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Fig. 20. Colour-coded superimposition of intraoral...

Fig. 20. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration Fig. 20. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration

Fig. 19. Colour-coded superimposition of intraoral...

Fig. 19. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration Fig. 19. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration

Fig. 18. Finalized prosthetic restoration after 1Â...

Fig. 18. Finalized prosthetic restoration after 1 year Fig. 18. Finalized prosthetic restoration after 1 year

Fig. 17. Histology of dentin augmentation. aAsteri...

Fig. 17. Histology of dentin augmentation. aactive process in the bone marrow lacunae with osteoblast rimming. No signs of necrosis or infection (H&E stain, Ă—100 magnification). b Larger magnification at Ă—200. c EvG (Elastica van Gieson) stain, Ă—200 Fig. 17. Histology of dentin augmentation. a Asterisk denotes incorporated dentin particle, surrounded by vital woven bone. Triangle shows rea...

Fig. 16. Single tooth X-ray, 1 year post-implanta...

Fig. 16. Single tooth X-ray, 1 year post-implantation, showing the finalized crown Fig. 16. Single tooth X-ray, 1 year post-implantation, showing the finalized crown

Fig. 15. Single tooth X-ray, showing a constant bo...

Fig. 15. Single tooth X-ray, showing a constant bone level 7 months after implant placement Fig. 15. Single tooth X-ray, showing a constant bone level 7 months after implant placement

Fig. 14. Single tooth X-ray immediately after the ...

Fig. 14. Single tooth X-ray immediately after the augmentation using autogenous dentin Fig. 14. Single tooth X-ray immediately after the augmentation using autogenous dentin

Fig. 13. a, b Clinical situation prior to implant ...

Fig. 13. Fig. 13. a, b Clinical situation prior to implant placement

Fig. 12. Axial view : Alveolar ridge preservation ...

Fig. 12. Axial view Fig. 12. Axial view

Fig. 11. Sagittal view : Alveolar ridge preservati...

Fig. 11. Sagittal view Fig. 11. Sagittal view

Fig. 10. Soft tissue graft placed on the recipient...

Fig. 10. Soft tissue graft placed on the recipient site Fig. 10. Soft tissue graft placed on the recipient site

Fig. 9. Soft tissue punch : Alveolar ridge preserv...

Fig. 9. Soft tissue punch Fig. 9. Soft tissue punch

Fig. 8. Autologous, particulated dentin in the alv...

Fig. 8. Autologous, particulated dentin in the alveolar socket Fig. 8. Autologous, particulated dentin in the alveolar socket

Fig. 7. Autologous, particulated dentin mixed with...

Fig. 7. Autologous, particulated dentin mixed with blood from the operating site Fig. 7. Autologous, particulated dentin mixed with blood from the operating site

Fig. 6. Autologous dentin with the desired particl...

Fig. 6. Autologous dentin with the desired particle size Fig. 6. Autologous dentin with the desired particle size

Fig. 5. Autologous dentin in a bone mill : Alveola...

Fig. 5. Autologous dentin in a bone mill Fig. 5. Autologous dentin in a bone mill

Fig. 4. Removal of enamel and the cementum : Alveo...

Fig. 4. Removal of enamel and the cementum Fig. 4. Removal of enamel and the cementum

Fig. 3. Removal of the pulp : Alveolar ridge prese...

Fig. 3. Removal of the pulp Fig. 3. Removal of the pulp

Fig. 2. The remaining root of tooth 11 : Alveolar ...

Fig. 2. The remaining root of tooth 11 Fig. 2. The remaining root of tooth 11

Fig. 1. Extraction with the benex system : Alveola...

Fig. 1. Extraction with the benex system Fig. 1. Extraction with the benex system

About this article : Alveolar ridge preservation w...

Valdec, S., Pasic, P., Soltermann, A. et al. Alveolar ridge preservation with autologous particulated dentin—a case series. Int J Implant Dent 3, 12 (2017). https://doi.org/10.1186/s40729-017-0071-9 Download citation Received: 07 December 2016 Accepted: 15 March 2017 Published: 30 March 2017 DOI: https://doi.org/10.1186/s40729-017-0071-9

Rights and permissions : Alveolar ridge preservati...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...

Author information : Alveolar ridge preservation w...

Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland Silvio Valdec, Pavla Pasic, Bernd Stadlinger & Martin Rücker Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland Alex Soltermann Clinic of Fixed and Removable Prosthodontics and Dental Mater...

Acknowledgements : Alveolar ridge preservation wit...

We would like to express our thanks to Dr. Gabriel Bosch for the superimposition, calculation and illustration of the intraoral scans. SV, BS and MR created the conception and study design. MR performed the surgical and DT the prosthodontic treatment. SV, PP and DT performed the data collection and AS the histological examination. SV, BS and AS analysed and interpreted the data. SV drafted the ma...

References : Alveolar ridge preservation with auto...

Sculean A, Berakdar M, Chiantella GC, Donos N, Arweiler NB, Brecx M. Healing of intrabony defects following treatment with a bovine-derived xenograft and collagen membrane. A controlled clinical study. J Clin Periodontol. 2003;30(1):73–80. Sutton DN, Lewis BR, Patel M, Cawood JI. Changes in facial form relative to progressive atrophy of the edentulous jaws. Int J Oral Maxillofac Surg. 2004;33(7...

References : Alveolar ridge preservation with auto...

Liu X, Li Q, Wang F, Wang Z. Maxillary sinus floor augmentation and dental implant placement using dentin matrix protein-1 gene-modified bone marrow stromal cells mixed with deproteinized boving bone: a comparative study in beagles. Arch Oral Biol. 2016;64:102–8. doi:10.1016/j.archoralbio.2016.01.004. Pang KM, Um IW, Kim YK, Woo JM, Kim SM, Lee JH. Autogenous demineralized dentin matrix from ex...

References : Alveolar ridge preservation with auto...

Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44. doi:10.1111/j.1600-0501.2005.01193.x. Guirado JL, Troiano M, Lopez-Lopez PJ, Ramirez-Fernandez MP, de Val JE, Marin JM, Gehrke SA. Different configuration of socket shield technique in peri-implant bone...

References : Alveolar ridge preservation with auto...

Al-Asfour A, Andersson L, Kamal M, Joseph B. New bone formation around xenogenic dentin grafts to rabbit tibia marrow. Dent Traumatol. 2013;29(6):455–60. doi:10.1111/edt.12045. Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1(1):11–25. Andersson L. Den...

Conclusion : Alveolar ridge preservation with auto...

Within the limits of this case series, it has been shown that particulated dentin of autologous teeth may serve as an alternative to autologous bone for alveolar ridge preservation prior to implant therapy. However, randomized studies on this treatment option are necessary.

Discussion : Alveolar ridge preservation with auto...

In humans, particulated tooth material has been used for sinus augmentation in order to enhance implant therapy. Preliminary results from five patients histologically showed an osteoconductive osteogenesis with partial resorption of tooth components [25]. In the present case series, all patients underwent socket preservation with AutoPD. In all cases, one or two upper frontal central incisors wer...

