FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Clinical oral implants research2020; 31(11); 1149-1158; doi: 10.1111/clr.13661

Horizontal bone grafting using equine-derived cancellous bone blocks is associated with severe complications: A prospective clinical and histological pilot study.

Abstract: The aim of this prospective, clinical study was to evaluate the clinical performance and histological outcome of a new equine hydroxyapatite collagenated bone block (eHAC) for horizontal bone grafting prior to implant placement. Methods: Five patients (two male/three female) with a mean age of 51.6 years (range 22-66 years) and a reduced horizontal bone width of the alveolar ridge (mean 3.5 mm) underwent horizontal bone grafting using eHAC at 10 grafting sites. Reentry was performed 6.9 months after the horizontal grafting procedure. Clinical follow-up (mean 28.9 month) considered width gain of the alveolar ridge, soft tissue healing, and complications. To evaluate graft incorporation, four additional patients underwent histological assessment of equine blocks adjacent to autologous blocks 3 and 6 months after grafting. Results: The study was terminated after graft failure was observed in four of five patients. Mean horizontal bone width had increased by 3.6 ± 1.22 mm. Three out of nine implants placed had to be removed due to graft failure. Histological evaluation revealed large amounts of soft connective tissue within the grafts (mean 67.3 ± 9.5%). The proportion of new bone formation 3 months after the lateral grafting procedure revealed an average of 8.6%, compared to 11.4% after 6 to 7 months. Conclusions: Lateral ridge grafting using eHAC achieved measurable horizontal width gain but revealed high rates of severe complications. Conclusions: Within the limitations of this study, eHAC bone blocks cannot be recommended for horizontal bone grafting.
© 2020 The Authors. Clinical Oral Implants Research published by John Wiley & Sons Ltd.
Get Full Text
Publication Date: 2020-09-17 PubMed ID: 32881075DOI: 10.1111/clr.13661Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research study aimed to assess the effectiveness and clinical outcome of an equine hydroxyapatite collagenated bone block (eHAC) for performing horizontal bone grafts. However, the results indicated high failure rates and various complications, leading the researchers to advise against the use of eHAC blocks for horizontal bone grafting.

Methodology

  • The research involved a clinical study on five patients, two males and three females, with a reduced horizontal bone width averaging 3.5mm, who were given eHAC for horizontal bone grafting in ten specific grafting sites.
  • They were reevaluated after 6.9 months post-grafting.
  • A mean of 28.9 months of clinical analysis further considered the gain in alveolar ridge width, soft tissue healing condition, and any developing complications.
  • Additionally, four more patients were observed histologically to evaluate graft incorporation with eHAC blocks compared to autologous blocks three and six months post-grafting.

Results

  • The study had to be shifted focus after a graft failure was observed in four out of the five initial patients.
  • While their average horizontal bone width increased by around 3.6mm, the grafting highly unsuccessful – three out of the nine implants had to be removed due to graft failure.
  • Histological analysis showed that there were high amounts of soft connective tissue within the grafts, averaging around 67.3%.
  • Compared to a new bone formation rate of just 8.6% three months after grafting and 11.4% after six to seven months, the graft failure rate was considerably high.

Conclusions

  • While the eHAC vertical ridge grafting technique resulted in measurable horizontal width gain, the rate of severe complications was staggeringly high.
  • Considering these substantial drawbacks, the study concludes that eHAC bone blocks are not advised for horizontal bone grafting.

Cite This Article

APA
Angermair J, Bosshardt DD, Nelson K, Flügge TV, Stricker A, Fretwurst T. (2020). Horizontal bone grafting using equine-derived cancellous bone blocks is associated with severe complications: A prospective clinical and histological pilot study. Clin Oral Implants Res, 31(11), 1149-1158. https://doi.org/10.1111/clr.13661

Publication

Clinical oral implants research
ISSN: 1600-0501
NlmUniqueID: 9105713
Country: Denmark
Language: English
Volume: 31
Issue: 11
Pages: 1149-1158

Researcher Affiliations

Angermair, Johannes
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Bosshardt, Dieter D
  • Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland.
  • Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Nelson, Katja
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Flügge, Tabea V
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Stricker, Andres
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Center of Implantology, Periodontology and 3D Head-and-Neck Imaging Lake Constance, Konstanz, Germany.
Fretwurst, Tobias
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.

