Margolin M D, Cogan A G, Taylor M, Buck D, McAllister T N, Toth C, McAllister B S
Department of Periodontology, Oregon Health Sciences University, Portland, USA.
J Periodontol. 1998 Aug;69(8):911-9. doi: 10.1902/jop.1998.69.8.911.
The posterior maxilla has traditionally been one of the most difficult areas to successfully place dental implants due to poor bone quality and close approximation to the maxillary sinus. Sinus augmentation procedures have become a viable means of assuring adequate bone for the placement of dental implants in this area. However, with the techniques currently employed, a considerable variation in the quality of bone attained with the sinus augmentation procedure exists. The purpose of this in vivo study was to evaluate the healing response and bone formation stimulated by 3 doses of recombinant human osteogenic protein-1 (rhOP-1), 0.25, 0.6, and 2.5 mg OP-1 per gram of collagen matrix; natural bone mineral; or collagen matrix alone (control) placed in the maxillary sinus of adult chimpanzees. Results were assessed using clinical, histologic, and radiographic techniques. Radiographic analysis of the computed tomography scans taken at 1 week, and 2.5, 4.5, and 6.5 months revealed a more rapid mineralization with the 2.5 mg OP-1/g collagen matrix and natural bone mineral treatment groups. The incremental bone mineral density (BMD) increase for these 2 treatments from 1 week to 2.5 months was over 2.5 times the increase found with the collagen matrix alone; these 2 treatments also had a higher BMD at the most superior slices evaluated when compared to the other 3 groups. Biopsy specimens were taken at 3.5, 5.5, and 7.5 months and for all 5 treatment groups bone formation was observed at all time points in the majority of the specimens. At 7.5 months the 2.5 and 0.6 mg OP-1/g collagen matrix treatment groups had an increase in the percent bone area when compared to the matrix alone control. In conclusion, these results demonstrate that sinus augmentation with natural bone mineral or 2.5 mg OP-1/g collagen matrix induce comparable radiographic and histologic evidence of bone formation and that both of these treatments performed superior to the control group of collagen matrix alone based upon all methods of evaluation.
由于骨质量差以及与上颌窦距离近，传统上后上颌骨一直是成功植入牙种植体最困难的区域之一。上颌窦提升术已成为确保该区域有足够骨量以植入牙种植体的可行方法。然而，就目前所采用的技术而言，上颌窦提升术后获得的骨质量存在相当大的差异。本体内研究的目的是评估3种剂量的重组人骨生成蛋白-1（rhOP-1）（每克胶原基质含0.25、0.6和2.5mg OP-1）、天然骨矿物质或仅胶原基质（对照）置于成年黑猩猩上颌窦后所刺激的愈合反应和骨形成。使用临床、组织学和影像学技术评估结果。对在1周、2.5、4.5和6.5个月时进行的计算机断层扫描的影像学分析显示，2.5mg OP-1/g胶原基质组和天然骨矿物质治疗组矿化更快。这两种治疗方法从1周到2.5个月的骨矿物质密度（BMD）增量增加是仅胶原基质组的2.5倍以上；与其他3组相比，在评估的最上方层面，这两种治疗方法的BMD也更高。在3.5、5.5和7.5个月时采集活检标本，所有5个治疗组在大多数标本的所有时间点均观察到骨形成。与仅基质对照相比，在7.5个月时，2.5和0.6mg OP-1/g胶原基质治疗组的骨面积百分比增加。总之，这些结果表明，天然骨矿物质或2.5mg OP-1/g胶原基质进行上颌窦提升可诱导类似的骨形成影像学和组织学证据，并且基于所有评估方法，这两种治疗方法均优于仅胶原基质的对照组。
