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1.
The surgical management of the cavity and bone defects in enchondroma cases: A prospective randomized trial.
Nazarova, NZ, Umarova, GS, Vaiman, M, Asilova, SU, Abba, M, Foonberg, M, Shterenshis, M
Surgical oncology. 2021;:101565
Abstract
BACKGROUND We compared the curettage/bone grafting and the curettage/bone graft substitutes surgical techniques in their relation to functional outcomes, oncologic outcome (recurrence, malignant transformation), the rate of postsurgical complications, durations of surgery and of postsurgical immobilization for hand-localized cases of solitary and multiple enchondromas. METHODS The current prospective randomized trial analyzed 200 adult patients (2012-2017) with enchondroma who underwent surgical intervention. The cases were randomly divided into Group 1 (n = 100; F 56, M 44) for surgeries with curettage and autogenous bone grafting, and Group 2 (n = 100; F 55, M 45) for surgeries with curettage and bone graft substitutes. The placebo control Group 3 consisted of cases operated by curettage only (n = 56; F 31, M 25). The follow-up period was set at 30 months. RESULTS The duration of surgery was 51 ± 4 min in Group 1 and 27 ± 1 min in Group 2 (p = 0.008). In Group 1, the rate of recurrence was 6% against 1% in Group 2 (p = 0.005). No other statistically significant differences in postsurgical outcomes between three involved groups were noted. CONCLUSION In cases of enchondroma of the hand, postsurgical functional outcomes, the rate of postsurgical complications, the duration of immobilization, and the time to complete recovery are not influenced by the type of chosen grafting material. The implementation of HAp-collagen bone substitutes in granules instead of autogenous bone grafting reduces the duration of surgery. The implementation of autogenous bone grafting may increase the rate of tumor recurrence.
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2.
Stentoplasty with Resorbable Calcium Salt Bone Void Fillers for the Treatment of Vertebral Compression Fracture: Evaluation After 3 Years.
Chen, M, Wang, R, Jia, P, Bao, L, Tang, H
Clinical interventions in aging. 2021;:843-852
Abstract
PURPOSE The aim of the study is to investigate the clinical and radiological outcomes of vertebral compression fractures treated by stentoplasty with resorbable calcium salt bone void fillers compared with balloon kyphoplasty (BKP). METHODS This prospective study included patients with fresh mono-thoracolumbar vertebral compression fractures. Patients enrolled were randomly divided into three groups. The patients in group A underwent stentoplasty with calcium sulfate/calcium phosphate (CSCP) composite filler and patients in group B with hydroxyapatite/collagen (HAP/COL) composite filler, while patients in group C underwent BKP with polymethylmethacrylate (PMMA). The clinical outcome was evaluated with visual analogue pain scale (VAS) and Oswestry disability score (ODI). The radiological results were evaluated with anterior height (AH) and Cobb angle of vertebral body. Computed tomography (CT) was used to assess osteogenesis effect. RESULTS Each group included 14 patients. The VAS, ODI, Cobb angle and AH were statistically improved compared with preoperative and there was no significant difference between the three groups. However, the AH in group A and group B at 1-year follow-up presented slight loss compared with 1 day after surgery. CT results suggested both group A and group B presented obvious bone trabecula formation and variations of CT value. CONCLUSION The stentoplasty with resorbable calcium salt bone void fillers demonstrated clinical outcomes similar to traditional BKP for vertebral compression fractures. Both HAP/COL and CSCP performed certain osteogenesis. However, stentoplasty with studied fillers showed slight loss of AH within 1 year after surgery.
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3.
Evaluation of the Efficacy of a 1:1 Mixture of β-TCP and rhPDGF-BB in the Surgical Management of Two- and Three-Wall Intraosseous Defects: A Prospective Clinical Trial.
Kavyamala, D, G, NVS, Dwarakanath, CD, Anudeep, M
The International journal of periodontics & restorative dentistry. 2019;(1):107-113
Abstract
The aim of this split-mouth clinical and radiographic study was to evaluate and compare the regenerative potential of a combination of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and beta tricalcium phosphate (β-TCP) to the established technique of bone grafting with β-TCP alone in the surgical management of intraosseous defects. A total of 24 sites in 12 subjects with intraosseous defects were included and randomly divided into test (rhPDGF-BB + β-TCP) and control (β-TCP alone) sites. Clinical parameters were recorded at baseline, 3 months, and 6 months. Radiographic parameters were evaluated at baseline and 6 months. Both groups showed statistically significant reductions of all clinical parameters. Intergroup comparison demonstrated a significantly greater probing pocket depth reduction and clinical attachment level gain in the test group. The mean percentage defect fill was significantly greater in the test group than in the control group at 3 and 6 months, and greater improvement in defect angle was also evident in the test group. Although both groups showed definitive improvements in all parameters, the test group showed significantly better results when used to treat human periodontal intraosseous defects.
