H Smukler — Page 3 | PubMed Health

PubMedDate not supplied

Histomorphometric evaluation of extraction sockets and deficient alveolar ridges treated with allograft and barrier membrane: a pilot study.

The aim of the study was to determine the fate of demineralized freeze-dried bone allograft (DFDBA) used in conjunction with a barrier membrane in the management of extraction sockets and deficient alveolar ridges, and to compare the amount of bone formed with that found in untreated sites. Ten biopsies were obtained from 8 grafted patients. Five biopsies were harvested from untreated sites during routine implant placement and analyzed for comparison. In the socket management procedure, DFDBA was packed tightly into the socket and covered with an expanded polytetrafluoroethylene (e-PTFE) membrane. Primary closure was achieved in all cases. In the ridge regeneration procedure, cortical columns were placed in the ridge projecting outward approximately 3 mm to create and maintain space for DFDBA particles packed between them; the columns were then covered by an e-PTFE membrane. Healing time ranged from 8 to 23 months. At the time of implant placement, bone cores (7 mm x 2 mm) were harvested, fixed in 10% formalin solution, and prepared for histologic examination. At the light microscopic level, no inflammation or fibrous encapsulation was observed. New bone formation on and around DFDBA particles was widespread. Histomorphometric analysis of the grafted specimens and untreated sites was carried out using the trabecular bone volume (TBV) index. The TBV in the maxillary test specimens was 55.03%, as compared to 57.33% of control cores. Unaltered DFDBA made up 8.7% of the test specimens. In the mandibular biopsies, the TBV was 56.6%, while for the controls it was 40.9%. The volume of DFDBA still present was 2.45%. The results tended to indicate that treatment with DFDBA in conjunction with cell occlusive membranes will result in new bone formation, predominantly by the process of conduction, which appears to be similar in amount and nature to that found in cores harvested from healed nonfunctional edentulous areas.

Adult↗

PubMedDate not supplied

A new approach to regeneration of surgically reduced alveolar ridges in dogs: a clinical and histologic study.

Premolar teeth were extracted from dogs and the remaining alveolar bone was surgically reduced to produce Class III ridge defects. Following 2 months of healing, a new technique using allogeneic cortical columns to prop up the raised mucoperiosteal flaps and create space for developing tissue was employed to create space for regeneration of the ridges. In the control sites, the cortical columns alone were used to prop up the mucoperiosteal flap; whereas in the experimental sites, barrier membranes (expanded polytetrafluoroethylene or bone membranes) were interposed between the flaps and the projecting cortical columns. In alternate sites, decalcified allogeneic freeze-dried particulate bone was added to fill the voids between the cortical columns, the underlying host bone, and the membranes. Variations of the new approach that were based on the principles of guided tissue regeneration provided the most significant gains in ridge width, with a mean aggregate gain of 3.31 mm. Histologically, all variations of the basic technique were seen to have augmented the surgically reduced ridges. Osseous regeneration was observed only where the barrier membranes were used. The addition of particulate bone filler did not appear to offer any advantage. This new approach to ridge augmentation meets the requirements for alveolar ridge regeneration.

Alveolar Bone Loss↗