Regenerativno kirurško liječenje periimplantitisa uz pomoć autolognog dentinskog grafta

master's thesis

• Title (english): Regenerative surgical therapy of periimplantitis using autologous dentin graft
• Author: Domagoj Kilić
• Mentor: Domagoj Vražić (mentor)
• Committee member: Domagoj Vražić (predsjednik povjerenstva)
• Committee member: Marko Granić (član povjerenstva)
• Committee member: Samir Čimić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2024, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Dentin i kost su zajedničkog porijekla od stanica neuralnog grebena, slične građe sa sličnim fizikalno-mehaničkim svojstvima. Kada je otkriveno da izvađeni zub nije otpad, već se nakon obrade može koristi kao jeftin nadomjesni koštani materijal, postavljeni su temelji njegove primjene u stomatologiji. Koristeći takav biomaterijal u svrhu regenerativnih postupaka, zub dobiva neprocjenjivu vrijednost, zamjenjujući potrebe za umjetnim, skupljim materijalima, pritom riskirajući i mogućnost odbacivanja. Dentinski graft je autologni biomaterijal koji se zbog svojih osteoinduktivnih i osteokonduktivnih svojstava danas standardno koristi u nizu oralnokirurških regenerativnih postupaka. Procesom demineralizacije se površinski iz dentina uklanjaju mineralne tvari i eksponira kolagena organska matrica. Izlaganjem organske kolagene matrice se iskazuju osteoinduktivna svojstva dentina koja potječu od faktora rasta poput koštanih morfogenetskih proteina (BMP-2) i transformirajućeg čimbenika rasta β (TGF- β), igrajući važnu ulogu u procesima izgradnje i obnove kosti. Djelomično demineralizirani dentinski graft pokazuje veću raspoloživost faktora rasta i poticanje procesa osteogeneze dok čestice mineraliziranog dentinskog grafta teže potiču procese osteogeneze, ali i teže podliježu procesima resorpcije, pružajući pritom bolju mehaničku potporu i osnovu za razvoj kosti. Periimplantitis je plakom uzrokovano patološko stanje tkiva oko implantata karakterizirano upalom periimplantne mukoze u vidu krvarenja, crvenila, supuracije, povećane dubine sondiranja i povlačenja marginalne gingive te radiološkim gubitkom koštane potpore. Zbog svojih idealnih bioloških karakteristika koja su dokazana uporabom grafta u regenerativnim postupcima poput prezervacije alveole, augmentacije alveolarnog grebena, podizanja dna maksilarnog sinusa, kod imedijatnog postavljanja implantata, postavlja se pitanje kakve rezultate daje njegova implementacija u implantologiju i regenerativno liječenje koštanih defekata uzrokovanih upalom tkiva oko implantata.

Abstract (english)

Dentin and bone originate from neural crest cells, with a similar structure and physicomechanical properties. When it was discovered that the extracted tooth was not a waste but could be used after processing as a cheap bone grafting material, the foundations were set for its application in dentistry. Using such a biomaterial in regenerative procedures, the tooth gains an invaluable reuse value, replacing the need for artificial, much more expensive, materials with no risk of rejection. Dentin graft is an autologous biomaterial that is now standardly used in many regenerative surgical procedures due to its osteoinductive and osteoconductive properties. The demineralization process removes mineral substances from the dentin surface and exposes the collagen organic matrix. The osteoinductive properties of dentin originate from growth factors such as bone morphogenetic proteins (BMP-2) and transforming growth factor β (TGF-β). They play an important role in bone re-building and repair processes. Partially demineralized dentin graft shows greater availability of growth factors and stimulation of the osteogenesis process. The particles of mineralized dentin graft are more difficult to stimulate and undergo resorption processes, thus providing better mechanical support and a basis for bone development. Peri-implantitis is a pathological condition of the tissue around the implant caused by plaque, characterized by inflammation of the peri-implant mucosa in the form of bleeding, redness, suppuration, increased probing depth and retraction of the marginal gingiva, and radiological loss of bone support. The successful use of the graft in regenerative procedures such as alveolus preservation, alveolar ridge augmentation procedures, and raising the maxillary sinus floor, with immediate implant placement, proved its ideal biological characteristics. We must ask ourselves what results will be obtained from its use in implantology and regenerative treatment of bone defects caused by tissue inflammation around implants.

• Keywords: periimplantitis; dentinski graft; regenerativno liječenje; povećanje alveolarnog grebena; podizanje dna sinusa; zubni implantat
• Keywords (english): Peri-Implantitis; Dentin Graft; Regenerative Therapy; Alveolar Ridge Augmentation; Sinus Floor Augmentation; Dental Implants
• Language: croatian
• URN:NBN: urn:nbn:hr:127:323190
• Study programme: Title: Integrated undergraduate and graduate university study of Dental Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor dentalne medicine (doktor dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-03 10:58:25