RESUMEN
BACKGROUND: Alveolar Bone loss occurs frequently during the first six months after tooth extraction. Various studies have proposed different methods to reduce as much as possible the atrophy of the alveolar ridge after tooth extraction. Filling the socket with biomaterials after extraction can reduce the resorption of the alveolar ridge. We compared the height of the alveolar process at the mesial and distal aspects of the extraction site and the resorption rate was calculated after the application of HA/ß-TCP or synthetic co-polymer polyglycolic - polylactic acid PLGA mixed with blood to prevent socket resorption immediately and after tooth extraction. METHODS: The study was conducted on 24 extraction sockets of impacted mandibular third molars bilaterally, vertically, and completely covered, with a thin bony layer. HA/ß-TCP was inserted into 12 of the dental sockets immediately after extraction, and the synthetic polymer PLGA was inserted into 12 of the dental sockets. All sockets were covered completely with a full-thickness envelope flap. Follow-up was performed for one year after extraction, using radiographs and stents for the vertical alveolar ridge measurements. RESULTS: The mean resorption rate in the HA/ß-TCP and PLGA groups was ± 1.23 mm and ± 0.1 mm, respectively. A minimal alveolar bone height reduction of HA/ß-TCP was observed after 9 months, the reduction showed a slight decrease to 0.93 mm, while this rate was 0.04 mm after 9 months in the PLGA group. Moreover, the bone height was maintained after three months, indicating a good HA/ß-TCP graft performance in preserving alveolar bone (1.04 mm) while this rate was (0.04 mm) for PLGA. CONCLUSION: The PLGA graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction. However, HA/ß-TCP causes greater resorption at augmented sites than PLGA, which clinicians should consider during treatment planning.
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Pérdida de Hueso Alveolar , Sustitutos de Huesos , Ácido Láctico , Copolímero de Ácido Poliláctico-Ácido Poliglicólico , Extracción Dental , Alveolo Dental , Humanos , Alveolo Dental/cirugía , Pérdida de Hueso Alveolar/prevención & control , Sustitutos de Huesos/uso terapéutico , Copolímero de Ácido Poliláctico-Ácido Poliglicólico/uso terapéutico , Masculino , Femenino , Ácido Láctico/uso terapéutico , Adulto , Ácido Poliglicólico/uso terapéutico , Proceso Alveolar/patología , Tercer Molar/cirugía , Diente Impactado/cirugía , Estudios de Seguimiento , Adulto Joven , Colgajos Quirúrgicos , Materiales Biocompatibles/uso terapéutico , Aumento de la Cresta Alveolar/métodos , Hidroxiapatitas/uso terapéutico , Mandíbula/cirugía , Fosfatos de Calcio/uso terapéutico , Resultado del TratamientoRESUMEN
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Effectiveness of Calcium Phosphate derivative agents on the prevention and remineralization of caries among children- A systematic review & meta-analysis of randomized controlled trials. Singal K, Sharda S, Gupta A, Malik VS, Singh M, Chauhan A, Agarwal A, Pradhan P, Singh M. J Evid Based Dent Pract. 2022; 22(3):101746. SOURCE OF FUNDING: Indian Council of Medical Research. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.
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Fosfatos de Calcio , Caries Dental , Fluoruros , Remineralización Dental , Niño , Humanos , Fosfatos de Calcio/uso terapéutico , Cariostáticos/uso terapéutico , Cariostáticos/farmacología , Cariostáticos/administración & dosificación , Caries Dental/prevención & control , Fluoruros/administración & dosificación , Fluoruros/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Metaanálisis como Asunto , Revisiones Sistemáticas como AsuntoRESUMEN
OBJECTIVES: The present study aimed to synthesize toothpastes containing Beta- TriCalcium Phosphate (ß-TCP) nanoparticles, functionalized with fluoride and tin, and test their ability to reduce erosive tooth wear (ETW). METHODS: Toothpastes were synthesized with the following active ingredients: 1100 ppm of fluoride (as sodium fluoride, F-), 3500 ppm of tin (as stannous chloride, Sn2+), and 800 ppm of ß-TCP (Sizes a - 20 nm; and b - 100 nm). Enamel specimens were randomly assigned into the following groups (n = 10): 1. Commercial toothpaste; 2. Placebo; 3 F-; 4. F- + ß-TCPa; 5. F- + ß-TCPb; 6. F- + Sn2+; 7. F- + Sn2+ + ß-TCPa and 8. F- + Sn2+ + ß-TCPb. Specimens were subjected to erosion-abrasion cycling. Surface loss (in µm) was measured by optical profilometry. Toothpastes pH and available F- were also assessed. RESULTS: Brushing with placebo toothpaste resulted in higher surface loss than brushing with F- (p = 0.005) and F- + ß-TCPb (p = 0.007); however, there was no difference between F- and F- + ß-TCPb (p = 1.00). Commercial toothpaste showed no difference from Placebo (p = 0.279). The groups F-, F- + ß-TCPa, F- + ß-TCPb, F- + Sn2+, F- + Sn2+ + ß-TCPa and F- + Sn2+ + ß-TCPb were not different from the commercial toothpaste (p > 0.05). Overall, the addition of ß-TCP reduced the amount of available fluoride in the experimental toothpastes. The pH of toothpastes ranged from 4.97 to 6.49. CONCLUSIONS: Although toothpaste containing ß-TCP nanoparticles protected enamel against dental erosion-abrasion, this effect was not superior to the standard fluoride toothpaste (commercial). In addition, the functionalization of ß-TCP nanoparticles with fluoride and tin did not enhance their protective effect. CLINICAL SIGNIFICANCE: Although ß-TCP nanoparticles have some potential to control Erosive Tooth Wear, their incorporation into an experimental toothpaste appears to have a protective effect that is similar to a commercial fluoride toothpaste.
