Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.
Department of Pathology and IBIMER, School of Medicine, University of Granada, Granada, Spain.
Clin Oral Implants Res. 2020 Jun;31(6):536-548. doi: 10.1111/clr.13590. Epub 2020 Mar 6.
To analyze a modified biphasic phycogenic biomaterial in comparison with anorganic bovine bone in maxillary sinus floor elevation in humans.
Eight male patients in need of bilateral two-stage sinus floor elevation were consecutively recruited for this randomized split-mouth study. A combination of autogenous cortical bone (ACB, 20%) and anorganic bovine bone (ABB, 80%) (ACB + ABB group) or ACB (20%) and modified biphasic phycogenic material (BP, 80%) (ACB + BP group) were randomly assigned to graft each sinus. Patients were followed up for 6 months post-surgery when bone samples were collected for analysis.
Radiographically, bone height gain was statistically higher in the ACB + ABB versus the ACB + BP group. While the analysis of the biological compartments showed differences in non-mineralized tissue (39.15 ± 20.97% vs. 65.87 ± 28.59%, ACB + ABB vs. ACB + BP respectively; p = .018) and remnant biomaterial particles (22.62 ± 17.01% vs. 7.96 ± 8.57%, respectively; p = .028), the percentage of mineralized tissue (38.23 ± 17.55% vs. 24.14 ± 24.66%, respectively; p = .398) showed no statistically significant difference. In contrast, ACB + ABB biopsies showed higher Musashi-1-positive cells per mm compared to ACB + BP biopsies (811.49 ± 875.30 vs. 236.90 ± 280.81; p < .018), where the fusiform cells corresponded mainly with fibroblasts, as demonstrated by ultrastructural analysis.
Both combinations of materials exhibited bone formation after 6 months of healing in the maxillary sinus cavity. However, the combination with biphasic phycogenic biomaterial induced a higher radiographical vertical resorption and graft collapse in comparison with the combination with anorganic bovine bone, possibly due to a higher remodeling of the graft.
分析一种改良的双相藻源生物材料与无机牛骨在人类上颌窦底提升中的比较。
连续招募了 8 名需要双侧两阶段窦底提升的男性患者进行这项随机分组的分口研究。将自体皮质骨（ACB，20%）和无机牛骨（ABB，80%）（ACB+ABB 组）或 ACB（20%）和改良的双相藻源材料（BP，80%）（ACB+BP 组）混合后随机填入每个窦腔。术后 6 个月采集骨样本进行分析时，对患者进行随访。
影像学上，ACB+ABB 组的骨高度增加明显高于 ACB+BP 组。然而，生物区室分析显示，非矿化组织（ACB+ABB 组为 39.15±20.97%，ACB+BP 组为 65.87±28.59%；p=0.018）和残留生物材料颗粒（ACB+ABB 组为 22.62±17.01%，ACB+BP 组为 7.96±8.57%；p=0.028）存在差异，矿化组织的百分比（ACB+ABB 组为 38.23±17.55%，ACB+BP 组为 24.14±24.66%；p=0.398）无统计学差异。相比之下，ACB+ABB 活检中的 Musashi-1 阳性细胞数 per mm 高于 ACB+BP 活检（811.49±875.30 与 236.90±280.81；p<0.018），超微结构分析表明，其中梭形细胞主要为成纤维细胞。
两种材料组合在上颌窦腔内愈合 6 个月后均有骨形成。然而，与无机牛骨相比，双相藻源生物材料组合导致更高的影像学垂直吸收和移植物塌陷，可能是由于移植物的更高重塑。