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4.
Prospective and Randomized Evaluation of ChronOS and Bio-Oss in Human Maxillary Sinuses: Histomorphometric and Immunohistochemical Assignment for Runx 2, Vascular Endothelial Growth Factor, and Osteocalcin.
Bonardi, JP, Pereira, RDS, Boos Lima, FBDJ, Faverani, LP, Griza, GL, Okamoto, R, Hochuli-Vieira, E
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 2018;(2):325-335
Abstract
PURPOSE The aim of this study was to compare ChronOS (β-tricalcium phosphate), Bio-Oss, and their addition to an autogenous bone graft in a 1:1 ratio in human maxillary sinus bone augmentation. MATERIALS AND METHODS Thirty maxillary sinuses were divided in 5 groups: group 1 included 6 maxillary sinuses grafted with autogenous bone graft alone; group 2 included 6 maxillary sinuses grafted with ChronOS; group 3 included 6 maxillary sinuses grafted with ChronOS and autogenous bone graft in a 1:1 ratio; group 4 included 6 maxillary sinuses grafted with Bio-Oss; and group 5 included 6 maxillary sinuses grafted with Bio-Oss and autogenous bone graft in a 1:1 ratio. The number of samples for each group was determined by the statistical power test. RESULTS The median areas of new bone formation in groups 1, 2, 3, 4, and 5 were 121,917.0, 83,787.0, 99,295.0, 65,717.0, and 56,230.0 μm2, respectively. Statistically significant differences were found between groups 3 and 5, groups 1 and 4, and groups 1 and 5 (P < .05). The median areas of remaining biomaterial were 2,900.5, 5,291.0, 2,662.0, 56,258.5, and 64,753.5 μm2 in groups 1, 2, 3, 4 and 5, respectively. Statistically significant differences occurred between groups 1 and 5, groups 3 and 5, and groups 2 and 5 (P < .05). Areas of connective tissue were 67,829.0 ± 22,984.6 μm2 in group 1, 97,445.9 ± 18,983.3 μm2 in group 2, 88,256.0 ± 21,820.5 μm2 in group 3, 65,501.8 ± 6,297.6 in group 4, and 70,203.2 ± 13,421.3 μm2 in group 5. CONCLUSIONS ChronOS combined with autogenous bone graft presented a behavior similar to that of autogenous bone graft alone. However, the groups treated with Bio-Oss showed immuno-labeling results indicating maturation of grafted bone.
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5.
Bone Incorporation of Silicate-Substituted Calcium Phosphate in 2-Stage Revision Anterior Cruciate Ligament Reconstruction: A Histologic and Radiographic Study.
von Recum, J, Schwaab, J, Guehring, T, Grützner, PA, Schnetzke, M
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2017;(4):819-827
Abstract
PURPOSE To evaluate the histologic and radiographic outcomes of using silicate-substituted calcium phosphate (Si-CaP) as bone graft substitute for the augmentation of tunnel defects in 2-stage revision anterior cruciate ligament (ACL) reconstruction. METHODS Forty patients undergoing 2-stage revision ACL reconstruction were included in a prospective, randomized controlled clinical trial between 2012 and 2015. The inclusion criteria were tunnel diameter of the tibial and/or femoral tunnel of 10 mm or greater after failed ACL reconstruction. Twenty patients received autologous bone from the iliac crest and 20 patients received Si-CaP as a bone graft substitute for tunnel grafting at the first-stage procedure. Punch biopsy specimens of the augmented tunnels were taken at the second-stage procedure, and histologic examination included quantitative analysis of the area of immature bone formation, lamellar bone, and bone marrow. Radiographic analysis included determination of the filling rates of the tunnels on postoperative computed tomography scans. RESULTS Forty patients with a mean age of 32 years (standard deviation [SD], 11.0 years) were analyzed. Histologic examination of the tunnels filled with Si-CaP showed that 15% (SD, 14%) of the area was covered with immature bone formation, 41% (SD, 10%) with well-organized lamellar bone, and 44% (SD, 8%) with bone marrow. In the control group (autologous bone), 58% (SD, 3%) of the area was covered with well-organized lamellar bone and 42% (SD, 3%) with bone marrow. Quantitative evaluation of the postoperative computed tomography scans showed a trend of better filling rates in patients with Si-CaP for the tibial tunnel (86% [SD, 17%] vs 78% [SD, 14%]; P = .131). Intraoperatively, Si-CaP was completely integrated into the original bone tunnel providing good stability for tunnel placement and tendon graft fixation comparable to autologous bone. CONCLUSIONS Si-CaP as bone graft substitute for tunnel augmentation in 2-stage revision ACL reconstruction shows good histologic, radiographic, and intraoperative integration comparable to autologous bone. LEVEL OF EVIDENCE Level I, prospective randomized controlled trial.