MeSH Terms

  • Adult
  • Aged
  • Alveolar Ridge Augmentation
  • Animals
  • Bone Transplantation
  • Cancellous Bone
  • Dental Implantation, Endosseous
  • Female
  • Horses
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Grant Funding

  • Geistlich Pharma AG

References

This article includes 30 references
  1. Benic GI, Thoma DS, Jung RE, Sanz-Martin I, Unger S, Cantalapiedra A, Hammerle CHF. Guided bone regeneration with particulate vs. block xenogenic bone substitutes: A pilot cone beam computed tomographic investigation. Clinical Oral Implants Research 28(11), e262-e270.
    doi: 10.1111/clr.13011google scholar: lookup
  2. Benic GI, Thoma DS, Munoz F, Sanz Martin I, Jung RE, Hammerle CH. Guided bone regeneration of peri-implant defects with particulated and block xenogenic bone substitutes. Clinical Oral Implants Research 27(5), 567-576.
    doi: 10.1111/clr.12625google scholar: lookup
  3. Cordaro L, Torsello F, Miuccio MT, di Torresanto VM, Eliopoulos D. Mandibular bone harvesting for alveolar reconstruction and implant placement: Subjective and objective cross-sectional evaluation of donor and recipient site up to 4 years. Clinical Oral Implants Research 22(11), 1320-1326.
    doi: 10.1111/j.1600-0501.2010.02115.xgoogle scholar: lookup
  4. Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: A pilot study. International Journal of Oral and Maxillofacial Implants 25(2), 374-378.
  5. Cusinato R, Pacenti M, Martello T, Fattori P, Morroni M, Palu G. Effectiveness of hydrogen peroxide and electron-beam irradiation treatment for removal and inactivation of viruses in equine-derived xenografts. Journal of Virological Methods 232, 39-46.
    doi: 10.1016/j.jviromet.2016.03.001google scholar: lookup
  6. Di Stefano DA, Artese L, Iezzi G, Piattelli A, Pagnutti S, Piccirilli M, Perrotti V. Alveolar ridge regeneration with equine spongy bone: A clinical, histological, and immunohistochemical case series. Clinical Implant Dentistry and Related Research 11(2), 90-100.
    doi: 10.1111/j.1708-8208.2008.00104.xgoogle scholar: lookup
  7. Draenert FG, Kammerer PW, Berthold M, Neff A. Complications with allogeneic, cancellous bone blocks in vertical alveolar ridge augmentation: Prospective clinical case study and review of the literature. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 122(2), e31-e43.
    doi: 10.1016/j.oooo.2016.02.018google scholar: lookup
  8. Elnayef B, Porta C, Suarez-Lopez Del Amo F, Mordini L, Gargallo-Albiol J, Hernandez-Alfaro F. The fate of lateral ridge augmentation: A systematic review and meta-analysis. International Journal of Oral and Maxillofacial Implants 33(3), 622-635.
    doi: 10.11607/jomi.6290google scholar: lookup
  9. Fontana F, Rocchietta I, Dellavia C, Nevins M, Simion M. Biocompatibility and manageability of a new fixable bone graft for the treatment of localized bone defects: Preliminary study in a dog model. The International Journal of Periodontics & Restorative Dentistry 28(6), 601-607.
  10. Fretwurst T, Gad LM, Nelson K, Schmelzeisen R. Dentoalveolar reconstruction: Modern approaches. Current Opinion in Otolaryngology & Head and Neck Surgery 23(4), 316-322.
    doi: 10.1097/moo.0000000000000167google scholar: lookup
  11. Fretwurst T, Nack C, Al-Ghrairi M, Raguse JD, Stricker A, Schmelzeisen R, Nahles S. Long-term retrospective evaluation of the peri-implant bone level in onlay grafted patients with iliac bone from the anterior superior iliac crest. Journal of Cranio-Maxillo-Facial Surgery 43(6), 956-960.
    doi: 10.1016/j.jcms.2015.03.037google scholar: lookup
  12. Fretwurst T, Wanner L, Nahles S, Raguse JD, Stricker A, Metzger MC, Nelson K. A prospective study of factors influencing morbidity after iliac crest harvesting for oral onlay grafting. Journal of Cranio-Maxillo-Facial Surgery 43(5), 705-709.
    doi: 10.1016/j.jcms.2015.03.023google scholar: lookup
  13. Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie 31(1-2), 1-4.
  14. Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: Clinical results with different bone grafts and bone-substitute materials. International Journal of Oral and Maxillofacial Implants 24(Suppl), 218-236.
  15. Nevins M, Al Hezaimi K, Schupbach P, Karimbux N, Kim DM. Vertical ridge augmentation using an equine bone and collagen block infused with recombinant human platelet-derived growth factor-BB: A randomized single-masked histologic study in non-human primates. Journal of Periodontology 83(7), 878-884.
