Xenograft

异种移植物
  • 文章类型: Journal Article
    目的:评估使用不可吸收的膜和自体骨片的骨移植组合在下颌骨中垂直引导骨再生(GBR)的功效,和高温处理(HTP)异种移植,通过CT扫描和microCT分析。材料和方法:患者在植入前进行垂直隆脊手术。外科手术包括皮瓣抬高和植骨的放置,该植骨包括1:1组合的自体下颌骨后骨碎片,和用d-PTFE膜覆盖的HTP异种移植物颗粒被修整以适合骨缺损的3D形状。这是用钛螺钉和销钉牢固固定的,和一层天然的胶原膜。评估术后并发症和脊测量。从CT扫描获得预骨增强和植入前放置骨参数。通过microCT检查植入过程中收集的活检标本。结果:所有13项研究程序均成功,无任何并发症。结果显示平均垂直和水平骨增加分别为3.35mm和5.15mm。共有33个植入物成功地放置在增强区域,不需要进一步的骨增强。MicroCT分析显示48%的骨头,15%填充材料,和37%的非钙化组织在扩大区域相比,65%的骨,3%填充材料,原骨中32%为非钙化组织.结论:自体骨和HTP异种移植的混合物,覆盖有d-PTFE膜和一层天然胶原膜对垂直GBR有效。
    Purpose: To evaluate the efficacy of vertical guided bone regeneration (GBR) in the mandible utilizing a non-resorbable membrane and a bone graft combination of autogenous bone chips, and high-temperature processed (HTP) xenograft, through CT scans and microCT analysis. Materials and Methods: Patients underwent vertical ridge augmentation procedures prior to implant placement. The surgical procedure included flap elevation and placement of a bone graft comprising a 1:1 combination of autogenous posterior mandible-derived bone chips, and HTP xenograft graft particles covered with a d-PTFE membrane trimmed to suit the 3D shape of the bone defect. This was fastened securely with titanium screws and pins, and a layer of native collagen membrane. Post-operative complications and ridge measurements were assessed. Pre bone augmentation and pre implant placement bone parameters were obtained from CT scans. Biopsy specimens collected during implantation were examined by microCT. Results: All 13 study procedures were successful without any complications. The results revealed average vertical and horizontal bone gains of 3.35 mm and 5.15 mm respectively. A total of 33 implants were successfully placed in the augmented areas, without the need for further bone augmentation. MicroCT analysis revealed 48% bone, 15% filler material, and 37% non-calcified tissue in the augmented region compared to 65% bone, 3% filler material, and 32% non-calcified tissue in the pristine bone. Conclusions: A mixture of autogenous bone and HTP xenograft, covered with a d-PTFE membrane and a layer of native collagen membrane is effective for vertical GBR.
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  • 文章类型: Journal Article
    近年来,拔牙后保持牙槽脊的重要性明显增加。肺泡脊保存(ARP)是一种常用的技术,各种骨替代材料和生物制剂以不同的组合应用。为此,在ARP后的前瞻性病例系列中,我们研究了组织学评估和随后的引导骨再生(GBR)在延迟种植中的临床必要性,其中包括新型去蛋白牛骨材料(95%)和物种特异性胶原(5%)(C-DBBM).值得注意的是,没有猪胶原蛋白的块状骨替代品是有限的,而且,该材料的组织学数据仍然有限.十个病人,每个计划进行拔牙和希望将来植入,包括在这项研究中。拔牙后,使用C-DBBM的嵌段形式与双折叠牛交联胶原膜(xCM)结合进行ARP。将该膜公开地暴露于口腔并使用十字形缝合线固定。经过130至319天的愈合期,使用静态计算机辅助植入手术(s-CAIS)进行引导环钻以插入植入物。对从先前用ARP处理的区域收获的核进行组织学处理和检查。任何植入都不需要引导骨再生(GBR)。组织学检查显示,在C-DBBM颗粒周围的各个阶段,通过并置膜状成骨作用,形成了松质骨小梁的晶格,以及较大的海绵状或致密小骨,残留最少。临床随访时间为2.5~4.5年,在此期间没有生物或技术并发症发生。在这个前瞻性案例系列的限制下,可以得出结论,使用这种新型C-DBBM与牛xCM结合使用的ARP可能是一种治疗选择,以避免在延迟植入中需要随后的GBR,并有可能获得牛物种特异性生物材料链。
    In recent years, the significance of maintaining the alveolar ridge following tooth extractions has markedly increased. Alveolar ridge preservation (ARP) is a commonly utilized technique and a variety of bone substitute materials and biologics are applied in different combinations. For this purpose, a histological evaluation and the clinical necessity of subsequent guided bone regeneration (GBR) in delayed implantations were investigated in a prospective case series after ARP with a novel deproteinized bovine bone material (95%) in combination with a species-specific collagen (5%) (C-DBBM). Notably, block-form bone substitutes without porcine collagen are limited, and moreover, the availability of histological data on this material remains limited. Ten patients, each scheduled for tooth extraction and desiring future implantation, were included in this study. Following tooth extraction, ARP was performed using a block form of C-DBBM in conjunction with a double-folded bovine cross-linked collagen membrane (xCM). This membrane was openly exposed to the oral cavity and secured using a crisscross suture. After a healing period ranging from 130 to 319 days, guided trephine drilling