title: Reimplantation of cultivated human bone cells from the posterior maxilla for sinus floor augmentation. Histological results from a randomized controlled clinical trial.
abstract: OBJECTIVE
  The aim of the present randomized clinical study was to evaluate histologically whether the addition of cultivated, autogenous bone cells to a composite graft of deproteinized bovine bone mineral (DBBM) and autogenous bone (AB) for sinus floor augmentation (SFA) enhance bone formation compared with what achieved after SFA with DBBM + AB alone.
  
  
  METHODS
  Twenty patients with remaining posterior maxillary alveolar crest height of less than 3 mm received SFA after randomization either with an DBBM and AB composite in a 1 : 1 ratio or with DBBM + AB supplemented with autogenous bone cells, which were cultivated from a bone biopsy harvested earlier from the tuberosity area. Four months after SFA, two cylindrical biopsies were taken from the augmented sinuses concomitantly with the implant site preparation by means of a trephine bur. An additional biopsy was taken from the tuberosity area. Bone density at the augmented sinus and the tuberosity area and the height of augmentation were estimated on non-decalcified histological sections prepared from the biopsies. A relative bone density index (RBD) was also calculated by dividing bone density at the augmented sinus with bone density at the tuberosity area.
  
  
  RESULTS
  All patients but one could receive two implants after SFA; in one patient, only one implant could be placed. All implants were osseointegrated and could be loaded. Median bone density in the sinus was 30% and 25% in the cell seeded and no-cells added DBBM + AB groups, respectively. Bone augmentation height averaged 6.0 and 5.4 mm and RBD averaged 0.48 and 0.73 in the cell seeded and no-cells added DBBM + AB groups, respectively. None of the differences between groups was statistically significant.
  
  
  CONCLUSIONS
  Cultivated autogenous bone cell seeded to a DBBM + AB composite did not significantly improve bone formation (density and height) after SFA, compared with what was achieved with DBBM + AB alone. Both approaches resulted into enough bone to support implant placement and osseointegration.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hilleroed Hospital/Rigshospitalet, Hilleroed, Denmark. nuhermund@hotmail.com
authors.forename: Niels Ulrich
authors.initials: NU
authors.lastname: Hermund
authors.forename: Andreas
authors.initials: A
authors.lastname: Stavropoulos
authors.forename: Ole
authors.initials: O
authors.lastname: Donatsky
authors.forename: Henrik
authors.initials: H
authors.lastname: Nielsen
authors.forename: Christian
authors.initials: C
authors.lastname: Clausen
authors.forename: Jesper
authors.initials: J
authors.lastname: Reibel
authors.forename: Bente
authors.initials: B
authors.lastname: Pakkenberg
authors.forename: Palle
authors.initials: P
authors.lastname: Holmstrup
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use; D015519:Bone Density; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000166:cytology*; D008875:Middle Aged; D016348:Osseointegration; D011862:Radiography, Panoramic; D059546:Sinus Floor Augmentation / Q000379:methods*; D018709:Statistics, Nonparametric; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D001672:Biocompatible Materials; D018786:Bone Substitutes