Haas Robert, Baron Monika, Donath Karl, Zechner Werner, Watzek Georg
Department of Oral Surgery, Dental School, University of Vienna, Austria.
Int J Oral Maxillofac Implants. 2002 May-Jun;17(3):337-46.
This experimental study in adult female sheep examined the value of nonresorbable porous hydroxyapatite (HA) as a grafting material in a single-stage sinus-lift procedure.
Two titanium plasma-flame-sprayed cylindric implants were placed bilaterally in each of 54 sinuses in 27 adult female sheep. In 2 groups of 18 sinuses each, the subantral hollow space was filled with porous HA or autogenous cancellous bone harvested from the iliac crest, respectively. Eighteen sinuses were not augmented and served as controls. The time course of new bone formation and bone remodeling was evaluated by sequential polyfluorochrome labeling. Observation periods were 12, 16, and 26 weeks after the surgical procedure. Six sinuses per observation period and test group were available for histologic evaluation.
All implants were osseointegrated in the local host bone. New bone formation was observed in a triangular area bounded by the implant surface, local buccal antral wall, and submucous connective tissue around all implants. The mean length of bone-implant contact was 3.9 +/- 0.3 mm in the control group, 5.7 +/- 0.3 mm in the autogenous bone group, and 5.9 +/- 0.3 mm in the group augmented with porous HA. During the observation period, the relative length of direct bone-implant contact increased from 20% to 25.1% in the control group, from 30.4% to 35.5% in the autogenous bone group, and from 29.8% to 41.7% in the HA group. At a distance of 1 mm from the implant, the mean bone volume was 29.7 +/- 15.7% in the autogenous bone group. In the group augmented with HA the mean bone volume was 11.2 +/- 13.0%.
There was no significant difference between HA and autogenous bone regarding bone-implant contact (P = .89).
Both groups showed a significantly greater bone-implant contact (HA: P = .002; autogenous bone: P = .0005) than the empty control group. However, since the results varied widely, the use of HA alone for sinus grafting should be used with discretion in sinus-lift procedures.
本实验研究对成年雌性绵羊进行，旨在检验不可吸收多孔羟基磷灰石（HA）作为单阶段鼻窦提升手术中移植材料的价值。
在27只成年雌性绵羊的54个鼻窦两侧各植入两枚钛等离子火焰喷涂圆柱形种植体。在两组各18个鼻窦中，分别用多孔HA或取自髂嵴的自体松质骨填充窦下中空间隙。18个鼻窦未进行增容，作为对照组。通过连续多荧光染料标记评估新骨形成和骨重塑的时间进程。观察期为手术后12周、16周和26周。每个观察期和试验组有6个鼻窦可用于组织学评估。
所有种植体均与局部宿主骨形成骨结合。在所有种植体周围，由种植体表面、局部颊侧窦壁和黏膜下结缔组织界定的三角形区域观察到新骨形成。对照组骨 - 种植体接触的平均长度为3.9±0.3mm，自体骨组为5.7±0.3mm，多孔HA增容组为5.9±0.3mm。在观察期内，对照组直接骨 - 种植体接触的相对长度从20%增加到25.1%，自体骨组从30.4%增加到35.5%，HA组从29.8%增加到41.7%。在距种植体1mm处，自体骨组的平均骨体积为29.7±15.7%。HA增容组的平均骨体积为11.2±13.0%。
HA与自体骨在骨 - 种植体接触方面无显著差异（P = 0.89）。
两组的骨 - 种植体接触均显著大于空白对照组（HA组：P = 0.002；自体骨组：P = 0.0005）。然而，由于结果差异很大，在鼻窦提升手术中单独使用HA进行鼻窦移植应谨慎。
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