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Cell and Tissue Banking

, Volume 13, Issue 4, pp 577–586 | Cite as

Fresh-frozen human bone allograft in vertical ridge augmentation: clinical and tomographic evaluation of bone formation and resorption

  • Luis Guilherme Scavone Macedo
  • Luiz Antonio Mazzucchelli-Cosmo
  • Nelson Luiz MacedoEmail author
  • Adriana Socorro Ferreira Monteiro
  • Wilson Roberto Sendyk
Article

Abstract

The aim of the current study is to evaluate fresh-frozen human bone allografts (FHBAs) used in vertical ridge augmentation clinically and by computed tomography, and to analyze the resulting bone formation and graft resorption. Sixteen FHBAs were grafted in the maxillae and mandibles of 9 patients. The FHBAs, which were provided by the Musculoskeletal Tissue Bank of Marilia Hospital (Unioss), were frozen at −80°C. After 7 months, dental implants were placed and bone parameters were evaluated. Vertical bone formation was measured by computerized tomography before (T0) and at 7 months (T1) after the surgical procedure. Bone graft resorption was measured clinically from a landmark screw head using a periodontal probe. The results were analyzed by Student’s t-test. Significant differences existed in the bone formation values at T0 and T1, with an average change of 4.03 ± 1.69 mm. Bone graft resorption values were 1.0 ± 0.82 mm (20%). Implants were placed with varying insertion torque values (35–45 Ncm), and achieved primary stability. This study demonstrates that FHBAs promote satisfactory vertical bone formation with a low resorption rates, good density, and primary implant stability.

