1. Assistant Professor, Dept. of Periodontics, Dental Materials Research Center, School of Dentistry, Babol University of Medical Sciences, Babol, Iran.
2. Associate Professor, Dept. of Oral & Maxillofacial Pathology, Dental Materials Research Center, School of Dentistry, Babol University of Medical Sciences, Babol, Iran.
3. Assistant  Professor,  Dept.  of  Biostatistics  &  Epidemiology,  Infectious  Diseases  &      Tropical
4. Medicine research Center, School of Medicine, Babol University, Babol, Iran.
5. Assistant Professor, Dept. of Periodontics, Dental Materials Research Center,  Dental School, Babol University of Medical Sciences, Babol, Iran. E-mail: am.kiakojori@mubabol.ac.ir

Abstract

Objective: Alveolar ridge preservation in patients with inadequate bone volume is one treatment option for successful implant placement and can be done by using bone graft materials. On the other hand, Ceno Bone has been recently produced by Hamanand Saz Baft Kish Co. as a bone bioimplant of allograft origin. This study aimed to assess the clinical, histologic and histomorphometric results of Bone Strip Allograft (CenoBone) for horizontal alveolar ridge augmentation.

Methods: In this semi-experimental clinical trial, 7 areas requiring horizontal ridge augmentation and subsequent implant placement in the maxilla were selected using non-randomized consecutive sampling. Surgeries were mostly performed via the buccal cortical plate of the edentulous ridge. The buccal bone was decorticated, Ceno Bone was fixed by titanium screws, covered with Ceno Membrane (resorbable) and sutured. Buccolingual width of the ridge was measured in stage-one surgery and six months later in stage-two surgery for implant placement. A core biopsy was also taken to assess the trabecular thickness, percentage of new bone formation, percentage of remnant particles, degree of inflammation, foreign body reaction, vitality, bone-biomaterial contact and number of blood vessels by microscopic, histologic and histomorphometric analyses of the slides. The clinical ridge width values in the first- and second-stage surgeries were analyzed  using Wilcoxon Signed Rank test.

Results: The mean clinical ridge width at 2mm distance from the ridge crest was 2.49 (0.72) mm in the first-stage and 4.79 (0.75) mm in the second-stage surgery. The mean clinical ridge width at 5mm distance from the ridge crest was 3.6 (0.57) mm in the first-stage and 6.3 (1.13) mm in the second-stage surgery. At both sites, application of Ceno Bone significantly increased the clinical ridge width in the second-stage surgery (both ps<0.05). Also, inflammation in most specimens (85.7%) was grade I and no case of foreign body reaction was seen. Bone was vital in all patients. The  mean  trabecular  thickness was  87.96  (38.74)μ.  The percentage  of new  bone  formation was

58.43 (26.42%) and the percentage of remnant particles was 4.07% (2.44%).

Conclusion: The results of this preliminary study revealed that application of CenoBone stimulates osteogenesis and significantly increases the clinical ridge width at 2 and 5mm distances from the ridge crest for implant placement.

Key words: Ceno Bone, Clinical, Horizontal augmentation, Osteogenesis, Ridge, Width.

Please cite this article as follows:

Amooian B, Seyyed Majidi M, Haji Ahmadi M, Kiakojouri A. Clinical, Histologic and Histomorphometric Evaluation of Bone Strip Allograft with Resorbable Membrane in Horizontal Alveolar Ridge Augmentation: A Preliminary Study. J Dent Sch2014; 32(2): 80-89.

Introduction:

Alveolar ridge resorption is a consequence of tooth extraction and is due to the changed physiological state of the bone (1). Six to 12 months after tooth extraction, 0.34-7.7 mm reduction occurs in ridge width and 0.2 to 3.25 mm in ridge height (2). Severe alveolar ridge resorption complicates the placement of conventional bridges or dental implants; and consequently, increases the treatment cost and duration (3). For years, autogenous bone procured from an intraoral or extraoral source was the gold standard for bone grafts. However, problems associated with the second surgery to procure bone, its invasiveness and limited volume of bone that could be taken (from an intraoral source) led to development of new approaches and production of bone replacement materials (4). Several allografts have been produced for this purpose including Freeze- Dried Bone Allograft (FDBA) and Demineralized Freeze-Dried Bone Allograft (DFDBA). Allogeneic products have several surgical applications due to their biocompatibility and bone remodeling potential (5, 6). On the other hand, CenoBone is a biomaterial produced by Hamanand Saz Baft Kish Co. as a bone bioimplantof allograft origin. Graft materials like CenoBone are made of non- vital connective tissue of human origin. After processing, they preserve their extracellular matrix. This matrix acts as a scaffold and re- accumulates the fibroblasts, blood vessels and epithelium from the adjacent host tissues (7). Sarkarat, et al. (2010) performed ridge preservation by using Ceno Bone graft material and confirmed its biocompatibility (7). Evidence regarding the use of bone allografts for alveolar ridge augmentation shows positive results. However, due to the existing limitations in this regard, most studies have been conducted on animal models (8). Considering the manufacturing of Ceno Bone by Hamanand Saz

Baft Kish Co., this study aimed to assess the clinical, histologic and histomorphometric results of Bone Strip Allograft (Ceno Bone) for horizontal ridge augmentation.