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Maxillo-Facciale

2021 Pubblicazione Scientifica

2021 Pubblicazione Scientifica

Mirko Ragazzo. Matteo Val, Giulia Montagner, Diletta Trojan, Stefano Fusetti, Luca Guarda Nardini 19 April 2021

Human amniotic membrane: an improvement in the treatment of Medication-related osteonecrosis of the jaw

 

Cell Tissue Bank
https://doi.org/10.1007/s10561-021-09922-y(0123456789().,-volV() 0123458697().,-volV)

Abstract

The aim of this article is to report the results obtained by the use of HAM in surgical wound healing and the reduction of relapse in patients affected by Medication-related osteonecrosis of the jaw (MRONJ).The study involved patients with the diagnosis of MRONJ, surgically treated between October 2016 and April 2019, in a case–control setting. Enrolled patients were randomly divided into 2 groups. One group will be treated with resective surgery and with the insertion of HAM patch (Group A), while the second group had been treated exclusively with resective surgery (Group B).The patients underwent MRONJ surgical treatment with the placement of amniotic membrane patches at the wound site. Data regarding the long-term complications/functions were evaluated at 3, 6, 12, and 24 months after surgery. Pain measurements were performed before the intervention (T0), 7(T1) and 30(T2) days after surgery. 49 patients were included in the study. 2 patients of GROUP A after 30 days since they were surgically treated showed persistent bone exposure. 5 patients of group B demonstrated a lack of healing of the surgical wound with the persistence of bone exposed to 30 days after surgery. Statistical analysis ruled out any difference in OUTCOME (relapse) between GROUP A and B (p = 0.23). However, the Fisher test highlighted a significant difference between the use of HAM and only surgical treatment in pain at rest (p = 0.032). The use of amniotic membrane implement the patient's quality of life and reduce pain perception. has a learning curve that is fast enough to justify its routine use.

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Amnion membrane for coverage of gingival recession: A novel application

Amnion membrane for coverage of gingival recession: A novel application

Rucha Shah, N. K. Sowmya, and D. S. Mehta 30 September 2014

Contemporany Clinical Dentistry

Amnion allograft has been used in the field of medicine for its exceptional wound-modulating properties. However, in the field of dentistry, only a limited number of reports have explored its potential in healing of oral wounds.

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A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone

A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone

Francesco Carinci, Giorgio Brunelli, Maurizio Franco, Alessandro Viscioni, Leone Rigo,Riccardo Guidi, Laura Strohmenger 05 November 2008

Abstract

Several studies have been performed to evaluate the clinical outcome of implants inserted into maxillae grafted with autogenous bone but few reports have focused on maxillae grafted  with fresh-frozen allogenous bone (FFAB). The purpose of this study is to retrospectively evaluate the clinical outcome of implants installed in resorbed maxillae augmented with FFAB. A total of 69 patients whom had been treated with FFAB grafts to their maxillae and implant placement 4 to 6 months later were retrospectively evaluated. Edentulism was total and partial in 22 and 47 cases, respectively. A total of 287 implants of various systems had been used. A life table analysis was performed. Marginal bone loss was calculated in radiographs. Five of the 287 implants were lost, giving a survival rate (SVR) of 98.3% over a mean follow-up time of 26 months.
The marginal bone resorption at the implants was 1.68 mm (SD = 0.44) after 1 year and 1.85 mm (SD = 0.98) after 4 years. The cumulative success rate based on defined criteria was 96% in the first year but decreased to 40% at 4 years because of marginal bone loss. The Kaplan–Meier algorithm demonstrated a better outcome for female patients, removable dentures, and total edentulism. No differences were detected among diameters, lengths, and implant site. Implants placed in FFAB showed a high SVR similar to that reported in previous studies on maxillae grafted with autogenous iliac crest bone. Although our data point to more marginal bone loss in partially edentulous patients and for fixed prosthetic restorations, the use of FFAB for reconstruction of the atrophic jaw prior to implant placement can be considered as a reliable alternative to autogenous bone.

