human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To evaluate the regenerative results of the addition of bone marrow aspirate concentrate , using a single or double centrifugation protocol , to a xenogeneic bone graft in sinus floor elevation . MATERIAL S AND METHODS Using a r and omized , controlled pilot study design in 15 consecutive patients , sinus floor elevation procedures were performed with a xenogenous bone graft alone ( control group , CG ) or associated with bone marrow aspirate concentrate obtained by single centrifugation ( single centrifugation group , SCG ) or double centrifugation ( double centrifugation group , DCG ) . In the patients in the single and double centrifugation groups , bone marrow was harvested from the iliac bone . Six months after the grafting procedures , bone biopsy specimens were obtained during implant placement and were analyzed by histomorphometry . RESULTS Histomorphometric analysis revealed a great amount of vital mineralized tissue in SCG followed by DCG when compared with the CG ( 38.44 ± 12.34 % , 34.63 ± 9.84 % , and 27.30 ± 5.55 % , respectively ) . SCG and DCG presented smaller amounts of nonvital mineralized tissue when compared with the CG ( 13.70 ± 7.50 % , 19.63 ± 8.35 % , and 22.79 ± 9.60 % , respectively ) , thus presenting higher levels of resorption . Although these differences were not statistically significant ( P > .05 ) , a tendency toward bone gain in the experimental groups ( SCG and DCG ) was found . All groups ( SCG , DCG , and CG ) showed similar levels of nonmineralized tissue ( 47.87 ± 6.31 % , 45.73 ± 7.33 % , and 49.90 ± 7.64 % , respectively ) . CONCLUSION This pilot study indicates that the clinical use of bone marrow aspirate concentrate , obtained by either a single or double centrifugation process , combined with a xenograft for maxillary sinus elevation seems to result in more adequate bone repair . However , clinical trials with a larger number of patients are required PURPOSE Autologous , allogenic , and alloplastic material s for bony reconstruction in the craniomaxillofacial region have specific drawbacks stimulating the ongoing search for new material s. Cultivated skin and mucosa grafts are in clinical routine use in head and neck reconstruction but so far , to the best of our knowledge , no successful clinical application has been described of periosteum-derived tissue-engineered bone for augmentation of the edentulous posterior maxilla . PATIENTS AND METHODS In a clinical study , augmentation of the posterior maxilla was carried out using a bone matrix derived from m and ibular periosteum cells on an Ethisorb ( Ethicon , Norderstedt , Germany ) fleece . In this report , we show the fabrication of the matrix , clinical application , and results in 27 patients . RESULTS In 18 patients , an excellent clinical , radiologic , and histologic result could be proved 3 months after augmentation . Histologically , the bone biopsy sample s from these patients revealed mineralized trabecular bone with remnants of the bio material . An unsuccessful result was found in 8 cases with a more extended augmentation procedure . The clinical inspection 3 months after augmentation showed almost no formation of new bone . In contrast , a replacement resorption with connective tissue was found . This may be the result of failure of the initial supply of the cells embedded within large cell-polymer constructs with sufficient oxygen and nutrients to sustain their survival and proliferation and allow for the integration of the developing tissue within the surrounding tissue . CONCLUSION Our achieved results suggest that periosteum-derived osteoblasts on a suitable matrix can form lamellar bone within 3 months after transplantation and provide a reliable basis for simultaneous or secondary insertion of dental implants Stem cell therapy offers potential in the regeneration of craniofacial bone defects ; however , it has not been studied clinical ly . Tissue repair cells ( TRCs ) isolated from bone marrow represent a mixed stem and progenitor population enriched in CD90- and CD14-positive cells . In this phase I/II , r and omized , controlled feasibility trial , we investigated TRC cell therapy to reconstruct localized craniofacial bone defects . Twenty-four patients requiring