title: Tissue-engineered polymer-based periosteal bone grafts for maxillary sinus augmentation: five-year clinical results.
abstract: OBJECTIVE
  Augmentation of the maxillary sinus with allogenic or alloplastic materials, as well as autologous bone grafts, has inherent disadvantages. Therefore, the aim of our study was to evaluate the long-term clinical repair effect of autologous periosteal bone grafts on atrophic maxillary bone.
  
  
  METHODS
  In the present retrospective cohort study, augmentation of the edentulous atrophic posterior maxilla was performed using autologous tissue-engineered periosteal bone grafts based on bioresorbable polymer scaffolds and, in a 1-step procedure, simultaneous insertion of dental implants. The clinical evaluation of 10 patients was performed by radiologic assessment of bone formation, with a follow-up of 5 years. Bone formation was further documented by measuring the bone height and by histologic examination.
  
  
  RESULTS
  Excellent clinical and radiologic results were achieved as early as 4 months after transplantation of the periosteal bone grafts. The bone height remained significantly (P < .05) greater (median 14.2 mm) than the preoperative atrophic bone (median 6.9 mm) during the 5-year observation period. Histologically, the bone biopsy specimens of 2 patients obtained after 6 months showed trabecular bone with osteocytes and active osteoblasts. No signs of bone resorption, formation of connective tissue, or necrosis were seen.
  
  
  CONCLUSIONS
  Our results suggest that the transplantation of autologous periosteal bone grafts and implantation of dental implants in a 1-step procedure is a reliable procedure that leads to bone formation in the edentulous posterior maxilla, remaining stable in the long term for a period of at least 5 years.
authors.affiliation: Laboratory for Tissue Engineering, Department of Rheumatology, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Trautvetter
authors.forename: Christian
authors.initials: C
authors.lastname: Kaps
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmelzeisen
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sauerbier
authors.forename: Michael
authors.initials: M
authors.lastname: Sittinger
mesh_terms: D020341:Absorbable Implants; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D001861:Bone Regeneration / Q000502:physiology; D016025:Bone Transplantation / Q000473:pathology*; D002508:Cephalometry / Q000379:methods; D015331:Cohort Studies; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000473:pathology / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery*; D010006:Osteoblasts / Q000473:pathology; D010011:Osteocytes / Q000473:pathology; D010012:Osteogenesis / Q000502:physiology; D010521:Periosteum / Q000637:transplantation*; D011108:Polymers / Q000737:chemistry; D012189:Retrospective Studies; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D020858:Tissue and Organ Harvesting / Q000379:methods; D014182:Transplantation, Autologous
chemical_list: D015921:Dental Implants; D011108:Polymers