Papers by Keyword: Bone Graft

Abstract: Nowadays, the requirements of scaffolds and bone grafts are increasing along with large defects increasing every year. Furthermore, large defects that occur in human bones are customary. However, this obstacle can be overcome by using 3D printing. This study aims to investigate the morphology, deviation dimension, shrinkage and hardness of hydroxyapatite (HA)/collagen composite, which these materials mimic with human bone. HA/collagen composite was printed using three-dimensional bioprinting based on extrusion with a print speed of 10 mm/min and a layer height of 0.5 mm. The composition of HA and collagen material is 70% and 30%, respectively, where this composition mimics natural bone. Morphology and dimension of HA/collagen composite were obtained by transmission electron microscope. Moreover, the deviation dimension and shrinkage were measured using the Miviewcap optical microscope and software Image J. The resulting HA/collagen composite clearly showed that collagen was in the form of fibers while HA was in an irregular shape. The average width and length of collagen were 5.98 + 0.20 nm and 82.48 + 6.23 nm, respectively. Moreover, the Average width and length of HA were 21.85 + 0.53 nm and 23.30 + 1.33 nm. The average deviation dimension in the X, Y, and Z axes was 2.69%, 1.40%, and 24.12%. Furthermore, shrinkage was 12.27%, 10.18%, and 19.06% on the X, Y, and Z axes. The average hardness of specimen 1 and 2 of HA/collagen composite were 0.0021594 HV.

Abstract: Bone graft materials are widely used in orthopedic and maxillofacial surgeries. The controlled resorbability of the graft material is essential for bone regeneration. Hydroxyapatite and biphasic calcium phosphate bone grafts have poor resorption and limited bone conductive effects. Histology analyses of bone biopsy from SCPC grafted human extraction sockets showed complete bone regeneration and graft resorption in absence of osteoclasts and macrophages. The hypothesis of the present study is that bioactive SCPC inhibits osteoclast’s activity due to the presence of resorbable silica phase in the material. Our objective is to analyze the effect of SCPC dissolution products on the resorption activity of osteoclasts. The conditioned medium was prepared by immersion of SCPC resorbable bioactive SCPC porous granules (Shefabone, Inc, USA) in cell culture medium at various ratios at 37°C for 3 days. The concentration of Si ions released from the SCPC granules into cell culture medium was measured using ICP-OES. Osteoclast precursors derived from human bone marrow were seeded on bone slices and cultured in the conditioned medium containing 10% FBS and osteoclast induction factors. Osteoclast differentiation and resorption were evaluated by TRAP staining and measurement of the volume of resorption pits on the bone slices. Mature multinuclear giant TRAP-positive osteoclasts were observed on the bone substrates after 14 days incubation in control medium containing osteoclast induction factors. In conditioned medium, the number of multinuclear TRAP-positive cells was significantly decreased as the concentration of SCPC dissolved silica increased. The dissolution of silica from SCPC into the culture medium correlates well with down regulation of osteoclast differentiation and the rapid bone regeneration in human bone defects.

Abstract: Introduction. A radicular cyst is an odontogenic cyst originated from residual epithelial cells (remnants of Malassez cells) of periodontal ligaments with the previous history of chronic inflammation. The radicular cyst usually results from traumatized pulp or necrotic pulp that is left untreated. This study aimed to treat the maxillary lateral incisor with necrotic pulp and radicular cyst by apicoectomy, retrograde closure using mineral trioxide aggregate, followed by enucleation and bone graft application. Case Report. A 28-year-old female patient who suffered from recurrence pain and swelling in the right maxillary incisor area came to Gadjah Mada University Dental. The patient had a history of trauma on her maxillary right incisor 12 years ago. Vitality test, percussion test and palpation test showed negative results. Cone beam computed tomography radiograph showed circular radiolucent lesions with a firm radiopaque border surrounding the apical of tooth resulted in a cortical bone loss on the labial aspect. The lateral maxillary incisor was diagnosed as necrotic pulp with the radicular cyst. Conventional endodontic treatment was performed in two visits using calcium hydroxide as intracanal medicament followed by class I composite resin restoration. Apicoectomy procedure was performed on the third visit using mineral trioxide aggregate as retrograde filling material followed by enucleation of radicular cysts and application of bone graft as bone regeneration material. Three months of control after treatment showed good bone tissue regeneration. Post-operative control in the third month showed functional bone tissue regeneration. Conclusion. Apicoectomy and retrograde closure using aggregate mineral trioxide followed by enucleation and bone graft application is a treatment of choice for pulp necrosis with the radicular cyst.

