Private Practice, Opatja, Croatia.
Department of Craniomaxillofacial and Plastic Surgery, University Hospital of Cologne, Cologne, Germany.
Clin Oral Implants Res. 2017 Oct;28(10):e175-e183. doi: 10.1111/clr.12983. Epub 2016 Sep 29.
To compare a monophasic (100% ß-TCP) and a biphasic (60% HA and 40% ß-TCP) bone substitute material (BSM) regarding biocompatibility, osteoconductivity and implant stability using histological, radiological and resonance frequency analysis.
Sixty-seven sinus floor elevations were performed in 60 patients. One patient group (monophasic bone substitute [MBS], 30 patients, 32 sinuses) was augmented by the use of the monophasic material (Bioresorb , Sybron Implant Solutions, Bremen, Germany), while the second group (biphasic bone substitute (BBS), 30 patients, 35 sinuses) received a biphasic material (Maxresorb , Botiss Biomaterials, Berlin, Germany). Cone beam CT images were taken immediately after augmentation and prior to implant placement after 6 months. Trephines were harvested, while the implant bed was prepared. Resonance frequency analysis was performed immediately after implant placement and 6 months later. Descriptive analysis was performed on all augmented sinus (n = 67). For statistical comparison of the groups, one sinus of each bilaterally treated patient was randomly excluded, resulting in 30 sinuses grafted with MBS and 30 sinuses grafted with BBS (n = 60).
Histomorphometrical analysis of all sinuses displayed comparable results for both groups regarding new bone matrix (MBS 36.16 ± 19.37%, BBS 38.42 ± 12.61%), residual BSM (MBS 30.26 ± 11.7%, BBS 32.66 ± 12.57%) and non-mineralized tissue (MBS 34.29 ± 18.32%, BBS 28.92 ± 15.04) %) (P > 0.05, respectively). Radiological volume of BBS was significantly more stable (volume loss of 22.2% for MBS, 6.66% for BBS; P < 0.001), and homogeneity of the graft after 6 months was higher for BBS than that for MBS (P < 0.05). Resonance frequency analysis endorsed a higher implant stability quotient for BBS after 6 months than that for MBS (MBS 78.31 ± 5.81, BBS 80.42 ± 6.31; P < 0.05, Mann-Whitney U-test, respectively).
Both monophasic and biphasic materials show good biocompatibility and osteoconductivity with satisfactory support on implant stability. BBS remains more stable in terms of volume maintenance and radiological graft homogeneity after a healing period of 6 months.
通过组织学、影像学和共振频率分析比较单相（100%β-TCP）和双相（60%HA 和 40%β-TCP）骨替代材料（BSM）的生物相容性、骨诱导性和植入物稳定性。
在 60 名患者中进行了 67 例鼻窦提升术。一组患者（单相骨替代物 [MBS]，30 名患者，32 个窦腔）使用单相材料（Bioresorb，Sybron Implant Solutions，不来梅，德国）进行了增强，而第二组患者（双相骨替代物 [BBS]，30 名患者，35 个窦腔）使用了双相材料（Maxresorb，Botiss Biomaterials，柏林，德国）。在增强后立即和 6 个月后植入前拍摄锥形束 CT 图像。在准备植入物时取出环钻。在植入后立即和 6 个月后进行共振频率分析。对所有增强窦（n=67）进行描述性分析。为了对两组进行统计学比较，从双侧治疗的每位患者中随机排除一个窦，从而得到 30 个用 MBS 增强的窦和 30 个用 BBS 增强的窦（n=60）。
对两组所有窦的组织形态计量学分析显示，新骨基质方面的结果相似（MBS 36.16±19.37%，BBS 38.42±12.61%），残余 BSM（MBS 30.26±11.7%，BBS 32.66±12.57%）和非矿化组织（MBS 34.29±18.32%，BBS 28.92±15.04%）（分别为 P>0.05）。BBS 的影像学体积稳定性明显更高（MBS 体积损失 22.2%，BBS 体积损失 6.66%；P<0.001），6 个月后 BBS 移植物的均匀性高于 MBS（P<0.05）。共振频率分析显示，6 个月后 BBS 的种植体稳定性商数高于 MBS（MBS 78.31±5.81，BBS 80.42±6.31；P<0.05，Mann-Whitney U 检验）。
单相和双相材料均表现出良好的生物相容性和骨诱导性，对种植体稳定性有满意的支持。在 6 个月的愈合期后，BBS 在体积维持和影像学移植物均匀性方面更为稳定。
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