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The Induction of Bone Formation
Published in Ugo Ripamonti, The Geometric Induction of Bone Formation, 2020
This theoretical potential has not been translated into acceptable results in human patients. Clinical trials in craniofacial and orthopaedic applications such as mandibular reconstructions and sinus-lift operations have indicated that supra physiological doses of a single recombinant human protein are needed to induce often unacceptable tissue regeneration whilst incurring significant costs without achieving equivalence to autogenous bone grafts (Ripamonti et al. 2007; Ferretti et al. 2010; Ripamonti et al. 2012a; Ripamonti et al. 2014).
Modified Disk-Up Sinus Reamer for Sinus Floor Elevation and Simultaneous Implant Placement: An Animal Study with Miniature Pigs
Published in Journal of Investigative Surgery, 2020
Hang-Ying Jin, Min-Hua Teng, Duode Wang, Xin Li, Jia-Yue Liang, Wen-Xue Wang, Shuai Jiang, Bao-Dong Zhao
The OSFE technique has been applied to clinical therapy for many years. Even though clinical studies have shown that OSFE is a relatively safe and mature technique with a high long-term implant survival rate, complications still occur. The most common complication is perforation of the sinus membrane, with an incidence of 0–58.3%, which could be caused by a thin membrane structure, improper surgical technique, and a limited surgical approach [24,27]. In this experiment, there was one case of implant failure on the control side. This most likely occurred because the tapping intensity is difficult to control with OSFE. If too much tapping force is used, causing a greenstick fracture, the irregular and sharp edges may puncture the mucosa. Additionally, when grafting material is transported by osteotome, the stress is so concentrated on the top that the membrane is prone to rupture. If the grafting material leaks into the maxillary sinus, infection may develop, affecting healing around the implant and increasing the risk of failure [7,28,29]. Although some specimens of the control side did not display obvious perforation, the metal color of the implant was visible; this may be a precursor to perforation. It is clear that safe and effective sinus lift tools are urgently needed to reduce the incidence of complications.
Haemostatic sponges as an alternative to granular bone substitute for sinus lifts
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
S. Okley, C. Mauprivez, P. Prada, M. Dubus, F. Velard, R. Rahouadj, H. Kerdjoudj, A. Baldit
The devices were provided in a cubic shape (∼10 mm edge) by the manufacturers and were not recut. This decision was supported by the fact that the aim is to mimic their use in surgical condition. In total 5 samples per device type have been studied: 3 in dry condition, 1 in saline buffer (PBS) saturated condition and 1 for volume analysis. The dry dimensions were measured thanks to a calliper and image analysis for the volume tracking. The samples were weighed with an accurate Sartorius CPA225D scale. The device’s microstructure has been assessed through scanning electron microscopy (SEM) through two conditions: native and after 50% of applied strain. This latter load refers to the manipulation of sponges while sinus lift surgery.
Platelet concentrates for bone regeneration: Current evidence and future challenges
Published in Platelets, 2018
Zahi Badran, Mohamed-Nur Abdallah, Jesus Torres, Faleh Tamimi
A meta-analysis on PRP as an adjunctive to bone grafts in sinus lift procedures [61] indicated that PRP improved slightly the outcome of the procedure. However, the results of the meta-analysis were not significant, and the review could only include six RCTs that were classified as having a high risk of bias. Moreover, the benefits seem to be mild even when significantly positive. The same conclusion was drawn by another systematic review by Del Fabbro et al. Thus, the authors stressed the low number of controlled studies and their heterogeneity [60]. Furthermore, despite some positive outcomes, population size and study methodology are generally weak elements that makes the evidence of the use of PC for bone regeneration questionable.