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This preliminary study aimed to assess the efficacy of zygomatic buttress bone grafting for nasal floor augmentation in patients with a unilateral alveolar cleft who were referred after the optimal timetable for this surgery had elapsed. Five patients, aged 12–18 years, with unilateral alveolar clefts were treated at Qaem Hospital, Mashhad, Iran. Initially, a mucous layer was established on the side of the cleft nose, followed by forming a bony bridge between the defect's sides through a bone graft derived from the zygomatic buttress and xenograft bone powder. Subsequently, the grafted region was covered with an absorbable collagen membrane, and the oral-side flap was sealed. Post-operative follow-ups occurred at 1 week, 1 month, and 3 months, and cone beam computed tomography (CBCT) was performed 6 months post-treatment. Discrepancy between the anterior edge height of the pyriform aperture on the healthy and cleft sides post-grafting was assessed. The average disparity between the height of the anterior edge of the pyriform aperture on the healthy side and the peak height achieved post-grafting on the cleft side was 1.90 ± 2.82 mm. Within the limitations of the study, it seems that zygomatic buttress is applicable for late unilateral alveolar bone grafting as an intraoral source, and is helpful in symmetric bony nasal floor reconstruction, with a good success rate. [ABSTRACT FROM AUTHOR]

Introduction: Despite the absence of bone grafting in the area outside the cage, lateral bridging callus outside cages (LBC) formation is often observed here following extreme lateral interbody fusion (XLIF) conversely to conventional methods of transforaminal lumbar interbody fusion and posterior lumbar interbody fusion. The LBC, which may increase stabilization and decrease nonunion rate in treated segments, has rarely been described. This study aimed to identify the incidence and associated factors of LBC following XLIF. Methods: We enrolled 136 consecutive patients [56 males, 80 females; mean age 69.6 (42-85) years] who underwent lumbar fusion surgery using XLIF, including L4/5 level with posterior fixation at a single institution between February 2013 and February 2018. One year postoperatively, the treated L4/5 segments were divided into the LBC formation and non-formation groups. Potential influential factors, such as age, sex, body mass index, bone density, height of cages, cage material (titanium or polyetheretherketone [PEEK]), presence or absence of diffuse idiopathic skeletal hyperostosis (DISH), and radiological parameters, were evaluated. Multivariate logistic regression analysis was performed for factors significantly different from the univariate analysis. Results: The incidence of LBC formation was 58.8%. Multivariate logistic regression analysis showed that the length of osteophytes [+1 mm; odds ratio, 1.29; 95% confidence interval, 1.17-1.45; p

Purpose: To present clinical outcomes of alveolar ridge augmentation using in situ autogenous block bone and to compare the outcomes with previous studies. Materials and Methods: The medical records of patients with a severe horizontal bone defect in a partially edentulous alveolar ridge (width < 3.5 mm), who received bone augmentation using in situ autogenous block bone, were retrospectively reviewed. After a 6-month or longer healing period, the augmentation effect was examined before implant placement. Cone beam computed tomography (CBCT) was performed before and after surgeries. The alveolar width of the bone grafts was measured on the CBCT images. Results: A total of 16 patients (22 grafts) were included. Graft exposure was seen in three grafts, which were classified as failed cases. The augmentation volume at implant placement in the failed cases was significantly lower than that of the successful cases. There were no significant differences in augmentation between anterior maxillary and mandibular implant sites. Conclusion: Autogenous bone grafting using in situ block bone is an effective and reliable approach for horizontal bone augmentation in the mandible and anterior maxilla that eliminates second donor site morbidity. Complete release of the buccal flap and tension-free suture is the key to avoiding wound dehiscence and ensuring the effectiveness of bone augmentation. [ABSTRACT FROM AUTHOR]

