Examinando por Autor "Tamimi, Faleh"

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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.
Effect of platelet rich plasma on sinus lifting: A randomized controlled clinical trial
(2011-12-02) Torres, Jesús; Tamimi, Faleh; Martínez, Pedro Pablo; Alkhraisat, Mohammad; Linares, Rafael; Hernandez, Gonzalo; Torres-Macho, Juan; López-Cabarcos, Enrique
6 7 Objective: The combination of anorganic bovine bone (ABB) with platelet rich plasma ABSTRACT 8 (PRP) has been widely used in bone regeneration procedures although its benefits are 9 10 11 12 13 14 15 16 17 18 19 20 a histology level and any adjunctive effects, we performed an ancillary study in 5 still unclear. The purpose of this study was to evaluate whether or not PRP improves the efficacy of ABB in sinus floor augmentation. In addition, we have investigated the effect of residual bone height and tobacco on implant survival in sinus augmentation procedures. Materials and Methods: 87 patients recruited for this study underwent 144 sinus floor augmentation procedures using ABB alone or ABB plus PRP (ABB+PRP) in a randomized clinical trial. A total of 286 implants were placed in the augmented bone, and their evolution was followed up for a period of 24 months. In order to investigate on 21 edentulous patients with symmetrical severely resorbed maxilla. In these patients, a 22 23 24 25 26 27 Results: Overall, 96.2% of ABB and 98.6% of ABB+PRP implant success was 28 bilateral sinus augmentation was randomly performed using ABB or ABB+PRP in a split-mouth design, and after 6 months, bone biopsies were taken from the implant sites for histological and histomorphometric analysis. obtained during the monitoring period and differences were not found between sites grafted with and without PRP in the 87 patients studied. Densitometry assessments and graft resorption were similar in both experimental groups. However, the histological and histomorphometrical analysis in the 5 edentulous patients revealed that bone 29 30 31 32 33 augmentation was significantly higher in sites treated with ABB+PRP (p¿0.05). 34 Another outcome from our study is that the lack of initial bone support (p¿0.05) and smoking (p=0.05) appeared to have a negative effect on the treatment success, that was accentuated when both circumstances coincided. 35 36 37 38 39 40 procedures. However, this study revealed that PRP can improve the osteoconductive 41 Conclusions: PRP is not a determining factor for implant survival in sinus lifting properties of ABB by increasing the volume of new bone formed. Moreover, in sinus augmentation procedures implant¿s survival rate seems more influenced by the residual bone height or by tobacco than by the type of bone graft. 42 43 44
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.
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