Discussion : Alveolar ridge preservation with auto...

The aim of this case series is to demonstrate the efficacy and safety of this novel augmentative procedure for ridge preservation prior to implant therapy. This shall serve as a basis for a prospective study. In all four cases, patients showed a stable volume of soft and hard tissues after the augmentation with AutoPD and good osseointegration of titanium implants, having been placed in this augm...

Results : Alveolar ridge preservation with autolog...

Four months post-extraction and augmentation with autologous, particulated dentin, all four patients received an implant placement in the augmented area. In all cases, a CBCT was taken in between the dentin augmentation and the implant placement. During implant placement, a biopsy of the bone from the augmented area was taken for histological examination (Fig. 17). The final prosthetic solution...

Case presentation : Alveolar ridge preservation wi...

The 1-year follow-up examination of the presented case showed an implant success, according to the appropriate clinical criteria [2] (Figs. 14, 15 and 16). The pink esthetic score (PES) was used for the evaluation of reproducible soft tissue around the final implant crown as a parameter for the aesthetic outcome [12]. Seven variables were evaluated comparing the soft tissue around the implant wi...

Material and methods : Alveolar ridge preservation...

An autologous soft tissue graft was harvested from the patient’s palate using a soft tissue punch (Biopsy Punch, kai Europe GmbH, Solingen, Germany) (Fig. 9). The graft had a comparable dimension as the recipient site. The gingival graft was placed on top of the augmentation material, adapted and carefully sutured to the marginal gingiva after the sulcus epithelium was removed with a rotating d...

Material and methods : Alveolar ridge preservation...

Four patients between 36 and 65 years of age are presented in this case series. There was no financial compensation. All four patients suffered from a trauma, causing damage to one or two teeth of the anterior maxilla. The frontal tooth/teeth has/had to be extracted. The pulp of the extracted teeth of three patients and the root canal filling of one patient had to be removed. All patients were in...

Background : Alveolar ridge preservation with auto...

Subsequent to tooth extraction, a resorption of the host bone as defined by atrophy of the alveolar ridge can be observed. Sutton et al. classified the different degrees of alveolar ridge atrophy [32]. Bone resorption especially occurs in the frontal and premolar area of the jaw in the region of the thin buccal lamella. This may lead to a change in contour [11, 28]. Physiological reason for this a...

Abstract : Alveolar ridge preservation with autolo...

Ridge preservation can be performed with autologous bone, alloplastic bone substitute material or a combination of both. Dentin is similar to bone in its chemical composition. In its use as bone substitute material, it undergoes a remodelling process and transforms to bone. The presented case report introduces a technique in which the extraction socket is augmented with autologous, particulated de...

Fig. 6. Histomorphometric evaluation results (cons...

Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others

Fig. 5. Histomicrograph of a biopsy from the BC ...

Fig. 5. Histomicrograph of a biopsy from the BC + EMD group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (d) and linearly polarized light (e and f). e, f Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized l...

Fig. 4. Histomicrograph of a biopsy from the BC gr...

Fig. 4. Histomicrograph of a biopsy from the BC group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (a) and linearly polarized light (b and c). b, c Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized light. In a...

Fig. 3. Histomicrograph of a biopsy from the BC ...

Fig. 3. Histomicrograph of a biopsy from the BC + EMD group. Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC + EMD removed during histological processing (square) surrounded by newly formed bone (asterisk), with large numbers of osteocytes and soft tissue (arrow) can be observed. There is direct contact between the BC reminiscent, soft...

Fig. 2. Histomicrograph of a biopsy from the BC gr...

Fig. 2. Histomicrograph of a biopsy from the BC group. a Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC removed during histological processing (square) in direct contact with newly formed bone (asterisk), containing a large number of osteocytes, and with soft tissue (arrow) can be observed (hematoxylin-eosin stain) Fig. 2. Histomicrograph ...

Fig. 1. Histomicrograph illustrating the various t...

Fig. 1. Histomicrograph illustrating the various tissue areas measured on the sections: newly formed bone (green mask), soft tissues (purple mask), and “others”, including residual bone substitute particles and empty spaces either due to removal of the bone substitute particles during to the decalcification processing or due to artifacts (white mask) Fig. 1. Histomicrograph illustrating t...

About this article : β-TCP/HA with or without ena...

Nery, J.C., Pereira, L.A.V.D., Guimarães, G.F. et al. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies. Int J Implant Dent 3, 18 (2017). https://doi.org/10.1186/s40729-017-0080-8 Download citation Received: 08 December 2016 Accepted: 22 April 2017 Published: 04 May 2017 DOI: https://do...

Rights and permissions : β-TCP/HA with or without...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Author information : β-TCP/HA with or without ena...

You can also search for this author in PubMed Google Scholar Correspondence to James Carlos Nery.

Author information : β-TCP/HA with or without ena...

Department of Implantology, São Leopoldo Mandic Research Center, Brasília, DF, Brazil James Carlos Nery, George Furtado Guimarães & Fabiana Mantovani Gomes França Department of Biochemistry and Tissue Biology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil Luís Antônio Violin Dias Pereira Department of Periodontology, UNESP – Univ. Estad...

References : β-TCP/HA with or without enamel matr...

Wikesjo UM, Sorensen RG, Kinoshita A, Wozney JM. RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration. Clin Implant Dent Relat Res. 2002;4:174–82. Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, et al. A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant...

References : β-TCP/HA with or without enamel matr...

Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, et al. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol. 2016;43:668–83. Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182â...

References : β-TCP/HA with or without enamel matr...

Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;17:CD008397. Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, et al. On the early mechanisms of bone formation after maxillary sinus membrane elevation: an experimental histological and immunohistochemical study. ...

Conclusions : β-TCP/HA with or without enamel mat...

The present study showed that maxillary sinus floor augmentation with BC resulted in adequate amounts of new bone formation allowing successful implant installation, while adding EMD did not have a significant effect.

Discussion : β-TCP/HA with or without enamel matr...

Nevertheless, the amount of bone generated with BC or BC + EMD herein was adequate to support successful implant placement and osseointegration of implants. In fact, more or less similar amounts of bone formation have been reported in studies evaluating human sinus biopsies after grafting with a variety of biomaterials (bone formation ranging approximately from 30 to 50%) [19]. On the other ha...

Discussion : β-TCP/HA with or without enamel matr...

The present study compared the histological and histomorphometrical outcome of healing after maxillary sinus floor augmentation with BC with or without EMD, based on human biopsies. The results showed that addition of EMD did not enhance the outcome of healing, neither in terms of quality nor quantity of new bone. Nevertheless, the amount of bone generated after maxillary sinus floor augmentation ...

Results : β-TCP/HA with or without enamel matrix ...

All ten patients showed uneventful healing after the sinus floor augmentation procedure as well as after dental implant placement, with no overt postoperative inflammation or infection. Consistently, in all ten patients, no significant jiggling of the drill was noticed during biopsy harvesting, while subjective drilling resistance during implant placement was similar in both groups and all implant...

Methods : β-TCP/HA with or without enamel matrix ...

