title: Tissue-engineered bone for maxillary sinus augmentation.
abstract: OBJECTIVE
  Autologous, allogenic, and alloplastic materials for bony reconstruction in the craniomaxillofacial region have specific drawbacks stimulating the ongoing search for new materials. Cultivated skin and mucosa grafts are in clinical routine use in head and neck reconstruction but so far, to the best of our knowledge, no successful clinical application has been described of periosteum-derived tissue-engineered bone for augmentation of the edentulous posterior maxilla.
  
  
  METHODS
  In a clinical study, augmentation of the posterior maxilla was carried out using a bone matrix derived from mandibular periosteum cells on an Ethisorb (Ethicon, Norderstedt, Germany) fleece. In this report, we show the fabrication of the matrix, clinical application, and results in 27 patients.
  
  
  RESULTS
  In 18 patients, an excellent clinical, radiologic, and histologic result could be proved 3 months after augmentation. Histologically, the bone biopsy samples from these patients revealed mineralized trabecular bone with remnants of the biomaterial. An unsuccessful result was found in 8 cases with a more extended augmentation procedure. The clinical inspection 3 months after augmentation showed almost no formation of new bone. In contrast, a replacement resorption with connective tissue was found. This may be the result of failure of the initial supply of the cells embedded within large cell-polymer constructs with sufficient oxygen and nutrients to sustain their survival and proliferation and allow for the integration of the developing tissue within the surrounding tissue.
  
  
  CONCLUSIONS
  Our achieved results suggest that periosteum-derived osteoblasts on a suitable matrix can form lamellar bone within 3 months after transplantation and provide a reliable basis for simultaneous or secondary insertion of dental implants.
authors.affiliation: Department of Maxillofacial Surgery, University Hospital Freiburg, Germany. praxis@kiefer-gesichtschirurgie.net
authors.forename: Ronald
authors.initials: R
authors.lastname: Schimming
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmelzeisen
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D001857:Bone Matrix / Q000166:cytology / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D003758:Dental Implantation, Endosseous; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000473:pathology / Q000601:surgery*; D008297:Male; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010006:Osteoblasts / Q000502:physiology; D010521:Periosteum / Q000166:cytology / Q000502:physiology; D023822:Tissue Engineering / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D018786:Bone Substitutes