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Fosfatos de Calcio , Esmalte Dental , Nanopartículas , Erosión de los Dientes , Pastas de Dientes , Fosfatos de Calcio/química , Fosfatos de Calcio/uso terapéutico , Pastas de Dientes/química , Pastas de Dientes/uso terapéutico , Erosión de los Dientes/prevención & control , Nanopartículas/química , Esmalte Dental/efectos de los fármacos , Concentración de Iones de Hidrógeno , Compuestos de Estaño/uso terapéutico , Compuestos de Estaño/química , Fluoruro de Sodio/uso terapéutico , Fluoruro de Sodio/química , Animales , Fluoruros/uso terapéutico , Estaño/química , Abrasión de los Dientes/prevención & control , Bovinos , Ensayo de Materiales , Propiedades de Superficie , Distribución Aleatoria , Cepillado Dental , HumanosRESUMEN
Objective:To investigate the therapeutic effect of ß-tricalcium phosphate in mastoid cavity obliteration for middle ear cholesteatoma under endoscope. Methods:Sixty patients with middle ear cholesteatoma admitted to our department from September 2021 to March 2022 were included in this study. The observation groupï¼n=30ï¼ received ß-tricalcium phosphate during mastoid cavity obliteration. The control groupï¼n=30ï¼ received autologous tissue during mastoid cavity obliteration. Pure tone audiometry was performed before surgery and after surgery in both groups, and the air conduction thresholds of 500, 1 000, 2 000 and 4 000 Hz were recorded. The external acoustic meatus cross-sectional area within 1 cm of the external acoustic meatus opening was measured during the operation and after the operation. The differences of postoperative ear drying time, hearing change and mastoid cavity healing were compared between the two groups. Results:The duration of postoperative dry ear in the observation group was 2-14 weeks, with an average of ï¼9.4±2.7ï¼ weeks, while that in the control group was 4-26 weeks, with an average ofï¼16.0±5.7ï¼ weeks. The difference in dry ear time between the two groups was statistically significantï¼P<0.05ï¼. In the observation group, the threshold change was -19-27 dB, with an average ofï¼6.4±10.7ï¼ dB, and in the control group, the threshold change was -9-17 dB, with an average of ï¼4.7±7.1ï¼ dB. There was no significant difference in hearing change between the two groupsï¼P>0.05ï¼. In the observation group, the cross-sectional area of 1 cm inside the ear canal opening was -5.9-8.2 mm², with an average of ï¼-0.6±2.6ï¼ mm², and in the control group, the cross-sectional area of 1 cm inside the ear canal opening was -5.5-5.2 mm², with an average of ï¼-0.4±2.3ï¼ mm². There was no significant difference in intraoperative cavity changes between the two groupsï¼P>0.05ï¼. Conclusion:The application of ß-tricalcium phosphate to fill the mastoid cavity during the operation of endoscopic middle ear cholesteatoma has no adverse effect on the hearing of patients, can shorten the postoperative dry ear time, and results in good postoperative healing, which is worth promoting.
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Fosfatos de Calcio , Colesteatoma del Oído Medio , Apófisis Mastoides , Humanos , Fosfatos de Calcio/uso terapéutico , Apófisis Mastoides/cirugía , Colesteatoma del Oído Medio/cirugía , Masculino , Femenino , Adulto , Endoscopía/métodos , Persona de Mediana Edad , Audiometría de Tonos Puros , Resultado del Tratamiento , EndoscopiosRESUMEN
Background and Objectives: Favorable short- and mid-term results for hydroxyapatite (HA)-tricalcium phosphate (TCP)-coated total hip arthroplasty (THA) (Trilogy/Zimmer) have been reported in the literature; however, the long-term results beyond 15 years have not been documented. Therefore, this study evaluated the long-term postoperative results, radiological bone changes, and implant fixation of the acetabular component of HA-TCP-coated THA. Materials and Methods: This is a retrospective cohort study of 212 patients who underwent primary HA-TCP-coated THA (Trilogy/Zimmer) at our institution between 1 October 2002, and 31 March 2008; 166 who were available for follow-up at least 15 years postoperatively were included (capture rate: 78.3%). All implants were Trilogy/Zimmer. We investigated the survival rate, with aseptic loosening as the endpoint. Clinical evaluations included the presence of dislocation and a modified Harris Hip Score (mHHS) preoperatively and at the final observation. Results: The mean age at surgery and at the follow-up period were 57.7 ± 9.6 and 17.1 ± 1.5 years, respectively. The survival rate was 99.4% (165/166), with aseptic loosening as the endpoint. Dislocation was observed in 4/166 (2.4%) patients. The mHHS improved significantly from 46.1 points preoperatively to 82.2 points during the last survey (p < 0.05). The results revealed that fixation was favorable in all cases except for one case of aseptic loosening. The Trilogy implant coated with HA-TCP was highly effective in bone induction, and bone ingrowth was considered to have occurred without failure, further indicating its usefulness. The long-term results of cementless THA using an HA-TCP coating (Trilogy/Zimmer), with a mean follow-up period of 17.1 years, revealed a commendable survival rate of 99.4%, considering aseptic loosening as the endpoint. Conclusions: HA-TCP-coated THA (Trilogy/Zimmer) had good long-term results. However, further long-term observation is required in patients who have undergone this surgery, and the stem side should be evaluated and investigated, including comorbidities.