Whether artificial bone provides comparable outcomes to autogenous bone has not been determined for osteonecrosis of the femoral head (ONFH). This study was conducted to compare the clinical outcomes of autogenous and artificial bone grafting (demineralized bone matrix/calcium sulfate [DBM/CaS]) through a modified lightbulb technique by percutaneous femoral neck-head fenestration for treating precollapse ONFH. A total of 73 Association Research Circulation Osseous Stage Ⅱ ONFH patients (81 hips) who had a mean follow-up of 61 months (range, 52 to 74) were included in this retrospective study. Among them were 40 hips treated with autogenous bone and 41 hips treated with DBM/CaS grafting through the percutaneous femoral neck-head fenestration. The Harris scores, radiographic progressions, clinical success rates, and survival analyses were analyzed. At final follow-up, the mean Harris score was 80 points (range, 63 to 92) in the DBM/CaS group and 76 points (range, 69 to 91) in the autogenous bone group (P =.751). The radiographic progression rate was 29.9% in the DBM/CaS group, without significant difference from the autogenous bone group, which was 37.5% (P =.43). About 73.2% of patients in the DBM/CaS group and 75% in the autologous bone group avoided a total hip arthroplasty (P =.85). Survival analysis for femoral head protection revealed similar outcomes between the 2 groups (P >.05). Percutaneous femoral neck-head fenestration combined with artificial bone (DBM/CaS) grafting had comparable clinical outcomes to autologous bone grafting on preventing femoral head collapse and rescuing THA at a mean of 61-month follow-up for treating early ONFH. [ABSTRACT FROM AUTHOR]

Aim: The aim of this systematic review was to systematically assess the papers comparing the surgical techniques of Alveolar Distraction Osteogenesis(ADO) and Autogenous Bone grafting (ABG) for Vertical Ridge Augmentation in terms of bone gain, bone resorption and incidences of complications. Metholodology: The review was registered on PROSPERO with the ID : CRD42021237671. A broad electronic survey was conducted in the PubMed, Scopus, Web of Science, Cochrane Library, and Virtual Health Library databases of all studies published till 08/03/2022. Four studies fulfilled the criteria to carry out a meta-analysis a in which a total of 58 patients underwent ADO and 43 patients for ABG. A total of 133 implants were placed in the ABG group and 124 in the ADO group. Statistical Analysis: DerSimonian–Laird estimator of variance was used for Random effect meta-analysis. The estimates of an intervention were expressed as the odds ratio (OR) and standard mean difference (SMD) in millimeters. Results: There was statistically significant difference in terms of bone height gain with SMD of − 0.78 (95% 0.04–1.55) in ABG. Bone resorption and complications were statistically insignificant with SMD of 0.52 (95% − 1.59 to 0.56) and OR 0.55 (95% 0.18–1.70), respectively. PROSPERO Registration ID: CRD42021237671. [ABSTRACT FROM AUTHOR]

Introduction: Orofacial clefts are the most common craniofacial birth defects, affecting a significant number of individuals worldwide. The alveolar cleft is a developmental defect that affects the alveolar process of the maxilla and is often associated with cleft lip and palate. Methods: In this case report, we present the case of a 20-year-old female patient with alveolar cleft who underwent secondary alveolar cleft reconstruction using autologous iliac bone grafting. The aim of the procedure was to restore the function and form of the maxillary arch, facilitate ridge augmentation for further prosthetic rehabilitation, repair the nasal floor, and facilitate orthodontic treatment. Results: The procedure was successful in achieving the desired outcomes, and the patient's occlusal relationship was improved. Additionally, the alar base symmetry was enhanced, and speech was improved. Conclusion: Alveolar cleft reconstruction using autologous iliac bone grafting is a successful approach to treating alveolar clefts. The procedure can restore the form and function of the maxillary arch and facilitate further prosthetic rehabilitation and orthodontic treatment. The effectiveness of the procedure should be monitored closely to ensure optimal outcomes. Update Dent. Coll. j: 2023; 13(1): 35-39