localized reconstruction of jawbone defects participated in this longitudinal trial . For regenerative therapy , patients were r and omized to receive either guided bone regeneration ( GBR ) or TRC transplantation . At 6 or 12 weeks following treatment , clinical and radiographic assessment s of bone repair were performed . Bone biopsies were harvested and underwent quantitative micro-computed tomographic ( μCT ) and bone histomorphometric analyses . Oral implants were installed , subsequently restored , and functionally loaded with tooth restorations . Reconstructed sites were assessed for 1 year following therapy . No study -related , serious adverse events were reported . Following therapy , clinical , radiographic , tomographic , and histological measures demonstrated that TRC therapy accelerated alveolar bone regeneration compared to GBR therapy . Additionally , TRC treatment significantly reduced the need for secondary bone grafting at the time of oral implant placement with a fivefold decrease in implant bony dehiscence exposure ( residual bone defects ) as compared to GBR-treated sites ( p < 0.01 ) . Transplantation of TRCs for treatment of alveolar bone defects appears safe and accelerates bone regeneration , enabling jawbone reconstruction with oral implants . The results from this trial support exp and ed studies of TRC therapy in the treatment of craniofacial deformities ( Clinical Trials.gov number CT00755911 ) This clinical study used injectable tissue-engineered bone , along with bone marrow-derived stromal cells ( BMDSCs ) and platelet-rich plasma ( PRP ) , to conduct maxillary sinus floor augmentation by the simultaneous placement of bone graft and dental implants and to examine the state of regenerated bone after functional loading in 16 sinus augmentations in 12 patients whose alveolar crestal bone height was 2 - 10 mm . We used PRP as an autologous scaffold-which provides signal molecules-with in vitro exp and ed BMDSCs to enhance osteogenesis . All 41 dental implants prepared with the material s were clinical ly stable after second-stage surgery . The height of mineralized tissue at 2 years showed the mean increases of 8.8 + /- 1.6 mm compared to preoperative values , and no adverse effects and remarkable bone absorption were seen in the 2 - 6-year follow-up time . Although these results are preliminary , injectable tissue-engineered bone would stably predict the success of bone formation and dental implants , reduce patient burden , and provide minimally invasive cell therapy for patients OBJECTIVES Aim of the pilot trial was to evaluate applicability and effects of directly autotransplanted tibial bone marrow ( BM ) aspirates on the incorporation of porous bovine bone mineral in a sinus lift model and on the osseointegration of dental implants . MATERIAL AND METHODS Six edentulous patients with bilaterally severely resorbed maxillae requiring sinus augmentation and implant treatment were included . During surgery , tibial BM was harvested and added to bone substitute material ( Bio-Oss ( ® ) ) at the r and omly selected test site . At control sites , augmentation was performed with Bio-Oss ( ® ) alone . The cellular content of each BM aspirate was checked for multipotency and surface antigen expression as quality control . Histomorphometric analysis of biopsies from the augmented sites after 3 and 6 months ( during implantation ) was used to evaluate effects on bone regeneration . Osseointegration of implants was evaluated with Periotest ( ® ) and radiographic means . RESULTS Multipotent cellular content in tibial BM aspirates was comparable to that in punctures from the iliac crest . No significant difference in amount of new bone formation and the integration of bone substitute particles was detected histomorphometrically . Periotest ( ® ) values and radiographs showed successful osseointegration of inserted implants at all sites . CONCLUSION Directly autotransplanted tibial BM aspirates did not show beneficial regenerative effects in the small study population ( N = 6 ) of the present pilot trial . However , the proximal tibia proved to be a potential donor site for small quantities of BM . Future trials should clarify whether concentration of tibial BM aspirates could effect higher regenerative potency Purpose . To