bone augmentation materials Dotaz Zobrazit nápovědu
Patologické kostní dutiny v čelistech souvisejí s výskytem kostních cyst a tumorů. U rozsáhlé kostní dutiny po cystektomii se může pooperační hematom při dehiscenci sutury sliznice zánětem rozpadnout. Dutina po cystě je spojená s ústní dutinou, hojí se komplikovaně a dlouhodobě. Je snahou vyplňovat dutiny materiálem, který nejen zmenší jejich objem, ale také stimuluje novou tvorbu kosti. Z materiálů, které sledujeme v rámci výzkumné aktivity, jsme užívali lidskou lyofilizovanou kostní drť (tři díly) a jeden díl trikalciumfosfátu, které jsou smíchány s venózní krví nemocného do vytvoření soudržné hmoty augmentátu. Antibiotika jsme nepřidávali. U nemocných po augmentaci a u kontrolní skupiny bez implantace materiálu pravidelně sledujeme stav kostního hojení a případné komplikace. Dosavadní výsledky u 32 nemocných s vyplněním směsí uvedených materiálů do 21 kostních dutin po cystách a u 11 kostních benigních tumorů ukazují na nekomplikované hojení.
Pathologic bone cavities of jaws are related to occurrence of bone cysts and tumors. In an extensive bone cavity after cystectomy, the post-operative haematoma may disintegrate due to inflammation at the dehiscence of the mucosa suture. The cavity originated by the cyst is connected with the oral cavity; the healing is complicated and long-continuing. We endeavor to fill this cavity with some kind of material that would not only reduce the cavity extent but also stimulate the bone re-creation. Within the framework of our research activity, we applied three shares of human lyophilized bone mash and one share of tricalcium-phosphate, which were mixed with venous blood of the respective patient until consistent material for augmentation was made. No antibiotics were added. Stage of bone healing and possible complications were regularly followed both in patients after augmentation and in a control group of patients without implanted material. Hitherto results revealed non-complicated healing in 32 patients in whom the augmentation with mixture of the above materials had been carried out (21 bone cavities after cysts and 11 benign bone tumors).
Subantrální augmentace (sinus lift) slouží ke zvýšení množství alveolární kostní hmoty laterální maxily potřebné k ukotvení zubních implantátů. Jako augmentační materiál lze použít autogenní kost nebo různé cizorodé materiály, kterými lze autogenní kost do jisté míry nahradit. Autoři pre- zentují histologické nálezy ve vzorcích odebraných 9 měsíců po augmentační operaci za použití autogenní kosti, deproteinované bovinní kosti (Bio-Oss) a beta-trikalciumfosfátu (Cerasorb). Ve všech případech byly pozorovány známky kostní novotvorby v souvislosti s augmentačním mate- riálem. Nová kost se tvořila především na jeho povrchu; v případě Cerasorbu byly nalezeny trá- mečky novotvořené kosti i uvnitř porézních granulí. Ze zjištěných výsledků vyplývá, že hlavním mechanismem, kterým zkoumané augmentační materiály působily kostní novotvorbu, byla osteo- kondukce. Nepřítomnost obrovskobuněčné granulomatózní reakce a výraznějšího zánětu dokládá dobrou snášenlivost použitých materiálů.
Subantral augmentation (sinus lift) is used to increase alveolar bone mass of lateral maxilla in order to insert dental implants. In addition to the autogenous bone several foreign materials can be used for augmentation and they can replace the autogenous bone to some extent. Histological findings in specimens taken nine months after augmentation with the autogenous bone, deproteinised bovine bone (Bio-Oss) and beta-tricalcium phosphate (Cerasorb) are presented. In all cases a new bone formation around the augmentation material was seen. The new bone was deposited predominantly on its surface. In cases with Cerasorb the new bone formation was observed within the porous granules, too. From the obtained results it can be concluded, that the main osteogenetic mechanism in the examined augmentation materials was osteoconduction. The biocompatibility of the used augmentation materials was evidenced by an absence of giant cell granulomatous reaction and of marked inflammatory infiltrate.
