Pre‐augmentation soft tissue expansion improves scaffold‐based vertical bone regeneration – a randomized study in dogs
Identifieur interne : 000584 ( Main/Exploration ); précédent : 000583; suivant : 000585Pre‐augmentation soft tissue expansion improves scaffold‐based vertical bone regeneration – a randomized study in dogs
Auteurs : Do An Kaner ; Han Zhao ; Wolfgang Arnold ; Hendrik Terheyden ; Anton FriedmannSource :
- Clinical Oral Implants Research [ 0905-7161 ] ; 2016.
Abstract
Soft 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.
Self‐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.
Test 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.
Preconditioning 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.
Url:
DOI: 10.1111/clr.12848
PubMed: 27145448
PubMed Central: 5484302
Affiliations:
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Le document en format XML
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<author><name sortKey="Arnold, Wolfgang" sort="Arnold, Wolfgang" uniqKey="Arnold W" first="Wolfgang" last="Arnold">Wolfgang Arnold</name>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<sec id="clr12848-sec-0001"><title>Objective</title>
<p>Soft 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.</p>
<p>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.</p>
</sec>
<sec id="clr12848-sec-0002"><title>Materials and methods</title>
<p>Self‐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.</p>
</sec>
<sec id="clr12848-sec-0003"><title>Results</title>
<p>Test 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.</p>
</sec>
<sec id="clr12848-sec-0004"><title>Conclusions</title>
<p>Preconditioning 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.</p>
</sec>
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