Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, Xi'an, China.
Clin Implant Dent Relat Res. 2020 Jun;22(3):281-291. doi: 10.1111/cid.12906. Epub 2020 Apr 8.
To investigate the feasibility of reducing the healing time of maxillary sinus floor elevation (MSFE) by a two-stage approach using deproteinized bovine bone mineral (DBBM) alone, based on clinical, histomorphometric, and microradiographic evaluations.
Twenty consecutive cases with an atrophic posterior edentulous maxilla were randomly assigned to two groups at a ratio of 1:1. The lateral window approach to MSFE with DBBM alone was followed by an 8-month bone-healing period in the control group compared to 5 months in the test group. During implant placement, bone biopsies were harvested from implant osteotomy sites for micro-computed tomography (CT), histological, and histomorphometric evaluations. Cone beam CT (CBCT) scans were performed before and immediately after MSFE and after the bone-healing periods. The implant stability quotient (ISQ) was measured sequentially at implant placement and 1, 3, and 6 months thereafter.
The histomorphometric and microradiographic results showed no significant differences in new bone formation on the augmented sinus floor between the two groups (all Ps > .05), except that trabecular thickness was significantly reduced and trabecular separation significantly increased in the test group (both Ps < .05). The ISQs of both groups increased continuously after implant placement, but the difference was not significant between the groups at each time point. CBCT analyses showed that the extent of volumetric loss was comparable after bone healing for 5 and 8 months (P > .05).
Within the limitations of this study, the bone-healing time of MSFE with DBBM alone for staged implant placement could be reduced to 5 months instead of 8 or 9 months, based on the histomorphometric, microradiographic, and clinical outcomes; however, impact on long-term implant survival remains unknown and needs further investigation with long-term follow-ups.
通过临床、组织形态计量学和微射线照相评估，研究单独使用脱蛋白牛骨矿物质（DBBM）进行两阶段方法减少上颌窦底提升（MSFE）愈合时间的可行性。
连续 20 例患有后牙缺失的萎缩性上颌骨患者，按照 1:1 的比例随机分为两组。对照组在 MSFE 中使用 DBBM 后，经过 8 个月的骨愈合期，而试验组为 5 个月。在植入物放置过程中，从植入物骨切开部位采集骨活检，进行微计算机断层扫描（CT）、组织学和组织形态计量学评估。在 MSFE 前后以及骨愈合期后进行锥形束 CT（CBCT）扫描。在植入物放置时和之后的 1、3 和 6 个月，连续测量植入物稳定性系数（ISQ）。
组织形态计量学和微射线照相结果显示，两组在增强窦底的新骨形成方面没有显著差异（所有 P 值均>0.05），但试验组的小梁厚度明显降低，小梁分离明显增加（均 P 值<0.05）。两组的 ISQ 在植入物放置后均持续增加，但在每个时间点两组之间的差异均无统计学意义。CBCT 分析显示，在骨愈合 5 个月和 8 个月后，体积损失程度相当（P 值>0.05）。
在本研究的限制范围内，基于组织形态计量学、微射线照相和临床结果，单独使用 DBBM 进行分期植入物放置的 MSFE 的骨愈合时间可缩短至 5 个月，而不是 8 或 9 个月；然而，对长期植入物生存的影响仍不清楚，需要进一步的长期随访研究。
