Search Results (24)

Background: Autologous dentin has emerged as a potential grafting material in regenerative oral surgery because of its structural and biological similarities to bone. This technical report describes a modified tooth-shell technique used for horizontal ridge reconstruction with simultaneous implant placement in two clinical cases involving the aesthetic zone. Case Presentation: The first case involved a 29-year-old female patient requiring extraction of a partially impacted, buccally positioned maxillary third molar (tooth 28). The extracted tooth was processed intraoperatively to obtain a dentin shell, which was fixed as a buccal plate during simultaneous implant placement. The remaining defect was filled with sticky bone prepared from biphasic calcium phosphate combined with platelet-rich fibrin. Radiographic evaluations performed at 4 and 6 months demonstrated stable ridge contours, while clinical follow-up continued for 2 years with maintenance of implant function and peri-implant tissue stability. The second case involved a 58-year-old female patient with a previous failure of immediate implantation in the anterior maxilla associated with implant overload, loss of implant stability, and buccal bone deficiency. After soft- and hard-tissue healing, ridge reconstruction was performed using a dentin shell prepared from tooth 18 together with simultaneous implant placement and immediate provisional restoration. Follow-up after 6 months revealed stable peri-implant tissues, a satisfactory aesthetic outcome, and successful prosthetic rehabilitation. Conclusions: The modified tooth-shell technique using autologous dentin provided satisfactory preliminary clinical and radiographic outcomes in both cases. These findings should be considered hypothesis-generating and require confirmation in larger prospective studies with longer follow-up periods. Full article

Background and Clinical Significance: Peri-implantitis is an inflammatory condition associated, among other factors, with biofilm accumulation, affecting peri-implant soft and hard tissues and potentially leading to implant loss. Its treatment remains challenging because no single decontamination or regenerative protocol has demonstrated clear superiority. This case report describes a comprehensive surgical and regenerative approach aimed at preserving an affected implant and restoring peri-implant tissue stability; Case Presentation: A systemically healthy 30-year-old patient presented with peri-implant bone loss around an implant in position 25, restored with a lithium disilicate crown and functioning for three years. Treatment included flap elevation, mechanical debridement and air-polishing of the implant surface, followed by thorough irrigation with sterile saline to remove residual abrasive particles and debris, photodynamic antimicrobial therapy, and laser therapy. Bone regeneration was performed using a bone substitute combined with injectable platelet-rich fibrin to produce sticky bone, which was covered with an advanced platelet-rich fibrin membrane. A provisional crown was placed without occlusal contact. After four months, a definitive crown with a modified emergence profile was delivered to improve hygienic access and reduce biofilm retention. Clinical and radiographic follow-up over five years demonstrated stable peri-implant tissues and maintained bone levels; Conclusions: The combined use of surgical decontamination, PRF-assisted regeneration, sticky bone, and prosthetic modification resulted in stable clinical and radiographic outcomes over five years. Identification and elimination of contributing factors were essential for long-term treatment success. Full article

Background: Extended platelet-rich fibrin (e-PRF) membranes are a novel 100% autologous biomaterial with a longer resorption time (4–6 months) than traditional solid-PRF membranes (two weeks). In part 1 of this 2-part publication series, four clinical variations for using these novel e-PRF membranes for socket preservation were introduced. In this randomized clinical trial (RCT), all four iterations of e-PRF membranes were compared to traditional collagen membranes in alveolar ridge preservation for hard and soft tissue dimensional changes and early wound healing outcomes. Methods: A single-center RCT was conducted, including 55 patients requiring the extraction of a single tooth with planned implant placement. All sockets were grafted with a “sticky bone” (bone allograft mixed with PRF) and secured with either a collagen membrane (control) or e-PRF membranes utilizing the four variations present in Part 1 (both formed extra-orally or intra-orally, each with or without an overlying solid PRF membrane). The time of fabrication and application of each e-PRF iteration was recorded. Cone beam computed tomography was utilized to evaluate horizontal and vertical ridge dimensions at baseline and 3 months post-operatively, and soft tissue thickness was also measured at both time intervals utilizing an endodontic reamer. Early wound healing was recorded at 2 weeks, utilizing the Landry, Turnbull, and Howley Index by three blinded clinicians. Results: The results demonstrated that, at 3 months, the e-PRF membranes fabricated utilizing all 4 treatment variations demonstrated equal improvements in horizontal and vertical ridge dimensions and soft tissue thickness when compared to collagen membranes. Additionally, the membrane (p = 0.029) and membrane w/solid (p = 0.021) groups demonstrated statistically significant superior early wound healing compared to the collagen membrane group. Notably, the Bio-Filler groups demonstrated statistically significant reduction in fabrication/application time compared to the membrane groups. Conclusions: Within the limitations of this RCT, all e-PRF iterations performed comparably to collagen membranes in maintaining both hard and soft tissue ridge dimensions when combined with sticky bone, while also significantly improving soft tissue wound healing. Future RCTs with alternative grafting materials, direct wound-margin assessment, and evaluation of patient-reported outcomes are necessary to clarify the advantages of each membrane type. Full article