investigate the regenerative results obtained with the association of bone marrow aspirate concentrate using the Bone Marrow Aspirate Concentrate ( BMAC ) method to a xenogeneic bone graft ( Bio-Oss ) in sinus floor elevation . Material s and Methods . Using a r and omized controlled study design in eight consecutive patients ( age of 55.4 ± 9.2 years ) , 16 sinus floor lift procedures were performed with Bio-Oss alone ( control group , CG , n = 8) or combined with bone marrow aspirate concentrate obtained via the BMAC method ( test group , TG , n = 8) . Six months after the grafting procedures , bone biopsies were harvested during implant placement and were analyzed by histomorphometry . Results . Histomorphometric analysis revealed a significantly higher amount ( p < 0.05 ) of vital mineralized tissue in TG when compared to the CG ( 55.15 ± 20.91 % and 27.30 ± 5.55 % , resp . ) . For nonvital mineralized tissue , TG presented a statistically higher level of Bio-Oss resorption ( p < 0.05 ) when compared with the CG ( 6.32 ± 12.03 % and 22.79 ± 9.60 % , resp . ) . Both groups ( TG and CG ) showed no significantly different levels ( p > 0.05 ) of nonmineralized tissue ( 38.53 ± 13.08 % and 49.90 ± 7.64 % , resp . ) . Conclusion . The use of bone marrow concentrate obtained by BMAC method increased bone formation in sinus lift procedures AIM To assess whether differences occur in bone formation after maxillary sinus floor elevation surgery with bovine bone mineral ( BioOss ( ® ) ) mixed with autogenous bone or autogenous stem cells . The primary endpoint was the percentage of new bone three months after the elevation procedure . MATERIAL AND METHODS In a r and omized , controlled split-mouth design , in 12 consecutive patients ( age 60.8 ± 5.9 years , range 48 - 69 years ) needing reconstruction of their atrophic maxilla , a bilateral sinus floor augmentation procedure was performed . R and omly , on one side the augmentation procedure was performed with bovine bone mineral ( BioOss ( ® ) ) seeded with mononuclear stem cells harvested from the posterior iliac crest ( test group ) while BioOss ( ® ) mixed with autogenous bone ( harvested from the retromolar area ) was applied on the contra-lateral side ( control group ) . On 14.8 ± 0.7 weeks after the sinus floor elevation , biopsies from the reconstructed areas were taken at the spots where subsequently the endosseous implants were placed . The biopsies were histomorphometrically analyzed . RESULTS Significantly more bone formation was observed in the test group ( 17.7 ± 7.3 % ) when compared with the control group ( 12.0%± 6.6 ; P=0.026 ) . In both the test and control group , all implants could be placed with primary stability . In one patient , not all biopsies contained BioOss ( ® ) . This patient was excluded from analysis . CONCLUSION Mesenchymal stem cells seeded on BioOss ( ® ) particles can induce the formation of a sufficient volume of new bone to enable the reliable placement of implants within a time frame comparable with that of applying either solely autogenous bone or a mixture of autogenous bone and BioOss ( ® ) . This technique could be an alternative to using autografts OBJECTIVES This prospect i ve clinical study was design ed to examine the healing process during the first 12 months after sinus grafting ( SG )  with autogenous culture-exp and ed bone cells ( ABC ) and bovine bone mineral ( BBM ) histomorphometrically and radiologically . MATERIAL AND METHODS Twenty-two sinuses of 12 patients ( mean age 56.2+/-9.3 years ) were grafted . Four weeks before , SG bone biopsies were obtained with a trephine burr and the bone cells were isolated and exp and ed . Every sinus was grafted with BBM and ABC . After 6 months , a biopsy was taken from each sinus and implants ( n=82 ) were placed . These were uncovered after another 6 months and fitted with dentures . The percent newly formed bone ( NB ) and the NB-to-BBM contact area were determined on undecalcified histologic sections . The sinus graft volume was evaluated by dental CT after SG ( CT 1 ) , after implant placement ( CT 2 ) and after implant uncovery ( CT 3 ) . RESULTS Postoperative healing was uneventful . The NB was 17.9+/-4.6 % and the contact area 26.8+/-13.1 % . The graft volume ( in mm(3 ) ) was 2218.4+/-660.9 