Sinus floor elevation using implants coated with recombinant human bone morphogenetic protein-2: micro-computed tomographic and histomorphometric analyses

Abstract

Objectives

The objective of this study was to determine the validity of a graft-free sinus floor elevation (SFE) procedure with simultaneous placement of recombinant morphogenetic protein-2 (rhBMP-2)-coated implants compared to uncoated control implants.

Methods

In 10 rabbits, SFE was performed on both sides. Dental implants were randomly placed in the sinus filled with a blood clot. Test implants were coated with rhBMP-2, whereas in the control group, implants were uncoated. Micro-computed tomographic and histomophometric analyses were performed at 4 and 8 weeks, including measurement for newly formed bone height (NBHm).

Results

Bone formation was evident along the implant surfaces up to the apex in test, but limited in control implants at 4 weeks. NBHm amounted to 5.1 mm (Q1 = 4.1; Q3 = 5.3) for test implants and to 3.4 mm (2.6; 3.7) for control implants at 4 weeks. NBHm then decreased to 8 weeks (3.4 mm (3.3; 3.7)) for test implants, whereas in control sites, NBHm increased slightly to 4.4 mm (4.1; 4.5) (p = 0.1250; p = 0.6250).

Conclusions

Implants coated with rhBMP-2 presented a strong osteogenic reaction at 4 weeks with more favorable outcomes in terms of bone formation along the implant surface up to the apex compared to uncoated control implants. Remodeling and resorption process between 4 and 8 weeks did not further improve the outcomes in the test, but in the control group.

Clinical relevance

The use of rhBMP-2-coated implants in a graft-free SFE might show an advantage in early implant stability to prevent collapse of membrane. However, a potential clinical benefit still needs to be proven.

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Adverse events in deep brain stimulation: A retrospective long-term analysis of neurological, psychiatric and other occurrences

by Carsten Buhmann, Torge Huckhagel, Katja Engel, Alessandro Gulberti, Ute Hidding, Monika Poetter-Nerger, Ines Goerendt, Peter Ludewig, Hanna Braass, Chi-un Choe, Kara Krajewski, Christian Oehlwein, Katrin Mittmann, Andreas K. Engel, Christian Gerloff, Manfred Westphal, Johannes A. Köppen, Christian K. E. Moll, Wolfgang Hamel

Background and objective

The extent to which deep brain stimulation (DBS) can improve quality of life may be perceived as a permanent trade-off between neurological improvements and complications of therapy, comorbidities, and disease progression.

Patients and methods

We retrospectively investigated 123 consecutive and non-preselected patients. Indications for DBS surgery were Parkinson's disease (82), dystonia (18), tremor of different etiology (21), Huntington's disease (1) and Gilles de la Tourette syndrome (1). AEs were defined as any untoward clinical occurrence, sign or patient complaint or unintended disease if related or unrelated to the surgical procedures, implanted devices or ongoing DBS therapy.

Results

Over a mean/median follow-up period of 4.7 years (578 patient-years) 433 AEs were recorded in 106 of 123 patients (86.2%). There was no mortality or persistent morbidity from the surgical procedure. All serious adverse events (SAEs) that occurred within 4 weeks of surgery were reversible. Neurological AEs (193 in 85 patients) and psychiatric AEs (78 in 48 patients) were documented most frequently. AEs in 4 patients (suicide under GPI stimulation, weight gain >20 kg, impairment of gait and speech, cognitive decline >2 years following surgery) were severe or worse, at least possibly related to DBS and non reversible. In PD 23.1% of the STN-stimulated patients experienced non-reversible (or unknown reversibility) AEs that were at least possibly related to DBS in the form of impaired speech or gait, depression, weight gain, cognitive disturbances or urinary incontinence (severity was mild or moderate in 15 of 18 patients). Age and Hoehn&Yahr stage of STN-simulated PD patients, but not preoperative motor impairment or response to levodopa, showed a weak correlation (r = 0.24 and 0.22, respectively) with the number of AEs.

Conclusions

DBS-related AEs that were severe or worse and non-reversible were only observed in PD (4 of 82 patients; 4.9%), but not in other diseases. PD patients exhibited a significant risk for non-severe AEs most of which also represented preexisting and progressive axial and non-motor symptoms of PD. Mild gait and/or speech disturbances were rather frequent complaints under VIM stimulation. GPI stimulation for dystonia could be applied with negligible DBS-related side effects.

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Response to Letter to the Editor: Prevalence of vestibular and balance disorders in children and adolescents according to age category: A multi-center study in Korea

Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Jong Dae Lee, Chang-Hee Kim, Seok Min Hong, Sung Huhn Kim, Myung-Whan Suh, Min-Beom Kim, Dae Bo Shim, Hosuk Chu, No Hee Lee, Minbum Kim, Sung Kwang Hong, Jae-Hyun Seo




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Letter to the editor regarding ‘Evaluation of vitamin D levels in children with primary epistaxis’

Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): M. Volkan Akdoğan, Evren Hızal




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Identification and in silico characterization of p.G380R substitution in FGFR3, associated with achondroplasia in a non-consanguineous Pakistani family

The dimerization efficiency of FGFR3 transmembrane domain plays a critical role in the formation of a normal skeleton through the negative regulation of bone development. Recently, gain-of-function mutations i...

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Heterotopic pancreas in the omphalomesenteric duct remnant in a 9-month-old girl: a case report and literature review

Heterotopic pancreas most commonly occurs in the upper gastrointestinal tract of adults, usually as an incidental finding. It seldom occurs at the umbilicus, and even rarely in the pediatric age group.

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Anesthesia for Heart Transplantation

Publication date: Available online 5 July 2017
Source:Anesthesiology Clinics
Author(s): Davinder Ramsingh, Reed Harvey, Alec Runyon, Michael Benggon

Teaser

This review seeks to evaluate current practices in heart transplantation. The goals of this article were to review current practices for heart transplantation and its anesthesia management. The article reviews current demographics and discusses the current criteria for candidacy for heart transplantation. The process for donor and receipt selection is reviewed. This is followed by a review of mechanical circulatory support devices as they pertain to heart transplantation. The pre-anesthesia and intraoperative considerations are also discussed. Finally, management after transplantation also is reviewed.


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