Lorenz Jonas, Barbeck Mike, Sader Robert A, Kirkpatrick Charles J, Russe Philippe, Choukroun Joseph, Ghanaati Shahram
1 Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany.
2 REPAIR-Lab, Institute of Pathology, Johannes Gutenberg University, Mainz, Germany.
J Oral Implantol. 2016 Jun;42(3):273-7. doi: 10.1563/aaid-joi-D-15-00133. Epub 2016 Jan 29.
Bone substitute materials of different origin and chemical compositions are frequently used in augmentation procedures to enlarge the local bone amount. However, relatively little data exist on the long-term tissue reactions. The presented case reports for the first time histological and histomorphometrical analyses of a nanocrystaline hydroxyapatite-based bone substitute material implanted in the human sinus cavity after an integration period of 3 years. The extracted biopsy was analyzed histologically and histomorphometrically with focus on the tissue reactions, vascularization, new bone formation, and the induction of a foreign body reaction. A comparably high rate of connective tissue (48.25%) surrounding the remaining bone substitute granules (42.13%) was observed. Accordingly, the amount of bone tissue (9.62%) built the smallest fraction within the biopsy. Further, tartrate-resistant acid phosphatase-positive and -negative multinucleated giant cells (4.35 and 3.93 cells/mm(2), respectively) were detected on the material-tissue interfaces. The implantation bed showed a mild vascularization of 10.03 vessels/mm(2) and 0.78%. The present case report shows that after 3 years, a comparable small amount of bone tissue was observable. Thus, the foreign body response to the bone substitute seems to be folded without further degradation or regeneration.
不同来源和化学成分的骨替代材料常用于增容手术以增加局部骨量。然而，关于长期组织反应的数据相对较少。本病例报告首次展示了在植入人体鼻窦腔3年的整合期后，对基于纳米晶羟基磷灰石的骨替代材料进行的组织学和组织形态计量学分析。对提取的活检组织进行了组织学和组织形态计量学分析，重点关注组织反应、血管化、新骨形成以及异物反应的诱导。观察到围绕剩余骨替代颗粒（42.13%）的结缔组织比例相对较高（48.25%）。因此，骨组织量（9.62%）在活检组织中占比最小。此外，在材料 - 组织界面检测到抗酒石酸酸性磷酸酶阳性和阴性的多核巨细胞（分别为4.35和3.93个细胞/mm²）。植入床显示出轻度血管化，为10.03条血管/mm²和0.78%。本病例报告表明，3年后可观察到相当少量的骨组织。因此，对骨替代材料的异物反应似乎已形成，且未进一步降解或再生。