The data for each tissue component from the three histological sections were averaged to represent the biopsy. Commercially available software (GraphPad Prism 5.0 for Windows, GraphPad Software Inc., USA) was utilized for statistical comparisons between groups and for drawing the graphics. The assumption of normality was checked using D’Agostino & Pearson omnibus test. The data for each evaluate...

Methods : β-TCP/HA with or without enamel matrix ...

Six months after grafting, another CBCT examination was carried out for implant planning. In the sequence, following the previously described antiseptic and anesthetic procedures, two implants with a sand-blasted and acid etching surface were installed in each of the grafted sinuses, i.e., 40 implants in total (32—Neoporous, Neodent, Curitiba, Paraná, Brazil; 8—SLA, Straumann, Basel, Switzerl...

Methods : β-TCP/HA with or without enamel matrix ...

This research project was approved by the Ethics Committee of the School of Dentistry and Dental Research Center São Leopoldo Mandic, Brazil, under the protocol 2010/0360. Ten consecutive patients (age range 35–75 years) with the need of bilateral maxillary sinus floor augmentation prior to the placement of four dental implants (two in each side of posterior maxilla) were selected for the stu...

Background : β-TCP/HA with or without enamel matr...

The aim of the present study was to compare histomorphometrically the outcome of maxillary sinus floor augmentation with β-TCP/HA with or without enamel matrix proteins (BC + EMD and EMD, respectively) in humans.

Background : β-TCP/HA with or without enamel matr...

Reconstruction of the edentulous and severely atrophied posterior maxilla is often performed by means of maxillary sinus floor augmentation in combination with dental implants [1, 2]. Various bone graft materials are typically used for enhancing bone formation within the sinus cavity; autogenous bone (AB) is considered as the gold standard due to its osteogenic, osteoinductive, and osteoconductive...

Abstract : β-TCP/HA with or without enamel matrix...

It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans. In ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the ot...

Fig. 6. Histomorphometric evaluation results (cons...

Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others

Fig. 5. Histomicrograph of a biopsy from the BC ...

Fig. 5. Histomicrograph of a biopsy from the BC + EMD group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (d) and linearly polarized light (e and f). e, f Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized l...

Fig. 4. Histomicrograph of a biopsy from the BC gr...

Fig. 4. Histomicrograph of a biopsy from the BC group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (a) and linearly polarized light (b and c). b, c Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized light. In a...

Fig. 3. Histomicrograph of a biopsy from the BC ...

Fig. 3. Histomicrograph of a biopsy from the BC + EMD group. Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC + EMD removed during histological processing (square) surrounded by newly formed bone (asterisk), with large numbers of osteocytes and soft tissue (arrow) can be observed. There is direct contact between the BC reminiscent, soft...

Fig. 2. Histomicrograph of a biopsy from the BC gr...

Fig. 2. Histomicrograph of a biopsy from the BC group. a Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC removed during histological processing (square) in direct contact with newly formed bone (asterisk), containing a large number of osteocytes, and with soft tissue (arrow) can be observed (hematoxylin-eosin stain) Fig. 2. Histomicrograph ...

Fig. 1. Histomicrograph illustrating the various t...

Fig. 1. Histomicrograph illustrating the various tissue areas measured on the sections: newly formed bone (green mask), soft tissues (purple mask), and “others”, including residual bone substitute particles and empty spaces either due to removal of the bone substitute particles during to the decalcification processing or due to artifacts (white mask) Fig. 1. Histomicrograph illustrating t...

About this article : β-TCP/HA with or without ena...

Nery, J.C., Pereira, L.A.V.D., Guimarães, G.F. et al. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies. Int J Implant Dent 3, 18 (2017). https://doi.org/10.1186/s40729-017-0080-8 Download citation Received: 08 December 2016 Accepted: 22 April 2017 Published: 04 May 2017 DOI: https://do...

Rights and permissions : β-TCP/HA with or without...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Author information : β-TCP/HA with or without ena...

You can also search for this author in PubMed Google Scholar Correspondence to James Carlos Nery.

Author information : β-TCP/HA with or without ena...

Department of Implantology, São Leopoldo Mandic Research Center, Brasília, DF, Brazil James Carlos Nery, George Furtado Guimarães & Fabiana Mantovani Gomes França Department of Biochemistry and Tissue Biology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil Luís Antônio Violin Dias Pereira Department of Periodontology, UNESP – Univ. Estad...

References : β-TCP/HA with or without enamel matr...

Wikesjo UM, Sorensen RG, Kinoshita A, Wozney JM. RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration. Clin Implant Dent Relat Res. 2002;4:174–82. Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, et al. A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant...

References : β-TCP/HA with or without enamel matr...

Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, et al. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol. 2016;43:668–83. Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182â...

References : β-TCP/HA with or without enamel matr...

Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;17:CD008397. Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, et al. On the early mechanisms of bone formation after maxillary sinus membrane elevation: an experimental histological and immunohistochemical study. ...

Conclusions : β-TCP/HA with or without enamel mat...

The present study showed that maxillary sinus floor augmentation with BC resulted in adequate amounts of new bone formation allowing successful implant installation, while adding EMD did not have a significant effect.

Discussion : β-TCP/HA with or without enamel matr...

Nevertheless, the amount of bone generated with BC or BC + EMD herein was adequate to support successful implant placement and osseointegration of implants. In fact, more or less similar amounts of bone formation have been reported in studies evaluating human sinus biopsies after grafting with a variety of biomaterials (bone formation ranging approximately from 30 to 50%) [19]. On the other ha...

Discussion : β-TCP/HA with or without enamel matr...

The present study compared the histological and histomorphometrical outcome of healing after maxillary sinus floor augmentation with BC with or without EMD, based on human biopsies. The results showed that addition of EMD did not enhance the outcome of healing, neither in terms of quality nor quantity of new bone. Nevertheless, the amount of bone generated after maxillary sinus floor augmentation ...

Results : β-TCP/HA with or without enamel matrix ...

All ten patients showed uneventful healing after the sinus floor augmentation procedure as well as after dental implant placement, with no overt postoperative inflammation or infection. Consistently, in all ten patients, no significant jiggling of the drill was noticed during biopsy harvesting, while subjective drilling resistance during implant placement was similar in both groups and all implant...

Methods : β-TCP/HA with or without enamel matrix ...

The data for each tissue component from the three histological sections were averaged to represent the biopsy. Commercially available software (GraphPad Prism 5.0 for Windows, GraphPad Software Inc., USA) was utilized for statistical comparisons between groups and for drawing the graphics. The assumption of normality was checked using D’Agostino & Pearson omnibus test. The data for each evaluate...

Methods : β-TCP/HA with or without enamel matrix ...

Six months after grafting, another CBCT examination was carried out for implant planning. In the sequence, following the previously described antiseptic and anesthetic procedures, two implants with a sand-blasted and acid etching surface were installed in each of the grafted sinuses, i.e., 40 implants in total (32—Neoporous, Neodent, Curitiba, Paraná, Brazil; 8—SLA, Straumann, Basel, Switzerl...

Methods : β-TCP/HA with or without enamel matrix ...

