Saffarzadeh Afchine, Gauthier Olivier, Bilban Melitta, Bagot D'Arc Maurice, Daculsi Guy
INSERM, U791, Faculté de Chirurgie Dentaire, University of Nantes, 1 Place Alexis Ricordeau, F-44042 Nantes cedex 1, France.
Clin Oral Implants Res. 2009 Oct;20(10):1133-9. doi: 10.1111/j.1600-0501.2009.01738.x. Epub 2009 Aug 4.
The aim of this study was to assess the efficacy and safety of macroporous biphasic calcium phosphate (MBCP())/fibrin grafts (TricOs((R)))/(Tisseel((R))) for sinus lift augmentation in sheep. Autologous bone grafts were used as a positive control, and dental implants were placed to assess the efficiency of the composite.
A total of 12 adult sheep (24 maxillary sinuses) were randomized to receive sinus lift augmentation with MBCP()/fibrin grafts obtained by either simultaneous or sequential addition of thrombin and fibrinogen to MBCP(), or autologous bone grafts. Six months post-sinus lift surgery, dental implants were placed. At 6 months post-sinus lift and 3 months after dental implant placement, the characteristics of newly formed bone and dental implant stability were assessed. The methods used were radiography, scanning electron microscopy, light microscopy, micro-CT analysis, radio frequency analysis (RFA), and image analysis.
There were no clinical adverse events in the post-operative period. New bone formation was similar for MBCP()/fibrin grafts and autografts at 21-20% and 20%, respectively, at 6 months, and at 34-35% and 35%, respectively, at 9 months. Implantability of dental implants was better at the time of placement with MBCP()/fibrin grafts than autografts at 81-88% and 69%, respectively. Three months after placement, RFA showed better implantability with MBCP()/fibrin grafts than with autografts at 75-82% and 71%, respectively. The bone contact measurements were around 50% for the three groups, without significant differences.
This study shows that following sinus lift augmentation in sheep, MBCP()/fibrin grafts support new bone formation that is comparable to autografts, while providing better support for the dental implants.
本研究旨在评估大孔双相磷酸钙（MBCP()）/纤维蛋白移植物（TricOs((R))）/（Tisseel((R))）用于绵羊上颌窦提升术的有效性和安全性。自体骨移植物用作阳性对照，并植入牙种植体以评估复合材料的效果。
总共12只成年绵羊（24个上颌窦）被随机分配，接受通过将凝血酶和纤维蛋白原同时或依次添加到MBCP()中获得的MBCP()/纤维蛋白移植物或自体骨移植物进行上颌窦提升术。上颌窦提升术后6个月，植入牙种植体。在上颌窦提升术后6个月以及牙种植体植入后3个月，评估新形成骨的特征和牙种植体稳定性。所使用的方法包括放射照相、扫描电子显微镜、光学显微镜、显微CT分析、射频分析（RFA）和图像分析。
术后期间无临床不良事件。6个月时，MBCP()/纤维蛋白移植物和自体移植物的新骨形成相似，分别为21%-20%和20%，9个月时分别为34%-35%和35%。使用MBCP()/纤维蛋白移植物时牙种植体的植入性在植入时优于自体移植物，分别为81%-88%和69%。植入后3个月，RFA显示使用MBCP()/纤维蛋白移植物时的植入性优于自体移植物，分别为75%-82%和71%。三组的骨接触测量值均约为50%，无显著差异。
本研究表明，在绵羊上颌窦提升术后，MBCP()/纤维蛋白移植物支持新骨形成，其效果与自体移植物相当，同时为牙种植体提供更好的支持。
