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使用两种不同吸收类型的骨替代物在人上颌窦中形成新骨,与或不与自体骨移植物联合使用:一项比较组织形态计量学、免疫组织化学和随机临床研究。

The new bone formation in human maxillary sinuses using two bone substitutes with different resorption types associated or not with autogenous bone graft: a comparative histomorphometric, immunohistochemical and randomized clinical study.

机构信息

Universidade do Grande Rio (UNIGRANRIO); Centro Universitário Serra dos Órgãos (UNIFESO).

Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP).

出版信息

J Appl Oral Sci. 2020 Dec 18;29:e20200568. doi: 10.1590/1678-7757-2020-0568. eCollection 2020.

Abstract

OBJECTIVE

The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants.

METHODOLOGY

40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1.

RESULTS

In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed.

CONCLUSION

This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.

摘要

目的

本研究旨在评估使用 5 种不同骨替代物进行上颌窦骨增量后新骨和结缔组织的形成以及生物材料的残留情况。通过骨钙素免疫标记来证明其钙化和接受牙种植体的可能性。

方法

40 例患者接受了上颌窦骨增量,分为 5 组:第 1 组 8 个上颌窦用自体骨移植物(AB)移植;第 2 组 8 个上颌窦用生物活性玻璃(BG)移植;第 3 组 8 个上颌窦用 1:1 的自体骨移植物和生物活性玻璃(BG+AB)移植;第 4 组 8 个上颌窦用 Bio-Oss(BO)移植;第 5 组 8 个上颌窦用 1:1 的自体骨移植物和 Bio-Oss(BO+AB)移植。

结果

AB 组在原始骨区形成 37.8%的骨,在中间区形成 38.1%,在根尖区形成 44.5%。BG 组在原始骨区形成 43.6%的骨,在中间区形成 37%,在根尖区形成 49.3%。BG+AB 1:1 组在原始骨区形成 39.0%的骨,在中间区形成 34.8%,在根尖区形成 36.8%。BO 组在原始骨区形成 33.4%的骨,在中间区形成 32.5%,在根尖区形成 34.3%。BO+AB 1:1 组在原始骨区形成 32.8%的骨,在中间区形成 36.1%,在根尖区形成 27.8%。骨钙素免疫标记显示所有组均呈强染色,可证明形成的骨的钙化。

结论

本研究表明,在骨愈合后 6 个月的上颌窦重建中,评估的各组均形成了合适的板层骨,因此可考虑植入牙种植体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f78b/7799149/923665c57a11/1678-7757-jaos-29-e20200568-gf01.jpg

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