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Clinical studies with Straumann® BoneCeramic
Abstracts
index pre-clinical studies
ridge augmentation: Clin Oral Implants Res. 2011 Apr;22(4):416-23. doi: 10.1111/j.1600-0501.2010.02154.x. Radiographic alveolar bone changes following ridge preservation with two different biomaterials. Mardas N, D'Aiuto F, Mezzomo L, Arzoumanidi M, Donos N. ..................................... 5 Clin Oral Implants Res. 2010 Jul;21(7):688-98. doi: 10.1111/j.1600-0501.2010.01918.x. Alveolar ridge preservation with guided bone regeneration and a synthetic bone substitute or a bovine-derived xenograft: a randomized, controlled clinical trial. Mardas N, Chadha V, Donos N. .................................................................................. 6 Clin Oral Implants Res. 2009 Jul;20(7):708-14. doi: 10.1111/j.1600-0501.2009.01708.x. Epub 2009 Apr 28. Ridge augmentation and maxillary sinus grafting with a biphasic calcium phosphate: histologic and histomorphometric observations. Friedmann A, Dard M, Kleber BM, Bernimoulin JP, Bosshardt DD. ............................ 7
bone defects: Clin Implant Dent Relat Res. 2012 Jan 11. doi: 10.1111/j.1708-8208.2011.00408.x. [Epub ahead of print] Randomized Controlled Trial to Compare Two Bone Substitutes in the Treatment of Bony Dehiscences. Van Assche N, Michels S, Naert I, Quirynen M. .......................................................... 8 J Periodontol. 2007 Nov;78(11):2216-25. Treatment of intrabony defects using guided tissue regeneration and autogenous spongiosa alone or combined with hydroxyapatite/beta-tricalcium phosphate bone substitute or bovine-derived xenograft. Zafiropoulos GG, Hoffmann O, Kasaj A, Willershausen B, Weiss O, Van Dyke TE. ... 9
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extraction sockets: Clin Implant Dent Relat Res. 2011 Mar;13(1):34-45. doi: 10.1111/j.1708-8208.2009.00184.x. Healing of extraction sockets filled with BoneCeramic® prior to implant placement: preliminary histological findings. De Coster P, Browaeys H, De Bruyn H. .................................................................... 10
sinus lift: Clin Implant Dent Relat Res. 2012 Mar;14(1):41-50. doi: 10.1111/j.1708-8208.2010.00224.x. Epub 2010 May 11. A prospective 1-year clinical and radiographic study of implants placed after maxillary sinus floor augmentation with synthetic biphasic calcium phosphate or deproteinized bovine bone. Lindgren C, Mordenfeld A, Hallman M. ...................................................................... 11 Clin Oral Implants Res. 2011 May;22(5):481-4. doi: 10.1111/j.1600-0501.2010.02042.x. Epub 2010 Dec 9. Implant survival after sinus elevation with Straumann(®) BoneCeramic in clinical practice: ad-interim results of a prospective study at a 15-month follow-up. Covani U, Orlando B, Giacomelli L, Cornelini R, Barone A........................................ 12 Clin Oral Implants Res. 2010 Sep;21(9):924-30. doi: 10.1111/j.1600-0501.2010.01933.x. Epub 2010 May 9. Back-scattered electron imaging and elemental analysis of retrieved bone tissue following sinus augmentation with deproteinized bovine bone or biphasic calcium phosphate. Lindgren C, Hallman M, Sennerby L, Sammons R. ................................................... 13 Clin Oral Implants Res. 2010 Feb;21(2):201-8. doi: 10.1111/j.1600-0501.2009.01821.x. Epub 2009 Dec 4. The use of Straumann Bone Ceramic in a maxillary sinus floor elevation procedure: a clinical, radiological, histological and histomorphometric evaluation with a 6-month healing period. Frenken JW, Bouwman WF, Bravenboer N, Zijderveld SA, Schulten EA, ten Bruggenkate CM. ....................................................................................................... 14 Int J Oral Maxillofac Implants. 2009 Nov-Dec;24(6):1093-100. Clinical histology of microimplants placed in two different biomaterials. Lindgren C, Sennerby L, Mordenfeld A, Hallman M. ................................................. 15 Clin Oral Implants Res. 2008 Jul;19(7):686-92. doi: 10.1111/j.1600-0501.2008.01539.x. Epub 2008 May 19 Histomorphometric assessment of bone formation in sinus augmentation utilizing a combination of autogenous and hydroxyapatite/biphasic tricalcium phosphate graft materials: at 6 and 9 months in humans. Artzi Z, Weinreb M, Carmeli G, Lev-Dor R, Dard M, Nemcovsky CE ........................ 16
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Clin Oral Implants Res. 2008 Aug;19(8):796-803. doi: 10.1111/j.1600-0501.2008.01565.x. Maxillary sinus grafting with Bio-Oss or Straumann Bone Ceramic: histomorphometric results from a randomized controlled multicenter clinical trial. Cordaro L, Bosshardt DD, Palattella P, Rao W, Serino G, Chiapasco M. ................. 17 Int J Periodontics Restorative Dent. 2008 Jun;28(3):273-81. Histomorphometric comparison of a biphasic bone ceramic to anorganic bovine bone for sinus augmentation: 6- to 8-month postsurgical assessment of vital bone formation. A pilot study. Froum SJ, Wallace SS, Cho SC, Elian N, Tarnow DP. .............................................. 18
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ABSTRACT
Clin Oral Implants Res. 2011 Apr;22(4):416-23. doi: 10.1111/j.1600-0501.2010.02154.x.
Radiographic alveolar bone changes following ridge preservation with two different biomaterials.
Mardas N, D'Aiuto F, Mezzomo L, Arzoumanidi M, Donos N.
