Resorbable screws for fixation of autologous bone grafts

: The aim of this study was to evaluate the suitability of resorbable screws made of poly (d.l‐lactide) acid (PDLLA) for fixation of autologous bone grafts related to graft regeneration and osseointegration of dental implants. In eight edentulous patients suffering from insufficient retention of the...

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Bibliographic Details
Published in:Clinical oral implants research 2006-06, Vol.17 (3), p.288-293
Main Authors: Raghoebar, Gerry M., Liem, Robert S. B., Bos, Rudolf R. M., Van Der Wal, Jacqueline E., Vissink, Arjan
Format: Article
Language:English
Subjects:
Absorbable Implants
Alveolar Ridge Augmentation - instrumentation
Alveolar Ridge Augmentation - methods
augmentation
autologous bone
Biopsy
Bone Regeneration - physiology
Bone Screws
Bone Transplantation - instrumentation
Connective Tissue - pathology
Dental Abutments
Dental Implants
Dental Prosthesis, Implant-Supported
Dentistry
Denture, Overlay
edentulous maxilla
Female
Follow-Up Studies
Giant Cells - pathology
Humans
Male
Maxilla - pathology
Maxilla - surgery
Maxillary Sinus - pathology
Maxillary Sinus - surgery
Middle Aged
Osseointegration - physiology
Polyesters - chemistry
resorbable screws
Titanium - chemistry
Wound Healing - physiology
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Summary:: The aim of this study was to evaluate the suitability of resorbable screws made of poly (d.l‐lactide) acid (PDLLA) for fixation of autologous bone grafts related to graft regeneration and osseointegration of dental implants. In eight edentulous patients suffering from insufficient retention of their upper denture related to a severely resorbed maxilla, the floor of both maxillary sinus and width of the alveolar crest were augmented with an autologous bone graft from the iliac crest. Randomly, the bone graft used to augment the alveolar crest was fixed with two titanium screws on one side and two resorbable screws on the other side (split‐mouth design). Three months after the reconstruction, a bone biopsy was taken with a trephine including one resorbable screw (N=8). Subsequently, six implants were placed in the left and right posterior maxilla. Six months later, at the abutment connection, a bone biopsy was taken including the other resorbable screw (N=8). The biopsies were processed for light microscopic examination. In addition, clinical parameters were scored. Wound healing was uneventful. Clinically no difference in wound healing was observed between sides treated with either a resorbable or titanium screw. No implants were lost. Six months after implantation, implant retained overdentures could be fabricated in all patients. All patients functioned well with their overdentures (follow‐up 22.2±4.3 months). Three as well as 9 months after insertion (remnants of), the resorbable screws were still visible after reflecting the mucoperiosteum. Histological examination confirmed that a considerable quantity of remnants of the resorbable screws was still present, although areas with some fragmentation of the PDLLA were also observed. The screws were separated by a fibrous tissue layer containing many giant cells from the bone. Particles of PDLLA were observed within these giant cells. This study revealed that resorbable screws made of PDLLA can be used for fixation of bone grafts. The bulk of the PDLLA material is still present after 9 months.
ISSN:0905-7161
1600-0501
DOI:10.1111/j.1600-0501.2005.01200.x