Tadjoedin Ette S, de Lange Gert L, Lyaruu D M, Kuiper Luit, Burger Elisabeth H
Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit, Amsterdam, The Netherlands.
Clin Oral Implants Res. 2002 Aug;13(4):428-36. doi: 10.1034/j.1600-0501.2002.130412.x.
In this study, high concentrations of bioactive glass (BG) particles were compared with autogenous bone in their capacity to augment maxillary bone when grafted in the human sinus floor using a split mouth design. Three female patients with severe maxillary atrophy underwent bilateral sinus floor elevation and bone grafting using 80-100% BG particles (300-355 microm in size) mixed with 20% to 0% iliac crest bone particles at one (experimental) side, and 100% iliac crest derived bone particles at the other (control) side. A total of 22 bone biopsies was taken at the time of fixture installation; that is, at 4, 6 and 15 months after grafting, and processed for histology and histomorphometry. At the control (autogenous bone) sides, trabecular bone amounted to 39% of the biopsy volume in the graft (site) at 4 months, almost 41% at 6 months, and 42% at 15 months. This bone contained viable osteocytes and was mostly of mature, lamellar type. At the experimental (BG particles) sides, the graft consisted of 27% of mostly woven (and some lamellar) bone at 4 months, 36% (woven and lamellar) bone at 6 months, and 39% (mainly lamellar) bone at 15 months. The grafted BG particles started to excavate at 4 months and their centers gradually filled with bone tissue. As a consequence, the volume of BG particles in the biopsy decreased from 29% at 4 months to 15% at 6 months and 8% at 15 months. The BG particles appeared to resorb within 1-2 years by dissolution rather than by osteoclastic activity. Parameters for bone turnover (% osteoid surface, % resorption surface) indicated that bone remodeling was very active at both experimental and control sides, during more than 6 months. These results suggest that mixtures of mainly (80-90%) BG particles and some (10-20%) autogenous bone are effective for bone regeneration in the augmented sinus offer 6 months healing time, while about 12 months healing time is needed for 100% BG particles.
在本研究中，采用双侧对照设计，比较了高浓度生物活性玻璃（BG）颗粒与人自体骨移植至人类上颌窦底时在上颌骨增量方面的能力。三名严重上颌骨萎缩的女性患者接受了双侧上颌窦底提升及骨移植，一侧（实验组）使用80 - 100%的BG颗粒（尺寸为300 - 355微米）与20%至0%的髂嵴骨颗粒混合，另一侧（对照组）使用100%的髂嵴来源骨颗粒。在种植体植入时，即移植后4、6和15个月，共采集了22份骨活检样本，并进行组织学和组织形态计量学处理。在对照组（自体骨）一侧，4个月时移植部位（位点）的小梁骨占活检体积的39%，6个月时近41%，15个月时为42%。该骨含有存活的骨细胞，主要为成熟的板层骨类型。在实验组（BG颗粒）一侧，4个月时移植物由27%的主要编织骨（和一些板层骨）组成，6个月时为36%（编织骨和板层骨），15个月时为39%（主要为板层骨）。移植的BG颗粒在4个月时开始被侵蚀，其中心逐渐被骨组织填充。因此，活检中BG颗粒的体积从4个月时的29%降至6个月时的15%，15个月时为8%。BG颗粒似乎在1 - 2年内通过溶解而非破骨细胞活性被吸收。骨转换参数（类骨质表面百分比、吸收表面百分比）表明，在超过6个月的时间里，实验组和对照组的骨重塑都非常活跃。这些结果表明，对于上颌窦增量骨再生，主要由（80 - 90%）BG颗粒和一些（10 - 20%）自体骨组成的混合物在6个月愈合时间时是有效的，而100% BG颗粒则需要约12个月的愈合时间。
