Måns Jungner1,2, Giovanni Cricchio2, Luiz A Salata3, Lars Sennerby4, Carina Lundqvist2, Malou Hultcrantz5, Stefan Lundgren2. 1. Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden. 2. Department of Oral and Maxillofacial Surgery, Umeå University, Umeå, Sweden. 3. Department of Oral & Maxillofacial Surgery and Periodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. 4. Department of Oral and Maxillofacial Surgery, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden. 5. Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
Abstract
BACKGROUND: Previous studies have shown predictable bone formation in the maxillary sinus after membrane elevation. However, how and where the bone is formed is not well understood. PURPOSE: The aim of the study was to histologically and immunohistochemically study the early bone formation events in primates after membrane elevation in the maxillary sinus. MATERIALS AND METHODS: Nine adult male tufted capuchin primates (Cebus apella) were included in the study. Eight animals were subjected to bilateral maxillary sinus membrane elevation using a lateral replaceable bone window technique. One oxidized dental implant was placed into the maxillary sinus cavity on both sides. In four animals, one sinus was left without any additional treatment, whereas the contralateral sinus was filled with autologous bone grafts from the tibia. In two animals, the implants were inserted under the elevated sinus membrane on both sides. In two animals, the sinus membrane was totally removed. The animals were euthanized after 10 or 45 days. One nonoperated animal representing pristine tissue conditions served as control. The maxillary sinuses with implants were retrieved and further processed for light microscopic ground sections or decalcified sections for immune-histochemical analyses. RESULTS: Bone formation started from the bottom of the sinus floor, sprouting into the granulation tissue along the implant surface under the elevated membrane irrespective of time and surgical technique. Bone formation was not seen in direct conjunction with the sinus membrane. A distinct expression of osteopontin was observed in the serous glands of the lamina propria close to the implant within all groups. CONCLUSION: Bone formation after sinus membrane elevation with or without additional bone grafts starts at the sinus floor and sprouts into the elevated space along the implant surface. The sinus membrane does not seem to present osteoinductive potential in sinus membrane elevation procedures in this study.
BACKGROUND: Previous studies have shown predictable bone formation in the maxillary sinus after membrane elevation. However, how and where the bone is formed is not well understood. PURPOSE: The aim of the study was to histologically and immunohistochemically study the early bone formation events in primates after membrane elevation in the maxillary sinus. MATERIALS AND METHODS: Nine adult male tufted capuchin primates (Cebus apella) were included in the study. Eight animals were subjected to bilateral maxillary sinus membrane elevation using a lateral replaceable bone window technique. One oxidized dental implant was placed into the maxillary sinus cavity on both sides. In four animals, one sinus was left without any additional treatment, whereas the contralateral sinus was filled with autologous bone grafts from the tibia. In two animals, the implants were inserted under the elevated sinus membrane on both sides. In two animals, the sinus membrane was totally removed. The animals were euthanized after 10 or 45 days. One nonoperated animal representing pristine tissue conditions served as control. The maxillary sinuses with implants were retrieved and further processed for light microscopic ground sections or decalcified sections for immune-histochemical analyses. RESULTS: Bone formation started from the bottom of the sinus floor, sprouting into the granulation tissue along the implant surface under the elevated membrane irrespective of time and surgical technique. Bone formation was not seen in direct conjunction with the sinus membrane. A distinct expression of osteopontin was observed in the serous glands of the lamina propria close to the implant within all groups. CONCLUSION: Bone formation after sinus membrane elevation with or without additional bone grafts starts at the sinus floor and sprouts into the elevated space along the implant surface. The sinus membrane does not seem to present osteoinductive potential in sinus membrane elevation procedures in this study.
Authors: James Carlos Nery; Luís Antônio Violin Dias Pereira; George Furtado Guimarães; Cassio Rocha Scardueli; Fabiana Mantovani Gomes França; Rubens Spin-Neto; Andreas Stavropoulos Journal: Int J Implant Dent Date: 2017-05-04
Authors: Florian Beck; Karoline Maria Reich; Stefan Lettner; Patrick Heimel; Stefan Tangl; Heinz Redl; Christian Ulm Journal: J Periodontol Date: 2020-08-19 Impact factor: 6.993