title: High concentrations of bioactive glass material (BioGran) vs. autogenous bone for sinus floor elevation.
abstract: In this study, high concentrations of bioactive glass (BG) particles were compared with autogenous bone in their capacity to augment maxillary bone when grafted in the human sinus floor using a split mouth design. Three female patients with severe maxillary atrophy underwent bilateral sinus floor elevation and bone grafting using 80-100% BG particles (300-355 microm in size) mixed with 20% to 0% iliac crest bone particles at one (experimental) side, and 100% iliac crest derived bone particles at the other (control) side. A total of 22 bone biopsies was taken at the time of fixture installation; that is, at 4, 6 and 15 months after grafting, and processed for histology and histomorphometry. At the control (autogenous bone) sides, trabecular bone amounted to 39% of the biopsy volume in the graft (site) at 4 months, almost 41% at 6 months, and 42% at 15 months. This bone contained viable osteocytes and was mostly of mature, lamellar type. At the experimental (BG particles) sides, the graft consisted of 27% of mostly woven (and some lamellar) bone at 4 months, 36% (woven and lamellar) bone at 6 months, and 39% (mainly lamellar) bone at 15 months. The grafted BG particles started to excavate at 4 months and their centers gradually filled with bone tissue. As a consequence, the volume of BG particles in the biopsy decreased from 29% at 4 months to 15% at 6 months and 8% at 15 months. The BG particles appeared to resorb within 1-2 years by dissolution rather than by osteoclastic activity. Parameters for bone turnover (% osteoid surface, % resorption surface) indicated that bone remodeling was very active at both experimental and control sides, during more than 6 months. These results suggest that mixtures of mainly (80-90%) BG particles and some (10-20%) autogenous bone are effective for bone regeneration in the augmented sinus offer 6 months healing time, while about 12 months healing time is needed for 100% BG particles.
authors.affiliation: Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit, Amsterdam, The Netherlands. E.Tadjoedin.OCB.ACTA@medicalVU.NL
authors.forename: Ette S
authors.initials: ES
authors.lastname: Tadjoedin
authors.forename: Gert L
authors.initials: GL
authors.lastname: de Lange
authors.forename: D M
authors.initials: DM
authors.lastname: Lyaruu
authors.forename: Luit
authors.initials: L
authors.lastname: Kuiper
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Burger
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D001672:Biocompatible Materials / Q000737:chemistry / Q000627:therapeutic use*; D001706:Biopsy; D001857:Bone Matrix / Q000473:pathology; D001861:Bone Regeneration / Q000502:physiology; D016723:Bone Remodeling / Q000502:physiology; D018786:Bone Substitutes / Q000737:chemistry / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D005898:Glass / Q000737:chemistry; D006801:Humans; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010011:Osteocytes / Q000473:pathology; D012995:Solubility; D014182:Transplantation, Autologous; D014945:Wound Healing / Q000502:physiology
chemical_list: D001672:Biocompatible Materials; C073544:Biogran; D018786:Bone Substitutes; D015921:Dental Implants