Periodontology Unit, Eastman Dental Institute, University College London, London, UK. [email protected]
OBJECTIVES: The aim of this randomized controlled trial was to evaluate radiographical bone changes following alveolar ridge preservation with a synthetic bone substitute or a bovine xenograft. METHODS: Alveolar ridge preservation was performed in 27 patients randomized in two groups. In the test group (n=14), the extraction socket was treated with Straumann bone ceramic(®) (SBC) and a collagen barrier membrane (Bio-Gide(®)), whereas in the control group (n=13) with deproteinized bovine bone mineral and the same barrier. Standardized periapical X-rays were taken at 4 time points, BL: after tooth extraction, GR: immediately after socket grafting, 4M: 16 weeks, 8M: 32 weeks post-operatively. The levels of the alveolar bone crest at the mesial (Mh), and distal (Dh) and central aspects of the socket were measured at all time points. All the radiographs obtained were subtracted from the follow-up images. The gain, loss and unchanged areas in terms of grey values were tested for significant difference between the two groups. RESULTS: In the test group, the Mh and Dh showed a mean difference (± standard deviation) of 0.9 ± 1.2 and 0.7 ± 1.8 mm, respectively, among BL-8M. In the control group, the Mh and Dh showed a mean difference of 0.4 ± 1.3 and 0.7 ± 1.3 mm, respectively (P>0.05). Both treatments presented similar gain in grey values between BL-GR, BL-4M and BL-8M. The SBC presented less loss in grey values between BL-4M and BL-8M (P<0.05). Radiographic assessment underestimated the intrasurgical measurements (mesial and distal) of an average 0.3 mm (95% CI, 0.02-0.6). CONCLUSION: Both types of bone grafts presented similar radiographic alveolar bone changes when used for alveolar ridge preservation.
PMID: 21561483 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Oral Implants Res. 2010 Jul;21(7):688-98. doi: 10.1111/j.1600-0501.2010.01918.x.
Alveolar ridge preservation with guided bone regeneration and a synthetic bone substitute or a bovine-derived xenograft: a randomized, controlled clinical trial.
Mardas N, Chadha V, Donos N.
Periodontology Unit, UCL - Eastman Dental Institute, London, UK.
OBJECTIVES: The aim of this randomized, controlled clinical trial was to compare the potential of a synthetic bone substitute or a bovine-derived xenograft combined with a collagen membrane to preserve the alveolar ridge dimensions following tooth extraction. METHODS: Twenty-seven patients were randomized into two treatment groups following single tooth extraction in the incisor, canine and premolar area. In the test group, the alveolar socket was grafted with Straumann Bone Ceramic (SBC), while in the control group, Bio-Oss deproteinized bovine bone mineral (DBBM) was applied. In both groups, a collagen barrier was used to cover the grafting material. Complete soft tissue coverage of the barriers was not achieved. After 8 months, during re-entry procedures and before implant placement, the horizontal and vertical dimensions of the residual ridge were re-evaluated and trephine biopsies were performed for histological analysis in all patients. RESULTS: Twenty-six patients completed the study. The bucco-lingual dimension of the alveolar ridge decreased by 1.1+/-1 mm in the SBC group and by 2.1+/-1 in the DBBM group (P<0.05). Both materials preserved the mesio-distal bone height of the ridge. No differences in the width of buccal and palatal bone plate were observed between the two groups. The histological analysis showed new bone formation in the apical part of the biopsies, which, in some instances, was in direct contact with both SBC and DBBM particles. The coronal part of the biopsies was occupied by a dense fibrous connective tissue surrounding the SBC and DBBM particles. CONCLUSION: Both biomaterials partially preserved the width and the interproximal bone height of the alveolar ridge.
PMID: 20636724 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Oral Implants Res. 2009 Jul;20(7):708-14. doi: 10.1111/j.1600-0501.2009.01708.x. Epub 2009 Apr 28.
Ridge augmentation and maxillary sinus grafting with a biphasic calcium phosphate: histologic and histomorphometric observations.
Friedmann A, Dard M, Kleber BM, Bernimoulin JP, Bosshardt DD.
Department of Periodontology, CharitéCenter 3, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Berlin, Germany. [email protected]
OBJECTIVES: This retrospective study reports on histologic and histomorphometric observations performed on human biopsies harvested from sites augmented exclusively by biphasic calcium phosphate [BCP: hydroxyapatite (HA)/ tricalcium phosphate (TCP) 60/40] and healed for a minimum of 6 months. MATERIALS AND METHODS: Five patients benefited from three augmentation regimens (i.e.: one-stage lateral augmentation; two-stage lateral augmentation; and two-stage sinus grafting). In all patients, a degradable collagen membrane served as a cell-occlusive barrier. Core biopsies were obtained from lateral as from crestal aspects 6-10 months after augmentation surgeries. For histologic and histomorphometric evaluations, the non-decalcified tissue processing was performed. RESULTS: The histological examination of 11 biopsies showed graft particles frequently being bridged by the new bone, and a close contact between the graft particles and newly formed bone was seen in all samples. The mean percentages of newly formed bone, soft tissue compartment, and graft material were 38.8% (+/-5.89%), 41.75% (+/-6.08%), and 19.63% (+/-4.85%), respectively. Regarding bone-to-graft contact values, the percentage of bone coverage of graft particles for all biopsies ranged from 27.83% to 80.17%. The mean percentage of bone coverage was 55.39% (+/-13.03%). CONCLUSIONS: Data from the present study demonstrated osteoconductivity scores for the BCP material (HA/TCP 60/40) in patients resembling those previously shown for grafting materials of xenogenic and alloplastic origin.
PMID: 19453566 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Implant Dent Relat Res. 2012 Jan 11. doi: 10.1111/j.1708-8208.2011.00408.x. [Epub ahead of print]
Randomized Controlled Trial to Compare Two Bone Substitutes in the Treatment of Bony Dehiscences.
Van Assche N, Michels S, Naert I, Quirynen M.
Periodontologist, Department of Periodontology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium; assistant professor, prosthodontist, Department of Prosthetic Dentistry/BIOMAT Research Cluster, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium; full professor, prosthodontist, Department of Prosthetic Dentistry/BIOMAT Research Cluster, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium; full professor, periodontologist, Department of Periodontology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium.