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Artroplastia de Reemplazo de Cadera , Humanos , Artroplastia de Reemplazo de Cadera/métodos , Artroplastia de Reemplazo de Cadera/instrumentación , Artroplastia de Reemplazo de Cadera/efectos adversos , Persona de Mediana Edad , Masculino , Femenino , Estudios de Seguimiento , Estudios Retrospectivos , Anciano , Resultado del Tratamiento , Durapatita/uso terapéutico , Fosfatos de Calcio/uso terapéutico , Prótesis de Cadera , Radiografía/métodos , Hidroxiapatitas/uso terapéutico , Estudios de Cohortes , Adulto , Materiales Biocompatibles RevestidosRESUMEN
OBJECTIVES: To compare the effectiveness of two 5% sodium fluoride (NaF) varnishes containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP) (MI VarnishTM) or tricalcium phosphate (TCP) (ClinproTM White) to the conventional 5% NaF varnish (Duraphat®) in preventing early childhood caries (ECC) in high-risk preschool children. METHODS: A double-blinded, randomized controlled trial recruited healthy 3-4-year-old children (N = 582) having at least one carious lesion (pre-cavitated or cavitated) after obtaining written informed consent from parents. Using a computer-generated random-number table, children were assigned to one of the 3 groups: Control group (n = 196): 5% NaF varnish (Duraphat®) or two test groups: 5% NaF with TCP (Clinpro™ White) (n = 193) and 5% NaF varnish with CPP-ACP (MI Varnish™) (n = 193) to receive quarterly (every 3 months) application over 24 months. RESULTS: Incidence of new caries over 2 years was 59.2% in MI Varnish™ group (n = 125), 65.1% in the Clinpro™ White group (n = 129) and 66.1% in the Duraphat® group (n = 127) (p = 0.466). The mean cavitated lesions increment was not significant among the 3 groups (p = 0.714), as was the mean increment in non-cavitated carious lesions (p = 0.223). There was no significant difference (p = 0.630) in the distribution of total fluoride varnish applications among the three groups. Also, no significant difference was found in comparison of outcomes among the different number of fluoride varnish applications received by children in each group. CONCLUSIONS: Both calcium- and phosphate-containing NaF varnishes showed similar efficacy against cavitated and non-cavitated carious lesions as compared to conventional NaF varnish in high-risk preschool children. CLINICAL SIGNIFICANCE: Randomized trial provided a crucial opportunity to advance the understanding of the clinical effectiveness of different fluoride varnishes in preventing early childhood caries. Varnishes containing tricalcium phosphate or casein phosphopeptide amorphous calcium phosphate when compared to sodium fluoride varnish, demonstrated a similar efficacy against early childhood caries in high caries-risk preschool children.
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Fosfatos de Calcio , Cariostáticos , Caseínas , Caries Dental , Fluoruros Tópicos , Fluoruro de Sodio , Humanos , Caries Dental/prevención & control , Caseínas/uso terapéutico , Preescolar , Fluoruro de Sodio/uso terapéutico , Fluoruros Tópicos/uso terapéutico , Femenino , Cariostáticos/uso terapéutico , Masculino , Método Doble Ciego , Fosfatos de Calcio/uso terapéutico , Resultado del TratamientoRESUMEN
BACKGROUND: Dental caries is a dynamic process. By using therapeutic agents, early, noncavitated lesions and caries limited to the enamel can be stopped or even remineralized. For the remineralization of the initial carious lesion, many nonfluoridated remineralizing agents were investigated. OBJECTIVES: An observational study to assess the remineralizing efficacy of tricalcium phosphate (TCP), nano-hydroxyapatite (nHAp) and ozone remineralizing agents on the artificial carious lesion. METHODOLOGY: In this observational research, the artificial carious lesion was produced on extracted 40 premolar teeth. Later, remineralizing agents (Group A: nHAp, Group B: TCP, Group C: Ozone remineralizing agents, Group D: Control group (Deionized water) were used to remineralize demineralized teeth. Utilizing the Vickers Hardness Number, the level of demineralization and remineralization was assessed. Later these readings were statistically assessed using the Tukey's HSD (honestly significant difference) and ANOVA tests in SPSS version 21.0. The P value was set at 0.05 or less. RESULTS: After demineralization, there was a decrease in enamel microhardness values, with 32% in Group A, 26% in Group B, 22% in Group C, and 21% in Group D, respectively. From the baseline to demineralization, there was a statistically significant decrease in microhardness across all groups. After remineralization, Groups A, B, and C experienced an increase in microhardness while Group D experienced no changes. This showed that Group A had the highest remineralization percentage, followed by Group B and Group C. CONCLUSION: nHAp and TCP had the greater remineralizing ability, which can be used to manage initial carious lesions.
