Roni Kolerman1, Joseph Nissan2, Marina Rahmanov2, José Luis Calvo-Guirado3, Nirit Tager Green4, Haim Tal4. 1. Department of Periodontology, the Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. daniaron@netvision.net.il. 2. Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 3. Department of General and Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain. 4. Department of Periodontology, the Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Abstract
OBJECTIVE: The aim of this study was to histomorphometrically test the hypothesis that graft consolidation originates from the sinus floor. MATERIALS AND METHODS: This prospective, randomized split-mouth study investigated patients undergoing bilateral maxillary lateral sinus floor augmentation using either freeze-dried bone allografts (FDBAs) or biphasic calcium phosphate (BCP) bone substitute. Apico-coronal core biopsies were harvested during implant placement 9 months after sinus floor augmentation, processed for histological observation, and measured histomorphometrically. RESULTS: Biopsies were taken from 26 bilateral sites in 13 patients. The density of new bone (NB) decreased with increasing distance from the sinus floor. The percentage mean surface of NB ranged from 31 ± 9.5% at 2 mm from the sinus floor (G1) to 27.7 ± 11.2% at 4 mm (G2) for the FDBA specimens and from 30.0 ± 11.0% at G1 to 23.5 ± 9.9% at G2 for the BCP specimens. Evaluation of the residual graft particle (GP) area alone as a function of distance from the floor revealed a clear inverse gradient of 7.1 ± 6.6 to 9.1 ± 10.3 between G1 and G2 for the FDBA allografts, with the same tendency for the BCP alloplasts (21.9 ± 9.9 to 27.7 ± 6.6, respectively). CONCLUSION: Our results support the concept that osteogenesis initiates in regions proximal to the bony walls of the maxillary sinus and may be enhanced by them. CLINICAL RELEVANCE: The nature of the grafting material had a greater influence on the degree of NB formation in regions distant from the native walls where there is reduced inherent osteogenic potential.
OBJECTIVE: The aim of this study was to histomorphometrically test the hypothesis that graft consolidation originates from the sinus floor. MATERIALS AND METHODS: This prospective, randomized split-mouth study investigated patients undergoing bilateral maxillary lateral sinus floor augmentation using either freeze-dried bone allografts (FDBAs) or biphasic calcium phosphate (BCP) bone substitute. Apico-coronal core biopsies were harvested during implant placement 9 months after sinus floor augmentation, processed for histological observation, and measured histomorphometrically. RESULTS: Biopsies were taken from 26 bilateral sites in 13 patients. The density of new bone (NB) decreased with increasing distance from the sinus floor. The percentage mean surface of NB ranged from 31 ± 9.5% at 2 mm from the sinus floor (G1) to 27.7 ± 11.2% at 4 mm (G2) for the FDBA specimens and from 30.0 ± 11.0% at G1 to 23.5 ± 9.9% at G2 for the BCP specimens. Evaluation of the residual graft particle (GP) area alone as a function of distance from the floor revealed a clear inverse gradient of 7.1 ± 6.6 to 9.1 ± 10.3 between G1 and G2 for the FDBA allografts, with the same tendency for the BCP alloplasts (21.9 ± 9.9 to 27.7 ± 6.6, respectively). CONCLUSION: Our results support the concept that osteogenesis initiates in regions proximal to the bony walls of the maxillary sinus and may be enhanced by them. CLINICAL RELEVANCE: The nature of the grafting material had a greater influence on the degree of NB formation in regions distant from the native walls where there is reduced inherent osteogenic potential.
Entities:
Keywords:
Biomaterials; Bone substitute; Gradient; Native bone; Sinus floor elevation
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