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Fresh-frozen human bone allograft in vertical ridge augmentation: clinical and tomographic evaluation of bone formation and resorption

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Abstract

The aim of the current study is to evaluate fresh-frozen human bone allografts (FHBAs) used in vertical ridge augmentation clinically and by computed tomography, and to analyze the resulting bone formation and graft resorption. Sixteen FHBAs were grafted in the maxillae and mandibles of 9 patients. The FHBAs, which were provided by the Musculoskeletal Tissue Bank of Marilia Hospital (Unioss), were frozen at −80°C. After 7 months, dental implants were placed and bone parameters were evaluated. Vertical bone formation was measured by computerized tomography before (T0) and at 7 months (T1) after the surgical procedure. Bone graft resorption was measured clinically from a landmark screw head using a periodontal probe. The results were analyzed by Student’s t-test. Significant differences existed in the bone formation values at T0 and T1, with an average change of 4.03 ± 1.69 mm. Bone graft resorption values were 1.0 ± 0.82 mm (20%). Implants were placed with varying insertion torque values (35–45 Ncm), and achieved primary stability. This study demonstrates that FHBAs promote satisfactory vertical bone formation with a low resorption rates, good density, and primary implant stability.

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References

  • AATB (1992) General standards of tissue banking, technical manual for muscle-skeletal tissue banking

  • Adell R, Eriksson B, Lekholm U, Branemark P-I, Jemt T (1990) Long-term follow-up study of Osseo integrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 5:347–359

    PubMed  CAS  Google Scholar 

  • Bassetti C, Kallenberger A (1980) Influence of chlorhexidine rinsing on the healing of oral mucosa and osseous lesions. J Periodontol 7(6):443–456

    Article  CAS  Google Scholar 

  • Bauer TW, Musclher GF (2000) Bone graft materials. Clin Orthop 371:10–27

    Article  PubMed  Google Scholar 

  • Branemark P-I, Lindstrom J, Halllén O, Breine U, Jeppson PH, Ohman A (1975) Reconstruction of the defective mandible. Scand J Plast Reconstr Surg 9:116–128

    Article  PubMed  CAS  Google Scholar 

  • Brazaitis MP, Mirvis SE, Greenberg J, Ord RA (1994) Severe retroperitoneal hemorrhage complicating anterior iliac bone graft acquisition. J Oral Maxillofac Surg 52:314–316

    Article  PubMed  CAS  Google Scholar 

  • Buckley SC, Stockley I, Hamer AJ, Kerry RM (2005) Irradiated allograft bone for acetabular revision surgery. Results at a mean of five years. J Bone Joint Surg Br 87:310–313

    PubMed  CAS  Google Scholar 

  • Camargo PM, Lekovic V, Weinlaender M, Klokkevold PR, Kenney EB, Dimitrijevic B, Nedic M, Jancovic S, Orsini M (2000) Influence of bioactive glass on changes in alveolar process dimensions after exodontia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90(5):581–586

    Article  PubMed  CAS  Google Scholar 

  • Carlsson GE, Thilander H, Hedegard B (1967) Histologic changes in the upper alveolar process after extractions with or without insertion of an immediate full denture. Acta Odontol Scand 25(1):21–43

    Article  PubMed  CAS  Google Scholar 

  • Clavero J, Lundgren S (2003) Ramus or chin grafts for maxillary sinus inlay and local onlay augmentation: comparison of donor site morbidity and complications. Clin Implant Dent Relat Res 5(3):154–160

    Article  PubMed  Google Scholar 

  • Czitrom AA, Gross AE, Langer F, Sim FH (1988) Bone banks and allografts in community practice. Instr Course Lect 37:13–24

    PubMed  CAS  Google Scholar 

  • D’Aloja E, Santi E, Aprilli G, Franchini M (2008) Fresh frozen homologous bone in oral surgery: case reports. Cell Tissue Bank 9:41–46. doi:10.1007/s10561-007-9053-0

    Article  PubMed  Google Scholar 

  • Garg AK, Morales MJ, Navarro I, Duarte F (1998) Autogenous mandibular bone grafts in the treatment of the resorbed maxillary anterior alveolar ridge: rationale and approach. Implant Dent 7(3):169–176

    Article  PubMed  CAS  Google Scholar 

  • Greenstein G, Greenstein B, Cavallaro J, Tarnow D (2009) The role of bone decortication in enhancing the results of guided bone regeneration: a literature review. J Periodontol 80(2):175–189. doi:10.1902/jop.2009.080309

    Article  PubMed  CAS  Google Scholar 

  • Hamer AJ, Strachan JR, Black MM, Ibbotson CJ, Stockley I, Elson RA (1996) Biochemical properties of cortical allograft bone using a new method of bone strength measurement. A comparison of fresh, fresh-frozen and irradiated bone. J Bone Joint Surg Br 78(3):363–368

