Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.
Department of Anatomy, School of Medicine, University of Granada, Granada, Spain.
Clin Oral Implants Res. 2018 Feb;29(2):192-201. doi: 10.1111/clr.13098. Epub 2017 Oct 26.
To compare the clinical and histologic outcomes of two different grafting materials (allograft and xenograft) when combined with autogenous bone and covered with a collagen membrane for sinus augmentation.
A parallel case series of fourteen patients in need of a unilateral sinus augmentation was evaluated in this study. Seven patients received a graft composed by autologous cortical bone (ACB) and anorganic bovine bone in a ratio of 1:1; the other seven patients received ACB mixed with an allograft in the same ratio. Bone biopsies were obtained 6 months after sinus augmentation at the time of implant placement. Comparative histomorphometrical, histopathological, and immunohistochemical analyses were conducted and statistically analyzed.
After 12 months of functional loading, all implants in both groups were clinical and radiographically successful. Histomorphometrically, although the initial bone formation was not significantly different between groups (new mineralized tissue: 41.03(12.87)% vs. 34.50(13.18)%, p = .620; allograft vs. xenograft groups), the graft resorbed faster in the allograft group (remnant graft particles: 9.83[7.77]% vs. 21.71[17.88]%; p = .026; allograft vs. xenograft groups). Non-mineralized tissue did not statistically differ either (49.00[14.32]% vs. 43.79[19.90]%; p = .710; allograft vs. xenograft groups). The histologic analyses revealed higher cellular content, four times more osteoid lines, and higher vascularization in the xenograft group. Musashi-1 (mesenchymal stromal cell marker) was also more intensively expressed in the xenograft group (p = .019).
Both composite grafts generate adequate substratum to receive dental implants after healing. Compared with the xenograft composite, allograft composite shows faster turnover and a quicker decrease in biological action after 6 months.
比较两种不同移植物（同种异体和异种）与自体骨结合并用胶原膜覆盖用于鼻窦提升的临床和组织学结果。
本研究评估了 14 例需要单侧鼻窦提升的患者的平行病例系列。7 例患者接受了由自体皮质骨（ACB）和 1:1 比例的无机牛骨组成的移植物；其他 7 例患者接受了同种异体与 ACB 以相同比例混合的移植物。在鼻窦提升后 6 个月，即在植入物放置时，获得了骨活检。进行了比较组织形态计量学、组织病理学和免疫组织化学分析，并进行了统计学分析。
在 12 个月的功能加载后，两组所有植入物均临床和放射学成功。组织形态计量学上，尽管两组的初始骨形成没有显著差异（新矿化组织：41.03%（12.87%）对 34.50%（13.18%），p=0.620；同种异体与异种移植物组），但同种异体组移植物更快地吸收（残留移植物颗粒：9.83%（7.77%）对 21.71%（17.88%）；p=0.026；同种异体与异种移植物组）。未矿化组织也没有统计学差异（49.00%（14.32%）对 43.79%（19.90%）；p=0.710；同种异体与异种移植物组）。组织学分析显示，异种移植物组具有更高的细胞含量、四倍多的类骨质线和更高的血管化。在异种移植物组中，Musashi-1（间充质基质细胞标志物）的表达也更为强烈（p=0.019）。
两种复合移植物在愈合后都能为植入物提供足够的基质。与异种移植物复合材料相比，同种异体复合材料在 6 个月后表现出更快的周转率和更快的生物作用下降。