Abstract: Chronic periodontitis characterized by a periodontal pocket over 5 mm, alveolar bone resorption accompanied by tooth mobility, requires periodontal surgical treatment. Conventional surgical treatment can not achieve the regeneration of periodontal tissue and thus requires regenerative procedures, such as with the addition of PRF. PDGF-BB is a growth factor that plays an important role in wound healing. Developments in additional bioactive ingredients in surgical procedures are used to regulate inflammation and increase the speed of the healing process. The purpose of this study was to determine the effect of PRF and bone graft (carbonate apatite) on PDGF-BB levels post-surgical flap in patients with chronic periodontitis. The experimental study with open label and consecutive sampling was conducted on 10 subjects of chronic periodontitis who received surgical flap treatment with bone graft and PRF; and 10 subjects without PRF. GCF samples were collected immediately before surgery and 7 days post flap surgery for examination of PDGF-BB levels by ELISA method. The data were calculated statistically by Mann-Whitney test (p <0.05). The results showed that the mean difference of PDGF-BB level in PRF group was 9.44 pg/ml (-1.20 – 37.79 pg/ml) with p value (0.013) and Non-PRF group was 7.97 pg/ml (-6.62 - 44.42 pg/ml) with p value (0.059). The p value in the PRF group > 0.05 means a significant increase in PDGF-BB levels on the 7^th day post flap surgery. Examination of PDGF levels, especially PDGF-BB, should be done in each healing phase of the wound from the inflammatory phase to the maturation and remodeling phase, for example on the 3^rd, 7^th, 14^th and 28^th days when PDGF levels approach zero and the healing process it's almost over, referring to the results of Alzahrani's research (2018) and also Matsuoka and Grotendorst (1989) which showed higher levels of PDGF-BB and VEGF in GCF on days 1, 3, 7 and 14 after surgery with minimally invasive surgery (MIS) technique. The conclusions of this study showed that the application of Platelet Rich Fibrin (PRF) and bone graft had an effect on the level of Platelet Derived Growth Factor (PDGF-BB) post-surgical flap in patients with chronic periodontitis, and elevated levels of PDGF-BB post-surgical flap with PRF application higher than surgical flap without the PRF application. Increased levels of PGDF-BB in the group applied to the PRF were higher than those that were not applied PRF, although statistically significant differences were not found, there was a tendency for the healing process of the PRF group to be better than the Non PRF group.

Abstract: Platelet Rich Fibrin (PRF) is a platelet that contains growth factor, such Vascular Endothelial Growth Factor (VEGF) that not only have implication in inflammation, stimulate tissue healing but also bone regeneration. The aim of this study was to evaluate the effect of combination PRF with bone graft (carbonate apatite) to VEGF level. This research is an experimental study, with consecutive sampling technique. This research was conducted by selecting 20 subjects (12 male, 8 female) which divided into two groups; 10 subjects in the treatment group were given bone graft and PRF application while another 10 subjects in the control group were given only bone graft without PRF application. The measurement of VEGF level was taken by inserting the paper point no.30 into sulcus before the surgery (D0) and one week after surgery (D7). VEGF level was assessed by ELISA method. All collected data were analyzed by using Wilcoxon test with p <0.05, and Mann-Whitney test with p <0.05. The treatment group, VEGF level at D0 was 3.8 pg/ml and D7 was 8,1 pg/ml. The difference in the level of VEGF was 4.3 pg/ml. The average of the control group at D0 was 4.5 pg/ml and D7 was 5.4 pg/ml, obtained the difference in the level of VEGF 0.9 pg/ml. The Mann Whitney Test analysis showed there was a significant difference between the treatment group and the control group with p-value 0.038. PRF with bone graft application influence the increased level of VEGF.

Abstract: Resorability of 3D printed hydroxyapatite (3DP HA) in deionized water solution which was buffered with succinic acid-NaOH (pH 5.5) and Tris(hydroxymethyl aminomethane) (pH 7.4) for 1, 7, 14 and 28 days was carried out. Weight change and release of calcium (Ca) and phosphorus (P) were used to evaluate the sample resorption. It was found that the weight of samples soaking in both pH 5.5 and 7.4 solutions decreased with increasing soaking times, but the degree of decrease was greater at pH 5.5 than at pH 7.4. ICP-OES results showed that the release of Ca and P in both pH solutions increased with immersing times. The amount of Ca and P released at pH 5.5 was higher than at pH 7.4. Phase composition of the samples and the microstructure of the sample were characterized using XRD and SEM respectively. XRD analysis showed that hydroxyapatite (HA) and octacalcium phosphate (OCP) phases were found at the center of all samples, but the intensity of OCP peaks tended to decrease with increasing times. Only HA was found on the sample surface after immersion in both pH solutions at all soaking periods. After immersion, newly formed crystals were seen both at the center and/or on the surface of samples. These results suggested that pH could influence the resorption of the samples and also the formation of new calcium phosphate crystals.

Abstract: Granule characteristics and the agglomeration ability of 3D printed hydroxyapatite granules (3DP HA) when contacting water were compared to those of commercial bone graft granules based on hydroxyapatite/β-tricalcium phosphate/collagen mixture (Sunmax). Microstructure, phase composition, water absorption and granular agglomeration of the granules were characterized. SEM showed that the granule sizes of Sunmax were in the range of 0.8-1.5 mm whereas that of 3DP HA was relatively more uniform at about 1 mm. 3DP HA granules comprised the weaving of numerous minute crystals containing large pores and having high porosity while Sunmax granules were crushed granules and having low porosity. XRD analysis confirmed that Sunmax granules were biphasic hydroxyapatite and β-tricalcium phosphate while 3DP HA granules were monophasic hydroxyapatite. Sunmax granules exhibited greater agglomeration volume than that of 3DP HA granules. However, the water absorption of 3DP HA granules was greater than that of Sunmax granules. The greater agglomeration ability of Sunmax granules was likely due to the collagen constituent of the granules which could act as adhesive to bind granules together in addition to water capillary action. In contrast, 3DP HA granules formed the agglomeration by the water film due to the capillary action only so the efficiency was lower although the water absorption was greater.