    PubMed  CAS  Google Scholar 

  • Hernandez-Alfaro F, Pages CM, Garcia E, Corchero G, Arranz C (2005) Palatal core graft for alveolar reconstruction: a new donor site. Int J Oral Maxillofac Implants 20(5):777–783

    PubMed  Google Scholar 

  • Heyligers IC, Klein-Nulend J (2005) Detection of living cells in non-processed but deep-frozen bone allografts. Cell Tissue Bank 6:25–31. doi:10.1007/s10561-005-1089-4

    Article  PubMed  Google Scholar 

  • Holtzclaw D, Toscano N, Eisenlohr L, Callan D (2008) The safety of bone allografts used in dentistry. JADA 139(9):1192–1199

    PubMed  CAS  Google Scholar 

  • Itoman M, Nakamura S (1991) Experimental study on allogenic bone grafts. Int Orthop 15(2):161–165

    Article  PubMed  CAS  Google Scholar 

  • Keith JD Jr, Petrungaro P, Leonetti JA, Elwell CW, Zeren KJ, Caputo C, Nikitakis NG, Schopf C, Warner MM (2006) Clinical and histologic evaluation of a mineralized block allograft: results from the development period (2001–2004). Int J Periodontics Restorative Dent 26(4):321–327

    PubMed  Google Scholar 

  • Leonetti JA, Koup R (2003) Localized maxillary ridge augmentation with a block allograft for dental implant placement: case reports. Implant Dent 12(3):217–226

    Article  PubMed  Google Scholar 

  • Malloy KM, Hilibrand AS (2002) Autograft versus allograft in degenerative cervical disease. Clin Orthop Relat Res 394:27–38

    Article  PubMed  Google Scholar 

  • Misch CM (1997) Comparison of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants 12(6):767–776

    PubMed  CAS  Google Scholar 

  • Misch CM, Misch CE, Rresnik RR, Ismail YH (1992) Reconstruction of maxillary alveolar defects with mandibular symphysis grafts for dental implants: a preliminary procedural report. Int J Oral Maxillofac Implants 7(3):360–366

    PubMed  CAS  Google Scholar 

  • Mizutani A, Fujita T, Watanabe S, Sakakida K, Okada Y (1990) Experiments on antigenicity and osteogenicity in allotransplanted cancellous bone. Int Orthop 14:243–248

    Article  PubMed  CAS  Google Scholar 

  • Nissan J, Romanos JE, Mardinger O, Chaushu G (2008) Immediate nonfunctional loading of single tooth implants in the anterior maxila following augmentation with freeze-dried cancellous block allograft: a case series. Int J Oral Maxillofac Implants 23(4):709–716

    PubMed  Google Scholar 

  • Parrish FF (1973) Allograft replacement of all or part of the end of a long bone following excision of a tumor. J Bone Joint Surg Am 55(1):1–22

    PubMed  CAS  Google Scholar 

  • Pelker RR, Friedlaender GE, Marlhan TC, Panjabi MM, Moen CJ (1984) Effects of freezing and freeze-drying on the biomechanical properties of rat bone. J Orthop Res 1(4):405–411

    Article  PubMed  CAS  Google Scholar 

  • Perrott DH, Smith RA, Kaban LB (1992) The use of fresh frozen allogeneic bone for maxillary and mandibular reconstruction. Int J Oral Maxillofac Surg 21(5):260–265

    Article  PubMed  CAS  Google Scholar 

  • Petrungaro PS, Amar S (2005) Localized ridge augmentation with allogenic block grafts prior to implant placement: case reports and histologic evaluations. Implant Dent 14(2):139–148

    Article  PubMed  Google Scholar 

  • Piattelli M, Scarano A, Piattelli A (1996) Vertical ridge augmentation using a resorbable membrane: a case report. J Periodontol 67(2):158–161

    Article  PubMed  CAS  Google Scholar 

  • Pietrokovski J, Massler M (1967) Alveolar ridge resorption following tooth extraction. J Prosthet Dent 17(1):21–27

    Article  PubMed  CAS  Google Scholar 

  • Prousssaefs P, Lozada J, Kleinman A, Rohrer MD (2002) The use of ramus autogenous block grafts for vertical alveolar ridge augmentation and implant placement: a pilot study. Int J Oral Maxillofac Implants 17(2):238–248

    Google Scholar 

  • Rajan GP, Fornaro J, Trentz O, Zellweger R (2006) Cancellous allograft versus autologous bone grafting for repair of comminuted distal radius fractures: a prospective, randomized trial. J Trauma 60(6):1322–1329

    Article  PubMed  Google Scholar 

  • Rozen BBT, Salai M, Herman A, Dudkiewicz I (2009) The effects of prolonged deep freezing on the biomechanical properties os osteochondral allografts. Cell Tissue Banking 10:27–31

