Examinando por Autor "Prados-Frutos, Juan Carlos"

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Bone Substitutes
(2011-12-02) Torres, Jesús; Tamimi, Faleh; Alkhraisat, Mohammad; López-Cabarcos, Enrique; Prados-Frutos, Juan Carlos
In daily clinical practise we frequently encounter situations in which the bone volume is insufficient for an ideal dental implant placement. Bone regeneration can provide the structural support necessary in these cases. Procedures such as sinus lifting and alveolar ridge augmentation have reached high levels of predictability and already are of major importance in implant practise. Interest for bone substitutes for alveolar ridge augmentation or preservation appears in the early 1980 ¿s alongside the development of endoosseous dental implants. Although first studies regarding bone substitutes dates from 1920 by Albee (Albee, 1920), until 1980 ¿s there are very few studies in reference this issue. From 1980 ¿s until nowadays an exponential number of studies about bone substitutes have been made. The reason for this increasing interest in bone substitutes stems from the fact that about 10- 20% of the patients that need treatments with dental implants, require bone regeneration procedures before implant placement. Moreover, more than 60% of the population in industrialized countries need dental prosthetic replacements (Peterson, 2006), ideally with implants. This is the reason why the market of dental implants is experiencing an increase of approximately 15% every year. Bone regeneration procedures are becoming an almost daily practice in dentistry all around the world as a result of the wide acceptance of dental implants as the ¿ideal ¿ option for oral rehabilitation. Bone regeneration procedures are critical for the success of dental implant treatments in cases where there is a deficiency in bone width and/or height. The cornerstone in these treatments is the use of bone substitutes to create a bone mantle that covers the screw to enhance implant stability and treatment outcome. In this chapter, we will discuss the different types of bone substitutes and recent developments achieved to enhance the outcomes of bone regeneration procedures with the newest available biomaterials. The term ¿bone graft ¿ was defined by Muschler (Bauer, 2000) as: ¿any implanted material that alone or in combination with other materials promotes a bone healing response by providing oteogenic, osteoinductive or osteoconductive properties ¿. An osteogenic material can be defined as one that has inherent capacity to form bone, which implies to contain living cells that are capable of differentiation into bone cells. An osteoinductive material 92 Implant Dentistry ¿ The Most Promising Discipline of Dentistry provides biologic signals capable to induce local cells to enter a pathway of differentiation leading to mature osteoblasts. An osteoconductive biomaterial provides a three-dimensional interconnected scaffold where local bone tissue may regenerate new living bone. However, osteoconductive biomaterials are unable to form bone or to induce its formation. Another property that is interesting to find especially in bone substitutes is biodegradability. This is defined as the capacity of degradation of a particle by two mechanisms principally; through a passive chemical degradation or dissolution, and through active cellular activity mediated by osteoclast and/or macrophages. Moreover, the biological properties of bone substitute biomaterials are also influenced by their porosity, surface geometry and surface chemistry. The events leading to bone healing and regeneration are influenced by all the variables mentioned above. These properties are related to the biomaterial itself, however, host factors such as bone quality, vascularity of the graft bed and tobacco addiction may also influence the final outcome of a bone regeneration procedure with a bone substitute.
Influence of the biomechanical evaluation of rupture using two shapes of same intramedullary implant after proximal interphalangeal joint arthrodesis to correct the claw/hammer pathology: A finite element study
(2024) Bayod-López, Javier; Becerro-de-Bengoa-Vallejo, Ricardo; Prados-Frutos, Juan Carlos; Losa-Iglesias, Marta; López-López, Daniel; Prados-Privado, María
We used finite element analysis to study the mechanical stress distribution of a new intramedullary implant used for proximal interphalangeal joint (PIPJ) arthrodesis (PIPJA) to surgically correct the claw-hammer toe deformity that affects 20% of the population. After geometric reconstruction of the foot skeleton from claw toe images of a 36-year-old male patient, two implants were positioned, in the virtual model, one neutral implant (NI) and another one 10° angled (10°AI) within the PIPJ of the second through fourth HT during the toe-off phase of gait and results were compared to those derived for the non-surgical foot (NSF). A PIPJA was performed on the second toe using a NI reduced tensile stress at the proximal phalanx (PP) (45.83 MPa) compared to the NSF (59.44 MPa; p < 0.001). When using the 10°AI, the tensile stress was much higher at PP and middle phalanges (MP) of the same toe, measuring 147.58 and 160.58 MPa, respectively, versus 59.44 and 74.95 MPa at corresponding joints in the NSF (all p < 0.001). Similar results were found for compressive stresses. The NI reduced compressive stress at the second PP (-65.12 MPa) compared to the NSF (-113.23 MPa) and the 10°AI (-142 MPa) (all p < 0.001). The von Mises stresses within the implant were also significantly lower when using NI versus 10°AI (p < 0.001). Therefore, we do not recommend performing a PIPJA using the 10°AI due to the increase in stress concentration primarily at the second PP and MP, which could promote implant breakage. Keywords: foot; foot deformities; foot diseases; musculoskeletal diseases.
