Block Bone Graft Fixation ( Onlay): A Modification of the Surgical Technique

Several reconstructive methods of the alveolar ridge have been reported to make possible future rehabilitations with implants. Many of these methods come from studies done in animals, mainly rats. With this clinical practice based on scientific evidence, any experimental procedure that can be undertaken in real life is fundamental. Thus, any research that emulates as closely as possible those techniques used in humans are important. This study describes the modification of the technique for block bone graft fixation (onlay) in rats using the lag screw-type technique, normally used in clinical procedures for grafts in humans. The conclusion was that the execution of the described procedures minimizes interference of blood flow in the area because of the maintenance of the muscle insertion in the buckle aspect of the most anterior region of the mandible, providing better stability to the graft and better contact interface of the graft and receptor bed.

Efeito do extrato insaponificável de abacate e soja na doença periodontal induzida, na osseointegração de implantes e no reparo de defeitos críticos de calvaria de ratos

Pós-graduação em Odontologia - FOAR

Healing Process of Autogenous Bone Graft in Spontaneously Hypertensive Rats Treated With Losartan: An Immunohistochemical and Histomorphometric Study

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

Morphofunctional characterization of decellularized vena cava as tissue engineering scaffolds

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

Influence Analysis of Cleft Type and Supernumerary Teeth Eruption in the Prognosis of Bone Graft in Patients With Cleft Palate

Objective: The aim of this study was to investigate the influence of cleft type and supernumerary tooth eruption on the treatment of palatal clefts with alveolar bone grafts.Materials and Methods: In this article, medical records of 40 patients with palatal clefts and associated supernumerary teeth who were treated with alveolar bone grafting in the Hospital for Craniofacial Anomalies Rehabilitation were assessed. The patients were studied to assess the influence of supernumerary teeth and the cleft severity on the prognosis of the alveolar bone graft.Results: Forty medical records were included in the assessment. When the teeth in the cleft had an anatomic shape close to canine, we called them precanine. When they were very small or malformed, we called them anomalous lateral incisors. The teeth studied showed good prognoses and were more expressive in the preforaminal clefts (87.5%) than in the transforaminal ones (62.5%). Moreover, the transforaminal clefts presented a higher percentage in satisfactory and poor prognoses (37.5%). The authors found that supernumerary teeth influenced the maintenance of alveolar bone graft height and that transforaminal clefts presented a worse prognosis than preforaminal clefts.

Calvarial Autogenous Bone Graft for Maxillary Ridge and Sinus Reconstruction for Rehabilitation With Dental Implants

Autogenous bone grafting is the gold-standard technique for bone augmentation procedures prior to implant placement. If the amount of available intraoral donor bone is insufficient, it is necessary to harvest bone graft from extraoral sites, such as calvaria. Although this technique is well established, only a few case reports show the histological analysis of the grafted bone at the moment of implant placement. This article reports the case of a 48-year-old female patient with a critical atrophic maxillary ridge reconstructed using autogenous calvarial bone graft prior to implant placement, with clinical and histological evaluation. Bone was collected under general anesthesia from the parietal bone. The outer cortical originated the bone blocks, and the medullar bone layer between was collected to be used in the sinus augmentation procedure, together with 5 of the bone blocks triturated. Six months after bone augmentation, 8 implants were placed in the grafted area and 2 biopsies were retrieved (anterior and the posterior regions), allowing the visualization of the bone-remodeling process in the grafted areas. The patient had a stable recovery. Our results showed that although necrotic bone could still be seen in the outer layer of the grafted area, the interface between this necrotic bone and the already remodeled bone was consistent with biocompatibility. Two-year radiographic evaluation showed success of the grafts and the implants in supporting an esthetic and functionally stable prosthesis. Summarizing, calvarial bone grafts are a viable alternative for the attainment of adequate bone volume prior to implant placement.

Effect of platelet-rich plasma on the healing of mandibular defects treated with fresh frozen bone allograft: a radiographic study in dogs

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Liberação de componentes do extrato de Casearia sylvestris Swartz empregando membranas de látex natural como suporte

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

Imunomarcação da OPG e RANKL no reparo ósseo após a cirurgia de elevação do seio maxilar com Bio-Oss

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação física e radiográfica de biomateriais usados para regeneração óssea

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Reabilitação total da maxila com enxerto intraoral: relato de caso

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.

Alveolar ridge and maxillary sinus augmentation using rhBMP-2: a systematic review

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.

Análise clínica, tomográfica e histológica comparativa entre ha+β-tcp isolado ou associado a proteínas derivadas do esmalte utilizadas como enxertos após a elevação da membrana do seio maxilar e colocação de implantes: estudo piloto

The aim of this study was to evaluate the clinical, tomographic, and histological similarity within the use of HA+β-TCP (Boneceramic) alone or associated with enamel matrix derived (EMD) proteins in sinus lifting procedures with subsequent dental implant placement. We selected two patients with residual bony ridges between 3 mm and 5 mm in height in need of bone grafts. Six months later, eight implants were installed (two implants at each site). Biopsies were made, and the tissue was processed and stained with HE solution. Tomographic evaluation showed bone height gain up to 10.0 mm on average. Histology showed new bone formation for both groups, with similar bone density and trabecular interconnectivity. It can be concluded that the HA+β-TCP graft isolated or associated to EMD provided bone height gain in sinus lifting procedures, with similar clinical, tomographic and histological characteristics.

Incorporação de enxertos ósseos autógenos e homógenos em humanos: abordagem tomográfica

The objective of this study was to evaluate the remodeling of autologous and homologous bone grafts in humans, using tomographic images. For this, CT images from 10 patients (5 treated with autologous bone grafts and 5 treated with homologous bone grafts), made previously to the grafting procedures, and 14 and 180 days post operatory were evaluated regarding to bone height, width, and density, in a total of 19 bone blocks, 10 homologous and 9 autologous. Results showed similarities between the two tested materials regarding bone width and density. It can be concluded that the homologous bone presented, in a tomographic approach, after 180 days of follow-up, characteristics which can corroborate its use as a bone graft material, providing and sustaining a good bone volume for oral rehabilitation with dental implants.