Haas Robert, Haidvogl Daniela, Dörtbudak Orhun, Mailath Georg
Department of Oral Surgery, School of Dentistry, Vienna, Vienna, Austria.
Clin Oral Implants Res. 2002 Dec;13(6):581-6. doi: 10.1034/j.1600-0501.2002.130602.x.
This study examines the biomechanical loading capacity of dental implants placed in the posterior maxilla in conjunction with subantral augmentation with either homogeneous demineralized freeze-dried bone from sheep (s-DFDB) or heterogeneous demineralized freeze-dried human bone (h-DFDB) as grafting material in sheep. In 36 adult female mountain sheep, the Schneiderian membrane was elevated extraorally in both maxillary sinuses, and two titanium plasma-flame-sprayed cylindrical implants were inserted in each lateral antral wall. Three groups of 18 maxillary sinuses each were augmented with s-DFDB, h-DFDB and autogenous bone from the illiac crest, respectively. In the remaining 18 sinuses, the subantral hollow space was left empty. Pull-out tests were carried out after intervals of 12, 16 and 26 weeks. The mean pull-out force needed, irrespective of time, was 259.3 N in the empty control group, 356.7 N in the group augmented with autogenous bone, 278.1 N in the test group augmented with h-DFDB and 365.2 N in the group augmented with s-DFDB, revealing no significant difference between the individual groups (P > 0.05). The implants of the group augmented with autogenous bone showed an increase in the mean pull-out force from 223.8 N after 12 weeks to 523.7 N after 26 weeks. The nonaugmented control group yielded values of 248 N after 12 weeks, which rose to 269.8 N at the last test, while the values of the h-DFDB group increased from 275.4 N to 325.4 N. The highest initial pull-out values were obtained in the s-DFDB group. They amounted to 310.5 N after 12 weeks and rose to 481.4 N after 26 weeks. Time thus proved to have a significant influence on the pull-out forces (P = 0.014) with a statistically proven linear trend (P = 0.007). The findings of this experimental study indicate that the use of homogeneous DFDB in one-stage sinus lift procedures results in a mechanical loading capacity of implants comparable to that achieved by autogenous cancellous bone from the iliac crest. In contrast, the use of heterogenous-DFDB resulted in only slightly higher pull-out forces than those observed in the nonaugmented control group after 26 weeks.
本研究探讨了在上颌后牙区植入牙种植体并结合上颌窦底提升术时，使用绵羊同种异体脱矿冻干骨（s-DFDB）或异种脱矿冻干人骨（h-DFDB）作为移植材料的生物力学承载能力。在36只成年雌性山羊中，经口外途径抬起双侧上颌窦的施奈德膜，在每个外侧窦壁植入两枚钛等离子火焰喷涂圆柱形种植体。将3组，每组18个上颌窦，分别用s-DFDB、h-DFDB和髂嵴自体骨进行上颌窦底提升。其余18个窦的上颌窦底中空区域保持空置。分别在12周、16周和26周后进行拔出试验。无论时间如何，空置对照组所需的平均拔出力为259.3N，自体骨移植组为356.7N，h-DFDB试验组为278.1N，s-DFDB移植组为365.2N，各组之间无显著差异（P>0.05）。自体骨移植组的种植体平均拔出力从12周后的223.8N增加到26周后的523.7N。未进行上颌窦底提升的对照组在12周后的拔出力值为248N，在最后一次测试时升至269.8N，而h-DFDB组的值从275.4N增加到325.4N。s-DFDB组获得的初始拔出力最高。12周后为310.5N，26周后升至481.4N。因此，时间对拔出力有显著影响（P=0.014），且具有统计学意义上的线性趋势（P=0.007）。本实验研究结果表明，在一期上颌窦提升术中使用同种异体DFDB可使种植体的机械承载能力与髂嵴自体松质骨相当。相比之下，使用异种DFDB在26周后产生的拔出力仅略高于未进行上颌窦底提升的对照组。
