Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Effect of the size of the bony access window and the collagen barrier over the window in sinus floor elevation: a preclinical investigation in a rabbit sinus model

  • Sim, Jeong-Eun (Department of Dentistry, Graduate School, Kyung Hee University) ;
  • Kim, Sangyup (Department of Dentistry, Graduate School, Kyung Hee University) ;
  • Hong, Ji-Youn (Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University) ;
  • Shin, Seung-Il (Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University) ;
  • Chung, Jong-Hyuk (Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University) ;
  • Lim, Hyun-Chang (Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University)
  • Received : 2021.11.03
  • Accepted : 2022.03.02
  • Published : 2022.08.31
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Abstract

Purpose: The aim of this study was to investigate the effect of (1) the size of the bony access window and (2) collagen membrane coverage over the window in sinus floor elevation in a rabbit sinus model. Methods: Small bony access windows (SW; ø 2.8 mm) were made in 6 rabbits and large windows (LW; ø 6 mm) in 6 other rabbits. Both sinuses in each rabbit were allocated to groups with or without coverage of a collagen membrane (CM) on the window, resulting in 4 groups: SW, LW, SW+CM, and LW+CM. After 4 weeks of healing, micro-computed tomographic, histologic, and histomorphometric analyses were performed. Results: Bony healing in the window area was incomplete in all groups, but most bone graft particles were well confined in the augmented cavity. Histologically, the pattern of new bone formation was similar in all groups. Histomorphometrically, the percentage of newly formed bone was greater in the groups with CM than in the groups without CM, and in the groups with SW than in the groups with LW (12.92%±6.40% in the SW+CM group, 4.21%±7.73% in the SW group, 10.45%±4.81% in the LW+CM group, 11.77%±3.83% in the LW group). The above differences were not statistically significant (P>0.05). Conclusions: The combination of a small bony access window and the use of a collagen membrane over the window favored new bone formation compared to other groups, but this result should be further investigated due to the limitations of the present animal model.

Keywords

Acknowledgement

The authors appreciate the research team at the Department of Periodontology, Kyung Hee University. The bone substitute materials (Maxpore) were kindly supported by Shinhung.