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6.
Cone Beam Computed Tomography Assessment of Maxillary Sinus Floor Augmentation Using Beta-Tricalcium Phosphate Alone or in Combination with Platelet-Rich Plasma: A Randomized Clinical Trial.
Kiliç, SC, Güngörmüş, M
The International journal of oral & maxillofacial implants. 2016;(6):1367-1375
Abstract
PURPOSE The aim of this study was to evaluate and compare the long-term clinical and radiographic outcomes between a bone graft substitute mixture (beta-tricalcium phosphate [β-TCP] and plateletrich plasma [PRP]) and β-TCP bone graft substitute alone used for sinus floor elevation. MATERIALS AND METHODS This randomized clinical trial included patients with an atrophic maxilla referred for maxillary sinus floor elevation. The elevated sinus cavities of patients were randomly filled with β-TCP plus PRP (study group) or β-TCP alone (control group). Residual bone crest height, vertical bone height gain, and bone graft resorption were measured on cone beam computed tomography (CBCT) images at 10 days and 6 months postoperatively. Incidence of sinus membrane perforations and maxillary sinus infections were recorded. Paired t and Student t tests were used for intragroup and intergroup comparisons, respectively. RESULTS The sample was composed of 18 subjects: nine subjects in the control group (mean age, 31.51 years) and nine subjects in the study group (mean age, 34.01 years). The mean residual bone crest height was found to be < 5 mm in both groups (4.88 mm in the control group and 2.70 mm in the study group, with no significant difference). From the 10-day to 6-month postoperative visit, mean vertical bone height gains were changed from 12.48 to 11.59 mm in the study group and from 14.77 to 13.19 mm in the control group, with no significant difference. The mean vertical bone graft resorption was -1.58 mm in the study group and -0.89 mm in the control group, with no significant difference. Sinus membrane perforation was observed in 3 of 18 patients. CONCLUSION In this study, PRP plus β-TCP graft substitute did not produce significantly more vertical bone height gain or significantly less vertical bone graft resorption compared with β-TCP graft substitute alone. Within the limitations of this study, however, it can be concluded that both grafting materials produced sufficient vertical bone height gain for safe implant placement.
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7.
The influence of particulated autogenous bone on the early volume stability of maxillary sinus grafts with biphasic calcium phosphate: a randomized clinical trial.
Kühl, S, Payer, M, Kirmeier, R, Wildburger, A, Acham, S, Jakse, N
Clinical implant dentistry and related research. 2015;(1):173-8
Abstract
BACKGROUND It is unknown whether autogenous bone impacts the grafts' stability when added to biphasic calcium phosphate (BCP) within the first six months of maxillary sinus augmentation (MSA). PURPOSE To investigate the volume stability of BCP alone and in mixtures with autogenous bone for MSA. MATERIALS AND METHODS Bilateral maxillary sinus augmentation was performed in eight patients in a split-mouth design using BCP at the control site and adding particulated autologous bone at the test site (BCPAB). Based on 16 computed tomography (CT) the volumetric changes were evaluated using the Voxim® software (version 6.3, IVS Technology GmbH, Chemnitz, Germany) by comparing the graft volumes within two weeks of the sinus lift procedure with CT data obtained six months later. Changes of the graft volumes were calculated and statistically significant differences between the two groups were evaluated. RESULTS Overall, the volumes decreased by 15% for BCP and 18% for BCPAB. The time-dependent decreases were statistically significant in both groups. Differences between the two groups were not statistically significant (p = .065). CONCLUSIONS An evident decrease of graft volume over the first 6 months of healing has to be expected irrespective of bone graft composite. Autogenous bone seems to have no evident impact on the volume decrease when added to BCP.
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8.
A prospective randomized comparison of PEEK cage containing calcium sulphate or demineralized bone matrix with autograft in anterior cervical interbody fusion.