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A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges

A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges

Omeje K, Efunkoya A, Amole I, Akhiwu B, Osunde D 01 July 2014

Journal of the Korean Association of Oral and Maxillofacial Surgeons (2014)

Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions

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Bilaminar Technique with Coronally Advanced Flap and Cryopreserved Human Amniotic Membrane in the Treatment of Gingival Recessions

Bilaminar Technique with Coronally Advanced Flap and Cryopreserved Human Amniotic Membrane in the Treatment of Gingival Recessions

Mario Martelloni, Pietro Boccaletto, Giulia Montagner, Diletta Trojan and Roberta Abate 26 August 2020

Hindawi
Case Reports in Dentistry
Volume 2020, Article ID 7827092, 4 pages https://doi.org/10.1155/2020/7827092

Abstract

Gingival recessions are usually treated with surgical therapies which involve the use of connective tissue autograft in order to thicken the gingival tissue. This has an important biological repercussion on patients since they will have surgical wounds in two different oral cavity sites. In this case report, we offer an alternative technique for the treatment of a Miller class I gingival recession. A 40-year-old female patient has been treated with a combination of bilaminar and coronally advance flap techniques to cover a Miller class I gingival recession with addition of cryopreserved human amniotic membrane. The human amniotic membrane has been employed to thicken the keratinized tissue. The human amniotic membrane in combination with bilaminar and coronally advance flap techniques has produced aesthetically and functionally satisfying results, covering completely the gingival recession and restoring the natural colour and thickness of the gingiva. Bilaminar technique with coronally advanced flap and cryopreserved human amniotic membrane is a valid alternative in treating Miller class I and II gingival recessions and reduce the biological morbidity of a double intervention.

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Clinical similarities and histological diversity comparing fresh frozen onlay bone blocks allografts and autografts in human maxillary reconstruction

Clinical similarities and histological diversity comparing fresh frozen onlay bone blocks allografts and autografts in human maxillary reconstruction

Spin-Neto R1, Landazuri Del Barrio RA, Pereira LA, Marcantonio RA, Marcantonio E, Marcantonio E Jr. 31 August 2013

Abstract

In the absence of autologous bone for harvesting, fresh-frozen bone allografts turned into an alternative for bone reconstruction procedures. The purpose of this study was to make a histological analysis of fresh-frozen onlay bone allografts (ALs), compared with autografts, in patients who needed maxillary reconstruction prior to dental implants placement. Twelve patients with bone deficiencies (width inferior to 4 mm) in the sites where the implants were planned were enrolled in the study. From these, six were elected to be treated with autogenous (AT) bone grafts and six with fresh-frozen bone AL. This last group included the patients who had absence of a convenient amount of bone in donor sites. Each patient received from one to six graft blocks, totalling to 12 ATs and 17 ALs. Seven months after grafting procedures, biopsies of the grafts were made using 2-mm internal diameter trephine burs, and processed for histological analysis. One biopsy was retrieved from each patient. Clinically, all grafts were found to be firm in consistency and well-incorporated to the receptor bed. Histological analysis showed a large amount of necrotic bone surrounded by few spots of new-formed bone in the AL group, suggesting low rate of graft remodeling. In the AT group, an advanced stage of bone remodeling was seen.
Human fresh-frozen bone block AL showed clinical compatibility for grafting procedures, although associated to slow remodeling process. Further studies are needed to define, at long term, the remodeling process chronology the clinical longitudinal results for fresh-frozen bone

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Comparative study of indigenously prepared and imported, demineralized, freeze-dried, irradiated bone allograft in the treatment of periodontal infrabony defects.

Comparative study of indigenously prepared and imported, demineralized, freeze-dried, irradiated bone allograft in the treatment of periodontal infrabony defects.

