This study evaluated the impact of soft tissue grafts to reduce marginal peri-implant recession (MPR) after 1 year of follow-up. A total of 24 patients with one single failing maxillary incisor presenting facial bone dehiscence and receiving an immediate implant, bone graft, and provisional were randomly divided into three groups (n = 8 in each group): control (CTL), collagen matrix (CM), and connective tissue graft (CTG). Clinical, photographic, and tomographic analyses were performed to evaluate tissue alterations. The use of a CTG avoided MPR (P < .05) and provided better contour of the alveolar ridge (P < .01) and greater thickness (P < .05) of the soft tissue at the implant facial aspect.
Aim
To compare the effect of recombinant human bone morphogenetic protein‐2 (rhBMP‐2) in an absorbable collagen sponge carrier (ACS) with autogenous bone graft for augmentation of the edentulous atrophic anterior maxilla.
Methods
Twenty‐four subjects were enrolled in a randomized, controlled, parallel‐group, open‐label clinical trial. Subjects either received rhBMP‐2/ACS (1.5 mg/ml) or particulated autogenous bone harvested from the mandibular retromolar region. A titanium‐mesh was used to provide space and wound stability. A guide was used to standardize clinical recordings using an analogue caliper. Alveolar ridge width was also assessed using cone‐beam computed tomography.
Results
rhBMP‐2/ACS yielded significantly greater radiographic horizontal bone gain compared with autogenous bone graft at immediate subcrestal levels (1.5 ± 0.7 versus 0.5 ± 0.9 mm; p = 0.01); non‐significant differences were observed at mid‐ (2.9 ± 0.8 versus 2.9 ± 0.9 mm; p = 0.98) and apical (1.7 ± 0.9 versus 1.8 ± 1.1 mm; p = 0.85) crestal levels. No significant differences in clinical horizontal bone gain were observed at 6 months between rhBMP‐2/ACS and autogenous bone graft (3.2 ± 0.9 mm versus 3.7 ± 1.4 mm; p = 0.31). Sixty‐two implants were placed after 6 month of healing with no significant differences between groups for number of implants, implant size, primary stability and survival.
Conclusions
rhBMP‐2/ACS appears a realistic alternative for augmentation of the edentulous atrophic anterior maxilla.
Among remarkable discoveries concerning propolis, such as antifungal, antiviral, and antioxidant activities, its anti-inflammatory, and mainly its antibacterial, properties deserve special attention when skin wound healing is concerned. Based on this and knowing the distinctive performance of bacterial (BC) membranes on wound healing, in this work it is proposed to demonstrate the potent antimicrobial activity and wound healing properties of a novel propolis containing biocellulose membrane. The obtained propolis/BC membrane was able to adsorb propolis not only on the surface, but also in its interstices demonstrated by scanning electron microscopy, X-ray diffraction, Fourier transform infrared (FT-IR) spectroscopy, and thermogravidimetric assays. Additionally, the polyphenolic compounds determination and the prominent antibacterial activity in the membrane are demonstrated to be dose dependent, supporting the possibility of obtaining propolis/BC membranes at the desired concentrations, taking into consideration its application and its skin residence time. Finally, it could be suggested that propolis/BC membrane may favor tissue repair in less time and more effectively in contaminated wounds.
Increasing evidence suggests that stromal cell-derived factor-1 (SDF-1/CXCL12) is involved in bone formation, though underlying molecular mechanisms remain to be fully elucidated. Also, contributions of SDF-1b, the second most abundant splice variant, as an osteogenic mediator remain obscure. We have shown that SDF-1b enhances osteogenesis by regulating bone morphogenetic protein-2 (BMP-2) signaling in vitro. Here we investigate the dose-dependent contribution of SDF-1b to suboptimal BMP-2-induced local bone formation; that is, a dose that alone would be too low to significantly induce bone formation. We utilized a critical-size rat calvarial defect model and tested the hypotheses that SDF-1b potentiates BMP-2 osteoinduction and that blocking SDF-1 signaling reduces the osteogenic potential of BMP-2 in vivo. In preliminary studies, radiographic analysis at 4 weeks postsurgery revealed a dose-dependent relationship in BMP-2-induced new bone formation. We then found that codelivery of SDF-1b potentiates suboptimal BMP-2 (0.5 mg) osteoinduction in a dose-dependent order, reaching comparable levels to the optimal BMP-2 dose (5.0 mg) without apparent adverse effects. Blocking the CXC chemokine receptor 4 (CXCR4)/SDF-1 signaling axis using AMD3100 attenuated the osteoinductive potential of the optimal BMP-2 dose, confirmed by qualitative histologic analysis. In conclusion, SDF-1b provides potent synergistic effects that support BMP-induced local bone formation and thus appears a suitable candidate for optimization of bone augmentation using significantly lower amounts of BMP-2 in spine, orthopedic, and craniofacial settings.
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