Engineered Bone by Autologous Osteoblasts on Polymeric Scaffolds in Maxillary Sinus Augmentation: Histologic Report

2010 ◽  
Vol 36 (6) ◽  
pp. 491-496 ◽  
Author(s):  
Carlo Mangano ◽  
Adriano Piattelli ◽  
Lucia Tettamanti ◽  
Francesco Mangano ◽  
Alessandro Mangano ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Bone Tissue ◽  
Dental Implant ◽  
Sinus Augmentation ◽  
Maxillary Sinus Augmentation ◽  
Initial Stability ◽  
Polymeric Scaffolds ◽  
Sinus Cavity ◽  
Posterior Maxilla ◽  
Regenerative Therapies

Abstract Several regenerative therapies have been used for maxillary sinus grafting. However, recent advances in modern bone tissue engineering techniques have been evaluated. The aim of this histologic report was to evaluate the bone obtained by a culture of autogenous osteoblasts seeded on polyglycolic-polylactid scaffolds in maxillary sinus augmentation. A 56-year-old partially edentulous male with severe atrophy of the posterior maxilla received 6 polyglycolid-polylactid disks (8 mm diameter × 2 mm depth, Oral Bone), each carrying 1.5 million autogenous osteoblasts into the depth of the sinus cavity. After 6 months healing, a bone core was harvested and histologically evaluated. The augmented maxillary sinus with engineered bone presented a mean of 28.89% and 71.11% of bone and medullary spaces, respectively. Data from this case report demonstrate that the newly formed bone provided by engineered bone tissue allowed proper initial stability for dental implant placement. However, the role of this new bone in the long-term success of dental implant anchorage needs further investigation.

scholarly journals Biphasic Calcium Phosphate Biomaterials: Stem Cell-Derived Osteoinduction or In Vivo Osteoconduction? Novel Insights in Maxillary Sinus Augmentation by Advanced Imaging

Materials ◽  
2021 ◽  
Vol 14 (9) ◽  
pp. 2159
Author(s):  
Giovanna Iezzi ◽  
Antonio Scarano ◽  
Luca Valbonetti ◽  
Serena Mazzoni ◽  
Michele Furlani ◽  
...  
Keyword(s):  
Calcium Phosphate ◽  
Maxillary Sinus ◽  
Biphasic Calcium Phosphate ◽  
Calcium Phosphates ◽  
Three Dimensional ◽  
Sinus Augmentation ◽  
Native Bone ◽  
Maxillary Sinus Augmentation ◽  
Posterior Maxilla

Maxillary sinus augmentation is often necessary prior to implantology procedure, in particular in cases of atrophic posterior maxilla. In this context, bone substitute biomaterials made of biphasic calcium phosphates, produced by three-dimensional additive manufacturing were shown to be highly biocompatible with an efficient osteoconductivity, especially when combined with cell-based tissue engineering. Thus, in the present research, osteoinduction and osteoconduction properties of biphasic calcium-phosphate constructs made by direct rapid prototyping and engineered with ovine-derived amniotic epithelial cells or amniotic fluid cells were evaluated. More in details, this preclinical study was performed using adult sheep targeted to receive scaffold alone (CTR), oAFSMC, or oAEC engineered constructs. The grafted sinuses were explanted at 90 days and a cross-linked experimental approach based on Synchrotron Radiation microCT and histology analysis was performed on the complete set of samples. The study, performed taking into account the distance from native surrounding bone, demonstrated that no significant differences occurred in bone regeneration between oAEC-, oAFMSC-cultured, and Ctr samples and that there was a predominant action of the osteoconduction versus the stem cells osteo-induction. Indeed, it was proven that the newly formed bone amount and distribution decreased from the side of contact scaffold/native bone toward the bulk of the scaffold itself, with almost constant values of morphometric descriptors in volumes more than 1 mm from the border.

scholarly journals Osteotome-Mediated Sinus Lift without Grafting Material: A Review of Literature and a Technique Proposal

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Silvio Taschieri ◽  
Stefano Corbella ◽  
Massimo Saita ◽  
Igor Tsesis ◽  
Massimo Del Fabbro
Keyword(s):  
Survival Rate ◽  
Maxillary Sinus ◽  
Alveolar Bone ◽  
Bone Volume ◽  
Large Sample Size ◽  
Sinus Augmentation ◽  
Lifting Technique ◽  
Maxillary Sinus Augmentation ◽  
Posterior Maxilla ◽  
Grafting Materials