AIM: This in vivo split-mouth randomized controlled trial compared a synthetic bone substitute with a bovine bone mineral to cover bone dehiscences after implant insertion. MATERIALS AND METHODS: Fourteen patients received four to six implants to support an overdenture. Two comparable dehiscences within the same patient were first covered with a layer of autogenous bone, followed by a layer of either Bio-Oss® (group 1; Geistlich Pharma AG, Wolhusen, Switzerland) or Straumann BoneCeramic® (group 2; Institut Straumann AG, Basel, Switzerland) and sealed by a resorbable membrane. The change in vertical dimension of the defect was measured at implant placement and at abutment connection (6.5 months). Clinical and radiological parameters were evaluated up to 1 year of loading. RESULTS: The vertical size of the defect at surgery was 6.4 ± 1.6 mm for group 1 and 6.4 ± 2.2 mm for group 2 sites, measured from the implant shoulder. After 6.5 months, the depth of the defect was reduced to 1.5 ± 1.2 mm and 1.9 ± 1.2 mm for group 1 and group 2 sites, respectively (p > 0.05). No implants failed during follow-up. Mean marginal bone loss over the SLActive surface was 0.94 mm (group 1), 0.81 mm (group 2), and 0.93 mm (group 3, no dehiscence) after 1 year of loading. CONCLUSION: Both bone substitutes behaved equally effectively.
PMID: 22236044 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
J Periodontol. 2007 Nov;78(11):2216-25.
Treatment of intrabony defects using guided tissue regeneration and autogenous spongiosa alone or combined with hydroxyapatite/beta-tricalcium phosphate bone substitute or bovine-derived xenograft.
Zafiropoulos GG, Hoffmann O, Kasaj A, Willershausen B, Weiss O, Van Dyke TE.
Department of Operative Dentistry and Periodontology, University of Mainz, Mainz, Germany. [email protected]
BACKGROUND: The aim of this case-control study was to investigate the clinical regeneration of deep intrabony defects using guided tissue regeneration (GTR) with autogenous spongiosa (ASB) alone or using GTR with a mixture of ASB with a bovine-derived xenograft (BDX) or a synthetic composite bone substitute (hydroxyapatite/beta-tricalcium phosphate [HA/beta-TCP]). METHODS: Sixty-four patients with a total of 93 intrabony defects of 2- or 3-wall morphology and an intrabony component (IC)>or=4 mm participated in this study. Defects were treated with a bioabsorbable membrane and ASB alone or ASB mixed with HA/beta-TCP or BDX. Clinical parameters measured at baseline and 12 months after surgery included IC, bleeding on probing (BOP), and plaque accumulation (PLI). Vertical bone gain (VBG) and percentage relative bone gain (RBG) were used as indicators of treatment efficacy. A stringent plaque control regimen was enforced in all patients during the 12-month observation period. RESULTS: At baseline, no statistically significant differences in any of the clinical parameters were observed between the groups. At 12 months, HA/beta-TCP and BDX treatments produced similar improvements in intrabony tissue regeneration as shown by VBG (P=0.616) and RBG (P=0.826) with significantly better outcomes than ASB alone (P<0.0001). Changes in BOP and PLI did not differ significantly between the groups. CONCLUSION: The combined use of ASB with BDX or HA/beta-TCP led to significantly greater gain of clinical attachment and hard tissue formation compared to the use of ASB alone.
PMID: 17970691 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Implant Dent Relat Res. 2011 Mar;13(1):34-45. doi: 10.1111/j.1708-8208.2009.00184.x.
Healing of extraction sockets filled with BoneCeramic® prior to implant placement: preliminary histological findings.
De Coster P, Browaeys H, De Bruyn H.
Unit of Oral Development and Applied Oral Histology, Paecamed Research, Faculty of Medicine and Health Sciences, Dental School, University of Ghent, De Pintelaan 185, Ghent, Belgium.
BACKGROUND: Various grafting materials have been designed to minimize edentulous ridge volume loss following tooth extraction by encouraging new bone formation in healing sockets. BoneCeramic® is a composite of hydroxyapatite and bèta-tricalcium phosphate with pores of 100-500 microns. PURPOSES: The aim of this study was to evaluate bone regeneration in healing sockets substituted with BoneCeramic® prior to implant procedures. MATERIALS AND METHODS: Fifteen extraction sockets were substituted with BoneCeramic® and 14 sockets were left to heal naturally in 10 patients (mean age 59.6 years). Biopsies were collected only from the implant recipient sites during surgery after healing periods ranging from 6-74 weeks (mean 22). In total, 24 biopsies were available; 10 from substituted and 14 from naturally healed sites. In one site, the implant was not placed intentionally and, in four substituted sites, implant placement had to be postponed due to inappropriate healing, hence from five sites biopsies were not available. Histological sections were examined by transmitted light microscope. RESULTS: At the time of implant surgery, bone at substituted sites was softer than in controls, compromising initial implant stability. New bone formation at substituted sites was consistently poorer than in controls, presenting predominantly loose connective tissue and less woven bone. CONCLUSION: The use of BoneCeramic® as a grafting material in fresh extraction sockets appears to interfere with normal healing processes of the alveolar bone. On the basis of the present preliminary findings, its indication as a material for bone augmentation, when implant placement is considered within 6-38 weeks after extraction, should be revised.
PMID: 19681930 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Implant Dent Relat Res. 2012 Mar;14(1):41-50. doi: 10.1111/j.1708-8208.2010.00224.x. Epub 2010 May 11.
A prospective 1-year clinical and radiographic study of implants placed after maxillary sinus floor augmentation with synthetic biphasic calcium phosphate or deproteinized bovine bone.
Lindgren C, Mordenfeld A, Hallman M.
Department of Oral and Maxillofacial Surgery, Linköping, Sweden. [email protected]
BACKGROUND: The technique of using bone grafts or different biomaterials for augmentation of the maxillary sinus prior to implant placement is well accepted by clinicians. However, clinical documentation of some bone substitutes is still lacking. Purpose: This prospective study was designed to evaluate the success rate of implants placed after maxillary sinus augmentation with a novel synthetic biphasic calcium phosphate (BCP) or deproteinized bovine bone (DBB), the latter acting as control. MATERIAL AND METHODS: Nine edentulous patients and two partially edentulous patients with a mean age of 67 years with a bilateral need for sinus augmentation, < 5 mm residual bone in the floor of the sinus and a crestal width ≥ 4 mm, were included in the study. After bilateral elevation of the Schneiderian membrane, all patients were randomized for augmentation with synthetic BCP in one side and DBB in the contralateral side. After 8 months of graft healing, 62 implants with an SLActive surface were placed. Implant survival, graft resorption, plaque index, bleeding on probing, sulcus bleeding index, probing pocket depth, and implant success rate were evaluated after 1 year of functional loading. RESULTS: After a mean of 118 days, all patients received their fixed prosthetic constructions. One implant was lost in each biomaterial, giving an overall survival rate of 96.8%. Success rates for implants placed in BCP and DBB were 91.7 and 95.7%, respectively. No significant difference in marginal bone loss was found around implants placed in BCP, DBB, or residual bone, respectively. The mean graft resorption was 0.43 mm (BCP) and 0.29 mm (DBB). CONCLUSION: In this limited study, implant success rate was not dependent on the biomaterial used for maxillary sinus augmentation. Similar results were found after 1 year of functional loading for implants placed after sinus augmentation using BCP or DBB.
