RESUMEN
Critical defects of the mandibular bone are very difficult to manage with currently available materials and technology. In the present work, we generated acellular and cellular substitutes for human bone by tissue engineering using nanostructured fibrin-agarose biomaterials, with and without adipose-tissue-derived mesenchymal stem cells differentiated to the osteogenic lineage using inductive media. Then, these substitutes were evaluated in an immunodeficient animal model of severely critical mandibular bone damage in order to assess the potential of the bioartificial tissues to enable bone regeneration. The results showed that the use of a cellular bone substitute was associated with a morpho-functional improvement of maxillofacial structures as compared to negative controls. Analysis of the defect site showed that none of the study groups fully succeeded in generating dense bone tissue at the regeneration area. However, the use of a cellular substitute was able to improve the density of the regenerated tissue (as determined via CT radiodensity) and form isolated islands of bone and cartilage. Histologically, the regenerated bone islands were comparable to control bone for alizarin red and versican staining, and superior to control bone for toluidine blue and osteocalcin in animals grafted with the cellular substitute. Although these results are preliminary, cellular fibrin-agarose bone substitutes show preliminary signs of usefulness in this animal model of severely critical mandibular bone defect.
RESUMEN
OBJETIVOS: Comparar los resultados de alveoloplastias secundarias realizadas en nuestro Hospital cuando utilizamos material de osteosíntesis y cuando el injerto óseo no precisa de dicho material, relacionándolos con factores como el sexo y la edad. MATERIAL Y MÉTODOS: Realizamos estudio retrospectivo de los años 2014-2019 en nuestro Hospital y seleccionamos los pacientes que cumplían los criterios de inclusión en nuestro estudio. Establecimos 2 grupos de edades: grupo A, edades entre 5-12 años (alveoloplastia secundaria mixta); grupo B, más de 12 años (alveoloplastia secundaria tardía). Para el injerto óseo se utilizó hueso autólogo procedente de cresta ilíaca o calota parietal. Dividimos los pacientes en 2 grupos: grupo I, pacientes con alveoloplastias que precisaron de material de osteosíntesis; grupo II, pacientes que no precisaron de material de osteosíntesis. Parámetros evaluados: los criterios de éxito de la alveoloplastia se valoraron según los parámetros clínicos descritos por Precious. La alveoloplastia era exitosa si cumplían todos los criterios de Precious al año de intervención. Evaluamos las complicaciones postoperatorias en ambos grupos. El análisis estadístico se realizó con el test exacto de Fisher para variables cualitativas. RESULTADOS: El éxito de la alveoloplastia se produjo en el 89,4% de los pacientes del grupo I, mientras que en el grupo II fue del 90,3%. La alveoloplastia fue exitosa en el 87,5% del sexo femenino frente al 91,17% de varones. En el 91,48% de los pacientes del grupo A la intervención fue un éxito frente al 66,6% del grupo B. En 2 pacientes del grupo I el material de osteosíntesis no se degradó en la valoración anual. No existieron diferencias significativas en ninguna de las comparaciones. CONCLUSIONES: La utilización de material de osteosíntesis no altera la integración del injerto óseo en pacientes a los que se realiza alveoloplastia. Factores como el sexo o la edad no influyen tampoco en los resultados de las intervenciones
OBJECTIVES: To compare the results of secondary alveoloplasty performed in one Hospital when osteosynthesis material was used and when the bone graft does not require this material, and relating them to factors such as gender and age. MATERIAL AND METHODS: A retrospective study was conducted from the years 2014 to 2019 in this Hospital on the selected patients who met the inclusion criteria. Two periods of ages, period A: ages between 5-12 years (mixed secondary alveoloplasty) and period B: greater than 12 years (late secondary alveoloplasty). Autologous bone from the iliac crest or parietal calotte was used for the bone graft. The patients were divided into 2 groups: group I: patients with alveoloplasties that required osteosynthesis material. Group II: patients who did not require osteosynthesis material. Parameters evaluated: the success criteria for alveoloplasty were assessed according to the clinical parameters described by Precious. Alveoloplasty was successful if they met all the criteria of Precious in the year of intervention. Postoperative complications in both groups were evaluated. The statistical analysis was performed using the exact Fisher test for qualitative variables. RESULTS: Alveoloplasty was successful in 89.4% of patients in group I, while it was 90.3% in group II. Alveoloplasty was successful in 87.5% of females compared to 91.17% of males. The intervention was a success in 91.48% of patients in group A, compared to 66.6% in group B. The osteosynthesis material in two patients of group I was not degraded in the annual assessment. There were no significant differences in any of the comparisons. CONCLUSIONS: The use of osteosynthesis material does not alter the integration of the bone graft in patients that undergo alveoloplasty. Factors such as gender or age do not influence the results of the interventions
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Alveoloplastia/métodos , Fijación Interna de Fracturas/métodos , Fisura del Paladar/diagnóstico , Fisura del Paladar/cirugía , Trasplante Óseo/métodos , Estudios Retrospectivos , Complicaciones Posoperatorias , Alveolo Dental/cirugía , Ortodoncia/métodos , Erupción Dental , Titanio/uso terapéuticoRESUMEN
OBJECTIVES: To compare the results of secondary alveoloplasty performed in one Hospital when osteosynthesis material was used and when the bone graft does not require this material, and relating them to factors such as gender and age. MATERIAL AND METHODS: A retrospective study was conducted from the years 2014 to 2019 in this Hospital on the selected patients who met the inclusion criteria. Two periods of ages, period A: ages between 5-12 years (mixed secondary alveoloplasty) and period B: greater than 12 years (late secondary alveoloplasty). Autologous bone from the iliac crest or parietal calotte was used for the bone graft. The patients were divided into 2 groups: group I: patients with alveoloplasties that required osteosynthesis material. Group II: patients who did not require osteosynthesis material. Parameters evaluated: the success criteria for alveoloplasty were assessed according to the clinical parameters described by Precious. Alveoloplasty was successful if they met all the criteria of Precious in the year of intervention. Postoperative complications in both groups were evaluated. The statistical analysis was performed using the exact Fisher test for qualitative variables. RESULTS: Alveoloplasty was successful in 89.4% of patients in group I, while it was 90.3% in group II. Alveoloplasty was successful in 87.5% of females compared to 91.17% of males. The intervention was a success in 91.48% of patients in group A, compared to 66.6% in group B. The osteosynthesis material in two patients of group I was not degraded in the annual assessment. There were no significant differences in any of the comparisons. CONCLUSIONS: The use of osteosynthesis material does not alter the integration of the bone graft in patients that undergo alveoloplasty. Factors such as gender or age do not influence the results of the interventions.