Department of Oral and Maxillofacial Surgery, Hilleroed Hospital/Rigshospitalet, Hilleroed, Denmark.
Clin Oral Implants Res. 2012 Sep;23(9):1031-7. doi: 10.1111/j.1600-0501.2011.02251.x. Epub 2011 Sep 8.
The aim of the present randomized clinical study was to evaluate histologically whether the addition of cultivated, autogenous bone cells to a composite graft of deproteinized bovine bone mineral (DBBM) and autogenous bone (AB) for sinus floor augmentation (SFA) enhance bone formation compared with what achieved after SFA with DBBM + AB alone.
Twenty patients with remaining posterior maxillary alveolar crest height of less than 3 mm received SFA after randomization either with an DBBM and AB composite in a 1 : 1 ratio or with DBBM + AB supplemented with autogenous bone cells, which were cultivated from a bone biopsy harvested earlier from the tuberosity area. Four months after SFA, two cylindrical biopsies were taken from the augmented sinuses concomitantly with the implant site preparation by means of a trephine bur. An additional biopsy was taken from the tuberosity area. Bone density at the augmented sinus and the tuberosity area and the height of augmentation were estimated on non-decalcified histological sections prepared from the biopsies. A relative bone density index (RBD) was also calculated by dividing bone density at the augmented sinus with bone density at the tuberosity area.
All patients but one could receive two implants after SFA; in one patient, only one implant could be placed. All implants were osseointegrated and could be loaded. Median bone density in the sinus was 30% and 25% in the cell seeded and no-cells added DBBM + AB groups, respectively. Bone augmentation height averaged 6.0 and 5.4 mm and RBD averaged 0.48 and 0.73 in the cell seeded and no-cells added DBBM + AB groups, respectively. None of the differences between groups was statistically significant.
Cultivated autogenous bone cell seeded to a DBBM + AB composite did not significantly improve bone formation (density and height) after SFA, compared with what was achieved with DBBM + AB alone. Both approaches resulted into enough bone to support implant placement and osseointegration.
本随机临床研究的目的是通过组织学评估，在单纯使用脱蛋白牛骨矿物质（DBBM）和自体骨（AB）复合移植物进行鼻窦底提升（SFA）的基础上，添加培养的自体骨细胞是否能增强骨形成，与单纯使用 DBBM+AB 进行 SFA 相比。
20 名患者的上颌后牙槽嵴高度剩余不足 3mm，随机分为两组，一组在 DBBM 和 AB 以 1:1 比例的复合移植物中添加自体骨细胞，另一组在 DBBM+AB 中添加自体骨细胞，这些细胞是从 earlier 从结节区采集的骨活检中培养出来的。SFA 后 4 个月，通过环钻同时从增强的窦腔和种植部位准备取两个圆柱形活检。从结节区取额外的活检。通过对取自活检的非脱钙组织学切片，估计增强窦和结节区的骨密度以及增强高度。还通过用增强窦的骨密度除以结节区的骨密度计算相对骨密度指数（RBD）。
所有患者（除 1 例外）均可在 SFA 后接受 2 个种植体；在 1 例患者中，只能放置一个种植体。所有种植体均骨整合并可负重。窦内中位数骨密度在细胞接种组和无细胞添加 DBBM+AB 组分别为 30%和 25%。骨增强高度平均为 6.0mm 和 5.4mm，RBD 平均为 0.48 和 0.73 在细胞接种组和无细胞添加 DBBM+AB 组。组间无统计学差异。
与单纯使用 DBBM+AB 相比，将培养的自体骨细胞接种到 DBBM+AB 复合移植物中，并不会显著改善 SFA 后的骨形成（密度和高度）。两种方法都产生了足够的骨来支持种植体的放置和骨整合。
