Jensen O T, Sennerby L
Department of Surgical Dentistry, University of Colorado School of Dentistry, Denver, USA.
Int J Oral Maxillofac Implants. 1998 Jul-Aug;13(4):513-21.
In this study, a new approach involving placement and subsequent retrieval of titanium microimplants was employed for the histologic investigation of the implant-tissue interface in conjunction with maxillary sinus floor augmentation. Nine patients scheduled for sinus floor augmentation and simultaneous placement of Brånemark implants were included in the study. After a sinus graft procedure and placement of implants, an additional microimplant was placed into the graft through the lateral wall of the sinus. At abutment connection, the microimplants were retrieved using a 3- or 5-mm-wide trephine drill. Six specimens were retrieved after 6 to 14 months from sites augmented with particulate radiated mineralized cancellous allograft. Another six implants were retrieved after 6 to 12 months from maxillary sinuses augmented with particulate autogenous bone grafts. The histologic analysis showed distinct differences between the two types of grafts. The sites with autogenous bones grafts displayed a normal morphology of bone and bone marrow, including formation of bone on the surfaces of the grafted particles and remodeling of newly formed as well as grafted bone. The bone was more mature after 11 to 14 months than at 6 months. The allografted sites had a mixed morphologic appearance of newly formed bone and nonviable allograft particles (about 75% of the total bone area) in loose connective tissue. Significantly more bone was found at the autografted than at the allografted implants. The use of autogenous bone for augmentation of the maxillary sinus floor resulted in a greater amount of viable bone surrounding the implant; however, simultaneous placement of implants apparently resulted in a low proportion of bone-implant contact after 6 to 14 months irrespective of graft type.
在本研究中，采用了一种涉及植入和随后取出钛微种植体的新方法，用于对上颌窦底提升术中种植体 - 组织界面进行组织学研究。该研究纳入了9例计划进行窦底提升并同时植入Brånemark种植体的患者。在进行窦移植手术并植入种植体后，通过窦侧壁将一个额外的微种植体植入移植物中。在连接基台时，使用3毫米或5毫米宽的环钻取出微种植体。6至14个月后，从用颗粒状辐射矿化松质骨同种异体移植物提升的部位取出6个标本。另外6个种植体在6至12个月后从用颗粒状自体骨移植物提升的上颌窦中取出。组织学分析显示两种移植物之间存在明显差异。自体骨移植物部位显示出正常的骨和骨髓形态，包括在移植颗粒表面形成骨以及新形成骨和移植骨的重塑。11至14个月后的骨比6个月时更成熟。同种异体移植部位在疏松结缔组织中呈现出新形成骨和无活力同种异体移植颗粒（约占总骨面积的75%）的混合形态外观。自体移植种植体处发现的骨明显多于同种异体移植种植体处。使用自体骨进行上颌窦底提升可使种植体周围有更多的存活骨；然而，无论移植物类型如何，同时植入种植体在6至14个月后显然导致骨 - 种植体接触比例较低。