Abstract Background To determine whether multiple drilling is effective in postponing the need for total hip arthroplasty (THA) in early-stage nontraumatic osteonecrosis of the femoral head (ONFH). Methods We identified 514 patients who were diagnosed with early-stage ONFH between January 2008 and December 2018. One hundred ninety-six patients underwent multiple drilling, and 318 patients had a natural course of progression. One hundred fifty-nine patients were selected for each group after case-control matching for preoperative demographics and modified Ficat and Arlet stage. The rates of THA conversion were compared. We also performed Cox regression to identify risk factors associated with THA conversion in patients who underwent multiple drilling. Results Kaplan-Meier survivorship with an endpoint of THA for nontraumatic reasons were not significantly different between the multiple drilling group (75.6, 95% confidence interval 67.8–83.4%) and the natural course group (72.2, 95% confidence interval 64.8–79.6%) at 5 years (log-rank, P = .191). In the Cox regression model, a larger extent of necrotic lesion, bone marrow edema (BME), and higher postoperative work intensity significantly increased the risk of THA conversion (P

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Autogenous bone augmentation is the gold standard for the treatment of extended bone defects prior to implantation. Bone augmentation from the zygomatic crest is a valuable option with several advantages, but the current literature for this treatment is scant. The aim of this study was to evaluate the increase in bone volume after locoregional bone augmentation using autogenous bone from the zygomatic alveolar crest as well as the complications and success rate. Results Analysis of the augmented bone volume in seven patients showed a maximum volume gain of 0.97 cm3. An average of 0.54 cm3 of autogenous bone (SD 0.24 cm3; median: 0.54 cm3) was augmented. Implantation following bone augmentation was possible in all cases. Complications occurred in three patients. Conclusion The zygomatic alveolar crest is a valuable donor site for autogenous alveolar onlay grafting in a locoregional area such as the maxillary front. Low donor site morbidity, good access, and its suitable convexity make it a beneficial choice for autogenous bone augmentation.

Background: The aim of this study is to present a very easy technique for coverage of dehiscence and fenestration defects around the dental implantsfrom the nearest bone source by using a sharp scalpel and the analysis of its clinical results.Materials and Methods:750 screw dental implants were inserted by the same surgeon. Exactly 112 of the (15%) implants had dehiscence defects and 23 of them (3 %) had fenestration defects. A bone sheet was obtained from the nearest available cortical bone for covering a bone defect around an implant by using a new no: 15 scalpel. Survival rates of implants were evaluated.Results:One hundred and thirty-five exposed implant surfaces were augmented with autogenous bone, harvested by scalpel technique. The survival rate of these implants was 100% with no significant clinical finding.Conclusion:The scalpel technique described in the present study is easy, effective and reliable for the management of dehiscence or fenestration defects of dental implants.Key words: Autogenous bone grafting, defects around dental implants, dental implants

