title: Bone regeneration in sinus lifts: comparing tissue-engineered bone and iliac bone.
abstract: Lifting of the sinus floor is a standard procedure for bony augmentation that enables dental implantation. Although cultivated skin and mucosal grafts are often used in plastic and maxillofacial surgery, tissue-engineered bone has not achieved the same success. We present the clinical results of dental implants placed after the insertion of periosteum-derived, tissue-engineered bone grafts in sinus lifts. Periosteal cells were isolated from biopsy specimens of periosteum, resuspended and cultured. The cell suspension was soaked in polymer fleeces. The cell-polymer constructs were transplanted by sinus lift 8 weeks after harvesting. The patients (n=35) had either one or both sides operated on. Seventeen had a one-stage sinus lift with simultaneous implantation (54 implants). In 18 patients the implants were inserted 3 months after augmentation (64 implants). Selected cases were biopsied. A control group (41 patients: one stage=48 implants, two stage=135 implants) had augmentation with autologous bone only. They were followed up clinically and radiologically for at least 24 months. Both implants and augmentation were significantly more successful in the control group. Failure of augmentation of the tissue-engineered bone was more common after large areas had been augmented. Eleven implants were lost in the study group and only one in the control group. Lifting the sinus floor with autologous bone is more reliable than with tissue-engineered transplants. Although lamellar bone can be found in periosteum-derived, tissue-engineered transplants, the range of indications must be limited.
authors.affiliation: Department of Oral and Craniomaxillofacial Surgery, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Pit
authors.initials: P
authors.lastname: Voss
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sauerbier
authors.forename: Margit
authors.initials: M
authors.lastname: Wiedmann-Al-Ahmad
authors.forename: Christoph
authors.initials: C
authors.lastname: Zizelmann
authors.forename: Andres
authors.initials: A
authors.lastname: Stricker
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmelzeisen
authors.forename: Ralf
authors.initials: R
authors.lastname: Gutwald
mesh_terms: D000328:Adult; D000368:Aged; D018786:Bone Substitutes; D016025:Bone Transplantation; D002478:Cells, Cultured; D003239:Connective Tissue Cells / Q000637:transplantation*; D003758:Dental Implantation, Endosseous; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D013516:Oral Surgical Procedures, Preprosthetic / Q000379:methods*; D010513:Periodontal Ligament / Q000166:cytology*; D011100:Polyglycolic Acid; D023822:Tissue Engineering; D054457:Tissue Scaffolds
chemical_list: D018786:Bone Substitutes; C460779:Ethisorb; D011100:Polyglycolic Acid