Whitt Josh, Al-Sabbagh Mohanad, Dawson Dolphus, Shehata Ehab, Housley-Smith Moly, Tezanos Alejandro, Kutkut Ahmad
University of Kentucky College of Dentistry, Lexington, KY, USA.
Division of Periodontology, University of Kentucky College of Dentistry, Lexington, KY, USA.
Int J Implant Dent. 2020 Jun 29;6(1):25. doi: 10.1186/s40729-020-00222-w.
This study aimed to evaluate the quality and quantity of newly generated bone in the maxillary sinus grafted with stem cell-based allograft material.
This study was a single site, prospective, blinded, randomized, and controlled clinical trial. Eleven subjects with 18 edentulous posterior maxillary sites requiring sinus augmentation for delayed implant placement using a lateral window approach were enrolled. At the time of sinus augmentation, test sinus was grafted with stem cell-based allograft (Osteocel Plus; NuVasive Therapeutics), while the control sinus was grafted with conventional cortico-cancellous allograft (alloOss; ACE Surgical). Cone beam computer tomography (CBCT) scan was taken before and 14 weeks post-sinus augmentation procedure, i.e., 2 weeks before implant placement. Thirty-six trephined core bone biopsies were harvested from the anterior and posterior grafted lateral-window osteotomy sites at the time of implant placement.
The results showed a statistically significant difference in the vital bone percentage between the test and the control groups at the posterior grafted sites (p = 0.03). There was no significant difference in the percentage of vital bone between the anterior and posterior grafted sites within the test and control groups (p > .05). The CBCT analysis showed that the maxillary sinuses at the posterior grafted sites were statistically wider than those at the anterior grafted sites in both groups (p < .05).
Different allograft bone materials can be used in the maxillary sinus augmentation procedures. Stem cell allograft has more osteogenic potential with a better outcome in the wide posterior sinus.
本研究旨在评估采用基于干细胞的同种异体移植材料进行上颌窦植骨后新生成骨的质量和数量。
本研究为单中心、前瞻性、盲法、随机对照临床试验。纳入11名受试者，其18个上颌后牙区无牙，需要采用外侧开窗法进行上颌窦提升术以延迟种植体植入。在进行上颌窦提升时，试验组上颌窦植入基于干细胞的同种异体移植物（Osteocel Plus；NuVasive Therapeutics公司），而对照组上颌窦植入传统的皮质松质骨同种异体移植物（alloOss；ACE Surgical公司）。在进行上颌窦提升术前及术后14周（即种植体植入前2周）进行锥形束计算机断层扫描（CBCT）。在种植体植入时，从移植的外侧开窗截骨术的前后部位采集36个环钻取芯骨活检样本。
结果显示，试验组和对照组在后牙移植部位的活骨百分比存在统计学显著差异（p = 0.03）。试验组和对照组内前牙和后牙移植部位的活骨百分比无显著差异（p > 0.05）。CBCT分析显示，两组后牙移植部位的上颌窦在统计学上比前牙移植部位的上颌窦更宽（p < 0.05）。
不同的同种异体骨材料可用于上颌窦提升手术。干细胞同种异体移植物具有更大的成骨潜力，在较宽的后牙区上颌窦中效果更佳。