- MeSH
- augmentace alveolárního výběžku metody MeSH
- lidé MeSH
- resorpce alveolární kosti terapie MeSH
- Check Tag
- lidé MeSH
PURPOSE: To compare the efficacy of 2 common materials in sinus augmentation surgery and to assess their contribution when enriched with autogenous bone. MATERIALS AND METHODS: The prospective human study was performed in 48 sinus grafting operations using beta-tricalcium phosphate or deproteinized bovine bone (pure or mixed with 10% to 20% autogenous bone) or autogenous bone. Biopsy specimens were taken after 9 months. Statistical evaluation was done with a 2-sample t test (P < .05). RESULTS: When autogenous bone was used, 49.2% +/- 3.1% of new bone was found, which is significantly higher than in all the other groups. A higher proportion (34.2% +/- 13.1%) of the new vital bone was found in the deproteinized bovine bone group, in comparison with the beta-tricalcium phosphate group (21.4% +/- 8.1%) and the beta-tricalcium phosphate composite graft group (24.0% +/- 6.6%; P < .05). No significant differences between single-component grafts and corresponding composite grafts were established. CONCLUSIONS: Sinus augmentation with the aforementioned augmentation materials is a well-accepted procedure. However, autogenous bone alone was the best material. More new bone was found using deproteinized bovine bone than beta-tricalcium phosphate. The addition of 10% to 20% autogenous bone to the bone substitute did not significantly influence the new bone formation.
- MeSH
- dospělí MeSH
- financování organizované MeSH
- fosforečnany vápenaté MeSH
- kostní náhrady MeSH
- lidé středního věku MeSH
- lidé MeSH
- minerály MeSH
- průřezové studie MeSH
- regenerace kostí MeSH
- senioři MeSH
- sinus maxillaris chirurgie MeSH
- skot MeSH
- stomatochirurgické předprotetické výkony metody MeSH
- transplantace kostí MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- skot MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- klinické zkoušky kontrolované MeSH
- srovnávací studie MeSH
- MeSH
- augmentace alveolárního výběžku * metody MeSH
- autologní transplantace MeSH
- buněčná a tkáňová terapie metody MeSH
- dentin * transplantace MeSH
- endoseální implantace zubů MeSH
- extrakce zubů MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- osteogeneze MeSH
- regenerace kostí * MeSH
- techniky in vitro MeSH
- Check Tag
- lidé MeSH
The pilot study deals with the clinical results of the regenerative therapeutical method in intraosseous periodontal defects done by surgical augmentation procedure using a material of a new generation prepared on the basis of a bioactive glass. A group of 10 individuals were treated properly for chronic periodontitis. Some of treated infraalveolar periodontal lesions, both periodontal pockets and interradicular defects, persisted or recurred in posterior teeth. In order to eliminate them they were indicated for advanced periodontal surgery or regenerative surgical therapy stimulating healing processes of supportive tissues, mostly alveolar bone around treated teeth. Relevant clinical parameters, i. e. values of the pocket depth, gingival recession, and loss of attachment were evaluated before and after the periodontal surgery and compared with each other. The therapy led to significant improvement of clinical parameters in terms of the reduction of pocket depth and loss of attachment values.
- MeSH
- biokompatibilní materiály terapeutické užití MeSH
- chronická parodontitida terapie MeSH
- dospělí MeSH
- keramika terapeutické užití MeSH
- kostní náhrady MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- pilotní projekty MeSH
- retrospektivní studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The issue of bone volume loss is playing an increasing role in bone tissue engineering. Research has focused on studying the preparation and use of different types of human or xenogenic materials and their osteogenic properties. An alternative source for this purpose could be autologous extracted teeth. The simple preparation protocol, minimal immune response, and rapid organizing of the newly formed bone with optimal mechanical properties predispose autologous hard teeth tissues (HTTs) as a promising material suitable in the indication of augmentation of maxillary and mandible defects, comparable to other high-end augmentation materials. The aim of this study was to experimentally evaluate the osteogenic potential of ground native autologous HTTs prepared by different demineralization procedures, aimed at potentiating the osteoinductive and osteoconductive properties of their organic components. The results indicate that the most effective preparation process for HTT stimulation is the application of Cleanser for 10 min followed by exposure to 0.6 N HCl for 5 min with a wash in phosphate-buffered saline solution.