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Fosfatos de Calcio , Caries Dental , Durapatita , Ozono , Remineralización Dental , Fosfatos de Calcio/uso terapéutico , Fosfatos de Calcio/farmacología , Remineralización Dental/métodos , Durapatita/uso terapéutico , Humanos , Ozono/uso terapéutico , Ozono/farmacología , Técnicas In Vitro , Cariostáticos/uso terapéutico , Cariostáticos/farmacología , Diente Premolar , Esmalte Dental/efectos de los fármacosRESUMEN
BACKGROUND: An ideal synthetic spacer for medial opening wedge high tibial osteotomy (MOWHTO) has not yet been developed. The authors have developed a new ß-tricalcium phosphate (ß-TCP) spacer with 60% porosity (N-CP60) by modifying the micro- and macro-pore structures of a conventional ß-TCP spacer (CP60) that is widely used in clinical practice. The purpose of this study was to compare the absorbability, osteoconductivity, and in vivo strength of the N-CP60 spacer with those of the CP60 spacer, when used in MOWHTO. METHODS: First, the porosity, diameter distribution of macro- and micropores, and compressive strength of each ß-TCP block were examined using methodology of biomaterial science. Secondly, a clinical study was performed using a total of 106 patients (106 knees) with MOWHTO, who were followed up for 18 months after surgery. In these knees, the N-CP60 and CP-60 spacers were implanted into 49 tibias and 57 tibias, respectively. The absorbability and osteoconductivity were radiologically evaluated by measuring the area of the implanted spacer remaining unabsorbed and assessing with the Hemert's score, respectively. The incidence of cracking in the implanted spacers was determined using computed radiography. Statistical comparisons were made with non-parametric tests. The significance level was set at p = 0.05. RESULTS: The N-CP60 and CP60 blocks had almost the same porosity (mean, 61.0% and 58.7%, respectively). The diameter of macropores was significantly larger (p < 0.0001) in the N-CP60 block than in the CP60 block, while the diameter of micropores was significantly smaller (p = 0.019) in the N-CP60 block. The ultimate strength of the N-CP60 block (median, 36.8 MPa) was significantly greater (p < 0.01) than that of the CP60 block (31.6 MPa). As for the clinical evaluations, the absorption rate of the N-CP60 spacer at 18 months after implantation (mean, 48.0%) was significantly greater (p < 0.001) than that of the CP60 spacer (29.0%). The osteoconductivity of the N-CP60 spacer was slightly but significantly higher (p = 0.0408) than that of the CP60 spacer only in zone 1. The incidence of in vivo cracking of the posteriorly located N-CP60 spacer at one month (mean, 75.5%) was significantly lower (p = 0.0035) than that of the CP60 spacer (91.2%). CONCLUSIONS: The absorbability, osteoconductivity, and compressive strength of the new N-CP60 spacer were significantly improved by modifying the macro- and micro-pore structures, compared with the conventional CP60 spacer. The N-CP60 spacer is more clinically useful than the CP60 spacer. TRIAL REGISTRATION NUMBER: H29-0002.
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Fosfatos de Calcio , Osteotomía , Tibia , Fosfatos de Calcio/uso terapéutico , Humanos , Femenino , Tibia/cirugía , Tibia/diagnóstico por imagen , Osteotomía/métodos , Osteotomía/instrumentación , Persona de Mediana Edad , Masculino , Anciano , Porosidad , Adulto , Regeneración Ósea , Resultado del Tratamiento , Implantes Absorbibles , Osteoartritis de la Rodilla/cirugía , Osteoartritis de la Rodilla/diagnóstico por imagen , Estudios de SeguimientoRESUMEN
OBJECTIVE: To investigate the impact of mineralized dentin matrix (MDM) on the prognosis on bone regeneration and migration of retained roots after coronectomy. MATERIALS AND METHODS: Patients were divided into three groups based on the type of bone graft after coronectomy: Group C (n = 20, collagen), Group T (n = 20, tricalcium phosphate (TCP) + collagen), and Group D (n = 20, MDM + collagen). CBCT scans, conducted immediately and 6 months after surgery, were analyzed using digital software. Primary outcomes, including changes in bone defect depth and retained root migration distance, were evaluated 6 months after surgery. RESULTS: After 6 months, both Groups D and T exhibited greater reduction of the bone defect and lesser retained root migration than Group C (p < 0.001). Group D had greater regenerated bone volume in the distal 2 mm (73 mm3 vs. 57 mm3, p = 0.011) and lesser root migration (2.18 mm vs. 2.96 mm, p < 0.001) than Group T. The proportion of completely bone embedded retained roots was also greater in Group D than in Group C (70.0% vs. 42.1%, p = 0.003). CONCLUSIONS: MDM is an appropriate graft material for improving bone defect healing and reducing retained root migration after coronectomy. CLINICAL RELEVANCE: MDM is an autogenous material prepared chairside, which can significantly improve bone healing and reduce the risk of retained root re-eruption. MDM holds promise as a routine bone substitute material after M3M coronectomy.
