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  1. Fulltext The Effect of Flapless and Full-thickness Flap Techniques on Implant Stability During the Healing Period
    Al-Juboori MJ, AbdulRahaman SB
    Open Dent J, 2015;9:243-9.
    PMID: 26312095 DOI: 10.2174/1874210601509010243
    PURPOSE: When soft tissue flaps are reflected for implant placement, the blood supply from the periosteum to the bone is disrupted. The aim of this study was to compare the effects of the flapless (FL) and full-thickness flap (FT) techniques on implant stability. Methods : Nine patients received 22 implants. The implants were placed using the FL technique on the contralateral side of the jaw; the FT technique was used as the control technique. Resonance frequency analysis (RFA) was performed at the time of implant placement and at 6 and 12 weeks after implant placement. RFA values were compared between the FL and FT groups and between time intervals in the same group. Results : The median (interquartile range [IQR]) RFA values at the time of implant placement were 75.00 (15.00) for the FL technique and 75.00 (9.00) for the FT technique. At 6 weeks, the median (IQR) values were 79 (3.30) for the FL technique and 80 (12.70) for the FT technique. At 12 weeks, the median (IQR) values were 82.3 (3.30) for the FL technique and 82.6 (8.00) for the FT technique. There were no significant differences between the 2 techniques at the time of implant placement, after 6 weeks or after 12 weeks, with p values of 0.994, 0.789, and 0.959, respectively. There were significant differences between the RFA values at the time of implant placement and after 6 weeks for the FL technique (p=0.028) but not for the FT technique (p=0.091). There were also significant differences between the RFA values at 6 weeks and the RFA values at 12 weeks for the FL technique (p=0.007) and for the FT technique (p=0.003). Conclusion : Periosteum preservation during the FL procedure will speed up bone remodeling and result in early secondary implant stability as well as early loading.
    Matched MeSH terms: Periosteum
  2. Fulltext Solitary osteochondroma in the body of the pubic bone: a cadaveric case report
    Nayak SB, Kumar N, Sirasanagandla SR, Srinivas SP, Pamidi N, Shetty SD
    Anat Cell Biol, 2018 Jun;51(2):136-138.
    PMID: 29984059 DOI: 10.5115/acb.2018.51.2.136
    Osteochondromas develop as cartilaginous nodules in the periosteum of bones. They are the commonest benign tumors of the skeleton, generally observed in the long bones. Rarely, they are also found in the axial skeleton, flat bones of skull and facial bones. During a regular dissection, we came across a solitary osteochondroma in posterior surface of the body of the right pubic bone. Histopathology of the bony projection confirmed the typical features of the osteochondroma. The symptomatic osteochondromas are usually evaluated during radiographic examination. Though, the observed osteochondroma is relatively smaller its unusual location is remarkable and knowledge of occurrence of such nodules is clinically important during the diagnosis and planning of treatment.
    Matched MeSH terms: Periosteum
  3. Differential osteogenic activity of osteoprogenitor cells on HA and TCP/HA scaffold of tissue engineered bone
    Ng AM, Tan KK, Phang MY, Aziyati O, Tan GH, Isa MR, et al.
    J Biomed Mater Res A, 2008 May;85(2):301-12.
    PMID: 17688285
    Biomaterial, an essential component of tissue engineering, serves as a scaffold for cell attachment, proliferation, and differentiation; provides the three dimensional (3D) structure and, in some applications, the mechanical strength required for the engineered tissue. Both synthetic and naturally occurring calcium phosphate based biomaterial have been used as bone fillers or bone extenders in orthopedic and reconstructive surgeries. This study aims to evaluate two popular calcium phosphate based biomaterial i.e., hydroxyapatite (HA) and tricalcium phosphate/hydroxyapatite (TCP/HA) granules as scaffold materials in bone tissue engineering. In our strategy for constructing tissue engineered bone, human osteoprogenitor cells derived from periosteum were incorporated with human plasma-derived fibrin and seeded onto HA or TCP/HA forming 3D tissue constructs and further maintained in osteogenic medium for 4 weeks to induce osteogenic differentiation. Constructs were subsequently implanted intramuscularly in nude mice for 8 weeks after which mice were euthanized and constructs harvested for evaluation. The differential cell response to the biomaterial (HA or TCP/HA) adopted as scaffold was illustrated by the histology of undecalcified constructs and evaluation using SEM and TEM. Both HA and TCP/HA constructs showed evidence of cell proliferation, calcium deposition, and collagen bundle formation albeit lesser in the former. Our findings demonstrated that TCP/HA is superior between the two in early bone formation and hence is the scaffold material of choice in bone tissue engineering.