Shah M, Lobo Gajiwala A, Shah S, Dave D. 01 September 2015

Cell and Tissue Banking (2015)


Demineralized freeze-dried bone allograft (DFDBA) has been used extensively in periodontal therapy. Questions have been raised however, about the osteogenic potential of the variety of grafts available. In India the cost factor is another important consideration. The aim of this study therefore was to evaluate the clinical efficiency of the low priced, indigenously prepared DFDBA obtained from the Tata Memorial Hospital (TMH) Tissue Bank, in periodontal regeneration in infrabony periodontal defects, as compared to DFDBA obtained from the Pacific Coast Tissue Bank (DEMBONE). The latter was used as the control. 16 patients with bilaterally similar periodontal infrabony defects were selected, and randomly allotted to the test and control groups.

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Effectiveness of fresh frozen and cryopreserved homologue iliac crest grafts used in sinus lifting a comparative study

Effectiveness of fresh frozen and cryopreserved homologue iliac crest grafts used in sinus lifting a comparative study

Alessandro Viscioni • Maurizio Franco • Adolfo Paolin • Elisa Cogliati • Maura Callegari • Ilaria Zollino • Vincenzo Sollazzo • Francesco Carinci 05 November 2011

Abstract

In the last decade, several investigators have reported that autologous and homologous fresh frozen bones (FFB) are effective materials to restore alveolar ridges previous to insert dental implants. Recently we have used cryopreserved homologue grafts (CFFB). Here we reported a retrospective comparative study between implants inserted in FFB and CFFB evaluate their clinical outcome. Patients were treated with a split mouth scheme for bone grafting with FFB and CFFB and spiral family implants (SPI) were inserted in the same surgical time. Several variables (patient, grafts, anatomic site, implant, prosthetic restoration) were investigated. Implant' failure and peri-implant bone resorption were considered as predictor of clinical outcome. A total of 84 SFIs were inserted in 12 patients. Implantswere inserted to replace 8 incisors, 4 cuspids, 31 remolars and 41 molars. The mean follow-up was 14 months. Three out of 84 implants was lost (i.e. survival rate SVR = 96.4%) and no differences were detected among the studied variables.  imilar result was obtained by analyzing the crestal bone resorption around implant' neck (i.e. success rate). FFB and CFFB have high and comparable survival and success rate. Implants inserted with one step surgical procedure in native (i.e. not grafted) bone, FFB and CFFB have similar  clinical outcome.

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Fresh-frozen bone case series of a new grafting material for sinus lift

Fresh-frozen bone case series of a new grafting material for sinus lift

Viscioni A, Dalla Rosa J, Paolin A, Franco M. 30 September 2010

Abstract

Statement of the problem: Although autologous bone is considered to be the gold standard grafting material, it needs to be harvested from patients, a process that can be off-putting and can lead to donor site morbidity. For this reason, homologous fresh-frozen bone (FFB) was used in the current study as an alternative graft material. Purpose of the study: The aim of this study was to evaluate the effectiveness of FFB as a grafting material in complex maxillary sinus lift with immediate implant insertion. Methods: FFB was obtained from the Veneto Tissue Bank and preserved at -80°C. Twenty-one patients were surgically treated with FFB block grafts in 26 maxillary sinus rehabilitations, with 47 immediate implant insertions, with a reopening phase after six months. All patients underwent orthopanoramic X-rays and CT scans before,immediately after and four months (X-ray only) post surgery. Bone biopsies were performed in order to evaluate the volume and density of the bone grafts, which all
showed optimal adherence without complications. Results: Four months post surgery, 64% of grafts showed no evidence of bone
resorption or resizing. In all other cases resorption was slight. All implants were clinically osseointegrated, with only one implant failure during the provisional prosthetic loading stage (97.8% success rate). Histological studies confirmed these results, showing the presence of new bone and sparse osteoclastic activity four months post implantation, with 80% mature bone material observed after 12 months.
Conclusions: Use of FFB permits effective bone-adding surgery and immediate implant insertion under local anaesthesia, decreasing both chair time and patient discomfort.