Background/Objectives: Vertical ridge augmentation remains a challenging procedure in alveolar bone reconstruction, with existing techniques often limited by surgical complexity, graft instability, and high resorption rates. This study evaluates the clinical and histological outcomes of a novel vertical ridge augmentation technique using a wide-head tenting pole screw (WHTPS) combined with sticky bone graft material. Methods: Five patients with vertical bone deficiencies (6–10 mm) in the maxilla or mandible underwent augmentation using a single WHTPS (rectangular or round wide-head type). Sticky bone was prepared using autologous tooth bone, allografts, or xenografts, combined with fibrin glue and covered with concentrated growth factor (CGF) membranes and/or resorbable collagen membranes. After 5–6 months of healing, the WHTPS was removed, and bone biopsies were taken for histological analysis. Results: Radiographic and histological evaluations confirmed successful ridge augmentation in all cases. Newly formed bone ranged from 21.2% to 57.5%. All patients proceeded to implant placement without complications. Radiographic, clinical, and histological assessments consistently showed that new bone formation extended up to the level of the screw head, indicating complete vertical fill of the augmented space. Histology showed well-integrated, mineralized bone with no signs of inflammation. The wide-head tenting pole screw was observed to support stable space maintenance and facilitate surgical handling and favorable outcomes in vertical ridge augmentation. Conclusions: In this case series, a single wide-head tenting pole screw appeared sufficient to maintain space and resist soft tissue pressure in wide alveolar bone defects during healing. This case series suggests that the wide-head tenting pole screw technique may be a feasible option for managing severe alveolar bone deficiencies. Full article

Aim: This retrospective observational clinical cohort study evaluated 84-month clinical and radiographic outcomes of a regenerative protocol combining autologous dentin grafts processed with the Tooth Transformer^® device and Concentrated Growth Factors (CGFs) in patients with severe maxillary atrophy undergoing sinus augmentation with simultaneous implant placement. Materials and Methods: Thirty-one patients (30–75 years) with residual crestal bone height ≥ 5 mm and requiring extraction of ≥2 molars were included. Extracted teeth were processed with the Tooth Transformer^® to obtain demineralized dentin granules (500–1000 µm), which were combined with CGFs prepared using the Medifuge MF200^® to form “sticky bone.” All patients underwent sinus lift via a lateral window approach (Hilt Tatum technique) with simultaneous placement of 98 implants (12–14 mm), which were loaded after six months. Results: At the 84-month follow-up, no implant failures or peri-implantitis were recorded. CBCT and clinical evaluations showed stable regenerated bone volume and absence of peri-implant bone resorption. All patients received fixed prostheses within six months without complications. Conclusions: The combined use of processed autologous dentin and CGFs proved to be a safe, predictable, and effective regenerative technique in cases of severe maxillary atrophy, with a 100% implant survival rate at five years. Full article

This study evaluated the bone regeneration effect and mechanical properties of “Sticky bone”, a mixture of platelet-rich fibrin (PRF) and synthetic bone grafts (SBGs), in the repair of large femoral bone defects in rabbits. Eighteen New Zealand white rabbits were included and randomly divided into a Sticky bone group and an SBG alone group. Bone graft samples were collected and analyzed at 4, 8, and 12 weeks after surgery. Micro- computed tomography (CT) analysis showed that the amount of the Sticky bone group in the grayscale ranges of 255–140 (highly mineralized tissue or unabsorbed bone powder) and 140–90 (representing new cancellous bone) was higher than that of the SBG group at each time point and decreased with the number of weeks. The compression strength test showed that the average compression strength of the Sticky bone group reached 5.17 MPa at the 12th week, which was 1.62 times that of the intact bone (3.19 MPa) and was significantly better than that of the SBG group (about 4.12 MPa). This study also confirmed for the first time that the use of a new polyethylene terephthalate (PET) blood collection tube to prepare PRF can stably release key growth factors such as platelet-derived growth factor-BB (PDGF-BB) and vascular endothelial growth factor (VEGF), which are conducive to early bone vascularization and cell proliferation. In summary, Sticky bone has the potential to promote bone formation, enhance tissue integration and mechanical stability, and can be used as an effective alternative material for repairing large-scale bone defects in clinical practice in the future. Full article

