Hürzeler M B, Quiñones C R, Kirsch A, Gloker C, Schüpbach P, Strub J R, Caffesse R G
Department of Prosthodontics, Albert-Ludwigs-University, Freiburg, Germany.
Clin Oral Implants Res. 1997 Dec;8(6):476-86. doi: 10.1034/j.1600-0501.1997.080606.x.
The aim of this study was to evaluate clinically, histologically and histometrically the use of anorganic bovine bone matrix (i.e. Bio-oss) as a grafting material for maxillary sinus augmentation procedures. In 4 adult male rhesus monkeys (i.e. Macaca mulatta) the 1st, 2nd and 3rd maxillary molars on one side of the jaws were extracted. The remaining bone between the alveolar crest and the bottom of the sinus was then reduced to 3-4 mm. After 3 months, maxillary sinus augmentation procedures were performed on one side of the jaws in each monkey and the sinuses were grafted with the bovine bone matrix. At that time, 2 IMZ pure titanium plasma coated implants were immediately placed into the augmented sinuses (i.e. simultaneous implants-loaded group). After 4 months, 2 additional similar implants were placed into these previously augmented sinuses (i.e. delayed implants-loaded group). Four months later, the abutment connection was performed and all 4 implants were loaded with a gold-alloy bridge for 6 months (i.e. until sacrifice of the animals). The contralateral side of each monkey received the same treatment with the exception that the extractions were performed 7 months after those in the opposite side and that the implants in this side were not loaded. Thus, 2 additional study groups (i.e. simultaneous implants-unloaded group and delayed implants-unloaded group) were obtained. Clinically, all loaded implants were stable at the day of sacrifice. Histologically, the grafted sinuses exhibited significant bone formation with integration of the bovine bone matrix particles to the new bone. Direct mineralized bone-to-implant contact was greater for the delayed implant placement groups than for the implants installed simultaneously with the sinus augmentation. Furthermore, the percentage of direct mineralized bone-to-implant contact was greater in the residual bone than in the augmented area. It was concluded that the anorganic bovine bone matrix facilitated bone formation and implant osseointegration in the augmented sinuses and that the delayed implant placement in combination with the sinus augmentation procedure seemed to be preferable.
本研究旨在从临床、组织学和组织计量学方面评估无定形牛骨基质（即Bio-oss）作为上颌窦提升术移植材料的应用。选取4只成年雄性恒河猴（即猕猴），拔除一侧颌骨的第一、第二和第三上颌磨牙。然后将牙槽嵴与窦底之间的剩余骨量减少至3 - 4毫米。3个月后，对每只猴子一侧颌骨进行上颌窦提升术，并用牛骨基质移植窦腔。此时，立即在增宽的窦腔内植入2枚IMZ纯钛等离子涂层种植体（即同期种植体加载组）。4个月后，在这些先前增宽的窦腔内再植入2枚类似的种植体（即延期种植体加载组）。4个月后，进行基台连接，所有4枚种植体用金合金桥加载6个月（即直至处死动物）。每只猴子的对侧接受相同治疗，但拔牙时间比另一侧晚7个月，且该侧种植体不加载。由此获得另外2个研究组（即同期种植体未加载组和延期种植体未加载组）。临床方面，处死时所有加载种植体均稳定。组织学方面，移植的窦腔显示出显著的骨形成，牛骨基质颗粒与新骨融合。延期种植组的直接矿化骨与种植体接触比与窦腔提升同时植入的种植体更多。此外，直接矿化骨与种植体接触的百分比在剩余骨中比在增宽区域更高。得出的结论是，无定形牛骨基质促进了增宽窦腔内的骨形成和种植体骨整合，并且延期种植结合窦腔提升术似乎更可取。
