Boëck-Neto Rodolfo Jorge, Gabrielli MárioFranciscoReal, Lia RaphaelCarlosComelli, Marcantonio Elcio, Shibli Jamil Awad, Marcantonio Elcio
Department of Periodontology, Araraquara Dental School, State University of São Paulo, Araraquara, Brazil.
J Periodontol. 2002 Mar;73(3):266-70. doi: 10.1902/jop.2002.73.3.266.
Maxillary sinus floor augmentation procedures are currently the treatment of choice when the alveolar crest of the posterior maxilla is insufficient for dental implant anchorage. This procedure aims to obtain enough bone with biomaterial association with the autogenous bone graft to create volume and allow osteoconduction. The objective of this study was to histologically and histometrically evaluate the bone formed after maxillary sinus floor augmentation by grafting with a combination of autogenous bone, from the symphyseal area mixed with DFDBA or hydroxyapatite.
Ten biopsies were taken from 10 patients 10 months after sinus floor augmentation using a combination of 50% autogenous bone plus 50% demineralized freeze-dried bone allograft (DFDBA group) or 50% autogenous bone plus 50% hydroxyapatite (HA group). Routine histological processing and staining with hematoxylin and eosin and Masson's trichrome were performed.
The histomorphometrical analysis indicated good regenerative results in both groups for the bone tissue mean in the grafted area (50.46+/-16.29% for the DFDBA group and 46.79+/-8.56% for the HA group). Histological evaluation revealed the presence of mature bone with compact and cancellous areas in both groups. The inflammatory infiltrate was on average nonsignificant and of mononuclear prevalence. Some biopsies showed blocks of the biomaterial in the medullary spaces close to the bone wall, with absence of osteogenic activity.
The results indicated that both DFDBA and HA associated with an autogenous bone graft were biocompatible and promoted osteoconduction, acting as a matrix for bone formation. However, both materials were still present after 10 months.
当上颌后牙区牙槽嵴不足以支持牙种植体锚固时，上颌窦底提升术是目前的首选治疗方法。该手术旨在通过生物材料与自体骨移植相结合来获得足够的骨量，以创造骨量并实现骨传导。本研究的目的是通过组织学和组织计量学方法评估在上颌窦底提升术中使用来自耻骨联合区的自体骨与脱矿冻干骨同种异体移植物（DFDBA）或羟基磷灰石混合移植后形成的骨组织。
在10名患者进行上颌窦底提升术后10个月，从每个患者身上获取10份活检样本，其中5名患者使用50%自体骨加50%脱矿冻干骨同种异体移植物（DFDBA组），另外5名患者使用50%自体骨加50%羟基磷灰石（HA组）。进行常规组织学处理，并用苏木精-伊红和马松三色染色。
组织形态计量学分析表明，两组在移植区域的骨组织平均值均显示出良好的再生结果（DFDBA组为50.46±16.29%，HA组为46.79±8.56%）。组织学评估显示两组均存在成熟骨，包括致密骨和松质骨区域。炎症浸润平均不显著，且以单核细胞为主。一些活检样本显示在靠近骨壁的髓腔内有生物材料块，且无成骨活性。
结果表明，DFDBA和HA与自体骨移植相结合均具有生物相容性，并促进骨传导，可作为骨形成的基质。然而，10个月后两种材料仍然存在。