Keywords

Dental implants Transplantation Allograft Bone bank Bone Fresh frozen graft 

References

  1. AATB (1992) General standards of tissue banking, technical manual for muscle-skeletal tissue bankingGoogle Scholar
  2. Adell R, Eriksson B, Lekholm U, Branemark P-I, Jemt T (1990) Long-term follow-up study of Osseo integrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 5:347–359PubMedGoogle Scholar
  3. Bassetti C, Kallenberger A (1980) Influence of chlorhexidine rinsing on the healing of oral mucosa and osseous lesions. J Periodontol 7(6):443–456CrossRefGoogle Scholar
  4. Bauer TW, Musclher GF (2000) Bone graft materials. Clin Orthop 371:10–27PubMedCrossRefGoogle Scholar
  5. Branemark P-I, Lindstrom J, Halllén O, Breine U, Jeppson PH, Ohman A (1975) Reconstruction of the defective mandible. Scand J Plast Reconstr Surg 9:116–128PubMedCrossRefGoogle Scholar
  6. Brazaitis MP, Mirvis SE, Greenberg J, Ord RA (1994) Severe retroperitoneal hemorrhage complicating anterior iliac bone graft acquisition. J Oral Maxillofac Surg 52:314–316PubMedCrossRefGoogle Scholar
  7. Buckley SC, Stockley I, Hamer AJ, Kerry RM (2005) Irradiated allograft bone for acetabular revision surgery. Results at a mean of five years. J Bone Joint Surg Br 87:310–313PubMedGoogle Scholar
  8. Camargo PM, Lekovic V, Weinlaender M, Klokkevold PR, Kenney EB, Dimitrijevic B, Nedic M, Jancovic S, Orsini M (2000) Influence of bioactive glass on changes in alveolar process dimensions after exodontia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90(5):581–586PubMedCrossRefGoogle Scholar
  9. Carlsson GE, Thilander H, Hedegard B (1967) Histologic changes in the upper alveolar process after extractions with or without insertion of an immediate full denture. Acta Odontol Scand 25(1):21–43PubMedCrossRefGoogle Scholar
  10. Clavero J, Lundgren S (2003) Ramus or chin grafts for maxillary sinus inlay and local onlay augmentation: comparison of donor site morbidity and complications. Clin Implant Dent Relat Res 5(3):154–160PubMedCrossRefGoogle Scholar
  11. Czitrom AA, Gross AE, Langer F, Sim FH (1988) Bone banks and allografts in community practice. Instr Course Lect 37:13–24PubMedGoogle Scholar
  12. D’Aloja E, Santi E, Aprilli G, Franchini M (2008) Fresh frozen homologous bone in oral surgery: case reports. Cell Tissue Bank 9:41–46. doi: 10.1007/s10561-007-9053-0 PubMedCrossRefGoogle Scholar
  13. Garg AK, Morales MJ, Navarro I, Duarte F (1998) Autogenous mandibular bone grafts in the treatment of the resorbed maxillary anterior alveolar ridge: rationale and approach. Implant Dent 7(3):169–176PubMedCrossRefGoogle Scholar
  14. Greenstein G, Greenstein B, Cavallaro J, Tarnow D (2009) The role of bone decortication in enhancing the results of guided bone regeneration: a literature review. J Periodontol 80(2):175–189. doi: 10.1902/jop.2009.080309 PubMedCrossRefGoogle Scholar
  15. Hamer AJ, Strachan JR, Black MM, Ibbotson CJ, Stockley I, Elson RA (1996) Biochemical properties of cortical allograft bone using a new method of bone strength measurement. A comparison of fresh, fresh-frozen and irradiated bone. J Bone Joint Surg Br 78(3):363–368PubMedGoogle Scholar
  16. Hernandez-Alfaro F, Pages CM, Garcia E, Corchero G, Arranz C (2005) Palatal core graft for alveolar reconstruction: a new donor site. Int J Oral Maxillofac Implants 20(5):777–783PubMedGoogle Scholar
  17. Heyligers IC, Klein-Nulend J (2005) Detection of living cells in non-processed but deep-frozen bone allografts. Cell Tissue Bank 6:25–31. doi: 10.1007/s10561-005-1089-4 PubMedCrossRefGoogle Scholar
  18. Holtzclaw D, Toscano N, Eisenlohr L, Callan D (2008) The safety of bone allografts used in dentistry. JADA 139(9):1192–1199PubMedGoogle Scholar
  19. Itoman M, Nakamura S (1991) Experimental study on allogenic bone grafts. Int Orthop 15(2):161–165PubMedCrossRefGoogle Scholar
  20. Keith JD Jr, Petrungaro P, Leonetti JA, Elwell CW, Zeren KJ, Caputo C, Nikitakis NG, Schopf C, Warner MM (2006) Clinical and histologic evaluation of a mineralized block allograft: results from the development period (2001–2004). Int J Periodontics Restorative Dent 26(4):321–327PubMedGoogle Scholar
  21. Leonetti JA, Koup R (2003) Localized maxillary ridge augmentation with a block allograft for dental implant placement: case reports. Implant Dent 12(3):217–226PubMedCrossRefGoogle Scholar
  22. Malloy KM, Hilibrand AS (2002) Autograft versus allograft in degenerative cervical disease. Clin Orthop Relat Res 394:27–38PubMedCrossRefGoogle Scholar
  23. Misch CM (1997) Comparison of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants 12(6):767–776PubMedGoogle Scholar
  24. Misch CM, Misch CE, Rresnik RR, Ismail YH (1992) Reconstruction of maxillary alveolar defects with mandibular symphysis grafts for dental implants: a preliminary procedural report. Int J Oral Maxillofac Implants 7(3):360–366PubMedGoogle Scholar
  25. Mizutani A, Fujita T, Watanabe S, Sakakida K, Okada Y (1990) Experiments on antigenicity and osteogenicity in allotransplanted cancellous bone. Int Orthop 14:243–248PubMedCrossRefGoogle Scholar
  26. Nissan J, Romanos JE, Mardinger O, Chaushu G (2008) Immediate nonfunctional loading of single tooth implants in the anterior maxila following augmentation with freeze-dried cancellous block allograft: a case series. Int J Oral Maxillofac Implants 23(4):709–716PubMedGoogle Scholar
