Salviano Saulo Henrique, Amorim Lopes João Carlos, Brum Igor da Silva, Frigo Lúcio, Dos Santos Mario José, Consonni Sílvio Roberto, de Carvalho Jorge José
Implantology Department, University São Leopoldo Mandic, Campinas, São Paulo, Brazil.
Implantology Department, Portuguese Catholic University, Lisboa, Portugal.
Int Med Case Rep J. 2021 Sep 29;14:697-706. doi: 10.2147/IMCRJ.S315757. eCollection 2021.
The development of techniques in biomaterials design and production added to advanced surgical procedures which enabled better and more predictable clinical outcomes. Maxillary sinus floor augmentation (MSFA) is among the more studied bone-guided regeneration procedure in the literature. The MSFA could be considered the gold standard procedure for bone-guided regeneration as it provides suitable functional and aesthetic solutions to alveolar ridge atrophy due to tooth loss.
This study aimed to conduct a detailed histomorphometric evaluation of collagen production in SFAs bone-guided regeneration, using nano-hydroxyapatite/ß-tricalcium phosphate (nano-HA/ß-TCP) composite.
A 52-year-old female had the left upper second premolar condemned due to periodontal disease, then a tooth implant replacement was planned. Due to maxillary sinus pneumatization, the MSFA had to be done before implant placement. Nano-HA/ß-TCP composite (2g) was used in the MSFA procedure. After nine months of the healing process, during the Cone Morse implant installation process, bone samples were collected for histologic analysis (sirius red, hematoxylin/eosin, polarized microscopy). Six months after implant installation, a ceramic crown was installed according to the patient's request.
Proper masticatory function and aesthetics were re-established. The histomorphometric evaluation indicated that nano-HA/ß-TCP composite did not show any area devoid of cellular activity in sirius red or hematoxylin/eosin staining and the percentage (%) of new bone collagen fibers was achieved using polarization technique evaluation.
According to these results, nano-HA/ß-TCP composite presented clinical and histomorphometric properties suit to be used as bone-guided regeneration biomaterial in MSFA. Furthermore, nano-HA/β-TCP composite provided a favorable nano-environment to bone cells, enhancing bone matrix production.
生物材料设计与生产技术的发展推动了先进外科手术的进步，从而实现了更好且更可预测的临床效果。上颌窦底提升术（MSFA）是文献中研究较多的骨引导再生手术之一。由于MSFA能为因牙齿缺失导致的牙槽嵴萎缩提供合适的功能和美学解决方案，故可被视为骨引导再生的金标准手术。
本研究旨在使用纳米羟基磷灰石/β - 磷酸三钙（nano - HA/β - TCP）复合材料，对MSFA骨引导再生中胶原蛋白的产生进行详细的组织形态计量学评估。
一名52岁女性因牙周病拔除左上第二前磨牙，随后计划进行牙齿种植修复。由于上颌窦气化，在种植体植入前必须先进行MSFA。在MSFA手术中使用了nano - HA/β - TCP复合材料（2g）。愈合过程9个月后，在进行锥形束种植体植入手术时，采集骨样本进行组织学分析（天狼星红、苏木精/伊红、偏光显微镜检查）。种植体植入6个月后，根据患者要求安装了陶瓷冠。
重建了正常的咀嚼功能和美观效果。组织形态计量学评估表明，在天狼星红或苏木精/伊红染色中，nano - HA/β - TCP复合材料未显示任何无细胞活性的区域，并且通过偏振技术评估得出了新骨胶原纤维的百分比（%）。
根据这些结果，nano - HA/β - TCP复合材料具有适合用作MSFA骨引导再生生物材料的临床和组织形态计量学特性。此外，nano - HA/β - TCP复合材料为骨细胞提供了有利的纳米环境，促进了骨基质的生成。
