implant placement.Results: Seven of 69 publications were eligible for review. rhBMP-2/ACS yielded clinically meaningful bone formationfor maxillary sinus augmentation that would allow placement of regular dental implants without consistent differencesbetween rhBMP-2 concentrations. Never theless, the statistical analysis showed that sinus augmentation following autog-enous bone graft was significantly greater (mean bone height: 1.6 mm, 95% CI: 0.5–2.7 mm) than for rhBMP-2/ACS(rhBMP-2 at 1.5 mg/mL). In extraction sockets, rhBMP-2/ACS maintained alveolar ridge height while enhancing alve olarridge width. Safety reports did not represent concerns for the proposed indications.Conclusions: rhBMP-2/ACS appears a promising alternative to autogenous bone grafts for alveolar ridge/maxillary sinusaugmentation; dose and carrier optimization may expand its efficacy, use, and clinical application.