This research project was approved by the Ethics Committee of the School of Dentistry and Dental Research Center São Leopoldo Mandic, Brazil, under the protocol 2010/0360. Ten consecutive patients (age range 35–75 years) with the need of bilateral maxillary sinus floor augmentation prior to the placement of four dental implants (two in each side of posterior maxilla) were selected for the stu...

Background : β-TCP/HA with or without enamel matr...

The aim of the present study was to compare histomorphometrically the outcome of maxillary sinus floor augmentation with β-TCP/HA with or without enamel matrix proteins (BC + EMD and EMD, respectively) in humans.

Background : β-TCP/HA with or without enamel matr...

Reconstruction of the edentulous and severely atrophied posterior maxilla is often performed by means of maxillary sinus floor augmentation in combination with dental implants [1, 2]. Various bone graft materials are typically used for enhancing bone formation within the sinus cavity; autogenous bone (AB) is considered as the gold standard due to its osteogenic, osteoinductive, and osteoconductive...

Abstract : β-TCP/HA with or without enamel matrix...

It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans. In ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the ot...

Fig. 7 Second stage surgery of patient in Fig. 1. ...

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

Fig. 6 Immunohistochemical analysis of slices from...

Fig. 6 Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC

Fig. 5. Histomorphometric analysis of the same sam...

ple. a Ground section stained with Levai-LaczkĂł. b Tissue identification of the ROI. c Closer view a bone and CCXBB. d Closer view of b Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-LaczkĂł. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b

Fig. 4. Histological samples. a CCXBB control with...

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 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 ingr...

Fig. 3. Re-entry procedure of patient in Fig. 1. ...

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 Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...

Fig. 2. Lateral bone augmentation of the alveolar ...

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 Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...

Fig. 1. Study chart and follow-up visits : Histomo...

Fig. 1. Study chart and follow-up visits Fig. 1. Study chart and follow-up visits

Table 4 Implant loss and tissue characteristics : ...

Differentiated tissues Implant lost (Yes/no) Mean SD Percentage SD (%) ...

Table 3 Immunohistochemical markers proportions (i...

Patient TRAP (%) OPN (%) ALP (%) OSC (%) 1 ...

Table 2 Quantitative histological analysis : Histo...

Tissue type Mean Standard deviation Median CI 95% Mineralized bone ...

Table 1 Clinical and histomorphometry assessments ...

Patient Soft tissue dehiscence Mineralized bone (%) CCXBB (%) Bone marrow (%) Connect...

About this article : Histomorphometric and immunoh...

Ortiz-VigĂłn, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement. Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1 Download citation Received: 21 March 2017 Accepted: 12 June 2017 Published: 21 Ju...

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Author information : Histomorphometric and immunoh...

ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar ...

Acknowledgements : Histomorphometric and immunohis...

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Acknowledgements : Histomorphometric and immunohis...

We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged. This study was partial...

References : Histomorphometric and immunohistochem...

Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480. Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...

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Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8. Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...

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Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4. Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46. Nissan ...

References : Histomorphometric and immunohistochem...

Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8. Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...

References : Histomorphometric and immunohistochem...

Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7. Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40. Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...

Abbreviations : Histomorphometric and immunohistoc...

Alkaline phosphatase Cone beam computed tomography Collagen containing xenogeneic bone block Native collagen membrane Deproteinized bovine bone mineral Etiology and Therapy of Periodontal Diseases Osteopontin Osteocalcine Tartrate-resistant acid phosphatase

Conclusions : Histomorphometric and immunohistoche...

Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...

Discussion : Histomorphometric and immunohistochem...

The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...

Discussion : Histomorphometric and immunohistochem...

When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...

Discussion : Histomorphometric and immunohistochem...

The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...

Results : Histomorphometric and immunohistochemica...

The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...

Results : Histomorphometric and immunohistochemica...

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 r...

Methods : Histomorphometric and immunohistochemica...

For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100. The obtained semi-thin sections were evaluated wit...

Methods : Histomorphometric and immunohistochemica...

Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...

Methods : Histomorphometric and immunohistochemica...

CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECsâ€...

Methods : Histomorphometric and immunohistochemica...

The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...

Background : Histomorphometric and immunohistochem...

Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...

Abstract : Histomorphometric and immunohistochemic...

The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures. In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...

Fig. 6. Patient # 1 (12-month healing time): incre...

Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification Ă—100) Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification Ă—100)

Fig. 5. Patient # 4 (9-month healing time): increa...

Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification Ă—100) Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification Ă—100)

Fig. 4. Patient # 1 (12-month healing time): overv...

Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification Ă—10) Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification Ă—10)

Fig. 3. Alveolar tissue height (in true mm) over a...

Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group

Fig. 2. Aveolar tissue height (in true mm) over a ...

Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group

Fig. 1. Images of patient # 5 (9-month healing tim...

Fig. 1. Images of patient # 5 (9-month healing time). a. Radiograph of the left maxillary sinus: situation 9 months after the maxillary sinus floor elevation procedure. b. With a trephine drill, the implant osteotomy is made and the biopsy is obtained. c. Clinical situation after placing two Straumann® SLA implants in the left posterior maxilla. d. Radiograph of two Straumann® SLA implants in...

Table 4 Histomorphometric evaluation of the biopsi...

Patient (N) Gender/age Retrieval location BV/TV (%) BS/TV (mm2/mm3) Tb.Th (ÎĽm) ...

Table 3 Histomorphometric evaluation of the biopsi...

Patient (N) Gender/age) Retrieval location BV/TV (%) BS/TV (mm2/mm3) Tb.Th (ÎĽm) ...

Table 1 Alveolar tissue height measurements on pan...

Patient Gender/age Implant site T0 T1 Increase ...

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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Ethics declarations : The use of a biphasic calciu...

Authors W.F. Bouwman, N. Bravenboer, J.W.F.H. Frenken, C.M. ten Bruggenkate and E.A.J.M. Schulten state that there are no conflicts of interest, either directly or indirectly. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : The use of a biphasic calcium...

Correspondence to E. A. J. M. Schulten.

Author information : The use of a biphasic calcium...

Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands W. F. Bouwman, C. M. ten Bruggenkate & E. A. J. M. Schulten Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands N. Bravenboer Department of Oral and Maxillofacial Su...

References : The use of a biphasic calcium phospha...

Groeneveld EH, van den Bergh JP, Holzmann P, ten Bruggenkate CM, Tuinzing DB, Burger EH. Mineralization processes in demineralized bone matrix grafts in human maxillary sinus floor elevations. J Biomed Mater Res. 1999;48:393–402. Schulten EAJM, Prins HJ, Overman JR, Helder MN, ten Bruggenkate CM, Klein-Nulend JA. Novel approach revealing the effect of collagenous membrane on osteoconduction in ...

References : The use of a biphasic calcium phospha...

Schopper C, Ziya-Ghazvini F, Goriwoda W, Moser D, Wanschitz F, Spassova E, Lagogiannis G, Auterith A, Ewers R. HA/TCP compounding of a porous CaP biomaterial improves bone formation and scaffold degradation—a long-term histological study. J Biomed Mater Res B Appl Biomater. 2005;74:458–67. Frenken JW, Bouwman WF, Bravenboer N, Zijderveld SA, Schulten EA, ten Bruggenkate CM. The use of Strauma...