Background: To determine whether multiple drilling is effective in postponing the need for total hip arthroplasty (THA) in early-stage nontraumatic osteonecrosis of the femoral head (ONFH).Methods: We identified 514 patients who were diagnosed with early-stage ONFH between January 2008 and December 2018. One hundred ninety-six patients underwent multiple drilling, and 318 patients had a natural course of progression. One hundred fifty-nine patients were selected for each group after case-control matching for preoperative demographics and modified Ficat and Arlet stage. The rates of THA conversion were compared. We also performed Cox regression to identify risk factors associated with THA conversion in patients who underwent multiple drilling.Results: Kaplan-Meier survivorship with an endpoint of THA for nontraumatic reasons were not significantly different between the multiple drilling group (75.6, 95% confidence interval 67.8-83.4%) and the natural course group (72.2, 95% confidence interval 64.8-79.6%) at 5 years (log-rank, P = .191). In the Cox regression model, a larger extent of necrotic lesion, bone marrow edema (BME), and higher postoperative work intensity significantly increased the risk of THA conversion (P < .05). Among patients treated with autogenous bone grafting, there was a lower risk of failure in patients with necrotic lesion less than 15% (P < .05).Conclusions: Multiple drilling is not effective in reducing the rate of THA conversion in early-stage nontraumatic ONFH. The risk of conversion to THA after multiple drilling is increased by a larger extent of necrotic lesion, presence of BME, and higher postoperative work intensity in patients with early-stage ONFH.Trial Registration: The trial was registered in the Chinese Clinical Trial Registry ( ChiCTR2000035180 ) dated 2 August 2020. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe the revascularization process of autogenous bone block grafts placed with or without an expanded polytetrafluoroethylene (e-PTFE) membrane. Materials and Methods: Thirty Wistar male rats had their mandibles augmented by either an autogenous bone block graft (group A) or an autogenous bone block graft covered with an e-PTFE membrane (group B). The animals were sacrificed by perfusion at baseline, 3, 7, 14, and 21 days after surgery. Results: After 3 days, the presence of vascular sprouts derived from the recipient bed was observed in group A; more discrete sprouts were also observed in group B. After 7 days, revascularization continued, with vessels derived from both the recipient bed and the surrounding connective tissue in group A but only from the recipient bed in group B. At 14 days, group A showed penetration of vessels at the periphery of the graft; the vessels reached varying distances inside it. In group B, revascularization of the graft occurred mainly near its perforation, its borders, and at the recipient bed-graft interface. After 21 days, graft vascular penetration could be observed throughout the extent of the graft in group A but only approximately halfway through the graft in group B. Discussion: The results emphasized the importance of the vascular network and of the revascularization process of the autogenous bone graft in new bone formation. Early vascular penetration and nutrition of the graft are key factors in its integration with the recipient bed. Conclusions: Revascularization of the bone graft occurred in both A and B. However, vascular sprouts originated only from the recipient bed in group A, while in group B the graft was penetrated by vessels from both the recipient bed and the surrounding connective tissue. The revascularization took place more promptly and was more intense and extensive in group A than in group B for all periods. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of the addition of platelet concentrate (PC) to autografts or bone substitutes on bone regeneration in standardized bone defects. Materials and Methods: Three standardized bone defects were prepared in both mandibular angles of 12 adult minipigs. The defects were grafted with autograft, anorganic bovine bone, or syntheticβ-tricalcium phosphate β-TCP). PC was added to only 1 side. The animals were divided into 4 groups, which were sacrificed at 4 different time points (1, 2, 4, and 8 weeks) for histologic and histomorphometric analysis. The concentrations of platelets and growth factors were measured to identify correlation to the histologic and histomorphometric results. Results: No correlation was found between platelet count in whole blood and platelet count in PC (rp = 0.36). Furthermore, no correlation could be demonstrated between the platelet count of the PC and the concentrations of PDGF-AB (rp = -0.27) and TGF-β (rp = 0.34). There were no signs of a stimulating effect of PC on bone formation in combination with autografts or bone substitutes at any time point (P = .89). Addition of PC did not alter the pattern of graft degradation. Discussion: The present study underlines the need for further investigation to identify the optimal concentrations of platelets and combinations of growth factors to achieve a predictable stimulatory effect on bone regeneration. One of the first steps to achieve this goal will be the development of a reliable method for the procurement of PC. Conclusion: PC had no impact on bone formation and graft degradation in standardized bone defects in the mandibles of minipigs. [ABSTRACT FROM AUTHOR]

Fifty patients with inadequate bone volume for implant placement were treated with mandibular bone grafts from the symphysis or ramus. The choice of donor site was determined by defect morphology and recipient site location. Although the harvest of bone was associated with low morbidity, the ramus donor site resulted in fewer complications. Implants were placed secondarily following a 4- to 6-month healing period. The onlay grafts exhibited minimal resorption and maintained their dense quality. The symphysis grafts were larger in overall volume, with a corticocancellous morphology. The ramus area provided essentially a cortical graft that was well suited for veneering ridge deficiencies; however, the surgical access in some cases was more difficult than in the anterior mandible. [ABSTRACT FROM AUTHOR]

