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Guided bone regeneration using individualized ceramic sheets
Maxillofacial Unit Halmstad, Region Halland, Halmstad, Sweden.
Maxillofacial Unit Halmstad, Region Halland, Halmstad, Sweden.
Maxillofacial Unit Halmstad, Region Halland, Halmstad, Sweden.
Maxillofacial Unit Halmstad, Region Halland, Halmstad, Sweden.
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2016 (English)In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 45, no 10, p. 1246-1252, article id S0901-5027(16)30103-5Article in journal (Refereed) Published
Abstract [en]

Guided bone regeneration (GBR) describes the use of membranes to regenerate bony defects. A membrane for GBR needs to be biocompatible, cell-occlusive, non-toxic, and mouldable, and possess space-maintaining properties including stability. The purpose of this pilot study was to describe a new method of GBR using individualized ceramic sheets to perfect bone regeneration prior to implant placement; bone regeneration was assessed using traditional histology and three-dimensional (3D) volumetric changes in the bone and soft tissue. Three patients were included. After full-thickness flap reflection, the individualized ceramic sheets were fixed. The sites were left to heal for 7 months. All patients were evaluated preoperatively and at 7 months postoperative using cone beam computed tomography and 3D optical equipment. Samples of the regenerated bone and soft tissue were collected and analyzed. The bone regenerated in the entire interior volume of all sheets. Bone biopsies revealed newly formed trabecular bone with a lamellar structure. Soft tissue biopsies showed connective tissue with no signs of an inflammatory response. This was considered to be newly formed periosteum. Thus ceramic individualized sheets can be used to regenerate large volumes of bone in both vertical and horizontal directions independent of the bone defect and with good biological acceptance of the material.

Place, publisher, year, edition, pages
Elsevier, 2016. Vol. 45, no 10, p. 1246-1252, article id S0901-5027(16)30103-5
Keywords [en]
ceramic, guided bone regeneration, human, membrane, vertical
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-18160DOI: 10.1016/j.ijom.2016.06.005ISI: 000384858000010PubMedID: 27364369Scopus ID: 2-s2.0-84977637559OAI: oai:DiVA.org:mau-18160DiVA, id: diva2:1462897
Available from: 2020-09-01 Created: 2020-09-01 Last updated: 2025-06-24Bibliographically approved
In thesis
1. On guided bone regeneration using ceramic membranes
Open this publication in new window or tab >>On guided bone regeneration using ceramic membranes
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Regeneration of bone in the oral and maxillofacial region can beachieved with different techniques such as autologous bone grafts,bone substitutes and guided bone regeneration. Guided boneregeneration is defined as creating a space between the bone and itssurrounding tissues, using a barrier that allows new bone to migrateinto the space while preventing other cell types from interfering. Thebarrier material should be biocompatible, have suitable occlusiveproperties and be able to maintain the created space for boneregeneration. A wide range of different materials has been used.The general aim was to evaluate a novel method of guided boneregeneration using designed ceramic space maintaining devices onanimals and humans. An experimental rabbit model was used in studies I, II and III.60 different domes shaped as halfspheres were fixed with titaniumscrews to the skull bone of 30 rabbits. The domes had 5 differentcharacteristics; 1) Dense hydroxyapatite with a moderately roughinner surface (HA rough), 2) Dense hydroxyapatite with a smoothinner surface (HA smooth), 3) Microporous hydroxyapatite with amoderately rough inner surface (HA μ), 4) Dense hydroxyapatite witha moderately rough inner surface and macroscopic holes (HA holes)and 5) Zirconia with a moderately rough inner surface (Zirconia).The domes were left to heal for 12 weeks before the animals wereeuthanized and the results were analysed with histomorphology andmicro-CT. The results revealed that Zirconia with a moderately rough innersurface produced the largest amount of newly formed bone althoughthe results were difficult to interpret as the Zirconia domes weredifficult to X-ray because of the very dense nature of the material.In study IV, 3 patients had bone regeneration treatment with aZirconia barrier. Patient 1 had posterior maxillary bone deficiencyin a transverse direction. Patient 2 had anterior maxillary bonedeficiency in a vertical and transverse direction. Patient 3 hadposterior mandibular bone deficiency in a vertical direction. Basedon individual digital models, Zirconia membranes correspondingto the amount of bone intended to be regenerated were designedand manufactured. The Zirconia membranes, were attached tothe underlying bone with titanium screws and covered with theperiosteum and mucosa. After a mean healing time of 7 months themembranes were removed and dental implants were installed. The results showed new bone regeneration corresponding tothe design of the space maintained. None of the patients had anymajor complications aside from normal postoperative discomfort.According to evaluation with CBCT all patients gained new bone inthe desired and preoperatively planned region.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology, 2016. p. 135
Series
Doctoral Dissertation in Odontology
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7692 (URN)20132 (Local ID)978-91-7104-676-5 (ISBN)978-91-7104-677-2 (ISBN)20132 (Archive number)20132 (OAI)
Note

Note: The papers are not included in the fulltext online.

Paper IV in dissertation as manuscript.

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-16Bibliographically approved

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