VitalCenter Margitsziget

The raison d’etre of human (allograft) bone grafting in dental implantology – László Párkány MD

Periodontologist 

After tooth loss, the jawbone undergoes gradual decomposition over the years, rendering it incapable of placing dental implants on its own, thereby making it impossible in many cases to establish a fixed denture.

Bone blocks removed from different donor areas (hip, shin, skull, jaw) have long been known and proven methods for replacing the broken jawbone. To date these procedures, are considered the „gold standard” for bone grafting (1) This procedure, although successful in many cases, has many disadvantages. It puts the patient under a very high surgical burdern (usually anesthesia), is time consuming, and the inserted bone block undergoes a high rate of absorption during healing, thus, in many cases, does not provide sufficient bone for implantation.

In order to avoid these disadvantages, various types of bone grafts have recently been introduced. The best known and most effective are animal (xenogeneic) and human (other human / allogeneic) bone grafts.

Recently, the „sausage” technique (2), which has been successfully used to replace the bone block procedure, has been shown to work predictably even with large jawbone defects, however, it worth mentioning as relative disadvantage that:

  • for proper bone formation for the procedure, 50% of own bone is required
  • the regenerated bone contains a significant proportion of inanimate bone graft even in the long run
  • the duration of healing is extremely long (9 months)

The most successful and well-known technique for applying blocks derived from own bone is the so-called „Khoury” technique (3), which uses thin cortical bone block plate and bone shavings for bone grafting, but requires quite invasive surgical intervention due to its own bone requirements. At the same time, the healing time is acceptable (6 months), the renegerated bone will be entirely your own bone.

A recently developed human bone graft (Bonealbumin, Hungary) obtained by inserting orthopedic prostheses from its own bone, is capable of producing a cortical disc and bone graft granules. Human bone is „alloyed” with blood serum albumin, which according to some studies promotes ossification, healing and even reduced patient complaitns during healing (4,5,6).

As a human bone gaft, its transformation time and thus its healing time comparable to its own bone (6 months), after a while, most (if not all) of the regenerated bone becomes its own bone, and without its own bone promoter effect can also promote the formation of new bone of adequate quality.

Allogeneic block grafts are comparable in efficacy to the increasingly popular GBR technique (7), but have the aforementioned benefits in  bone grafting.

The aim of this study is to compare the „sasusage” technique and the performed with bonealbumin modified „Khoury” technique in the case of severely decomposed jawbone defects:

  • healing time
  • quantity and quality of newly formed bone

Sources:

  1. Comparison of Two Techniques for Lateral Ridge Augmentation in Mandible With Ramus Block
    Barbu HM, Andreescu CF, Lorean A, Kolerman R, Moraru L, Mortellaro C, Mijiritsky E. J Craniofac Surg. 2016 May;27(3):662-7. doi: 10.1097/SCS.0000000000002561.
  1. Long-Term Results of Peri-implant Conditions in Periodontally Compromised Patients Following Lateral Bone Keeve PL, Khoury F.
    Int J Oral Maxillofac Implants. 2017 Jan/Feb;32(1):137-146. doi: 10.11607/jomi.4880.
  1. Horizontal ridge augmentation with a collagen membrane and a combination of particulated autogenous bone and anorganic bovine bone-derived mineral: a prospective case series in 25
    Urban IA, Nagursky H, Lozada JL, Nagy K.
    Int J Periodontics Restorative Dent. 2013 May-Jun;33(3):299-307. doi: 10.11607/prd.1407.
  1. Albumin-coated structural lyophilized bone allografts: a clinical report of 10
    Klára T, Csönge L, Janositz G, Csernátony Z, Lacza Z.
    Cell Tissue Bank. 2014 Mar;15(1):89-97. doi: 10.1007/s10561-013-9379-8. Epub 2013 May 16.
  1. Serum albumin coating of demineralized bone matrix results in stronger new bone
    Horváthy DB, Vácz G, Szabó T, Szigyártó IC, Toró I, Vámos B, Hornyák I, Renner K, Klára T, Szabó BT, Dobó-Nagy C, Doros A, Lacza Z.
    J Biomed Mater Res B Appl Biomater. 2016 Jan;104(1):126-32. doi: 10.1002/jbm.b.33359. Epub 2015 Feb 10.
  1. Bone-Albumin filling decreases donor site morbidity and enhances bone formation after anterior cruciate ligament reconstruction with bone-patellar tendonbone
    Schandl K, Horváthy DB, Doros A, Majzik E, Schwarz CM, Csönge L, Abkarovits G, Bucsi L, Lacza Z.
    Int Orthop. 2016 Oct;40(10):2097-2104. Epub 2016 Jun 29.
  1. Block allograft technique versus standard guided bone regeneration: a randomized clinical
    Amorfini L, Migliorati M, Signori A, Silvestrini-Biavati A, Benedicenti S.
    Clin Implant Dent Relat Res. 2014 Oct;16(5):655-67. doi: 10.1111/cid.12040. Epub 2013 Jan 25.

 

Use of BoneAlbumin bone graft for dental implant bone graft: preliminary results

Endre Lantos(1), György Péter (1), Sarolta Popráczy (1)

VitalCenter Dent, Budapest (1)

Introduction: BoneAlbumin is a home-made, serum-albuminized, lyophilized human bone meal that has proven efficacy in many areas of bone grafting, but little information is available on its use in dental implant bone grafting. Our clinical research was conducted to clarify this issue. So far, 17 people (63%) have completed the study.

Material and method: Volunteers who underwent implantation due to partial or complete tooth failure and who required bone graft (n=27) received BoneAlbumin bone graft after informed consent, followed by histological sampling and follow-up CBCT at 6 months, followed by implantation.

Results: In all cases, the shrinkage of the bone substitute was negligible and greatly allowed implantation. The histological examination showed a very large reconstruction. No treatment-related complications were observed.

Conclusion: BoneAlbumin can be used safely and with good efficacy in the tested indication.

The raison d’etre of human (allograft) bone grafting in dental implantology

21.09.2018 PROJECTDAY

SpringFairs Celje 17.03.2019

MedTech Luzern 10-11.09.2019

Hívjon minket!
Kapcsolat