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Human Amniotic Membrane Positioning in the Surgical Treatment of Temporomandibular Joint Degenerative Disorder

Human Amniotic Membrane Positioning in the Surgical Treatment of Temporomandibular Joint Degenerative Disorder

Luca Guarda-Nardini, Diletta Trojan, Giulia Montagner, Elisa Cogliati, Matteo Bendini and Daniele Manfredini 03 March 2019

Hindawi
Case Reports in Surgery
Volume 2019, Article ID 6037191, 5 pages

Abstract

Temporomandibular joint (TMJ) arthritis is a degenerative pathology that may cause pain and dysfunction.
Nonsurgical therapy is the traditional treatment of TMJ diseases but if ineffective, TMJ surgery can be performed and may include arthroplasty with interposition of autograft. The encouraging results reported with the use of human amniotic membrane (HAM) in different surgical fields have highlighted its potential, but approaches providing the positioning of HAM within the intra-articular space of arthritic TMJs have never been investigated. Case Presentation. A 48-year-old woman was presented with limited mouth opening and pain with palpation at the left joint. A severe TMJ degeneration was diagnosed, and a surgical treatment was necessary. In the present case report, the authors describe the application of a cryopreserved HAM patch within the joint space as a disc-replacing film during major surgeries for discectomy and arthroplasty. Three months after the intervention, the patient reported an overall improvement in chewing efficiency as well as the absence of pain. Conclusions. According to the regenerative effects of HAM, the design of trials on the topic should be encouraged for its possible inclusion within the field of TMJ disease practice. 

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Lateral alveolar ridge augmentation using tenting screws, acellular dermal matrix, and freeze-dried bone allograft alone or with particulate autogenous bone

Lateral alveolar ridge augmentation using tenting screws, acellular dermal matrix, and freeze-dried bone allograft alone or with particulate autogenous bone

Caldwell GR, Mills MP, Finlayson R, Mealey BL. 28 February 2015

The International journal of periodontics & restorative dentistry (2015)


This randomized prospective study evaluated the clinical benefits of using a corticocancellous mixture of freeze-dried bone allograft alone or in combination (1:1) with particulated autogenous bone for horizontal ridge augmentation and subsequent implant placement. Twenty-four patients with atrophic ridges received lateral ridge augmentations with particulate grafts placed around tenting screws and covered with a fixed acellular dermal matrix membrane.

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Management of temporomandibular joint degenerative disorders with human amniotic membrane: Hypothesis of action

Management of temporomandibular joint degenerative disorders with human amniotic membrane: Hypothesis of action

Luca Guarda-Nardini, Diletta Trojan, Adolfo Paolin, Daniele Manfredini 28 May 2017

Medical Hypotheses 104 (2017) 68–71

Abstract

Approaches providing the positioning of human amniotic membrane (HAM) within the intra-articular
space of arthritic TMJs have never been investigated. This contrasts with the increasing amount of evidence
suggesting the potential positive effects of HAM on a number of surgical conditions, even included
the interpositional arthroplasty for TMJ ankylosis. Thus, the possible usefulness of HAM to restore joint
functions in severely damaged TMJs could be hypothesized.
Based on these premises, the clinical research question ‘‘Is human amniotic membrane positioning
effective to reduce symptoms and restore jaw function in patients with severe inflammatorydegenerative
disorders of the temporomandibular joint?" has been addressed by performing a systematic
review of the literature. Out of potential 11988 and 8883 citations in the PubMed and Scopus databases,
respectively, only five were of possible interest for inclusion in the review, but none of them addressed
specifically the clinical research question.
Thus, the hypothetical background for usefulness was discussed. The benefits of HAM positioning in
TMJs with severe inflammatory-degenerative disorders could be related with its anti-inflammatory
and anti-microbial and analgesic properties as well as its low immunogenicity. Studies in which HAM
is positioned within the joint space of patients with severe TMJ degeneration, either as a discreplacing
film during major surgeries for discectomy and arthroplasty or as an injectable solution that
can be needle-inserted after an arthrocentesis procedure, should be designed to test the hypothesis.