PMID: 20491816 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Oral Implants Res. 2011 May;22(5):481-4. doi: 10.1111/j.1600-0501.2010.02042.x. Epub 2010 Dec 9.
Implant survival after sinus elevation with Straumann(®) BoneCeramic in clinical practice: ad-interim results of a prospective study at a 15-month follow-up.
Covani U, Orlando B, Giacomelli L, Cornelini R, Barone A.
Tirrenian Stomatologic Institute, Lido di Camaiore, Lucca, Italy. [email protected]
OBJECTIVES: Elevation of the sinus floor with Straumann(®) BoneCeramic gave promising results in some recent clinical studies. However, no study has evaluated the long-term survival of implants after this surgical procedure. We are conducting a prospective, observational study to evaluate the long-term implant survival after this surgical procedure in clinical practice. We present here an ad-interim report of this study, including only patients with ≥12-month follow-up after implant placement. METHODS: This prospective cohort study will last until a follow-up of 5 years will be achieved in at least 50 patients. Inclusion criteria are: age ≥18 years; presence of a maxillary partial unilateral or bilateral edentulism involving the premolar/molar areas; elective rehabilitation with oral implants; and physical capability to tolerate conventional surgical and restorative procedures. Patients are treated according to the two-stage technique and the preparation is filled with Straumann(®) BoneCeramic. Implant survival is evaluated every 3 months for the first 2 years, and then every 6 months up to 5 years. RESULTS: Fifteen patients are considered in this ad-interim analysis. Mean follow-up was 14.9 ± 3.1 (range: 6-18 months). In total, three implants failed, in one single patient, 6 months after insertion. The cumulative implant survival rate was 92.5% (95% confidence interval: 83.0-100%). CONCLUSIONS: This ad-interim analysis suggests that the elevation of the sinus floor with Straumann(®) BoneCeramic may be an effective clinical option over >1-year follow-up. A longer term follow-up will allow a deeper characterization of these preliminary findings.
PMID: 21143534 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Oral Implants Res. 2010 Sep;21(9):924-30. doi: 10.1111/j.1600-0501.2010.01933.x. Epub 2010 May 9.
Back-scattered electron imaging and elemental analysis of retrieved bone tissue following sinus augmentation with deproteinized bovine bone or biphasic calcium phosphate.
Lindgren C, Hallman M, Sennerby L, Sammons R.
Department of Oral and Maxillofacial Surgery, Linköping, Sweden.
OBJECTIVES: To compare resorption of a synthetic biphasic calcium phosphate (BCP) bone-graft substitute with deproteinized bovine bone (DBB) used for human maxillary sinus augmentation. MATERIALS AND METHODS: Eleven patients underwent bilateral maxillary sinus floor augmentation with DBB in one side and a BCP (40%beta-tricalcium phosphate (beta-TCP) and 60% hydroxyapatite) in the contralateral side. Simultaneously, with the augmentation on each side a microimplant was placed vertically from the top of the alveolar crest penetrating the residual bone and the grafting material. Eight months after initial surgery the microimplants were retrieved with a surrounding bone core. The composition of residual graft material and surrounding bone was analysed by scanning electron microscopy and energy dispersive X-ray spectroscopy. RESULTS: Residual graft material of both types was present as 10-500 mum particles in direct contact with, or completely surrounded by, newly formed bone; smaller particles were also present in non-mineralized tissue. In the case of BCP the bone-graft substitute interface showed evidence of superficial disintegration of particles into individual grains. Median Ca/P ratios (at.%), determined from >200 discreet sites within residual graft particles and adjacent bone, were: DBB: 1.61 (confidence interval [CI] 1.59-1.64); BCP: 1.5 (CI 1.45-1.52); DBB-augmented bone: 1.62 (CI 1.59-1.66); BCP-augmented bone: 1.52 (CI 1.47-1.55); P=0.028 for DBB vs. BCP and DBB- vs. BCP-augmented bone. The reduction in Ca/P ratio for BCP over the healing period is consistent with the dissolution of beta-TCP and reprecipitation on the surface of calcium-deficient hydroxyapatite. CONCLUSION: The beta-TCP component of BCP may be gradually substituted by calcium-deficient hydroxyapatite over the healing period. This process and superficial degranulation of BCP particles may influence the progress of resorption and healing.
PMID: 20491837 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Oral Implants Res. 2010 Feb;21(2):201-8. doi: 10.1111/j.1600-0501.2009.01821.x. Epub 2009 Dec 4.
The use of Straumann Bone Ceramic in a maxillary sinus floor elevation procedure: a clinical, radiological, histological and histomorphometric evaluation with a 6-month healing period.
Frenken JW, Bouwman WF, Bravenboer N, Zijderveld SA, Schulten EA, ten Bruggenkate CM.