    Matched MeSH terms: Periosteum/cytology*; Periosteum/metabolism
  4. Effects of anodizing parameters and heat treatment on nanotopographical features, bioactivity, and cell culture response of additively manufactured porous titanium
    Amin Yavari S, Chai YC, Böttger AJ, Wauthle R, Schrooten J, Weinans H, et al.
    Mater Sci Eng C Mater Biol Appl, 2015 Jun;51:132-8.
    PMID: 25842117 DOI: 10.1016/j.msec.2015.02.050
    Anodizing could be used for bio-functionalization of the surfaces of titanium alloys. In this study, we use anodizing for creating nanotubes on the surface of porous titanium alloy bone substitutes manufactured using selective laser melting. Different sets of anodizing parameters (voltage: 10 or 20V anodizing time: 30min to 3h) are used for anodizing porous titanium structures that were later heat treated at 500°C. The nanotopographical features are examined using electron microscopy while the bioactivity of anodized surfaces is measured using immersion tests in the simulated body fluid (SBF). Moreover, the effects of anodizing and heat treatment on the performance of one representative anodized porous titanium structures are evaluated using in vitro cell culture assays using human periosteum-derived cells (hPDCs). It has been shown that while anodizing with different anodizing parameters results in very different nanotopographical features, i.e. nanotubes in the range of 20 to 55nm, anodized surfaces have limited apatite-forming ability regardless of the applied anodizing parameters. The results of in vitro cell culture show that both anodizing, and thus generation of regular nanotopographical feature, and heat treatment improve the cell culture response of porous titanium. In particular, cell proliferation measured using metabolic activity and DNA content was improved for anodized and heat treated as well as for anodized but not heat-treated specimens. Heat treatment additionally improved the cell attachment of porous titanium surfaces and upregulated expression of osteogenic markers. Anodized but not heat-treated specimens showed some limited signs of upregulated expression of osteogenic markers. In conclusion, while varying the anodizing parameters creates different nanotube structure, it does not improve apatite-forming ability of porous titanium. However, both anodizing and heat treatment at 500°C improve the cell culture response of porous titanium.
    Matched MeSH terms: Periosteum/cytology; Periosteum/drug effects*; Periosteum/physiology
  5. Effectiveness of Gingivoperiosteoplasty on Alveolar Bone Reconstruction and Facial Growth in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis
    El-Ashmawi NA, ElKordy SA, Salah Fayed MM, El-Beialy A, Attia KH
    Cleft Palate Craniofac J, 2019 04;56(4):438-453.
    PMID: 30052473 DOI: 10.1177/1055665618788421
    OBJECTIVE: The aim of the systematic review is to evaluate the effects of gingivoperiosteoplasty (GPP) on alveolar bone quality and facial growth in patients with cleft lip and palate (CLP).

    SEARCH METHODS: Electronic and manual search was done up to October 2017.

    ELIGIBILITY CRITERIA: Clinical and observational studies that compared GPP to control; patients without GPP evaluated either before or after the age for secondary bone graft (SBG).

    DATA COLLECTION AND ANALYSIS: Studies selection was done by 2 authors independently. Risk ratio and mean difference with 95% confidence intervals (CIs) were calculated using random-effects models.