Nineteen patients received tumoricidal doses of radiation and subsequently underwent mandibular endosseous implant reconstruction, followed by dental rehabilitation with complete arch fixed osseoprostheses. Eight of the 19 patients also underwent autogenous bone graft reconstruction for mandibular discontinuity. A surgical and prosthetic protocol for irradiated head and neck oncology patients is presented. The 10-year retrospective study of 19 consecutively treated patients revealed an endosseous implant survival of 99%, dental osseoprosthesis continuous service of 100%, and successful bone graft reconstruction of 89%. [ABSTRACT FROM AUTHOR]

Sufficient bone volume is still considered the most important prerequisite for the osseointegration of dental implants. The TIME technique (autogenous bone grafting combined with stabilization using a titanium mesh) for localized alveolar ridge augmentation was evaluated in 20 patients who had insufficient bone volumes for the primary placement of dental implants. Different clinical recordings were evaluated at TIME stage 1 (augmentation surgery) and at TIME stage 2 (reentry surgery with mesh removal and simultaneous dental implant placement). In most patients, single- or extended-tooth gaps (up to four units) were augmented with autogenous bone harvested from the chin or retromolar area. With the exception of temporary disturbances of tooth sensibility, no morbidity at the donor sites was observed. In one patient, the stabilizing titanium micromesh had to be removed prematurely because of graft infection. At the reentry surgery, the bone grafts were found to be completely incorporated in 75% of the patients. In 15% of the patients, only minimal graft resorption was observed (less than 10% of the graft volume). Subsequently, 28 implants could be placed in 19 patients. The stabilizing titanium mesh was best suited for vertical ridge augmentations. Another feature of the mesh was the excellent tissue compatibility, with little clinical or histologic inflammation, even when the mesh had become exposed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Recessions following immediate implant insertion are frequently reported in the literature. Data regarding implant installation in presence of mucogingival recessions are rare. Purpose: This study observes soft tissue level changes following immediate implant insertion and provisionalization of implants with or without connective tissue grafts in the anterior maxilla in patients with initial mucogingival recession within a follow‐up period between one and eight years. Materials and Methods: Twenty‐six patients with marginal gingival recessions, which were designated for extraction and immediate implant insertion in the anterior zone of the maxilla (13‐23), were included. Out of a larger group of immediate implants only single tooth replacements with 1 to 3 mm recession and a pre‐ and post‐op CB‐CT were selected. Facial bone deficiencies were grafted flaplessly with autologous bone in all sites. In a group of 13 patients the recessions (mean 2.3 ± 0.7 mm, range 1.0‐3.0 mm) were grafted additionally by connective tissue (ABG + CTG), in the remaining 13 patients no soft tissue grafting (mean recession 1.8 ± 0.6 mm, range 1.0‐3.0 mm) was performed (ABG). The marginal hard and soft tissue level, the width of the keratinized mucosa, the PES, and implant success were evaluated. Results: After a mean follow‐up period of 45 months the recessions were significantly reduced in the ABG group from 1.8 to 0.9 mm. The improvement was even more pronounced in the ABG + CTG group (from 2.3 to 0.5 mm). The PES improved significantly in both groups. At final examination all implants were still in function. Within the observational period, in 5 of 13 implants a marginal bone loss of more than 1 mm was noticed in the ABG, but in none of the ABG + CTG group. Conclusions: These clinical results provide evidence that immediate implant placement might improve the facial soft tissue level. This was more evident in cases with a greater recession and an additional treatment with connective tissue grafts. [ABSTRACT FROM AUTHOR]

