title: Histological evaluation of healing after transalveolar maxillary sinus augmentation with bioglass and autogenous bone.
abstract: OBJECTIVE
  The aim was to evaluate histologically the outcome of a bioglass and autogenous bone (at 1 : 1 ratio) composite implantation for transalveolar sinus augmentation.
  
  
  METHODS
  In 31 patients, during implant installation ca. 4 months after sinus augmentation, biopsies were harvested through the transalveolar osteotomy by means of a trephine bur and non-decalcified sections through the long axis of the cylinder were produced. After a strict selection process, taking into account the presurgical residual bone height and biopsy length, 8 and 15 biopsies representing the new tissues formed inside the sinus and the transalveolar osteotomy, respectively, qualified for analysis. The tissue fractions occupied by newly formed bone (mineralized tissue+bone marrow), soft connective tissue, residual biomaterial+empty spaces, and debris inside the sinus cavity or the transalveolar osteotomy were estimated.
  
  
  RESULTS
  Bone and connective tissue fraction in the newly formed tissues inside the sinus cavity averaged 23.4 ± 13.2% and 54.1 ± 23.5%, respectively. Residual biomaterial, empty spaces, and debris averaged 1.9 ± 3.5%, 10.5 ± 6.3%, and 8.4 ± 14.5%, respectively. In the transalveolar osteotomy, bone and connective tissue fraction averaged 41.6 ± 14.3% and 46.1 ± 13%, respectively, while the amount of residual biomaterial, empty spaces, and debris was 2.8 ± 5%, 4.7 ± 1.9%, and 3.2 ± 2.6%, respectively. Statistically significant differences between the sinus cavity and the transalveolar osteotomy were found only for bone and empty spaces' values (P=0.02 and 0.04, respectively).
  
  
  CONCLUSIONS
  Sinus augmentation with a bioglass and autogenous bone composite is compatible with bone formation that, in a short distance from the floor of the sinus, shows similar density as that reported previously for other commonly used bone substitutes. New bone fraction inside the transalveolar osteotomy was almost twice as much as in the sinus cavity, while the amount of residual biomaterial was much less than that inside the sinus.
authors.affiliation: Department of Periodontology, School of Dentistry, University of Aarhus, Aarhus, Denmark. stavropoulos@odont.au.dk
authors.forename: Andreas
authors.initials: A
authors.lastname: Stavropoulos
authors.forename: Catalin
authors.initials: C
authors.lastname: Sima
authors.forename: Andrea
authors.initials: A
authors.lastname: Sima
authors.forename: Jens
authors.initials: J
authors.lastname: Nyengaard
authors.forename: Thorkild
authors.initials: T
authors.lastname: Karring
authors.forename: Anton
authors.initials: A
authors.lastname: Sculean
mesh_terms: D001706:Biopsy; D001861:Bone Regeneration; D016025:Bone Transplantation / Q000379:methods*; D002516:Ceramics / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000637:transplantation*; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D013516:Oral Surgical Procedures, Preprosthetic / Q000379:methods*; D010027:Osteotomy; D059546:Sinus Floor Augmentation / Q000379:methods*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: C022107:Bioglass