Fresh frozen homologous bone in oral surgery: case reports
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Fresh frozen homologous bone in oral surgery: case reports Ernesto D’Aloja Æ Enrico Santi Æ Giuseppe Aprili Æ Massimo Franchini
Received: 1 June 2007 / Accepted: 24 September 2007 / Published online: 11 October 2007 Springer Science+Business Media B.V. 2007
Abstract Intraoral bone defects may be treated using autologous grafts, homologous grafts, heterologous grafts or synthetic products. Autologous bone is now considered the gold standard for bone grafting procedures. Homologous fresh frozen bone, provided by bone banks, is frequently utilized by orthopaedic surgeons because it is considered a safe material from immunological and viral points of view.In the cases reported here, homologous bone was used to repair some osseous defects without changing the surgical protocol utilized for autologous bone procedures. The main advantages of this strategy are low morbidity, shorter surgical times, more comfort and less risk of infection for the patient as well as the greater availability of bone. Keywords
Oral surgery Fresh frozen bone
Introduction The substitution of natural dentition is currently managed predominantly by implant therapy. Longterm clinical results achieved with implant therapy
E. D’Aloja E. Santi Negrar, Verona, Italy G. Aprili M. Franchini (&) Regional Tissue Bank, City Hospital of Verona, Piazzale Stefani, 1, 37126 Verona, Italy e-mail: [email protected]
are usually positive and stable, although a variety of problems can be encountered when a patient needs such therapy. Proper treatment planning should include a detailed clinical history and evaluations of aesthetics and functional parameters, quality and amount of residual bone, bone crest height, the relation of dental arches (usually towards a third class), and the reduction of both bone density and amount of keratinized tissue. Numerous classifications have been proposed to describe the morphology of bone defects, including those by Cawood et al. (1988), Lekholm and Zarb (1985), and Tinti and Parma-Benfenati (2003). Ideal clinical situations are, however, very rare. Progressive bone resorption is a common finding, especially when a long time has passed since the loss of the tooth. The amount of bone graft material needed to reconstruct bone defects is 1–3 ml for the loss of one tooth, 4–10 ml for loss of 2–3 teeth, at least 10 ml for a sinus lift, 20 ml for a bilateral sinus lift, and 30– 50 ml for severe maxillary atrophy (Di Stefano and Cazzaniga 2003; Elves and Pratt 1975). A variety of surgical techniques have been proposed to manage different types of bone defects. The surgical techniques currently employed for bone augmentation (bone distraction excluded) make use of a variety of graft materials, which have different osteoinductive, osteoconductive and osteogenic properties. The materials employed for bone grafting are autologous bone, homologous bone, heterologous
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bone, and synthetic products (hydroxyapatite, tricalcium phosphate, calcium phosphate, bio-glass, etc). Each of these materials has advantages an
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