Long-Term Stability of Contour Augmentation in the Esthetic Zone: Histologic and Histomorphometric Evaluation of 12 Human Biopsies 14 to 80 Months after Augmentation

Simon S. Jensen; Dieter D Bosshardt; Reinhard Gruber; Daniel Buser

doi:10.1902/jop.2014.140182

Long-Term Stability of Contour Augmentation in the Esthetic Zone: Histologic and Histomorphometric Evaluation of 12 Human Biopsies 14 to 80 Months after Augmentation

Simon S. Jensen, Dieter D Bosshardt, Reinhard Gruber, Daniel Buser

43 Citations (Scopus)

Abstract

BACKGROUND: Contour augmentation around early-placed implants (Type 2 placement) using autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) and a collagen barrier membrane has been documented to predictably provide esthetically satisfactory clinical outcomes. In addition, recent data from cone beam computed tomography studies have shown the augmented volume to be stable long-term. However, no human histologic data are available to document the tissue reactions to this bone augmentation procedure.

METHODS: Over an 8-year period, 12 biopsies were harvested 14 to 80 months after implant placement with simultaneous contour augmentation in 10 patients. The biopsies were subjected to histologic and histomorphometric analysis.

RESULTS: The biopsies consisted of 32.0% ± 9.6% DBBM particles and 40.6% ± 14.6% mature bone. 70.3% ± 14.5% of the DBBM particle surfaces were covered with bone. On the remaining surface, multinucleated giant cells with varying intensity of tartrate-resistant acid phosphatase staining were regularly present. No signs of inflammation were visible, and no tendency toward a decreasing volume fraction of DBBM over time was observed.

CONCLUSIONS: The present study confirms previous findings that osseointegrated DBBM particles do not tend to undergo substitution over time. This low substitution rate may be the reason behind the clinically and radiographically documented long-term stability of contour augmentation using a combination of autogenous bone chips, DBBM particles, and a collagen membrane.

Original language	English
Journal	Journal of Periodontology
Volume	85
Issue number	11
Pages (from-to)	1549-1556
Number of pages	8
ISSN	0022-3492
DOIs	https://doi.org/10.1902/jop.2014.140182
Publication status	Published - 2014
Externally published	Yes

Keywords

Acid Phosphatase/analysis
Adult
Aged
Aged, 80 and over
Alveolar Process/pathology
Alveolar Ridge Augmentation/methods
Animals
Autografts/transplantation
Biopsy/methods
Bone Substitutes/therapeutic use
Bone Transplantation/methods
Cattle
Collagen
Dental Implants
Esthetics, Dental
Female
Follow-Up Studies
Giant Cells/pathology
Humans
Isoenzymes/analysis
Longitudinal Studies
Male
Membranes, Artificial
Middle Aged
Osseointegration/physiology
Osteogenesis/physiology
Tartrate-Resistant Acid Phosphatase
Treatment Outcome

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10.1902/jop.2014.140182

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Long-Term Stability of Contour Augmentation in the Esthetic Zone: Histologic and Histomorphometric Evaluation of 12 Human Biopsies 14 to 80 Months after Augmentation. / Jensen, Simon S.; Bosshardt, Dieter D; Gruber, Reinhard et al.
In: Journal of Periodontology, Vol. 85, No. 11, 2014, p. 1549-1556.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Long-Term Stability of Contour Augmentation in the Esthetic Zone: Histologic and Histomorphometric Evaluation of 12 Human Biopsies 14 to 80 Months after Augmentation",

abstract = "BACKGROUND: Contour augmentation around early-placed implants (Type 2 placement) using autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) and a collagen barrier membrane has been documented to predictably provide esthetically satisfactory clinical outcomes. In addition, recent data from cone beam computed tomography studies have shown the augmented volume to be stable long-term. However, no human histologic data are available to document the tissue reactions to this bone augmentation procedure.METHODS: Over an 8-year period, 12 biopsies were harvested 14 to 80 months after implant placement with simultaneous contour augmentation in 10 patients. The biopsies were subjected to histologic and histomorphometric analysis.RESULTS: The biopsies consisted of 32.0% ± 9.6% DBBM particles and 40.6% ± 14.6% mature bone. 70.3% ± 14.5% of the DBBM particle surfaces were covered with bone. On the remaining surface, multinucleated giant cells with varying intensity of tartrate-resistant acid phosphatase staining were regularly present. No signs of inflammation were visible, and no tendency toward a decreasing volume fraction of DBBM over time was observed.CONCLUSIONS: The present study confirms previous findings that osseointegrated DBBM particles do not tend to undergo substitution over time. This low substitution rate may be the reason behind the clinically and radiographically documented long-term stability of contour augmentation using a combination of autogenous bone chips, DBBM particles, and a collagen membrane.",