    doi: 10.1902/jop.2012.110478google scholar: lookup
  16. Nkenke E, Radespiel-Troger M, Wiltfang J, Schultze-Mosgau S, Winkler G, Neukam FW. Morbidity of harvesting of retromolar bone grafts: A prospective study. Clinical Oral Implants Research 13(5), 514-521.
    doi: 10.1034/j.1600-0501.2002.130511.xgoogle scholar: lookup
  17. Nkenke E, Schultze-Mosgau S, Radespiel-Troger M, Kloss F, Neukam FW. Morbidity of harvesting of chin grafts: A prospective study. Clinical Oral Implants Research 12(5), 495-502.
    doi: 10.1034/j.1600-0501.2001.120510.xgoogle scholar: lookup
  18. Ortiz-Vigon A, Martinez-Villa S, Suarez I, Vignoletti F, Sanz M. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement. International Journal of Implant Dentistry 3(1), 24.
    doi: 10.1186/s40729-017-0087-1google scholar: lookup
  19. Ortiz-Vigon A, Suarez I, Martinez-Villa S, Sanz-Martin I, Bollain J, Sanz M. Safety and performance of a novel collagenated xenogeneic bone block for lateral alveolar crest augmentation for staged implant placement. Clinical Oral Implants Research 29(1), 36-45.
    doi: 10.1111/clr.13036google scholar: lookup
  20. Pistilli R, Felice P, Piatelli M, Nisii A, Barausse C, Esposito M. Blocks of autogenous bone versus xenografts for the rehabilitation of atrophic jaws with dental implants: Preliminary data from a pilot randomised controlled trial. European Journal of Oral Implantology 7(2), 153-171.
  21. Richardson KC, Jarett L, Finke EH. Embedding in epoxy resins for ultrathin sectioning in electron microscopy. Stain Technology 35, 313-323.
    doi: 10.3109/10520296009114754google scholar: lookup
  22. Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dental Materials 31(6), 640-647.
    doi: 10.1016/j.dental.2015.03.005google scholar: lookup
  23. Sanz-Sanchez I, Ortiz-Vigon A, Sanz-Martin I, Figuero E, Sanz M. Effectiveness of lateral bone augmentation on the alveolar crest dimension: A systematic review and meta-analysis. Journal of Dental Research 94(9 Suppl), 128S-142S.
    doi: 10.1177/0022034515594780google scholar: lookup
  24. Schwarz F, Ferrari D, Balic E, Buser D, Becker J, Sager M. Lateral ridge augmentation using equine- and bovine-derived cancellous bone blocks: A feasibility study in dogs. Clinical Oral Implants Research 21(9), 904-912.
    doi: 10.1111/j.1600-0501.2010.01951.xgoogle scholar: lookup
  25. Schwarz F, Mihatovic I, Ghanaati S, Becker J. Performance and safety of collagenated xenogeneic bone block for lateral alveolar ridge augmentation and staged implant placement. A monocenter, prospective single-arm clinical study. Clinical Oral Implants Research 28(8), 954-960.
    doi: 10.1111/clr.12902google scholar: lookup
  26. Simion M, Nevins M, Rocchietta I, Fontana F, Maschera E, Schupbach P, Kim DM. Vertical ridge augmentation using an equine block infused with recombinant human platelet-derived growth factor-BB: A histologic study in a canine model. The International Journal of Periodontics & Restorative Dentistry T 29(3), 245-255.
  27. Tozaki T, Swinburne J, Hirota K, Hasegawa T, Ishida N, Tobe T. Improved resolution of the comparative horse-human map: Investigating markers with in silico and linkage mapping approaches. Gene 392(1-2), 181-186.
    doi: 10.1016/j.gene.2006.12.018google scholar: lookup
  28. Troeltzsch M, Troeltzsch M, Kauffmann P, Gruber R, Brockmeyer P, Moser N, Schliephake H. Clinical efficacy of grafting materials in alveolar ridge augmentation: A systematic review. Journal of Cranio-Maxillo-Facial Surgery 44(10), 1618-1629.
    doi: 10.1016/j.jcms.2016.07.028google scholar: lookup
  29. Wiltfang J, Jatschmann N, Hedderich J, Neukam FW, Schlegel KA, Gierloff M. Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts - a prospective study of two cohorts. Clinical Oral Implants Research 25(2), e127-e132.
    doi: 10.1111/clr.12074google scholar: lookup
  30. Zecha PJ, Schortinghuis J, van der Wal JE, Nagursky H, van den Broek KC, Sauerbier S, Raghoebar GM. Applicability of equine hydroxyapatite collagen (eHAC) bone blocks for lateral augmentation of the alveolar crest. A histological and histomorphometric analysis in rats. International Journal of Oral and Maxillofacial Surgery 40(5), 533-542.
    doi: 10.1016/j.ijom.2011.01.007google scholar: lookup

