Mahesh Lanka, Mascarenhas Glenn, Bhasin Meenu Taneja, Guirado Calvo, Juneja Saurabh
Private Practitioner, The Specialist Clinic, Saket, New Delhi, India.
Private Practitioner, Mclin Dent, Mumbai, Maharashtra, India.
Natl J Maxillofac Surg. 2020 Jul-Dec;11(2):258-262. doi: 10.4103/njms.NJMS_81_19. Epub 2020 Dec 16.
Grafting in oral implantology involves bone augmentation procedures with various bone graft materials. Success of such procedures is evaluated through the amount of bone volume and bone formed at the grafted site. The primary aim of this prospective study was to histomorphometrically evaluate and compare the new bone formation with Bio Oss or Cerabone in the lateral approach sinus augmentation procedure.
The research targeted 22 patients who were either partially or completely edentulous posterior maxilla with residual alveolar height 3 mm at the site of implantation and underwent a two staged surgical protocol, with a lateral approach sinus grafting with either Bio Oss or Cerabone. Bone trephine biopsies for histological analysis were harvested 6 months after augmentation while preparing the osteotomies for implant placement trephine. The histologic evaluation was performed comparing the newly formed bone, marrow spaces, biomaterial particles remnants, and presence of osteocytes embedded in both trabecular bone and bone tissue near the anorganic bovine bone.
The present study showed that neither of the graft material showed any active osteoclasts and host inflammatory reaction. From sites grafted with Cerabone, an ample amount of mature lamellated bone formation was seen, also host inflammatory response was indicative of minimal reactive inflammatory response suggestive of good acceptability of the graft material by the host. No significant differences between the groups could be detected with regard to new bone formation and residual bone substitute.
The results of the study illustrates that both the bone substitute materials allow predictable new bone formation in sinus augmentation procedures.
口腔种植学中的植骨涉及使用各种骨移植材料进行骨增量手术。此类手术的成功通过移植部位形成的骨体积和骨量来评估。本前瞻性研究的主要目的是通过组织形态计量学评估和比较在外侧入路鼻窦增量手术中使用Bio Oss或Cerabone后的新骨形成情况。
该研究针对22例上颌后牙区部分或全部无牙、种植部位残余牙槽嵴高度为3 mm的患者，采用两阶段手术方案，通过外侧入路用Bio Oss或Cerabone进行鼻窦植骨。在增量6个月后，在准备种植体植入的环钻截骨术时采集骨环钻活检样本进行组织学分析。组织学评估比较了新形成的骨、骨髓腔、生物材料颗粒残余物，以及嵌入无机牛骨附近小梁骨和骨组织中的骨细胞的存在情况。
本研究表明，两种移植材料均未显示任何活跃的破骨细胞和宿主炎症反应。在使用Cerabone移植的部位，可见大量成熟的板层骨形成，宿主炎症反应也表明反应性炎症反应最小，提示宿主对移植材料具有良好的可接受性。在新骨形成和残余骨替代物方面，两组之间未检测到显著差异。
该研究结果表明，两种骨替代材料在鼻窦增量手术中均能实现可预测的新骨形成。
