title: Histological observations on biopsies harvested following sinus floor elevation using a bioactive glass material of narrow size range.
abstract: We evaluated the bone augmenting capacity of bioactive glass particles, size range 300-355 microns (BG-particles), in human sinus floor elevations using histomorphometrical methods. A total of 10 patients underwent bilateral grafting, using a 1:1 mixture of autogenous bone particles (from iliac crest) and BG-particles at one side (experimental side), and bone particles only at the other side (control side, split mouth design). A total of 72 bone biopsies were taken at the time of fixture installation; that is, 3 patients at 4 months, 3 at 5 months and 3 at 6 months after grafting and 1 patient at 16 months (when she presented again). In each case 6 biopsies were taken, 3 left and 3 right. Histomorphometry showed that in grafts at control sides, trabecular bone was present after 4 months, comprising almost 41% of the tissue volume. This bone contained viable osteocytes and was of mature lamellar type and showed a mature histological appearance. Bone volume continued to increase slightly, to 42% at 5 months, 44% at 6 months and 45% at 16 months. The graft volume at experimental sides consisted at 4 months for 28% of woven and some lamellar bone, and increased to 35% at 5 months and 38% at 6 months, when mainly lamellar bone was found. At 16 months a lamellar bone volume of 45% was found. The BG-particles transformed and became excavated with time, starting at 4 months, and their centers gradually filled with bone tissue. All BG-particles had disappeared by resorption at 16 months after grafting and had been replaced by bone tissue. Parameters of bone turnover (% osteoid surface, % resorption surface, mineral apposition rate as measured by tetracycline labeling) indicated that bone remodeling was very active at both sides, during more than 6 months, despite the mature histological appearance of the bone tissue. From these histological observations, we conclude that a 1:1 mixture of autogenous bone/BG-particles seems a promising alternative to autogenous bone only, when low amounts of bone tissue are available for sinus augmentation.
authors.affiliation: Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit, Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
authors.forename: E S
authors.initials: ES
authors.lastname: Tadjoedin
authors.forename: G L
authors.initials: GL
authors.lastname: de Lange
authors.forename: P J
authors.initials: PJ
authors.lastname: Holzmann
authors.forename: L
authors.initials: L
authors.lastname: Kulper
authors.forename: E H
authors.initials: EH
authors.lastname: Burger
mesh_terms: D020341:Absorbable Implants; D001672:Biocompatible Materials / Q000737:chemistry / Q000627:therapeutic use*; D001706:Biopsy; D001857:Bone Matrix / Q000473:pathology; D016723:Bone Remodeling / Q000502:physiology; D001862:Bone Resorption / Q000473:pathology; D018786:Bone Substitutes / Q000737:chemistry / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D005260:Female; D005456:Fluorescent Dyes; D005500:Follow-Up Studies; D005898:Glass / Q000737:chemistry*; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010011:Osteocytes / Q000473:pathology; D010012:Osteogenesis / Q000502:physiology; D013752:Tetracycline
chemical_list: D001672:Biocompatible Materials; C073544:Biogran; D018786:Bone Substitutes; D015921:Dental Implants; D005456:Fluorescent Dyes; D013752:Tetracycline