Quiñones C R, Hürzeler M B, Schüpbach P, Kirsch A, Blum P, Caffesse R G, Strub J R
IberoAmerican Institute of Periodontology and Oral Implantology, San Juan, PR, USA.
Clin Oral Implants Res. 1997 Dec;8(6):487-96. doi: 10.1034/j.1600-0501.1997.080607.x.
The aim of this study was to evaluate clinically, histologically and histometrically the use of porous hydroxyapatite (i.e. Interpore-200) as a bone 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 and the remaining bone between the alveolar crest and the bottom of the sinus was 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 grafted with the porous hydroxyapatite. Two IMZ titanium plasma-sprayed cylinder implants were then immediately placed into the augmented sinus (i.e. simultaneous implants-loaded group). After 4 months, 2 additional similar implants were placed into the 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). 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. Histologic analysis demonstrated a significant amount of new bone formation in the augmented sinuses. Porous hydroxyapatite graft particles appeared to be integrated to the new bone. The percentage of direct mineralized bone-to-implant contact in the augmented area was greater on the delayed-placed implants than on the simultaneously-placed implants. Also, the percentage of direct mineralized bone-to-implant contact was greater in the residual bone than in the augmented area. It was concluded that this porous hydroxyapatite bone graft enhanced bone formation and bone-to-implant contact in the augmented sinuses and that the delayed implant placement in combination with the sinus augmentation procedure appears to result in a higher percentage of direct mineralized bone-to-implant contact.
本研究旨在从临床、组织学和组织计量学方面评估多孔羟基磷灰石（即Interpore-200）作为上颌窦提升术骨移植材料的应用。在4只成年雄性恒河猴（即猕猴）中，拔除一侧颌骨的第一、第二和第三上颌磨牙，并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，并用多孔羟基磷灰石移植窦腔。然后立即在增强的窦腔中植入2颗IMZ钛等离子喷涂圆柱种植体（即同期种植体加载组）。4个月后，在先前增强的窦腔中再植入2颗类似的种植体（即延期种植体加载组）。4个月后，进行基台连接，所有4颗种植体用金合金桥加载6个月（即直至处死）。每只猴子的对侧接受相同的治疗，但拔牙时间比另一侧晚7个月，且该侧的种植体不加载。因此，又获得了另外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）。临床上，所有加载种植体在处死当天均稳定。组织学分析表明，增强的窦腔中有大量新骨形成。多孔羟基磷灰石移植颗粒似乎与新骨整合。延期植入种植体的增强区域中直接矿化骨与种植体接触的百分比高于同期植入种植体。此外，剩余骨中直接矿化骨与种植体接触的百分比高于增强区域。得出的结论是，这种多孔羟基磷灰石骨移植增强了增强窦腔中的骨形成和骨与种植体的接触，并且延期种植体植入结合窦腔提升术似乎导致直接矿化骨与种植体接触的百分比更高。
