344 research outputs found

    Biologic Agents to Promote Periodontal Regeneration and Bone Augmentation

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    Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142088/1/cap0080.pd

    Effect of Membrane Exposure on Guided Bone Regeneration: A Systematic Review and Meta‐Analysis

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    Aims: This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri-implant sites and edentulous ridges. Material and Methods: Electronic and manual literature searches were conducted by two independent reviewers using four databases, including MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, for articles up to February 2017. Articles were included if they were human clinical trials or case series reporting outcomes of GBR procedures with and without membrane exposure. A random-effects meta-analysis was conducted, and the weighted mean difference (WMD) between the two groups and 95% confidence interval (CI) were reported. Results: Overall, eight articles were included in the quantitative analysis. The WMD of the horizontal bone gain at edentulous ridges was −76.24% (95% CI = −137.52% to −14.97%, p = .01) between sites with membrane exposure and without exposure. In addition, the WMD of the dehiscence reduction at peri- implant sites was −27.27% (95% CI of −45.87% to −8.68%, p = .004). Both analyses showed significantly favorable outcomes at the sites without membrane exposure. Conclusion: Based on the findings of this study, membrane exposure after GBR procedures has a significant detrimental influence on the outcome of bone augmentation. For the edentulous ridges, the sites without membrane exposure achieved 74% more horizontal bone gain than the sites with exposure. For peri-implant dehiscence defects, the sites without membrane exposure had 27% more defect reduction than the sites with exposure

    Stem cell therapy for reconstruction of alveolar cleft and trauma defects in adults: A randomized controlled, clinical trial

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    BackgroundStem cell therapy with bone marrow‐derived mesenchymal stem cells is a promising tissue engineering strategy to promote regeneration of craniofacial bone.PurposeTo determine whether cell therapy with ex vivo expanded stem cell populations would be safe and efficacious in the regeneration of large alveolar defects in patients with a history of cleft palate or craniofacial trauma.Materials and MethodsEighteen patients (10 patients with traumatic injury and 8 patients with cleft palate) presenting with missing teeth associated with horizontal alveolar bone deficiencies were included in this randomized controlled clinical trial. Patients were randomized to receive either conventional autogenous block grafts or stem cell therapy. After a healing period of 4 months the treated sites were re‐entered and the bone width re‐assessed prior to implant placement. Implant stability was evaluated through torque testing of the implant upon insertion and at 6 months postloading.ResultsThe mean gain in bone width was 1.5 ± 1.5 mm in the stem cell therapy group and 3.3 ± 1.4 mm in the control group. Overall, bone gain was higher in trauma patients as compared to patients with cleft palate, for both the control and the stem cell therapy groups. Most postoperative complications were wound dehiscences and incision line openings. Implants were placed successfully in 5 out of 10 patients in the stem cell therapy group and in all 8 patients in the control group. One implant from the control/cleft palate group failed before loading, while the rest of the implants were loaded successfully and remained stable at 6 months. The patients who did not receive implants were re‐treated with autogenous block bone graft.ConclusionThe ability of stem cells to treat large alveolar defects is safe, yet, their ability to completely reconstitute large alveolar defects is limited. This approach requires further optimization to meet the outcomes seen using current methods to treat large defects, particularly those resultant of cleft palate.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138871/1/cid12506.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138871/2/cid12506_am.pd
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