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands. [email protected]
OBJECTIVES: In this study, we evaluated the quality and quantity of bone formation in maxillary sinus floor elevation procedure using a new fully synthetic biphasic calcium phosphate (BCP) consisting of a mixture of 60% hydroxyapatite and 40% of beta-tricalcium phosphate (Straumann Bone Ceramic). MATERIAL AND METHODS: A unilateral maxillary sinus floor elevation procedure was performed in six patients using 100% BCP. Biopsy retrieval for histological and histomorphometric analysis was carried out before implant placement after a 6-month healing period. RESULTS: In this study, the maxillary sinus floor elevation procedure with the use of BCP showed uneventful healing. Radiological evaluation after 6 months showed maintenance of vertical height gained immediately after surgery. Primary stability was achieved with all Straumann SLA dental implants of 4.1 mm diameter and 10 or 12 mm length. The implants appeared to be osseointegrated well after a 3-month healing period. Histological investigation showed no signs of inflammation. Cranial from the native alveolar bone, newly formed mineralized tissue was observed. Also, osteoid islands as well as connective tissue were seen around the BCP particles, cranial from the front of newly formed mineralized tissue. Close bone-to-substitute contact was observed. Histomorphometric analysis showed an average bone volume/total volume (BV/TV) of 27.3% [standard deviation (SD) 4.9], bone surface/total volume (BS/TV) 4.5 mm(2)/mm(3) (SD 1.1), trabecula-thickness (TbTh) 132.1 mum (SD 38.4), osteoid-volume/bone volume (OV/BV) 7.5% (SD 4.3), osteoid surface/bone surface (OS/BS) 41.3% (SD 28.5), osteoid thickness (O.Th) 13.3 mum (SD 4.7) and number of osteoclasts/total area (N.Oc/Tar) 4.4 1/mm (SD 5.7). CONCLUSIONS: Although a small number of patients were treated, this study provides radiological and histological evidence in humans confirming the suitability of this new BCP for vertical augmentation of the atrophied maxilla by means of a maxillary sinus floor elevation procedure allowing subsequent dental implant placement after a 6-month healing period. The newly formed bone had a trabecular structure and was in intimate contact with the substitute material, outlining the osteoconductive properties of the BCP material. Bone maturation was evident by the presence of lamellar bone.
PMID: 19958374 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Int J Oral Maxillofac Implants. 2009 Nov-Dec;24(6):1093-100.
Clinical histology of microimplants placed in two different biomaterials.
Lindgren C, Sennerby L, Mordenfeld A, Hallman M.
Department of Oral and Maxillofacial Surgery, Dept of Oral and Maxillofacial Surgery, Linköping, Sweden.
PURPOSE: This randomized, controlled study was designed to compare bone formation around microimplants with a sandblasted, acid-etched surface placed at the time of maxillary sinus floor augmentation with a synthetic biphasic calcium phosphate (BCP) or deproteinized bovine bone (DBB). MATERIALS AND METHODS:Nine completely edentulous patients and two partially edentulous patients (six women, five men) with a mean age of 67 years (range, 50 to 79 years) requiring bilateral sinus augmentation were included in the study. The patients were randomized for augmentation with BCP (test) in one side and DBB (control) in the contralateral side. At the time of augmentation, one microimplant on each side was placed vertically from the top of the alveolar crest, penetrating the residual bone and the grafting material. After 8 months of graft healing, at the time of ordinary implant placement, all 22 microimplants were retrieved with a surrounding bone core for histologic analyses. RESULTS:The bone-to-implant contact in the BCP group was 64.6% +/- 9.0%, versus 55.0% +/- 16.0% for the DBB group. The difference was not significant. The corresponding values for the area of newly formed bone in the biopsies were 41.1% +/- 9.8% and 41.6% +/- 14.0% for BCP and DBB, respectively. There were significantly more DBB particles in contact with newly formed bone than BCP particles (87.9 +/- 18.2% versus 53.9 +/- 26.1%; Wilcoxon rank sum test; P = .007). CONCLUSION: In this randomized, controlled clinical trial, new bone formation and bone-to-implant contact around microimplants with a sandblasted, acid-etched surface was found to be equivalent between sinuses augmented with BCP or DBB. Significantly more DBB particles than BCP particles were in contact with newly formed bone, but the clinical relevance of this has yet to be established.
PMID: 20162114 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Oral Implants Res. 2008 Jul;19(7):686-92. doi: 10.1111/j.1600-0501.2008.01539.x. Epub 2008 May 19
Histomorphometric assessment of bone formation in sinus augmentation utilizing a combination of autogenous and hydroxyapatite/biphasic tricalcium phosphate graft materials: at 6 and 9 months in humans.
Artzi Z, Weinreb M, Carmeli G, Lev-Dor R, Dard M, Nemcovsky CE.
Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. [email protected]
OBJECTIVE: The aim of this study was to examine the efficacy of a new biphasic hydroxyapatite/tricalcium phosphate (HA/TCP) bone substitute in combination with particulate autogenous bone in sinus floor augmentation procedures. MATERIAL AND METHODS: A simultaneous or a two-stage sinus augmentation and implant placement were conducted in 28 patients. A mixture of HA/TCP and autogenous bone chips in a 1 : 1 ratio was used as the grafting biomaterial. Cylindrical specimen bone retrieval was performed in all patients except one. Specimens were harvested either at 6 (n=14) or 9 (n=13) months post-augmentation. For histologic and histomorphometric evaluations, the non-decalcified tissue processing (Donath's technique) was performed. RESULTS: Newly formed bone around the grafted particles was found in all samples. The encircling, highly cellular bone followed the outline of the grafted particles in direct contact. Both woven and lamellar types of bone were observed. Morphometrically, the total mean bone area fraction of all sections was 34.8+/-10.3%, increasing from 28.6+/-7.8% at 6 months to 41.6+/-8.3% at 9 months (P<0.001). Mean particle area fraction average was 25.5+/-11.6% and 23.5+/-9.3% at 6 and 9 months, respectively, with a total mean of 24.5+/-10.4%. The increase in bone area fraction was not significantly correlated to the decrease of the grafted particles area fraction. CONCLUSIONS: The biphasic HA/TCP showed biocompatible and osteoconductive properties. This alloplast as a composite with autogenous bone chips promotes newly formed bone, which increases in its fraction along an extended healing period.
PMID: 18492077 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Clin Oral Implants Res. 2008 Aug;19(8):796-803. doi: 10.1111/j.1600-0501.2008.01565.x.
Maxillary sinus grafting with Bio-Oss or Straumann Bone Ceramic: histomorphometric results from a randomized controlled multicenter clinical trial.
Cordaro L, Bosshardt DD, Palattella P, Rao W, Serino G, Chiapasco M.