- Publikační typ
- časopisecké články MeSH
Uvádíme základní členění náhrad kostní tkáně s jejich klady a zápory, s důrazem na arteficiální náhrady; dále vlastní zkušenosti se dvěma typy náhrad používanými na našem pracovišti a také výhledy biologické augmentace kostní tkáně.
Bone tissue substitutes are divided into basic classification with its pros and cons described. Arteficial bone grafts are especially pointed out in article, publishing our own experience with two specific synthetic preps. Finally there is a blink in the near future of bone tissue augmentation.
- MeSH
- alografty transplantace MeSH
- hojení ran MeSH
- kostní náhrady * klasifikace MeSH
- lidé MeSH
- protézy a implantáty využití MeSH
- transplantace kostí klasifikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Osteoporotic vertebral fractures can be treated by minimally invasive percutaneous vertebral augmentation with bone cement using vertebroplasty or balloon kyphoplasty. Transcutaneous reduction and vertebral body stenting has been the most recent principle. In contrast to balloon placement in kyphoplasty, the stent remains in the vertebral body and supports both the vertebral body and cement filling. In this retrospective study we present the essential information on the method and our first results. MATERIAL AND METHODS: The method of vertebral body stent placement was used in 22 patients treated at 29 levels. Of these, 19 patients with 26 segments followed up for 3 months were evaluated. The group included 12 women and seven men with an average age of 68.3 years (12 to 83). The patients assessed their subjective complaints on the visual analogue scale (VAS) before surgery, and then at 1, 6 and 12 weeks post-operatively. The value of vertebral body reduction was obtained by measurement of anterior, middle and posterior vertebral body heights (AVBH, MVBH and PVBH, respectively) and a change in the vertebral body kyphotic angle (VBKA). RESULTS: Twenty-four vertebrae were treated for osteoporotic fracture and two as preventive stenting in metastatic breast cancer. In 24 fractures, the stents extended fully in 20 vertebrae, i.e., 40 stents. These fractures evidently were not older than 3 months. In four segments, a total of eight stents did not extend at all or did only slightly. The 20 stabilised vertebral bodies had an average AVBH value of 19.41 mm pre-operatively and that of 22.775 mm post-operatively, which is an average increase by 3.365 mm in absolute numbers and by 17.34 %. The average pre- and post-operative MVBH values were 16.625 mm and 23.065 mm, which was improvement by 6.41 mm or by 38.56 %. The average PVBH values pre- and post-operatively were 26.835 mm and 28.31 mm, which meant improvement by 1.475 mm or by 5.5 %. The average correction of the kyphotic angle was 4.58°, i.e., 35.2 %, from a VBKA of 11.71° pre-operatively to 7.13° post-operatively. There were five cases (22.7 %) of cement leakage, i.e., two of ventral leakage, one of lateral leakage, one of dorsal leakage through a canal left in the pedicle by cannula insertion, and a dorsal leakage in metastatic disease. No neurological findings were recorded. The average VAS scores were as follows: 81.4 before surgery, 30.6 at 1 week, 16.3 at 6 weeks and 15.4 at 12 weeks after surgery. DISCUSSION: Two experimental and one clinical study on vertebral body stenting only have been available in the recent relevant literature. In comparison with their results as well as with those of previous reports on vertebroplasty and kyphoplasty, our results showed high quality fracture reduction in all vertebrae. The rapid decrease in pain intensity in our group is comparable with all available groups treated by any method of vertebral body augmentation by cement injection; and cement leakage was recorded in even fewer cases. CONCLUSIONS: The novel method of vertebral body stenting with cement augmentation provides a rapid pain relief, gives stability to fracture reduction and has a low rate of cement leakage. However, care must be taken not to indicate cases with a damaged posterior corticalis of the vertebral body.
- MeSH
- cementování metody využití MeSH
- dospělí MeSH
- fraktury páteře chirurgie MeSH
- interpretace statistických dat MeSH
- kostní cementy terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů MeSH
- nádory prsu chirurgie komplikace MeSH
- osteoporóza chirurgie komplikace MeSH
- páteř chirurgie patologie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- statistika jako téma MeSH
- stenty využití MeSH
- výsledek terapie MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
