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Background: Tissue banking includes the process starting from procurement to the distribution and usage of allograft tissues. The use of bone bank in orthopaedics is not widely seen. Our objective is to describe the 10-year allograft donor and recipient data from a fully functioning tissue bank in India, analyse the types of grafts used, indications and demand for various grafts. This will show the need for a tissue bank in a tertiary care orthopaedic setup. Methods: Analysis of donor and recipient data for allografts of a tissue bank in an Indian tertiary care setup was done from 2012 to 2022. The number of grafts procured and used were analysed. The recipient and donor sites were also analysed. Results: In 10 years, the tissue bank provided 2776 grafts and received 1962 donations. Slices procured after total knee replacements were the most commonly used allografts (28.03%). Acute fracture with bone loss or severe comminution (23.11%) being the most common indication of bone grafting was a major result of our study. Among these, proximal tibia (27.79%) was the most frequent recipient site. Tissue bank has also served patients in neurosurgery, ophthalmology, oromaxillofacial surgery, otorhinolaryngology, urology and wound care. Conclusion: A tissue bank is a useful setup in tertiary care orthopaedic hospitals. Allografts were most widely used for acute trauma management. Allografts provide large graft quantity and reduce surgical time. Hence a tissue bank is not only an asset to the establishment but also to the surrounding hospitals, to which the grafts can be supplied. [ABSTRACT FROM AUTHOR]

Introduction: Achieving regeneration of the lost periodontal structures after surgical approach plays a major role. This healing can be interrupted due to the presence of invasive bacteria which is present in the periodontal tissues. Aim: To compare laser-assisted and conventional flap surgery using microsurgical instruments and under surgical operating microscope with hydroxyapatite graft in the treatment of intrabony defects. Materials and Methods: This prospective randomised split-mouth clinical study was conducted in Department of Periodontology at Vishnu Dental College, Bhimavaram, Andhra Pradesh, India, from June 2020 to December 2021. A total of 24 bilateral intrabony defects were selected for the study. Control sites (n=12) received the graft after conventional open flap debridement. In the test group (n=12), graft placement was done followed by laser irradiation with diode laser (980 nm, power: 3.0 W; frequency 2.5 KHz) for 30 seconds. The entire flap surgery procedure was performed under Surgical Operating Microscope (SOM). Clinical parameters such as plaque index, gingival index, probing depth, relative attachment level, were assessed at 3 months and 6 months. Healing index was assessed after 7 days of surgery. Radiographic parameters were assessed at baseline and 6 months using Cone Beam Computed Tomography (CBCT). Descriptive statistics, Independent samples t-test, repeated measures analysis of variance and Paired t-tests were used in data analysis. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: Intragroup comparison showed statistical significance in all clinical and radiographical parameters (p-value<0.001). Intergroup comparison between the test and control group did not show any statistical significance in terms of plaque index, gingival index, relative Clinical attachment level, probing depth (p-value≥0.05). Intragroup comparison of the depth of defect was statistically significant in both test (p-value=0.011) and control groups (p-values=0.002). Intergroup comparison did not show any statistical significance in linear bone fill (p-value=0.1). Intergroup comparison did not show any statistical significance in defect angle (p-value=0.773). No statistical significance was obtained in percentage fill (p-value=0.074). Intergroup comparison did not show any statistical significance in the clinical and radiographical parameters. Conclusion: The additional laser irradiation at the test site did not exhibit any significant benefits in the bone regeneration. All the outcomes were similar in test and control group. [ABSTRACT FROM AUTHOR]

