Sverzut Alexander T, Rodrigues Danillo C, Lauria Andrezza, Armando Rogério S, de Oliveira Paulo T, Moreira Roger W F
Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil.
Clin Oral Implants Res. 2015 Jun;26(6):633-8. doi: 10.1111/clr.12346. Epub 2014 Feb 6.
The installation of dental implants in the posterior maxilla is often faced with resorbed alveolar processes, resulting from a combination of pneumatization of the maxillary sinus, the effects of periodontal disease, and physiological bone resorption. The sinus lift surgery has been practiced since 1980 with the aim to increase bone height in this region for an implant supported prosthetic rehabilitation, and various filling materials have been used for such.
This study aimed to clinically, radiographically, and histologically evaluate a preparation of calcium phosphate cement (Bone Source(®), BS) used as filling material in maxillary sinus elevation surgery.
Ten patients were operated requiring maxillary sinus graft for future placement of osseointegrated implants. After a period ranging from 9 to 16 months, a clinical evaluation and biopsy of the grafted area in the region adjacent to the axis of the implant to be inserted were performed.
Clinically and radiographically, no evidence of resorption/substitution of BS was noticed. Although no patients have had postoperative complications and the material presented fully biocompatible characteristics with woven bone in intimate contact with BS, it was not possible to place any implants due to minimal bone formation and friability of the material.
It was concluded that despite the osteoconductive capacity of BS, this conventional calcium phosphate preparation does not support sufficient amount of new bone formation that could allow its use as filling material for maxillary sinus floor lift and subsequent dental implant placement.
上颌后牙区种植体植入常面临牙槽骨吸收,这是由上颌窦气化、牙周病影响及生理性骨吸收共同导致的。自1980年起开展了上颌窦提升手术,目的是增加该区域骨高度以进行种植体支持的修复治疗,并且已使用多种填充材料。
本研究旨在从临床、影像学和组织学方面评估一种磷酸钙骨水泥制剂(骨源(®),BS)作为上颌窦提升手术填充材料的效果。
10例患者接受手术,需要进行上颌窦植骨以便日后植入骨结合种植体。在9至16个月的一段时间后,对拟植入种植体轴线附近区域的移植部位进行了临床评估和活检。
在临床和影像学上,未发现BS有吸收/替代的迹象。尽管没有患者出现术后并发症,且该材料与紧密接触BS的编织骨呈现出完全的生物相容性,但由于骨形成极少且材料易碎,无法植入任何种植体。
得出的结论是,尽管BS具有骨传导能力,但这种传统的磷酸钙制剂不能支持足够量的新骨形成,因此不能用作上颌窦底提升及后续牙种植体植入的填充材料。