Lim Ee Lian, Ngeow Wei Cheong, Kadir Kathreena, Naidu Murali
Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia.
Department of Anatomy, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
Biomimetics (Basel). 2023 Mar 10;8(1):115. doi: 10.3390/biomimetics8010115.
The maxilla is generally acknowledged as being more trabecular than the mandible. Allograft currently available for use in the maxillofacial region is harvested from the hip and long bones, irrespective of their local characteristics, and grafted onto the jawbones. Other alternative are autograft or commercially available bone substitutes. Due to their inherent differences, an in-depth understanding of the bone microarchitecture is important to develop the most compatible graft for use at the maxilla. This cross-sectional study aimed to determine the microstructures of bone harvested from different sites of the maxilla, to be used for standard setting. Forty-nine specimens from seven human cadavers were harvested from the zygomatic buttress, anterior maxillary sinus wall, anterior nasal spine and anterior palate. Each bone block, measuring of 10 mm × 5 mm, was harvested using rotary instruments. Bone analysis was performed following micro-computed tomography to obtain trabecular number (Tb.N), trabecular separation (Tb.Sp), trabecular thickness (Tb.Th), and bone volume fraction (BV/TV). There were site-related differences, with BV/TV that ranged between 37.38% and 85.83%. The Tb.N was the lowest at the palate (1.12 (mm)) and highest at the anterior maxillary sinus wall (1.41 (mm)) region. The palate, however, had the highest trabecular separation value (Tb.Sp) at 0.47 mm. The TB.Th was the lowest at the anterior nasal spine (0.34 mm) but both the zygoma and anterior maxillary sinus regions shared the highest Tb.Th (0.44 mm). Except for having the lowest Th.Sp (0.35 mm), the anterior maxillary sinus wall consistently showed higher values together with the zygomatic buttress in all other parameters. Concurring with current clinical practice of harvesting autograft from the zygomatic buttress and anterior maxillary sinus wall, their bony characteristic serve as the microarchitecture standard to adopt when developing new bone graft materials for use in the maxilla.
一般认为上颌骨比下颌骨的骨小梁更多。目前可用于颌面区域的同种异体骨是从髋部和长骨获取的，而不考虑其局部特征，然后移植到颌骨上。其他替代方法是自体骨移植或市售骨替代物。由于它们固有的差异，深入了解骨微结构对于开发最适合上颌骨使用的移植物很重要。这项横断面研究旨在确定从不同上颌骨部位获取的骨的微观结构，以用于标准设定。从七具人类尸体上获取了49个标本，取自颧突、上颌窦前壁、前鼻棘和前腭。每个10毫米×5毫米的骨块使用旋转器械获取。在微型计算机断层扫描后进行骨分析，以获得骨小梁数量（Tb.N）、骨小梁间距（Tb.Sp）、骨小梁厚度（Tb.Th）和骨体积分数（BV/TV）。存在部位相关差异，BV/TV在37.38%至85.83%之间。Tb.N在腭部最低（1.12（毫米）），在上颌窦前壁区域最高（1.41（毫米））。然而，腭部的骨小梁间距值（Tb.Sp）最高，为0.47毫米。Tb.Th在前鼻棘处最低（0.34毫米），但颧骨和上颌窦前区域的Tb.Th最高（0.44毫米）。除了具有最低的Th.Sp（0.35毫米）外，上颌窦前壁在所有其他参数上与颧突一起始终显示出较高的值。与目前从颧突和上颌窦前壁获取自体骨的临床实践一致，它们的骨特征可作为开发用于上颌骨的新型骨移植材料时采用的微结构标准。
