Y Baena Ruggero Rodriguez, Lupi Saturnino Marco, Pastorino Roberta, Maiorana Carlo, Lucchese Alessandra, Rizzo Silvana
Department of Clinico Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, Pavia, Italy.
J Craniofac Surg. 2013 May;24(3):845-8. doi: 10.1097/SCS.0b013e31827ca01a.
Although numerous biomaterials are used for maxillary sinus-lift surgery, the ideal material for such procedures has not yet been identified. Both heterologous and alloplastic bone substitutes have a solely osteoconductive effect and lack the osteoinductive properties of the bone morphogenetic proteins typical of autologous bone. Our group assessed a new alloplastic graft material, poly(lactic-co-glycolic) acid/hydroxyapatite (PLGA/HA), implanted in a human model of maxillary sinus-lift surgery. For this prospective, random, double-blind trial, we used deproteinized bovine bone (DBB) as the comparison material. Radiographic bone vertical height and density were assessed at approximately 28 weeks after grafting using cone-beam computed tomography. The vertical dimension of the regenerated bone was equivalent between the 2 groups. The density of the bone regenerated using PLGA/HA was significantly lower than that obtained with DBB. Despite clinical assessments demonstrating that PLGA/HA has sufficient characteristics for use in sinus-lift surgery, DBB provided greater bone density and an equivalent vertical dimension of grafted bone. Further studies are needed to supplement the radiologic findings with histologic and micromorphometric examinations.
尽管有多种生物材料用于上颌窦提升手术,但尚未确定适用于此类手术的理想材料。异体和异质骨替代物仅具有骨传导作用,缺乏自体骨典型的骨形态发生蛋白的骨诱导特性。我们的研究小组评估了一种新型异质移植材料,聚乳酸-乙醇酸共聚物/羟基磷灰石(PLGA/HA),将其植入上颌窦提升手术的人体模型中。在这项前瞻性、随机、双盲试验中,我们使用脱蛋白牛骨(DBB)作为对照材料。在移植后约28周,使用锥形束计算机断层扫描评估骨垂直高度和密度。两组再生骨的垂直尺寸相当。使用PLGA/HA再生的骨密度显著低于使用DBB获得的骨密度。尽管临床评估表明PLGA/HA具有用于窦提升手术的足够特性,但DBB提供了更高的骨密度和相当的移植骨垂直尺寸。需要进一步的研究,通过组织学和微观形态学检查来补充放射学研究结果。