Browse > Article

SINUS FLOOR GRAFTING USING CALCIUM PHOSPHATE NANO-CRYSTAL COATED XENOGENIC BONE AND AUTOLOGOUS BONE  

Pang, Kang-Mi (Dept. of Oral & Maxillofacial Surgery, College of Dentistry, Seoul National University)
Li, Bo-Han (Dept. of Oral & Maxillofacial Surgery, College of Dentistry, Seoul National University)
Alrashidan, Mohamed (Dept. of Oral & Maxillofacial Surgery, College of Dentistry, Seoul National University)
Yoo, Sang-Bae (Dental Research Institute, Seoul National University)
Sung, Mi-Ae (Department of Craniofacial Structure & Functional Biology, College of Dentistry, Seoul National University)
Kim, Soung-Min (Dept. of Oral & Maxillofacial Surgery, College of Dentistry, Seoul National University)
Jahng, Jeong-Won (Dental Research Institute, Seoul National University)
Kim, Myung-Jin (Dept. of Oral & Maxillofacial Surgery, College of Dentistry, Seoul National University)
Ko, Jea-Seung (Oscotech Co.)
Lee, Jong-Ho (Dept. of Oral & Maxillofacial Surgery, College of Dentistry, Seoul National University)
Publication Information
Maxillofacial Plastic and Reconstructive Surgery / v.31, no.3, 2009 , pp. 243-248 More about this Journal
Abstract
Purpose: Rehabilitation of the edentulous posterior maxilla with dental implants often poses difficulty because of insufficient bone volume caused by pneumatization of the maxillary sinus and by crestal bone resorption. Sinus grafting technique was developed to increase the vertical height to overcome this problem. The present study was designed to evaluate the sinus floor augmentation with anorganic bovine bone (Bio-$cera^{TM}$) using histomorphometric and clinical measures. Patients and methods: Thirteen patients were involved in this study and underwent total 14 sinus lift procedures. Residual bone height was ${\geq}2mm$ and ${\leq}6mm$. Lateral window approach was used, with grafting using Bio-$cera^{TM}$ only(n=1) or mixed with autogenous bone from ramus and/or maxillary tuberosity(n=13). After 6 months of healing, implant sites were created with 3mm diameter trephine and biopsies taken for histomorphometric analysis. The parameters assessed were area fraction of new bone, graft material and connective tissue. Immediate and 6 months after grafting surgery, and 6 months after implantation, computed tomography (CT) was taken and the sinus graft was evaluated morphometric analysis. After implant installation at the grafted area, the clinical outcome was checked. Results: Histomorphometry was done in ten patients.Bio-$cera^{TM}$ particles were surrounded by newly formed bone. The graft particles and newly formed bone were surrounded by connective tissue including small capillaries in some fields. Imaging processing revealed $24.86{\pm}7.59%$ of new bone, $38.20{\pm}13.19%$ connective tissue, and $36.92{\pm}14.51%$ of remaining Bio-$cera^{TM}$ particles. All grafted sites received an implant, and in all cases sufficient bone height was achieved to install implants. The increase in ridge height was about $15.9{\pm}1.8mm$ immediately after operation (from 13mm to 19mm). After 6 months operation, ridge height was reduced about $11.5{\pm}13.5%$. After implant installation, average marginal bone loss after 6 months was $0.3{\pm}0.15mm$. Conclusion: Bio-$cera^{TM}$ showed new bone formation similar with Bio-$Oss^{(R)}$ histomorphometrically and appeared to be an effective bone substitute in maxillary sinus augmentation procedure with the residual bone height from 2 to 6mm.
Keywords
Calcium phosphate nano-crystal coated xenograft; Sinus floor grafting; Histomorphometric analysis;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Froum SJ, Wallace SS, Cho SC, Nicolas E, Tarnow DP: Histomorphometric comparison of a biphasic bone ceramic to anorganic bovine bone for sinus augmentation: 6- to 8- month postsurgical assessment of vital bone formation. A pilot study. The International Journal of Periodontics & Restorative Dentistry 28 : 273, 2008
2 Buser D, Mericske-Stern R, Bernard JP, Behneke A, Behneke N, Hirt HP, Belser UC, Lang NP: Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants. Clin Oral Implants Res 8 : 161, 1997   DOI   ScienceOn
3 Valentini P, Abensur D, Densari D, Graziani J, Hammerle C: Histological evaluation of Bio-Oss in a 2-stage sinus floor elevation and implantation procedure. Clin Oral Implants Res 9 : 59, 1998   DOI   ScienceOn
4 Daculsi G: Biphasic calcium phosphateconcept applied to artificial bone, implant coating and injectable bone substitute. Biomaterials 19 : 1473, 1998   DOI   PUBMED   ScienceOn
5 Zijderveld SA, Schulten EA, Aartman IH, Ten Bruggenkate CM: Long-term changes in graft height after maxillary sinus floor elevation with different grafting materials: radiographic evaluation with a minimum followup of 4.5 years. Clin Oral Implants Res. 2009   DOI   ScienceOn
6 Sung SJ, Chung HJ, Park HJ, Kim OS, Kim YJ: The effect of the Ca-P coated DBBP on osseous regeneration in the rat calvarial bone defect. The Journal of the Korean Academy of Periodontology 34 : 475, 2004
7 Traini T, Degidi M, Sammons R, Stanley P, Piattelli A: Histologic and elemental microanalytical study of anorganic bovine bone substitution following sinus floor augmentation in humans. J Periodontol 79 : 1232, 2008   DOI   ScienceOn
8 Yildirim M, Spiekermann H, Biesterfeld S, Edelhoff D: Maxillary sinus augmentation using xenogenic bone substitute material Bio-Oss in combination with venous blood. Clin Oral Implants Res 11 : 217, 2000   DOI   ScienceOn
9 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 18 : 528, 1998
10 Lee Y-M, Shin S-Y, Kim J-Y: Bone reaction to bovine hydroxyapatite for maxillary sinus floor augmentation: Histologic results in humans. Int J Periodontics Restorative Dent 26 : 471, 2006
11 Wallace SS, Froum SJ: Effect of maxillary sinus augmentation on the survival of endosseous dental implants. A systematic review. Ann Periodontol 8 : 328, 2003   DOI   ScienceOn
12 Boyne PJ, James RA: Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg 38 : 613, 1980   PUBMED
13 Moy PK, Lundgren S, Holmes RE: Maxillary sinus augmentation: histomorphometric analysis of graft materials for maxillary sinus floor augmentation. J Oral Maxillofac Surg 51 : 857, 1993   DOI   ScienceOn
14 Fugazzotto P, Vlassis J: Long-term success of sinus augmentation using various surgical approaches and grafting materials. Int J Oral Maxillofac Implants 13 : 52, 1998