Background: A tissue bank is an establishment that aids in retrieval, processing, storage, and distribution of human tissue for transplantation. For many years, such banks have been dispensing tissue to orthopaedic surgeons, performing reconstructive surgeries. Methodology: The retrieval, preparation, and delivery of musculoskeletal tissue used for transplantation is an intricate process involving varying practices among different musculoskeletal tissue banks. Results: Musculoskeletal allografts are used in various orthopaedic surgeries ranging from primary bone defects, trauma, and carcinoma to congenital disabilities. Every decade brings in paradigm shifts and new hope for treating challenging cases with the aid of newer devices and materials. Conclusion: This review article outlines various technical, regulatory and quality enhancement steps involved in tissue banking. Also, it discusses the road ahead and the research avenues for developing novel allograft products with the synergy of tissue banks and clinicians. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate changes in alveolar bone height after direct sinus elevation and simultaneous implant placement in the posterior edentulous maxilla. Materials and Methods: A prospective clinical study was conducted of patients undergoing sinus elevation for implant placement in the posterior maxilla to replace missing teeth. Residual alveolar bone height was between 4 and 7.5 mm. Lateral osteotomy of the maxillary sinus, followed by simultaneous implant placement without bone grafting, was performed under local anesthesia. Prosthetic restoration was completed 9 months later. The changes in alveolar bone height at the sinus floor were assessed radiographically after 1 week and 6, 9, 18, and 28 months after implant placement. Probing depths, implant mobility, and crestal bone loss were assessed at the same intervals. Results: Twenty-eight patients (17 women and 11 men) participated in the study. Forty-five implants were placed and followed after prosthetic rehabilitation. At 18 months after loading of the implants, alveolar bone height in the area of sinus elevation ranged from 7.40 to 11.55 mm. Increases in alveolar bone height at the sinus floor ranged from 2.05 to 5.40 mm at a minimum of 18 months after loading, a statistically significant gain. Crestal bone loss and changes in probing depths were not significant in any patients, and all implants remained clinically stable. The implant success rate was 100% without any complications after 18 to 28 months of follow-up. Conclusion: Placement of endosseous implants in the atrophic posterior maxilla in conjunction with sinus elevation without bone grafting resulted in a significant amount of bone formation around the implants at the sinus floor, resulting in successful restorations and eliminating the need for bone grafting. [ABSTRACT FROM AUTHOR]

Objective: To compare the regenerative potential of bone graft used alone and in combination with barrier membrane in noncontained human periodontal infrabony defects. Method and Materials: Twelve patients (7 men and 5 women, 30 to 65 years of age) with moderate to severe chronic periodontitis were included in the study. A total of 16 one- or two-walled intraosseous defects were selected and randomly divided for decalcified freeze-dried bone allograft, alone (control group) or in combination with polylactic acid, polyglycolic acid barrier membrane (test group). Pocket probing depth (PPD), clinical attachment level (CAL), radiologic bone fill (RBF), and alveolar height reduction (AHR) were recorded immediately before surgery and after 3 and 6 months postoperatively. The ANOVA and Newman-Keuls post hac tests were used for statistical analysis. A two-tailed probability value of P < .05 was considered to be statistically significant. Results: For bone graft alone, PPD reduction was 2.00 ± 0.19 mm, CAL gain was 1.38 ± 0.18 mm, and RBF was 0.63 ± 0.26 mm: for the test group, PPD reduction was 2.75 ± 0.37 mm, CAL gain was 1.50 ± 0.27 mm, and RBF was 1.13 ± 0.23 mm. AHR for the control and test groups was 0.38 and 0.37 mm respectively. Conclusion: These results confirmed nonsignificant clinical and radiologic differences in regenerative outcome with bone graft alone and with guided tissue regeneration in the treatment of noncontained human periodontal infrabony defects. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of β-tricalcium phosphate (β-TCP) (Synthograft, Bicon USA) in periodontal osseous defects in comparison to open flap debridement (OFD). Method and Materials: Twelve patients showing clinical and radiographic evidence of almost identical bilateral infrabony defects were selected. The infrabony defects in the 12 patients were treated with OFD+β-TCP on one side and OFD on the other side. Clinical evaluation was performed at baseline and 6 months following therapy. Results: No differences in probing depth (PD) reduction or clinical attachment level (CAL) gain were observed, although a statistically significant difference was observed for the defect fill between the two groups. Six months after therapy, sites treated with OFD+β-TCP showed a reduction in mean PD from 9.67 ± 2.35 mm to 4.00 ± 1.60 mm (P < .05), a change in mean CAL from 9.92 ± 3.15 mm to 5.00 ± 3.86 mm (P < .05), and the mean defect fill was 2.92 ± 0.90 mm. In the sites treated with only OFD, the mean PD was reduced from 7.58 ± 1.08 mm to 2.67 ± 0.65 mm (P < .05), the mean CAL changed from 6.83 ± 1.34 mm to 1.83 ± 1.64 mm (P < .05), and the mean defect fill was 0.83 ± 0.39 mm. Reduction of 5 mm in PD was observed in 5 of the 12 defects (42%); 4 of the 12 defects (33%) gained 3 mm of CAL in the test sites. PD reductions and CAL gains of 3 to 6 mm were measured in the majority of the cases (60% to 75%) regardless of treatment modality. Conclusion: Within the constraints of this study, both therapies resulted in significant PD reductions and CAL gains 6 months after surgery. Sites treated with OFD+β-TCP showed a significant defect fill compared to those treated with OFD alone. [ABSTRACT FROM AUTHOR]