Introduction: Despite the absence of bone grafting in the area outside the cage, lateral bridging callus outside cages (LBC) formation is often observed here following extreme lateral interbody fusion (XLIF) conversely to conventional methods of transforaminal lumbar interbody fusion and posterior lumbar interbody fusion. The LBC, which may increase stabilization and decrease nonunion rate in treated segments, has rarely been described. This study aimed to identify the incidence and associated factors of LBC following XLIF., Methods: We enrolled 136 consecutive patients [56 males, 80 females; mean age 69.6 (42-85) years] who underwent lumbar fusion surgery using XLIF, including L4/5 level with posterior fixation at a single institution between February 2013 and February 2018. One year postoperatively, the treated L4/5 segments were divided into the LBC formation and non-formation groups. Potential influential factors, such as age, sex, body mass index, bone density, height of cages, cage material (titanium or polyetheretherketone [PEEK]), presence or absence of diffuse idiopathic skeletal hyperostosis (DISH), and radiological parameters, were evaluated. Multivariate logistic regression analysis was performed for factors significantly different from the univariate analysis., Results: The incidence of LBC formation was 58.8%. Multivariate logistic regression analysis showed that the length of osteophytes [+1 mm; odds ratio, 1.29; 95% confidence interval, 1.17-1.45; p<0.0001] was significant LBC formation predictive factors. Receiver operating characteristic curve analysis demonstrated that the cut-off value for osteophyte length was 14 mm, the sensitivity was 58.8%, the specificity was 84.4%, and the area under the ROC curve for this model was 0.79., Conclusions: The incidence of LBC formation was 58.8% in L4/5 levels one year after the XLIF procedure. We demonstrated that the length of the osteophyte was significantly associated with LBC formation., Competing Interests: Conflicts of Interest: The authors declare that there are no relevant conflicts of interest., (Copyright © 2023 The Japanese Society for Spine Surgery and Related Research.)

Maxillary sinus enlargement often occurs in the maxillary posterior edentulous area and reduces the available bone height for implantation. Therefore, maxillary sinus lift and bone graft procedures are necessary to provide sufficient available bone. Autogenous bone grafting is the best base for implant osseointegration. Recently, tibial bone has been recognized as an alternative extraoral donor site. We present a case in which we used a proximal tibia bone graft for maxillary sinus augmentation under local anesthesia without sedation in the dental office. During a 4-year postoperative follow-up, gait was not disturbed and the scar on the donor site remained unremarkable.

Vertical defects of the alveolar crest often restrict the placement of implants. The outcome of vertical augmentation is unpredictable so we aimed to develop a technique that has predictable results. We used autogenous grafts trimmed to shells less than 1 mm thick to rebuild the vertical dimensions of the alveolar ridge. The shells were fixed with microscrews and the vertical space between the shell and the residual bone was filled with autogenous particulate bone. Vertical dimensions before and after augmentation were measured and descriptive statistics calculated. A total of 17 patients (10 female, 7 male, mean (SD) age 46 (17) years) had 18 sites augmented (2 sites in one patient). In 2 cases the wound dehisced and healing was by secondary intention. The rest healed uneventfully. The mean (SD) vertical defect was 4.7 (1.4) mm and mean (SD) resorption during consolidation was 0.5 (0.7) mm. All 30 previously planned implants were placed, and none failed during the first year. Loading was monitored for a mean (SD) period of 14.6 (10.5) months. The technique showed promising results and could be an alternative to procedures that use extraoral donor sites. [ABSTRACT FROM AUTHOR]

