Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
Identifieur interne : 000204 ( Pmc/Checkpoint ); précédent : 000203; suivant : 000205Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement
Auteurs : Alberto Ortiz-Vig N ; Sergio Martinez-Villa ; I Aki Suarez ; Fabio Vignoletti ; Mariano SanzSource :
- International Journal of Implant Dentistry [ 2198-4034 ] ; 2017.
Abstract
The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.
In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed using CCXBB as bone replacement grafts. Twenty-six weeks postoperatively, a re-entry procedure was performed to evaluate the bone width for adequate implant placement and two histological specimens were retrieved from each patient, one being processed for ground sectioning and the other for decalcified paraffin-included sections. In non-decalcified sections, the relative proportions occupied by bone, biomaterials, and connective tissue present in the biopsies were identified. In de-calcified sections, structures and cells positive for osteopontin (OPN), tartrate-resistant acid phosphatase activity (TRAP), osteocalcin (OSC), and alkaline phosphatase (ALP) were assessed.
Soft tissue dehiscence occurred during the follow-up in 5 out of 15 patients (33.3%). The mean crest width at baseline was 2.78 mm (SD 0.57) and the mean crest width at re-entry was 6.90 mm (SD 1.22), with a mean ridge width increase of 4.12 mm (SD 1.32). Twenty-six bone biopsies were obtained from 13 patients. Histomorphometric analysis showed a mean of 26.90% (SD 12.21) of mineralized vital bone (MVB), 21.37% (SD 7.36) of residual CCXBB, 47.13% (SD 19.15) of non-mineralized tissue, and 0.92% of DBBM. The immunohistochemical analysis revealed a large number of OPN-positive cells 8.12% (SD 4.73), a lower proportion of TRAP positive multinuclear cells 5.09% (SD 4.91), OSC-positive cells 4.09% (SD 4.34), and a limited amount of ALP positive cells 1.63% (SD 2).
CCXBB achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. In light of the histological outcomes and implant failures, special attention must be placed to prevent soft tissue dehiscence when CCXBB is used in severe atrophic alveolar crests.
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DOI: 10.1186/s40729-017-0087-1
PubMed: 28634845
PubMed Central: 5478548
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement</title>
<author><name sortKey="Ortiz Vig N, Alberto" sort="Ortiz Vig N, Alberto" uniqKey="Ortiz Vig N A" first="Alberto" last="Ortiz-Vig N">Alberto Ortiz-Vig N</name>
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<author><name sortKey="Suarez, I Aki" sort="Suarez, I Aki" uniqKey="Suarez I" first="I Aki" last="Suarez">I Aki Suarez</name>
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<author><name sortKey="Vignoletti, Fabio" sort="Vignoletti, Fabio" uniqKey="Vignoletti F" first="Fabio" last="Vignoletti">Fabio Vignoletti</name>
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<series><title level="j">International Journal of Implant Dentistry</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.</p>
</sec>
<sec><title>Methods</title>
<p>In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed using CCXBB as bone replacement grafts. Twenty-six weeks postoperatively, a re-entry procedure was performed to evaluate the bone width for adequate implant placement and two histological specimens were retrieved from each patient, one being processed for ground sectioning and the other for decalcified paraffin-included sections. In non-decalcified sections, the relative proportions occupied by bone, biomaterials, and connective tissue present in the biopsies were identified. In de-calcified sections, structures and cells positive for osteopontin (OPN), tartrate-resistant acid phosphatase activity (TRAP), osteocalcin (OSC), and alkaline phosphatase (ALP) were assessed.</p>
</sec>
<sec><title>Results</title>
<p>Soft tissue dehiscence occurred during the follow-up in 5 out of 15 patients (33.3%). The mean crest width at baseline was 2.78 mm (SD 0.57) and the mean crest width at re-entry was 6.90 mm (SD 1.22), with a mean ridge width increase of 4.12 mm (SD 1.32). Twenty-six bone biopsies were obtained from 13 patients. Histomorphometric analysis showed a mean of 26.90% (SD 12.21) of mineralized vital bone (MVB), 21.37% (SD 7.36) of residual CCXBB, 47.13% (SD 19.15) of non-mineralized tissue, and 0.92% of DBBM. The immunohistochemical analysis revealed a large number of OPN-positive cells 8.12% (SD 4.73), a lower proportion of TRAP positive multinuclear cells 5.09% (SD 4.91), OSC-positive cells 4.09% (SD 4.34), and a limited amount of ALP positive cells 1.63% (SD 2).</p>
</sec>
<sec><title>Conclusions</title>
<p>CCXBB achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. In light of the histological outcomes and implant failures, special attention must be placed to prevent soft tissue dehiscence when CCXBB is used in severe atrophic alveolar crests.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Implant Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Implant Dent</journal-id>
<journal-title-group><journal-title>International Journal of Implant Dentistry</journal-title>