Objective: This study aimed to compare the efficacy of Sticky Tooth (ST) derived from ground teeth and Sticky Bone (SB) based on equine bone and human allograft in maxillary bone defect regeneration through histological examination. Materials and Methods: Forty patients underwent maxillary alveolar ridge regeneration using four different biomaterials: Sticky Tooth processed with the BonMaker device (n = 10), Sticky Tooth prepared with the Smart Dentin Grinder (n = 10) Sticky Bone derived from an equine xenograft (n = 10), and Sticky Bone derived from human allografts (n = 10). CBCT imaging was performed preoperatively, post-regeneration, and during follow-up. Histological and quantitative statistical evaluation was conducted on biopsy samples obtained four months post-regeneration at the time of implant placement. Results: Successful alveolar ridge regeneration was achieved in all 40 patients. Histological analyses confirmed good integration between the biomaterials and bone tissue without signs of inflammation. Conclusion: Histological comparisons demonstrated that both ST and SB are effective biomaterials for bone regeneration. However, ST exhibited a faster bone healing process compared to xenograft and allograft SB. Full article

Background: The aim of this study was to analyse the results of the mastoid obliteration technique with sticky bone (SB) and compare them with those obtained using bioactive glass S53P4 (BAG). Methods: This prospective preliminary study comprised 28 adults who underwent canal wall down (CWD) surgery using two mastoid obliterative techniques: SB (n = 21) or BAG (n = 7). The SB group was treated with the patients’ own bone dust and injectable platelet rich fibrin (IPRF) (n = 13%) or bone dust, IPRF, and additionally allogenic lyophilised demineralised bone (n = 9%). Results: Nine months after the surgery, in the SB group, retroauricular depression was observed in three (14%) patients, temporary retroauricular fistula in one (5%), and a conical and smooth external auditory canal (EAC) was achieved in 15 (71%). Mean EAC capacity was 0.6 mL higher than in the contralateral ear. In the SB group, the tympanic membrane (TM) of nineteen (91%) patients was fully healed, one (5%) had TM perforation, and one (5%) developed a retraction pocket. In the BAG group, retroauricular depression was observed in four (57%) patients, temporary retroauricular fistula was present in one (14%), and a conical and smooth EAC was achieved in five (71%). Mean EAC capacity was 0.3 mL higher than on the opposite side. In the BAG group, we stated six (86%) patients with fully healed TM and one (14%) with a retraction pocket. One cholesteatoma was found in the BAG group and two in SB, (14% vs. 10%). After 9 months, all patients in both groups achieved a dry and self-cleaning cavity. Conclusions: Mastoid obliteration in CWD surgery using SB or BAG allows for reconstruction of the conical shape of the EAC with a volume similar to that of a healthy ear. Both techniques seem to have a minimal risk of complications and result in a dry, self-cleaning cavity. Further studies concerning a larger series of cases are necessary to confirm the findings of this preliminary analysis. Full article

Sliver carp is a nutritious and abundant species in China, but its low market value stems from its thin meat, small bones and strong odor. Processing it into surimi enhances its economic value, though surimi typically has low gel strength and is prone to deterioration. Recently, three-dimensional (3D) printing has gained attention as an innovative additive manufacturing technique for personalization and process simplification requiring high-performance materials. This study intended to develop an optimized surimi formula for 3D printing with dynamic high-pressure microfluidization (DHPM)-modified pea protein isolate (PPI) and microcrystalline cellulose (MCC). Firstly, the effect of DHPM on PPI properties was evaluated, followed by the optimization of the surimi gel formula (72.093% water content, 3.203% PPI, 1.728% MCC, 1% salt, 1% collagen peptide and 20.976% sliver carp paste) and 3D printing parameters (2000 mm/min at 25 °C with a 1.5 mm nozzle). Rheological comparisons between the optimized surimi, surimi with commercial antifreeze and surimi with only PPI or MCC indicated that the optimized formulation exhibited clearer 3D printing outlines and reduced stickiness due to a higher recovery and lower loss modulus. These results demonstrated that DHPM-treated PPI and MCC enhanced the 3D printability of silver carp surimi gel, providing a new idea for a surimi product and supporting its potential applications in food 3D printing. Full article

