orthopaedic surgery

The effect of bone particle size on the histomorphometric and clinical outcomes following lateral ridge augmentation procedures. A randomized double blinded controlled trial

AUTHORS

Hussein S. Basma, Muhammad H.A. Saleh, Nico C. Geurs, Peng Li, Andrea Ravidà, Hom-Lay Wang, Ramzi V. Abou-Arraj

ABSTRACT

Background

The aim of this randomized clinical trial was to clinically and histologically compare the amount and quality of bone gained after lateral ridge augmentation (LRA) procedures performed using small (250-1000μm) versus large (1000-2000μm) particle size cortico-cancellous bone allografts at 6 months following surgical intervention.

Materials and Methods

22 patients, each presenting with ridge width less than 5mm were enrolled. Patients were randomly allocated to small (SP) and large particle (LP) size graft. The gain in ridge width at the level of the crest and 4mm apical to the crest was assessed via a standardized procedure before grafting and at time of implant placement, using a surgical caliper and a novel digital technique using cone beam computed tomography (CBCT). Six months following the procedure, trephine bone cores were taken from 19 augmented sites out of 17 patients (14/19 sites were in the posterior mandible) who completed the study for clinical, histologic and histomorphometric analysis.

Results

17 patients (19 sites) completed the study. LP size graft resulted in greater ridge width gain at the level of the crest (LP, 5.1 ± 1.7; SP, 3.7 ± 1.3 mm; p = 0.0642) and 4mm apical to the crest (LP, 5.9 ± 2.2; SP, 5.1 ± 1.8 mm; p = 0.4480) compared with the SP. No statistical significance for the bone density at the time of implant placement (p = 1.00) was found. Vital bone formation was more extensive in the SP compared with the LP 41.0 ± 10.1% vs 31.4 ± 14.8%, respectively (p = 0.05).

Conclusion

The results of the present article show a trend of higher ridge gain using LP during bone augmentation procedure. Future research with bigger sample size should confirm the results of the present article.

A selected small molecule prevents inflammatory osteolysis through restraining osteoclastogenesis by modulating PTEN activity

Inflammatory osteolysis is a severe infectious bone disorder that occurs during orthopaedic surgery and is caused by disruptions in the dynamic balance of bone matrix homeostasis, which makes this condition a burden on surgical procedures. Developing novel therapeutic drugs about inhibiting excessive osteoclastogenesis acts as an efficient approach to preventing inflammatory bone destruction.