SourceDepartment of Periodontology and Implant Dentistry, Eastman Dental Hospital, Rome, Italy. [email protected]
INTRODUCTION: This investigation was designed to compare the histomorphometric results from sinus floor augmentation with anorganic bovine bone (ABB) and a new biphasic calcium phosphate, Straumann Bone Ceramic (BCP). MATERIALS AND METHODS: Forty-eight maxillary sinuses were treated in 37 patients. Residual bone width was > or =6 mm and height was > or =3 mm and <8 mm. Lateral sinus augmentation was used, with grafting using either ABB (control group; 23 sinuses) or BCP (test group; 25 sinuses); sites were randomly assigned to the control or test groups. After 180-240 days of healing, implant sites were created and biopsies taken for histological and histomorphometric analyses. The parameters assessed were (1) area fraction of new bone, soft tissue, and graft substitute material in the grafted region; (2) area fraction of bone and soft tissue components in the residual alveolar ridge compartment; and (3) the percentage of surface contact between the graft substitute material and new bone. RESULTS: Measurable biopsies were available from 56% of the test and 81.8% of the control sites. Histology showed close contact between new bone and graft particles for both groups, with no significant differences in the amount of mineralized bone (21.6+/-10.0% for BCP vs. 19.8+/-7.9% for ABB; P=0.53) in the biopsy treatment compartment of test and control site. The bone-to-graft contact was found to be significantly greater for ABB (48.2+/-12.9% vs. 34.0+/-14.0% for BCP). Significantly less remaining percentage of graft substitute material was found in the BCP group (26.6+/-5.2% vs. 37.7+/-8.5% for ABB; P=0.001), with more soft tissue components (46.4+/-7.7% vs. 40.4+/-7.3% for ABB; P=0.07). However, the amount of soft tissue components for both groups was found not to be greater than in the residual alveolar ridge. DISCUSSION: Both ABB and BCP produced similar amounts of newly formed bone, with similar histologic appearance, indicating that both materials are suitable for sinus augmentation for the placement of dental implants. The potential clinical relevance of more soft tissue components and different resorption characteristics of BCP requires further investigation.
PMID: 18705811 [PubMed - indexed for MEDLINE] index clinical studies
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ABSTRACT
Int J Periodontics Restorative Dent. 2008 Jun;28(3):273-81.
Histomorphometric comparison of a biphasic bone ceramic to anorganic bovine bone for sinus augmentation: 6- to 8-month postsurgical assessment of vital bone formation. A pilot study.
Froum SJ, Wallace SS, Cho SC, Elian N, Tarnow DP.
SourceDepartment of Periodontology and Implant Dentistry, College of Dentistry, New York University, New York, USA. [email protected]
This blinded, randomized, controlled pilot investigation is the first to histomorphometrically compare vital bone formation following bilateral sinus grafting with a biphasic calcium phosphate (BCP) (Straumann Bone Ceramic) to an anorganic bovine bone matrix (ABBM) (Bio-Oss) 6 to 8 months following graft placement. Twelve patients were selected. Following elevation of the lateral sinus walls, one material was placed in the right sinus and the other material was placed in the left sinus, as determined by randomization. Six to 8 months after grafting (with the same time frame used for each patient), a trephine core was taken from the grafted area and sent for histomorphometric analysis. Cores were obtained from 21 healed sinuses in 12 patients. Nine patients provided bilateral cores. Histomorphometric analysis of 10 BCP cores and 11 ABBM cores revealed an average vital bone content of 28.35% and 22.27%, respectively. The average percentage of residual graft particles was 28.4% in the BCP cores and 26.0% in the ABBM cores. The difference in vital bone formation was not significantly different (n = 9 patients, paired t test) between bilateral sinuses treated with the BCP and those treated with the ABBM. Histologically, both materials appeared to be osteoconductive and support new bone formation. Future studies are needed to confirm the ability of this regenerated bone to support dental implant maintenance over time.
PMID: 18605603 [PubMed - indexed for MEDLINE] index clinical studies
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Pre-clinical studies with Straumann® BoneCeramic
Abstracts
in vitro: Tissue Eng Part A. 2011 Apr;17(7-8):1147-56. doi: 10.1089/ten.TEA.2009.0577. Epub 2011 Feb 15. Survival of transplanted rat bone marrow-derived osteogenic stem cells in vivo. Zimmermann CE, Gierloff M, Hedderich J, Açil Y, Wiltfang J, Terheyden H.............. 21 Clin Oral Investig. 2012 Jun;16(3):867-78. doi: 10.1007/s00784-011-0558-3. Epub 2011 May 17. Effect of coating Straumann Bone Ceramic with Emdogain on mesenchymal stromal cell hard tissue formation. Mrozik KM, Gronthos S, Menicanin D, Marino V, Bartold PM .................................... 22 Folia Morphol (Warsz). 2006 Feb;65(1):63-5. The ultrastructure and processing properties of Straumann Bone Ceramic and NanoBone. Dietze S, Bayerlein T, Proff P, Hoffmann A, Gedrange T. ......................................... 23 Folia Morphol (Warsz). 2006 Feb;65(1):37-42. The in vitro viability and growth of fibroblasts cultured in the presence of different bone grafting materials (NanoBone and Straumann Bone Ceramic). Kauschke E, Rumpel E, Fanghänel J, Bayerlein T, Gedrange T, Proff P. ................. 24
bone defects: J Biomed Mater Res B Appl Biomater. 2009 Jul;90(1):171-81. doi: 10.1002/jbm.b.31271. Comparative study of biphasic calcium phosphates with different HA/TCP ratios in mandibular bone defects. A long-term histomorphometric study in minipigs. Jensen SS, Bornstein MM, Dard M, Bosshardt DD, Buser D. ................................... 25 Clin Oral Implants Res. 2007 Dec;18(6):752-60. Epub 2007 Sep 20. Evaluation of a novel biphasic calcium phosphate in standardized bone defects: a histologic and histomorphometric study in the mandibles of minipigs Jensen SS, Yeo A, Dard M, Hunziker E, Schenk R, Buser D. ................................... 26
20
Int J Oral Maxillofac Surg. 2007 Dec;36(12):1198-206. Epub 2007 Sep 10. Guided bone regeneration at dehiscence-type defects using biphasic hydroxyapatite + beta tricalcium phosphate (Bone Ceramic) or a collagen-coated natural bone mineral (BioOss Collagen): an immunohistochemical study in dogs. Schwarz F, Herten M, Ferrari D, Wieland M, Schmitz L, Engelhardt E, Becker J. ..... 27
21
ABSTRACT
Tissue Eng Part A. 2011 Apr;17(7-8):1147-56. doi: 10.1089/ten.TEA.2009.0577. Epub 2011 Feb 15.
