Page 102 - Read Online
P. 102
viability of the bone tissue is maintained and can
begin osteogenesis. Another positive factor is the
utilization of autogenous bone tissue of membranous
and not of endocondral origin, a material known to
be more efficient because it has lower reabsorption
levels. [16]
The surgical technique described for the procurement of
particulate intraoral autogenous bone material is simple,
efficient and safe. The possibility of harvesting bone
graft while the implant site is being prepared allows
the procurement of the particulate bone without the
disadvantages of donor site morbidity.
ACKNOWLEDGMENTS
Figure 4: The picture shows continuous osteoblasts line (arrows) on
mature bone (HE, ×20) The authors wish to thank Dr. Adolfo Apicella of the Anatomy
and Histopathology Department “Luciano Armanni,” Second
University of Naples, Naples, Italy, for his valuable contribution
and have histologically well-preserved structures with a to the present study.
large number of osteocytes in a calcified matrix. In an
[8]
animal study, Coradazzi et al. found that harvested bone REFERENCES
[9]
resorbed more rapidly and showed higher osteoinductive
potential than particulate bone in the early healing 1. Jakse N, Seibert FJ, Lorenzoni M, Eskici A, Pertl C. A modifi ed technique
stages. of harvesting tibial cancellous bone and its use for sinus grafting. Clin Oral
Implants Res 2001;12:488-94.
Particle size and available bone volume are important 2. Gamradt SC, Lieberman JR. Bone graft for revision hip arthroplasty: biology
factors for graft material. In general, small particles and future applications. Clin Orthop Relat Res 2003;(417):183-94.
are preferred secondary to more rapid resorption, 3. Mazock JB, Schow SR, Triplett RG. Proximal tibia bone harvest: review of
greater surface area, and enhanced ostogenesis, [10-12] technique, complications, and use in maxillofacial surgery. Int J Oral Maxillofac
but particles that are too small lack the space for the 4. Implants 2004;19:586-93.
Matsuda M, Satoh Y, Ono K. Scanning electron microscopic and light
migration and proliferation of cells, vessels, and bone. microscopic observations on morphological changes of freeze-dried bone
A pore size of at least 100 μ is necessary. Zaner and implantation in rats: comparison with fresh autogenous bone transplantation.
[12]
Yukna recommended that an appropriate particle size Histol Histopathol 1992;7:393-403.
would be 300–500 μ. 5. Hu ZM, Peel SA, Sandor GK, Clokie CM. The osteoinductive activity of bone
morphogenetic protein (BMP) purifi ed by repeated extracts of bovine bone.
Grafting particulate bone is considered a better Growth Factors 2004;22:29-33.
option than en bloc harvesting because of the former’s 6. Bünger MH, Langdahl BL, Andersen T, Husted L, Lind M, Eriksen EF,
capacity to adapt to the site of engraftment; it enables Bünger CE. Semiquantitative mRNA measurements of osteoinductive
growth factors in human iliac-crest bone: expression of LMP splice variants
a larger quantity of harvested material to be grafted, in human bone. Calcif Tissue Int 2003;73:446-54.
with advantages in terms of long-term cell survival, 7. Peleg M, Garg AK, Misch CM, Mazor Z. Maxillary sinus and ridge
although the latter aspect is influenced both by the augmentations using a surface-derived autogenous bone graft. J Oral Maxillofac
harvesting technique and the dimensions of the particles. [7] Surg 2004;62:1535-44.
8. Blay A, Tunchel S, Sendyk WR. Viability of autogenous bone grafts obtained
The drill was set at low speed as this has been shown by using bone collectors: histological and microbiological study. Pesqui Odontol
to preserve viable osteocytes. [13,14] For these reasons, an 9. Bras 2003;17:234-40.
Coradazzi LF, Garcia IR Jr, Manfrin TM. Evaluation of autogenous bone grafts,
investigation was made on the methods of obtaining particulate or collected during osteotomy with implant burs: histologic
autogenous bone tissue by means of drills, and the and histomorphometric analysis in rabbits. Int J Oral Maxillofac Implants
possibility for preservation of cells with bone induction 2007;22:201-7.
capacity was evaluated. 10. Shapoff CA, Bowers GM, Levy B, Mellonig JT, Yukna RA. The effect
of particle size on the osteogenic activity of composite grafts of
The use of bone harvested should be considered allogeneic freeze-dried bone and autogenous marrow. J Periodontol
to be an extremely conservative technique, since it 1980;51:625-30.
eliminates the need to obtain autogenous bone material 11. Pallesen L, Schou S, Aaboe M, Hjørting-Hansen E, Nattestad A, Melsen F.
Infl uence of particle size of autogenous bone grafts on the early stages of
from a second surgical site, which can be complex. [15] bone regeneration: a histologic and stereologic study in rabbit calvarium. Int
J Oral Maxillofac Implants 2002;17:498-506.
There are no studies to date which have histologically 12. Zaner DJ, Yukna RA. Particle size of periodontal bone grafting materials.
evaluated the bone harvested during implant site J Periodontol 1984;55:406-9.
preparation. From the results obtained it is concluded 13. Rogers GF, Greene AK, Mulliken JB, Proctor MR, Ridgway EB. Exchange
that the harvesting method described is capable cranioplasty using autologous calvarial particulate bone graft effectively
of preserving cells with bone induction capacity, repairs large cranial defects. Plast Reconstr Surg 2011;127:1631-42.
secondary to a large number of osteoblasts and 14. Beederman M, Alkureishi LW, Lam S, Warnke P, Reid RR. Exchange hybrid
cranioplasty using particulate bone graft and demineralized bone matrix: the
the expression of viable cells. This suggests that the best of both worlds. J Craniofac Surg 2014;25:451-4.
96 Plast Aesthet Res || Vol 1 || Issue 3 || Dec 2014