Implant rehabilitation of the edentulous posterior maxilla may be a challenging procedure in the presence of insufficient bone volume for implant placement. Maxillary sinus augmentation with or without using grafting materials aims to provide adequate bone volume. The aim of the present study was to systematically review the existing literature on transalveolar maxillary sinus augmentation without grafting materials and to propose and describe an osteotome-mediated approach in postextraction sites in combination with platelet derivative. The systematic review showed that high implant survival rate (more than 96% after 5 years) can be achieved even without grafting the site, with a low rate of complications. Available alveolar bone height before surgery was not correlated to survival rate. In the described case report, three implants were placed in posterior maxilla after extraction of two teeth. An osteotome-mediated sinus lifting technique was performed with the use of platelet derivative (PRGF); a synthetic bone substitute was used to fill the gaps between implant and socket walls. No complications occurred, and implants were successfully in site after 1 year from prosthetic loading. The presented technique might represent a viable alternative for the treatment of edentulous posterior maxilla with atrophy of the alveolar bone though it needs to be validated by studies with a large sample size.

scholarly journals Evidence-Based Clinical Efficacy of Leukocyte and Platelet-Rich Fibrin in Maxillary Sinus Floor Lift, Graft and Surgical Augmentation Procedures

2020 ◽  
Vol 7 ◽  
Author(s):  
Mohamadamin Damsaz ◽  
Consuelo Zumarán Castagnoli ◽  
Majid Eshghpour ◽  
Daryouosh Hamidi Alamdari ◽  
Aida Hamidi Alamdari ◽  
...  
Keyword(s):  
Growth Factors ◽  
Maxillary Sinus ◽  
Dental Implant ◽  
Bone Substitutes ◽  
Platelet Concentrates ◽  
Sinus Augmentation ◽  
Platelet Rich Fibrin ◽  
Positive Effects ◽  
Maxillary Sinus Augmentation ◽  
Sinus Floor

Bone augmentation techniques have increasingly been indicated for re-creating adequate bone height and volume suitable for dental implant sites. This is particularly applicable in the severely atrophic posterior maxilla where sinus perforation (ruptured Schneiderian membrane) is a very common complication and sinus floor elevation or lift is frequently considered a standard procedure. The augmentation of the maxillary sinus can be performed with or without grafting biomaterials. Herein, numerous biomaterials and bone substitutes have been proposed, primarily to sustain the lifted space. In addition, cytokines and growth factors have been used to stimulate angiogenesis, enhance bone formation as well as improve healing and recovery period, either as the sole filling material or in combination with bone substitute materials. Within such, is the family of autologous blood extracts, so-called platelet concentrates, which are simply the “product” resulting from the simple centrifugation of collected whole blood samples of the patient, immediately pre-surgery. Platelet-Rich Fibrin (PRF), a sub-family of platelet concentrates, is a three-dimensional (3-D) autogenous biomaterial obtained, without including anti-coagulants, bovine thrombin, additives, or any gelifying agents during the centrifugation process. Today, it is safe to say that, in implant dentistry and oral and maxillofacial surgery, PRFs (particularly, the pure platelet-rich fibrin or P-PRF and leukocyte and platelet-rich fibrin or L-PRF sub-classes) are receiving the most attention, essentially due to their simplicity, rapidness, user-friendliness/malleability, and cost-effectiveness. Whether used as the sole “bioactive” filling/additive material or combined with bone substitutes, the revolutionary second-generation PRFs have been very often associated with promising clinical results. Hence, this review aims to provide a 10-years update on the clinical effectiveness of L-PRF when applied/used as the “sole” biomaterial in maxillary sinus augmentation procedures. An electronic search using specific keywords for L-PRF and maxillary sinus augmentation was conducted in three main databases (PubMed-MEDLINE database, Google Scholar and Cochrane library) for the period between January 2009–February 2020. The quest yielded a total of 468 articles. Based on the pre-established strict inclusion/exclusion criteria, only seven articles were deemed eligible and included in the analysis. Surprisingly, of the 5 studies which used de-proteinized bovine bone mineral (DBBM) in combination with L-PRF, 60% acclaimed no significant effects and only 40% declared positive effects. Of the two articles which had used allogenous bone graft, 50% declared no significant effects and 50% acclaimed positive effects. Only one study had used L-PRF as the sole grafting material and reported a positive effect. Likewise, positive effects were reported in one other study using L-PRF in combination with a collagen membrane. Due to the heterogeneity of the included studies, this review is limited by the inability to perform a proper systematic meta-analysis. Overall, most of the published studies reported impressive results of L-PRF application as a grafting material (sole or adjuvant) in maxillary sinus augmentation and dental implant restorative procedures. Yet, distinct technical processing for L-PRF preparation was noted. Hence, studies should be approached with caution. Here in, in sinus lift and treatment of Schneider membrane, the formation of mature bone remains inconclusive. More studies are eagerly awaited in order to prove the beneficial or detrimental effects of PRFs, in general and L-PRFs, in specific; especially in their tissue regenerative potential pertaining to the promotion of angiogenesis, enhancing of cell proliferation, stimulation of cell migration and autocrine/paracrine secretion of growth factors, as well as to reach a consensus or a conclusive and distinct determination of the effect of leukocytes (and their inclusion) on inflammation or edema and pain; a call for standardization in PRFs and L-PRFs composition reporting and regimenting the preparation protocols.

