Guarnieri Renzo, Belleggia Fabrizio, Ippoliti Stefano, DeVilliers Patrica, Stefanelli Luigi Vito, Di Carlo Stefano, Pompa Giorgio
Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Roma Italy.
Private Implant Practice, Roma Italy.
J Oral Maxillofac Res. 2016 Mar 31;7(1):e3. doi: 10.5037/jomr.2016.7103. eCollection 2016 Jan-Mar.
The aim of this study was to evaluate the clinical, radiographic and histologic results when a highly purified xenogenic bone (Laddec(®)) was used as grafting material in maxillary sinuses.
In fifteen patients requiring unilateral maxillary sinus augmentation, the grafting procedure was performed with Laddec(®). Forty-two implants were installed after a 6 month healing period. The height of the augmented sinus was measured radiographically immediately after augmentation and postoperatively up to 36 months. At the time of implant placement, a bone core was harvested in each patient for histological examination.
The cumulative implant survival rate was 97.6%. The original height was 3.65 (SD 0.7) mm and the augmented sinus height was 13.8 (SD 1.4) mm after the surgery. The reduced height of grafted xenogenic material (RDL) at the implant insertion was 0.83 (SD 0.38) mm, and at the final postoperative visit was 0.91 (SD 0.25) mm, showing no significant correlation with the follow-up periods by Spearman's test (P = 0.118). In addition, no significant difference in the RDL was observed according to the site of implantation (P = 0.682). The mean implant marginal bone loss was 0.38 (SD 0.24) mm. Histological analysis showed the bone cores were composed of 64.72 (SD 3.44)% newly formed bone, 17.41 (SD 2.02)% connective tissue, 16.93 (SD 2.83)% residual graft particles, and 0.94 (SD 0.11)% inflammatory cells.
According to our data, the highly purified xenogenic bone (Laddec(®)), used as graft material in the sinus lift procedure, may create adequate bone volume, and appropriate osseointegration of dental implants.
本研究的目的是评估在上颌窦中使用高度纯化的异种骨（Laddec®）作为移植材料时的临床、影像学和组织学结果。
在15例需要单侧上颌窦增高的患者中，采用Laddec®进行移植手术。6个月愈合期后植入42颗种植体。在增高后立即通过影像学测量增高后的上颌窦高度，并在术后长达36个月进行测量。在植入种植体时，采集每位患者的骨芯进行组织学检查。
种植体累积存留率为97.6%。术前原始高度为3.65（标准差0.7）mm，术后增高后的上颌窦高度为13.8（标准差1.4）mm。种植体植入时移植的异种材料（RDL）减少的高度为0.83（标准差0.38）mm，术后最终随访时为0.91（标准差0.25）mm，Spearman检验显示与随访时间无显著相关性（P = 0.118）。此外，根据种植部位观察到RDL无显著差异（P = 0.682）。种植体边缘骨平均吸收为0.38（标准差0.24）mm。组织学分析显示骨芯由64.72（标准差3.44）%的新形成骨、17.41（标准差2.02）%的结缔组织、16.93（标准差2.83）%的残留移植颗粒和0.94（标准差0.11）%的炎性细胞组成。
根据我们的数据，在窦底提升术中用作移植材料的高度纯化的异种骨（Laddec®）可能会产生足够的骨量，并使牙种植体实现适当的骨结合。
