title: Highly porous hydroxyapatite with and without local harvested bone in sinus floor augmentation: a histometric study in pigs.
abstract: OBJECTIVE
  Sinus floor augmentation with autologous bone is an accepted treatment option in dental implantology. In this study, an entirely synthetic, nano-structured, hydroxyapatite-based bone substitute material (SBSM, NanoBone(®); Artoss, Rostock, Germany) was supplemented with a mixture of locally harvested bone to enhance osteogenesis.
  
  
  METHODS
  Bilateral sinus augmentation procedures were performed in eight domestic pigs using the lateral window technique. On the right side (control), 2.6 ml of SBSM was used, and on the left side (test), 2.6 ml of SBSM with additional 15% (390 μl) autologous bone was used. At the time of augmentation, a titanium implant (ITI(®)) was inserted from a laterocaudal direction. After 3 months, the sites of augmentation were removed and examined in non-decalcified sections by microradiography and fluorescence microscopy of sequentially labelled specimens and histometry.
  
  
  RESULTS
  On both sides, a significant amount of newly formed bone was observed. However, a statistically significant difference in the bone-implant contact was observed in the control group (median, 28.9%) compared with the test side with the additional autologous bone (median, 40.6%) (P = 0.01). Different bone density was achieved from the coronal to apical surfaces (medians, 54.6%, 9.6%, and 27.5%) compared with the test side (medians, 55.2%, 40.6%, and 44.2%). The median of augmentation height was 8.6 mm on the control side and 11.5 mm on the test side (P = 0.01). Bone apposition was observed in both groups after 15 days.
  
  
  CONCLUSIONS
  The SBSM shows acceptable results in sinus floor augmentation. The additional use of locally harvested autologous bone enhances bone density and osseointegration of the implants.
authors.affiliation: Clinic of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Möller
authors.forename: Yahya
authors.initials: Y
authors.lastname: Acil
authors.forename: Falk
authors.initials: F
authors.lastname: Birkenfeld
authors.forename: Eleonore
authors.initials: E
authors.lastname: Behrens
authors.forename: Hendrik
authors.initials: H
authors.lastname: Terheyden
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltfang
mesh_terms: D000818:Animals; D018786:Bone Substitutes / Q000737:chemistry / Q000494:pharmacology*; D016025:Bone Transplantation / Q000379:methods*; D017886:Durapatite / Q000737:chemistry / Q000494:pharmacology*; D005260:Female; D008852:Microradiography; D008856:Microscopy, Fluorescence; D049329:Nanostructures; D010012:Osteogenesis / Q000187:drug effects*; D016062:Porosity; D059546:Sinus Floor Augmentation / Q000379:methods*; D013552:Swine
chemical_list: D018786:Bone Substitutes; D017886:Durapatite
keywords: NanoBone; autologous bone; bone graft; sinus floor augmentation