Survival of transplanted rat bone marrow-derived osteogenic stem cells in vivo.
Zimmermann CE, Gierloff M, Hedderich J, Açil Y, Wiltfang J, Terheyden H.
Department of Oral and Craniomaxillofacial Surgery, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany. [email protected]
This study was designed to trace bone marrow-derived stromal cells (MSC) after implantation in an ectopic rat model of bone tissue engineering. MSC were isolated from adult donor rats, expanded, seeded on a hydroxyapatite/β-tricalcium phosphate bone graft substitute (Straumann® BoneCeramic), and cultivated until confluent. Before subcutaneous implantation of seeded constructs and controls (unseeded bone graft substitute) in isogenic rats (n = 32), cells were labeled with the fluorescent dye carboxyfluoresceine-diacetate-succinimidyl-ester. Specimens were harvested at sacrifice on day 1, 3, 7, or 14 after implantation (n = 8 per group) and processed for histology (hematoxylin and eosin, CD68, 4',6-diamidino-2-phenylindol). Carboxyfluoresceine-diacetate-succinimidyl-ester-labeled transplanted cells were quantified in decalcified sections (50 fields of view per specimen) at 488 nm. Over time, transplanted cells decreased in number from 31.3 ± 2.3 (day 1) to 9.2 ± 1.1 (day 3) and 0.3 ± 0.1 (day 7) (p < 0.001). Fourteen days postimplantation MSC could no longer be identified. Additionally, starting on day 3 postimplantation, cellular disintegration was noted. Multinucleated giant cells were present in constructs and controls on day 7 and increased to day 14 postimplantation. These results indicate that ectopically transplanted MSC survive for a rather short time after implantation. Possible reasons for early cell death are discussed.
PMID: 21142699 [PubMed - indexed for MEDLINE] index pre-clinical studies
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ABSTRACT
Clin Oral Investig. 2012 Jun;16(3):867-78. doi: 10.1007/s00784-011-0558-3. Epub 2011 May 17.
Effect of coating Straumann Bone Ceramic with Emdogain on mesenchymal stromal cell hard tissue formation.
Mrozik KM, Gronthos S, Menicanin D, Marino V, Bartold PM.
Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road Adelaide, South Australia 5005, Australia. [email protected]
Periodontal tissue engineering requires a suitable biocompatible scaffold, cells with regenerative capacity, and instructional molecules. In this study, we investigated the capacity of Straumann Bone Ceramic coated with Straumann Emdogain, a clinical preparation of enamel matrix protein (EMP), to aid in hard tissue formation by post-natal mesenchymal stromal cells (MSCs) including bone marrow stromal cells (BMSCs) and periodontal ligament fibroblasts (PDLFs). MSCs were isolated and ex vivo-expanded from human bone marrow and periodontal ligament and, in culture, allowed to attach to Bone Ceramic in the presence or absence of Emdogain. Gene expression of bone-related proteins was investigated by real time RT-PCR for 72 h, and ectopic bone formation was assessed histologically in subcutaneous implants of Bone Ceramic containing MSCs with or without Emdogain in NOD/SCID mice. Alkaline phosphatase activity was also assessed in vitro, in the presence or absence of Emdogain. Collagen-I mRNA was up-regulated in both MSC populations over the 72-h time course with Emdogain. Expression of BMP-2 and the osteogenic transcription factor Cbfa-1 showed early stimulation in both MSC types after 24 h. In contrast, expression of BMP-4 was consistently down-regulated in both MSC types with Emdogain. Up-regulation of osteopontin and periostin mRNA was restricted to BMSCs, while higher levels of bone sialoprotein-II were observed in PDLFs with Emdogain. Furthermore, alkaline phosphatase activity levels were reduced in both BMSCs and PDLFs in the presence of Emdogain. Very little evidence was found for ectopic bone formation following subcutaneous implantation of MSCs with Emdogain-coated or -uncoated Bone Ceramic in NOD/SCID mice. The early up-regulation of several important bone-related genes suggests that Emdogain may have a significant stimulatory effect in the commitment of mesenchymal cells to osteogenic differentiation in vitro. While Emdogain inhibited AP activity and appeared not to induce ectopic bone formation, longer-term studies are required to determine whether it promotes the final stages of osteoblast formation and mineralization at gene and protein levels. While used in clinical applications, whether Emdogain and other commercial preparations of EMPs truly possess the capacity to induce the regeneration of bone or other components of the periodontium remains to be established.
PMID: 21584694 [PubMed - indexed for MEDLINE] index pre-clinical studies
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ABSTRACT
Folia Morphol (Warsz). 2006 Feb;65(1):63-5.
The ultrastructure and processing properties of Straumann Bone Ceramic and NanoBone.
Dietze S, Bayerlein T, Proff P, Hoffmann A, Gedrange T.
Clinic for Orthodontics and Preventive and Pediatric Dentistry, University of Greifswald Dental School, Greifswald, Germany. [email protected]
The ultrastructure, fundamental chemistry, and processing modes of fully synthetic bone grafting materials are relevant to the reconstruction of osseous defects. Rapid progress in the profitable market of biomaterials has led to the development of various bone substitutes. Despite all these efforts, an ideal and full substitute of autologous bone is not yet in sight. With regard to anorganic calcium phosphate ceramics, Straumann Bone Ceramic and NanoBone are compared. These have a similar composition and are osteoconductive, which indispensably requires contact with well-vascularised bone.
PMID: 16783740 [PubMed - indexed for MEDLINE] index pre-clinical studies
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ABSTRACT
Folia Morphol (Warsz). 2006 Feb;65(1):37-42.
The in vitro viability and growth of fibroblasts cultured in the presence of different bone grafting materials (NanoBone and Straumann Bone Ceramic).
Kauschke E, Rumpel E, Fanghänel J, Bayerlein T, Gedrange T, Proff P.
