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      Vertical bone augmentation using collagenated or non-collagenated bone substitute materials with or without recombinant human bone morphogenetic protein-2 in a rabbit calvarial model

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          Abstract

          Purpose

          The aim of this study was to determine 1) the bone-regenerative effect of porcine bone block materials with or without collagen matrix incorporation, 2) the effect of a collagen barrier, and 3) the effect of adding recombinant human bone morphogenetic protein-2 (rhBMP-2) to the experimental groups.

          Methods

          Four treatment modalities were applied to rabbit calvaria: 1) deproteinized bovine bone mineral blocks (DBBM), 2) porcine bone blocks with collagen matrix incorporation (PBC), 3) porcine bone blocks alone without collagen matrix incorporation (PB), and 4) PBC blocks covered by a collagen membrane (PBC+M). The experiments were repeated with the addition of rhBMP-2. The animals were sacrificed after either 2 or 12 weeks of healing. Micro-computed tomography (micro-CT), histologic, and histomorphometric analyses were performed.

          Results

          Micro-CT indicated adequate volume stability in all block materials. Histologically, the addition of rhBMP-2 increased the amount of newly formed bone (NB) in all the blocks. At 2 weeks, minimal differences were noted among the NB of groups with or without rhBMP-2. At 12 weeks, the PBC+M group with rhBMP-2 presented the greatest NB ( P<0.05 vs. the DBBM group with rhBMP-2), and the PBC and PB groups had greater NB than the DBBM group ( P>0.05 without rhBMP-2, P<0.05 with rhBMP-2).

          Conclusions

          The addition of rhBMP-2 enhanced NB formation in vertical augmentation using bone blocks, and a collagen barrier may augment the effect of rhBMP-2.

          Graphical Abstract

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          Most cited references37

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          "PASS" principles for predictable bone regeneration.

          Guided bone regeneration is a well-established technique used for augmentation of deficient alveolar ridges. Predictable regeneration requires both a high level of technical skill and a thorough understanding of underlying principles of wound healing. This article describes the 4 major biologic principles (i.e., PASS) necessary for predictable bone regeneration: primary wound closure to ensure undisturbed and uninterrupted wound healing, angiogenesis to provide necessary blood supply and undifferentiated mesenchymal cells, space maintenance/creation to facilitate adequate space for bone ingrowth, and stability of wound and implant to induce blood clot formation and uneventful healing events. In addition, a novel flap design and clinical cases using this principle are presented.
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            Biodegradation of differently cross-linked collagen membranes: an experimental study in the rat.

            The aim of the present study was to compare the biodegradation of differently cross-linked collagen membranes in rats. Five commercially available and three experimental membranes (VN) were included: (1) BioGide (BG) (non-cross-linked porcine type I and III collagens), (2) BioMend (BM), (3) BioMendExtend (BME) (glutaraldehyde cross-linked bovine type I collagen), (4) Ossix (OS) (enzymatic-cross-linked bovine type I collagen), (5) TutoDent (TD) (non-cross-linked bovine type I collagen, and (6-8) VN(1-3) (chemical cross-linked porcine type I and III collagens). Specimens were randomly allocated in unconnected subcutaneous pouches separated surgically on the back of 40 wistar rats, which were divided into five groups (2, 4, 8, 16, and 24 weeks), including eight animals each. After 2, 4, 8, 16, and 24 weeks of healing, the rats were sacrificed and explanted specimens were prepared for histologic and histometric analysis. The following parameters were evaluated: biodegradation over time, vascularization, tissue integration, and foreign body reaction. Highest vascularization and tissue integration was noted for BG followed by BM, BME, and VN(1); TD, VN(2), and VN(3) showed prolongated, while OS exhibited no vascularization. Subsequently, biodegradation of BG, BM, BME and VN(1) was faster than TD, VN(2), and VN(3). OS showed only a minute amount of superficial biodegradation 24 weeks following implantation. Biodegradation of TD, BM, BME, VN(2), and VN(3) was associated with the presence of inflammatory cells. Within the limits of the present study, it was concluded that cross-linking of bovine and porcine-derived collagen types I and III was associated with (i) prolonged biodegradation, (ii) decreased tissue integration and vascularization, and (iii) in case of TD, BM, BME, VN(2), and VN(3) foreign body reactions.
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              Effectiveness of vertical ridge augmentation interventions: A systematic review and meta-analysis

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                Author and article information

                Journal
                J Periodontal Implant Sci
                J Periodontal Implant Sci
                JPIS
                Journal of Periodontal & Implant Science
                Korean Academy of Periodontology
                2093-2278
                2093-2286
                December 2023
                07 March 2023
                : 53
                : 6
                : 429-443
                Affiliations
                [1 ]Department of Periodontology, Kyung Hee University, College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea.
                [2 ]Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
                [3 ]Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
                [4 ]Institute for Research and Education in Dental Medicine, Lugano, Switzerland.
                Author notes
                Correspondence: Ui-Won Jung. Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. drjew@ 123456yuhs.ac , Tel: +82-2-2228-3185, Fax: +82-2-392-0398

                Hyun-Chang Lim and Goran I. Benic contributed equally to the study.

                Author information
                https://orcid.org/0000-0001-7695-1708
                https://orcid.org/0000-0001-7262-7345
                https://orcid.org/0000-0001-6371-4172
                https://orcid.org/0000-0001-7551-7934
                Article
                10.5051/jpis.2204240212
                10761281
                37038830
                1847f2d4-1db3-4fab-9b6d-dd4bddffe4be
                Copyright © 2023. Korean Academy of Periodontology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/).

                History
                : 25 October 2022
                : 01 January 2023
                : 17 January 2023
                Funding
                Funded by: Korea Medical Device Development Fund
                Award ID: KMDF_PR_20200901_0240
                Categories
                Research Article
                Implant Science

                Dentistry
                animal model,bone morphogenetic protein 2,bone substitutes,histology
                Dentistry
                animal model, bone morphogenetic protein 2, bone substitutes, histology

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