Histomorphometric and immunohistochemical analysis of human maxillary sinus-floor augmentation using porous β-tricalcium phosphate for dental implant treatment.
OBJECTIVE
This study utilized the constitution and expression of Runx2/Cbfa1 to conduct 6-month-post-operation histomorphometrical and histochemical analysis of osteocalcin in bone regeneration following sinus-floor augmentation procedures using β-tricalcium phosphate (β-TCP) and autogenous cortical bone.


METHODS
Thirteen sinuses of nine patients were treated with sinus-floor augmentation using 50% β-TCP and 50% autogenous cancellous bone harvested from the ramus of the mandible. Biopsies of augmented sinuses were taken at 6 months for histomorphometric and immunohistochemical measurements.


RESULTS
Runx2/Cbfa1- and osteocalcin-positive cells were found around TCP particles and on the bone surface. Approximately 60% of cells found around TCP particles stained positive for Runx2/Cbfa1. Fewer cells stained positive for osteocalcin. These positive cells decreased apically with increasing vertical distance from the maxillary bone surface. Histomorphometric analysis showed that the augmented site close to residual bone and periosteum contained approximately 42% bony tissue and 42% soft connective tissue, and the remaining 16% consisted of TCP particles. On the other hand, the augmented bone far from residual bone and periosteum contained 35% bony tissue and 50% soft connective tissue.


CONCLUSIONS
Our data suggest that TCP particles attract osteoprogenitor cells that migrate into the interconnecting micropores of the bone-substitute material by 6 months. The augmented site close to residual bone contained a higher proportion of bony tissue and a lower proportion of soft connective tissue than did the augmented site far from residual bone.
Division of Oral and Maxillofacial Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, Science of Physical Functions, Kyushu Dental College, Kitakyusyu City, Japan.
Shinji
S
Miyamoto
Kouhei
K
Shinmyouzu
Ikuya
I
Miyamoto
Kenji
K
Takeshita
Toshihisa
T
Terada
Tetsu
T
Takahashi
D001706:Biopsy; D001861:Bone Regeneration; D002130:Calcium Phosphates / Q000627:therapeutic use*; D050659:Core Binding Factor Alpha 1 Subunit / Q000378:metabolism; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D006801:Humans; D007150:Immunohistochemistry; D008443:Maxillary Sinus / Q000601:surgery*; D015675:Osteocalcin / Q000378:metabolism; D059546:Sinus Floor Augmentation / Q000379:methods*; D014057:Tomography, X-Ray Computed
D002130:Calcium Phosphates; D050659:Core Binding Factor Alpha 1 Subunit; D015921:Dental Implants; C493709:RUNX2 protein, human; C485817:beta-tricalcium phosphate; D015675:Osteocalcin