Iezzi Giovanna, Degidi Marco, Scarano Antonio, Petrone Giovanna, Piattelli Adriano
Dental School, University of Chieti-Pescara, Chieti, Italy.
J Periodontol. 2007 Oct;78(10):2057-61. doi: 10.1902/jop.2007.070062.
Anorganic bone matrix (ABM) is reported to have osteoconductive properties. No inflammatory or adverse responses have been reported when this material is used in sinus augmentation procedures. ABM is said to be a bioabsorbable biomaterial, but histologic data seem to suggest that the resorption process is slow. Long-term histologic data in humans are lacking. The aim of this case report was to evaluate the bone response to ABM used in maxillary sinus augmentation and retrieved 14 years after surgery.
Titanium dental implants were inserted in two sinuses augmented with ABM. The implants were osseointegrated and functioned well for 14 years. After this period of loading, the connecting screw of one of the implants inserted in the left maxilla broke, and it was necessary to remove the implant. A bone core of the augmented area was harvested separately during the implant removal.
A very high quantity of mature, compact bone and a small percentage of residual grafted biomaterial were found. About 5% to 7% of the bone was undergoing remodeling. In most cases, residual ABM particles were surrounded by marrow spaces. In other areas, lamellar bone was found in tight contact with the particle surfaces. Histomorphometry showed that the mean amount of mature, compact bone was 71.0% +/- 2.28%, the mean amount of ABM was 22.1% +/- 3.18%, and the mean amount of marrow spaces was 11.2% +/- 5.42%.
ABM seemed to resorb very slowly; after 14 years, only a small quantity of residual grafted particles was present. ABM is an effective graft material for sinus augmentation procedures. Vital, mature bone was formed and maintained over a long period with no chronic inflammatory cell infiltrate, foreign body response, or other adverse effects.
据报道，无机骨基质（ABM）具有骨传导特性。当该材料用于鼻窦增高术时，未报告有炎症或不良反应。ABM据说是一种可生物吸收的生物材料，但组织学数据似乎表明吸收过程缓慢。缺乏人类的长期组织学数据。本病例报告的目的是评估上颌窦增高术中使用的ABM在术后14年取出时的骨反应。
将钛牙种植体植入两个用ABM增高的鼻窦中。种植体实现了骨整合并良好地发挥功能达14年。在这段负载期后，植入左上颌的其中一个种植体的连接螺钉断裂，有必要取出种植体。在取出种植体时，单独采集了增高区域的骨芯。
发现了大量成熟的致密骨和少量残留的移植生物材料。约5%至7%的骨正在进行重塑。在大多数情况下，残留的ABM颗粒被骨髓腔包围。在其他区域，发现板层骨与颗粒表面紧密接触。组织形态计量学显示，成熟致密骨的平均量为71.0%±2.28%，ABM的平均量为22.1%±3.18%，骨髓腔的平均量为11.2%±5.42%。
ABM似乎吸收非常缓慢；14年后，仅存在少量残留的移植颗粒。ABM是鼻窦增高术的一种有效移植材料。形成并长期维持了有活力的成熟骨，没有慢性炎性细胞浸润、异物反应或其他不良反应。