References : The use of a biphasic calcium phospha...

Beirne JC, Barry HJ, Brady FA, Morris VB. Donor site morbidity of the anterior iliac crest following cancellous bone harvest. Int J Oral Maxillofac Surg. 1996;25:268–71. Vermeeren JIJF, Wismeijer D, van Waas MAJ. One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants: a 5-year follow-up. Int J Oral Maxillofac Surg. 1996;2:112–5. Nkenke E, Stel...

References : The use of a biphasic calcium phospha...

Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613–6. Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30:207–29. Del Fabbro M, Rosano G, Taschieri S. Implant survival rates after maxillary sinus augmentation. Eur J Oral Sci. 2008;116:497–506. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systemat...

Conclusions : The use of a biphasic calcium phosph...

Based on clinical, radiological, histological, and histomorphometric analysis, this study confirms the suitability of BCP for vertical augmentation of the posterior maxilla by means of an MSFE procedure, allowing dental implant placement after 9 and 12 months healing times. Yet, complete degradation of the BCP particles does not occur within a 12-month healing time. From a histological and histom...

Discussion : The use of a biphasic calcium phospha...

In the cranial part of the biopsy, some osteoid islands with osteogenic activity were detected, possibly caused by osteoinductive properties from the lifted bony trap-door. In the present study, histomorphometric analyses revealed that the vital bone volume was higher in the 9-month healing time group than in the 12-month healing time group, while one would expect to find more newly formed bone in...

Discussion : The use of a biphasic calcium phospha...

This study presents the clinical, radiological, histological and histomorphometric results on the use of a biphasic calcium phosphate (Straumann® bone ceramic) in a MSFE procedure with healing times of 9 and 12 months. During the clinical evaluation, it appeared that both 9-month and 12-month healing times resulted in integration of the grafted BCP with the original maxillary bone (sinus floor),...

Results : The use of a biphasic calcium phosphate ...

Histological observations did not show inflammatory cells in the tissue adjacent to the bone substitute particles. Bone marrow-like tissue, which included blood vessels, was observed in between the bone trabeculae (Fig. 4). Reinforcement by lamellar bone was shown in some areas after 9 and 12 months (Figs. 5 and 6). No Howship’s lacunae could be detected on the characteristic outlines of the su...

Results : The use of a biphasic calcium phosphate ...

None of the 10 patients showed postoperative inflammation or infection after the MSFE procedure nor during surgical re-entry for dental implant placement. When opening the area for dental implant insertion, the grafted area proved to be well vascularized and the tissue at the site of the former trap-door location was slightly flexible and had a fibrous aspect. Between the periosteum and the bone g...

Methods : The use of a biphasic calcium phosphate ...

Parameters evaluating vital bone mass/bone structure: 1: Vital bone volume (BV): percentage of the grafted section that is vital bone tissue (%) 2: Bone surface (BS): BS expressed as a fraction of the total vital bone volume (mm2/mm3) 3: Thickness of bone trabeculae (Tb.Th) (ÎĽm) Parameters evaluating bone turnover: 1: Osteoid volume (OV): fraction of the vital bone tissue section that is ost...

Methods : The use of a biphasic calcium phosphate ...

All 22 inserted dental implants were clinically tested for good primary stability. Osseointegration at abutment connection was tested with a 35-Ncm torque. One experienced oral and maxillofacial surgeon (CB) carried out all follow-up examinations. Panoramic radiographs were made at patient’s intake (T0); immediately after the MSFE procedure (T1); immediately after dental implant placement (T2);...

Methods : The use of a biphasic calcium phosphate ...

A midcrestal incision was made with vertical release incisions at the canine and tuberosity region. A full-thickness mucoperiosteal flap was elevated. The lateral maxillary sinus wall was prepared using a diamond burr with copious irrigation with sterile isotonic saline, regarding the contour of the maxillary sinus as observed on the preoperative panoramic radiograph. A bony top-hinge trap-door wa...

Methods : The use of a biphasic calcium phosphate ...

In this study, 10 consecutive healthy patients were selected for a unilateral MSFE procedure. Five patients received dental implants 9 months after MSFE and five patients underwent dental implant surgery 12 months after MSFE. In the 9-month group (three men and two women), the average age was 56.6 years (range 40 to 64 years); in the 12-month group (one man and four women), the average age was...

Background : The use of a biphasic calcium phospha...

β-TCP is a biocompatible osteoconductive calcium phosphate that may provide a scaffold for potential bony ingrowth [24]. β-TCP resorbs rather quickly but not necessarily at the same rate as new bone formation [25,26,27]. Most research focused on either using the relative unresorbable HA as a scaffold or β-TCP as a degradable component [19, 24,25,26, 28, 29]. Zerbo et al. [30] concluded that due...

Background : The use of a biphasic calcium phospha...

Maxillary sinus floor elevation (MSFE) is a surgical procedure to enhance the bone height in the posterior maxilla with graft material, allowing dental implant placement (later or at the same time) [1, 2]. This pre-implant procedure is predictable and results in a dental implant survival of more than 93.8% 3 years after dental implant placement [3]. According to Pjetursson [4] in his systematic r...

Abstract : The use of a biphasic calcium phosphate...

This study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% Ăź-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-month healing time. A unilateral MSFE procedure, using 100% BCP, was performed in two series of five patients with hea...

About this article : Alveolar ridge preservation w...

Valdec, S., Pasic, P., Soltermann, A. et al. Alveolar ridge preservation with autologous particulated dentin—a case series. Int J Implant Dent 3, 12 (2017). https://doi.org/10.1186/s40729-017-0071-9 Download citation Received: 07 December 2016 Accepted: 15 March 2017 Published: 30 March 2017 DOI: https://doi.org/10.1186/s40729-017-0071-9

Rights and permissions : Alveolar ridge preservati...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Author information : Alveolar ridge preservation w...

Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland Silvio Valdec, Pavla Pasic, Bernd Stadlinger & Martin Rücker Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland Alex Soltermann Clinic of Fixed and Removable Prosthodontics and Dental Mater...

Acknowledgements : Alveolar ridge preservation wit...

We would like to express our thanks to Dr. Gabriel Bosch for the superimposition, calculation and illustration of the intraoral scans. SV, BS and MR created the conception and study design. MR performed the surgical and DT the prosthodontic treatment. SV, PP and DT performed the data collection and AS the histological examination. SV, BS and AS analysed and interpreted the data. SV drafted the ma...

References : Alveolar ridge preservation with auto...

Sculean A, Berakdar M, Chiantella GC, Donos N, Arweiler NB, Brecx M. Healing of intrabony defects following treatment with a bovine-derived xenograft and collagen membrane. A controlled clinical study. J Clin Periodontol. 2003;30(1):73–80. Sutton DN, Lewis BR, Patel M, Cawood JI. Changes in facial form relative to progressive atrophy of the edentulous jaws. Int J Oral Maxillofac Surg. 2004;33(7...

