Effect of sex-hormone levels, sex, body mass index and other host factors on human craniofacial bone regeneration with bioactive tricalcium phosphate grafts.
Little is known regarding the associations between sex-hormone levels, sex, body mass index (BMI), age, other host factors and biomaterial stimulated bone regeneration in the human craniofacial skeleton. The aim of this study was to elucidate the associations between these factors and bone formation after sinus floor augmentation procedures (SFA) utilizing a bioactive tricalcium phosphate (TCP) bone grafting material. We conducted a prospective study in a human population in which 60 male and 60 female participants underwent SFA and dental implant placement using a staged approach. BMI as well as levels of serum estradiol (E2), total testosterone (TT), and the free androgen index (FAI) were measured by radioimmunoassay and electrochemoluminescent-immunoassay. At implant placement, 6 months after SFA, bone biopsy specimens were harvested for hard tissue histology, the amount of bone formation was evaluated by histomorphometry and immunohistochemical analysis of osteogenic marker expression. The Wilcoxon rank-sum U test, Spearman correlations and linear regression analysis were used to explore the association between bone formation and BMI, hormonal and other host factors. BMI and log E2 were significantly positively associated with bone formation in male individuals (p < 0.05). Histomorphometry revealed trends toward greater bone formation and osteogenic marker expression with non-smokers compared to smokers. In male patients, higher E2 levels and higher BMI enhanced TCP stimulated craniofacial i.e. intramembranous bone repair.
Dept. of Experimental Orofacial Medicine, Philipps University Marburg, 35039 Marburg, Germany. Electronic address: knabec@med.uni-marburg.de.
Christine
C
Knabe
Dept. of Experimental Orofacial Medicine, Philipps University Marburg, 35039 Marburg, Germany.
Aynur
A
Mele
Dept. of Endocrinology and Diabetology, Philipps University Marburg, 35033 Marburg, Germany.
Peter Herbert
PH
Kann
Dept. of Prosthodontics, Philipps University Marburg, 35039 Marburg, Germany.
Barbara
B
Peleska
Dept. of Experimental Orofacial Medicine, Philipps University Marburg, 35039 Marburg, Germany; Dept. of Periodontology, Ain Shams University, Cairo, Egypt.
Doaa
D
Adel-Khattab
Institute of Laboratory Medicine and Pathobiochemistry, Philipps-University, 35033 Marburg, Germany.
Harald
H
Renz
Coordinating Center for Clinical Trials, Philipps University Marburg, 35043 Marburg, Germany.
Alexander
A
Reuss
RMS Foundation, 2544 Bettlach, Switzerland.
Marc
M
Bohner
Dept. of Experimental Orofacial Medicine, Philipps University Marburg, 35039 Marburg, Germany; Dept. of Prosthodontics, Philipps University Marburg, 35039 Marburg, Germany; European Center of Dental Implantology (ECDI), 14193 Berlin, Germany.
Michael
M
Stiller
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001861:Bone Regeneration / Q000502:physiology*; D018786:Bone Substitutes / Q000737:chemistry; D016025:Bone Transplantation / Q000379:methods*; D002130:Calcium Phosphates / Q000737:chemistry*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D012038:Regeneration / Q000502:physiology*; D012727:Sex Characteristics; D059546:Sinus Floor Augmentation / Q000379:methods; D016896:Treatment Outcome
D018786:Bone Substitutes; D002130:Calcium Phosphates; D012739:Gonadal Steroid Hormones; C018392:tricalcium phosphate
Body mass index; Craniofacial bone regeneration; Estradiol; Host factors; Sex-hormone levels; Sinus floor augmentation; Smoking; Testosterone; Tricalcium phosphate