The topic of this experimental thesis is the modified periosteal inhibition surgical technique, designed by Dr. Andrea Grassi to preserve the bone volume of the post-extraction socket. It involves the use of a 0.5 mm soft cortical plate which is fixed with human fibrin glue (HFG) to the buccal cortical of the post-extraction alveolus, with the aim of avoiding its reabsorption. In fact, by separating the periosteum from the alveolus, the migration of osteoclast precursors from the outside to the inside is prevented and, consequently, the osteoclastic activity itself. In addition, to promote bone healing no more biomaterial grafting is performed in the alveolus, but the intra-alveolar blood clot is left to act undisturbed which, after extraction, is stabilized with a collagen sponge. The thesis is structured in two parts. The first is the introductory one and is organized into four chapters: the first summarizes the embryology and anatomy of the maxillary bones, the second deals with the complex biology of bone tissue, and the third describes the alveolar bone and the dynamics of the its resorption caused by extraction and, finally, in the last chapter the healing process is deepened and the properties and roles of the biomaterials and the sealing fibrin glue used to rebuild bone are discussed. The second part is, instead, the experimental one, in which the objectives of the study, the materials and methods, the results obtained and the discussion of the same are illustrated, in order to draw conclusions that can be applied in daily clinical practice.
L’argomento di questa tesi sperimentale è la tecnica chirurgica di inibizione periostale modificata, ideata dal Dr. Andrea Grassi per preservare il volume osseo dell’alveolo post-estrattivo. Essa prevede l’impiego di una lamina corticale soft da 0.5 mm che viene fissata mediante colla di fibrina umana (HFG) alla corticale vestibolare dell’alveolo post-estrattivo, con la finalità di evitarne il riassorbimento. Infatti, separando il periostio dall’alveolo, viene impedita la migrazione dei precursori degli osteoclasti dall’esterno verso l’interno e, di conseguenza, l’attività osteoclastica stessa. Inoltre, per promuovere la guarigione ossea non si effettua più nessun’innesto di biomateriale nell’alveolo, ma si lascia agire indisturbato il coagulo ematico intra-alveolare che, dopo l’estrazione, viene stabilizzato con una spugna di collagene. La tesi è strutturata in due parti. La prima è quella introduttiva ed è organizzata in quattro capitoli: nel primo viene riassunta l’embriologia e l’anatomia delle ossa mascellari, nel secondo viene trattata la complessa biologia del tessuto osseo, nel terzo vengono descritti l’osso alveolare e le dinamiche del suo riassorbimento causate dall’estrazione e, infine, nell’ultimo capitolo viene approfondito il processo di guarigione e vengono discusse le proprietà e i ruoli dei biomateriali e della colla di fibrina sigillante impiegati per ricostruire l’osso. La seconda parte è, invece, quella sperimentale, in cui vengono illustrati gli obiettivi dello studio, i materiali e i metodi, i risultati ottenuti e la discussione degli stessi, al fine di trarre delle conclusioni che possano essere applicate nella pratica clinica quotidiana.
La preservazione dell'alveolo post-estrattivo con tecnica di inibizione periostale modificata
BRUNO, RAFFAELE
2021/2022
Abstract
The topic of this experimental thesis is the modified periosteal inhibition surgical technique, designed by Dr. Andrea Grassi to preserve the bone volume of the post-extraction socket. It involves the use of a 0.5 mm soft cortical plate which is fixed with human fibrin glue (HFG) to the buccal cortical of the post-extraction alveolus, with the aim of avoiding its reabsorption. In fact, by separating the periosteum from the alveolus, the migration of osteoclast precursors from the outside to the inside is prevented and, consequently, the osteoclastic activity itself. In addition, to promote bone healing no more biomaterial grafting is performed in the alveolus, but the intra-alveolar blood clot is left to act undisturbed which, after extraction, is stabilized with a collagen sponge. The thesis is structured in two parts. The first is the introductory one and is organized into four chapters: the first summarizes the embryology and anatomy of the maxillary bones, the second deals with the complex biology of bone tissue, and the third describes the alveolar bone and the dynamics of the its resorption caused by extraction and, finally, in the last chapter the healing process is deepened and the properties and roles of the biomaterials and the sealing fibrin glue used to rebuild bone are discussed. The second part is, instead, the experimental one, in which the objectives of the study, the materials and methods, the results obtained and the discussion of the same are illustrated, in order to draw conclusions that can be applied in daily clinical practice.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/9492