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2019 Pubblicazione Scientifica

2019 Pubblicazione Scientifica

Martelloni M, Montagner G, Trojan D, Abate R 26 August 2020

Amniotic Membrane In Palatal Epithelial-Connective Tissue Reconstruction

 

2019 Nov 19;12:349-354. doi: 10.2147/IMCRJ.S213275. eCollection 2019.

Abstract

Mucogingival surgery has the objective to obtain coverage of the recession, with a favorable long-term prognosis, but also to minimize postoperative problems and surgery-related risks. Human amniotic membrane is increasingly employed for periodontal tissue repair in order to promote epithelialization and to reduce pain and scar tissue formation. A 38-year-old female patient reports dental hypersensitivity resulting from gingival recession affecting tooth 4.1. A mucogingival surgical procedure was proposed and a partial-thickness flap of epithelial-connective tissue was harvested from the palate and grafted on to the receiving site. The amniotic membrane was positioned at the donor site to reduce postoperative morbidity and to encourage rapid palatal healing. One week after the application of HAM (human amniotic membrane), the wound was healed and 1 month after the donor site was completely re-epithelialized. The present case report suggests that in the surgical treatment of gingival recession with palatal epithelial-connective tissue graft, HAM promotes rapid epithelialization of the palatal donor site wound with a reduction in morbidity.

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Pubblicazione Scientifica

Pubblicazione Scientifica

Procopio O, Trojan D, Frigo AC, Paolin A 30 May 2019

Use of homologous bone for alveolar crest reconstruction in 483 patients with 5 years' outcomes post implantation

Oral Maxillofac Surg. 2019 May 30. doi: 10.1007/s10006-019-00781-2.

Procopio O, Trojan D, Frigo AC, Paolin A

Abstract

PURPOSE: The purpose of this study was to evaluate the clinical course of bone reconstruction of the alveolar crest using homologous fresh-frozen bone harvested from deceased donors.

METHODS: A retrospective survey was based on the Castelfranco Veneto Hospital database, in which 3264 clinical records with a primary or secondary diagnosis of alveolar atrophy were collected over a 10-year period. A random sample of 483 patients with at least 5 years' follow-up was included in the survey. Patients were contacted by telephone and administered a questionnaire with specific questions to build a significant sample.

RESULTS: Of the patients, 449 (93% of the sample) had an uneventful follow-up after surgery and 93.2% received at least one implant, with a mean of 3.4 implants per patient. At the time of the survey, 93% of the patients were wearing a dental prosthesis, 86.9% had not lost any implants, and 6.7% had lost at least one implant, while 6.4% still had implants but presented some clinical problems. Finally, patients were asked to provide an index score (1-10 points) on the therapy as a whole, i.e., bone graft, implants, and prostheses. A score of insufficient (up to 5 points) was given by 5.3% of patients, of sufficient (6 to 7 points) by 6.1%, and of good/very good (over 7) by 88.6%.

CONCLUSIONS: Homologous bone for alveolar crest reconstruction can be a valid alternative to autologous grafting if specific tissue limitations are considered when planning therapy. Creeping substitution is partial and slower than in autologous grafts, especially in cases where cortical bone is thick or volume graft is very large. The quality of soft tissue coverage and mucosa lining is also important, possibly due to slower tissue revascularization, so future implants should predictably be positioned primarily within the original host bone.

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Reconstruction of Severely Atrophic Jaws Using Homografts and Simultaneous Implant Placement A Retrospective Study

Reconstruction of Severely Atrophic Jaws Using Homografts and Simultaneous Implant Placement A Retrospective Study

Viscioni A, Rigo L, Franco M, Brunelli G, Avantaggiato A, Sollazzo V, Carinci F. 30 September 2010