scholarly journals Comparative Histological and Histomorphometric Results of Six Biomaterials Used in Two-Stage Maxillary Sinus Augmentation Model after 6-Month Healing

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Gerardo La Monaca ◽  
Giovanna Iezzi ◽  
Maria Paola Cristalli ◽  
Nicola Pranno ◽  
Gian Luca Sfasciotti ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Bone Allograft ◽  
Bovine Bone ◽  
Graft Material ◽  
Histomorphometric Analysis ◽  
Sinus Augmentation ◽  
Maxillary Sinus Augmentation ◽  
Freeze Dried ◽  
Posterior Maxilla ◽  
Bone Biopsies

Objectives. To evaluate the performances of six different bone substitute materials used as graft in maxillary sinus augmentation by means of histological and histomorphometric analysis of bone biopsies retrieved from human subjects after a 6-month healing period. Materials and Methods. Six consecutive patients (3 males, 3 females, aged 50-72 years), healthy, nonsmokers, and with good oral hygiene, presenting edentulous posterior maxilla with a residual bone crest measuring ≤ 4 mm in vertical height and 3 to 5 mm in horizontal thickness at radiographic examination, were selected to receive sinus augmentation and delayed implant placement. Under randomized conditions, sinus augmentation procedures were carried out using mineralized solvent-dehydrated bone allograft (MCBA), freeze-dried mineralized bone allograft (FDBA), anorganic bovine bone (ABB), equine-derived bone (EB), synthetic micro-macroporous biphasic calcium-phosphate block consisting of 70% beta-tricalcium phosphate and 30% hydroxyapatite (HA-β-TCP 30/70), or bioapatite-collagen (BC). After 6 months, bone core biopsies were retrieved and 13 implants were placed. Bone samples were processed for histological and histomorphometric analysis. CT scans were taken before and after surgery. After 4 months of healing, patients were restored with a provisional fixed acrylic resin prosthesis, as well as after further 2-4 months with a definitive cemented zirconia or porcelain-fused-to-metal crowns. Results. There were no postoperative complications or implant failures. The histological examination showed that all biomaterials were in close contact with newly formed bone, surrounding the graft granules with a bridge-like network. No signs of acute inflammation were observed. The histomorphometry revealed 20.1% newly formed bone for MCBA, 32.1% for FDBA, 16.1% for ABB, 22.8% for EB, 20.3% for HA-β-TCP 30/70, and 21.4% for BC. Conclusions. Within the limitations of the present investigation, all the six tested biomaterials showed good biocompatibility and osteoconductive properties when used in sinus augmentation procedures, although the FDBA seemed to have a better histomorphometric result in terms of newly formed bone and residual graft material. This trial is registered with ClinicalTrials.gov Identifier (Registration Number): NCT03496688.

scholarly journals Sinus-Lift Ways and Types of Sinus Augmentation and Use of Piezo-Surgery Device for Fenestration of Sinus Maxillaries

2017 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Maxillary Sinus ◽  
Dental Implant ◽  
Sinus Lift ◽  
Sinus Augmentation ◽  
Posterior Maxilla ◽  
Maxillary Molar ◽  
Molar Teeth ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Upper Jaw

