FlexMetric bone marrow aspirator yields laboratory and clinically improved results from mesenchymal stem and progenitor cells without centrifugation.

Several devices used to harvest stem/progenitor cells from bone marrow are available to clinicians. This study compared three devices measuring stem cell yields and correlating those yields to bone regeneration. A flexible forward aspirating system Marrow Marxman (MM), a straight needle aspirating on withdrawal system Marrow Cellutions (MC), and a straight needle aspirating on withdrawal and centrifuging the aspirate (BMAC) were compared in a side-to-side patient comparison, as well as tissue engineered bone grafts.

Early Childhood (0 to 5 years) Presents the Greatest Risk for Facial Dog Bites.

Purpose: The purpose of the present study is to compare the characteristics of dog bite wounds to the face and that of the rest of the body among the pediatric population in the United States and to determine independent risk factors for dog bite wounds to the face.

Methods: A retrospective cohort study was conducted using the Kids' Inpatient Database. There were multiple, heterogenous predictor variables.

Hyperbaric oxygen is still needed in the management and prevention of mandibular necrosis: a response to Mr. Richard Clarke.

Mr. Richard Clarke presents in this Journal his arguments against continued application of hyperbaric oxygen (HBO2) therapy to the pre-extraction neoadjuvant treatment or the treatment of frank mandibular ORN. In the same article he advocates a promising renewed interest in HBO2 as a radiosensitizer.

Reconstruction of a Post-Traumatic Maxillary Ridge Using a Radial Forearm Free Flap and Immediate Tissue Engineering (Bone Morphogenetic Protein, Bone Marrow Aspirate Concentrate, and Cortical-Cancellous Bone): Case Report.

The purpose of this article is to describe reconstruction of the maxillary alveolar ridge by use of a microvascular free flap combined with an immediate tissue-engineered bone graft. This novel surgical technique involved the use of a radial forearm free flap and immediate allogeneic avascular bone graft augmented with bone morphogenetic protein and bone marrow aspirate concentrate. A poly-d,l-lactic acid mesh was used as a containment unit for the bone graft.

Recurrent Malignancy in Osteoradionecrosis Specimen.

Purpose: Osteoradionecrosis (ORN) is a well-known complication of head and neck radiation therapy. Statistically, the mandible is the most commonly affected site. The incidental finding of malignancy in the resection specimen has been documented but is somewhat rare.

Regeneration of a Tooth in a Tissue-Engineered Mandible After Resection of a Central Giant Cell Tumor. Demonstrating Evidence of Functional Matrix Theory and Ectodermal Origin of Teeth in a Human Model-A Case Report.

Central giant cell tumors (CGCTs) are uncommon lesions occurring in the jaw. They are benign but locally destructive osteolytic lesions. They usually occur in pediatric patients 5 to 15 years of age.

A technique for the treatment of oral-antral fistulas resulting from medication-related osteonecrosis of the maxilla: the combined buccal fat pad flap and radical sinusotomy.

Objective: Bisphosphonates and monoclonal antibodies directed at osteoclastic function are frequently used to treat postmenopausal and corticosteroid-induced osteoporosis. They are also used in the treatment of certain metastatic malignancies. However, osteonecrosis of the jaw has been reported after intravenous, subcutaneous, or oral use of these agents.

A decade of bisphosphonate bone complications: what it has taught us about bone physiology.

While the AIDS epidemic of the 1980s taught the medical and dental professions much about immune cells and the immune system's cellular relationships, the bisphosphonate-induced osteonecrosis epidemic of the past decade has taught these same professions much about bone turnover, bone cell cross talk, the response and functional relationship of bone cells to loading, and drug effects on cellular dynamic relationships. The present article explores the literature as well as both evidence- and experience-based data to discuss known bone pathologies and physiologic mechanisms as well as uncover new findings: (1) bone remodeling is the mechanism by which bone adapts to loading stresses, termed either bone modeling or Wolff's law, and it is also the mechanism for bone renewal; (2) osteoclastic bone resorption triggers bone renewal at a rate of about 0.7%/day by its release of growth factors; (3) bisphosphonates prevent the renewal of old and injured bone, thus making it brittle and more likely to fracture over time; (4) bisphosphonates have a half-life in bone of 11 years because of their irreversible binding to bone via their central carbon atom; (5) when administered intravenously, bisphosphonate loads bone and accumulates in bone 142.

Translational research: The CD34+ cell is crucial for large-volume bone regeneration from the milieu of bone marrow progenitor cells in craniomandibular reconstruction.

