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  • Title: Allogeneic bone block for challenging augmentation-a clinical, histological, and histomorphometrical investigation of tissue reaction and new bone formation.
    Author: Lorenz J, Kubesch A, Al-Maawi S, Schwarz F, Sader RA, Schlee M, Ghanaati S.
    Journal: Clin Oral Investig; 2018 Dec; 22(9):3159-3169. PubMed ID: 29524026.
    Abstract:
    OBJECTIVES: The aim of the present study was the histological investigation of an allogeneic spongious bone block for horizontal and vertical ridge augmentation in humans. The amount of new bone, soft tissue, and residual bone substitute were histomorphometrically assessed after a mean healing period of 6 months. MATERIALS AND METHODS: Fourteen patients received augmentation with an allogeneic spongious bone block (Tutobone®, Tutogen Medical, Neunkirchen, Germany). After 6 months of healing, 28 implants were placed with simultaneous harvesting of bone biopsies for histological and histomorphometrical analysis. Moreover, samples from the bone blocks were collected as blanks and analyzed histologically. The formation of new bone, connective tissue, and remaining bone substitute material as well as vascularization and formation of multinucleated giant cells (MNCGs) within the augmentation bed were analyzed. RESULTS: New bone formation could be observed primarily in close proximity to the bone block. Histomorphometrical analyses showed 18.65 ± 12.20% newly formed bone, 25.93 ± 12.36% allogeneic spongious bone block, and 53.45 ± 10.34% connective tissue. MNCGs were observed on the biomaterial surface. Furthermore, organic residues were evident, as donor-related cellular remnants within the osteocyte lacunae were found in the blank bone blocks and in the analyzed biopsies. CONCLUSION: Despite the presence of donor-related organic remnants, the bone block shows the ability to serve as a scaffold for new bone formation. Within the limits of the present study, the detect organic remnants seemed not to affect the bone formation or influence the host in the long term. CLINICAL RELEVANCE: Clinicians have to make a conscious choice of the applied biomaterials with regard to their components and structure to support tissue regeneration and maintain patient safety.
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