Effect of a Rapidly Resorbable Calcium Alkali Phosphate Bone Grafting Material on Osteogenesis after Sinus Floor Augmentation in Humans

2017 ◽  
Vol 758 ◽  
pp. 239-244 ◽  
Author(s):  
Christine Knabe ◽  
Tom Knauf ◽  
Doaa Adel-Khattab ◽  
Barbara Peleska ◽  
Wolf Dietrich Hübner ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Substitutes ◽  
Apical Region ◽  
Graft Material ◽  
Matrix Mineralization ◽  
Native Bone ◽  
Ridge Augmentation ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor

Sinus floor augmentation (SFA) has become a well-established pre-implantology procedure for alveolar ridge augmentation of the posterior maxilla. Using bioceramic bone substitutes avoids second-site surgery for autograft harvesting. Compared to the bone substitutes which are currently clinically available, there is a significant need for bone substitutes which degrade more rapidly, but still stimulate osteogenesis at the same time. This has led to the development of bioactive, rapidly resorbable calcium alkali orthophosphate (CAOP) materials, which have a greater solubility than tricalcium phosphate. In this study the biodegradability and effect of a silica containing CAOP (Si-CAOP) on osteogenesis was evaluated in human biopsies sampled 6 months after SFA and compared to that of TCP utilizing hard tissue histology, histomorphometry and immunohistochemical analysis of osteogenic marker expression. Both materials facilitated bone formation and matrix mineralization, which were still actively progressing from the sinus floor in an apical direction 6 months after SFA. With the Si-CAOP grafting material however, bone formation, the bone-biomaterial-contact, i.e. bone-bonding, and particle degradation were significantly greater compared to TCP in the apical region of the biopsies, i.e. at the largest distance from the native bone of the sinus floor. This was accompanied by greater expression of Col I, BSP and OC in the newly formed bone tissue in the Si-CAP samples compared to TCP. Six months after implantation Si-CAOP facilitated greater bone formation and biodegradability than the TCP graft material, whose excellent osteoconductive properties have been widely documented. Consequently, Si-CAOP can be regarded as excellent grafting material for SFA in a clinical setting.

scholarly journals Surgeons’ Performance Determining the Amount of Graft Material for Sinus Floor Augmentation Using Tomography

2017 ◽  
Vol 28 (3) ◽  
pp. 385-390 ◽  
Author(s):  
Adriana Dibo Cruz ◽  
Guilherme Alvares Peixoto ◽  
Marcelo Freitas Aguiar ◽  
Gabriela Alessandra Cruz Galhardo Camargo ◽  
Nicolas Homs
Keyword(s):  
Maxillary Sinus ◽  
Diagnostic Tools ◽  
Graft Material ◽  
Convenience Sample ◽  
Computed Tomography Images ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Maxillary Sinus Floor Augmentation

Abstract This study aimed to assess the performance of surgeons in determining the amount of graft material required for maxillary sinus floor augmentation in a preoperative analysis using cone-beam computed tomography images. A convenience sample of 10 retrospective CBCT exams (i-CAT®) was selected. Scans of the posterior maxilla area with an absence of at least one tooth and residual alveolar bone with an up to 5 mm height were used. Templates (n=20) contained images of representative cross-sections in multiplanar view. Ten expert surgeons voluntarily participated as appraisers of the templates for grafting surgical planning of a 10 mm long implant. Appraisers could choose a better amount of graft material using scores: 0) when considered grafting unnecessary, 1) for 0.25 g in graft material, 2) for 0.50 g, 3) for 1.00 g and 4) for 1.50 g or more. Reliability of the response pattern was analyzed using Cronbach’s a. Wilcoxon and Mann-Whitney tests were performed to compare scores. Regression analysis was performed to evaluate whether the volume of sinuses (mm3) influenced the choose of scores. In the reliability analysis, all values were low and the score distribution was independent of the volume of the maxillary sinuses (p>0.05), which did not influence choosing the amount of graft material. Surgeons were unreliable to determine the best amount of graft material for the maxillary sinus floor augmentation using only CBCT images. Surgeons require auxiliary diagnostic tools to measure the volume associated to CBCT exams in order to perform better.

scholarly journals Sinus Augmentation by Platelet-Rich Fibrin Alone: A Report of Two Cases with Histological Examinations

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Naofumi Aoki ◽  
Takeo Kanayama ◽  
Michinori Maeda ◽  
Koichiro Horii ◽  
Hironori Miyamoto ◽  
...  
Keyword(s):  
Tissue Sample ◽  
Lateral Sinus ◽  
Graft Material ◽  
Sinus Augmentation ◽  
Platelet Rich Fibrin ◽  
First Case ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor ◽  
The Right

In sinus floor augmentation of an atrophic posterior maxilla, platelet-rich fibrin (PRF) has been used as a graft material. We herein report two cases with histological evaluations of PRF after the surgery. The first case was a 28-year-old female with an atrophic right posterior maxilla who was treated with sinus floor augmentation and simultaneous implant placement using PRF as the sole graft material in our hospital. Twenty-four months after surgery, the implant was unfortunately removed because of occlusal overloading by parafunctional habits. During implant replacement, a tissue sample was obtained from the site of augmentation with PRF and was evaluated histologically. The second case was a 58-year-old man with severe alveolar atrophy of the right maxilla who underwent lateral sinus augmentation using only PRF in a two-stage procedure in our hospital. Samples were obtained at the second-stage surgery and histological examinations were performed. As a result, new bone formation was confirmed histologically in both cases. Our findings show that the use of PRF as a graft material during sinus floor augmentation induces natural bone regeneration.

Enhancement of Vertical Alveolar Ridge Augmentation in Canine Defect Model Grafted with Resorbable Bioceramic Composite

2016 ◽  
Vol 720 ◽  
pp. 53-57 ◽  
Author(s):  
Rania A. Fahmy ◽  
Samia Soliman ◽  
Ahmed El-Ghannam ◽  
Samir R. Nouh
Keyword(s):  
Bone Density ◽  
Bone Formation ◽  
Graft Material ◽  
Alveolar Ridge ◽  
Alveolar Ridge Augmentation ◽  
Native Bone ◽  
Ridge Augmentation ◽  
Defect Sites ◽  
Histologic Evaluation ◽  
Bioactive Ceramic

Aim: This study was performed to evaluate histologically and radiographically the quality and the quantity of the formed bone after alveolar ridge augmentation using micro-granules of SCPC50 resorbable bioactive ceramic with and without rhBMP-2.Material and methods: Saddle-type alveolar ridge defects (12X7) mm were created in dog mandibles. Defects were grafted with micro-granules of SCPC50 resorbable bioactive ceramic loaded with rhBMP-2 10 μg and covered with collagen membrane. Control groups included defects grafted with SCPC50 granules without rhBMP-2 and un-grafted defects. Radiographs were taken for the dissected defect sites at 2 and 4 months. Radiographs were analyzed for bone density using the ImageJ 1.46 program. Dissected defect sites were then fixed in formalin and processed for histologic and hitomorphometric analysis. Data was statistically analyzed using student t-test and 1-way ANOVA test with p<0.05 as statistically significant.Results: Radiographic analysis of augmented bone revealed bone density equal to or denser than the surrounding native bone in SCPC50 treated defects with and without rhBMP-2. Qualitative and quantitative histologic evaluation revealed dense well arranged bone trabeculae in both the SCPC50 treated defects with and without rhBMP-2 with more rapid bone formation and graft resorption in the rhBMP-2 group. Maturation of newly formed bone was noted on the periphery and inside the SCPC50 pores. No adverse reactions, excessive bone formation or fluid filled voids were detected.Conclusion: Results of this study suggest that SCPC50 is an effective graft material in alveolar ridge augmentation. SCPC/rhBMP-2 hybrid accelerated bone regeneration and enhanced bone quality and quantity as revealed by radiographic and histologic evaluation.

Clinical and histological outcomes of maxillary sinus floor augmentation with synthetic bone substitutes for dental implant treatment: A meta-analysis.

2021 ◽  
Author(s):  
Jorge Toledano-Serrabona ◽  
Aleida Romeu-i-Fontanet ◽  
Cosme Gay-Escoda ◽  
Octavi Camps-Font ◽  
Mª Ángeles Sánchez-Garcés
Keyword(s):  
Maxillary Sinus ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Bone Substitutes ◽  
Graft Material ◽  
Sinus Floor Augmentation ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Histological Results ◽  
Maxillary Sinus Floor Augmentation

The objective of the present review was to gather all available human randomized clinical trials comparing the clinical and histological results of synthetic bone substitutes used in maxillary sinus floor augmentation. Authors electronically searched in Pubmed/Medline, Scopus and Cochrane databases to analyse the success of endosseous dental implant, implant failure, peri-implant marginal bone loss, newly formed bone and residual bone graft material.  After the search, ten randomized clinical trials were included. Four studies ranging from low to unclear risk of bias were used for meta-analysis, being able to compare only biphasic calcium phosphate (BCP) and deproteinized bovine bone (DBB). A greater amount of residual graft material (mean difference -MD- 4.80 mm; 95% CI, 9.35 to 0.26; P= 0.040) was found in DBB group. No other statistically significant differences were found between BCP and DBB for the rest of outcomes. Thus, our results suggested that BCP can be considered a suitable alternative to DBB in maxillary sinus floor augmentation due to its clinical and histological results.

scholarly journals EFFECT OF A BIOACTIVE CALCIUM ALKALI ORTHOPHOSPHATE BONE GRAFTING MATERIAL AS COMPARED TO TRICALCIUM PHOSPHATE ON OSTEOGENESIS AFTER SINUS FLOOR AUGMENTATION IN PATIENTS

2021 ◽  
Vol 57 (1) ◽  
pp. 1-18
Author(s):  
Hana- Ayad Ensir ◽  
◽  
Tom Knauf ◽  
Doaa Adel-Khattab ◽  
Alina Bednarek ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Regeneration ◽  
Tricalcium Phosphate ◽  
Bone Grafting ◽  
Type I ◽  
Complete Replacement ◽  
Volume Stability ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor

Sinus floor augmentation (SFA) has become a well-recognized procedure for site development in the atrophic posterior maxilla prior to dental implant placement. There has been an increasing search for relatively rapidly resorbable bone substitutes that enhance bone formation and facilitate bone regeneration with complete replacement by functional bone tissue. This has led to the development of a glassy crystalline silica-containing calcium alkali orthophosphate (Si-CAOP). The specific aim of this study was to assess histologically the effect of this grafting material on osteogenesis and osteogenic marker expression and to compare this effect to that of β-tricalcium phosphate (β-TCP) in human biopsies obtained 6 months after SFA. Cylindrical biopsies, harvested 6 months after SFA, were processed for immunohistochemical analysis of sawed hard tissue sections using primary antibodies specific to osteocalcin (OC), collagen type I (Col I), bone sialoprotein (BSP), and alkaline phosphatase (ALP). Furthermore, the bone and particle area fraction were measured histomorphometrically in all biopsies in order to characterize bone formation and degradation of the bone grafting materials. Both biomaterials facilitated osteoblast differentiation and bone regeneration of resorbed alveolar ridges, resulting in sufficient bone formation for supporting dental implants. Si-CAOP specimens displayed more advanced bone formation and significantly greater particle degradation than TCP sites. This was accompanied by significantly higher expression of OC, Col I, BSP, and ALP in the osteoid in contact with the degrading particles. These promising results indicate that the Si-CAOP material has great potential use for SFA in humans, thereby confirming its superiority to β-TCP. A prospective study involving a larger patient number, a split-mouth design and analysis of angiogenic properties and of cone-beam CT-data for assessing the volume stability of the augmented area is warranted to further confirm the high osteogenic capacity of Si-CAOP for orofacial bone regeneration.

scholarly journals Maxillary Sinus Floor Augmentation Using an Equine-Derived Graft Material: Preliminary Results in 17 Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
F. Rivara ◽  
M. Negri ◽  
S. Lumetti ◽  
L. Parisi ◽  
A. Toffoli ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Graft ◽  
Fibrous Tissue ◽  
Lateral Approach ◽  
Graft Material ◽  
New Bone Formation ◽  
Sinus Floor Elevation ◽  
Bone Deficiency ◽  
Posterior Maxilla ◽  
Sinus Floor

Objective. Sinus floor elevation with lateral approach is probably the most frequently performed reconstructive procedure to rehabilitate posterior maxilla when a bone deficiency is present. Different graft materials have been proposed and tested, often with high clinical performances and predictable results. Histological analysis is required when evaluating new materials. We investigated human biopsies retrieved after sinus floor elevation procedure by histomorphometric evaluation to test the performance of an equine-derived bone grafting material. Study Design. Seventeen consecutive patients were enrolled and sinus lift surgeries were performed using an equine bone graft. Six months after surgery, at implant placement, bone samples were collected. Histomorphometry analysis was carried out on decalcified samples. Results. All surgeries were uneventful and no additional grafting was required prior to implant insertion. Forty percent of new bone formation was detected, which represented the most abundant tissue retrieved, followed by the residual graft material (33%) and fibrous tissue (27%). A significant reduction in particles size demonstrates a remodeling activity of the graft material. Conclusion. Within the limitations of this study, this equine-derived bone graft proved to be an effective material to induce new bone formation in the sinus floor elevation procedure.

A Sinus Floor Reaugmentation Technique Around an Apically Exposed Implant Into the Maxillary Sinus

2019 ◽  
Vol 45 (3) ◽  
pp. 213-217
Author(s):  
Daisuke Ueno ◽  
Noriko Banba ◽  
Akira Hasuike ◽  
Kazuhiko Ueda ◽  
Toshiro Kodama
Keyword(s):  
Case Report ◽  
Maxillary Sinus ◽  
Dental Implants ◽  
Treatment Option ◽  
Prolonged Treatment ◽  
Sinus Cavity ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor ◽  
Recovery Approach

Sinus floor augmentation (SFA) is the most predictable treatment option in the atrophic posterior maxilla. However, exposure of the apical implant body into the maxillary sinus cavity is an occasionally observed phenomenon after SFA. Although most penetrating dental implants remain completely asymptomatic, they may induce recurrent rhinosinusitis or implant loss. Removal of the implant should be considered if there is significant implant exposure that results in prolonged treatment and increased costs. This case report demonstrates a recovery approach using sinus floor reaugmentation without implant removal in a patient with an apically exposed implant into the maxillary sinus cavity.

RADIOLOGICAL CHANGES IN MAXILLARY SINUS MORPHOLOGY AFTER LATERAL SINUS FLOOR AUGMENTATION

2020 ◽  
Vol 74 (4) ◽  
pp. 1-5
Author(s):  
Oleksandr Shpachynskyi ◽  
Viacheslav Didkovskij ◽  
Andrii Kopchak
Keyword(s):  
Medical Center ◽  
Clinical Signs ◽  
Endoscopic Examination ◽  
Membrane Thickness ◽  
Bovine Bone ◽  
Lateral Sinus ◽  
Posterior Maxilla ◽  
Sinus Floor Augmentation ◽  
Sinus Floor ◽  
Radiological Changes

Background: Restoration of the masticatory function in patients with edentulous posterior maxilla is often challenging due to the severe atrophy of the alveolar ridges and insufficient bone quantity for implant supported dentures. The purpose of this study was to analyze the change in Shneiderian membrane thickness after lateral sinus floor augmentation (LSFA) using cone beam computed tomography (CBCT). Methodology/Principal: LSFA procedures using different bovine bone materials with and withaut immediate implantation were performed at the Stomatological Medical Center of Bohomolets National Medical University in 87 patients, from 2016 to 2018. CBCT examination was performed before LSFA procedure in all patients, postoperative period: up to 1 month after surgery; and after 6 months, before implant placement or loading. Results: Postoperative CBCT performed in early postsurgical period demonstrated that the number of cases with type A decreased significantly from 86,67 to 26,75%. Type B radiological picture increased from 20,33% to 26,75 %. Type C was observed in 7,5 vs 41,73%. Type D and E were observed in 13.91 and 2.14%. The clinical signs of the acute sinusitis or specific complaints were recorded only in 2 cases. In 3 cases radiological findings resembled to F type. Conclusions: The minor radiologic changes in mucous morphology were observed preoperatively in 17.12% of patients who underwent LSFA procedures. The incidence of sinusitis consisted 19.26 % while the frequency of asymptomatic radiological changes was significantly higher. It consisted 68.48 in early and 47.1 % in late (6 months). As the differential diagnosis for such changes based only on clinical and radiological data is difficult, the obtained results prove the importance of preoperative endoscopic examination.

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