    RESULTS: Thirteen articles were included in the review. All studies were at high risk of bias. Poorer alveolar bone quality was found in the GPP group compared to the SBG group. The pooled data showed a statistically significant increase in the incidence of Bergland type III in the GPP group compared to SBG (risk ratio: 11.51, 95% CI: 3.39-35.15). As for facial growth, GPP group resulted in a more retruded maxillary position (as indicated by "Sella-Nasion-Subspinale" angle [SNA value]) compared to control group by -1.36 (CI: -4.21 to 1.49) and -1.66 (CI: -2.48 to -0.84) when evaluated at 5 and 10 years, respectively. The protocol for presurgical infant orthopedics used in conjunction with the GPP procedure might have affected the results of the alveolar bone and facial growth outcomes.

    CONCLUSIONS: Definitive conclusions about the effectiveness of GPP cannot be drawn. Very weak evidence indicated that GPP might not be an efficient method for alveolar bone reconstruction for patients with unilateral and bilateral CLP. Gingivoperiosteoplasty surgery could lead to maxillary growth inhibition in patients with CLP.

    Matched MeSH terms: Periosteum
  6. Strategy for generating tissue-engineered human bone construct
    Tan KK, Aminuddin BS, Tan GH, Sabarul Afian M, Ng MH, Fauziah O, et al.
    Med J Malaysia, 2004 May;59 Suppl B:43-4.
    PMID: 15468810
    The strategy used to generate tissue-engineered bone construct, in view of future clinical application is presented here. Osteoprogenitor cells from periosteum of consenting scoliosis patients were isolated. Growth factors viz TGF-B2, bFGF and IGF-1 were used in concert to increase cell proliferation during in vitro cell expansion. Porous tricalcium phosphate (TCP)-hydroxyapatite (HA) scaffold was used as the scaffold to form 3D bone construct. We found that the addition of growth factors, greatly increased cell growth by 2 to 7 fold. TCP/HA proved to be the ideal scaffold for cell attachment and proliferation. Hence, this model will be further carried out on animal trial.
    Matched MeSH terms: Periosteum/cytology*
  7. Bone regeneration performance of surface-treated porous titanium
    Amin Yavari S, van der Stok J, Chai YC, Wauthle R, Tahmasebi Birgani Z, Habibovic P, et al.
    Biomaterials, 2014 Aug;35(24):6172-81.
    PMID: 24811260 DOI: 10.1016/j.biomaterials.2014.04.054
    The large surface area of highly porous titanium structures produced by additive manufacturing can be modified using biofunctionalizing surface treatments to improve the bone regeneration performance of these otherwise bioinert biomaterials. In this longitudinal study, we applied and compared three types of biofunctionalizing surface treatments, namely acid-alkali (AcAl), alkali-acid-heat treatment (AlAcH), and anodizing-heat treatment (AnH). The effects of treatments on apatite forming ability, cell attachment, cell proliferation, osteogenic gene expression, bone regeneration, biomechanical stability, and bone-biomaterial contact were evaluated using apatite forming ability test, cell culture assays, and animal experiments. It was found that AcAl and AnH work through completely different routes. While AcAl improved the apatite forming ability of as-manufactured (AsM) specimens, it did not have any positive effect on cell attachment, cell proliferation, and osteogenic gene expression. In contrast, AnH did not improve the apatite forming ability of AsM specimens but showed significantly better cell attachment, cell proliferation, and expression of osteogenic markers. The performance of AlAcH in terms of apatite forming ability and cell response was in between both extremes of AnH and AsM. AcAl resulted in significantly larger volumes of newly formed bone within the pores of the scaffold as compared to AnH. Interestingly, larger volumes of regenerated bone did not translate into improved biomechanical stability as AnH exhibited significantly better biomechanical stability as compared to AcAl suggesting that the beneficial effects of cell-nanotopography modulations somehow surpassed the benefits of improved apatite forming ability. In conclusion, the applied surface treatments have considerable effects on apatite forming ability, cell attachment, cell proliferation, and bone ingrowth of the studied biomaterials. The relationship between these properties and the bone-implant biomechanics is, however, not trivial.