References : Alveolar ridge preservation with auto...

Liu X, Li Q, Wang F, Wang Z. Maxillary sinus floor augmentation and dental implant placement using dentin matrix protein-1 gene-modified bone marrow stromal cells mixed with deproteinized boving bone: a comparative study in beagles. Arch Oral Biol. 2016;64:102–8. doi:10.1016/j.archoralbio.2016.01.004. Pang KM, Um IW, Kim YK, Woo JM, Kim SM, Lee JH. Autogenous demineralized dentin matrix from ex...

References : Alveolar ridge preservation with auto...

Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44. doi:10.1111/j.1600-0501.2005.01193.x. Guirado JL, Troiano M, Lopez-Lopez PJ, Ramirez-Fernandez MP, de Val JE, Marin JM, Gehrke SA. Different configuration of socket shield technique in peri-implant bone...

References : Alveolar ridge preservation with auto...

Al-Asfour A, Andersson L, Kamal M, Joseph B. New bone formation around xenogenic dentin grafts to rabbit tibia marrow. Dent Traumatol. 2013;29(6):455–60. doi:10.1111/edt.12045. Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1(1):11–25. Andersson L. Den...

Conclusion : Alveolar ridge preservation with auto...

Within the limits of this case series, it has been shown that particulated dentin of autologous teeth may serve as an alternative to autologous bone for alveolar ridge preservation prior to implant therapy. However, randomized studies on this treatment option are necessary.

Discussion : Alveolar ridge preservation with auto...

In humans, particulated tooth material has been used for sinus augmentation in order to enhance implant therapy. Preliminary results from five patients histologically showed an osteoconductive osteogenesis with partial resorption of tooth components [25]. In the present case series, all patients underwent socket preservation with AutoPD. In all cases, one or two upper frontal central incisors wer...

Discussion : Alveolar ridge preservation with auto...

The aim of this case series is to demonstrate the efficacy and safety of this novel augmentative procedure for ridge preservation prior to implant therapy. This shall serve as a basis for a prospective study. In all four cases, patients showed a stable volume of soft and hard tissues after the augmentation with AutoPD and good osseointegration of titanium implants, having been placed in this augm...

Results : Alveolar ridge preservation with autolog...

Four months post-extraction and augmentation with autologous, particulated dentin, all four patients received an implant placement in the augmented area. In all cases, a CBCT was taken in between the dentin augmentation and the implant placement. During implant placement, a biopsy of the bone from the augmented area was taken for histological examination (Fig. 17). The final prosthetic solution...

Case presentation : Alveolar ridge preservation wi...

The 1-year follow-up examination of the presented case showed an implant success, according to the appropriate clinical criteria [2] (Figs. 14, 15 and 16). The pink esthetic score (PES) was used for the evaluation of reproducible soft tissue around the final implant crown as a parameter for the aesthetic outcome [12]. Seven variables were evaluated comparing the soft tissue around the implant wi...

Material and methods : Alveolar ridge preservation...

An autologous soft tissue graft was harvested from the patient’s palate using a soft tissue punch (Biopsy Punch, kai Europe GmbH, Solingen, Germany) (Fig. 9). The graft had a comparable dimension as the recipient site. The gingival graft was placed on top of the augmentation material, adapted and carefully sutured to the marginal gingiva after the sulcus epithelium was removed with a rotating d...

Material and methods : Alveolar ridge preservation...

Four patients between 36 and 65 years of age are presented in this case series. There was no financial compensation. All four patients suffered from a trauma, causing damage to one or two teeth of the anterior maxilla. The frontal tooth/teeth has/had to be extracted. The pulp of the extracted teeth of three patients and the root canal filling of one patient had to be removed. All patients were in...

Background : Alveolar ridge preservation with auto...

Subsequent to tooth extraction, a resorption of the host bone as defined by atrophy of the alveolar ridge can be observed. Sutton et al. classified the different degrees of alveolar ridge atrophy [32]. Bone resorption especially occurs in the frontal and premolar area of the jaw in the region of the thin buccal lamella. This may lead to a change in contour [11, 28]. Physiological reason for this a...

Abstract : Alveolar ridge preservation with autolo...

Ridge preservation can be performed with autologous bone, alloplastic bone substitute material or a combination of both. Dentin is similar to bone in its chemical composition. In its use as bone substitute material, it undergoes a remodelling process and transforms to bone. The presented case report introduces a technique in which the extraction socket is augmented with autologous, particulated de...

About this article : β-TCP/HA with or without ena...

Nery, J.C., Pereira, L.A.V.D., Guimarães, G.F. et al. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies. Int J Implant Dent 3, 18 (2017). https://doi.org/10.1186/s40729-017-0080-8 Download citation Received: 08 December 2016 Accepted: 22 April 2017 Published: 04 May 2017 DOI: https://do...

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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Author information : β-TCP/HA with or without ena...

You can also search for this author in PubMed Google Scholar Correspondence to James Carlos Nery.

Author information : β-TCP/HA with or without ena...

Department of Implantology, São Leopoldo Mandic Research Center, Brasília, DF, Brazil James Carlos Nery, George Furtado Guimarães & Fabiana Mantovani Gomes França Department of Biochemistry and Tissue Biology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil Luís Antônio Violin Dias Pereira Department of Periodontology, UNESP – Univ. Estad...

References : β-TCP/HA with or without enamel matr...

Wikesjo UM, Sorensen RG, Kinoshita A, Wozney JM. RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration. Clin Implant Dent Relat Res. 2002;4:174–82. Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, et al. A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant...

References : β-TCP/HA with or without enamel matr...

Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, et al. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol. 2016;43:668–83. Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182â...

References : β-TCP/HA with or without enamel matr...

Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;17:CD008397. Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, et al. On the early mechanisms of bone formation after maxillary sinus membrane elevation: an experimental histological and immunohistochemical study. ...

Conclusions : β-TCP/HA with or without enamel mat...

The present study showed that maxillary sinus floor augmentation with BC resulted in adequate amounts of new bone formation allowing successful implant installation, while adding EMD did not have a significant effect.

Discussion : β-TCP/HA with or without enamel matr...

Nevertheless, the amount of bone generated with BC or BC + EMD herein was adequate to support successful implant placement and osseointegration of implants. In fact, more or less similar amounts of bone formation have been reported in studies evaluating human sinus biopsies after grafting with a variety of biomaterials (bone formation ranging approximately from 30 to 50%) [19]. On the other ha...

Discussion : β-TCP/HA with or without enamel matr...

The present study compared the histological and histomorphometrical outcome of healing after maxillary sinus floor augmentation with BC with or without EMD, based on human biopsies. The results showed that addition of EMD did not enhance the outcome of healing, neither in terms of quality nor quantity of new bone. Nevertheless, the amount of bone generated after maxillary sinus floor augmentation ...

Results : β-TCP/HA with or without enamel matrix ...

All ten patients showed uneventful healing after the sinus floor augmentation procedure as well as after dental implant placement, with no overt postoperative inflammation or infection. Consistently, in all ten patients, no significant jiggling of the drill was noticed during biopsy harvesting, while subjective drilling resistance during implant placement was similar in both groups and all implant...