was performed for implant insertion utilizing static computer-aided implant surgery (s-CAIS). Cores harvested from the area previously treated with ARP were histologically processed and examined. Guided bone regeneration (GBR) was not necessary for any of the implantations. Histological examination revealed the development of a lattice of cancellous bone trabeculae through appositional membranous osteogenesis at various stages surrounding C-DBBM granules as well as larger spongy or compact ossicles with minimal remnants. The clinical follow-up period ranged from 2.5 to 4.5 years, during which no biological or technical complications occurred. Within the limitations of this prospective case series, it can be concluded that ARP using this novel C-DBBM in combination with a bovine xCM could be a treatment option to avoid the need for subsequent GBR in delayed implantations with the opportunity of a bovine species-specific biomaterial chain.
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  • 文章类型: Case Reports
    在安装牙科植入物之前通常需要骨增强。这里,我们报告了一个病人,他以前接受了使用异种移植的右上颌骨增强,其次是成功的植入物安装。七年后,该患者出现粘膜开窗术,该区域骨暴露,并提供了最近诊断为皮肤扁平苔藓的病史。进行了几次尝试以控制局势,最后,我们在该部位采用结缔组织移植。一块骨头被送去做组织学评估,结果表明存在被炎症细胞包围的未吸收的移植材料,该区域没有骨形成的证据。该病例提供了组织学证据,表明在评估期间使用异种移植物缺乏新骨形成。这个病例还显示了扁平苔藓,一个可能的原因口腔并发症的患者进行增强和植入安装。
    Bone augmentation is often required before the installation of dental implants. Here, we report a case for a patient who previously received bone augmentation at the upper right jaw using a xenogenic graft, followed by successful implant installation. Seven years later, the patient presented with mucosal fenestration with bone exposure at the area and gave a history of a recent diagnosis of cutaneous lichen planus. Several attempts were made to manage the situation, and finally, we resorted to connective tissue graft placement at the site. A piece of bone was sent for histologic evaluation, where the results indicated the presence of un-resorbed graft material surrounded by inflammatory cells, with no evidence of bone formation in the area. The case presents histologic evidence for the lack of new bone formation using xenograft over the evaluation period. The case also shows lichen planus, a possible cause for oral complication for patients undergoing augmentation and implant installation.
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  • 文章类型: Case Reports
    Systemic lupus erythematosus (SLE) with oral desquamative lesions is one of the rare clinical entities. Periodontal disease and SLE display various mechanisms and possess a wide range of pathological characteristics. The tissue destruction mechanism of periodontitis and autoimmune diseases share similar pathways, and mounting reports studied the association between these two entities. The present case is of a 24-year-old female patient who complained of generalized widening of spaces in between the teeth. Along with it, She suffered from loss of hair, weakness, edema in the legs as well as arthralgia. The patient was identified to be suffering from SLE according to the American Rheumatism Association and European Academy of Dermatology and Venereology criteria 1 year before she reported to the dentist. She suffered from hair loss, weakness, arthralgia as well as edema in the legs. Based on the oral, clinical, and radiographic findings, she was diagnosed with aggressive periodontitis case. After nonsurgical periodontal treatment, the flap was reflected, debridement was done, after root conditioning with tetracycline, bovine osseous xenograft was placed in all the sites where ever there is angular bone loss, later sutured with interrupted direct loop suturing technique with 4-0 silk suture. Clinical and radiographic evaluation was done every 6 weeks to check the progress of the treatment. 6 months and 8-year follow-up revealed satisfactory clinical and radiographic outcomes. Based on the present case report and the previous literature, we recommend the use of xenograft in treating aggressive periodontitis patients.