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To evaluate the regenerative results of the addition of bone marrow aspirate concentrate , using a single or double centrifugation protocol , to a xenogeneic bone graft in sinus floor elevation . MATERIAL S AND METHODS Using a r and omized , controlled pilot study design in 15 consecutive patients , sinus floor elevation procedures were performed with a xenogenous bone graft alone ( control group , CG ) or associated with bone marrow aspirate concentrate obtained by single centrifugation ( single centrifugation group , SCG ) or double centrifugation ( double centrifugation group , DCG ) . In the patients in the single and double centrifugation groups , bone marrow was harvested from the iliac bone . Six months after the grafting procedures , bone biopsy specimens were obtained during implant placement and were analyzed by histomorphometry . RESULTS Histomorphometric analysis revealed a great amount of vital mineralized tissue in SCG followed by DCG when compared with the CG ( 38.44 ± 12.34 % , 34.63 ± 9.84 % , and 27.30 ± 5.55 % , respectively ) . SCG and DCG presented smaller amounts of nonvital mineralized tissue when compared with the CG ( 13.70 ± 7.50 % , 19.63 ± 8.35 % , and 22.79 ± 9.60 % , respectively ) , thus presenting higher levels of resorption . Although these differences were not statistically significant ( P > .05 ) , a tendency toward bone gain in the experimental groups ( SCG and DCG ) was found . All groups ( SCG , DCG , and CG ) showed similar levels of nonmineralized tissue ( 47.87 ± 6.31 % , 45.73 ± 7.33 % , and 49.90 ± 7.64 % , respectively ) . CONCLUSION This pilot study indicates that the clinical use of bone marrow aspirate concentrate , obtained by either a single or double centrifugation process , combined with a xenograft for maxillary sinus elevation seems to result in more adequate bone repair . However , clinical trials with a larger number of patients are required PURPOSE Autologous , allogenic , and alloplastic material s for bony reconstruction in the craniomaxillofacial region have specific drawbacks stimulating the ongoing search for new material s. Cultivated skin and mucosa grafts are in clinical routine use in head and neck reconstruction but so far , to the best of our knowledge , no successful clinical application has been described of periosteum-derived tissue-engineered bone for augmentation of the edentulous posterior maxilla . PATIENTS AND METHODS In a clinical study , augmentation of the posterior maxilla was carried out using a bone matrix derived from m and ibular periosteum cells on an Ethisorb ( Ethicon , Norderstedt , Germany ) fleece . In this report , we show the fabrication of the matrix , clinical application , and results in 27 patients . RESULTS In 18 patients , an excellent clinical , radiologic , and histologic result could be proved 3 months after augmentation . Histologically , the bone biopsy sample s from these patients revealed mineralized trabecular bone with remnants of the bio material . An unsuccessful result was found in 8 cases with a more extended augmentation procedure . The clinical inspection 3 months after augmentation showed almost no formation of new bone . In contrast , a replacement resorption with connective tissue was found . This may be the result of failure of the initial supply of the cells embedded within large cell-polymer constructs with sufficient oxygen and nutrients to sustain their survival and proliferation and allow for the integration of the developing tissue within the surrounding tissue . CONCLUSION Our achieved results suggest that periosteum-derived osteoblasts on a suitable matrix can form lamellar bone within 3 months after transplantation and provide a reliable basis for simultaneous or secondary insertion of dental implants Stem cell therapy offers potential in the regeneration of craniofacial bone defects ; however , it has not been studied clinical ly . Tissue repair cells ( TRCs ) isolated from bone marrow represent a mixed stem and progenitor population enriched in CD90- and CD14-positive cells . In this phase I/II , r and omized , controlled feasibility trial , we investigated TRC cell therapy to reconstruct localized craniofacial bone defects . Twenty-four patients requiring localized