Citations

This article has been cited 5 times.
  1. Christensen JG, Grønlund GP, Georgi SR, Starch-Jensen T, Bruun NH, Jensen SS. Horizontal Alveolar Ridge Augmentation with Xenogenic Block Grafts Compared with Autogenous Bone Block Grafts for Implant-retained Rehabilitation: a Systematic Review and Meta-Analysis. J Oral Maxillofac Res 2023 Apr-Jun;14(2):e1.
    doi: 10.5037/jomr.2023.14201pubmed: 37521322google scholar: lookup
  2. Smeets R, Matthies L, Windisch P, Gosau M, Jung R, Brodala N, Stefanini M, Kleinheinz J, Payer M, Henningsen A, Al-Nawas B, Knipfer C. Horizontal augmentation techniques in the mandible: a systematic review. Int J Implant Dent 2022 May 9;8(1):23.
    doi: 10.1186/s40729-022-00421-7pubmed: 35532820google scholar: lookup
  3. Canullo L, Pesce P, Antonacci D, Ravidà A, Galli M, Khijmatgar S, Tommasato G, Sculean A, Del Fabbro M. Soft tissue dimensional changes after alveolar ridge preservation using different sealing materials: a systematic review and network meta-analysis. Clin Oral Investig 2022 Jan;26(1):13-39.
    doi: 10.1007/s00784-021-04192-0pubmed: 34669038google scholar: lookup
  4. Schwarz F, Sahin D, Civale-Schweighöfer S, Becker J. Long-term outcomes following lateral alveolar ridge augmentation using a collagenated xenogeneic bone block: a monocenter, prospective single-arm clinical study. Int J Implant Dent 2021 Feb 22;7(1):9.
    doi: 10.1186/s40729-021-00293-3pubmed: 33615414google scholar: lookup
  5. Huang X, Lou Y, Duan Y, Liu H, Tian J, Shen Y, Wei X. Biomaterial scaffolds in maxillofacial bone tissue engineering: A review of recent advances. Bioact Mater 2024 Mar;33:129-156.
    doi: 10.1016/j.bioactmat.2023.10.031pubmed: 38024227google scholar: lookup
Subscribe to our newsletter
Join 99,850 horse owners like you who receive our email updates on horse health and nutrition.