title: TRAP-Positive Multinucleated Giant Cells Are Foreign Body Giant Cells Rather Than Osteoclasts: Results From a Split-Mouth Study in Humans.
abstract: This study compared the material-specific tissue response to the synthetic, hydroxyapatite-based bone substitute material NanoBone (NB) with that of the xenogeneic, bovine-based bone substitute material Bio-Oss (BO). The sinus cavities of 14 human patients were augmented with NB and BO in a split-mouth design. Six months after augmentation, bone biopsies were extracted for histological and histomorphometric investigation prior to dental implant insertion. The following were evaluated: the cellular inflammatory pattern, the induction of multinucleated giant cells, vascularization, the relative amounts of newly formed bone, connective tissue, and the remaining bone substitute material. NB granules were well integrated in the peri-implant tissue and were surrounded by newly formed bone tissue. Multinucleated giant cells were visible on the surfaces of the remaining granules. BO granules were integrated into the newly formed bone tissue, which originated from active osteoblasts on their surface. Histomorphometric analysis showed a significantly higher number of multinucleated giant cells and blood vessels in the NB group compared to the BO group. No statistical differences were observed in regard to connective tissue, remaining bone substitute, and newly formed bone. The results of this study highlight the different cellular reactions to synthetic and xenogeneic bone substitute materials. The significantly higher number of multinucleated giant cells within the NB implantation bed seems to have no effect on its biodegradation. Accordingly, the multinucleated giant cells observed within the NB implantation bed have characteristics more similar to those of foreign body giant cells than to those of osteoclasts.
authors.affiliation: 1  FORM-Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Lorenz
authors.affiliation: 1  FORM-Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany.
authors.forename: Alica
authors.initials: A
authors.lastname: Kubesch
authors.affiliation: 2  Private Practice, Bokštų 9, LT-92125 Klaipeda, Lithuania.
authors.forename: Tadas
authors.initials: T
authors.lastname: Korzinskas
authors.affiliation: 1  FORM-Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany.|3  REPAIR-Lab, Institute of Pathology, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
authors.forename: Mike
authors.initials: M
authors.lastname: Barbeck
authors.affiliation: 4  Practice-Clinic Büsingpark, Kaiserstraße 74, 63065 Offenbach, Germany.
authors.forename: Constantin
authors.initials: C
authors.lastname: Landes
authors.affiliation: 1  FORM-Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sader
authors.affiliation: 3  REPAIR-Lab, Institute of Pathology, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Kirkpatrick
authors.affiliation: 1  FORM-Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany.|3  REPAIR-Lab, Institute of Pathology, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
authors.forename: Shahram
authors.initials: S
authors.lastname: Ghanaati
mesh_terms: D000818:Animals; D018786:Bone Substitutes; D002417:Cattle; D015726:Giant Cells; D015743:Giant Cells, Foreign-Body; D006801:Humans; D009055:Mouth; D010010:Osteoclasts
chemical_list: D018786:Bone Substitutes
keywords: Bio-Oss; NanoBone; foreign body reaction; multinucleated giant cells; osteoclasts