Methods : β-TCP/HA with or without enamel matrix ...

The data for each tissue component from the three histological sections were averaged to represent the biopsy. Commercially available software (GraphPad Prism 5.0 for Windows, GraphPad Software Inc., USA) was utilized for statistical comparisons between groups and for drawing the graphics. The assumption of normality was checked using D’Agostino & Pearson omnibus test. The data for each evaluate...

Methods : β-TCP/HA with or without enamel matrix ...

Six months after grafting, another CBCT examination was carried out for implant planning. In the sequence, following the previously described antiseptic and anesthetic procedures, two implants with a sand-blasted and acid etching surface were installed in each of the grafted sinuses, i.e., 40 implants in total (32—Neoporous, Neodent, Curitiba, Paraná, Brazil; 8—SLA, Straumann, Basel, Switzerl...

Methods : β-TCP/HA with or without enamel matrix ...

This research project was approved by the Ethics Committee of the School of Dentistry and Dental Research Center São Leopoldo Mandic, Brazil, under the protocol 2010/0360. Ten consecutive patients (age range 35–75 years) with the need of bilateral maxillary sinus floor augmentation prior to the placement of four dental implants (two in each side of posterior maxilla) were selected for the stu...

Background : β-TCP/HA with or without enamel matr...

The aim of the present study was to compare histomorphometrically the outcome of maxillary sinus floor augmentation with β-TCP/HA with or without enamel matrix proteins (BC + EMD and EMD, respectively) in humans.

Background : β-TCP/HA with or without enamel matr...

Reconstruction of the edentulous and severely atrophied posterior maxilla is often performed by means of maxillary sinus floor augmentation in combination with dental implants [1, 2]. Various bone graft materials are typically used for enhancing bone formation within the sinus cavity; autogenous bone (AB) is considered as the gold standard due to its osteogenic, osteoinductive, and osteoconductive...

Abstract : β-TCP/HA with or without enamel matrix...

It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans. In ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the ot...

Fig. 8. Soft tissue dehiscence (a) CCXBB exposure ...

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 re...

Fig. 7. Second stage surgery of patient in Fig. 1...

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 Fig. 7. Second stage sur...

Fig. 6. Immunohistochemical analysis of slices fro...

Fig. 6. Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC Fig. 6. Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC

Fig. 5. Histomorphometric analysis of the same sam...

section stained with Levai-LaczkĂł. b Tissue identification of the ROI. c Closer view aized bone and CCXBB. d Closer view of b Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-LaczkĂł. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b

Fig. 4. Histological samples. a CCXBB control with...

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 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 ingr...

Fig. 3. Re-entry procedure of patient in Fig. 1. ...

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 Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...

Fig. 2. Lateral bone augmentation of the alveolar ...

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 Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...

Fig. 1. Study chart and follow-up visits : Histomo...

Fig. 1. Study chart and follow-up visits Fig. 1. Study chart and follow-up visits

Table 4 Implant loss and tissue characteristics : ...

Differentiated tissues Implant lost (Yes/no) Mean SD Percentage SD (%) ...

Table 3 Immunohistochemical markers proportions (i...

Patient TRAP (%) OPN (%) ALP (%) OSC (%) 1 ...

Table 2 Quantitative histological analysis : Histo...

Tissue type Mean Standard deviation Median CI 95% Mineralized bone ...

Table 1 Clinical and histomorphometry assessments ...

Patient Soft tissue dehiscence Mineralized bone (%) CCXBB (%) Bone marrow (%) Connect...

About this article : Histomorphometric and immunoh...

Ortiz-VigĂłn, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement. Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1 Download citation Received: 21 March 2017 Accepted: 12 June 2017 Published: 21 Ju...

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Author information : Histomorphometric and immunoh...

ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar ...

Acknowledgements : Histomorphometric and immunohis...

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Acknowledgements : Histomorphometric and immunohis...

We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged. This study was partial...

References : Histomorphometric and immunohistochem...

Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480. Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...

References : Histomorphometric and immunohistochem...

Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8. Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...

References : Histomorphometric and immunohistochem...

Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4. Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46. Nissan ...

References : Histomorphometric and immunohistochem...

Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8. Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...

References : Histomorphometric and immunohistochem...

Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7. Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40. Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...

Abbreviations : Histomorphometric and immunohistoc...

Alkaline phosphatase Cone beam computed tomography Collagen containing xenogeneic bone block Native collagen membrane Deproteinized bovine bone mineral Etiology and Therapy of Periodontal Diseases Osteopontin Osteocalcine Tartrate-resistant acid phosphatase

Conclusions : Histomorphometric and immunohistoche...

Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...

Discussion : Histomorphometric and immunohistochem...

The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...

Discussion : Histomorphometric and immunohistochem...

When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...

Discussion : Histomorphometric and immunohistochem...

The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...

Results : Histomorphometric and immunohistochemica...

The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...

Results : Histomorphometric and immunohistochemica...

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 r...

Methods : Histomorphometric and immunohistochemica...

For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100. The obtained semi-thin sections were evaluated wit...

Methods : Histomorphometric and immunohistochemica...

Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...

Methods : Histomorphometric and immunohistochemica...

CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECsâ€...

Methods : Histomorphometric and immunohistochemica...

The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...

Background : Histomorphometric and immunohistochem...

Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...

Abstract : Histomorphometric and immunohistochemic...

The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures. In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...

Fig. 6. Patient # 1 (12-month healing time): incre...

Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification Ă—100) Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification Ă—100)

Fig. 5. Patient # 4 (9-month healing time): increa...

Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification Ă—100) Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification Ă—100)

Fig. 4. Patient # 1 (12-month healing time): overv...

Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification Ă—10) Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification Ă—10)

Fig. 3. Alveolar tissue height (in true mm) over a...

Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group

Fig. 2. Aveolar tissue height (in true mm) over a ...

Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group

Fig. 1. Images of patient # 5 (9-month healing tim...

Fig. 1. Images of patient # 5 (9-month healing time). a. Radiograph of the left maxillary sinus: situation 9 months after the maxillary sinus floor elevation procedure. b. With a trephine drill, the implant osteotomy is made and the biopsy is obtained. c. Clinical situation after placing two Straumann® SLA implants in the left posterior maxilla. d. Radiograph of two Straumann® SLA implants in...

Table 4 Histomorphometric evaluation of the biopsi...

Patient (N) Gender/age Retrieval location BV/TV (%) BS/TV (mm2/mm3) Tb.Th (ÎĽm) ...

Table 3 Histomorphometric evaluation of the biopsi...

Patient (N) Gender/age) Retrieval location BV/TV (%) BS/TV (mm2/mm3) Tb.Th (ÎĽm) ...

Table 2 Radiological results (alveolar tissue heig...

Patient Gender/age Implant site T0 T1 Increase ...

Table 1 Alveolar tissue height measurements on pan...

Patient Gender/age Implant site T0 T1 Increase ...

About this article : The use of a biphasic calcium...

