Galindo-Moreno Pablo, Hernández-Cortés Pedro, Aneiros-Fernández José, Camara Miguel, Mesa Francisco, Wallace Stephen, O'Valle Francisco
Oral Surgery and Implant Dentistry Department, School of Dentistry, University of Granada, Granada, Spain.
Department of Traumatology and Orthopedic Surgery, San Cecilio Clinical Hospital, University of Granada, Granada, Spain.
Clin Oral Implants Res. 2014 Mar;25(3):366-371. doi: 10.1111/clr.12112. Epub 2013 Jan 28.
Our objectives were to examine vascular and cellular colonization in anorganic bovine bone (ABB) after 6 months of healing in human maxillary sinus augmentation grafts.
Fifty unilateral maxillary sinus augmentation procedures were performed on 50 consecutive patients. Bone cores were obtained through the implant receptor sites 6 months later and evaluated with morphological image analysis and immunohistochemical techniques.
Image analysis revealed a mean of 35.44 ± 16% vital bone, 31.66 ± 15% non-mineralized tissue, and 32.72 ± 25% remnant ABB particles. In our patients, neovascularization in 46.3% of cases was demonstrated within ABB particles 6 months after sinus floor augmentation surgery. Neovascularization of ABB particles was inversely related to age, directly to osteoclast number per mm², and not influenced by habits or disease. CD44-positive cells colonization was found in 74% of cases. An important correlation was found regarding CD44 expression and number of vessel in ABB particles (r = 0.624 P < 0.001, Pearson). Osteopontin expression was detected on the interstitial boundary of bone with ABB particles and within the osteocyte lacunae and bone canaliculi and was relationship with presence of CD44-positive cells inside ABB particles (r = 0.388, P = 0.046, Pearson).
In conclusion, images compatible with osteone colonized by osteocytes CD44 positive and neovascularization in ABB particles were observed after 6 months of graft maturation. These biologic events have not previously been morphologically and immunohistochemically documented.
我们的目的是研究人类上颌窦提升植骨术后6个月时，无机牛骨（ABB）中的血管和细胞定植情况。
对50例连续患者进行了50次单侧上颌窦提升手术。6个月后通过种植体植入部位获取骨芯，并采用形态学图像分析和免疫组化技术进行评估。
图像分析显示，平均有35.44±16%的活性骨、31.66±15%的非矿化组织和32.72±25%的残余ABB颗粒。在我们的患者中，46.3%的病例在窦底提升手术后6个月时，ABB颗粒内出现了新血管形成。ABB颗粒的新血管形成与年龄呈负相关，与每平方毫米破骨细胞数量呈正相关，且不受习惯或疾病影响。74%的病例中发现了CD44阳性细胞定植。发现ABB颗粒中CD44表达与血管数量之间存在重要相关性（r = 0.624，P < 0.001，Pearson检验）。在与ABB颗粒相邻的骨间质边界以及骨细胞陷窝和骨小管内检测到骨桥蛋白表达，且与ABB颗粒内CD44阳性细胞的存在有关（r = 0.388，P = 0.046，Pearson检验）。
总之，在植骨成熟6个月后，观察到了与CD44阳性骨细胞定植以及ABB颗粒内新血管形成相符的图像。这些生物学事件此前尚未在形态学和免疫组化方面得到记录。