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Regeneración Ósea , Fosfatos de Calcio , Colágeno , Tomografía Computarizada de Haz Cónico , Dentina , Humanos , Masculino , Femenino , Fosfatos de Calcio/uso terapéutico , Pronóstico , Persona de Mediana Edad , Colágeno/uso terapéutico , Regeneración Ósea/efectos de los fármacos , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/cirugía , Adulto , Corona del Diente/cirugía , Resultado del Tratamiento , Trasplante Óseo/métodos , Sustitutos de Huesos/uso terapéuticoRESUMEN
Graft materials available to supplement hindfoot and ankle arthrodesis procedures include autologous (autograft) or allogeneic bone graft (allograft) but also bone graft substitutes such as demineralized bone matrix, calcium sulfate, calcium phosphate, and tricalcium phosphate/hydroxyapatite. In addition, biologic agents, such as recombinant human bone morphogenetic protein-2 or recombinant human platelet derived growth factor-BB (rhPDGF-BB), and preparations, including platelet-rich plasma or concentrated bone marrow aspirate, have been used to facilitate bone healing in ankle or hindfoot arthrodesis. The purpose of this review was to summarize the available clinical evidence surrounding the utilization and efficacy of the above materials and biological agents in ankle or hindfoot arthrodesis procedures, with emphasis on the quality of the existing evidence to facilitate clinical decision making.
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Artrodesis , Trasplante Óseo , Humanos , Artrodesis/métodos , Trasplante Óseo/métodos , Sustitutos de Huesos/uso terapéutico , Articulación del Tobillo/cirugía , Fosfatos de Calcio/uso terapéuticoRESUMEN
PURPOSE: The primary objective of this study was to determine time to full weight-bearing after the use of a calcium-sulfate-calcium phosphate bone substitute (CaSO4/CaPO4) as a bone void filler in the treatment of primary benign bone tumours following intralesional curettage. The secondary objectives were to determine surgical complications and recurrence rates. METHODS: Retrospective review of patients identified from a surgeon-specific orthopaedic oncology database, who underwent curettage of benign bone tumours and subsequent bone void filling with CaSO4/CaPO4. RESULTS: A total of 39 patients (20 males, 19 females) met inclusion criteria with an average age of 31 years (range: 13 to 62 years), a median follow-up of 3.7 years, and a maximum follow-up of 11 years. The most common tumour diagnosis was giant cell tumour of bone (GCT) (n = 19), and the most common location was the proximal tibia (n = 9). The mean volume of tumour excised was 74.1 cm3 including extraosseous bone expansion due to tumour growth, with a mean of volume of 21.4 mL of CaSO4/CaPO4 used to fill the intraosseous cavitary defects to restore normal bone anatomy. None of the lesions required additional internal fixation. The primary outcome measure, average time to full weight-bearing/full range of motion, was 11 weeks and 6 weeks for upper and lower extremity lesions, respectively. Secondary outcomes included tumour recurrence requiring reoperation in five patients and infection requiring reoperation in two patients. CONCLUSION: This study demonstrates that CaSO4/CaPO4 is a viable option as a bone void filler in the reconstruction of cavitary defects following removal of primary benign bone tumours. CaSO4/CaPO4 provides sufficient bone regeneration early in the post-operative period to allow progression to full weight-bearing within weeks without the need for internal fixation. There were no graft-specific complications noted.
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Neoplasias Óseas , Sustitutos de Huesos , Fosfatos de Calcio , Sulfato de Calcio , Legrado , Soporte de Peso , Humanos , Masculino , Femenino , Adulto , Estudios Retrospectivos , Neoplasias Óseas/cirugía , Fosfatos de Calcio/uso terapéutico , Persona de Mediana Edad , Adolescente , Sustitutos de Huesos/uso terapéutico , Adulto Joven , Factores de TiempoRESUMEN
BACKGROUND: Beta-tricalcium phosphate (ß-TCP) is a biocompatible ceramic material widely used in the field of oral regeneration. Due to its excellent biological and mechanical properties, it is increasingly utilized for alveolar ridge augmentation or guided bone regeneration (GBR). With recent advances in computer-aided design and manufacturing (CAD/CAM), ß-TCP can now be used in the form of digitally designed patient-specific scaffolds for customized bone regeneration (CBR) of advanced defects in a two-stage implant therapy concept. In this case report following the CARE case report guidelines, we present a novel application of a patient-specific ß-TCP scaffold in pre-implant mandibular alveolar ridge augmentation. CASE PRESENTATION: A 63-year-old female patient with significant horizontal bone loss in the posterior mandible was treated with a custom ß-TCP scaffold in the context of a two-stage backward-planned implant therapy. Cone-beam computed tomography nine months after augmentation showed successful integration of the scaffold into the surrounding bone, allowing implant placement. Follow-up until two years after initial surgery showed excellent oral and peri-implant health. CONCLUSIONS: This case highlights the potential of patient-specific ß-TCP scaffolds for alveolar ridge augmentation and their advantage over traditional techniques, including avoidance of xeno-, allo-, and autografts. The results provide encouraging evidence for their use in clinical practice. Patient-specific ß-TCP scaffolds may be a promising alternative for clinicians seeking to provide their patients with safe, predictable, and effective alveolar ridge augmentation results in customized bone regeneration procedures.