reconstruction of jawbone defects participated in this longitudinal trial . For regenerative therapy , patients were r and omized to receive either guided bone regeneration ( GBR ) or TRC transplantation . At 6 or 12 weeks following treatment , clinical and radiographic assessment s of bone repair were performed . Bone biopsies were harvested and underwent quantitative micro-computed tomographic ( μCT ) and bone histomorphometric analyses . Oral implants were installed , subsequently restored , and functionally loaded with tooth restorations . Reconstructed sites were assessed for 1 year following therapy . No study -related , serious adverse events were reported . Following therapy , clinical , radiographic , tomographic , and histological measures demonstrated that TRC therapy accelerated alveolar bone regeneration compared to GBR therapy . Additionally , TRC treatment significantly reduced the need for secondary bone grafting at the time of oral implant placement with a fivefold decrease in implant bony dehiscence exposure ( residual bone defects ) as compared to GBR-treated sites ( p < 0.01 ) . Transplantation of TRCs for treatment of alveolar bone defects appears safe and accelerates bone regeneration , enabling jawbone reconstruction with oral implants . The results from this trial support exp and ed studies of TRC therapy in the treatment of craniofacial deformities ( Clinical Trials.gov number CT00755911 ) This clinical study used injectable tissue-engineered bone , along with bone marrow-derived stromal cells ( BMDSCs ) and platelet-rich plasma ( PRP ) , to conduct maxillary sinus floor augmentation by the simultaneous placement of bone graft and dental implants and to examine the state of regenerated bone after functional loading in 16 sinus augmentations in 12 patients whose alveolar crestal bone height was 2 - 10 mm . We used PRP as an autologous scaffold-which provides signal molecules-with in vitro exp and ed BMDSCs to enhance osteogenesis . All 41 dental implants prepared with the material s were clinical ly stable after second-stage surgery . The height of mineralized tissue at 2 years showed the mean increases of 8.8 + /- 1.6 mm compared to preoperative values , and no adverse effects and remarkable bone absorption were seen in the 2 - 6-year follow-up time . Although these results are preliminary , injectable tissue-engineered bone would stably predict the success of bone formation and dental implants , reduce patient burden , and provide minimally invasive cell therapy for patients OBJECTIVES Aim of the pilot trial was to evaluate applicability and effects of directly autotransplanted tibial bone marrow ( BM ) aspirates on the incorporation of porous bovine bone mineral in a sinus lift model and on the osseointegration of dental implants . MATERIAL AND METHODS Six edentulous patients with bilaterally severely resorbed maxillae requiring sinus augmentation and implant treatment were included . During surgery , tibial BM was harvested and added to bone substitute material ( Bio-Oss ( ® ) ) at the r and omly selected test site . At control sites , augmentation was performed with Bio-Oss ( ® ) alone . The cellular content of each BM aspirate was checked for multipotency and surface antigen expression as quality control . Histomorphometric analysis of biopsies from the augmented sites after 3 and 6 months ( during implantation ) was used to evaluate effects on bone regeneration . Osseointegration of implants was evaluated with Periotest ( ® ) and radiographic means . RESULTS Multipotent cellular content in tibial BM aspirates was comparable to that in punctures from the iliac crest . No significant difference in amount of new bone formation and the integration of bone substitute particles was detected histomorphometrically . Periotest ( ® ) values and radiographs showed successful osseointegration of inserted implants at all sites . CONCLUSION Directly autotransplanted tibial BM aspirates did not show beneficial regenerative effects in the small study population ( N = 6 ) of the present pilot trial . However , the proximal tibia proved to be a potential donor site for small quantities of BM . Future trials should clarify whether concentration of tibial BM aspirates could effect higher regenerative potency Purpose . To investigate