Results : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [1]
Twenty-eight CCXBB blocks were placed in 15 patients that fulfilled the selection criteria (12 women and 3 men) with a mean age of 54.5 (SD 8.34).
The detailed clinical and radiographical outcomes have been reported previously [21]. In brief, one patient experienced pain and soft tissue dehiscence leading to removal of the graft material 3 days after the regenerative procedure. Another patient refused to proceed to implant placement after suffering an early dehiscence also leading to a complete removal of the graft. From the remaining 13 patients completing the study, the alveolar ridge width augmented from a mean 2.78 mm (SD 0.55) at baseline to 6.90 mm (SD 1.22) at re-entry, resulting in a statistical significant mean alveolar crest width gain of 4.12 mm (SD 1.32) Sixteen weeks after implant placement a second stage procedure and a soft tissue augmentation was performed (Fig. 7).
Although soft tissue dehiscence, with different degrees of graft exposure, occurred at different time points in 5 out of 15 patients (33.3%) (Fig. 8), 24 implants were placed in 13 patients. Table 1 depicts the data on survival rates at the time of loading. Three implants were lost in three patients at the time of abutment connection, and one patient presenting very narrow ridge at baseline (<2 mm) lost all the implants. Nevertheless, all implants could be replaced without additional grafting procedure.
Histological biopsies from 13 patients were harvested and processed for histological analysis. The histomorphology of the healed CCXBB bone grafts evidenced in most of the samples newly formed mineralized vital woven bone, as well as residual graft material, bone marrow, and non-mineralized connective tissue (Fig. 5). Residual CCXBB appeared to be integrated with the new bone, which had grown within the graft trabeculae. CCXBB and DBBM were identified only by the presence of empty lacunae and cement lines separating the graft from the parent bone (Fig. 5c). In four of the specimens analyzed, minimal or no signs of new bone formation were appreciated, showing an inflammatory infiltrate with neutrophils and macrophages associated with tissue destruction (Fig. 4b).
Serial posts:
- Abstract : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
- Background : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
- Methods : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [1]
- Methods : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [2]
- Methods : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [3]
- Methods : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [4]
- Results : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [1]
- Results : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [2]
- Discussion : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [1]
- Discussion : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [2]
- Discussion : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [3]
- Conclusions : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
- Abbreviations : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
- References : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [1]
- References : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [2]
- References : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [3]
- References : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [4]
- References : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [5]
- Acknowledgements : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [1]
- Acknowledgements : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement [2]
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- About this article : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
- Table 1 Clinical and histomorphometry assessments (i.e., dehiscences, mineralized bone, CCXBB, bone marrow, connective tissue, and implant lost) : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
- Table 2 Quantitative histological analysis : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
- Table 3 Immunohistochemical markers proportions (i.e., TRAP, OPN, ALP, and OSC) : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
- Table 4 Implant loss and tissue characteristics : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
- Fig. 1. Study chart and follow-up visits : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant
- Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b Perforations and adaptation of the cortical layer. c Shaping, pre-wetting and fixation of CCXBB with titanium screws. d Horizontal contour and peripheral gap between CCXBB and bone layer. e Outlying DBBM filling. f CM stabilized with pins : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant
- Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Horizontal bone augmentation. c Screws and pins removal and bone trephine sampling. d Implants placement and buccal bone width from the implant shoulder. e Primary flap closure. f Implants submerged healing : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant
- Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingrowth : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant
- Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view aarrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant
- Fig. 6. Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant
- Fig. 7. Second stage surgery of patient in Fig. 1. a Vestibular depth reduction after augmentation and implant placement. b Partial thickness and apical repositioned flap. c CMX healing and soft tissue dehiscence with CCXBB exposure. d Dehiscence healing after re-contouring and buccal emergency profile. e Buccal aspect of the final restoration. f Buccal ridge contour : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant
- Fig. 8. Soft tissue dehiscence (a) CCXBB exposure 15 weeks after bone augmentation, the dehiscence healed 2 weeks later after reducing the graft exposure (b) after soft tissue augmentation and abutment connection leading to the loss of the mesial implant. After partial removal of the bone graft and place a connective tissue graft the area healed properly and a month later it was possible to replace the implant : Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant