Yildirim M, Spiekermann H, Handt S, Edelhoff D
Department of Prosthodontics, University of Aachen, Germany.
Int J Oral Maxillofac Implants. 2001 Jan-Feb;16(1):23-33.
The aim of the present clinical study was to determine, through histologic and histomorphometric investigations of human bone specimens, whether the addition of autogenous bone to the bone substitute material Bio-Oss can produce a high-quality implant site. To improve vertical bone height, 13 sinus floor elevations were carried out in a total of 12 patients. Augmentation of the maxillary sinus floor was completed using a mixture of Bio-Oss and bone harvested intraorally from the mandibular symphysis, the retromolar space, or the tuberosity region. Following an average of 7.1 months of healing, 36 Brånemark System implants were placed. During this surgical intervention, 23 cylinder-shaped bone biopsies were taken from the augmented maxillary region using trephine burs. Histologic analysis of the bone biopsies revealed that the Bio-Oss granulate was well-integrated into the newly formed bone; 33.1% (+/- 12.4%) of the substitute material surface was in direct contact with bone. Histomorphometric analysis of the samples revealed an average percentage proportion of bone of 18.9% (+/- 6.4%). The bovine substitute material and soft tissue occupied, respectively, 29.6% (+/- 8.9%) and 51.5% (+/- 9.4%) of the measured surface. When the implants were uncovered after an average healing phase of 6 months, all 36 implants had become osseointegrated. The combination of osteoconductive Bio-Oss and osteoinductive autogenous bone thus proved to be a material suitable for application in sinus floor augmentation.
本临床研究的目的是通过对人体骨标本进行组织学和组织形态计量学研究,确定在骨替代材料Bio-Oss中添加自体骨是否能产生高质量的种植位点。为提高垂直骨高度,对12例患者共进行了13次上颌窦底提升术。使用Bio-Oss与从下颌骨联合、磨牙后间隙或结节区域口腔内采集的骨混合完成上颌窦底的增高。平均愈合7.1个月后,植入36枚Brånemark系统种植体。在此次手术干预过程中,使用环钻从增高的上颌区域获取23个圆柱形骨活检样本。骨活检的组织学分析显示,Bio-Oss颗粒与新形成的骨良好整合;替代材料表面33.1%(±12.4%)与骨直接接触。样本的组织形态计量学分析显示,骨的平均百分比比例为18.9%(±6.4%)。牛替代材料和软组织分别占测量表面的29.6%(±8.9%)和51.5%(±9.4%)。平均6个月愈合期后暴露种植体时,所有36枚种植体均已实现骨结合。因此,具有骨传导性的Bio-Oss与骨诱导性自体骨的组合被证明是一种适用于上颌窦底增高的材料。