Abstract

In the past decade, several investigators have reported that implants inserted in autografts in the same operation (ie, simultaneously inserted implants [SIIs]) have achieved excellent results. However, no report regarding SIIs placed in fresh frozen bone (FFB) is available. Thus, the authors planned a retrospective study on a series of SIIs placed in homologue FFB (but not immediately loaded) to evaluate their clinical outcome. In addition, a comparison with implants inserted in FFB in a second stage (ie, delayed inserted implants) was performed. Seventeen patients were grafted with FFB, and 48 implants were inserted in the same operation. Implant diameter and length ranged from 3.25 to 4.0 mm and from 10.0 to 15 mm, respectively. Data were compared with 302 implants inserted in FFB in a second operation during the same period in 64 patients. Analyzing SIIs, it was noted that only 3 implants were lost (ie, survival rate [SVR] = 93.7%), and no differences were detected among the studied variables by using lost implants as a predictor of clinical outcome. On the contrary, by using crestal bone resorption around the implant's neck and specific cutoff values, it was possible to demonstrate that prosthetic restoration (ie, removable overdentures) correlated with a statistically significant lower delta insertion abutment junction (ie, reduced crestal bone loss) and thus with a better clinical outcome. By comparing SIIs with implants inserted in a second stage in FFB, a better outcome for delayed implants was demonstrated. Implants inserted simultaneously with FFB grafts had a high survival and success rate. SIIs inserted in FFB can be considered reliable devices, although a higher marginal bone loss is to be expected when fixed prosthetic restorations are used. Implants inserted in a second surgical stage have a better SVR and success rate than SIIs.

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Repair of oral mucosal defects with cryopreserved human amniotic membrane grafts: prospective clinical study

Repair of oral mucosal defects with cryopreserved human amniotic membrane grafts: prospective clinical study

I.B. Kar, A.K. Singh, P.C. Mohapatra, P.K. Mohanty, S. Misra 30 November 2014

 International Journal of Oral & Maxillofacial Surgery  

Abstract

The aim of this study was to evaluate the clinical outcome of the surgical repair of oral mucosal defects using cryopreserved human amniotic membrane (HAM) as a graft material. Thirty-four patients with precancerous lesions such as leukoplakia, erythroplakia, and verrucous hyperplasia were included. Fresh amniotic membrane was obtained from women undergoing elective caesarean section; the membrane was cleaned, prepared in antibiotic solutions, and preserved at -80 °C. Results suggested that HAM promotes healing and epithelialization without specific complications. Thus we conclude that the use of HAM gives promising results in the repair of post-surgical oral mucosal defects.

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Temporomandibular Joint Arthroplasty with Human Amniotic Membrane - Case Report

Temporomandibular Joint Arthroplasty with Human Amniotic Membrane - Case Report

Bauer F, Hingsammer LM, Wolff KD, Kesting MR. 18 March 2013

 2013;13:e17. Epub 2013 Mar 18.

Abstract

This case reports the usage of human amniotic membrane combined with a costochondral graft as an interpositional material in temporomandibular joint reconstruction for the first time in humans. Because of the favorable outcome 20 months postoperatively, it has to be considered as an approach bringing to light the antiadhesive potential of amniotic membrane. This case report must be regarded as initial spadework and should motivate other institutions to intensify their clinical research in this field. Because of the fact that currently used interpositional materials do not prevent the recurrence of temporomandibular joint ankylosis sufficiently, it is of great interest to establish a proper therapeutic intervention fulfilling these demands. Furthermore, the demonstrated antiadhesive properties of amniotic membrane highlight its multifaceted field of application. Nevertheless, further studies have to prove the findings reported in our case.

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Use of amnion as a graft material in vestibuloplasty a preliminary report

Use of amnion as a graft material in vestibuloplasty a preliminary report

Mohammad Hassan Samandari, Masoud Yaghmaei, Masoud Ejlali, Mohammad Moshref, Arash Shoja Saffar 05 April 2004

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Abstract

The aim of this study was to evaluate the clinical use of amnion as a biodegradable graft material for vestibuloplasty.

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Use of amnion as a graft material in vestibuloplasty a preliminary report

Use of amnion as a graft material in vestibuloplasty a preliminary report

Mohammad Hassan Samandari, Masoud Yaghmaei, Masoud Ejlali, Mohammad Moshref, Arash Shoja Saffar 05 April 2004

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Abstract

The aim of this study was to evaluate the clinical use of amnion as a biodegradable graft material for vestibuloplasty.

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