References

  1. Chiapasco M, Zaniboni M. Methods to treat the edentulous posterior maxilla: implants with sinus grafting. J Oral Maxillofac Surg 2009;67:867-71. https://doi.org/10.1016/j.joms.2008.11.023
  2. Chao YL, Chen HH, Mei CC, Tu YK, Lu HK. Meta-regression analysis of the initial bone height for predicting implant survival rates of two sinus elevation procedures. J Clin Periodontol 2010;37:456-65. https://doi.org/10.1111/j.1600-051X.2010.01555.x
  3. Wallace SS, Froum SJ. Effect of maxillary sinus augmentation on the survival of endosseous dental implants. A systematic review. Ann Periodontol 2003;8:328-43. https://doi.org/10.1902/annals.2003.8.1.328
  4. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol 2008;35 Suppl:216-40. https://doi.org/10.1111/j.1600-051X.2008.01272.x
  5. Duttenhoefer F, Souren C, Menne D, Emmerich D, Schon R, Sauerbier S. Long-term survival of dental implants placed in the grafted maxillary sinus: systematic review and meta-analysis of treatment modalities. PLoS One 2013;8:e75357.
  6. Ohayon L, Taschieri S, Friedmann A, Del Fabbro M. Bone graft displacement after maxillary sinus floor augmentation with or without covering barrier membrane: a retrospective computed tomographic image evaluation. Int J Oral Maxillofac Implants 2019;34:681-91. https://doi.org/10.11607/jomi.6940
  7. Barone A, Ricci M, Grassi RF, Nannmark U, Quaranta A, Covani U. A 6-month histological analysis on maxillary sinus augmentation with and without use of collagen membranes over the osteotomy window: randomized clinical trial. Clin Oral Implants Res 2013;24:1-6.
  8. Imai H, Lang NP, Ferri M, Hirota A, Apaza Alccayhuaman KA, Botticelli D. Tomographic assessment on the influence of the use of a collagen membrane on dimensional variations to protect the antrostomy after maxillary sinus floor augmentation: a randomized clinical trial. Int J Oral Maxillofac Implants 2020;35:350-6. https://doi.org/10.11607/jomi.7843
  9. Wallace SS, Tarnow DP, Froum SJ, Cho SC, Zadeh HH, Stoupel J, et al. Maxillary sinus elevation by lateral window approach: evolution of technology and technique. J Evid Based Dent Pract 2012;12 Suppl:161-71. https://doi.org/10.1016/S1532-3382(12)70030-1
  10. Smiler DG. The sinus lift graft: basic technique and variations. Pract Periodontics Aesthet Dent 1997;9:885-93.
  11. Testori T, Wallace S. Surgical procedures: lateral window approach. Maxillary sinus surgery and alternatives in treatment. Chicago: Quintessence Publishing; 2009.
  12. Avila-Ortiz G, Wang HL, Galindo-Moreno P, Misch CE, Rudek I, Neiva R. Influence of lateral window dimensions on vital bone formation following maxillary sinus augmentation. Int J Oral Maxillofac Implants 2012;27:1230-8.
  13. Baldini N, D'Elia C, Bianco A, Goracci C, de Sanctis M, Ferrari M. Lateral approach for sinus floor elevation: large versus small bone window - a split-mouth randomized clinical trial. Clin Oral Implants Res 2017;28:974-81. https://doi.org/10.1111/clr.12908
  14. Lu W, Xu J, Wang HM, He FM. Influence of lateral windows with decreased vertical height following maxillary sinus floor augmentation: a 1-year clinical and radiographic study. Int J Oral Maxillofac Implants 2018;33:661-70. https://doi.org/10.11607/jomi.6213
  15. Scala A, Vina-Almunia J, Carda C, Martin de Llano JJ, Soto-Penaloza D, Penarrocha-Diago M, et al. Sequential healing of the elevated sinus floor with different size of antrostomy: a histomorphometric study in rabbits. Oral Maxillofac Surg 2020;24:403-10. https://doi.org/10.1007/s10006-020-00859-2
  16. Peleg M, Garg AK, Mazor Z. Healing in smokers versus nonsmokers: survival rates for sinus floor augmentation with simultaneous implant placement. Int J Oral Maxillofac Implants 2006;21:551-9.
  17. Kilkenny C, Browne WJ, Cuthill IC, Emerson M, Altman DG. Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. PLoS Biol 2010;8:e1000412.
  18. Lim HC, Zhang ML, Lee JS, Jung UW, Choi SH. Effect of different hydroxyapatite:β-tricalcium phosphate ratios on the osteoconductivity of biphasic calcium phosphate in the rabbit sinus model. Int J Oral Maxillofac Implants 2015;30:65-72. https://doi.org/10.11607/jomi.3709
  19. Lim HC, Son Y, Hong JY, Shin SI, Jung UW, Chung JH. Sinus floor elevation in sites with a perforated schneiderian membrane: What is the effect of placing a collagen membrane in a rabbit model? Clin Oral Implants Res 2018;29:1202-11. https://doi.org/10.1111/clr.13385
  20. Thoma DS, Lim HC, Sapata VM, Yoon SR, Jung RE, Jung UW. Recombinant bone morphogenetic protein-2 and platelet-derived growth factor-BB for localized bone regeneration. Histologic and radiographic outcomes of a rabbit study. Clin Oral Implants Res 2017;28:e236-43. https://doi.org/10.1111/clr.13002
  21. Kawakami S, Lang NP, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the height of the antrostomy in sinus floor elevation assessed by cone beam computed tomography- a randomized clinical trial. Int J Oral Maxillofac Implants 2019;34:223-32. https://doi.org/10.11607/jomi.7112
  22. Retzepi M, Donos N. Guided bone regeneration: biological principle and therapeutic applications. Clin Oral Implants Res 2010;21:567-76. https://doi.org/10.1111/j.1600-0501.2010.01922.x
  23. Sohn JY, Park JC, Um YJ, Jung UW, Kim CS, Cho KS, et al. Spontaneous healing capacity of rabbit cranial defects of various sizes. J Periodontal Implant Sci 2010;40:180-7. https://doi.org/10.5051/jpis.2010.40.4.180
  24. Froum SJ, Tarnow DP, Wallace SS, Rohrer MD, Cho SC. Sinus floor elevation using anorganic bovine bone matrix (OsteoGraf/N) with and without autogenous bone: a clinical, histologic, radiographic, and histomorphometric analysis--Part 2 of an ongoing prospective study. Int J Periodontics Restorative Dent 1998;18:528-43.
  25. Tarnow DP, Wallace SS, Froum SJ, Rohrer MD, Cho SC. Histologic and clinical comparison of bilateral sinus floor elevations with and without barrier membrane placement in 12 patients: part 3 of an ongoing prospective study. Int J Periodontics Restorative Dent 2000;20:117-25.
  26. Tawil G, Mawla M. Sinus floor elevation using a bovine bone mineral (Bio-Oss) with or without the concomitant use of a bilayered collagen barrier (Bio-Gide): a clinical report of immediate and delayed implant placement. Int J Oral Maxillofac Implants 2001;16:713-21.
  27. Cho YS, Hwang KG, Jun SH, Tallarico M, Kwon AM, Park CJ. Radiologic comparative analysis between saline and platelet-rich fibrin filling after hydraulic transcrestal sinus lifting without adjunctive bone graft: a randomized controlled trial. Clin Oral Implants Res 2020;31:1087-93. https://doi.org/10.1111/clr.13655
  28. Lopez MA, Andreasi Bassi M, Confalone L, Carinci F. Maxillary sinus floor elevation via crestal approach: the evolution of the hydraulic pressure technique. J Craniofac Surg 2014;25:e127-32. https://doi.org/10.1097/SCS.0000000000000457
  29. Tallarico M, Meloni SM, Xhanari E, Pisano M, Cochran DL. Minimally invasive sinus augmentation procedure using a dedicated hydraulic sinus lift implant device: a prospective case series study on clinical, radiologic, and patient-centered outcomes. Int J Periodontics Restorative Dent 2017;37:125-35. https://doi.org/10.11607/prd.2914
  30. Lee EU, Lim HC, Hong JY, Lee JS, Jung UW, Choi SH. Bone regenerative efficacy of biphasic calcium phosphate collagen composite as a carrier of rhBMP-2. Clin Oral Implants Res 2016;27:e91-9. https://doi.org/10.1111/clr.12568
  31. Schmitz JP, Hollinger JO. The critical size defect as an experimental model for craniomandibulofacial nonunions. Clin Orthop Relat Res 1986:299-308.