Comparative study on bone regeneration of cystic lesions

Obiettivi. Determinare la rigenerazione ossea di difetti cistici delle ossa mascellari dopo riempimento con osso autologo o con copolimero PLA-PGA (Fisiograft ®) tramite valutazioni cliniche, radiologiche e istologiche. Materiali e Metodi. Otto pazienti maschi consenzienti, affetti da cisti odontogena in rapporto a elementi dentari a prognosi infausta in cui il trattamento endodontico clinico era fallito, sono stati sottoposti a intervento di enucleazione cistica e a innesto con osso autologo (gruppo di controllo GC) o con copolimero (gruppo di trattamento GT) con follow-up di 4 mesi. Risultati. I risultati clinici e radiologici (area, diametri, livelli di grigio) evidenziano un lieve miglior esito per il gruppo di controllo, senza differenze statistiche significative. L’analisi istologica delle biopsie di quattro mesi evidenziava uno steady-state osteogenico nel GC, con frammenti di osso risparmiato dagli osteoclasti e porzioni di osso neoformato. Osso neoformato a fibre intrecciate e attività fosfatasi alcalina positiva erano invece caratteristiche distintive del GT. L’ammontare di osso presente (TBV) non risultava differente nei due gruppi (m ~ 16,5%). Conclusioni. I risultati ottenibili con il copolimero, non molto diversi da quelli conseguiti con osso autologo, sono da considerarsi molto apprezzabili in considerazione della maneggevolezza del materiale e dell’assenza della necessità di un sito donatore secondario. Abstract Comparative study on bone regeneration of cystic lesions Objectives. To evaluate healing of cystic lesions in human jawbone filled with autologous bone or PLA-PGA copolymer (Fisiograft®), by means of clinical, radiological and histological methods. Material and Methods. After informed consent eight male patients underwent surgical treatment of dental cysts caused by teeth where endodontic treatment failed. Patients were randomly divided into 2 groups: the first (control group) received an autologous bone graft while the second (treatment group) was treated by copolymer with a follow-up of 4 months. Results. Autologous bone provided a lightly better clinical and radiological (area, diameters, gray level) outcome without statistically significant differences. Bone activities were enhanced in sites treated with copolymer, whereas a steady-state was observed with autologous bone. The amount of bone (TBV) was similar in both groups (m ~ 16,5%). Conclusions. Our results indicate that best outcomes are achieved using autologous bone graft, but good results can also follow the use of copolymer to promote healing of severe bone defects. Additionally, copolymer is easy to handle and does not require a secondary donor site.

□Objectives. To evaluate healing of cystic lesions in human jawbone filled with autologous bone or PLA-PGA copolymer (Fisiograft ®), by means of clinical, radiological and histological methods. □Material and Methods. After informed consent eight male patients underwent surgical treatment of dental cysts caused by teeth where endodontic treatment failed. Patients were randomly divided into 2 groups: the first (control group) received an autologous bone graft while the second (treatment group) was treated by copolymer with a follow-up of 4 months. □Results. Autologous bone provided a lightly better clinical and radiological (area, diameters, gray level) outcome without statistically significant differences. Bone activities were enhanced in sites treated with copolymer, whereas a steady-state was observed with autologous bone. The amount of bone (TBV) was similar in both groups (m ∼ 16,5%). □Conclusions. Our results indicate that best outcomes are achieved using autologous bone graft, but good results can also follow the use of copolymer to promote healing of severe bone defects. Additionally, copolymer is easy to handle and does not require a secondary donor site.