Influence of surrounding soft tissues on onlay bone graft incorporation

Alberius, Per; Gordh, Monica; Lindberg, Lars; Johnell, Olof

doi:10.1016/s1079-2104(96)80373-8

Cited by 24 publications

(35 citation statements)

References 40 publications

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“…However, non‐pedicled grafts initially obtain nutrients and oxygen through diffusion from surrounding tissues only (Alberius et al. ; Winet ). Hence, impairment of perfusion critically affects bone healing (Glowacki ; Kanczler & Oreffo ).…”

Section: Discussionmentioning

confidence: 99%

Pre‐augmentation soft tissue expansion improves scaffold‐based vertical bone regeneration – a randomized study in dogs

Kaner

Zhao

Arnold

et al. 2016

Clinical Oral Implants Res

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ObjectiveSoft tissue (ST) dehiscence with graft exposure is a frequent complication of vertical augmentation. Flap dehiscence is caused by failure to achieve tension‐free primary wound closure and by the impairment of flap microcirculation due to surgical trauma.Soft tissue expansion (STE) increases ST quality and quantity prior to reconstructive surgery. We hypothesized that flap preconditioning using STE would reduce the incidence of ST complications after bone augmentation and that optimized ST healing would improve the outcome of bone regeneration.Materials and methodsSelf‐filling tissue expanders were implanted in mandibular bone defects in ten beagle dogs. After expansion, alloplastic scaffolds were placed for vertical bone augmentation in STE sites and in control sites without STE pre‐treatment. ST flap microcirculation was analysed using laser Doppler flowmetry. The incidence of graft exposures was evaluated after 2 weeks. Bone formation was assessed after 2 months, using histomorphometry and immunohistochemistry.ResultsTest sites showed significantly less impairment of perfusion and faster recovery of microcirculation after bone augmentation. Furthermore, no flap dehiscences occurred in STE sites. Bone regeneration was found in both groups; however, significantly greater formation of new bone was detected in test sites with preceding STE.ConclusionsPreconditioning using STE improved ST healing and bone formation after vertical augmentation. The combination of STE and the subsequent placement of alloplastic scaffolds may facilitate the reconstruction of severe bone defects.

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Section: Discussionmentioning

confidence: 99%

Pre‐augmentation soft tissue expansion improves scaffold‐based vertical bone regeneration – a randomized study in dogs

Kaner

Zhao

Arnold

et al. 2016

Clinical Oral Implants Res

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“…19,20 Once in the final position, the distance between the mobilized block and the adjacent bone is a critical factor for the type of healing 21-23 : a space 2 mm appears to have the highest potential for healing through osseous union. [24][25][26] Also, the stabilization of the mobilized segment emerges as a crucial moment in promoting osseous repair [27][28][29] : mobility can result in scar formation, encapsulation, and/or sloughing of the segment. Precise and narrow osteotomies and firm immobilization of the relocated segment are the key factors in minimizing transient ischemia of the bone block, favoring clot stabilization and osseous repair.…”

Section: Discussionmentioning

confidence: 99%

Surgical Relocation of a Malpositioned, Unserviceable Implant Protruding Into the Maxillary Sinus Cavity. A Clinical Report

Stacchi

Bonino

Lenarda

2012

Journal of Oral Implantology

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Malpositioned implants always result in significant mechanical and aesthetic restorative challenges. This case report describes the correction of position of an unserviceable osseointegrated implant also protruding into the maxillary sinus cavity. This surgical technique facilitated the relocation of an implant-bony segment into a more favorable aesthetic and biomechanical position in a single stage surgery.

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“…In addition, the periosteum contributes substantially to bone growth. Capillary perfusion impairment or failure in the periosteum is reported to lead to disturbed bone growth especially in association with bone augmentation, bone distraction and cleft surgery [6]. A basic requirement for the preservation of periosteal functions is the presence of adequate blood flow in periosteal vessels.…”

Section: Introductionmentioning

confidence: 99%

“…A basic requirement for the preservation of periosteal functions is the presence of adequate blood flow in periosteal vessels. Especially in bone augmentation procedures, which are routinely performed prior to the insertion of dental implants, the presence of a well-vascularized recipient bed is essential for a successful outcome [6,7]. …”

Section: Introductionmentioning

confidence: 99%

Increase in periosteal angiogenesis through heat shock conditioning

et al. 2011

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ObjectiveIt is widely known that stress conditioning can protect microcirculation and induce the release of vasoactive factors for a period of several hours. Little, however, is known about the long-term effects of stress conditioning on microcirculation, especially on the microcirculation of the periosteum of the calvaria. For this reason, we used intravital fluorescence microscopy to investigate the effects of heat shock priming on the microcirculation of the periosteum over a period of several days.MethodsFifty-two Lewis rats were randomized into eight groups. Six groups underwent heat shock priming of the periosteum of the calvaria at 42.5°C, two of them (n = 8) for 15 minutes, two (n = 8) for 25 minutes and two (n = 8) for 35 minutes. After 24 hours, a periosteal chamber was implanted into the heads of the animals of one of each of the two groups mentioned above. Microcirculation and inflammatory responses were studied repeatedly over a period of 14 days using intravital fluorescence microscopy. The expression of heat shock protein (HSP) 70 was examined by immunohistochemistry in three further groups 24 hours after a 15-minute (n = 5), a 25-minute (n = 5) or a 35-minute (n = 5) heat shock treatment. Two groups that did not undergo priming were used as controls. One control group (n = 8) was investigated by intravital microscopy and the other (n = 5) by immunohistochemistry.ResultsDuring the entire observation period of 14 days, the periosteal chambers revealed physiological microcirculation of the periosteum of the calvaria without perfusion failures. A significant (p < 0.05) and continuous increase in functional capillary density was noted from day 5 to day 14 after 25-minute heat shock priming. Whereas a 15-minute exposure did not lead to an increase in functional capillary density, 35-minute priming caused a significant but reversible perfusion failure in capillaries. Non-perfused capillaries in the 35-minute treatment group were reperfused by day 10. Immunohistochemistry demonstrated an increase in cytoprotective HSP70 expression in the periosteum after a 15-minute and a 35-minute heat shock pretreatment when compared with the control group. The level of HSP70 expression that was measured in the periosteum after 25 minutes of treatment was significantly higher than the levels observed after 15 or 35 minutes of heat shock exposure.ConclusionA few days after heat shock priming over an appropriate period of time, a continuous increase in functional capillary density is seen in the periosteum of the calvaria. This increase in perfusion appears to be the result of the induction of angiogenesis.

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Influence of surrounding soft tissues on onlay bone graft incorporation

Cited by 24 publications

References 40 publications

Pre‐augmentation soft tissue expansion improves scaffold‐based vertical bone regeneration – a randomized study in dogs

Pre‐augmentation soft tissue expansion improves scaffold‐based vertical bone regeneration – a randomized study in dogs

Surgical Relocation of a Malpositioned, Unserviceable Implant Protruding Into the Maxillary Sinus Cavity. A Clinical Report

Increase in periosteal angiogenesis through heat shock conditioning

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