    Matched MeSH terms: Periosteum/cytology; Periosteum/drug effects; Periosteum/ultrastructure
  8. Fulltext Hole on the palate, saliva in the nose: what is your diagnosis?
    Irfan Mohamad, Shamina Sara Moses, Rose linda Abdul Rahman
    Archives of Orofacial Sciences, 2013;8(1):44-45.
    MyJurnal
    A 69-year-old lady was diagnosed to have mucoepidermoid carcinoma of hard palate 3 years ago. She completed 20 cycles of external beam radiotherapy and 5 cycles of mould brachytherapy and remained asymptomatic until she again presented to us with the recurrence of a painless mass at the hard palate. The hard mass appeared as an ulcerated dimple measuring 2 x 1 cm located at the junction of the hard and soft palate, more towards the right. Excision biopsy of the mass was done with a 1cm circumferential margin deep to the periosteum, with the resulting exposed bony defect covered with a rotational flap from the soft palate. During follow-up, the patient complained that the saliva came up into the nose whenever she swallowed. Oral examination (Figure 1) and flexible nasopharyngolaryngoscopy (FNPLS) (Figure 2) were performed. What is your diagnosis?
    Matched MeSH terms: Periosteum
  9. Autologous human fibrin as the biomaterial for tissue engineering
    Ruszymah BH
    Med J Malaysia, 2004 May;59 Suppl B:30-1.
    PMID: 15468804
    Patient own fibrin may act as the safest, cheapest and immediate available biodegradable scaffold material in clinical 1 tissue engineering. This study investigated the feasibility of using patient own fibrin isolated from whole blood to construct a new human cartilage, skin and bone. Constructed in vitro tissues were implanted on the dorsal part of the nude mice for in vivo maturation. After 8 weeks of implantation, the engineered tissues were removed for histological analysis. Our results demonstrated autologous fibrin has great potential as clinical scaffold material to construct various human tissues.
    Matched MeSH terms: Periosteum/cytology
  10. Recurrent gigantic pyogenic granuloma disturbing speech and mastication: a case report and literature review
    Ong MA, Chai WL, Ngeow WC
    Ann Acad Med Singap, 1998 Mar;27(2):258-61.
    PMID: 9663321
    A case of gigantic pyogenic granuloma with three recurrences in the lower anterior gingiva is presented. Surgical wide excision of the lesion is the treatment of choice. The tumour must be excised down to the periosteum and the irritants around it removed to avoid recurrence. A contributing factor to the gigantic lesion is hormonal changes during pregnancy. Long-term review for 18 months after the third surgery showed no evidence of recurrence at the surgical site.
    Matched MeSH terms: Periosteum/surgery
  11. Fulltext Strides towards the realization of cure for cartilage defects and osteoarthritis: the limitation and regulatory challenges
    Ude Chinedu Cletus, Azizi Miskon, Ruszymah Idrus
    Sains Malaysiana, 2018;47(11):2757-2767.
    Despite remarkable mechanical durability and strength, hyaline cartilage has very limited capacity for self-repair when injured and over time, may degenerate to osteoarthritis. We evaluated the most significant mile stones attained, in the pursuit of cure for cartilage defects and osteoarthritis. The basic treatment options include: Natural or physical therapy, medications, nutritional supplements, nutriceuticals and chondroprotective agents. Next are repairs and replacements, which include surgical procedures: Debridement/chondroplasty, microfracturing, mosaicplasty, periosteum transplantation, osteochondral autografting and allografting, high tibial osteotomy and total knee arthroplasty. But, current trend has shifted from repair, replacement, to most recently regeneration. Regenerations include the cell and gene therapies. While cell therapy involves the use of cells isolated from different tissues to cause regeneration of cartilage; gene therapy involves the selection of appropriate gene and optimal vector to incorporate cDNA. There has been much positivity reported with big animal models, which has led to several ongoing clinical trials. Translations of these findings hold high promises, though not without inherent regulatory hurdles. Considering the initial success rates, there are increasing hopes of realizing these treatments from bench to bedsides. Significant improvements in the treatment of cartilage degenerations and osteoarthritis have been made so far, but no gold standard delineated.
    Matched MeSH terms: Periosteum
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