Abstract: Bone grafting is a surgical procedure that replaces missing bone with material from patient′s own body, an artificial, synthetic, or natural substitute. As natural bone grows, it generally replaces the graft material completely, resulting in a fully integrated region of new bone. The type of bone graft are allograft-based bone graft involves allograft bone, Factor-based bone graft are natural and recombinant growth , cell-based bone grafts, ceramic-based bone graft substitutes, polymer-based bone graft. The aim of study are to explore the influence of variations in the composition of alginate 8wt % , 10wt % , 12wt % to the characterization and the role of compacting pressure variation to the characterization of hydroxyapatite – alginate and to explore the best composition variation of alginate in which provides the best characteristics for application as a bone graft. All of the materials were mixed with a magnetic stirrer into liquid until homogeny, dried with oven with temperature of 50 °C, and then frozen for optimalizing the drying with sublimation method. The variation of Alginate composition were 8%wt, 10%wt, 12%wt, while the variation of compaction were 1 N/m², 2 N/m², 3 N/m². The sample characterization used Fourrier Transform Infra Red (FTIR) test, compressive strength test, and MTT Assay test. Based on morphology assay, the pore sizes from samples with greater compaction force produces an increasingly smaller pore size. The result showed that variation of hydroxyapatite – alginate composition had effect to compressive strength value. The higher percentage composition of alginate, the greater pressure will increase the value of its compressive compaction and strength. The result of cytotoxicity test showed that nine samples were non toxic. In this research, the sample with composition 12% wt alginate and 3 N/ m² in compaction was the best characteristic according to mechanical aspect.

Abstract: Bone graft substitute materials play an important role in oral rehabilitation and understanding the biological effects of these materials is important for an optimum use. Many bone graft substitutes have been approved for clinical use but this large variability make it hard to select a graft materials. The present study aimed to evaluate the methods that we can today use to assess the degree of osseointegration of the synthetic bone augmentation materials.For this study we made three study groups, each of them consisting of six laboratory rats. On the maxilla of this animals 3-mm diameter experimental cavities were carried out. For the first study group the cavities were augmented with the collagen fleece Alveoprotect, for the second group with the synthetic bone graft Ossceram nano, and in the third group the experimental cavities were left unaugmented. The obtained samples were subjected to three examination methods: clinical and radiological examination, Optical Coherence Tomography (OCT), and a histological study.The evaluation methods of bone graft materials may be divided in two categories: in vivo and in vitro methods. In vivo methods include clinical evaluation and imagistic such as radiological or computer tomography (CT) evaluation. Even a minimal but careful direct clinical observation allows observing the appearance of the bone defect healing at its different stages. CBCT scan is the imaging method of choice in the graft materials repairment of the osseous defects because provides 3D volumetric measurements of newly formed hard tissues.Optical Coherence Tomography (OCT) is a constantly growing imaging method characterized by high spatial resolution and noninvasive subsurface detection. The OCT allowed us to evaluate the surface and subsurface of the ongoing healing bone defects in a non-destructive manner.For the in vitro methods histological methods represents the classical evaluation of the bone graft materials biological integration. On the histological samples we generally noticed the experimental defects filling with connective tissue with various bone ingrowths from the surrounding bone tissue.However new emerging methods give new opportunities to a more accurate research of this materials. The microcomputed tomography analysis may determine the relationships and differences in three-dimensional bone mineral density and microtrabecular structures between bone grafts and their adjacent native boneTo design and produce an efficient bone graft, the researchers and clinicians should have sufficient knowledge of the characteristics of grafts such as osteogenesis, osteoinductivity, and osteoconductivity, and their other advantages and disadvantages.

Abstract: Benign lytic lesions represent a frequent pathology in our clinic. Regarding therapy, we approach these benign tumors through curettage and filling the defects with bone grafting or bone substitutes like hydroxyapatite crystals and tricalcium phosphate.We want to evaluate the efficiency of both bone grafts and bone substitutes regarding bone consolidation, osseointegration and time until absorption for tricalcium phosphate and hydroxyapatite crystals combination. We analyzed 14 patients treated in our clinic through curettage and defect filling during the last three years: 9 patients’ beneficiated from bone grafting and for the other 5 we used a hydroxyapatite and tricalcium phosphate combination from the same supplier. Diagnoses were bone cyst, non-ossifying fibroma and giant-cell tumor. Therapeutic method was linked with bone graft availability. Follow-up was 24 months through periodical x-ray controls in our clinic. Bone consolidation was satisfactory in all cases with no defect collapse. In conclusion, bone substitutes like combinations of hydroxyapatite crystals and tricalcium phosphate are a useful and safe method for surgical treatment of strictly benign lytic tumors.