Are culture-expanded autogenous bone cells a clinically reliable option for sinus grafting?
OBJECTIVE
This prospective clinical study was designed to examine the healing process during the first 12 months after sinus grafting (SG) with autogenous culture-expanded bone cells (ABC) and bovine bone mineral (BBM) histomorphometrically and radiologically.


METHODS
Twenty-two sinuses of 12 patients (mean age 56.2+/-9.3 years) were grafted. Four weeks before, SG bone biopsies were obtained with a trephine burr and the bone cells were isolated and expanded. Every sinus was grafted with BBM and ABC. After 6 months, a biopsy was taken from each sinus and implants (n=82) were placed. These were uncovered after another 6 months and fitted with dentures. The percent newly formed bone (NB) and the NB-to-BBM contact area were determined on undecalcified histologic sections. The sinus graft volume was evaluated by dental CT after SG (CT 1), after implant placement (CT 2) and after implant uncovery (CT 3).


RESULTS
Postoperative healing was uneventful. The NB was 17.9+/-4.6% and the contact area 26.8+/-13.1%. The graft volume (in mm(3)) was 2218.4+/-660.9 at the time of CT 1, 1694+/-470.4 at the time of CT 2 and 1347.9+/-376.3 at the time of CT 3 (P<.01). Three implants were lost after uncovery. Reimplantation and prosthodontic rehabilitation were successful throughout.


CONCLUSIONS
These results suggest that SG with ABC and BBM in a clinical setting provides a bony implant site which permits implant placement and will tolerate functional loading.
Fuerst
Gabor
G
Department of Oral Surgery, University School of Dentistry, Medical University of Vienna, Vienna, Austria. gabor.fuerst@meduniwien.ac.at
Strbac
Georg D
GD
Vasak
Christoph
C
Tangl
Stefan
S
Leber
Johanna
J
Gahleitner
Andre
A
Gruber
Reinhard
R
Watzek
Georg
G
D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001706:Biopsy; D001857:Bone Matrix / Q000637:transplantation; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D018929:Cell Culture Techniques; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use*; D016348:Osseointegration / Q000502:physiology; D010011:Osteocytes / Q000637:transplantation*; D010012:Osteogenesis / Q000502:physiology; D023861:Photography, Dental; D011446:Prospective Studies; D023822:Tissue Engineering / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
C077540:Bio-Oss; D018786:Bone Substitutes; D015921:Dental Implants; D008903:Minerals