title: Human histologic evaluation of the use of the dental putty for bone formation in the maxillary sinus: case series.
abstract: A proof-of-principle study was conducted to assess the safety and efficacy of dental putty as an alternative sinus augmentation biomaterial. Six healthy patients requiring a total of 10 sinus augmentations received sinus augmentations. All patients volunteered and signed an informed consent based on the Helsinki declaration of 1975, as revised in 2000. The sinus augmentation was performed under local anesthesia with a mucoperiosteal flap elevated to expose the buccal wall of the maxillary sinus. The space was then filled with the dental putty in several increments, and the window was covered with an absorbable collagen membrane. Biopsies were harvested from all 10 treated sinuses using a 3-mm trephine bur at the time of implant placement at either 6 or at 9 months after sinus augmentation. All patients completed the study without complications, except for 1 patient who reported fistulas at 1 and 2 months after the surgery. Clinical reentry revealed that regenerated bone on the osteotomy site was soft and immature. The ground sections of the biopsied cores revealed minimum amounts of trabeculation surrounded by an abundant array of irregular-shaped residual alloplastic particles embedded in loose connective tissue. The present study's findings revealed inadequate bone formation, although the material appears to be bioinert as there is no elicitation of inflammatory response.
authors.affiliation: Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Cambridge, MA, USA. dkim@hsdm.harvard.edu
authors.forename: David M
authors.initials: DM
authors.lastname: Kim
authors.forename: Myron
authors.initials: M
authors.lastname: Nevins
authors.forename: Marcelo
authors.initials: M
authors.lastname: Camelo
authors.forename: Marc L
authors.initials: ML
authors.lastname: Nevins
authors.forename: Peter
authors.initials: P
authors.lastname: Schupbach
authors.forename: Vinicius S
authors.initials: VS
authors.lastname: Rodrigues
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Fiorellini
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001706:Biopsy; D001861:Bone Regeneration / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use*; D002516:Ceramics / Q000627:therapeutic use*; D003094:Collagen; D003238:Connective Tissue / Q000473:pathology; D003751:Dental Fistula / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery*; D008567:Membranes, Artificial; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology*; D059745:Piezosurgery / Q000379:methods; D011183:Postoperative Complications; D016300:Radiography, Bitewing / Q000379:methods; D059546:Sinus Floor Augmentation / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D001672:Biocompatible Materials; C022107:Bioglass; D018786:Bone Substitutes; D008567:Membranes, Artificial; D003094:Collagen