Incorporation and Remodeling of Bone Block Allografts in the Maxillary Reconstruction: A Randomized Clinical Trial
Bibliographic record
Abstract
BACKGROUND: Severe alveolar atrophy often presents a challenge for the implant surgery. The significant lack of bone in the alveolar ridges may compromise the final restorations both from the aesthetic and functional standpoints. OBJECTIVES: To evaluate the behavior of bone block allografts for the maxillary augmentation and to investigate its incorporation, remodeling, and implant survival rates in two different healing time points. MATERIAL AND METHODS: Sixty-six consecutive patients (52 female/14 male, mean age: 57.95 ± 9.06 years old), presenting 113 atrophic alveolar ridges underwent maxillary augmentation with fresh-frozen allogeneic bone blocks from tibia. Patients were randomly assigned in two groups: Group 1-patients who would wait 4 months for implant placement after grafting, and Group 2-patients who would wait 6 months. Events of infection, suture dehiscence or mucosal perforation were recorded. Cone-beam computed tomography scans were compared volumetrically between the time of the grafting surgery and reentry procedure after incorporation. Biopsies were collected and subjected to histological, histomorphometric and immunehistochemical analysis. RESULTS: A total of 305 implants were placed in the reconstructed sites. The mean resorption rate in Group 1 (13.98% ± 5.59) was significantly lower than Group 2 (31.52% ± 6.31). The amount of calcified tissue, newly formed bone and remaining graft particles demonstrated no difference between groups. The samples showed evident immunolabeling for the podoplanin protein in both groups. The implants cumulative survival rate was 94.76%. CONCLUSIONS: The findings of the present study indicate that there is a significant difference regarding the resorption of the grafts when waiting 4 or 6 months before placing the implants, even though no difference was found in the histological, histomorphometric, and immunohistochemical features. Both 4-month and 6-months healing times are suitable for the implant placement.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".