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Histomorphometric comparison of maxillary pristine bone and composite bone graft biopsies obtained after sinus augmentation
Journal article   Peer reviewed

Histomorphometric comparison of maxillary pristine bone and composite bone graft biopsies obtained after sinus augmentation

Pablo Galindo-Moreno, Ildefonso Moreno-Riestra, Gustavo Avila, Juan Emilio Fernández-Barbero, Francisco Mesa, Mariano Aguilar, Hom-Lay Wang and Francisco O'Valle
Clinical oral implants research, Vol.21(1), pp.122-128
01/2010
DOI: 10.1111/j.1600-0501.2009.01814.x
PMID: 19845707
url
https://hdl.handle.net/2027.42/78644View
Open Access

Abstract

Sinus grafting is a technique oriented to facilitate implant placement in posterior atrophic maxillae. Several modifications of the original technique and a wide variety of materials have been proposed; most of them associated with implant survival rates. However, the quality of the bone obtained after the application of certain grafting materials has not been fully elucidated yet. The aims of this multicenter study were to analyse histomorphometrical samples obtained 6 months after sinus grafting using a composite graft consisting of anorganic bovine bone (ABB)+ autologous bone (AB), and to compare these samples with maxillary pristine bone biopsies. Ninety maxillary sinus augmentations were performed for delayed implant placement (N = 90) in 45 consecutive patients (test group). Bone cores were harvested 6 months after grafting for histomorphometric and ultrastructural study. Control pristine bone biopsies were taken from the posterior maxilla of 10 patients (control). Bone radiographic changes were assessed up to 24 months after implant loading. The total mean values after analysis of test cores revealed a proportion of 46.08 + or - 16.6% of vital bone, 42.27 + or - 15.1% of non-mineralized connective tissue, and 37.02 + or - 25.1% of the remaining ABB particles. Significant bone remodeling activities were noticed in sinus grafting samples when compared with pristine bone. A statistically significant difference was observed in the number of osteoid lines between two groups, with higher values in the test one (15.1 + or - 11.48% vs. 2.5 + or - 2.2%, P = 0.0005). Ultrastructural study showed that vital trabecular bone was in intimal contact with ABB particles. Radiographic analysis revealed that the higher the proportion of remaining ABB, the lower the total vertical resorption of the graft. Sinus grafting constitutes an excellent model for the study of de novo bone formation patterns and graft consolidation, when a combination of different bone substitutes is applied. The combination of ABB+AB yields highly satisfactory outcomes from both a clinical and a histologic perspective.
Osteogenesis - physiology Prospective Studies Humans Middle Aged Bone Substitutes - pharmacology Maxilla - ultrastructure Male Maxilla - surgery Bone Matrix - transplantation Cattle Dental Implantation, Endosseous Maxillary Sinus - diagnostic imaging Adult Female Alveolar Ridge Augmentation - methods Maxilla - diagnostic imaging Osseointegration - physiology Treatment Outcome Biocompatible Materials - pharmacology Maxillary Sinus - surgery Radiography Animals Biopsy Aged Bone Transplantation - methods

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