Institute of Anatomy and Cell Biology, Ernst Moritz Arndt University, Greifswald, Germany. [email protected]
Different clinical applications, including dentistry, are making increasing demands on bone grafting material. In the present study we have analysed the viability, proliferation and growth characteristics of fibroblasts cultured in vitro together with two different bone grafting materials, NanoBone and Straumann Bone Ceramic, over a period of 24 and 28 days respectively. Viability was measured at least every 72 hours by using the alamarBlue assay, a test that measures quantitatively cell proliferation and viability but does not require cell fixation or extraction. After one week of culture fibroblast viability was as high as in controls for both grafting materials and remained high (> 90%) for the duration of the experiment. Cell growth was evaluated microscopically. Scanning electron microscopy revealed a dense fibroblast growth at the surface of both bone grafting materials after three weeks of in vitro culture. Generally, our in vitro analyses contribute to further insights into cell - scaffold interactions.
PMID: 16783734 [PubMed - indexed for MEDLINE] index pre-clinical studies
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ABSTRACT
J Biomed Mater Res B Appl Biomater. 2009 Jul;90(1):171-81. doi: 10.1002/jbm.b.31271.
Comparative study of biphasic calcium phosphates with different HA/TCP ratios in mandibular bone defects. A long-term histomorphometric study in minipigs.
Jensen SS, Bornstein MM, Dard M, Bosshardt DD, Buser D.
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, CH-3010 Berne, Switzerland. [email protected]
Three biphasic calcium phosphate (BCP) bone substitute materials with hydroxyapatite (HA)/tricalcium phosphate (TCP) ratios of 20/80, 60/40, and 80/20 were compared to coagulum, particulated autogenous bone, and deproteinized bovine bone mineral (DBBM) in membrane-protected bone defects. The defects were prepared in the mandibles of 24 minipigs that were divided into four groups of six with healing times of 4, 13, 26, and 52 weeks, respectively. The histologic and histomorphometric evaluation focused on differences in amount and pattern of bone formation, filler degradation, and the interface between bone and filler. Collapse of the expanded polytetrafluoroethylene barrier membrane into the coagulum defects underlined the necessity of a filler material to maintain the augmented volume. Quantitatively, BCP 20/80 showed bone formation and degradation of the filler material similar to autografts, whereas BCP 60/40 and BCP 80/20 rather equaled DBBM. Among the three BCP's, the amount of bone formation and degradation of filler material seemed to be inversely proportional to the HA/TCP ratio. The fraction of filler surface covered with bone was highest for autografts at all time points and was higher for DBBM than BCP 80/20 and 60/40 at the early healing phase. TRAP-positive multinucleated cells were identified on BCP and DBBM surfaces without showing typical signs of resorption lacunae.
PMID: 19085941 [PubMed - indexed for MEDLINE] index pre-clinical studies
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ABSTRACT
Clin Oral Implants Res. 2007 Dec;18(6):752-60. Epub 2007 Sep 20.
Evaluation of a novel biphasic calcium phosphate in standardized bone defects: a histologic and histomorphometric study in the mandibles of minipigs
Jensen SS, Yeo A, Dard M, Hunziker E, Schenk R, Buser D.
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, Berne, Switzerland. [email protected]
OBJECTIVE: A novel biphasic calcium phosphate (CaP) granulate consisting of hydroxyapatite (HA) and beta-tricalciumphosphate (TCP) was compared with pure HA and pure TCP and with autograft as positive control. MATERIALS AND METHODS: Four standardized bone defects were prepared in both mandibular angles of 16 minipigs and grafted with autogenous bone chips, HA, HA/TCP (60% : 40%), or TCP. Histologic and histomorphometric analysis of bone formation and graft degradation followed healing periods of 2, 4, 8, and 24 weeks. RESULTS: 2 weeks: more bone formation in defects filled with autograft than with the three CaP materials (P<0.05). 4 weeks: bone formation differed significantly (P<0.05) between all four materials (autograft>TCP>HA/TCP>HA). 8 weeks: more bone formation in defects with autograft and TCP than with HA/TCP (P<0.05), and HA/TCP had more bone formation than HA (P<0.05). 24 weeks: no difference in bone formation between the groups. Autograft and TCP resorbed quickly and almost completely over 8 weeks, whereas HA/TCP and HA showed limited degradation over 24 weeks. CONCLUSION: All defects healed with mature lamellar bone and intimate contact between bone and the remaining graft material. The rate of bone formation corresponded to the content of TCP in the CaP materials.
PMID: 17888014 [PubMed - indexed for MEDLINE] index pre-clinical studies
27
ABSTRACT
Int J Oral Maxillofac Surg. 2007 Dec;36(12):1198-206. Epub 2007 Sep 10.
Guided bone regeneration at dehiscence-type defects using biphasic hydroxyapatite + beta tricalcium phosphate (Bone Ceramic) or a collagen-coated natural bone mineral (BioOss Collagen): an immunohistochemical study in dogs. Schwarz F, Herten M, Ferrari D, Wieland M, Schmitz L, Engelhardt E, Becker J.
Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany. [email protected]
The aim of this study was to immunohistochemically investigate bone regeneration following application of either hydroxyapatite+beta tricalcium phosphate (BCG) or a collagen-coated natural bone mineral (BOC) in combination with a collagen membrane at dehiscence-type defects in dogs. Standardized buccal dehiscence defects were surgically created following implant bed preparation in six beagle dogs. Defects were randomly filled with either BOC (BioOss Collagen) or BCG (Bone Ceramic) according to a split-mouth design, and covered with a native porcine derived collagen membrane (BioGide). After 1, 4 and 9 weeks of submerged healing, dissected blocks were processed for immunohistochemical (osteocalcin) and histomorphometrical analysis (residual defect length, new bone-implant contact, area of new bone fill, percentage of osseointegrated bone-graft particles). Both groups revealed a significant decrease in mean residual defect length, and increases in mean new bone-implant contact, bone fill and percentage of osseointegrated bone-graft particles after 4 and 9 weeks of healing. Remaining BCG and BOC granules were completely integrated into a secondarily formed network of spongiosa, but there was no osteoclastic activity at the surface of either type of bone-graft particle. Both BCG and BOC may provide an osteoconductive scaffold to support guided bone regeneration procedures at dehiscence-type defects.
PMID: 17826958 [PubMed - indexed for MEDLINE] index pre-clinical studies