    Article  Google Scholar 

  • Schreurs BW, Sloof TJ, Buma P, Gardeniers JW, Huiskers R (1968) Acetabular reconstruction with impacted morsellised cancellous bone graft and cement. A 10- to 15-year follow-up of 60 revision arthroplasties. J Bone Joint Surg Br 80(3):391–395

    Article  Google Scholar 

  • Simion M, Trisi P, Piattelli A (1994) Vertical ridge augmentation using a membrane technique associated with Osseo integrated implants. Int J Periodontics Restorative Dent 14(6):496–511

    PubMed  CAS  Google Scholar 

  • Simpson D, Kakarala G, Hampson K, Steele N, Ashton B (2007a) Viable cells survive in fresh frozen human bone allografts. Acta Orthop 78(1):26–30. doi:10.1080/17453670610013385

    Article  PubMed  Google Scholar 

  • Simpson DKG, Hampson K, Steele N, Ashton B (2007b) Viable cells survive in fresh frozen human bone allografts. Acta Orthopaedica 78(1):26–30

    Article  PubMed  Google Scholar 

  • Smolka W, Bosshardt DD, Mericske-Stern R, Iiguka T (2006) Changes in the volume and density of calvarial split bone grafts after alveolar ridge augmentation. Clin Oral Implants Res 17(2):149–155

    Article  PubMed  Google Scholar 

  • Stevenson S, Li XQ, Davy DT, Klein L, Goldberg VM (1997) Critical biological determinants of incorporation of non vascularized cortical bone grafts. Quantification of a complex process and structure. J Bone Joint Surg Am 79:1–16

    Article  PubMed  CAS  Google Scholar 

  • Tomford WW (2000) Bone allografts: past, present and future. Cell Tissue Bank 1(2):105–109

    Article  PubMed  Google Scholar 

  • Triplett RG, Schow SR (1996) Autologous bone grafts and endosseous implants: complementary techniques. J Oral Maxillofac Surg 54(4):486–494

    Article  PubMed  CAS  Google Scholar 

  • Vaccaro AR, Cirello J (2002) The use of allograft bone and cages in fractures of the cervical, thoracic, and lumbar spine. Clin Orthop Relat Res 394:19–26

    Article  PubMed  Google Scholar 

  • Viscioni AFM, Rigo L, Guidi R, Spinelli G, Carinci F (2009) Retrospective study of standard -diameter implants inserted into allografts. J Oral Maxillofac Surg 67:387–393

    Article  PubMed  Google Scholar 

  • Weyts FA, Bos PK, Dinjens WN, van Doorn WJ, van Biezen FC, Weinans H, Verhaar JA (2003) Living cells in 1 of 2 frozen femoral heads. Acta Odontol Scand 74(6):661–664. doi:10.1080/00016470310018162

    Google Scholar 

  • Wildemann B, Kadow-Romacker A, Pruss A, Hass NP, Schmidmaier G (2007) Quantification of growth factors in allogenic bone grafts extracted with three different methods. Cell Tissue Bank 8:107–114. doi:10.1007/s10561-006-9021-0

    Article  PubMed  CAS  Google Scholar 

  • Zarb GA, Lekholm E (1985) Patient selection and preparation. In: Branemark PI, Zarb GA, Albrektsson T (eds) Tissue integrated protheses, Quintessenz Verlags-GmbH, Berlin, pp 199–209

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Authors and Affiliations

  1. Department of Dental Materials and Prosthesis, São Paulo State University, UNESP, São José dos Campos Dental School, São Paulo, Brazil

    Luis Guilherme Scavone Macedo

  2. Periodontics and Implantology, São Paulo, Brazil

    Luiz Antonio Mazzucchelli-Cosmo

  3. Department of Diagnosis and Surgery, Periodontics Division, São Paulo State University, UNESP, São José dos Campos Dental School, São Paulo, Brazil

    Nelson Luiz Macedo

  4. Bioscience Center for Special Health Care Needs (CEBAPE), São Paulo State University, UNESP, São José dos Campos Dental School, São Paulo, Brazil

    Adriana Socorro Ferreira Monteiro

  5. Periodontics and Implantology, UNISA, Santo Amaro Dental School, São Paulo, Brazil

    Wilson Roberto Sendyk

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  1. Luis Guilherme Scavone Macedo
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  2. Luiz Antonio Mazzucchelli-Cosmo
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  3. Nelson Luiz Macedo
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Correspondence to Nelson Luiz Macedo.

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Macedo, L.G.S., Mazzucchelli-Cosmo, L.A., Macedo, N.L. et al. Fresh-frozen human bone allograft in vertical ridge augmentation: clinical and tomographic evaluation of bone formation and resorption. Cell Tissue Bank 13, 577–586 (2012). https://doi.org/10.1007/s10561-011-9274-0

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  • DOI: https://doi.org/10.1007/s10561-011-9274-0

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