Purpose: This study investigated the role of the bone marrow-derived CD34+ cell in a milieu of osteoprogenitor cells, bone marrow plasma cell adhesion molecules, recombinant human bone morphogenetic protein (rhBMP), and a matrix of crushed cancellous allogeneic bone in the clinical regeneration of functionally useful bone in craniomandibular reconstructions. The history and current concepts of bone marrow hematopoietic stem cells and mesenchymal stem cells are reviewed as they relate to bone regeneration in large continuity defects of the mandible.

Materials And Methods: Patients with 6- to 8-cm continuity defects of the mandible with retained proximal and distal segments were randomized into two groups.

The deception and fallacies of sponsored randomized prospective double-blinded clinical trials: the bisphosphonate research example.

The randomized prospective double-blinded clinical trial (RCT) is accepted as Level I evidence and is highly regarded. However, RCTs that gained FDA approval of drugs such as Vioxx, Fen-Phen, and oral and intravenous bisphosphonates have proven to generate misleading results and have not adequately identified serious adverse reactions. The development, research, and clinical marketing of the oral and intravenous bisphosphonates can serve as a representative example for the deteriorated value of many of today's RCTs.

Biointegration of the osteo-odonto lamina in the modified osteo-odonto keratoprosthesis: engineering of tissue to restore lost vision.

The modified osteo-odonto keratoprosthesis (MOOKP) is a biologic keratoprosthesis that is used to treat a severely scarred cornea. The procedure involves multiple stages, including the transplantation of buccal mucosa to the damaged ocular surface and the implantation of an osteo-odonto lamina with a mounted polymethylmethacrylate lens. Among the keratoprostheses currently available, the MOOKP has proven to be the most effective based on the number of patients who have undergone the procedure and the duration of documented follow-up.

A qualitative and quantitative analysis of autologous human multipotent adult stem cells derived from three anatomic areas by marrow aspiration: tibia, anterior ilium, and posterior ilium.

Purpose: The purpose of this article was to compare the yields of stromal multipotent stem cells (CD34+ and CD105+) and hematopoetic multipotent stem cells (CD44+) obtained from different areas via bone marrow aspiration (BMA).

Materials And Methods: Sixty 60-mL bone marrow aspirates were taken from the tibial plateau, the anterior ilium, and the posterior ilium using a single point-of-care BMA technique and a single BMA concentration (BMAC) device. A 1-mL portion of each sample was used to determine CD stem cell concentrations and the nucleated cell count.

rhBMP-2/ACS grafts versus autogenous cancellous marrow grafts in large vertical defects of the maxilla: an unsponsored randomized open-label clinical trial.

Purpose: This study compared the histologic parameters and outcomes of two types of grafts in large vertical maxillary defects: a composite graft of recombinant human bone morphogenetic protein-2/acellular collagen sponge (rhBMP-2/ACS), crushed cancellous freeze-dried allogeneic bone (CCFDAB), and platelet-rich plasma (PRP); and size-matched 100% autogenous grafts.

Materials And Methods: Twenty patients each were treated with a composite graft, which contained 1.05 mg rhBMP-2/ACS per two-tooth segment together with CCFDAB and PRP, or a 100% autogenous graft prior to implant placement.

Dental implants and the use of rhBMP-2.

Tissue engineering is an emerging field of medicine and dentistry that combines the body's natural biologic response to tissue injury with engineering principles. The goal is to replicate or reconstruct the natural form and function of missing tissues and organs. Tissue-engineered bone with native qualities will be necessary for implantation or migration of engineered teeth in the future, and is currently required for the osseointegration of dental implants.

Dental implants and the use of rhBMP-2.

Tissue engineering is an emerging field of medicine and dentistry that combines the body's natural biologic response to tissue injury with engineering principles. The goal is to replicate or reconstruct the natural form and function of missing tissues and organs. Tissue-engineered bone with native qualities will be necessary for implantation or migration of engineered teeth in the future, and is currently required for the osseointegration of dental implants.

Oral and maxillofacial surgeons' role in the first successful modified osteo-odonto-keratoprosthesis performed in the United States.

Corneal disease constitutes the second most common cause of blindness and often leads to corneal damage or scarring. Several corneal scarring is a complex and difficult condition for ophthalmologists to manage. In the most severe cases, the scarring is accompanied by excessive dryness and keratinization of the ocular surface.

Pivotal, randomized, parallel evaluation of recombinant human bone morphogenetic protein-2/absorbable collagen sponge and autogenous bone graft for maxillary sinus floor augmentation.

Purpose: The purpose of this prospective study was to evaluate the safety and effectiveness of recombinant human morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge (ACS) compared with an autogenous bone graft when used for 2-stage maxillary sinus floor augmentation. The study assessed new bone formation, placement integration, and functional loading after 6 months and long term for 2 years.

Materials And Methods: A total of 160 subjects were randomized, enrolled, and followed from January 1999 to February 2004 at 21 centers in the United States.