Quiñones C R, Hürzeler M B, Schüpbach P, Arnold D R, Strub J R, Caffesse R G
IberoAmerican Institute of Periodontology and Oral Implantology, San Juan, PR, USA.
Clin Oral Implants Res. 1997 Dec;8(6):497-505. doi: 10.1034/j.1600-0501.1997.080608.x.
The aim of this study was to evaluate clinically, histologically and histometrically the use of hydroxyapatite-coated dental implants in conjunction with maxillary sinus augmentation procedures. In 4 adult male Rhesus monkeys (Macaca mulatta) the 3 maxillary molars on 1 side of the jaws were extracted and the remaining bone between the alveolar crest and the floor of the sinus was reduced to 3-4 mm. After 3 months, maxillary sinus augmentation procedures were performed in each monkey and the sinuses were grafted with a porous hydroxyapatite bone graft (Interpore-200). At the same time, 2 hydroxyapatite-coated cylinder implants (IMZ) were immediately placed into the augmented sinuses (i.e. simultaneous-implants-loaded group). Four months later, 2 additional similar implants were placed into the previously augmented sinuses (i.e. delayed-implants-loaded group). After 4 months, 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 removal of the maxillary molars was 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 and unloaded implants were stable the day of sacrifice. Histologically, the grafted sinuses exhibited a significant amount of new bone formation with integration of the porous hydroxyapatite graft particles and hydroxyapatite-coat of the dental implants to the new bone. Histometric analysis indicated that on the loaded side the implants placed simultaneously with the sinus lift procedure exhibited greater direct mineralized bone-to-implant contact than the delayed placed implants. In addition, the percentage of direct mineralized bone-to-implant contact was significantly greater in the residual bone in comparison to the augmented area in all groups. Loading of the implants exhibited a positive effect on the percentage of direct mineralized bone-to-implant contact in the augmented area. It could be concluded that hydroxyapatite-coated implants may be of benefit when used in conjunction with sinus augmentation procedures.
本研究旨在从临床、组织学和组织计量学方面评估羟基磷灰石涂层牙种植体与上颌窦提升术联合使用的效果。选取4只成年雄性恒河猴（猕猴），拔除一侧颌骨的3颗上颌磨牙，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，对每只猴子进行上颌窦提升术，并用多孔羟基磷灰石骨移植材料（Interpore - 200）对上颌窦进行植骨。同时，将2枚羟基磷灰石涂层圆柱状种植体（IMZ）立即植入植骨后的上颌窦内（即同期种植体加载组）。4个月后，再将另外2枚相似的种植体植入先前已植骨的上颌窦内（即延期种植体加载组）。4个月后，进行基台连接，所有4枚种植体均用金合金桥加载6个月（即直至处死动物）。每只猴子的对侧接受相同治疗，不同之处在于上颌磨牙的拔除时间比另一侧晚7个月，且该侧的种植体不加载。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）。临床上，处死当天，所有加载和未加载的种植体均稳定。组织学上，植骨后的上颌窦显示出大量新骨形成，多孔羟基磷灰石移植颗粒以及牙种植体的羟基磷灰石涂层与新骨融合。组织计量学分析表明，在上颌窦提升术同期植入种植体的加载侧，种植体与直接矿化骨的接触比延期植入的种植体更多。此外，与所有组的植骨区相比，剩余骨中种植体与直接矿化骨接触的百分比显著更高。种植体加载对植骨区种植体与直接矿化骨接触的百分比有积极影响。可以得出结论，羟基磷灰石涂层种植体与上颌窦提升术联合使用可能有益。