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Aumento de la Cresta Alveolar , Fosfatos de Calcio , Tomografía Computarizada de Haz Cónico , Andamios del Tejido , Humanos , Aumento de la Cresta Alveolar/métodos , Fosfatos de Calcio/uso terapéutico , Femenino , Persona de Mediana Edad , Mandíbula/cirugía , Regeneración Ósea/efectos de los fármacos , Implantación Dental Endoósea/métodos , Diseño Asistido por Computadora , Pérdida de Hueso Alveolar/cirugíaRESUMEN
OBJECTIVE: Periodontitis is an inflammatory condition induced by subgingival bacterial dysbiosis, resulting in inflammatory-mediated destruction of tooth-supporting structures, potentially leading to the formation of infrabony defects. This case report describes the treatment of a patient who presented with a combination 1-2-wall defect on tooth 21. To maintain the residual periodontal attachment and minimize esthetic consequences, a regenerative approach was performed using recombinant human platelet-derived growth factor-BB (rh-PDGF-BB) and ß-tricalcium phosphate (ß-TCP). MATERIALS AND METHODS: At the time of postscaling/root planing reevaluation, a 34-year-old Asian male initially diagnosed with molar/incisor pattern stage III grade C periodontitis exhibited a 6-mm residual probing depth on the mesiopalatal aspect of tooth 21. Periodontal regenerative surgery was performed using rh-PDGF-BB with ß-TCP, without the use of a membrane. RESULTS: At the 1-year follow-up, a significant reduction in probing depth and radiographic evidence of bone fill were observed. Additionally, re-entry surgery for implant placement at site tooth 23 confirmed bone fill in the defect on tooth 21. CONCLUSION: These results demonstrate the efficacy of rh-PDGF-BB with ß-TCP in enhancing periodontal regeneration and support its use as a treatment option when treating poorly contained infrabony defects in the esthetic zone.
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Becaplermina , Fosfatos de Calcio , Regeneración Tisular Guiada Periodontal , Humanos , Masculino , Fosfatos de Calcio/uso terapéutico , Adulto , Becaplermina/uso terapéutico , Regeneración Tisular Guiada Periodontal/métodos , Proteínas Recombinantes/uso terapéutico , Proteínas Recombinantes/administración & dosificación , Pérdida de Hueso Alveolar/cirugía , Pérdida de Hueso Alveolar/tratamiento farmacológico , Pérdida de Hueso Alveolar/patología , Periodontitis/cirugía , Periodontitis/tratamiento farmacológico , Proteínas Proto-Oncogénicas c-sis/uso terapéutico , Regeneración Ósea/efectos de los fármacos , Estética DentalRESUMEN
BACKGROUND: Autologous bone grafting is the standard treatment for the surgical management of atrophic nonunion of long bones. Other solutions, such as bone marrow mesenchymal stem cells (BM-MSC) combined with phospho-calcium material, have also been used. Here we evaluate the safety and early efficacy of a novel procedure using autologous or allogenic adipose tissue mesenchymal stromal cells (AT-MSC) seeded in a patented tricalcium phosphate-based biomaterial for the treatment of bone regeneration in cases of atrophic nonunion. METHODS: This was a prospective, multicentric, open-label, phase 2 clinical trial of patients with atrophic nonunion of long bones. Biografts of autologous or allogenic AT-MSC combined with a phosphate substrate were manufactured prior to the surgical procedures. The primary efficacy was measured 6 months after surgery, but patients were followed for 12 months after surgery and a further year out of the scope of the study. All adverse events were recorded. This cohort was compared with a historical cohort of 14 cases treated by the same research team with autologous BM-MSC. RESULTS: A total of 12 patients with atrophic nonunion of long bones were included. The mean (SD) age was 41.2 (12.1) years and 66.7% were men. Bone healing was achieved in 10 of the 12 cases (83%) treated with the AT-MSC biografts, a percentage of healing similar (11 of the 14 cases, 79%) to that achieved in patients treated with autologous BM-MSC. Overall, two adverse events, in the same patient, were considered related to the procedure. CONCLUSIONS: The results of this study suggest that AT-MSC biografts are safe for the treatment of bone regeneration in cases of atrophic nonunion and reach high healing rates. TRIAL REGISTRATION: Study registered with EUDRA-CT (2013-000930-37) and ClinicalTrials.gov (NCT02483364).
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Tejido Adiposo , Materiales Biocompatibles , Fosfatos de Calcio , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas , Trasplante Autólogo , Humanos , Fosfatos de Calcio/farmacología , Fosfatos de Calcio/uso terapéutico , Células Madre Mesenquimatosas/citología , Masculino , Femenino , Persona de Mediana Edad , Tejido Adiposo/citología , Adulto , Trasplante Homólogo , Resultado del Tratamiento , Atrofia , Estudios ProspectivosRESUMEN
Non-union during healing of bone fractures affects up to ~5% of patients worldwide. Given the success of recombinant human platelet-derived growth factor-B chain homodimer (rhPDGF-BB) in promoting angiogenesis and bone fusion in the hindfoot and ankle, rhPDGF-BB combined with bovine type I collagen/ß-TCP matrix (AIBG) could serve as a viable alternative to autografts in the treatment of non-unions. Defects (~2 mm gaps) were surgically induced in tibiae of skeletally mature New Zealand white rabbits. Animals were allocated to one of four groups-(1) negative control (empty defect, healing for 8 weeks), (2 and 3) acute treatment with AIBG (healing for 4 or 8 weeks), and (4) chronic treatment with AIBG (injection 4 weeks post defect creation and then healing for 8 weeks). Bone formation was analyzed qualitatively and semi-quantitatively through histology. Samples were imaged using dual-energy X-ray absorptiometry and computed tomography for defect visualization and volumetric reconstruction, respectively. Delayed healing or non-healing was observed in the negative control group, whereas defects treated with AIBG in an acute setting yielded bone formation as early as 4 weeks with bone growth appearing discontinuous. At 8 weeks (acute setting), substantial remodeling was observed with higher degrees of bone organization characterized by appositional bone growth. The chronic healing, experimental, group yielded bone formation and remodeling, with no indication of non-union after treatment with AIBG. Furthermore, bone growth in the chronic healing group was accompanied by an increased presence of osteons, osteonal canals, and interstitial lamellae. Qualitatively and semiquantitatively, chronic application of AI facilitated complete bridging of the induced non-union defects, while untreated defects or defects treated acutely with AIBG demonstrated a lack of complete bridging at 8 weeks.
