A histological study of non-ceramic hydroxyapatite as a bone graft substitute material in the vertical bone augmentation of the posterior mandible using an interpositional inlay technique: A split mouth evaluation.
The aim of this study was to compare the influence of graft material (non-ceramic hydroxyapatite versus autologous bone) on bone behaviour and perform a resonance frequency analysis of implants placed in augmented sites to evaluate stability. For this study, 11 patients with bilateral edentulous areas in the mandibular posterior region were selected. Alveolar augmentation osteotomies were bilaterally (split mouth design) performed. In one hemiarch, the space generated by the osteotomy was grafted with an interpositional intra-oral autologous bone graft (control group). In the other hemiarch, the space generated by the osteotomy was grafted with an interpositional non-ceramic hydroxyapatite (ncHA) (test group). The groups were randomized. After 6 months of healing, a bone sample was retrieved from each side for histological evaluation using a trephine drill that was 2-mm in internal diameter. The implant stability quotient (ISQ) was measured by the resonance frequency immediately following implant placement at baseline and after 6 months of follow-up. Good incorporation of the graft was observed in both groups; however, in the test group, a residual-grafted material was observed. Bone density and marrow spaces were similar between groups. Correlations between the ISQ values and the histometric variables were not observed (p>0.05). The results of this trial suggest that both intra-oral autologous bone and ncHA may be elected as interpositional grafting materials to vertically augment posterior atrophic mandibles.
Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil.
Karen
K
Bechara
Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil.
Alexandre M
AM
Dottore
Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil.
Paulo Y
PY
Kawakami
Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil; Biotecnos - Private Center of Research, Santa Maria, RS, Brazil.
Sergio A
SA
Gehrke
Department of Biomimetics, New York University, New York, USA.
Paulo G
PG
Coelho
Department of Oral Medicine and Oral Pathology, University of Chieti, Chieti, Italy.
Adriano
A
Piattelli
Department of Oral Medicine and Oral Pathology, University of Chieti, Chieti, Italy.
Giovanna
G
Iezzi
Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil. Electronic address: jashibli@yahoo.com.
Jamil Awad
JA
Shibli
D000328:Adult; D000368:Aged; D064728:Alveolar Bone Grafting; D000540:Alveolar Ridge Augmentation; D001672:Biocompatible Materials; D001846:Bone Development; D001853:Bone Marrow / Q000033:anatomy & histology; D001863:Bone Screws; D018786:Bone Substitutes; D016025:Bone Transplantation; D017886:Durapatite; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008422:Materials Testing; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000601:surgery; D010027:Osteotomy; D011446:Prospective Studies; D014025:Titanium
D001672:Biocompatible Materials; D018786:Bone Substitutes; D017886:Durapatite; D014025:Titanium
Bone graft; Inlay bone grafts; Non-ceramic hydroxyapatite; Posterior mandible graft; Resonance frequency analysis