</journal-title-group>
<issn pub-type="epub">2198-4034</issn>
<publisher><publisher-name>Springer Berlin Heidelberg</publisher-name>
<publisher-loc>Berlin/Heidelberg</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28634845</article-id>
<article-id pub-id-type="pmc">5478548</article-id>
<article-id pub-id-type="publisher-id">87</article-id>
<article-id pub-id-type="doi">10.1186/s40729-017-0087-1</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ortiz-Vigón</surname>
<given-names>Alberto</given-names>
</name>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Martinez-Villa</surname>
<given-names>Sergio</given-names>
</name>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Suarez</surname>
<given-names>Iñaki</given-names>
</name>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vignoletti</surname>
<given-names>Fabio</given-names>
</name>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Sanz</surname>
<given-names>Mariano</given-names>
</name>
<address><phone>+34 913942010</phone>
<email>marsan@ucm.es</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2157 7667</institution-id>
<institution-id institution-id-type="GRID">grid.4795.f</institution-id>
<institution>ETEP Research Group, Facultad de Odontología,</institution>
<institution>Universidad Complutense de Madrid,</institution>
</institution-wrap>
Plaza Ramón y Cajal, 28040 Madrid, Spain</aff>
</contrib-group>
<pub-date pub-type="epub"><day>21</day>
<month>6</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>21</day>
<month>6</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection"><month>12</month>
<year>2017</year>
</pub-date>
<volume>3</volume>
<elocation-id>24</elocation-id>
<history><date date-type="received"><day>21</day>
<month>3</month>
<year>2017</year>
</date>
<date date-type="accepted"><day>12</day>
<month>6</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s). 2017</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.</p>
</sec>
<sec><title>Methods</title>
<p>In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed using CCXBB as bone replacement grafts. Twenty-six weeks postoperatively, a re-entry procedure was performed to evaluate the bone width for adequate implant placement and two histological specimens were retrieved from each patient, one being processed for ground sectioning and the other for decalcified paraffin-included sections. In non-decalcified sections, the relative proportions occupied by bone, biomaterials, and connective tissue present in the biopsies were identified. In de-calcified sections, structures and cells positive for osteopontin (OPN), tartrate-resistant acid phosphatase activity (TRAP), osteocalcin (OSC), and alkaline phosphatase (ALP) were assessed.</p>
</sec>
<sec><title>Results</title>
<p>Soft tissue dehiscence occurred during the follow-up in 5 out of 15 patients (33.3%). The mean crest width at baseline was 2.78 mm (SD 0.57) and the mean crest width at re-entry was 6.90 mm (SD 1.22), with a mean ridge width increase of 4.12 mm (SD 1.32). Twenty-six bone biopsies were obtained from 13 patients. Histomorphometric analysis showed a mean of 26.90% (SD 12.21) of mineralized vital bone (MVB), 21.37% (SD 7.36) of residual CCXBB, 47.13% (SD 19.15) of non-mineralized tissue, and 0.92% of DBBM. The immunohistochemical analysis revealed a large number of OPN-positive cells 8.12% (SD 4.73), a lower proportion of TRAP positive multinuclear cells 5.09% (SD 4.91), OSC-positive cells 4.09% (SD 4.34), and a limited amount of ALP positive cells 1.63% (SD 2).</p>
</sec>
<sec><title>Conclusions</title>
<p>CCXBB achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. In light of the histological outcomes and implant failures, special attention must be placed to prevent soft tissue dehiscence when CCXBB is used in severe atrophic alveolar crests.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Clinical trial</kwd>
<kwd>Bone regeneration</kwd>
<kwd>Alveolar ridge augmentation</kwd>
<kwd>Xenogeneic bone substitutes</kwd>
<kwd>Heterografts</kwd>
<kwd>Histology</kwd>
<kwd>Immunohistochemistry</kwd>
<kwd>Dental implants</kwd>
</kwd-group>
<funding-group><award-group><funding-source><institution>Geistlich Pharma AG</institution>
</funding-source>
<award-id>10828-019</award-id>
</award-group>
</funding-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2017</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Martinez Villa, Sergio" sort="Martinez Villa, Sergio" uniqKey="Martinez Villa S" first="Sergio" last="Martinez-Villa">Sergio Martinez-Villa</name>
<name sortKey="Ortiz Vig N, Alberto" sort="Ortiz Vig N, Alberto" uniqKey="Ortiz Vig N A" first="Alberto" last="Ortiz-Vig N">Alberto Ortiz-Vig N</name>
<name sortKey="Sanz, Mariano" sort="Sanz, Mariano" uniqKey="Sanz M" first="Mariano" last="Sanz">Mariano Sanz</name>
<name sortKey="Suarez, I Aki" sort="Suarez, I Aki" uniqKey="Suarez I" first="I Aki" last="Suarez">I Aki Suarez</name>
<name sortKey="Vignoletti, Fabio" sort="Vignoletti, Fabio" uniqKey="Vignoletti F" first="Fabio" last="Vignoletti">Fabio Vignoletti</name>
</noCountry>
</tree>
</affiliations>
</record>
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