Xie, Y, Li, H, Yuan, J, Fu, L, Yang, J, Zhang, P
International orthopaedics. 2015;(6):1129-36
Abstract
PURPOSE A variety of bone substitutes have been successfully used to fill PEEK cages in cervical interbody fusion in order to avoid the complications related to bone harvesting from the donor site. However, no controlled study has previously been conducted to compare the effectiveness of PEEK interbody cages containing calcium sulphate/ demineralized bone matrix (CS/DBM) with autogenous cancellous bone for the treatment of cervical spondylosis. The objective of this prospective, randomized clinical study was to evaluate the effectiveness of implanting PEEK cages containing CS/DBM for the treatment of cervical radiculopathy and/or myelopathy. METHODS Sixty-eight patients with cervical radiculopathy and/or myelopathy were randomly assigned to receive one- or two-level discectomy and fusion with PEEK interbody cages containing CS/DBM or autogenous iliac cancellous bone (AIB). The patients were followed up for two years postoperatively. The radiological and clinical outcomes were assessed during a two-year follow-up. RESULTS The mean blood loss was 75 ± 18.5 ml in the CS/DBM group and 100 ± 19.6 ml (P < 0.01) in the AIB group. The fusion rate was 94.3 % in the CS/DBM group and 100 % in the AIB group at 12-month follow-up. The fusion rate was 100 % at final follow-up in both groups. No significant difference (P > 0.05) was found regarding improvement of JOA score and segmental lordosis as well as neck and arm pain at all time intervals between the two groups. The total complication rate was significantly higher (P < 0.05) in the AIB group than in the CS/DBM group, but there was no significant difference between the two groups (P > 0.05) when comparing the complications in the neck. CONCLUSIONS In conclusion, the PEEK interbody fusion cage containing CS/DBM or AIB following one- or two-level discectomy had a similar outcome for cervical spondylotic radiculopathy and/or myelopathy. The rate of fusion and the recovery rate of JOA score between the two groups were the same. The filling of CS/DBM in the PEEK cage instead of AIB has the advantage of less operative blood loss and fewer complications at the donor site.
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9.
Efficacy of nanocrystalline bone substitute biphasic calcium phosphate/poly-DL-lactide-co-glycolide for periodontal intrabony defects filling.
Stevanović, M, Biočanin, V, Nedkić, M, Ignjatović, N
Vojnosanitetski pregled. 2015;(8):689-95
Abstract
BACKGROUND/AIM: Different bone substitutes have been used for filling and reparation of intrabony defects. The aim of this study was to compare nanocrystalline material, biphasic calcium phosphate poly-DL-lactide-co-glycolide (BCP/PLGA) with deproteinised bovine bone (DPBB) and beta-tricalcium phosphate (P-TCP) in the treatment of periodontal intrabony defects. METHODS The study included 24 patients with bilateral, intrabony defects in the region of the upper first and second premolar, and the upper first molar. On one side of the mouth, DPBB (BioOss) was used to fill defects in upper premolars while P-TCP (RTR) was used for the upper first molar. BCP/PLGA was applied into periodontal defects of the upper premolars and upper first molar of the opposite side. RESULTS The comparison of the BCP/PLGA and the P-TCP group, 6 months following filling of defects, showed a statistically significant reduction of periodontal pocket depth (PPD) and the position of the cement-enamel junction (CEJ) in the group with BCP/PLGA, when compared to the beta-TCP group. The reduction of PPD and CEJ was similar in the groups treated with BCP/PLGA and DPBB. CONCLUSION Significant reductions of PPD and CEJ were registered in the group with BCP/PLGA when compared to the beta-TCP group.
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10.
Use of autogenous bone and beta-tricalcium phosphate in maxillary sinus lifting: a prospective, randomized, volumetric computed tomography study.
Gorla, LF, Spin-Neto, R, Boos, FB, Pereira, Rdos S, Garcia-Junior, IR, Hochuli-Vieira, E
International journal of oral and maxillofacial surgery. 2015;(12):1486-91
Abstract
The correction of bone defects can be performed using autogenous or alloplastic materials, such as beta-tricalcium phosphate (β-TCP). This study compared the changes in bone volume (CBV) after maxillary sinus lifting using autogenous bone (n = 12), autogenous bone associated with β-TCP 1:1 (ChronOS; DePuy Synthes, Paoli, CA, USA) (n = 9), and β-TCP alone (n = 11) as grafting material, by means of cone beam computed tomography (CBCT). CBV was evaluated by comparing CBCT scans obtained in the immediate postoperative period (5-7 days) and at 6 months postoperative in each group using OsiriX software (OsiriX Foundation, Geneva, Switzerland). The results showed an average resorption of 45.7 ± 18.6% for the autogenous bone group, 43.8 ± 18.4% for the autogenous bone+β-TCP group, and 38.3 ± 16.6% for the β-TCP group. All bone substitute materials tested in this study presented satisfactory results for maxillary sinus lifting procedures regarding the maintenance of graft volume during the healing phase before the insertion of implants, as assessed by means of CBCT.