Resident, Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Consultant Oral and Maxillofacial Surgeon, Medical Faculty University RWTH Aachen, Aachen, Germany.
J Oral Maxillofac Surg. 2021 Jun;79(6):1246-1254. doi: 10.1016/j.joms.2020.12.040. Epub 2020 Dec 30.
Sinus floor elevation without using autogenous bone graft or bone substitute will eliminate donor site morbidity and reduce the cost and the risk of infection. We evaluated the bone gain after sinus membrane elevation without graft or using bone substitute in the same maxilla. Dental implants were inserted simultaneously as a 1-stage procedure.
In a split-mouth design, we conducted a randomized double-blinded clinical trial performing sinus lifts and simultaneous implant insertion in 10 healthy patients (n = 20). On the 1 site, we performed graft-less sinus lift (group 1) and on the other site Cerabone was used as bone substitute (group 2), respectively. The quantity and quality of bone gained in each sinus were evaluated and compared radiologically and histomorphometrically.
After 6 months, the average gain of bone height was 6.21 and 9.58 mm in group 1 and 2, respectively, as measured radiologically (P < .001, P < .001). Histomorphometric examination showed significantly higher thickness of trabeculae and bone formation in group 1 (P = .003 and P = .002). However, the neovascularization was higher, but not significantly (P = .288).
Radiological bone gain was similar in both groups. However, histomorphometric examination showed superior bone formation in graft-less group as compared to the Cerabone group. The blood clot seems to be an adequate filler and excellent medium for bone formation. More studies in split-mouth design are needed to compare different bone substitutes.
不使用自体骨移植物或骨替代物进行鼻窦底提升将消除供体部位的发病率,并降低成本和感染风险。我们评估了在同一上颌骨中不使用移植物或使用骨替代物进行鼻窦膜提升后的骨增量。同时作为 1 期手术植入牙种植体。
在分口设计中,我们进行了一项随机双盲临床试验,在 10 名健康患者(n=20)中进行鼻窦提升和同时植入。在 1 个部位,我们进行了无移植物鼻窦提升(第 1 组),而在另一个部位,Cerabone 用作骨替代物(第 2 组)。通过影像学和组织形态计量学评估和比较每个窦腔中获得的骨量和质量。
6 个月后,第 1 组和第 2 组的平均骨高度增加分别为 6.21 和 9.58mm(P<.001,P<.001)。组织形态计量学检查显示第 1 组的小梁和骨形成厚度明显较高(P=.003 和 P=.002)。然而,新生血管化更高,但不显著(P=.288)。
两组的影像学骨增量相似。然而,组织形态计量学检查显示无移植物组的骨形成优于 Cerabone 组。血凝块似乎是一种合适的填充物和极好的骨形成介质。需要更多的分口设计研究来比较不同的骨替代物。