    Résumé Le lupus érythémateux systémique (LES) avec lésions buccales desquamatives est l\'une des rares entités cliniques. La maladie parodontale et le LED présentent divers mécanismes et possèdent un large éventail de caractéristiques pathologiques. Le mécanisme de destruction des tissus de la parodontite et des maladies auto-immunes partage des voies similaires. partagent des voies similaires, et de nombreux rapports ont étudié l\'association entre ces deux entités. Le cas présent est celui d\'une patiente de 24 ans 24 ans qui se plaignait d\'un élargissement généralisé des espaces entre les dents. En plus de cela, elle a souffert d\'une perte de cheveux, de faiblesse, d\'œdème dans les jambes et d\'arthralgie. La patiente a été identifiée comme souffrant d\'un LED selon les critères de l\'American Rheumatism Association et de l\'Académie européenne de dermatologie et de vénéréologie un an avant de se présenter chez le dentiste. Elle souffrait de de perte de cheveux, de faiblesse, d\'arthralgie et d\'œdèmes dans les jambes. Sur la base des résultats buccaux, cliniques et radiographiques, elle a été diagnostiquée comme souffrant de parodontite agressive. Après un traitement parodontal non chirurgical, le lambeau a été réfléchi, un débridement a été effectué, après un conditionnement radiculaire après conditionnement radiculaire à la tétracycline, une xénogreffe osseuse bovine a été placée dans tous les sites où il y avait une perte osseuse angulaire. technique de suture en boucle directe interrompue avec une suture en soie 4-0. Une évaluation clinique et radiographique a été faite toutes les 6 semaines pour vérifier la progression du traitement. traitement. Le suivi à 6 mois et à 8 ans a révélé des résultats cliniques et radiographiques satisfaisants. Sur la base du présent rapport de cas et de la littérature précédente, nous recommandons l\'utilisation de la xénogreffe dans le traitement des patients atteints de parodontite agressive. Mots-clés: Parodontite, lupus érythémateux systémique, xénogreffe.
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  • 文章类型: Case Reports
    现在,牙科植入物是替代缺失牙齿的最佳治疗方法。然而,由于手术中的解剖学限制和错误,并发症可能需要进一步的治疗干预.在这个案例报告中,研究了由于植入物放置引起的鼻腭管囊肿(NPDC)。经过临床和影像学评估,观察到单眼射线不透性和对鼻腭管的干扰。在此之后,进行皮瓣抬高。随后,囊肿被摘除,骨缺损用异种移植物填充,并进一步用可吸收膜覆盖。组织病理学结果证实NPDC为明确诊断。六个月后,缺陷得到了彻底解决。
    Dental implants are now the best treatment method to replace missing teeth. However, complications may necessitate further therapeutic interventions because of anatomic limitations and mistakes during surgical procedures. In this case report, a nasopalatine duct cyst (NPDC) due to implant placement was studied. After clinical and radiographic evaluation, unilocular radiolucency with disturbance to the nasopalatine canal was observed. Following that, flap elevation was performed. Subsequently, the cyst was enucleated, and the bone defect was filled with xenograft and further covered with a resorbable membrane. Histopathology results confirmed NPDC as the definite diagnosis. After six months, the defect was completely resolved.
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  • 文章类型: Journal Article
    在安装牙科植入物之前通常需要骨增强。这里,我们报告了一个病人,他以前接受了使用异种移植的右上颌骨增强,其次是成功的植入物安装。七年后,该患者出现粘膜开窗术,该区域骨暴露,并提供了最近诊断为皮肤扁平苔藓的病史。进行了几次尝试以控制局势,最后,我们在该部位采用结缔组织移植。一块骨头被送去做组织学评估,结果表明存在被炎症细胞包围的未吸收的移植材料,该区域没有骨形成的证据。该病例提供了组织学证据,表明在评估期间使用异种移植物缺乏新骨形成。这个病例还显示了扁平苔藓,一个可能的原因口腔并发症的患者进行增强和植入安装。
