title: Influence of Healing Period Upon Bone Turn Over on Maxillary Sinus Floor Augmentation Grafted Solely with Deproteinized Bovine Bone Mineral: A Prospective Human Histological and Clinical Trial.
abstract: OBJECTIVE
  To investigate the influence of maturation timing upon histological, histomorphometric and clinical outcomes when deproteinized bovine bone mineral (DBBM) was used as a sole biomaterial for staged maxillary sinus floor augmentation (MSFA).
  
  
  METHODS
  Patients with a posterior edentulous maxillary situation and a vertical bone height ≤ 4 mm were included in this study. A staged MSFA was carried out. After MSFA with DBBM as a sole grafting material, biopsy cores were harvested with simultaneous implant placement followed by a healing period of 5, 8, and 11 months, respectively. Micro-CT, histologic and histomorphometric analyses were performed.
  
  
  RESULTS
  Forty-one patients were enrolled and 38 bone core biopsies were harvested. Significantly greater BV/TV was observed between 5- and 8-month healing from micro-CT analysis. Histomorphometric analyses showed the ratio of mineralized newly formed bone increased slightly from 5 to 11 months; however, no statistically significant difference was reached (p = .409). Residual bone substitute decreased from 37.3 ± 5.04% to 20.6 ± 7.45%, achieving a statistical significant difference from of 5 up to 11 months (p < .01). Moreover, no implant failure, biological or technical complication occurred after 12-month follow-up of functional loading.
  
  
  CONCLUSIONS
  DBBM utilized as sole grafting material in staged MSFA demonstrated to be clinically effective regardless of the healing period. Histomorphometrical and micro-CT assessments revealed that at later stages of healing (8 and 11 months) there is a higher proportion of newly-bone formation compared to earlier stages (5 months). Moreover, the longer the maturation period, the substantially lesser remaining biomaterial could be expected. Even though, these facts did not seem to negatively impact on the implant prognosis 1-year after loading.
authors.affiliation: Assistant professor, Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: Second Dental Clinic, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Research fellow, Department of Periodontics and Oral Medicine, The University of Michigan, MI, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Monje
authors.affiliation: Professor, Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Faculty, Second Dental Clinic, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011.
authors.forename: Yueping
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Professor, Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011.
authors.forename: Yiqun
authors.initials: Y
authors.lastname: Wu
mesh_terms: D000328:Adult; D000818:Animals; D001672:Biocompatible Materials; D001706:Biopsy; D016723:Bone Remodeling / Q000502:physiology*; D018786:Bone Substitutes; D002417:Cattle; D005260:Female; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000502:physiology*; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology*; D011446:Prospective Studies; D059546:Sinus Floor Augmentation; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*; D055114:X-Ray Microtomography
chemical_list: D001672:Biocompatible Materials; D018786:Bone Substitutes
keywords: deproteinized bovine bone mineral; histological analyses; implant survival rate; maxillary sinus floor augmentation