title: Foreign Body Giant Cell-Related Encapsulation of a Synthetic Material Three Years After Augmentation.
abstract: Bone substitute materials of different origin and chemical compositions are frequently used in augmentation procedures to enlarge the local bone amount. However, relatively little data exist on the long-term tissue reactions. The presented case reports for the first time histological and histomorphometrical analyses of a nanocrystaline hydroxyapatite-based bone substitute material implanted in the human sinus cavity after an integration period of 3 years. The extracted biopsy was analyzed histologically and histomorphometrically with focus on the tissue reactions, vascularization, new bone formation, and the induction of a foreign body reaction. A comparably high rate of connective tissue (48.25%) surrounding the remaining bone substitute granules (42.13%) was observed. Accordingly, the amount of bone tissue (9.62%) built the smallest fraction within the biopsy. Further, tartrate-resistant acid phosphatase-positive and -negative multinucleated giant cells (4.35 and 3.93 cells/mm(2), respectively) were detected on the material-tissue interfaces. The implantation bed showed a mild vascularization of 10.03 vessels/mm(2) and 0.78%. The present case report shows that after 3 years, a comparable small amount of bone tissue was observable. Thus, the foreign body response to the bone substitute seems to be folded without further degradation or regeneration.
authors.affiliation: 1   Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Lorenz
authors.affiliation: 1   Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany.|2   REPAIR-Lab, Institute of Pathology, Johannes Gutenberg University, Mainz, Germany.
authors.forename: Mike
authors.initials: M
authors.lastname: Barbeck
authors.affiliation: 1   Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sader
authors.affiliation: 2   REPAIR-Lab, Institute of Pathology, Johannes Gutenberg University, Mainz, Germany.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Kirkpatrick
authors.affiliation: 3   Private practice, Reims, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Russe
authors.affiliation: 4   Pain Clinic, Nice, France.
authors.forename: Joseph
authors.initials: J
authors.lastname: Choukroun
authors.affiliation: 1   Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany.|2   REPAIR-Lab, Institute of Pathology, Johannes Gutenberg University, Mainz, Germany.
authors.forename: Shahram
authors.initials: S
authors.lastname: Ghanaati
mesh_terms: D018786:Bone Substitutes; D001842:Bone and Bones; D017886:Durapatite; D015743:Giant Cells, Foreign-Body; D006801:Humans
chemical_list: D018786:Bone Substitutes; D017886:Durapatite
keywords: foreign body reaction; multinucleated giant cells; nanobone; osteoclasts