Influence of fresh-frozen allogeneic bone grafts architecture on its incorporation : radiographic and histomorphometric comparison to the gold-standard

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Influence of fresh-frozen allogeneic bone grafts architecture on its incorporation : radiographic and histomorphometric comparison to the gold-standard

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Title Influence of fresh-frozen allogeneic bone grafts architecture on its incorporation : radiographic and histomorphometric comparison to the gold-standard
Author(s) Spin-Neto, Ruben ; Coletti, Felipe ; Pereira, Luis ; Marcantonio Jr, Elcio ; Stavropoulos, Andreas ; Wenzel, Ann
Date 2013
English abstract
Background: The influence of fresh-frozen block bone allograft architecture on its incorporation and dimensional remodeling remains unclear. Aim/Hypothesis: To compare cortical (AL-C) and corticocancellous (AL-CC) fresh-frozen block bone allografts to cortical block bone autografts (AT) in terms of histomorphometrical graft incorporation and radiographic dimensional remodeling, 6–8 months after grafting for anterior maxillary ridge augmentation. Material and methods: Twenty-four patients, requiring ridge augmentation in the anterior maxilla prior to implant placement, were treated with AT, AL-C or AL-CC (eight patients per graft type). During implant installation surgery, 6–8 months after grafting, cylindrical biopsies were harvested perpendicularly to the lateral aspect of the augmented alveolar ridge; the relative volumes of vital and necrotic bone, and soft tissue, were histomorphometrically estimated. Furthermore, all patients were examined with CBCT prior to surgery, and 14 days and 6–8 months after grafting. Amount of augmentation and dimensional block graft remodeling over time were evaluated by comparing planimetric measurements of the alveoral ridge made on serial, parasagittal, CBCT sections generated throughout the augmentation area, for each patient. Average values were calculated for each graft type; comparisons among groups and observation times were performed using repeated-measures ANOVA and Tukey post-hoc test. P was set at <0.05. Results: Histomorphometrical analysis showed that the AL-CC group had the smallest amount of necrotic bone (38.2 12.1%) compared to AT (56.7 25.9%, P < 0.05) and AL-C (83.7 10.8%, P < 0.0001). AL-CC showed the largest amount of soft tissues (52.5 11.7%) compared to AT (18.1 17.1%, P < 0.0001) and AL-C (12.3 8.5%, P < 0.0001). Larger amounts of viable bone were found in the AT-treated group (25.1 11.2%) compared to AL-CC and AL-C groups (9.3 3.8% and 3.9 4.6%, respectively; P < 0.0001). The radiographic evaluation showed that all type of grafts resulted in a significant increase in alveolar ridge dimensions, with no significant differences among the groups at the various observation times. However, graft resorption in the AL-CC group was significantly larger (P < 0.05) compared to that observed in the AT and AL-C groups. Conclusions and clinical implications: AL block bone graft architecture influences their incorporation and dimensional remodeling. Corticocancellous AL blocks seem to show larger resorption over time, while cortical blocks seem to show the least amounts of vital bone 6–8 months after grafting. Only a small portion of the AL block consists of vital bone 6–8 months after grafting.
DOI http://dx.doi.org/10.1111/clr.12246 (link to publisher's fulltext)
Publisher Wiley
Host/Issue Abstracts of the EAO 22nd Annual Scientific Meeting. Publication of this supplement was sponsored by the European Association for Osseointegration;
Volume 24
Series/Issue Clinical Oral Implants Research;s9
ISSN 0905-7161
Pages 54
Language eng (iso)
Subject(s) Medicine
Research Subject Categories::ODONTOLOGY
Note European Association of Osseointegration, EAO 22nd Annual Scientific Meeting, Dublin, Ireland 17-19 October 2013
Handle http://hdl.handle.net/2043/18424 (link to this page)
Link http://www.colloquium.eu/congres/14EAO/docs/EAO_Final_Programme_2013.pdf (external link to related web page)

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