Taniguchi Zenzaburo, Esposito Marco, Xavier Samuel Porfirio, Silva Erick Ricardo, Botticelli Daniele, Buti Jacopo, Baba Shunsuke
Int J Oral Maxillofac Implants. 2025 Jul 25;40(4):417-426. doi: 10.11607/jomi.11011.
To assess the efficacy and safety of a sticky dual-phase porcine-derived bone substitute compared to a similar dual-phase xenogeneic non-adhesive bone graft in the presence of induced perforations of the sinus membrane during sinus elevation procedures in a split-mouth rabbit model.
Bilateral sinus floor elevations were performed in 12 rabbits. The sinus mucosa was intentionally perforated using a blade on both sides and randomly filled with either a corticocancellous bone embedded in a 20% thermosensitive gel (sticky bone test group [GTO]) or a corticocancellous bone and 10% collagen (control group [mp3]). Healing progress was evaluated after 2 and 10 weeks in 12 animals (6 in each group) with CBCT imaging, microcomputed tomography (microCT), and histologic assessments.
One animal of the 2-week group died but was substituted. No other complications were observed. At the 2-week time point, CBCTs revealed that biomaterial particles were observed in the vicinity of the sinus membrane in two out of six sinuses of each group but never dispersed into the sinus. MicroCT and histology consistently revealed few granules beyond the elevated region. Histologically, five sinuses in the mp3 group and two sinuses in the GTO group exhibited granules outside the elevated region but in the vicinity of the perforations. In the 10-week groups, the number of affected sinuses decreased to one in the mp3 group and two in the GTO group. Throughout all observations, the graft granules consistently resided proximate to the elevated region. MicroCT demonstrated a reduction in the volume of the elevated region by approximately 12% after 2 weeks and 50% to 54% after 10 weeks.
The use of both sticky and non-sticky bone substitutes was observed to prevent a substantial amount of particles from extruding through an induced perforation of the sinus membrane. This suggests that it could be possible to use a sticky bone substitute as an alternative to a barrier membrane to avoid the extrusion of bone granules in the presence of accidental perforation of the sinus membrane in clinical practice. After 10 weeks of healing, the volume of the elevated region decreased by approximately 50%, possibly due to biomaterial resorption and loss through the surgically created perforation.
在兔双颌模型的鼻窦提升手术中，当存在诱导性鼻窦黏膜穿孔时，评估一种粘性双相猪源骨替代物与一种类似的双相异种非粘性骨移植材料相比的有效性和安全性。
对12只兔子进行双侧鼻窦底提升术。使用刀片在两侧故意造成鼻窦黏膜穿孔，并随机填充嵌入20%热敏凝胶的皮质骨松质骨（粘性骨试验组 [GTO]）或皮质骨松质骨和10%胶原蛋白（对照组 [mp3]）。在12只动物（每组6只）中，分别在2周和10周后通过CBCT成像、微型计算机断层扫描（microCT）和组织学评估来评估愈合进展。
2周组中有1只动物死亡但已被替换。未观察到其他并发症。在2周时间点，CBCT显示每组6个鼻窦中有2个在鼻窦黏膜附近观察到生物材料颗粒，但从未扩散到鼻窦中。MicroCT和组织学一致显示在提升区域之外几乎没有颗粒。组织学上，mp3组有5个鼻窦和GTO组有2个鼻窦在提升区域之外但在穿孔附近出现颗粒。在10周组中，受影响的鼻窦数量在mp3组降至1个，在GTO组降至2个。在所有观察中，移植颗粒始终位于提升区域附近。MicroCT显示提升区域的体积在2周后减少了约12%，在10周后减少了50%至54%。
观察到使用粘性和非粘性骨替代物均可防止大量颗粒通过诱导性鼻窦黏膜穿孔挤出。这表明在临床实践中，当鼻窦黏膜意外穿孔时，使用粘性骨替代物作为屏障膜的替代品以避免骨颗粒挤出是可能的。愈合10周后，提升区域的体积减少了约50%，这可能是由于生物材料的吸收以及通过手术造成的穿孔流失所致。
