Bassil Joseph, Naaman Nada, Lattouf Raed, Kassis Cynthia, Changotade Sylvie, Baroukh Brigitte, Senni Karim, Godeau Gaston
Department of Oral Surgery, Faculty of Dental Medicine, St Joseph University, Beirut, Lebanon.
J Oral Implantol. 2013 Feb;39(1):73-80. doi: 10.1563/AAID-JOI-D-11-00012. Epub 2011 Sep 9.
The aim of the present study was to evaluate bone formation after maxillary sinus augmentation using bovine bone substitute material Bio-Oss alone by means of clinical, histological, and histomorphometrical examination of human biopsies. Deproteinized bovine bone (DPBB, Bio-Oss) was used to fill cavities after elevation of the sinus mucosa following major sinus pneumatization. Twenty patients with edentulous posterior maxillae were treated with 20 sinus augmentation procedures using a 2-stage technique. Residual lateral maxillary bone height was less than 3 mm. Forty-nine Straumann endosseous implants were used to complete the implant-prosthetic rehabilitation. Forty cylinder-shaped bone biopsies were taken from the augmented maxillary region 8 months after grafting during the second-stage surgery before implant placement. All implants were loaded 3 months after insertion, and no failures were recorded. Histomorphometrical analysis showed an average percentage of newly formed bone of 17.6% (± 2.8%) and a proportion of residual bone substitute material of 29.9% (± 4.9%) of the total biopsy area. Intimate contact between newly formed bone and Bio-Oss was detected along 28.2% (± 6.8%) of the particle surfaces. The results also showed that in all cases, the DPBB granules had been interconnected by bridges of vital newly formed bone. Inorganic bovine bone appears to be biocompatible and osteoconductive, and it can be used with success as a bone substitute in maxillary sinus augmentation procedures.
本研究的目的是通过对人体活检组织进行临床、组织学和组织形态计量学检查，评估单独使用牛骨替代材料Bio-Oss进行上颌窦提升术后的骨形成情况。在主要上颌窦气化后提升窦黏膜后，使用脱蛋白牛骨（DPBB，Bio-Oss）填充腔隙。20例上颌后牙区无牙患者采用两阶段技术进行了20次窦提升手术。上颌骨外侧剩余骨高度小于3mm。使用49颗士卓曼种植体完成种植修复。在第二阶段手术植入种植体前，于植骨后8个月从上颌骨植骨区获取40个圆柱形骨活检组织。所有种植体植入后3个月加载，未记录到失败病例。组织形态计量学分析显示，新形成骨的平均百分比为17.6%（±2.8%），剩余骨替代材料占活检总面积的比例为29.9%（±4.9%）。新形成骨与Bio-Oss之间沿28.2%（±6.8%）的颗粒表面存在紧密接触。结果还显示，在所有病例中，DPBB颗粒已通过有活力的新形成骨桥相互连接。无机牛骨似乎具有生物相容性和骨传导性，可成功用作上颌窦提升手术中的骨替代材料。