Maxillary sinus floor augmentation (also termed sinus lift, sinus graft, sinus augmentation or sinus procedure) is a surgical procedure which aims to increase the amount of bone in the posterior maxilla (upper jaw bone), in the area of the premolar and molar teeth, by lifting the lower Schneiderian membrane (sinus membrane) and placing a bone graft [2]. When a tooth is lost the alveolar process begins to remodel. The vacant tooth socket collapses as it heals leaving an edentulous (toothless) area, termed a ridge [3]. This collapse causes a loss in both height and width of the surrounding bone. In addition, when a maxillary molar or premolar is lost, the floor of the maxillary sinus expands, which further diminishes the thickness of the underlying bone. Overall, this leads to a loss in volume of bone that is available for implantation of dental implants, which rely on osseointegration (bone integration), to replace missing teeth [1]. The goal of the sinus lift is to graft extra bone into the maxillary sinus, so more bone is available to support a dental implant. A Special form of Reconstruction of bone, especially changing the vertical structure of the maxillary Sinus floor in the upper jaw and the establishment of the mucous membranes of Sinusitis purpose of dental implant called Sinuslift [4, 5, 6 & 8]. Distance-maxillary sinus is often so low that an implant can not be included in stable long enough. With the incorporation of bone material or bone grafting, maxillary sinus floor, ‘grow’ and that this level can be implanted implants safe. Sinuslift distinguish Extern and Intern [9,10].

Radiological Evaluation of Maxillary Sinus Augmentation with Calcium Phosphate Materials and Influence of Titanium Dental Implant Artifacts

2017 ◽  
Vol 267 ◽  
pp. 145-148
Author(s):  
Laura Neimane ◽  
Andrejs Skagers
Keyword(s):  
Calcium Phosphate ◽  
Maxillary Sinus ◽  
Dental Implant ◽  
Alveolar Bone ◽  
Sinus Augmentation ◽  
Maxillary Bone ◽  
Maxillary Sinus Augmentation ◽  
Sinus Floor Augmentation ◽  
Titanium Dental Implant ◽  
Sinus Floor

Sinus floor augmentation operations with calcium phosphate materials are performed when natural maxillary bone quality and quantity fail to be able to support titanium dental implants. Sinus floor augmentation can be done in one step operation when titanium implant is inserted at the same time when calcium phosphate materials. This type surgery can be done if there is enough maxillary alveolar bone height to stabilize the implant. If there is not enough bone then two step maxillary floor augmentation is performed when dental implant is placed after few months. Calcium phosphate materials are often used for maxillary sinus augmentation. These materials cause remineralization of residual maxillary alveolar bone [1]. That can be observed histologically [2,3]. However histological evaluation often means interference. Radiological investigation can be used to examine postoperatively augmented area. Nowadays cone beam computed tomography (CBCT) is the radiological method of choice for maxillofacial region due to low radiation and high quality images. There was no date found in literature on maxillary bone remineralization measured in voxel grey value density (VV) on CBCT. Rotation movement of CBCT cause beam hardening artifacts [4,5] that can alter correct measurements of bone and augmentation zone radiodensity. The aim of this study was to calculate remineralization of maxillary alveolar bone after augmentation with calcium phosphate materials radiologically and degree of artifacts created by titanium dental implant in CBCT images.

scholarly journals Biomechanical Analysis of Grafted and Nongrafted Maxillary Sinus Augmentation in the Atrophic Posterior Maxilla with Three-Dimensional Finite Element Method

Scanning ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Xuan Wang ◽  
Tianqi Zhang ◽  
Enli Yang ◽  
Zhiyuan Gong ◽  
Hongzhou Shen ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Bone Quality ◽  
Three Dimensional ◽  
Biomechanical Analysis ◽  
Sinus Augmentation ◽  
Maxillary Sinus Augmentation ◽  
Posterior Maxilla ◽  
Atrophic Maxilla ◽  
Von Mises ◽  
Three Dimensional Finite Element

This study is aimed at determining the optimal sinus augmentation approach considering the poor bone condition in the zone of atrophic posterior maxilla. A series of simplified maxillary segment models varying in residual bone height (RBH) and bone quality were established. A 10 mm standard implant combined with two types of maxillary sinus augmentation methods was applied with the RBH, which was less than 10 mm in the maxilla. The maximal equivalent von Mises (EQV) stress in residual bone was evaluated. Bone quality had an enormous impact on the stress magnitude of supporting bone. Applying sinus augmentation combined with grafts was suitable for stress distribution, and high-stiffness graft performed better than low-stiffness one. For 7 mm and 5 mm atrophic maxilla, nongrafted maxillary sinus augmentation was feasible in D3 bone. Poor bone quality was a negative factor for the implant in the region of atrophic posterior maxilla, which could be improved by grafts. Meanwhile, the choice of maxillary sinus augmentation approaches should be determined by the RBH and quality.

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