keywords = "Acid Phosphatase/analysis, Adult, Aged, Aged, 80 and over, Alveolar Process/pathology, Alveolar Ridge Augmentation/methods, Animals, Autografts/transplantation, Biopsy/methods, Bone Substitutes/therapeutic use, Bone Transplantation/methods, Cattle, Collagen, Dental Implants, Esthetics, Dental, Female, Follow-Up Studies, Giant Cells/pathology, Humans, Isoenzymes/analysis, Longitudinal Studies, Male, Membranes, Artificial, Middle Aged, Osseointegration/physiology, Osteogenesis/physiology, Tartrate-Resistant Acid Phosphatase, Treatment Outcome",

author = "Jensen, {Simon S.} and Bosshardt, {Dieter D} and Reinhard Gruber and Daniel Buser",

year = "2014",

doi = "10.1902/jop.2014.140182",

language = "English",

volume = "85",

pages = "1549--1556",

journal = "Journal of Periodontology",

issn = "0022-3492",

publisher = "American Academy of Periodontology",

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T1 - Long-Term Stability of Contour Augmentation in the Esthetic Zone

T2 - Histologic and Histomorphometric Evaluation of 12 Human Biopsies 14 to 80 Months after Augmentation

AU - Jensen, Simon S.

AU - Bosshardt, Dieter D

AU - Gruber, Reinhard

AU - Buser, Daniel

PY - 2014

Y1 - 2014

N2 - BACKGROUND: Contour augmentation around early-placed implants (Type 2 placement) using autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) and a collagen barrier membrane has been documented to predictably provide esthetically satisfactory clinical outcomes. In addition, recent data from cone beam computed tomography studies have shown the augmented volume to be stable long-term. However, no human histologic data are available to document the tissue reactions to this bone augmentation procedure.METHODS: Over an 8-year period, 12 biopsies were harvested 14 to 80 months after implant placement with simultaneous contour augmentation in 10 patients. The biopsies were subjected to histologic and histomorphometric analysis.RESULTS: The biopsies consisted of 32.0% ± 9.6% DBBM particles and 40.6% ± 14.6% mature bone. 70.3% ± 14.5% of the DBBM particle surfaces were covered with bone. On the remaining surface, multinucleated giant cells with varying intensity of tartrate-resistant acid phosphatase staining were regularly present. No signs of inflammation were visible, and no tendency toward a decreasing volume fraction of DBBM over time was observed.CONCLUSIONS: The present study confirms previous findings that osseointegrated DBBM particles do not tend to undergo substitution over time. This low substitution rate may be the reason behind the clinically and radiographically documented long-term stability of contour augmentation using a combination of autogenous bone chips, DBBM particles, and a collagen membrane.

AB - BACKGROUND: Contour augmentation around early-placed implants (Type 2 placement) using autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) and a collagen barrier membrane has been documented to predictably provide esthetically satisfactory clinical outcomes. In addition, recent data from cone beam computed tomography studies have shown the augmented volume to be stable long-term. However, no human histologic data are available to document the tissue reactions to this bone augmentation procedure.METHODS: Over an 8-year period, 12 biopsies were harvested 14 to 80 months after implant placement with simultaneous contour augmentation in 10 patients. The biopsies were subjected to histologic and histomorphometric analysis.RESULTS: The biopsies consisted of 32.0% ± 9.6% DBBM particles and 40.6% ± 14.6% mature bone. 70.3% ± 14.5% of the DBBM particle surfaces were covered with bone. On the remaining surface, multinucleated giant cells with varying intensity of tartrate-resistant acid phosphatase staining were regularly present. No signs of inflammation were visible, and no tendency toward a decreasing volume fraction of DBBM over time was observed.CONCLUSIONS: The present study confirms previous findings that osseointegrated DBBM particles do not tend to undergo substitution over time. This low substitution rate may be the reason behind the clinically and radiographically documented long-term stability of contour augmentation using a combination of autogenous bone chips, DBBM particles, and a collagen membrane.

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KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Alveolar Process/pathology

KW - Alveolar Ridge Augmentation/methods

KW - Animals

KW - Autografts/transplantation

KW - Biopsy/methods

KW - Bone Substitutes/therapeutic use

KW - Bone Transplantation/methods

KW - Cattle

KW - Collagen

KW - Dental Implants

KW - Esthetics, Dental

KW - Female

KW - Follow-Up Studies

KW - Giant Cells/pathology

KW - Humans

KW - Isoenzymes/analysis

KW - Longitudinal Studies

KW - Male

KW - Membranes, Artificial

KW - Middle Aged

KW - Osseointegration/physiology

KW - Osteogenesis/physiology

KW - Tartrate-Resistant Acid Phosphatase

KW - Treatment Outcome

U2 - 10.1902/jop.2014.140182

DO - 10.1902/jop.2014.140182

M3 - Journal article

C2 - 25008214

SN - 0022-3492

VL - 85

SP - 1549

EP - 1556

JO - Journal of Periodontology

JF - Journal of Periodontology

IS - 11

ER -

Long-Term Stability of Contour Augmentation in the Esthetic Zone: Histologic and Histomorphometric Evaluation of 12 Human Biopsies 14 to 80 Months after Augmentation

Abstract

Keywords

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