Background: Recent studies have demonstrated that nonoperative treatment of displaced midshaft clavicle fractures have a high prevalence of symptomatic malunion and nonunion with nonoperative treatment [Hill et al. J Bone Joint Surg Br 79: 537-539, 1997; Mckee et al. J Trauma 47: 616, 2001; Simon Eur J Orthop Surg Traumatol 20: 521-525, 2010]. Although good results have been demonstrated with open reduction internal fixation (ORIF), complications still exist thus fixation was augmented. This retrospective study was undertaken to determine the efficacy of open reduction and internal fixation (ORIF) augmented with bioresorbable calcium phosphate (BCP) cement compared with standard autogenous bone grafting (ABG) of acute displaced, midshaft clavicle fractures. Methods: At our level I trauma institute, from July, 2007 to September 2008, each patient who presented with a clavicle fracture that was deemed operative received plate fixation supplemented with bioresorbable calcium phosphate cement or autogenous bone grafting. Patient records and radiographs were retrospectively reviewed. Follow-up included standard radiographs to evaluate union at a minimum of 6 months. All complications were also reviewed. Results: Two different clavicle plating systems, Smith and Nephew (Smith and Nephew, Memphis, USA) (18 clavicles) and Implant Technology Systems (I.T.S., Lassnitzhohe, Austria) (24 clavicles), were used with autogenous bone graft (14 patients) or bioabsorbable calcium phosphate (28 clavicles). Of forty patients treated with open reduction internal fixation, 6 complications have occurred at a minimum of 6-month follow-up. Three prominent hardware occurrences necessitated plate removal. One nonunion, one distal screw cutout, and one hardware breakage have been treated successfully with revision plating. Using Fisher's exact test, no statistical significance was seen between the autogenous bone grafting (2) and bioabsorbable calcium phosphate (4) in regard to overall failure incidence ( P = 0.66). Complications necessitating revision ORIF with bioabsorbable calcium phosphate (2) and bone graft (1) were not statistically significant either ( P = 0.73). Conclusion: There appears to be no statistically significant difference between union and complication rates between bioresorbable calcium phosphate cement and autogenous bone graft in this retrospective study. [ABSTRACT FROM AUTHOR]

im: To describe a case series to highlight the clinical effectiveness of single-stage posterior debridement and transforaminal lumbar interbody fusion (TLIF) with autogenous bone grafting and posterior instrumentation in the surgical management of lumbar tuberculosis. Methods: This case series involves 14 lumbar tuberculosis patients treated with the above given surgical procedure. The following parameters have been evaluated: visual analog scale (VAS) score, erythrocyte sedimentation rate (ESR) and C-reactive protein value, vertebral body loss, deformity angle, kyphotic angle, lumbar lordotic angle and fusion status of affected segment. The mean time of follow-up is 38.2 months (30-46). Results: Significant improvement was found in all radiologic parameters, and significant decrease in VAS and ESR were noted after surgery. Bony fusion was seen in all cases within a mean time of 4.3 months (range 3-7 months). No postoperative instrumental complication and recurrence were noted. Conclusion: Single-stage posterior debridement and TLIF with autogenous bone grafting and posterior instrumentation is a safe and effective approach to treating with early-diagnosed and less-involved lumbar tuberculosis. [ABSTRACT FROM AUTHOR]

Abstract: A new internal distraction device, comprising a square-bodied bow, a transport plate, a traction mechanism, and two stabilisers, was developed to allow transportation of bone around an arc. Eight adult goats were studied. A curved mandibulectomy 3cm long was made on the mandibular angle. The distractor was implanted to restore the defect. The bone was distracted at a rate of 1mm per day after a 5-day latent period. Distraction lasted 25 to 32 days. Curvilinear distraction was successful in six of the eight goats. After consolidation periods of four or eight weeks, smooth curved bone masses were restored in the distracted areas. Radiographically, there was considerable bone density in the distraction area and opaque columns streamed in the direction of distraction. Histological examination showed membranous bony regeneration in the restored bone. These results suggest that restoration of curved bone defects using the new internal transport distraction device was feasible in goats. [Copyright &y& Elsevier]

