Bone Augmentation, Bone Loss, Alveolar
Conditions
Keywords
platelet concentrate, horizontal bone augmentation, sticky bone, Histology, Raman spectroscopy
Brief summary
This case series aimed to assess the efficacy of a novel horizontal ridge augmentation modality using histomorphometry and Raman spectroscopy. Combinations of sticky bone and tenting screws without autologous bone were used as augmentative materials.
Detailed description
This case series aimed to evaluate the efficacy of the horizontal augmentation technique using the tenting screw technique with sticky bone. The main aim was to determine whether this method provides similar results to the gold standard GBR or autologous onlay block grafts. In addition, the validity of neglecting autologous graft and its possible substitution with growth factor concentrate were examined. The novelty of this study is that no human histological examination of the described procedure has been conducted previously. It is hypothesized that the stick bone containing autologous platelet concentrate can substitute the use of particulate autologous bone graft in these type of procedures. In this prospective case series study five patients were enrolled and treated with the same type of bone augmentation in order to increase the alveolar ridge in the horizontal dimension with the previously mentioned technique. After 5 months of healing a second reentry surgery was performed in order to harvest the bone core for biopsy, to asses the chemical compound composition by Raman spectroscopy in vivo and to place the dental implants at the same time. Newly formed tissues were evaluated clinically during reentry, radiologically by CBCT acquisition, qualitatively and quantitatively by histological processing and physicochemically by means of Raman spectroscopy.
Interventions
PROCEDUREHorizontal bone augmentation
After taking six 9 mL tubes of blood from the patient, advanced (A-PRF) and liquid (S-PRF) PRFs were prepared. A-PRF was chopped, added to the xenogeneic bone substitute (THE Graft; Purgo Biologics Inc.), and then impregnated with the liquid S-PRF, which enabled the particulate bone substitute to become moldable and turned into a block (sticky bone). After local anesthesia, a midcrestal incision was made with one vertical releasing incision at the flap's mesial end. After full-thickness flap elevation, a periosteal releasing incision was made at the flap's apical portion. The alveolar bone was decorticalized on the buccal aspect with surgical burs. Next, the prepared bonded graft matrix was adapted to the ridge. Then, tenting screws (Pro-fix; Osteogenics) were placed to maintain the periosteum in an elevated and tension-free position The bone augmentation material was covered with A-PRF membranes. Finally, tension-free wound closure was performed.
Sponsors
Purgo Biologics Inc.
FORM-Lab
Semmelweis University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
All subjects undergo the same type of horizontal bone augmentation using sticky bone (combination of xenograft and autologous platelet rich concentrate) and tenting screws.
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* one or more missing teeth in the jaw's posterior area, where horizontal bone width is ≤5 mm. * no deficiency in the vertical dimension. * The tooth must have been removed ≥4 months before augmentation. * The patient should understand the nature of the research and be compliant in study-related activities
Exclusion criteria
* pregnancy * smoking * uncontrolled diabetes * systemic diseases or drug consumption affecting bone metabolism, and clinically relevant osteoporosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Amount of newly formed bone by means of histomorphometry | 5 months postoperatively | The percentage of newly formed bone of the augmented site within the biopsy |
| Amount of graft material bone by means of histomorphometry | 5 months postoperatively | The percentage of graft material (THE Graft; Purgo Biologics Inc.) of the augmented site within the biopsy |
| Amount of soft tissue by means of histomorphometry | 5 months postoperatively | The percentage of soft tissue of the augmented site within the biopsy |
| The quality of the newly formed tissues by means of histology | 5 months postoperatively | The descriptive analyses of the cells and tissue structure of the augmented site within the biopsy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| CBCT analysis | 5 months postoperatively | Horizontal bone volume gain (measured in mm) evaluated on pre- and postoperative CBCT-s. |
| The clinical descriptive bone assessment of the augmented bone site | 5 months postoperatively | The descriptive clinical assessment is a subjective evaluation of the augmented bone judged by the operator. The presence of possibly occuring non-integrated graft remnants can be assessed during reentry surgery. |
| In vivo spectroscopy analyses of the augmented site with a Raman spectrometer device | 5 months postoperatively | Raman investigation (measuring wavelength in the range 300-1800 cm-1) highlights the peaks (Raman shift) for the main bone components (chemical groups and elements) in order to evaluate differences between bone tissue for the investigated patients. Differences in peaks intensity on raw spectra reflected the differences in the quantities of the chemical components for investigated specimens. |
Countries
Hungary
Outcome results
None listed