Case of Severe Bone Atrophy of the Posterior Maxilla Rehabilitated With Blocks of Equine Origin Bone

Pistilli, Roberto; Signorini, Luca; Pisacane, Alberto; Lizio, Giuseppe; Felice, Pietro

doi:10.1097/id.0b013e3182777239

Cited by 17 publications

(15 citation statements)

References 31 publications

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“…Allografts and xenografts are osteoconductive but not osteoinductive [4,5], unlike other xenograft equine-derived biomaterials. They are used successfully in several fields of oral surgery [6][7][8][9][10][11][12][13][14] and should be preferred for being resistant to prion infections (i.e., Bovine Spongiform Encephalopathies) [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Comparative Investigation of Cutting Devices on Bone Blocks: An SEM Morphological Analysis

et al. 2019

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Background: Bone regeneration is a reliable technique when the bone volume is insufficient to provide a functional and aesthetic outcome in surgery and implantoprosthesis procedures. When bone blocks are used but do not match the shape of the defect, the block must be adapted. The aim of our research was to evaluate, by Scanning Electron Microscopy (SEM) morphological observation, how different cutting devices modify the bone surface. Method: Four equine bone blocks were divided into 15 cubic shape samples with ultrasonic and sonic tips, as well as diamond, tungsten carbide, and Lindemann burs. The uncut surface of the obtained bone block was used as a control. Two observers independently analyzed the SEM observation recording, including cut precision, depth of incision, thermal damages, and presence of bone debris. For each group, sharpness, depth, carbonization, and bone debris were expressed as mean values. Results: The osteotomy performed with an ultrasonic tip shows the best results, preserving the bone morphology in both quantitative and qualitative analyses. The bone surface appeared sufficiently clean from debris and showed a reduced presence of carbonization. Conclusion: The shaping of the bone block as in vivo osteotomy respects the bone morphology and allows it to achieve the relevant biological and clinical outcome.

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Section: Introductionmentioning

confidence: 99%

“…Moreover, nonantigenic equine bone retains type I collagen, along with a cellular matrix that contains a high amount of growth factors such IGF II, TGF-beta, IGF I, PDGF, bFGF, and BMPs [17]. Many vitro studies show the positive effects of collagen in the production of new bone [7,[18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Comparative Investigation of Cutting Devices on Bone Blocks: An SEM Morphological Analysis

et al. 2019

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“…Equine-derived bone substitutes have shown optimal results in oral surgery and a good safety profile [ 7 , 8 , 11 , 28 – 32 ]. Unlike almost all other heterologous bone grafts, they have also demonstrated osteoinductive properties and the preservation of several growth factors which enhance osteocyte colonization and new bone development [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Wide Anterior Maxillary Reconstruction with Equine Bone Xenograft: A Case Report of 24-Month Follow-Up

Cicco

Colella

Tartaro

et al. 2020

Case Reports in Surgery

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Introduction. Orofacial reconstruction plays an important role in the treatment of patients affected by oral and maxillofacial cancers. Improvements in technologies and studies of biomaterials have widely expanded surgical possibilities to achieve good functional and aesthetic outcomes. By the way, xenografting procedures gained great consensus in the last decades, because of their documented reliability and efficacy. We present a case of anterior maxillary chondrosarcoma (CHS) that has undergone surgical ablation followed by reconstruction with an equine-derived bone xenograft. Case Presentation. A 68-year-old woman affected by CHS of the premaxilla underwent surgical ablation involving the four incisors followed by reconstruction using an equine-derived bone substitute. Bony reconstruction was planned to achieve implant and dental prosthetic rehabilitation at a second surgical time. Primary surgery was carried out without complications. Good integration of the graft was confirmed by radiological examination. At 12-month follow-up, the patient refused the implant placement and spontaneously adopted a mobile prosthesis. One year later, plates and screws were removed, because of the exposure of a titanium plate. The graft was finally rejected within 3 weeks. Discussion. Nonantigenic equine-derived biomaterials have shown reliability and a good safety profile. In the presented case, implant insertion should have been performed 12 months after the primary surgery. During the follow-up, until dental mobile prosthesis was applied, clinical and instrumental examinations demonstrated a good integration of the graft. We suppose that a chronic inflammation of the mucosa led to the exposure of the plate, perhaps due to pressure, minimal movements, or imperfect fitting of the mobile prosthesis. Removal of fixation means was performed to prevent grafting failure, without success. On the other hand, missing load could induce the graft to act just like a prosthesis, without a real process of integration. Safety and reliability of equine-derived bone xenografts cannot be currently confirmed if not followed by implant insertion and dental rehabilitation.

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“…It has been reported that a bone block is a reliable material for regenerative procedures with predictable long-term positive results [ 33 ]. The space maintaining characteristics of the blocks can overcome the poor three-dimensional stability of the particulate substitutes offering an adequate mechanical support to the overlying tissue [ 16 , 34 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

Steam Sterilization of Equine Bone Block: Morphological and Collagen Analysis

Giudice

Rizzo

Centofanti

et al. 2018

BioMed Research International

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Introduction The use of equine bone blocks is widely reported for bone augmentation techniques. The block must be shaped according to the form of the defect that should be regenerated. The shaping could be performed by hand before or during the surgery, in a sterile ambient, or using a CNC milling machine that could not be sterile. The aim of our study was to evaluate if a steam sterilization could provide a medical grade sterilization of the blocks and to evaluate if bone microstructure and collagen structures change after different steam sterilization protocols provided by mainstream autoclave. Materials and Method Two blocks of equine bone were divided into 16 samples. 1 sample was used as control and not submitted to any treatment. 15 samples were infected with a Streptococcus faecalis bacterial culture. The samples were singularly packed, randomly divided into 3 groups, and submitted to autoclave sterilization on the same device. The groups were submitted to a sterilization cycle (Gr. A: 121°C, 1,16 bar for 20′; Gr. B:134°C, 2,16 bar for 4′; Gr. C: 134°C, 2,16 bar for 3.30 min.). 2 samples for each group were evaluated for the sterility. 3 samples for each group were observed at SEM to notice the macro- and microstructure modification and to confocal microscope to observe the collagen. Results All samples were sterile. The SEM evaluation showed, in all groups, a preserved morphological structure. Confocal microscope evaluation shows that the collagen structure appears to be more uniform and preserved in group C. ConclusionData show that autoclave steam sterilization could be reliable to obtain sterilization of equine bone blocks.

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Case of Severe Bone Atrophy of the Posterior Maxilla Rehabilitated With Blocks of Equine Origin Bone

Abstract: The deantigenated equine bone was biocompatible and resorbed only minimally. This material seems to offer excellent potential for being incorporated in a procedure that increases the width of edentulous alveolar crests.

Cited by 17 publications

References 31 publications

Comparative Investigation of Cutting Devices on Bone Blocks: An SEM Morphological Analysis

Comparative Investigation of Cutting Devices on Bone Blocks: An SEM Morphological Analysis

Wide Anterior Maxillary Reconstruction with Equine Bone Xenograft: A Case Report of 24-Month Follow-Up

Steam Sterilization of Equine Bone Block: Morphological and Collagen Analysis

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