Comparison of Autologous and Heterologous
Bone Graft Stability Effects for Filling Maxillary
Bone Gap After Le Fort I Osteotomy

Eser, Cengiz; Gencel, Eyüphan; Gökdoğan, Mahmut; Kesiktaş, Erol; Yavuz, Metin

doi:10.17219/acem/40450

Cited by 18 publications

(11 citation statements)

References 26 publications

(28 reference statements)

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“…Classically, autogenous grafts are indicated for bone regeneration, but with the advent of new biomaterials, other alternatives are viable 4,[6][7][8] . Grafts based on bioactive glass granules are haloplasts materials capable of stimulating osteoblast differentiation and activation via the formation of silica phosphate layers [12][13][14][15][16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

“…Other studies, with longer postoperative periods have proven biomaterial efficacy as accelerators of bone formation and biocompatibility [6][7][8][9][10][12][13][14][15][16][17][18][21][22][23][24][25][26][27][28][29] . S53P4 demonstrated potential as a non-determinant stimulator of bone repair at 6 months, and was biological compatible with maxillary sinus membrane.…”

Section: Discussionmentioning

confidence: 99%

“…Le Fort I osteotomies are indicated for maxillary mobility and repositioning, for the treatment of dento-skeletal discrepancies that affect the middle third of the face. Maxillary advancement and extrusion movements generate inter-segmental bone spaces, with a requirement for bone grafting, proportional to the size of the resulting gaps 4 , 6 – 8 . Our study investigated 25 cases of bone gaps requiring bone grafting, in view of the significant surgical maxillary advancement that resulted in the incidence of considerable gaps, especially in G1 (Table 1 , 2 , 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…Autogenous grafts minimize large bone discontinuities in the osteotomy line 4 , 6 – 8 . Similarly, several bone substitutes have been created to decrease morbidity in patients 9 – 11 .…”

Section: Introductionmentioning

confidence: 99%

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Bioactive glass granules S53P4 in osteotomy Le Fort I

Cruz

Souza

Menezes³

et al. 2020

Sci Rep

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We evaluated bioactive glass graft (S53P4) in patients undergoing Le Fort I osteotomy, with nongrafted patients as controls. Computed tomography facial scans of the 25 patients submitted for Le Fort I were divided into two groups: Group 1-S53P4 group and Group 2-without grafting. CT scans were analyzed in the immediate postoperative period (T1) and 6 months later (T2), for linear bone gap measurements, tomographic radiodensity and behavior of the maxillary sinus. A Kruskal-Wallis test on bone gap data adopted α significance levels (p ≤ 0.05). The Friedman test (p ≤ 0.05) was used to evaluate sinus reaction cores. For gap measurements, we observed a decrease in median data between T1 and T2 in both groups, with statistical significances observed between groups in T0; G1 presented statistical difference in its two studied times (p ≤ 0.0001). For bone density, the studied data behaved inversely. G1′s bone density decreased from T1 to T2, whereas in G2 there was an increase from T1 to T2. S53P4 did not elicit increased reactions and/or sinus infections in the G1 group (p ≥ 1.00). S53P4 did not impact on Le Fort I osteotomies as a coadjuvant and a favorable factor in bone formation, and appeared innocuous in the maxillary sinus. Orthognathic surgery mobilizes and repositions the jaw bone base via osteotomy, to ensure functional and aesthetic results for dental-skeletal discrepancies 1-3. Tridimensional surgical movements of the upper jaw are considered unstable with larger bone gaps, thus increasing the need for bone grafts, especially in upper jaw advances of > 4 mm, which normally generate bone discontinuities of > 3 mm 1-7. Autogenous grafts minimize large bone discontinuities in the osteotomy line 4,6-8. Similarly, several bone substitutes have been created to decrease morbidity in patients 9-11. This follows recent technological innovations that cater for increased tissue regeneration and pathogen inhibition 12-14. In 1969, Hench et al. developed materials based on bioactive glass 12,13. Since then, these materials have been used in modern clinical applications such as dentistry, orthopedic surgeries and otorhinolaryngology 12. S53P4 produces osteoconductive biological responses at tissue-biomaterial interfaces, by forming silica gel layers that attract and differentiate osteoblasts into bone. The material interacts with growth factors to stimulate angiogenesis and pathogen inhibition via elevated pH and osmotic pressure 12,13,15-17. No studies have yet explored S53P4 in linear bone defects of few walls as in Le Fort I osteotomies, considering the anatomical proximity to the maxillary sinus and its behavior in front of bioactive glass. Therefore, we evaluated S53P4 in patients undergoing Le Fort I osteotomies, with non-grafted patients as controls. Materials and methods This retrospective observational case-control study evaluated data from medical records and CT scans of individuals who underwent Le Fort I osteotomy using a bioactive glass graft, when compared with non-grafted individuals. Ethical considerations...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bioactive glass granules S53P4 in osteotomy Le Fort I

Cruz

Souza

Menezes³

et al. 2020

Sci Rep

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“…This implies that reliable results from studies on bovine ribs may be achieved only carrying out a relatively high number of experiments and still they should be interpreted with care. An equine material has been placed on the market as a bone substitute to be used in dentistry, maxillofacial surgery and orthopedics [23,28,29,30,31,32,33,34,35,36]. Interestingly, the process equine bone is subjected to manufacture this graft is a mild, collagen-preserving one, implying that equine bone blocks achieved through this process retain their trabecular structure and their original mechanic characteristics.…”

Section: Introductionmentioning

confidence: 99%

Bone Density and Implant Primary Stability. A Study on Equine Bone Blocks

Orlando

Arosio

et al. 2019

Dentistry Journal

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Previous results on synthetic blocks mimicking bone indicate that bone density can be measured by the friction encountered by a rotating probe while it descends into bone, and that primary implant stability may be measured through the integral (I) of the torque–depth curve at implant insertion. This study aims to repeat those tests on collagen-preserving equine bone blocks as they better reproduce the mechanical properties of natural bone. Fifteen cancellous equine blocks had their density measured using a measuring probe. This was compared to their known physical density through linear regression analysis. Implant placement was carried out into six cancellous equine blocks and primary stability was measured using (I), as well as the insertion torque (IT), the implant stability quotient (ISQ), and the reverse torque (RT). The relation between (I), (IT), (ISQ), and (RT) was investigated by correlation analysis. Bone density measured using the probe correlated significantly with actual density, both with (r = 0.764) and without irrigation (r = 0.977). (I) correlated significantly with IT and RT under all irrigation conditions, and with ISQ only without irrigation (r = 0.886). The results suggest that the probe provides actual bone density measurements. They also indicate that (I) measures primary implant stability and is more sensitive to density variations than IT, RT, and ISQ. Results are consistent with those obtained on synthetic blocks but suggest that equine bone blocks may better reproduce the mechanical properties of human cancellous alveolar bone. This should be the subject of additional studies.

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