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Becaplermina , Fosfatos de Calcio , Colágeno Tipo I , Animales , Conejos , Fosfatos de Calcio/uso terapéutico , Bovinos , Proteínas Recombinantes/uso terapéutico , Proteínas Recombinantes/farmacología , Fracturas de la Tibia/cirugía , Fracturas no Consolidadas/tratamiento farmacológico , Factor de Crecimiento Derivado de Plaquetas/uso terapéutico , Curación de Fractura/efectos de los fármacos , Tibia , Osteogénesis/efectos de los fármacosRESUMEN
OBJECTIVES: This in vitro study aimed to evaluate the effect of resin infiltration combined with casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) or bioactive glass (BAG) on the stability of enamel white spot lesions (WSLs) treatment. MATERIALS AND METHODS: Eighty-four enamel blocks were prepared from the buccal surfaces of sound human premolars. All enamel blocks were placed in a demineralisation solution for 3 days to establish the artificial enamel WSLs. Enamel blocks with WSLs were randomly divided into three groups (n = 28 each group): RI/B: one-off resin infiltration followed by twice daily BAG treatment; RI/C: one-off resin infiltration followed by twice daily CPP-ACPF treatment; RI: one-off resin infiltration treatment only (as control) and subjected to pH cycling for 7 days. Surface morphology, elemental analysis, crystal characteristics, surface roughness and microhardness of enamel surfaces were investigated by scanning electron microscopy and energy-dispersive spectrometry observation, X-ray diffraction (XRD), atomic force microscope and Vickers' hardness testing, respectively. RESULTS: Mean values of the surface roughness (mean±standard deviation (nm)) were 24.52±5.07, 27.39±5.87 and 34.36±4.55 for groups RI/B, RI/C and RI respectively (p = 0.003). The calcium to phosphate ratios were 1.32±0.16, 1.22±0.26 and 0.69±0.24 for groups RI/B, RI/C and RI respectively (p < 0.001). XRD revealed apatite formation in all three groups. The mean enamel surface microhardness (kg/mm2) of the groups were 353.93±28.49, 339.00±27.32 and 330.38±22.55 for groups RI/B, RI/C and RI respectively (p = 0.216). CONCLUSIONS: Resin infiltration combined with CPP-ACPF or BAG remineralisation appears to improve the surface properties of WSLs. CLINICAL SIGNIFICANCE: The combination of resin infiltration and CPP-ACPF/BAG remineralisation may be a potential treatment for the management of the WSLs.
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Caries Dental , Esmalte Dental , Humanos , Esmalte Dental/patología , Fluoruros/farmacología , Fluoruros/uso terapéutico , Fluoruros/análisis , Fosfatos de Calcio/farmacología , Fosfatos de Calcio/uso terapéutico , Caries Dental/patologíaRESUMEN
OBJECTIVE: This study aimed to evaluate the regenerative capacities of octacalcium phosphate collagen composite (OCP/Col) in one-wall intrabony defects in dogs. The background data discuss the present state of the field: No study has assessed the efficacy of OCP/Col for periodontal regeneration therapy despite the fact that OCP/Col has proved to be efficient for bone regeneration. METHODS: In six beagle dogs, the mandibular left third premolars were extracted 12 weeks before the experimental surgery. Standardized bone defects (5 mm in height and 4 mm in width) were simulated on the distal surface of the second premolars and mesially on the fourth premolars. The defect was filled with either OCP/Col (experimental group) or left empty (control group). Histological and histomorphometric characteristics were compared 8 weeks after surgery. RESULTS: No infectious or ankylotic complications were detected at any of the tested sites. The experimental group exhibited a significantly greater volume, height, and area of newly formed bone than the control group. The former also showed a greater height of the newly formed cementum than the latter, although the results were not statistically significant. The newly formed periodontal ligaments were inserted into newly formed bone and cementum in the experimental group. CONCLUSION: OCP/Col demonstrated high efficacy for bone and periodontal tissue regeneration that can be successfully applied for one-wall intrabony defects.