Bouwman, W.F., Bravenboer, N., Frenken, J.W.F.H. et al. The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times. Int J Implant Dent 3, 34 (2017). https://doi.org/10.1186/s40729-017-0099-x Download citation Received: 22 May 2017 Accepted...

Rights and permissions : The use of a biphasic cal...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Ethics declarations : The use of a biphasic calciu...

Authors W.F. Bouwman, N. Bravenboer, J.W.F.H. Frenken, C.M. ten Bruggenkate and E.A.J.M. Schulten state that there are no conflicts of interest, either directly or indirectly. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Author information : The use of a biphasic calcium...

Correspondence to E. A. J. M. Schulten.

Author information : The use of a biphasic calcium...

Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands W. F. Bouwman, C. M. ten Bruggenkate & E. A. J. M. Schulten Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands N. Bravenboer Department of Oral and Maxillofacial Su...

References : The use of a biphasic calcium phospha...

Groeneveld EH, van den Bergh JP, Holzmann P, ten Bruggenkate CM, Tuinzing DB, Burger EH. Mineralization processes in demineralized bone matrix grafts in human maxillary sinus floor elevations. J Biomed Mater Res. 1999;48:393–402. Schulten EAJM, Prins HJ, Overman JR, Helder MN, ten Bruggenkate CM, Klein-Nulend JA. Novel approach revealing the effect of collagenous membrane on osteoconduction in ...

References : The use of a biphasic calcium phospha...

Schopper C, Ziya-Ghazvini F, Goriwoda W, Moser D, Wanschitz F, Spassova E, Lagogiannis G, Auterith A, Ewers R. HA/TCP compounding of a porous CaP biomaterial improves bone formation and scaffold degradation—a long-term histological study. J Biomed Mater Res B Appl Biomater. 2005;74:458–67. Frenken JW, Bouwman WF, Bravenboer N, Zijderveld SA, Schulten EA, ten Bruggenkate CM. The use of Strauma...

References : The use of a biphasic calcium phospha...

Beirne JC, Barry HJ, Brady FA, Morris VB. Donor site morbidity of the anterior iliac crest following cancellous bone harvest. Int J Oral Maxillofac Surg. 1996;25:268–71. Vermeeren JIJF, Wismeijer D, van Waas MAJ. One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants: a 5-year follow-up. Int J Oral Maxillofac Surg. 1996;2:112–5. Nkenke E, Stel...

References : The use of a biphasic calcium phospha...

Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613–6. Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30:207–29. Del Fabbro M, Rosano G, Taschieri S. Implant survival rates after maxillary sinus augmentation. Eur J Oral Sci. 2008;116:497–506. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systemat...

Conclusions : The use of a biphasic calcium phosph...

Based on clinical, radiological, histological, and histomorphometric analysis, this study confirms the suitability of BCP for vertical augmentation of the posterior maxilla by means of an MSFE procedure, allowing dental implant placement after 9 and 12 months healing times. Yet, complete degradation of the BCP particles does not occur within a 12-month healing time. From a histological and histom...

Discussion : The use of a biphasic calcium phospha...

In the cranial part of the biopsy, some osteoid islands with osteogenic activity were detected, possibly caused by osteoinductive properties from the lifted bony trap-door. In the present study, histomorphometric analyses revealed that the vital bone volume was higher in the 9-month healing time group than in the 12-month healing time group, while one would expect to find more newly formed bone in...

Discussion : The use of a biphasic calcium phospha...

This study presents the clinical, radiological, histological and histomorphometric results on the use of a biphasic calcium phosphate (Straumann® bone ceramic) in a MSFE procedure with healing times of 9 and 12 months. During the clinical evaluation, it appeared that both 9-month and 12-month healing times resulted in integration of the grafted BCP with the original maxillary bone (sinus floor),...

Results : The use of a biphasic calcium phosphate ...

Histological observations did not show inflammatory cells in the tissue adjacent to the bone substitute particles. Bone marrow-like tissue, which included blood vessels, was observed in between the bone trabeculae (Fig. 4). Reinforcement by lamellar bone was shown in some areas after 9 and 12 months (Figs. 5 and 6). No Howship’s lacunae could be detected on the characteristic outlines of the su...

Results : The use of a biphasic calcium phosphate ...

None of the 10 patients showed postoperative inflammation or infection after the MSFE procedure nor during surgical re-entry for dental implant placement. When opening the area for dental implant insertion, the grafted area proved to be well vascularized and the tissue at the site of the former trap-door location was slightly flexible and had a fibrous aspect. Between the periosteum and the bone g...

Methods : The use of a biphasic calcium phosphate ...

Parameters evaluating vital bone mass/bone structure: 1: Vital bone volume (BV): percentage of the grafted section that is vital bone tissue (%) 2: Bone surface (BS): BS expressed as a fraction of the total vital bone volume (mm2/mm3) 3: Thickness of bone trabeculae (Tb.Th) (ÎĽm) Parameters evaluating bone turnover: 1: Osteoid volume (OV): fraction of the vital bone tissue section that is ost...

Methods : The use of a biphasic calcium phosphate ...

All 22 inserted dental implants were clinically tested for good primary stability. Osseointegration at abutment connection was tested with a 35-Ncm torque. One experienced oral and maxillofacial surgeon (CB) carried out all follow-up examinations. Panoramic radiographs were made at patient’s intake (T0); immediately after the MSFE procedure (T1); immediately after dental implant placement (T2);...

Methods : The use of a biphasic calcium phosphate ...

A midcrestal incision was made with vertical release incisions at the canine and tuberosity region. A full-thickness mucoperiosteal flap was elevated. The lateral maxillary sinus wall was prepared using a diamond burr with copious irrigation with sterile isotonic saline, regarding the contour of the maxillary sinus as observed on the preoperative panoramic radiograph. A bony top-hinge trap-door wa...

Methods : The use of a biphasic calcium phosphate ...

In this study, 10 consecutive healthy patients were selected for a unilateral MSFE procedure. Five patients received dental implants 9 months after MSFE and five patients underwent dental implant surgery 12 months after MSFE. In the 9-month group (three men and two women), the average age was 56.6 years (range 40 to 64 years); in the 12-month group (one man and four women), the average age was...

Background : The use of a biphasic calcium phospha...

β-TCP is a biocompatible osteoconductive calcium phosphate that may provide a scaffold for potential bony ingrowth [24]. β-TCP resorbs rather quickly but not necessarily at the same rate as new bone formation [25,26,27]. Most research focused on either using the relative unresorbable HA as a scaffold or β-TCP as a degradable component [19, 24,25,26, 28, 29]. Zerbo et al. [30] concluded that due...

Background : The use of a biphasic calcium phospha...

Maxillary sinus floor elevation (MSFE) is a surgical procedure to enhance the bone height in the posterior maxilla with graft material, allowing dental implant placement (later or at the same time) [1, 2]. This pre-implant procedure is predictable and results in a dental implant survival of more than 93.8% 3 years after dental implant placement [3]. According to Pjetursson [4] in his systematic r...

Abstract : The use of a biphasic calcium phosphate...

This study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% Ăź-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-month healing time. A unilateral MSFE procedure, using 100% BCP, was performed in two series of five patients with hea...