Two techniques for the preparation of cell-scaffold constructs suitable for sinus augmentation: steps into clinical application.
The objective of this clinical trial was the analysis of 2 methods for engineering of autologous bone grafts for maxillary sinus augmentation with secondary implant placement. Group 1 (8 patients, 12 sinuses): cells of mandibular periosteum were cultured in a good manufacturing practice laboratory (2 weeks) with autologous serum and then transferred onto a collagen matrix. After another week, these composites were transplanted into the sinuses. In group 2A (2 patients, 3 sinuses), cells of maxillary bone were cultivated with autologous serum for 2 weeks, seeded onto natural bone mineral (NBM, diameter [Ø] = 8 mm) blocks, and cultivated for another 1.5 months. These composites were transplanted into the sinuses. Group 2B (control, 3 patients, 5 sinuses) received NBM blocks alone. In the course of implant placement 6 (group 1) and 8 (group 2) months later, core biopsy were taken. Clinical follow-up period was 1 to 2.5 years in group 1 and approximately 7 years in groups 2A and 2B. New vital bone was found in all cases at median densities of 38% (n = 12) in group 1, 32% in group 2A (n = 3), and 25% in group 2B (n = 5). Differences between group 1 and 2B as well as 2A and 2B were statistically significant ( p = 0.025). No adverse effects were seen. All methods described were capable of creating new bone tissue with sufficient stability for successful implant placement.
Springer
Ingo N
IN
Department of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Nocini
Pier F
PF
Schlegel
Karl A
KA
De Santis
Daniele
D
Park
Jung
J
Warnke
Patrick H
PH
Terheyden
Hendrik
H
Zimmermann
Robert
R
Chiarini
Luigi
L
Gardner
Klaus
K
Ferrari
Francesca
F
Wiltfang
Jörg
J
D000328:Adult; D000368:Aged; D000818:Animals; D001284:Atrophy / Q000628:therapy; D001705:Bioprosthesis; D018786:Bone Substitutes; D017690:Cell Transplantation / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D008439:Maxillary Diseases / Q000628:therapy*; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D016348:Osseointegration; D010521:Periosteum / Q000473:pathology / Q000637:transplantation; D023822:Tissue Engineering / Q000379:methods; D014182:Transplantation, Autologous
D018786:Bone Substitutes