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Regeneración Ósea , Fosfatos de Calcio , Colágeno , Animales , Perros , Fosfatos de Calcio/uso terapéutico , Regeneración Ósea/efectos de los fármacos , Colágeno/uso terapéutico , Pérdida de Hueso Alveolar/cirugía , Ligamento Periodontal/patología , Sustitutos de Huesos/uso terapéutico , Regeneración Tisular Guiada Periodontal/métodos , Masculino , Mandíbula/cirugía , Cemento Dental/patologíaAsunto(s)
Fosfatos de Calcio , Necrosis de la Cabeza Femoral , Procedimientos Quirúrgicos Mínimamente Invasivos , Humanos , Materiales Biocompatibles , Fosfatos de Calcio/uso terapéutico , Cerámica , Necrosis de la Cabeza Femoral/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Resultado del TratamientoRESUMEN
BACKGROUND: Several methods were introduced for enamel biomimetic remineralization that utilize a biomimetic analogue to interact and absorb bioavailable calcium and phosphate ions and induce crystal nucleation on demineralized enamel. Amelogenin is the most predominant enamel matrix protein that is involved in enamel biomineralization. It plays a major role in developing the enamel's hierarchical microstructure. Therefore, this study was conducted to evaluate the ability of an amelogenin-inspired peptide to promote the remineralization potential of fluoride and a supersaturated calcium phosphate solution in treating artificially induced enamel carious lesions under pH-cycling regimen. METHODS: Fifty enamel slices were prepared with a window (4*4 mm2 ) on the surface. Five samples were set as control healthy enamel and 45 samples were subjected to demineralization for 3 days. Another 5 samples were set as control demineralized enamel and 40 enamel samples were assigned into 8 experimental groups (n=5) (P/I, P/II, P/III, P/AS, NP/I, NP/II, NP/III and NP/AS) according to peptide treatment (peptide P or non-peptide NP) and remineralizing solution used (I; calcium phosphate solution, II; calcium phosphate fluoride solution, III; fluoride solution and AS; artificial saliva). Samples were then subjected to demineralization/remineralization cycles for 9 days. Samples in all experimental groups were evaluated using Raman spectroscopy for mineral content recovery percentage, microhardness and nanoindentation as healthy, demineralized enamel and after pH-cycling. Data were statistically analysed using two-way repeated measures Anova followed by Bonferroni-corrected post hoc test for pairwise multiple comparisons between groups. Statistical significance was set at p= 0.05. Additionally, XRD, FESEM and EDXS were used for crystal orientation, surface morphology and elemental analysis after pH-cycling. RESULTS: Nanocrystals clumped in a directional manner were detected in peptide-treated groups. P/II showed the highest significant mean values in mineral content recovery (63.31%), microhardness (268.81±6.52 VHN), elastic modulus (88.74±2.71 GPa), nanohardness (3.08±0.59 GPa) and the best crystal orientation with I002/I300 (1.87±0.08). CONCLUSION: Despite pH changes, the tested peptide was capable of remineralizing enamel with ordered crystals. Moreover, the supplementary use of calcium phosphate fluoride solution with peptide granted an enhancement in enamel mechanical properties after remineralization.
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Caries Dental , Fluoruros , Humanos , Fluoruros/farmacología , Amelogenina/farmacología , Amelogenina/uso terapéutico , Cariostáticos/farmacología , Cariostáticos/uso terapéutico , Biomimética , Fosfatos de Calcio/farmacología , Fosfatos de Calcio/uso terapéutico , Minerales , Fosfatos , Remineralización Dental/métodos , Concentración de Iones de HidrógenoRESUMEN
STUDY DESIGN: Experimental porcine anterior cervical discectomy and fusion (ACDF) model: a proof-of-concept study. OBJECTIVE: The effect of monetite synthetic bone graft (SBG) containing calcium pyrophosphate and ß-tricalcium phosphate on cervical spinal fusion in a noninstrumented two-level large animal model. SUMMARY OF BACKGROUND DATA: ACDF is the gold standard surgical technique for the treatment of degenerative cervical spinal diseases. However, pseudarthrosis associated with increased patient morbidity occurs in â¼2.6% of the surgeries. SBG may enhance bony fusion and subsequently decrease the risk of pseudarthrosis. Recent studies on monetite-based SBGs for use in large cranial defects in humans have shown promising bone healing results, necessitating further investigation of their use in cervical spinal fusion. MATERIALS AND METHODS: Four adult female Danish Göttingen minipigs received partial cervical anterior discectomy and intervertebral defects at an upper and lower level. One defect was filled with SBG, and the other was left empty. Bony fusion was evaluated using computed tomography (CT) at three-month intervals for 12 months. Fifteen months postsurgery, the animals were euthanized for further ex vivo qualitative histopathologic and micro-CT evaluations. Fusion rates were compared using the Fisher exact test at each time point. RESULTS: Increased interbody bony fusion rates were observed at SBG levels (4/4) compared with control levels (0/4) evaluated by CT at 6 and 9 months postsurgery ( P =0.029). Fusion was observed at all SBG levels 12 months postsurgery and at only one control level. Histopathologic evaluation confirmed high-quality interbody bony fusion at all SBG levels and fusion by spondylosis at one control level. CONCLUSION: This proof-of-concept study provides preliminary evidence of a novel, calcium pyrophosphate-containing, and ß-tricalcium phosphate-containing monetite SBG that promotes bony fusion compared with a negative control in a clinically relevant porcine model of ACDF.