A retrospective preliminary histomorphometric and clinical investigation on sinus augmentation using enzyme-deantigenic, collagen-preserving equine bone granules and plasma rich in growth factors

Abstract

Background Enzyme-deantigenic equine bone (EDEB) is a substitute of autogenous bone. Mixing it with plasma rich in growth factors (PRGF) seems a viable option to achieve enhanced bone formation in alveolar bone augmentation surgeries. This retrospective study aims to first report the histomorphometric and clinical outcomes achieved when using the EDEB/PRGF mixture for performing sinus augmentation procedures followed by delayed implant placement. Materials and methods Records of 11 patients who underwent 14 sinus augmentation surgeries using EDEB/PRGF followed by delayed implant placement were retrospectively collected and analyzed to assess histomorphometric data concerning newly formed bone (NFB) and residual biomaterial (RB) recorded at implant placement, marginal bone loss (MBL) values of implants placed in the augmented sinuses, and implant and prosthetic success and survival rates. Results At 5.6 ± 1.1 months after grafting, NFB and RB were 34.0 ± 9.1% and 11.3 ± 2.2% respectively, and no histologic signs of inflammation or immune reaction were observed in any of the 34 bone biopsies being collected. Further, 86.5 ± 4.3 months after implant placement, MBL was 0.40 ± 0.07 mm. No implant or prosthesis failed, and the implant success and survival rates were 100% Conclusions Within the limitations of the present study, grafting EDEB/PRGF for lateral sinus augmentation and delayed implant placement seems to be safe. Compared to published data concerning EDEB alone, results of the present study do not suggest that the EDEB/PRGF combination may provide a histomorphometric or medium-/long-term clinical advantage.

Collagen-Based Biomaterials for Tissue Engineering

“…51 A retrospective clinical study indicated that plasma rich in growth factors (PRGF) added to enzymedeantigenic equine bone (EDEB) may not provide synergistic effects, which needs prospective, comparative studies to verify. 52 BMP-2 plus absorbable collagen sponge showed a larger and faster bone formation area than the BMP-2-coated TCP group and platelet-rich fibrin-mixed TCP group at 2 weeks, which indicates that collagen sponge can be used as a good carrier of such growth factors. 53 Gingival recession is the root surface exposure caused by the retraction of the free gingiva to the root of the enamel cementum boundary, leading to dentin sensitivity, root caries and noncarious defects, food impaction, and aesthetic distress.…”

“…The shape of the disk can repair maxillary sinus fistula, which is easier to operate than granular bone . A retrospective clinical study indicated that plasma rich in growth factors (PRGF) added to enzyme-deantigenic equine bone (EDEB) may not provide synergistic effects, which needs prospective, comparative studies to verify . BMP-2 plus absorbable collagen sponge showed a larger and faster bone formation area than the BMP-2-coated TCP group and platelet-rich fibrin-mixed TCP group at 2 weeks, which indicates that collagen sponge can be used as a good carrier of such growth factors …”

A comparison between anorganic bone and collagen-preserving bone xenografts for alveolar ridge preservation: systematic review and future perspectives

“…The preservation of type I collagen in bone substitutes can improve socket healing in ARP procedures by a series of processes, including (1) enhanced stimulation by endogenous growth factors; (2) longer duration of regenerative stimuli; (3) physiological modulation of bone metabolism and remodeling; and (4) increased osteoblast adhesion, proliferation, and differentiation [95][96][97][98]. Indeed, this might have contributed to the successful clinical outcomes with CBXs use reported for different oral surgery procedures including sinus lift bone grafting [42,[99][100][101][102], ridge augmentation [103][104][105], and peri-implant-guided bone regeneration [106][107][108]. However, direct clinical comparisons between anorganic and CBXs for socket preservation were only reported in three clinical trials [31,38,82], so the superiority of one biomaterial over another has not been established yet.…”

Horizontal GBR with anorganic equine bone combined with a customized titanium mesh

“…Regarding the grafting materials, numerous types have been used in GBR over the years. These include bioceramic materials such as beta‐tricalcium phosphate (β‐TCP), 18 hydroxyapatite (HA), biphasic calcium phosphate (BCP), and freeze‐dried bone allograft (FDBA) 19 as well as heterologous bone substitutes 6,20–24 . Often, bone regeneration is performed using a mix of heterologous bone and autologous bone chips 25 .…”

“…These include bioceramic materials such as beta‐tricalcium phosphate (β‐TCP), 18 hydroxyapatite (HA), biphasic calcium phosphate (BCP), and freeze‐dried bone allograft (FDBA) 19 as well as heterologous bone substitutes. 6 , 20 , 21 , 22 , 23 , 24 Often, bone regeneration is performed using a mix of heterologous bone and autologous bone chips. 25 In this case report, we describe a 60‐year‐old male patient with a large horizontal bone defect in the fourth quadrant who was successfully treated using the GBR technique with a titanium mesh and anorganic equine bone, a slow resorbing biomaterial.…”