  27. Parrish FF (1973) Allograft replacement of all or part of the end of a long bone following excision of a tumor. J Bone Joint Surg Am 55(1):1–22PubMedGoogle Scholar
  28. Pelker RR, Friedlaender GE, Marlhan TC, Panjabi MM, Moen CJ (1984) Effects of freezing and freeze-drying on the biomechanical properties of rat bone. J Orthop Res 1(4):405–411PubMedCrossRefGoogle Scholar
  29. Perrott DH, Smith RA, Kaban LB (1992) The use of fresh frozen allogeneic bone for maxillary and mandibular reconstruction. Int J Oral Maxillofac Surg 21(5):260–265PubMedCrossRefGoogle Scholar
  30. Petrungaro PS, Amar S (2005) Localized ridge augmentation with allogenic block grafts prior to implant placement: case reports and histologic evaluations. Implant Dent 14(2):139–148PubMedCrossRefGoogle Scholar
  31. Piattelli M, Scarano A, Piattelli A (1996) Vertical ridge augmentation using a resorbable membrane: a case report. J Periodontol 67(2):158–161PubMedCrossRefGoogle Scholar
  32. Pietrokovski J, Massler M (1967) Alveolar ridge resorption following tooth extraction. J Prosthet Dent 17(1):21–27PubMedCrossRefGoogle Scholar
  33. Prousssaefs P, Lozada J, Kleinman A, Rohrer MD (2002) The use of ramus autogenous block grafts for vertical alveolar ridge augmentation and implant placement: a pilot study. Int J Oral Maxillofac Implants 17(2):238–248Google Scholar
  34. Rajan GP, Fornaro J, Trentz O, Zellweger R (2006) Cancellous allograft versus autologous bone grafting for repair of comminuted distal radius fractures: a prospective, randomized trial. J Trauma 60(6):1322–1329PubMedCrossRefGoogle Scholar
  35. Rozen BBT, Salai M, Herman A, Dudkiewicz I (2009) The effects of prolonged deep freezing on the biomechanical properties os osteochondral allografts. Cell Tissue Banking 10:27–31CrossRefGoogle Scholar
  36. Schreurs BW, Sloof TJ, Buma P, Gardeniers JW, Huiskers R (1968) Acetabular reconstruction with impacted morsellised cancellous bone graft and cement. A 10- to 15-year follow-up of 60 revision arthroplasties. J Bone Joint Surg Br 80(3):391–395CrossRefGoogle Scholar
  37. Simion M, Trisi P, Piattelli A (1994) Vertical ridge augmentation using a membrane technique associated with Osseo integrated implants. Int J Periodontics Restorative Dent 14(6):496–511PubMedGoogle Scholar
  38. Simpson D, Kakarala G, Hampson K, Steele N, Ashton B (2007a) Viable cells survive in fresh frozen human bone allografts. Acta Orthop 78(1):26–30. doi: 10.1080/17453670610013385 PubMedCrossRefGoogle Scholar
  39. Simpson DKG, Hampson K, Steele N, Ashton B (2007b) Viable cells survive in fresh frozen human bone allografts. Acta Orthopaedica 78(1):26–30PubMedCrossRefGoogle Scholar
  40. Smolka W, Bosshardt DD, Mericske-Stern R, Iiguka T (2006) Changes in the volume and density of calvarial split bone grafts after alveolar ridge augmentation. Clin Oral Implants Res 17(2):149–155PubMedCrossRefGoogle Scholar
  41. Stevenson S, Li XQ, Davy DT, Klein L, Goldberg VM (1997) Critical biological determinants of incorporation of non vascularized cortical bone grafts. Quantification of a complex process and structure. J Bone Joint Surg Am 79:1–16PubMedCrossRefGoogle Scholar
  42. Tomford WW (2000) Bone allografts: past, present and future. Cell Tissue Bank 1(2):105–109PubMedCrossRefGoogle Scholar
  43. Triplett RG, Schow SR (1996) Autologous bone grafts and endosseous implants: complementary techniques. J Oral Maxillofac Surg 54(4):486–494PubMedCrossRefGoogle Scholar
  44. Vaccaro AR, Cirello J (2002) The use of allograft bone and cages in fractures of the cervical, thoracic, and lumbar spine. Clin Orthop Relat Res 394:19–26PubMedCrossRefGoogle Scholar
  45. Viscioni AFM, Rigo L, Guidi R, Spinelli G, Carinci F (2009) Retrospective study of standard -diameter implants inserted into allografts. J Oral Maxillofac Surg 67:387–393PubMedCrossRefGoogle Scholar
  46. Weyts FA, Bos PK, Dinjens WN, van Doorn WJ, van Biezen FC, Weinans H, Verhaar JA (2003) Living cells in 1 of 2 frozen femoral heads. Acta Odontol Scand 74(6):661–664. doi: 10.1080/00016470310018162 Google Scholar
  47. Wildemann B, Kadow-Romacker A, Pruss A, Hass NP, Schmidmaier G (2007) Quantification of growth factors in allogenic bone grafts extracted with three different methods. Cell Tissue Bank 8:107–114. doi: 10.1007/s10561-006-9021-0 PubMedCrossRefGoogle Scholar
  48. Zarb GA, Lekholm E (1985) Patient selection and preparation. In: Branemark PI, Zarb GA, Albrektsson T (eds) Tissue integrated protheses, Quintessenz Verlags-GmbH, Berlin, pp 199–209Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Luis Guilherme Scavone Macedo
    • 1
  • Luiz Antonio Mazzucchelli-Cosmo
    • 2
  • Nelson Luiz Macedo
    • 3
    Email author
  • Adriana Socorro Ferreira Monteiro
    • 4
  • Wilson Roberto Sendyk
    • 5
  1. 1.Department of Dental Materials and ProsthesisSão Paulo State University, UNESPSão PauloBrazil
  2. 2.Periodontics and ImplantologySão PauloBrazil
  3. 3.Department of Diagnosis and Surgery, Periodontics DivisionSão Paulo State University, UNESPSão PauloBrazil
  4. 4.Bioscience Center for Special Health Care Needs (CEBAPE)São Paulo State University, UNESPSão PauloBrazil
  5. 5.Periodontics and Implantology, UNISASanto Amaro Dental SchoolSão PauloBrazil

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