Hürzeler M B, Quiñones C R, Kirsch A, Schüpbach P, Krausse A, Strub J R, Caffesse R G
Department of Prosthodontics, Albert-Ludwigs-University, Freiburg, Germany.
Clin Oral Implants Res. 1997 Oct;8(5):401-11. doi: 10.1034/j.1600-0501.1997.080507.x.
The aim of this study was to evaluate clinically, histologically, and histometrically the use of autogenous bone combined with porous hydroxyapatite (Interpore 200) as a grafting material for maxillary sinus augmentation procedures. In 4 adult male rhesus monkeys (Macaca mulatta) the 1st, 2nd and 3rd maxillary molars on one side of the jaws were extracted. After a healing period of 3 months, maxillary sinus augmentation procedures were performed in each monkey, and the sinuses were grafted with autogenous bone from the monkeys' tibia mixed in a 3:1 ratio with porous hydroxyapatite. At the same time, 2 pure titanium plasma-sprayed IMZ cylinder implants were immediately placed into the augmented sinuses (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 of the animals). The contralateral side of each monkey received similar treatment with the exception that the extractions were performed 7 months after those in the opposite side and that the implants 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 a significant amount of new bone formation. The porous hydroxyapatite granules appeared integrated with the newly formed bone. Histometric analyses revealed that delayed implant placement resulted in a greater amount of direct mineralized bone-to-implant contact in the augmented area than the simultaneous implant placement. Furthermore, the percentage of direct mineralized bone-to-implant contact was far more significant in the residual bone than in the augmented area. It was concluded that the autogenous bone/porous hydroxyapatite graft combination enhanced bone formation and mineralized bone-to-implant contact in the augmented sinuses and that the delayed implant placement may be favorable for sinus augmentation procedures.
本研究旨在从临床、组织学和组织计量学方面评估自体骨联合多孔羟基磷灰石（Interpore 200）作为上颌窦提升术移植材料的应用情况。在4只成年雄性恒河猴（猕猴）中，拔除一侧颌骨的第一、第二和第三上颌磨牙。经过3个月的愈合期后，对每只猴子进行上颌窦提升术，并用取自猴子胫骨的自体骨与多孔羟基磷灰石按3:1的比例混合后植入窦内。同时，将2枚纯钛等离子喷涂IMZ圆柱种植体立即植入提升后的窦内（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提升的窦内（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类似治疗，但拔牙时间比另一侧晚7个月，且种植体不加载。因此，又得到另外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）。临床检查发现，处死时所有加载种植体均稳定。组织学检查显示，移植后的窦内有大量新骨形成。多孔羟基磷灰石颗粒似乎与新形成的骨整合在一起。组织计量学分析表明，延期植入种植体比同期植入种植体在提升区域产生更多的直接矿化骨与种植体接触。此外，直接矿化骨与种植体接触的百分比在剩余骨中比在提升区域更显著。得出的结论是，自体骨/多孔羟基磷灰石移植组合可促进提升后的窦内骨形成和矿化骨与种植体接触，且延期植入种植体可能有利于上颌窦提升术。