Background: Platelet-rich fibrin (PRF) is a concentrate derived from autologous blood, containing platelets, fibrin, and growth factors (GF) obtained through centrifugation. PRF can be mixed with bone replacement material to form sticky bone, which is then introduced into the desired area for stabilizing and graft-covering. Depending on the centrifugation protocol, the effectiveness of the end products can vary. This controlled clinical study examines the impact of our established PRF protocol in alveolar augmentation and dental implant placement on vertical bone loss. Materials and Methods: A total of 362 implants were performed in 170 patients at the Department of Oral and Maxillofacial Surgery at the University Hospital Innsbruck between 2018 and 2021. After accounting for lost implants, we retrospectively evaluated a radiological vertical bone loss exceeding 1 mm in the first year as the primary endpoint. Results: The use of PRF was significantly associated with vertical bone loss > 1 mm (OR = 0.32, 95% CI (0.13–0.81), p = 0.016). There were no significant associations between PRF and the number of implants lost, the type of augmentation, or bone loss. Discussion: A-PRF+ sticky bone grafts, when combined with bone graft materials, show reduced resorption rates, indicating their potential to enhance graft stability in oral implantology. Our data indicate that the Medifuge MF 100 (Silfradent srl, Forlì, Italy) is effective in producing A-PRF+. Full article

Background: Schatzker type II fractures usually need to be grafted. Autograft bone from the iliac crest represents the gold standard, but it comes with high rates of morbidity on the donor side. Sticky bone is one of the regenerative therapies that aims to find new solutions to treat bone defects and to overcome the limitation of conventional options regarding bone grafts, due to their content in growth factors, which offer osteo-induction and osteo-conduction properties. Notably, regenerative dentistry has been at the forefront of applying these products in bone regeneration, demonstrating that PRF produces a highly promising “sticky bone” when combined with bone chips. To the best of our knowledge, this grafting technique has not been used in the orthopedic field to date. Methods: The subject was a 53-year-old woman with a Schatzker type II tibial plateau fracture, for which a new autologous bone grafting technique, i.e., sticky bone, was used for the treatment of the fracture. Results: This case reports the effectiveness of sticky bone as autologous bone graft used in Shatzker type II tibial plateau fracture. As an indispensable component of regenerative medicine, it seems to be an ideal biologic graft with a fibrin-rich structure that provides effective treatment in impressed tibial plateau fractures. Conclusion: Sticky bone showed promising results and should be considered in the future as an appropriate bone implant. Full article

Introduction: Although various surgical techniques have been utilized in the reconstruction of severely resorbed alveolar bone, its regeneration is still regarded as a major challenge. Most of the surgical techniques used in advanced ridge augmentation have the disadvantages of prolonging the patient’s edentulous healing and increasing the need for surgical revisits because simultaneous implant placement is not allowed. This report presents a new and simplified method for advanced ridge augmentation, which utilizes a vertical tenting device. Case Presentation: The first case presented the reconstruction of the mandibular posterior region with severely resorbed alveolar bone due to peri-implantitis using tenting pole abutment for ridge augmentation. The second and third cases presented three-dimensional ridge augmentations in severely resorbed ridges due to periodontitis. The last case presented horizontal ridge augmentation using a vertical tenting device. All cases were performed under local anesthesia. Implants were simultaneously placed in the bone defect area. A vertical tensioning device was then connected to the implant platform to minimize the collapse of the bone graft during the bone regeneration period due to the contraction of the soft tissue matrix. A sticky bone graft was transplanted onto the exposed surface of the implant and on top of the vertical tensioning device. After covering with an absorbable barrier membrane, the soft tissues were sutured without tension. Conclusions: In all cases, prosthetic restorations were provided to patients after a bone grafting period of 5–6 months, leading to a rapid restoration of masticatory function. Results tracked for up to 6 years revealed observed stable reconstruction of the alveolar bone. The use of a vertical tenting device can prevent the collapse of biomaterials in the augmented ridge during the healing period, leading to predictable outcomes when achieving three-dimensional ridge augmentation. Full article