    Bone augmentation is often required before the installation of dental implants. Here, we report a case for a patient who previously received bone augmentation at the upper right jaw using a xenogenic graft, followed by successful implant installation. Seven years later, the patient presented with mucosal fenestration with bone exposure at the area and gave a history of a recent diagnosis of cutaneous lichen planus. Several attempts were made to manage the situation, and finally, we resorted to connective tissue graft placement at the site. A piece of bone was sent for histologic evaluation, where the results indicated the presence of un-resorbed graft material surrounded by inflammatory cells, with no evidence of bone formation in the area. The case presents histologic evidence for the lack of new bone formation using xenograft over the evaluation period. The case also shows lichen planus, a possible cause for oral complication for patients undergoing augmentation and implant installation.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:ACL重建有明显的失败率。为了解决对廉价强壮组织的需求,开发了一种“人源化”猪组织的处理过程,并在灵长类动物和人类中进行了测试。本报告描述了使用猪异种移植ACL重建装置的首次人体临床试验的长期结果。
    方法:该研究于2003年使用Z-Lig™异种移植物ACL装置进行,作为先导临床可行性研究。通过酶促消除α-gal表位并通过部分交联以减缓巨噬细胞渗入生物转化植物中,对该装置进行了处理,以减缓其免疫介导的破坏。
    结果:10例患者接受了Z-Lig™装置重建。10例患者中有5例因随后的创伤而失败(n=3),关节纤维化(n=1),和手术技术错误(n=1)。在12年的评估后,一名患者失去了随访。每个剩余的患者报告一个稳定的完全运动的膝盖。身体检查与ACL稳定性测试的分数小于1的分数一致。MRI显示设备的成熟重塑。患者报告的结果评分没有明显下降,身体检查,或MRI外观从12到20年的随访。
    结论:对一小群患者的研究表明,将猪韧带生物假体植入撕裂的ACL患者体内,可以将生物假体重建为自体ACL,并在20年内保持成功。如果有其他临床试验的支持,将猪组织人源化的可能性为无限的组织重建临床材料打开了大门。
    方法:IV,案例系列。
    OBJECTIVE: ACL reconstruction has a significant failure rate. To address the need for inexpensive strong tissue, a treatment process to \"humanize\" porcine tissue was developed and tested in primates and humans. This report describes the long-term outcomes from the first human clinical trial using a porcine xenograft ACL reconstruction device.
    METHODS: The study was performed with Z-Lig™ xenograft ACL device in 2003 as a pilot clinical feasibility study. This device was processed to slow its immune-mediated destruction by enzymatic elimination of α-gal epitopes and by partial crosslinking to slow the infiltration of macrophages into the biotransplant.
    RESULTS: Ten patients underwent reconstruction with the Z-Lig™ device. Five of 10 patients failed due to subsequent trauma (n = 3), arthrofibrosis (n = 1), and surgical technical error (n = 1). One patient was lost to follow-up after the 12-year evaluation. Each remaining patient reported a stable fully athletic knee. Physical exams are consistent with a score of less than one on the ACL stability tests. MRIs demonstrate mature remodeling of the device. There is no significant degradation in patient-reported outcome scores, physical exams, or MRI appearance from 12 to 20-year follow-ups.
    CONCLUSIONS: The studies in a small group of patients have demonstrated that implantation of porcine ligament bioprosthesis into patients with torn ACLs can result in the reconstruction of the bioprosthesis into autologous ACL that remains successful over 20 years. The possibility of humanizing porcine tissue opens the door to unlimited clinical material for tissue reconstructions if supported by additional clinical trials.
    METHODS: IV, case series.
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  • 文章类型: Case Reports
    背景:引导组织再生(GTR)是一种常见的治疗方式,用于纠正分叉中的垂直或骨缺损。在GTR中使用多种材料,其中同种异体移植物和异种移植物是最广泛使用的。每种材料都具有影响再生潜力的独特特性。一种新的异种/同种异体骨移植组合可以通过提供空间维持(异种移植)和骨诱导性(同种异体移植)来改善GTR的结果。本病例报告的目的是根据临床和影像学结果评估新型异种/同种异体联合材料的疗效。
    方法:34岁,健康男性在9号和10号之间出现近端垂直骨丢失。临床检查显示8毫米的探测深度没有活动性。射线照相检查显示30-50%骨丢失的宽而深的垂直骨缺损。使用异种/同种异体骨移植和胶原膜分层技术治疗缺损。
    结果:6个月和12个月的随访显示,探查深度和放射学骨填充显着减少。
    结论:GTR使用异种/同种异体骨移植和胶原膜的分层技术显示了对深而宽的垂直骨缺损的适当校正。12个月的随访显示健康的牙周组织,探查深度和骨水平正常。本文受版权保护。保留所有权利。
    BACKGROUND: Guided tissue regeneration (GTR) is a common treatment modality for correcting vertical or bony defects in furcations. Multiple materials are used in GTR with allografts and xenografts being the most widely used. Each material has distinctive properties affecting the regenerative potential. A new bone graft combination of xenogeneic/allogeneic may improve the outcome of GTR by providing space maintenance (Xenograft) and osteoinductive potential (Allograft). The aim of this case report is to evaluate the efficacy of the new combined xenogeneic/allogeneic material based on clinical and radiographic outcomes.
