Objective: Bone augmentation with the titanium mesh (Ti-mesh) technique is susceptible to a large rate of complications such as morbidity of bone graft donor site, and mesh exposure to the oral cavity. The purpose of this study was to evaluate the efficacy of anorganic bovine bone (ABB) in alveolar bone augmentation with the Ti-mesh technique, as an alternative to autologous bone grafts. In addition, we investigated the effect of platelet rich plasma (PRP) in preventing mesh exposure, by applying it to cover the Ti-mesh. Materials and Methods: The 30 patients recruited for this study underwent 43 alveolar bone augmentation with the Ti-mesh technique using in all of them ABB as graft material. In 15 patients the Ti-meshes were covered with PRP (PRP group) while in the other 15 the Ti-meshes were not (control group). After 6 months, patients were called for clinical, radiographic and histological evaluation, and implant placement surgery. A total of 97 implants were placed in the augmented bone and their evolution was followed up for a period of 24 months. Results: Significant differences were found between the two study groups in terms of complications and bone formation. In the control group 28.5% of the cases suffered from mesh exposure, while in the PRP group, no exposures were registered. Radiographic analysis revealed that bone augmentation was higher in the PRP group than in the control group. Interestingly, mesh exposure seemed to be a risk factor regarding graft resorption and failure. Overall, 97.3% of implants placed in the control group and 100% of those placed in the PRP group were successful during the monitoring period. We suggest that the positive effect of PRP on the Ti-mesh technique is due to its capacity to improve soft tissue healing, thereby protecting the mesh and graft material secured beneath the gingival tissues. Conclusions: Alveolar bone augmentation using ABB alone in the Ti-mesh technique is sufficient for implant rehabilitation. Besides, covering the Ti-meshes with PRP was a determining factor for avoiding mesh exposure in this study. Titanium mesh exposure provoked significant bone loss, but in most cases it did not affect the subsequent placement of implants. Key words: anorganic bovine bone, bone regeneration, platelet rich plasma, titanium mesh, exposure. Clinical Relevance Scientific rationale: Osteoconductive properties of ABB have been described in many bone augmentation procedures with good results, so it seemed reasonable to expect similar outcomes when applied in the Ti mesh technique. Although the use of PRP in bone regeneration is a moot question its effects over soft tissue seems to be clearer. In this study we compare both the efficacy of ABB alone and the effect of PRP over soft tissues in the titanium mesh technique. Principal findings: ABB alone produces sufficient bone volume augmentation for implant rehabilitation and the use of PRP covering the titanium mesh can improve the soft tissue healing over the titanium mesh preventing its exposure. Practical implications:...

In the present study we report a facile and reproducible method of preparing magnetic thermosensitive hybrid material based on P(NIPAM) microgels covered with gamma-Fe2O3 nanoparticles of 6-nm size. The iron oxide nanoparticles provided magnetic response to the microgels. In addition, the presence of the magnetic nanoparticles on the microgels altered their swelling behavior and shifted their volume phase transition temperature to higher values. In particular, for inorganic shells with 18% (w/w) of magnetic nanoparticles the volume phase transition of the microgels was shifted from 36 to 40 degrees C. In contrast, for shells consisting of 38% (w/w) magnetic nanoparticles the volume phase transition of the microgels was almost blocked, thus indicating that the microgel thermal response was strongly affected by the presence of the inorganic nanoparticles. The synthesized thermosensitive magnetic microgels are envisaged to be ideal for potential applications as thermosensitive targeted drug delivery systems.

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