the regenerative results obtained with the association of bone marrow aspirate concentrate using the Bone Marrow Aspirate Concentrate ( BMAC ) method to a xenogeneic bone graft ( Bio-Oss ) in sinus floor elevation . Material s and Methods . Using a r and omized controlled study design in eight consecutive patients ( age of 55.4 ± 9.2 years ) , 16 sinus floor lift procedures were performed with Bio-Oss alone ( control group , CG , n = 8) or combined with bone marrow aspirate concentrate obtained via the BMAC method ( test group , TG , n = 8) . Six months after the grafting procedures , bone biopsies were harvested during implant placement and were analyzed by histomorphometry . Results . Histomorphometric analysis revealed a significantly higher amount ( p < 0.05 ) of vital mineralized tissue in TG when compared to the CG ( 55.15 ± 20.91 % and 27.30 ± 5.55 % , resp . ) . For nonvital mineralized tissue , TG presented a statistically higher level of Bio-Oss resorption ( p < 0.05 ) when compared with the CG ( 6.32 ± 12.03 % and 22.79 ± 9.60 % , resp . ) . Both groups ( TG and CG ) showed no significantly different levels ( p > 0.05 ) of nonmineralized tissue ( 38.53 ± 13.08 % and 49.90 ± 7.64 % , resp . ) . Conclusion . The use of bone marrow concentrate obtained by BMAC method increased bone formation in sinus lift procedures AIM To assess whether differences occur in bone formation after maxillary sinus floor elevation surgery with bovine bone mineral ( BioOss ( ® ) ) mixed with autogenous bone or autogenous stem cells . The primary endpoint was the percentage of new bone three months after the elevation procedure . MATERIAL AND METHODS In a r and omized , controlled split-mouth design , in 12 consecutive patients ( age 60.8 ± 5.9 years , range 48 - 69 years ) needing reconstruction of their atrophic maxilla , a bilateral sinus floor augmentation procedure was performed . R and omly , on one side the augmentation procedure was performed with bovine bone mineral ( BioOss ( ® ) ) seeded with mononuclear stem cells harvested from the posterior iliac crest ( test group ) while BioOss ( ® ) mixed with autogenous bone ( harvested from the retromolar area ) was applied on the contra-lateral side ( control group ) . On 14.8 ± 0.7 weeks after the sinus floor elevation , biopsies from the reconstructed areas were taken at the spots where subsequently the endosseous implants were placed . The biopsies were histomorphometrically analyzed . RESULTS Significantly more bone formation was observed in the test group ( 17.7 ± 7.3 % ) when compared with the control group ( 12.0%± 6.6 ; P=0.026 ) . In both the test and control group , all implants could be placed with primary stability . In one patient , not all biopsies contained BioOss ( ® ) . This patient was excluded from analysis . CONCLUSION Mesenchymal stem cells seeded on BioOss ( ® ) particles can induce the formation of a sufficient volume of new bone to enable the reliable placement of implants within a time frame comparable with that of applying either solely autogenous bone or a mixture of autogenous bone and BioOss ( ® ) . This technique could be an alternative to using autografts OBJECTIVES This prospect i ve clinical study was design ed to examine the healing process during the first 12 months after sinus grafting ( SG )  with autogenous culture-exp and ed bone cells ( ABC ) and bovine bone mineral ( BBM ) histomorphometrically and radiologically . MATERIAL AND METHODS Twenty-two sinuses of 12 patients ( mean age 56.2+/-9.3 years ) were grafted . Four weeks before , SG bone biopsies were obtained with a trephine burr and the bone cells were isolated and exp and ed . Every sinus was grafted with BBM and ABC . After 6 months , a biopsy was taken from each sinus and implants ( n=82 ) were placed . These were uncovered after another 6 months and fitted with dentures . The percent newly formed bone ( NB ) and the NB-to-BBM contact area were determined on undecalcified histologic sections . The sinus graft volume was evaluated by dental CT after SG ( CT 1 ) , after implant placement ( CT 2 ) and after implant uncovery ( CT 3 ) . RESULTS Postoperative healing was uneventful . The NB was 17.9+/-4.6 % and the contact area 26.8+/-13.1 % . The graft volume ( in mm(3 ) ) was 2218.4+/-660.9 
    Output:
    