评价一种新的双相磷酸钙用于上颌窦底提升：Micro-CT 和组织形态计量学分析。

Evaluation of a new biphasic calcium phosphate for maxillary sinus floor elevation: Micro-CT and histomorphometrical analyses.

机构信息

Department of Oral and Maxillofacial Surgery, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam Movement Sciences, Amsterdam, The Netherlands.

Department of Orthopedic Surgery, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands.

出版信息

Clin Oral Implants Res. 2018 May;29(5):488-498. doi: 10.1111/clr.13146. Epub 2018 Apr 11.

OBJECTIVES

Synthetic biphasic calcium phosphate (BCP) with a hydroxyapatite/ß-tricalcium phosphate (HA/ß-TCP) ratio of 60/40 (BCP60/40) is successfully used as alternative for autologous bone in patients undergoing maxillary sinus floor elevation (MSFE) for dental implant placement. A high percentage of HA in BCP60/40 may hamper efficient scaffold remodeling. Osteogenesis and neovascularization are pivotal in effective bone regeneration. We aimed to investigate whether differences exist in osteogenic and/or vasculogenic potential of BCP60/40 and BCP20/80 in patients undergoing MSFE.

MATERIALS AND METHODS

Twenty patients undergoing MSFE were treated with BCP60/40 (n = 10) or BCP20/80 (n = 10). Bone and graft volumes were determined by micro-computed tomography and histomorphometrical analysis of biopsies of the augmented region. Osteoid volumes, number of osteoclasts, and blood vessels were determined by histomorphometrical analysis. The biopsies were taken 6.5 months (26 weeks) postoperatively prior to dental implant placement.

RESULTS

Bone and osteoid volumes were 9.7% and 0.8% higher at the most cranial side of the BCP20/80 biopsies compared to the BCP60/40 biopsies. Graft volumes, number of osteoclasts, and blood vessels were similar in both groups.

CONCLUSIONS

BCP20/80 showed enhanced osteogenic potential in patients undergoing MSFE compared to BCP60/40, due to either a faster bone remodeling rate or an earlier start of bone formation in BCP20/80-treated patients, suggesting that a higher TCP content positively contributes to the bone remodeling rate. Therefore, BCP20/80 might perform better, at least in the short term, as a scaffold for bone augmentation in the MSFE model than BCP60/40 as more bone is formed, and more osteoid is deposited at the cranial side in BCP20/80-treated patients compared to BCP60/40-treated patients. However, catch-up of BCP60/40 in the long term cannot be ruled out.

目的

合成双相磷酸钙（BCP）中羟磷灰石/β-磷酸三钙（HA/β-TCP）的比例为 60/40（BCP60/40），成功地用作接受上颌窦底提升（MSFE）以进行牙种植体植入的患者的自体骨替代物。BCP60/40 中 HA 的高百分比可能会阻碍有效的支架重塑。成骨和新生血管对于有效的骨再生至关重要。我们旨在研究在接受 MSFE 的患者中，BCP60/40 和 BCP20/80 的成骨和/或血管生成潜力是否存在差异。

材料和方法

20 名接受 MSFE 的患者分别接受 BCP60/40（n=10）或 BCP20/80（n=10）治疗。通过微计算机断层扫描和增强区域活检的组织形态计量分析来确定骨和移植物的体积。通过组织形态计量分析来确定类骨质体积、破骨细胞数量和血管。在植入牙科种植体之前，在手术 6.5 个月（26 周）后进行活检。

结果

BCP20/80 活检的最颅侧骨和类骨质体积分别比 BCP60/40 活检高 9.7%和 0.8%。两组的移植物体积、破骨细胞数量和血管均相似。

结论

与 BCP60/40 相比，BCP20/80 在接受 MSFE 的患者中表现出增强的成骨潜力，这可能是由于 BCP20/80 治疗的患者更快的骨重塑率或更早开始骨形成，这表明更高的 TCP 含量对骨重塑率有积极贡献。因此，与 BCP60/40 相比，BCP20/80 作为 MSFE 模型中的骨增强支架可能表现更好，至少在短期内，因为在 BCP20/80 治疗的患者中形成了更多的骨，并且在颅侧沉积了更多的类骨质。然而，不能排除 BCP60/40 在长期内的追赶。