Taschieri Silvio, Corbella Stefano, Weinstein Roberto, Di Giancamillo Alessia, Mortellaro Carmen, Del Fabbro Massimo
*Department of Biomedical, Surgical and Dental Sciences, Research Centre in Oral Health, Università degli Studi di Milano†IRCCS Istituto Ortopedico Galeazzi‡Department of Biomedical, Surgical and Dental Sciences, Research Centre in Oral Implantology, Università degli Studi di Milano§Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan||Department of Health Sciences "A. Avogadro," University of Eastern Piedmont, Novara, Italy.
J Craniofac Surg. 2016 May;27(3):702-7. doi: 10.1097/SCS.0000000000002522.
Maxillary sinus floor elevation procedure has the objective of augmenting available bone in atrophic posterior maxilla to allow dental implants placement. The main aim of this prospective study was to evaluate clinically and histomorphometrically the performance of biphasic calcium phosphate (BCP) used in conjunction with platelet-rich plasma (PRP) compared with demineralized bovine bone matrix (DBBM) and PRP in sinus floor elevation surgery.
Patients candidate to sinus floor elevation were treated using either BCP and PRP or DBBM and PRP. Biopsies were retrieved using trephine bur during implant placement surgery 6 months after grafting. Clinical success of implants was evaluated 1 year after prosthesis delivery. Histomorphometric analysis was performed assessing the relative volume of newly formed bone.
A total of 20 patients were recruited, and 20 sinus augmentation procedures were performed, 10 for each group. A total of 42 implants were placed. One year after prosthetic loading a 100% implant survival rate was reported in both groups. Histomorphometric analysis revealed that the mean amount of new bone formation was 18.6 ± 3.3% in BCP group and it was 21.9 ± 4.9% in DBBM group, without statistically significant difference. In BCP group a greater amount of collagen type I was found with respect to DBBM group.
Both grafting materials led to an excellent performance regarding implant survival rate after 1 year follow-up, without any significant adverse sequelae. A similar capability of inducing new bone formation was observed in both groups, even though the higher quantity of collagen type I in BCP group may suggest a greater potential for bone formation over time as compared with DBBM.
上颌窦底提升术旨在增加萎缩性上颌后牙区的可用骨量,以便植入牙种植体。这项前瞻性研究的主要目的是,从临床和组织形态计量学方面评估双相磷酸钙(BCP)联合富血小板血浆(PRP)与脱矿牛骨基质(DBBM)联合PRP在上颌窦底提升手术中的性能。
符合上颌窦底提升条件的患者,分别采用BCP和PRP或DBBM和PRP进行治疗。在植骨6个月后的种植体植入手术中,使用环钻获取活检组织。在义齿交付1年后评估种植体的临床成功率。进行组织形态计量学分析,评估新形成骨的相对体积。
共招募20例患者,进行了20次上颌窦提升手术,每组10例。共植入42颗种植体。义齿加载1年后,两组报告的种植体存活率均为100%。组织形态计量学分析显示,BCP组新骨形成的平均量为18.6±3.3%,DBBM组为21.9±4.9%,差异无统计学意义。与DBBM组相比,BCP组发现更多的I型胶原蛋白。
两种植骨材料在1年随访后,在种植体存活率方面均表现出色,且无任何明显的不良后遗症。两组均观察到相似的诱导新骨形成的能力,尽管BCP组中较高量的I型胶原蛋白可能表明,与DBBM相比,随着时间推移其骨形成潜力更大。