Clinical and histologic evaluation of a mineralized block allograft: results from the developmental period (2001-2004).
This article reports on a multicenter evaluation of a novel, sterile, antigen-inactivated, mineralized block allograft in humans during a 3-year developmental period. Consecutive partially edentulous patients (n = 73) with severe localized ridge defects (n = 82) were treated with the material. After 4 to 6 months of healing, tapered screw implants were placed in the grafted bone and subsequently restored. Patients were monitored 25 to 36 months after prosthetic restoration. A biopsy was taken of one patient and submitted for histomorphometric analysis. Block allograft survival was 93% at 12 months, and resorption ranged from none (69%) to slight (0 to 2 mm) (31%) for all surviving allografts. Seven block allografts failed and were removed because of improper contouring, prosthesis impingement, and/or infection. The sites were successfully re-treated and restored with dental implants. Soft tissue dehiscence was successfully treated in seven other sites. Implant survival was 99%. One implant failed without allograft failure. It was replaced with a larger-diameter implant, treated with guided bone regeneration, and subsequently restored. Histomorphometric analysis showed rapid incorporation of the allograft at 6 months without inflammation or necrosis. The block allografts were more technique-sensitive than autografts, which necessitated meticulous surgical technique and follow-up. Short-term results for the block allografts indicated a high degree of predictability, but long-term follow-up is needed.
Keith
J Daulton
JD
Petrungaro
Paul
P
Leonetti
Joseph A
JA
Elwell
Charles W
CW
Zeren
Karl J
KJ
Caputo
Chris
C
Nikitakis
Nikolaos G
NG
Schöpf
Christoph
C
Warner
Michael M
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000295:instrumentation / Q000379:methods*; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000628:therapy; D016019:Survival Analysis; D014184:Transplantation, Homologous; D014945:Wound Healing / Q000502:physiology
D015921:Dental Implants