Guided Bone Regeneration of an Atrophic Mandible with a Heterologous Bone Block

Abstract

The aim of this work was to test the effectiveness of using enzymatically deantigenated equine bone block as a scaffold for guided bone regeneration (GBR) during a horizontal augmentation of the lower jaw. A partially edentulous atrophic mandible was augmented using an equine-derived block with an expanded polytetrafluoroethylene membrane. After 8.5 months, two bone core samples were collected at the augmentation site, and implants were placed. A definitive prosthesis delivered 6 months after implant placement provided excellent functional and aesthetic rehabilitation throughout the follow-up period. Histological and histomorphometrical analysis of the biopsies showed newly formed bone to be present and the residual biomaterial was still undergoing remodeling. Comparison of cone beam computed tomography scans taken before augmentation and 26 months later showed maintenance of ridge width and possible corticalization of the vestibular augmented ridge side. The equine-derived bone block placed in accordance with GBR principles provided a successful clinical, radiographic, and histological outcome.

A Preshaped Titanium Mesh for Guided Bone Regeneration with an Equine-Derived Bone Graft in a Posterior Mandibular Bone Defect: A Case Report

“…This seems to confer to the graft remodeling kinetics comparable to that of natural bone; indeed, very few residual biomaterial particles could be identified by histological examination, implying that this equine-derived xenograft can be expected to be nearly completed resorbed 6.5 years after grafting. This result is consistent with the present clinical evidence on this bone substitute [41,42,43,44,45,46,47,48,49,50].…”

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.…”

Relação entre a densidade mineral óssea e a resistência à compressão de blocos ósseos xenógenos / Relationship between bone mineral density and compressive strength of xenogenous bone blocks

“…15 Na sua forma particulada, os biomateriais devem ser usados conjuntamente com outros dispositivos que mantenham o volume do enxerto (e.g., parafusos e/ou telas de titânio), considerando-se que a maxila e mandíbula estão sujeitas a forças mecânicas compressivas, musculares e funcionais. 16 Na sua forma estruturada (blocos), os biomateriais são naturalmente capazes de manter o volume do enxerto. Entretanto, suas características devem idealmente se aproximar às de um enxerto autógeno, i.e., devem ser passíveis de adaptação e fixação ao leito ósseo nativo por meio de parafusosparticularmente por meio da pressão exercida diretamente pela cabeça do parafuso sobre o blocopara garantir a estabilidade e imobilidade do enxerto.…”