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The purpose of this study was to evaluate the capacity of composite grafts consisting of either particulated cancellous or particulated cortical bone and anorganic bovine bone mineral (BBM) (Bio-Oss®) to induce regeneration in standardized critical size bony defects overlying the frontal sinus. Four full thickness critical size bone defects were made in the frontal bone in each of 8 skeletally mature female goats. These defects were filled at random with composite cancellous bone/BBM grafts or composite cortical bone/BBM grafts. Control defects were not included but could be evaluated using data from a previous study in which the same experimental setting was used (Merkx et al. 1999a). Fluorochrome bone markers were injected subcutaneously 1 and 5 weeks after implantation, and 1 week before the animals were killed. Two animals were killed at 3, 6, 12 and 24 weeks after surgery respectively. The results were evaluated by histological means including fluorescence microscopy. In conclusion, composite grafts consisting of autogenous cancellous bone/BBM yield good results, combining the advantages of each material alone and reducing the disadvantages of each when used separately. Critical size defects in the maxillofacial area, overlying a paranasal sinus, filled with this material heal uneventfully within 12 weeks. Composite grafts consisting of cortical bone and BBM show less favorable results. These grafts induce osteoclasts, probably by the presence of non-functional BBM, resulting in resorption of the cortical bone chips. [ABSTRACT FROM AUTHOR]

• CGRP could promotes the proliferation and osteogenic differentiation of BMSCs. • CGRP-modified BMSCs may promote bone formation and repair in the femoral head. • CGRP-modified BMSCs combined with autogenous bone grafting improved the success of treatment for ONFH. Calcitonin gene-related peptide (CGRP) promotes proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), which influence bone regeneration and reconstruction. We previously established CGRP-modified BMSCs that express the CGRP gene and demonstrated that this elevated CGRP expression promotes osteogenic differentiation of BMSCs. The current study investigated the therapeutic effects of CGRP-modified BMSCs combined with autogenous bone grafting for the treatment of osteonecrosis of the femoral head (ONFH) in rabbits. ONFH model rabbits were divided into three groups: CGRP, BMSCs/pLV5-CGRP combined with autogenous bone grafting; NC, BMSCs/pLV5-NC combined with autogenous bone grafting; and Blank, BMSCs combined with autogenous bone grafting. After autogenous bone grafting, mRNA and protein expression levels of osteogenesis-related genes (CGRP, OCN, Runx2, BMP-2, and OPG) were measured in the femoral head, as were ALP, laminin, and collagen type I contents. The fraction of trabecular bone area, percentage of empty osteocyte lacunae, maximum compressive strength, and mean elasticity modulus of the femoral head were also determined. Our results demonstrated that CGRP-modified BMSCs combined with autogenous bone grafting accelerated osteogenic differentiation of BMSCs, improved osteogenesis efficiency, and promoted the repair and reconstruction of bone tissue in the femoral head, which significantly improved the success rate of ONFH treatment. [ABSTRACT FROM AUTHOR]

We hypothesised that cells obtained via a Reamer-Irrigator-Aspirator (RIA) system retain substantial osteogenic potential and are at least equivalent to graft harvested from the iliac crest. Graft was harvested using the RIA in 25 patients (mean age 37.6 years (18 to 68)) and from the iliac crest in 21 patients (mean age 44.6 years (24 to 78)), after which ≥ 1 g of bony particulate graft material was processed from each. Initial cell viability was assessed using Trypan blue exclusion, and initial fluorescence-activated cell sorting (FACS) analysis for cell lineage was performed. After culturing the cells, repeat FACS analysis for cell lineage was performed and enzyme-linked immunosorbent assay (ELISA) for osteocalcin, and Alizarin red staining to determine osteogenic potential. Cells obtained via RIA or from the iliac crest were viable and matured into mesenchymal stem cells, as shown by staining for the specific mesenchymal antigens CD90 and CD105. For samples from both RIA and the iliac crest there was a statistically significant increase in bone production (both p < 0.001), as demonstrated by osteocalcin production after induction. Medullary autograft cells harvested using RIA are viable and osteogenic. Cell viability and osteogenic potential were similar between bone grafts obtained from both the RIA system and the iliac crest.