AUTOLOGOUS STROMAL STEM CELLS (SSC) IN MAXILLARY SINUS AUGMENTATION: AN EXPERIMENTAL STUDY IN MINIPIG

Objective: The aim of the proposed study was to evaluate whether the combination of SSC with natural hydroxyapatite (HA) would improve the amount and the speed of bone formation and the bone to implant contact in maxillary sinus augmentation procedure. Material & Methods: Six adult mini-pigs were included in the study. The mini-pigs were housed individually at the institute animal facility 4 weeks before surgery. Bone marrow cells were harvested from adult mini-pig 3 weeks before the operation. The cells isolated by centrifugation were expanded in CO2 incubators to the number required for the procedure. Prior to surgery the animals were premedicated and receive anesthesia. Minipig received bilateral maxillary sinus augmentation. Through an extraoral approach, a window 1 71 cm was cut into the bony facial sinus wall, and the antral membrane was elevated from the sinus floor. The SSC/ HA was placed into the right maxillary sinus, while HA alone was placed in the left maxillary sinus as a control. At the same time a titanium implant was inserted in each sinus from a laterocaudal direction. Radiography were taken every 2 weeks. Mini-pig were euthanized at two time points after 8 and after 12 weeks. The maxillae were removed and a block-session of each sinus was fixed to be histologically and histomorphometrically studied. Results: The use of SSC seemed to increase the quantity of newly-formed bone. Conclusions: The addition of stromal stem cells could, probably, be a useful tool to improve the results in sinus augmentation procedures

A LONG-TERM RETROSPECTIVE STUDY OF TWO DIFFERENT IMPLANT SURFACE PLACED AFTER RECONSTRUCTION OF THE SEVERELY RESORBED MAXILLA USING LE FORT I OSTEOTOMY AND INTERPOSITIONAL BONE GRAFT

Purpose: In this retrospective study, the long-term survival and success rates of implants with 2 different surfaces placed in extremely atrophic maxillae augmented with Le Fort I osteotomy and interpositional bone grafts were assessed. Materials and Methods: In 12 consecutive patients (7 female, 5 male; average age, 55 years; age range, 47 to 63 years), the resorbed maxilla was reconstructed using Le Fort I osteotomy in combination with interpositional iliac bone grafts. After 5 to 6 months, machined or titanium plasma-sprayed implants were inserted. The patients were followed clinically and radiographically for 6 to 12 years (mean 102 ± 24.42 months) after prosthetic loading. Implant outcome in terms of survival and success using Albrektsson’s criteria was analyzed. Results: In all cases, the bone-grafting procedures allowed implant placement. Of the 104 implants placed (53 machined and 51 titanium plasma-sprayed), 11 failed, resulting in an overall cumulative survival rate of 89.4%. When the success rate was calculated using the defined criteria, the cumulative success rate was 67.3%. The respective survival and success rates were 86.8% and 66.0% for the machined implants and 92.2% and 68.7% for the titanium plasma-sprayed implants. The mean marginal bone resorption was 2.91 ± 0.77 mm (range, 0.6 to 4.9 mm) around machined implants and 2.72 ± 0.84 mm (range, 0.7 to 5.3 mm) around titanium plasma-sprayed implants. No significant differences in survival, success rate, or marginal bone resorption were found between the 2 implant groups. Conclusions: Le Fort I osteotomy combined with bone grafts and delayed implant placement gave predictable long-term results. There was a distinct relationship between implant survival and the long-term success rate. The implant surface had no significant effect on the survival, success rate, or marginal bone resorption. Int J Oral Maxillofac Implants 2008;23:911–918 Key words: alveolar bone augmentation, atrophic maxilla, autogenous bone graft, dental implants, follow-up study, Le Fort I osteotom

BRANEMARK AND FRIALIT IMPLANTS FOR THE REHABILITATION OF GRAFTED MAXILLA: A 6-12-YEAR STUDY (poster)

Aim. The aim of the present study was to evaluate whether there was a difference between implants with a machined- or a rough-surface placed after Le Fort 1 osteotomy and interpositional iliac bone grafts regarding survival, success rate and marginal bone loss during a 6- to 12 year observation period. Materials and Methods. Twelve patients with extremely resorbed maxillae were subjected to Le Fort 1 advancement and interpositional bone grafts. After 4-5 months 104 implants were inserted (from a minimum of 5 up to 12): 53 Br\ue5nemark machined implants and 51 Frialit 2 implants with TPS coating. Implants were surgically exposed 6-7 months later. All the patients received fixed proshesis. Clinical and radiographical examinations of the bone grafts and implants were evaluated in all cases. Results. The Frialit group was followed up for a mean period of 100\ub118.06 (range 72\u2013120) months and Branemark group for 104\ub129.06 (range 72\u2013144) months. During the whole observation period, 10.6% (11/104) of all implants were lost. Frialit implants had the highest survival and success rate (92.2% and 68.7%, respectively), than group 2 (Branemark implants) (86.8% and 66%, respectively), but the difference was not statistically significant (P=0.8235). The mean marginal bone loss was 2.88 mm (SD. 0.83) for the Branemark group and 2.69 mm (SD. 0.75) for the Frialit group. No significant difference was found (p=0. 059). Conclusion. The results of this study showed that Branemark and Frialit implants had comparable survival and success rate and marginal bone loss in autogenous grafted maxillary bone

A LONG-TERM RETROSPECTIVE STUDY OF TWO DIFFERENT IMPLANT SURFACE PLACED AFTER RECONSTRUCTION OF THE SEVERELY RESORBED MAXILLA USING LE FORT I OSTEOTOMY AND INTERPOSITIONAL BONE GRAFT

Purpose: In this retrospective study, the long-term survival and success rates of implants with 2 different surfaces placed in extremely atrophic maxillae augmented with Le Fort I osteotomy and interpositional bone grafts were assessed. Materials and Methods: In 12 consecutive patients (7 female, 5 male; average age, 55 years; age range, 47 to 63 years), the resorbed maxilla was reconstructed using Le Fort I osteotomy in combination with interpositional iliac bone grafts. After 5 to 6 months, machined or titanium plasma-sprayed implants were inserted. The patients were followed clinically and radiographically for 6 to 12 years (mean 102 \ub1 24.42 months) after prosthetic loading. Implant outcome in terms of survival and success using Albrektsson\u2019s criteria was analyzed. Results: In all cases, the bone-grafting procedures allowed implant placement. Of the 104 implants placed (53 machined and 51 titanium plasma-sprayed), 11 failed, resulting in an overall cumulative survival rate of 89.4%. When the success rate was calculated using the defined criteria, the cumulative success rate was 67.3%. The respective survival and success rates were 86.8% and 66.0% for the machined implants and 92.2% and 68.7% for the titanium plasma-sprayed implants. The mean marginal bone resorption was 2.91 \ub1 0.77 mm (range, 0.6 to 4.9 mm) around machined implants and 2.72 \ub1 0.84 mm (range, 0.7 to 5.3 mm) around titanium plasma-sprayed implants. No significant differences in survival, success rate, or marginal bone resorption were found between the 2 implant groups. Conclusions: Le Fort I osteotomy combined with bone grafts and delayed implant placement gave predictable long-term results. There was a distinct relationship between implant survival and the long-term success rate. The implant surface had no significant effect on the survival, success rate, or marginal bone resorption. Int J Oral Maxillofac Implants 2008;23:911\u2013918 Key words: alveolar bone augmentation, atrophic maxilla, autogenous bone graft, dental implants, follow-up study, Le Fort I osteotom