Platelet rich plasma prevents titanium mesh exposure in alveolar ridge augmentation with anorganic bovine bone
(2011-12-02) Torres-Macho, Jesús; Tamimi, Faleh; Alkhraisat, Mohammad; Manchón Miralles, Ángel; Linares, Rafael; Prados-Frutos, Juan Carlos; López-Cabarcos, Enrique
4 5 6 7 Bone augmentation with the titanium mesh (Ti-mesh) technique is susceptible to a large ABSTRACT Objective: 8 rate of complications such as morbidity of bone graft donor site, and mesh exposure to 9 10 11 12 13 14 15 16 17 18 19 20 for clinical, radiographic and histological evaluation, and implant placement surgery. A the oral cavity. The purpose of this study was to evaluate the efficacy of anorganic bovine bone (ABB) in alveolar bone augmentation with the Ti-mesh technique, as an alternative to autologous bone grafts. In addition, we investigated the effect of platelet rich plasma (PRP) in preventing mesh exposure, by applying it to cover the Ti-mesh. Materials and Methods: The 30 patients recruited for this study underwent 43 alveolar bone augmentation with the Ti-mesh technique using in all of them ABB as graft material. In 15 patients the Ti-meshes were covered with PRP (PRP group) while in the other 15 the Ti-meshes were not (control group). After 6 months, patients were called 21 total of 97 implants were placed in the augmented bone and their evolution was 22 23 24 25 26 27 complications and bone formation. In the control group 28.5% of the cases suffered 28 followed up for a period of 24 months. Results: Significant differences were found between the two study groups in terms of from mesh exposure, while in the PRP group, no exposures were registered. Radiographic analysis revealed that bone augmentation was higher in the PRP group than in the control group. Interestingly, mesh exposure seemed to be a risk factor regarding graft resorption and failure. 29 30 31 32 33 Overall, 97.3% of implants placed in the control group and 100% of those placed in the 34 PRP group were successful during the monitoring period. We suggest that the positive effect of PRP on the Ti-mesh technique is due to its capacity to improve soft tissue healing, thereby protecting the mesh and graft material secured beneath the gingival tissues. 35 36 37 38 39 40 Conclusions: Alveolar bone augmentation using ABB alone in the Ti-mesh technique is 41 sufficient for implant rehabilitation. Besides, covering the Ti-meshes with PRP was a determining factor for avoiding mesh exposure in this study. Titanium mesh exposure provoked significant bone loss, but in most cases it did not affect the subsequent placement of implants.
Soft Tissue Augmentation Techniques in Implants Placed and Provisionalized Immediately: A Systematic Review.
(Wiley, 2016-07-19) Rojo, Rosa; Prados-Frutos, Juan Carlos; Manchón, Ángel; Rodríguez-Molinero, Jesús; Sammartino, Gilberto; Calvo Guirado, José Luis; Gómez-de Diego, Rafael
The aim of this study was to evaluate the effectiveness of techniques for soft tissue augmentation in the placement of immediate implants with and without provisionalization and to assess the quality of the reports in the literature. Randomized clinical trials, prospective clinical trials, and case series were included in this review. Clinical questions were formulated and organised according to the PICOS strategy. An electronic search was performed in PubMed, Cochrane Central Register of Controlled Trials, Scopus, and ISI Web up until June 2016. Interexaminer agreement on eligibility (k = 0.842; p = 0.103) and quality (k = 0.933; p < 0.001) was high. Methodological approaches were assessed using criteria based on design related forms designed by the Dutch Cochrane Collaboration. Finally, 14 papers were identified. In two studies, the implant survival was 90%; for the rest of the studies it was 100%. All studies reported favourable aesthetic, biological, and radiographic outcomes. Surgical and biomechanical complications of this technique were not relevant. This technique effectively compensates for the expected loss of volume of the oral soft tissues and maintains high success rates with good aesthetic results over time.
Vertical bone augmentation with 3D synthetic monetite blocks in the rabbit calvaria
(2011-12-02) Torres, Jesús; Tamimi, Faleh; Alkhraisat, Mohammad; Prados-Frutos, Juan Carlos; Gbureck, Uwe; Barralet, Jake; López-Cabarcos, Enrique
Introduction Long-term success of osteointegrated dental implants requires sufficient volume of healthy bone at the recipient sites. However, this is frequently lacking as a result of trauma, tooth loss or infection. Onlay autografting is amongst the most predictable techniques for craniofacial vertical bone augmentation, however, complications related to donor site morbidity are common and alternatives to onlay autografts are desirable. Aim Develop and evaluate a new synthetic onlay block for vertical bone augmentation. Material and methods Sixteen synthetic monetite monolithic discs-shaped blocks were prepared using a 3D printing technique. The blocks were computer-designed, and had a diameter of 9.0 mm, a thickness of either 4.0 mm (n=8) or 3.0 mm (n=8), and one 0.5 mm wide central hole that enabled their surgical fixation with osteosynthesis screws. The blocks were randomly allocated in each side of the calvaria (right or left) of 8 New Zealand rabbits and fixed with the screws in order to achieve vertical bone augmentation. Eight weeks after the surgical intervention the animals were sacrificed and the calvaria were retrieved for histological analysis. The following parameters were analyzed: the interaction between the graft and the original bone surface, the amount of bone ingrowth within the graft, and the gain in bone height achieved by the procedure. Wilcoxon t test was used for evaluated significantly differences between the two types of monetite bone blocks grafts. Results The blocks were easy to handle and no damage or fracture was registered while being screw-fixated to the calvarial bone. As a result, the surgical procedure was easy and quick. After a healing of 8 weeks, the synthetic blocks were strongly fused to the calvarial bone surface. Upon histological observation, the monetite blocks appeared to be infiltrated by newly formed bone, without histological signs of necrosis, osteolysis or foreign body reaction. Histomorphometry revealed that bone augmentation occurred within and over the monetite block. The 4.0 and 3.0 mm high blocks were filled with newly formed bone in 35% and 41% of their respective volumes. These observations indicated that craniofacial bone augmentations of at least 4 mm could be achieved with synthetic monetite blocks. Conclusion Within the limits of our study, this novel material may be able to eliminate the need for autologous bone transplantation for the augmentation of large vertical bone defects