Platelet-rich Fibrin (PRF), a second-generation blood concentrate, offers a versatile structure for bone regeneration due to its composition of fibrin, growth factors, and cytokines, with adaptations like denatured albumin-enriched with liquid PRF (Alb-PRF), showing potential for enhanced stability and growth factor dynamics. Researchers have also explored the combination of PRF with other biomaterials, aiming to create a three-dimensional framework for enhanced cell recruitment, proliferation, and differentiation in bone repair studies. This study aimed to evaluate a combination of Alb-PRF with nanostructured carbonated hydroxyapatite microspheres (Alb-ncHA-PRF), and how this association affects the release capacity of growth factors and immunomodulatory molecules, and its impact on the behavior of MG63 human osteoblast-like cells. Alb-PRF membranes were prepared and associated with nanocarboapatite (ncHA) microspheres during polymerization. MG63 cells were exposed to eluates of both membranes to assess cell viability, proliferation, mineralization, and alkaline phosphatase (ALP) activity. The ultrastructural analysis has shown that the spheres were shattered, and fragments were incorporated into both the fibrin mesh and the albumin gel of Alb-PRF. Alb-ncHA-PRF presented a reduced release of growth factors and cytokines when compared to Alb-PRF (p < 0.05). Alb-ncHA-PRF was able to stimulate osteoblast proliferation and ALP activity at lower levels than those observed by Alb-PRF and was unable to positively affect in vitro mineralization by MG63 cells. These findings indicate that the addition of ncHA spheres reduces the biological activity of Alb-PRF, impairing its initial effects on osteoblast behavior. Full article

Background: The number of periprosthetic joint infections caused by vancomycin-resistant pathogens is increasing. Currently, no PMMA cement is commercially available to cover VRE. Daptomycin shows promising results in treating infection, offering a good safety profile and a reduced risk of developing resistance. The purpose of this in vitro study was to investigate the mechanical stability, handling properties, elution behavior, and antimicrobial effectiveness of PMMA cement loaded with three different daptomycin concentrations in comparison to commercially available antibiotic-loaded bone cement (ALBC). Methods: Mechanical properties and handling characteristics (ISO 5833, DIN 53435), HPLC elution, antimicrobial effectiveness with proliferation assay (DIN 17025), and inhibition zone testing were investigated. Results: All tested daptomycin concentrations met the ISO and DIN standards for mechanical strength. Loading of 40 g of PMMA cement with 0.5 g of daptomycin did not show any antimicrobial effectiveness, in contrast to 1.0 g and 1.5 g. PMMA cement with 1.5 g of daptomycin was the best in terms of elution and effectiveness, and it showed good ISO mechanical strength; ISO doughing was sticky for a little longer and setting was faster compared to the vancomycin-containing reference cement. Conclusion: PMMA cement containing 0.5 g of gentamicin and 1.5 g of daptomycin could be a good alternative to the already established COPAL^® (Wehrheim, Germany) G+V for the treatment of PJIs caused by VRE. Full article

Background: The current review aims to provide an overview of the most recent research on the potentials of concentrated growth factors used in the maxillary sinus lift technique. Materials and methods: “PRP”, “PRF”, “L-PRF”, “CGF”, “oral surgery”, “sticky bone”, “sinus lift” were the search terms utilized in the databases Scopus, Web of Science, and Pubmed, with the Boolean operator “AND” and “OR”. Results: Of these 1534 studies, 22 publications were included for this review. Discussion: The autologous growth factors released from platelet concentrates can help to promote bone remodeling and cell proliferation, and the application of platelet concentrates appears to reduce the amount of autologous bone required during regenerative surgery. Many authors agree that growth factors considerably enhance early vascularization in bone grafts and have a significantly positive pro-angiogenic influence in vivo when combined with alloplastic and xenogeneic materials, reducing inflammation and postoperative pain and stimulating the regeneration of injured tissues and accelerating their healing. Conclusions: Even if further studies are still needed, the use of autologous platelet concentrates can improve clinical results where a large elevation of the sinus is needed by improving bone height, thickness and vascularization of surgical sites, and post-operative healing. Full article