    METHODS: A 34-year-old healthy male presented with vertical bone loss interproximally between #\'s 9 and 10. Clinical exam revealed 8 mm probing depth without mobility. The radiographic exam revealed a wide and deep vertical bony defect of 30%-50% bone loss. The defect was treated using a layering technique with xenogeneic/allogeneic bone graft and collagen membrane.
    RESULTS: The 6- and 12-month follow-ups revealed a significant reduction in probing depths and radiographic bone fill.
    CONCLUSIONS: GTR using a layering technique of xenogeneic/allogeneic bone graft and collagen membrane showed proper correction of a deep and wide vertical bony defect. The 12-month follow-up revealed healthy periodontium with normal probing depths and bone level.
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  • 文章类型: Case Reports
    异种移植材料的使用广泛用于几乎所有口腔骨缺损中,用于再生和重建目的。以下护理报告中介绍的异种移植用法可实现良好的骨缺损愈合,并可保存受影响的前磨牙。使用骨材料的任何可能的变化来确保骨缺损改善愈合是相当常见的。在某些情况下,手术范围要求在靠近各种神经和血管的地方切除每个囊肿。下肺泡,轨道下,语言,精神神经是颌骨中大多数手术部位最常见的神经。使用一些额外的材料,如胶原蛋白海绵,骨替代物,可吸收膜,或其他额外的材料可用于每个骨缺损重建,但应小心处理,如以下情况所述。在计划使用之前,用紧密的锥形束计算机断层扫描成像进行每次手术是很重要的,这对确定每个病变的范围和重要结构的接近程度非常有帮助。有很多因素可能会影响任何可能的神经损伤,尤其是不同的神经解剖变异.甚至包括骨膜下准备和邻近组织压迫在内的因素也可能影响后期的神经功能。当病变通过颊皮质板扩张时,当存在软组织波动时,需要一些特别的护理。与所呈现的案例相似,压碎的限制,吹,或对神经纤维的任何刺激都可以改善术后的预后。当伤口和周围组织被小心处理时,可能发生任何损坏或感觉异常的可能性有限。当神经本身受损或割伤时,功能的丧失可能是永久性的。在手术前1-2天立即或甚至预防性处方维生素B与NSAIDs(非甾体抗炎药)(或其他额外的补充药物可以及时改善神经功能。可能的神经损伤可分为许多病因。当神经被囊肿生长到囊肿壁中时,会出现完全不同的情况。所提供的病例报告描述了从下颌基础去除囊肿的结果和治疗方式。
    The usage of xenograft material is widely used in almost all oral cavity bone defects for regenerative and reconstructive purposes. The presented xenograft usage in the following care report enabled good bone defect healing and enabled the preservation of affected premolars. It is quite common to use any possible variations of bone materials to ensure bone defect improved healing. In some cases, the scope of surgeries requires the removal of each cyst within close proximity to various nerves and vessels. The inferior alveolar, infraorbital, lingual, and mental nerves are those most commonly adjacent to most operating sites in jaw bones. The usage of some additional materials such as collagen sponges, bone substitutes, resorbable membranes, or other additional materials are useful in each bone defect reconstruction but should be handled with care, as described in the following case. Before planning their usage, it is important to perform each surgery with close cone beam computed tomography imaging, which is very helpful to establish the scope of each lesion and the proximity of vital structures. There are a lot of factors that might influence any possible nerve damage, especially the different nerve anatomical variations. Even factors including the subperiosteal preparation and compression of adjacent tissues might influence later nerve function. When the lesion is expanding through the buccal cortical plate and when soft tissue fluctuation is present, some special care is needed. Similar to the presented case, a limitation in crushing, blowing, or any irritation of nerve fibers improves later postoperative outcomes. When the wound and surrounding tissues are handled with care, a limited possibility of any damage or paresthesia can occur. When the nerve itself is damaged or cut, loss of function can be permanent. Immediately after or even prophylactic prescription 1-2 days before the surgery of Vitamin B with NSAIDs (Non-steroidal anti-inflammatory drugs) (or other additional supplementary medicaments can improve nerve function in time. Possible nerve damage can be divided into many etiological factors. A quite different situation arises when the nerve is pulled in by the cyst growth into the cyst wall. The presented case report describes the outcomes of a cyst removal from the mandibular basis and treatment modalities.
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