Bone microbial contamination influences autogenous grafting in sinus augmentation.
BACKGROUND
The oral occurrence of putative microbial pathogens in humans has been documented in health and disease. The presence of periodontopathogens in patients with a history of periodontal disease may have a negative impact on bone regeneration. This investigation was conducted to confirm the presence of periodontal pathogens in bone particles harvested intraorally for maxillary sinus augmentation and to assess the clinical and radiographic outcomes 6 to 12 months after bone augmentation.


METHODS
Culture and polymerase chain reaction (PCR)-based identification were performed by paper-point sampling of intraorally harvested bone particles in a group of 12 maintenance patients undergoing maxillary sinus augmentation. Radiographs were taken to assess and compare bone healing and volume gain at baseline and at 6 to 12 months after augmentation.


RESULTS
The presence of periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans [previously Actinobacillus actinomycetemcomitans], Prevotella intermedia, Tannerella forsythia [previously T. forsythensis], Fusobacterium nucleatum, Parvimonas micra [previously Peptostreptococcus micros or Micromonas micros], Campylobacter rectus, enteric Gram-negative rods, and Dialister pneumosintes) was identified in 10 of 12 patients (83%) by culture, PCR, or both and was associated with greater bone volume loss at 6 months postaugmentation. The PCR-positive triad, P. gingivalis, A. actinomycetemcomitans, and P. intermedia, was associated with pronounced volume loss of the grafted sinus at 6 months.


CONCLUSIONS
To the best of our knowledge, this is the first study to confirm osseous microbial contamination with major periodontopathogens in individuals undergoing maxillary sinus augmentation with a history of periodontitis. The effect on the grafting outcome translated into bone volume loss in the grafted sinus 6 months postaugmentation. Specific microbial contamination may have an impact on osteogenesis in osseous regeneration.
Verdugo
Fernando
F
Private practice, Huntington Beach, CA, USA. fverdugo@perio.org
Castillo
Ana
A
Moragues
María D
MD
Pontón
José
J
D000328:Adult; D000368:Aged; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001439:Bacteroides / Q000302:isolation & purification; D001862:Bone Resorption / Q000382:microbiology; D016025:Bone Transplantation / Q000000981:diagnostic imaging / Q000379:methods*; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000382:microbiology*; D044883:Campylobacter rectus / Q000302:isolation & purification; D003758:Dental Implantation, Endosseous; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D016967:Fusobacterium nucleatum / Q000302:isolation & purification; D006085:Graft Survival; D016965:Gram-Negative Anaerobic Straight, Curved, and Helical Rods / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010462:Peptostreptococcus / Q000302:isolation & purification; D010518:Periodontitis / Q000382:microbiology*; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D018713:Prevotella intermedia / Q000302:isolation & purification; D011859:Radiography; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome; D048373:Treponema denticola / Q000302:isolation & purification