title: Equine and porcine bone substitutes in maxillary sinus augmentation: a histological and immunohistochemical analysis of VEGF expression.
abstract: The aim of this work was to investigate the morphological structure and the expression of vascular endothelial growth factor (VEGF) after maxillary sinus augmentation through equine and porcine bone substitutes in humans. Ten patients showing edentulous posterior maxilla underwent maxillary sinus augmentation through particulate equine bone substitute and 10 patients through particulate porcine bone substitute. At the moment of implants insertion, 6 months after grafting, bone specimens were withdrawn and processed for morphological and immunohistochemical analyses. Notwithstanding the almost comparable clinical performances of both bone substitutes, histological results showed a better integration when an equine bone substitute was used compared to a porcine one. In particular, evident signs of particles resorption were observed in equine bone substitute group specimens compared to porcine ones. Immunohistochemical analysis showed a statistically significant increase of VEGF expression in equine compared to porcine bone substitute group specimens. These results showed both bone substitutes to achieve comparable clinical performance, indicating their successful use for bone regenerative procedures. However, in the same experimental time, equine group specimens showed evident resorption phenomena, whereas no or little signs of resorption were evident in the porcine group specimens. However, a more rapid and intense vascularization was achieved in equine bone substitute group, as demonstrated by immunohistochemical analysis for VEGF expression. Even if differences in vascularization significantly affect the clinical performance of a heterologous bone substitute, its ability to be resorbed is also very important in influencing long-term integration and long-term predictability of implant-prosthetic rehabilitation in regenerated sites.
authors.affiliation: From the *Departments of Medical, Oral and Biotechnological Sciences and †Pharmacy, University "G. d'Annunzio," Chieti-Pescara; ‡Department of Dentistry, University "Ateneo Vita-Salute S. Raffaele," Milan; §Pistoia (private practice); ∥Department of Medical Science, Faculty of Medicine, University of Eastern Piedmont, Novara; and ¶Oral Surgery Unit, Regina Margherita Pediatric Hospital, Turin, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tetè
authors.forename: Vincenzo Luca
authors.initials: VL
authors.lastname: Zizzari
authors.forename: Raffaele
authors.initials: R
authors.lastname: Vinci
authors.forename: Susi
authors.initials: S
authors.lastname: Zara
authors.forename: Umberto
authors.initials: U
authors.lastname: Di Tore
authors.forename: Marco
authors.initials: M
authors.lastname: Manica
authors.forename: Amelia
authors.initials: A
authors.lastname: Cataldi
authors.forename: Carmen
authors.initials: C
authors.lastname: Mortellaro
authors.forename: Adriano
authors.initials: A
authors.lastname: Piattelli
authors.forename: Enrico
authors.initials: E
authors.lastname: Gherlone
mesh_terms: D000818:Animals; D015519:Bone Density / Q000502:physiology; D001861:Bone Regeneration / Q000502:physiology; D001862:Bone Resorption / Q000209:etiology; D018786:Bone Substitutes / Q000737:chemistry / Q000627:therapeutic use*; D003094:Collagen / Q000737:chemistry / Q000627:therapeutic use*; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006736:Horses; D006801:Humans; D007150:Immunohistochemistry; D007575:Jaw, Edentulous / Q000473:pathology / Q000601:surgery; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010011:Osteocytes / Q000473:pathology; D010012:Osteogenesis / Q000502:physiology; D059745:Piezosurgery / Q000379:methods; D059546:Sinus Floor Augmentation / Q000379:methods*; D013552:Swine; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
chemical_list: D018786:Bone Substitutes; D015921:Dental Implants; D042461:Vascular Endothelial Growth Factor A; D003094:Collagen