Luo Zhi-Bin, Zhang Qing-Bin, Zhang Zhao-Qiang, Chen Dan, Yan Wang-Xiang, Li Ke-Feng, Chen Yu
Department of Oral Implantology, Guanghua School of Stomatology, Institute of Stomatological Research, Sun Yat-sen University, Guangzhou, 510055, China,
Clin Oral Investig. 2013 Dec;17(9):2003-10. doi: 10.1007/s00784-013-0922-6. Epub 2013 Jan 29.
The purpose of this study is to retrospectively explore the utilization of coralline hydroxyapatite in maxillary sinus augmentation.
One hundred and eighteen cases of sinus lift with coralline hydroxyapatite (CHA) were included in this study. In detail, simultaneous implantation was conducted in 78 patients (174 implants) and delayed implantation was done in 40 cases (82 implants) around 6 months after bone transplantation. The clinical features and X-ray radiographs after operation were analyzed to evaluate osseointegration procedures according to a planned medical follow-up. In the delayed group, around 6 months, a bone biopsy was taken just during implant placement in order to evaluate the new formed bone from a histological and histomorphometrical point of view. A further 6 months later, abutment connection was performed, and the patients received prosthetic restoration of the missing teeth.
Clinically, the incisions healed well. No abnormal reactions were found during follow-up period. All the 174 simultaneous implants were successful after 1-5 years of medical review; Out of 82 delayed implants, 3 were found to be loose. Histologically, all the specimens showed signs of active remodeling, and all the tissues had a large amount of osteocyte at sixth month after sinus augmentation. New bone formed dramatically. Radiologically, the density of CHA gradually reduced since the beginning of the third month, and CHA may be completely resolved at about fifth year.
CHA is proven an ideal bone graft material for its reliable clinical results and favorable histocompatibility in the treatment of sinus atrophy or other kinds of insufficient bone volume in this region. Moreover, CHA's signal application can achieve desired clinical effect.
This study shows the clinic application of CHA in maxillary sinus augmentation. Compared with popular mixture of autogenous bone and grafting materials, our results show CHA's signal application can achieve ideal osseointegration interface and satisfying clinic effect.
本研究旨在回顾性探讨珊瑚羟基磷灰石在上颌窦提升术中的应用。
本研究纳入118例采用珊瑚羟基磷灰石（CHA）进行窦底提升的病例。具体而言，78例患者（174枚种植体）进行了同期种植，40例患者（82枚种植体）在骨移植后约6个月进行了延期种植。根据计划的医学随访，分析术后的临床特征和X线片，以评估骨整合过程。在延期种植组，大约6个月时，在植入种植体时进行骨活检，以便从组织学和组织形态计量学角度评估新形成的骨。再过6个月后，进行基台连接，患者接受缺失牙的修复治疗。
临床上，切口愈合良好。随访期间未发现异常反应。经过1至5年的医学复查，所有174枚同期种植体均成功；82枚延期种植体中，有3枚松动。组织学上，所有标本均显示出活跃重塑的迹象，在窦底提升术后6个月时，所有组织中都有大量骨细胞。新骨大量形成。放射学上，自第三个月开始，CHA的密度逐渐降低，大约在第五年时CHA可能完全消失。
CHA因其可靠的临床效果和良好的组织相容性，被证明是治疗该区域窦萎缩或其他骨量不足的理想骨移植材料。此外，CHA的应用能取得理想的临床效果。
本研究展示了CHA在上颌窦提升术中的临床应用。与常用的自体骨和移植材料混合物相比，我们的结果表明CHA的应用能实现理想的骨整合界面和令人满意的临床效果。
