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Challenges and Opportunities in Bone Regeneration

Challenges and Opportunities in Bone Regeneration

Bali, P., Mahesh, L., Shukla, S., & Jain, A. (2023)

Abstract

Objective: To histologically compare three different alloplasts and assess bone regeneration

Study Design: Bone core of three different bone grafts was procured from a grafted site after a period of 6 months and implants were placed. The bone cores were studied histologically at higher magnification and bone formation was analyzed.

Results: All the grafts showed good results clinically, however histologically β -TCP had shown better results and more bone formation as compared to others.

Conclusion: Chronologically, Powerbone® shows the maximum formation of mature bone followed by Adbone® and then Novabone®

Gobbi, A., Morales, M., & Valsecchi, G. (2022)

Abstract

This article gives a comprehensive review of a two-step single surgical alternative that searches to preserve the patient’s cartilage and joint. It addresses the knee from a 360-degree perspective; First, from the articular side, full-thickness cartilage lesions are treated with hyaluronic acid (HA) scaffold combined with bone marrow aspirate concentrate (BMC), which restores the articular cartilage with a hyaline-like tissue. Then, deep inside the subchondral bone, a minimally invasive procedure called Osteo-Core-Plasty (OCP) is conducted when it is affected. This procedure serves to restore the subchondral bone with structural bone autograft and BMAC derived signaling cells. The HA-BMC cartilage preserving technique with more than ten years of follow-up provides persistent and prothesis sparing surgical results, while OCP offers the further benefits of the new technology for deep joint bone-core treatment and regeneration with significant improvement in clinical score outcomes and magnetic resonance imaging. Given the evidence, these articular preservation techniques can be considered the new paradigm knee arthroplasty surgery as they can achieve a valuable and holistic approach to early osteoarthritis treatment.

Baranes, D., & Kurtzman, G. M. (2023)

Abstract

Augmentation of the maxillary sinus when severe atrophy and/or pneumatization of the sinus has occurred results in minimal crestal height that will not allow simultaneous implant placement has been a clinical challenge. The lateral sinus augmentation approach has been traditionally utilized in these clinical situations, but there are known complications such as membrane tears and increased post-operative issues that follow use of this technique. This article aims to propose a new technique utilizing specific surgical instruments, making it possible to increase the height of the crestal bone under the maxillary sinus in cases of significant atrophy, without complications using a two-stage crestal approach with a bi-phasic calcium sulphate as the graft material. The article will discuss the technique, present a case example and review 51 cases representing initially 1-3 mm sub sinus crestal bone heights that the technique was utilized with.

Fritsch, T., Vukovic, M. A., & Grimm, W. (2023

Abstract

Resident stem cell pools in many tissues/organs are responsible not only for tissue maintenance during physiologic turnover but also for the process of bone healing following dental implant insertion. Recent advances have been made toward inducing stem cell mobilization and directing patients’ own cells to sites of interest for treating a broad spectrum of diseases in regenerative dentistry. An evolving body of work corroborates that delivering guidance cues can mobilize stem cells from the palate and drive these cells toward a specific region. In addition, the transplantation of cell-friendly biomaterials incorporating certain biomolecules has led to the regeneration of lost/damaged tissue without the need for delivering cellular materials manipulated ex vivo. Recently, cell homing has resulted in remarkable biological discoveries in the laboratory as well as great curative successes in preclinical scenarios. Here, we review using the results of an initial clinical- and histological-controlled study the biological evidence underlying in vivo cell mobilization and homing with the aim of leveraging endogenous reparative cells for therapeutic applications in dental regenerative implantology. Considering both the promise and the obstacles of this approach, we discuss the results how oral-derived neural crest-derived stem cells of the in vivo milieu can be modified to promote the native regenerative process and inspire future tissue-engineering design.

Zampa, E., Siormpas, K., & Silvestros, S. (2023)

Abstract

An increasing number of studies report on periodontal ligament-mediated implant placement procedures to mitigate the biological sequel of total tooth extraction in the esthetic zone. Longitudinal results of these techniques show promising results for ridge dimensional stability achieved by partial extraction of the root followed by immediate implant placement. Nonetheless, because of the recency of these techniques, there is a dearth of clinical documentation of related complications and protocols for their management. In this case report, we present the management of a complication in an implant in the aesthetic zone utilizing the “root-membrane” technique with a four-year followup. Total extraction of the root membrane and guided bone regeneration resolved the dental-related complication