Background and Objective : A narrow alveolar ridge is an obstacle to optimal rehabilitation of the dentition. There are several complex and invasive techniques to counter the ridge augmentation dilemma, with most of them exhibiting low feasibility. Hence, this randomized clinical trial aims to evaluate the effectiveness of a Minimalistic Ridge Augmentation (MRA) technique, in conjunction with low-level laser therapy (LLLT). Materials and Methods : A total of 20 patients ( n = 20) were selected, with 10 assigned to the test group (MRA+LLLT) and the other 10 to the control group (MRA). A vertical incision of approximately 10 mm was placed mesial to the defect and tunneled to create a subperiosteal pouch across the entire width of the defect. At the test sites, a diode laser (AnARC Fox TM Surgical Laser 810 nm) was used to deliver LLLT (parameters: 100 mW, with a maximum energy distribution of 6 J/cm 2 in the continuous wave mode for 60 s per point) to the exposed bone surface inside the pouch, followed by graft (G-Graft, Surgiwear TM , Shahjahanpur, India) deposition with a bone graft carrier. The control sites were not irradiated with a laser. Results : A horizontal ridge width gain of >2 mm was observed in both groups. The changes in bone density for the test and control groups were -136 ± 236.08 HU and -44.30 ± 180.89 HU, respectively. Furthermore, there was no statistically significant difference between the test and control groups in these parameters. Conclusion : The study findings reveal that the MRA technique is relatively simple and feasible for alveolar ridge augmentation. The role of LLLT in the process requires further elucidation.

Background Osteogenic augmentation is required in various orthopaedic conditions. Defects caused by removal of malignant or local bone tumours requires reconstructive surgeries to restore skeletal continuity and bone grafts to fill bone defects. Different modalities which can help to increase osteogenesis include autografts, allografts and synthetic bone graft substitutes. Autograft is the gold standard, provides osteogenic, osteoinductive and osteoconductive properties but has limitations of requirement for additional incisions, poor bone quality in elderly patients, increases operation time, causes donor site pain and morbidity and likely permanent residual disability and limited amount. Autograft is the gold standard but is available in limited amount and morbidities associated with it. Bone graft substitutes are costly, limited in quantity and don't integrate with host bone. Bone allografts are a good option, but not widely used in India and there are sparse reports in literature from developing countries. Our study signifies use of gamma irradiated deep freezed bone allografts in treatment of various bone tumours. Methods It's a prospective descriptive study. Strict inclusion and exclusion criteria, as per standard guidelines of American and European Association of Tissue Banking, were followed. We have a in-house facility of gamma irradiated deep freezed bone allografts available in hospital. 20 patients with giant cell tumours of proximal tibia, proximal ulna and distal radius, aneurysmal bone cysts of proximal humerus and distal radius, etc were operated during one year and followed up for atleast 24 weeks thereafter. Sloof's Criteria was used for assessing osteointegration of grafts. Results Allografts have not only accepted well but defects have healed and bone integration is at various stages. Only one patient got infected (5%). 19 out of 20 patients (95 %) in our study group had either attained or at various stages of osteointegration and healing. Conclusions We conclude that deep freezed bone allografts is a viable option in patients with large bone defects after resection of bone tumours, thus give satisfactory surgical outcome, with no serious side effects. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]