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新鲜冷冻同种异体移植物联合牛骨矿物质可增强上颌窦提升术中的骨形成。

Fresh-frozen allografts combined with bovine bone mineral enhance bone formation in sinus augmentation.

作者信息

Sehn Felipe Perraro, Dias Rafael Rodrigues, de Santana Santos Thiago, Silva Erick Ricardo, Salata Luiz Antonio, Chaushu Gavriel, Xavier Samuel Porfírio

机构信息

Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil.

Department of Oral and Maxillofacial Surgery, School of Dentistry, Tel Aviv University, Israel.

出版信息

J Biomater Appl. 2015 Feb;29(7):1003-13. doi: 10.1177/0885328214552709. Epub 2014 Sep 22.

Abstract

We evaluated histologically, histomorphometrically, and tomographically the effects of the association of fresh-frozen bone allograft (FFB) with bovine bone mineral (BBM) in maxillary sinus floor augmentation. In total, 34 maxillary sinuses from 29 patients, with a mean age of 51.32 (±6.44) years, underwent sinus augmentation. Patients were divided into control and test groups (17 sinuses each). The controls were grafted with allograft bone, and the test group received a combination of FFB and BBM at a 2:1 ratio. After 6 months, bone samples were collected for histological and histomorphometric examinations. The implant survival rates were 93.02% (control group) and 100% (test group) at 6 months after functional loading. Median volumetric reductions of 28.32% (17.05-44.05) and 12.62% (5.65-16.87) were observed for the control and test groups, respectively. Statistically significant histomorphometric differences were found between the control and test groups regarding newly formed bone 12.54% (10.50-13.33) vs. 24.42% (17.62-35.92), p < 0.001, total bone 48.34% (39.03-54.42) vs. 61.32% (50.61-64.96), p = 0.007, and connective tissue 51.66% (45.57-60.97) vs. 39.30% (35.03-49.37), p = 0.007. The addition of BBM to allograft bone in maxillary sinus augmentation resulted in higher percentages of new bone formation and total bone, and permitted implant placement with a low rate of osseointegration failure at the 6-month follow-up.

摘要

我们通过组织学、组织形态计量学和断层扫描评估了新鲜冷冻骨移植(FFB)与牛骨矿物质(BBM)联合用于上颌窦底提升的效果。总共对29例患者的34个上颌窦进行了窦底提升,患者平均年龄为51.32(±6.44)岁。患者分为对照组和试验组(每组17个窦)。对照组植入同种异体骨,试验组接受FFB与BBM按2:1比例的联合移植。6个月后,采集骨样本进行组织学和组织形态计量学检查。功能加载6个月后,对照组和试验组的种植体存活率分别为93.02%和100%。对照组和试验组的体积中位数减少率分别为28.32%(17.05 - 44.05)和12.62%(5.65 - 16.87)。在新形成骨方面,对照组和试验组之间存在统计学上的显著组织形态计量学差异,分别为12.54%(10.50 - 13.33)和24.42%(17.62 - 35.92),p < 0.001;总骨量方面,分别为48.34%(39.03 - 54.42)和61.32%(50.61 - 64.96),p = 0.007;结缔组织方面,分别为51.66%(45.57 - 60.97)和39.30%(35.03 - 49.37),p = 0.007。在上颌窦提升中,将BBM添加到同种异体骨中可导致更高的新骨形成百分比和总骨量,并在6个月随访时允许以低骨整合失败率植入种植体。

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