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Histomorphometric and micro‐CT analyses of calvarial bone grafts used to reconstruct the extremely atrophied maxilla

BACKGROUND: Calvarial bone grafts are successful in the reconstruction of the severely atrophied maxilla as a pre‐implant procedure. However, not much is known about graft incorporation at the microscopic level. PURPOSE: This study aimed to assess calvarial bone conversion 4 months after being graft...

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Autores principales: Wortmann, Dagmar E., Klein‐Nulend, Jenneke, van Ruijven, Leo J., Vissink, Arjan, Raghoebar, Gerry M., Schortinghuis, Jurjen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590101/
https://www.ncbi.nlm.nih.gov/pubmed/32920912
http://dx.doi.org/10.1111/cid.12936
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author Wortmann, Dagmar E.
Klein‐Nulend, Jenneke
van Ruijven, Leo J.
Vissink, Arjan
Raghoebar, Gerry M.
Schortinghuis, Jurjen
author_facet Wortmann, Dagmar E.
Klein‐Nulend, Jenneke
van Ruijven, Leo J.
Vissink, Arjan
Raghoebar, Gerry M.
Schortinghuis, Jurjen
author_sort Wortmann, Dagmar E.
collection PubMed
description BACKGROUND: Calvarial bone grafts are successful in the reconstruction of the severely atrophied maxilla as a pre‐implant procedure. However, not much is known about graft incorporation at the microscopic level. PURPOSE: This study aimed to assess calvarial bone conversion 4 months after being grafted in the edentulous maxillary bone. MATERIALS AND METHODS: In 13 patients (age:65.3 ± 8.7 years) the atrophic maxilla was reconstructed with autologous calvarial bone. Biopsies were taken from fresh calvarial bone grafts and from the reconstructed maxillae after 4 months of healing. Micro‐CT, histomorphometric, and histological analysis were performed. From three patients biopsies were obtained after 9, 11, or 45 months. RESULTS: The micro‐CT analysis revealed that in the maxilla the calvarial bone was well preserved even after 45 months. Histology showed progressive incorporation of grafted bone within a maxillary bone. Osteoid and osteocytes were present in all biopsies indicating new bone formation and vital bone. Histomorphometrically, the percentage of grafted bone volume over total volume decreased from 79.8% (IQR78.7‐83.3) in fresh calvarial grafts to 59.3% (IQR44.8‐64.6) in healed grafts. The biopsies were taken after 9, 11, and 45 months showed similar values. CONCLUSIONS: Calvarial bone grafts result in stable and viable bone, good incorporation into native maxillary bone, and a minor decrease in bone volume after healing. Consequently, they provide a solid base for implant placement in severely atrophied edentulous maxillary bone.
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spelling pubmed-75901012020-10-30 Histomorphometric and micro‐CT analyses of calvarial bone grafts used to reconstruct the extremely atrophied maxilla Wortmann, Dagmar E. Klein‐Nulend, Jenneke van Ruijven, Leo J. Vissink, Arjan Raghoebar, Gerry M. Schortinghuis, Jurjen Clin Implant Dent Relat Res Original Articles BACKGROUND: Calvarial bone grafts are successful in the reconstruction of the severely atrophied maxilla as a pre‐implant procedure. However, not much is known about graft incorporation at the microscopic level. PURPOSE: This study aimed to assess calvarial bone conversion 4 months after being grafted in the edentulous maxillary bone. MATERIALS AND METHODS: In 13 patients (age:65.3 ± 8.7 years) the atrophic maxilla was reconstructed with autologous calvarial bone. Biopsies were taken from fresh calvarial bone grafts and from the reconstructed maxillae after 4 months of healing. Micro‐CT, histomorphometric, and histological analysis were performed. From three patients biopsies were obtained after 9, 11, or 45 months. RESULTS: The micro‐CT analysis revealed that in the maxilla the calvarial bone was well preserved even after 45 months. Histology showed progressive incorporation of grafted bone within a maxillary bone. Osteoid and osteocytes were present in all biopsies indicating new bone formation and vital bone. Histomorphometrically, the percentage of grafted bone volume over total volume decreased from 79.8% (IQR78.7‐83.3) in fresh calvarial grafts to 59.3% (IQR44.8‐64.6) in healed grafts. The biopsies were taken after 9, 11, and 45 months showed similar values. CONCLUSIONS: Calvarial bone grafts result in stable and viable bone, good incorporation into native maxillary bone, and a minor decrease in bone volume after healing. Consequently, they provide a solid base for implant placement in severely atrophied edentulous maxillary bone. John Wiley & Sons, Inc. 2020-09-13 2020-10 /pmc/articles/PMC7590101/ /pubmed/32920912 http://dx.doi.org/10.1111/cid.12936 Text en © 2020 The Authors. Clinical Implant Dentistry and Related Research Published by Wiley Periodicals LLC This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Wortmann, Dagmar E.
Klein‐Nulend, Jenneke
van Ruijven, Leo J.
Vissink, Arjan
Raghoebar, Gerry M.
Schortinghuis, Jurjen
Histomorphometric and micro‐CT analyses of calvarial bone grafts used to reconstruct the extremely atrophied maxilla
title Histomorphometric and micro‐CT analyses of calvarial bone grafts used to reconstruct the extremely atrophied maxilla
title_full Histomorphometric and micro‐CT analyses of calvarial bone grafts used to reconstruct the extremely atrophied maxilla
title_fullStr Histomorphometric and micro‐CT analyses of calvarial bone grafts used to reconstruct the extremely atrophied maxilla
title_full_unstemmed Histomorphometric and micro‐CT analyses of calvarial bone grafts used to reconstruct the extremely atrophied maxilla
title_short Histomorphometric and micro‐CT analyses of calvarial bone grafts used to reconstruct the extremely atrophied maxilla
title_sort histomorphometric and micro‐ct analyses of calvarial bone grafts used to reconstruct the extremely atrophied maxilla
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590101/
https://www.ncbi.nlm.nih.gov/pubmed/32920912
http://dx.doi.org/10.1111/cid.12936
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