IADR Abstract Archives
The Comparative Study of Bone Healing in Maxillary Sinus Augmentation Using Coarse and Fine Granules of Xenograft
Objectives: To demonstrate microstructure of newly formed bone pattern, residual particle and fibrous formation in histomorphometric study related with radiographic study (micro CT analysis) in clinical trial model using Bio-Oss® grafting material (two different particle sizes) in maxillary sinus augmentation procedure as a primary outcome and evaluation of short term implant failure as a secondary outcome.
Methods: Randomized, double blind, clinical trial was performed in twenty-two patients. Candidates were divided into 2 groups randomly, group I; twelve patients were subjected to sinus lift procedure using Gelstlich Bio-Oss ® small granule grafting (0.25-1mm), group II; ten patients were subjected to sinus lift procedure using Bio-Oss® coarse granule grafting (1-2mm). After sinus augmentation for 6 months, bone specimens were harvested before dental implant placement procedure. Specimens were subjected to micro CT analysis and histological analysis in aspects of newly formed bone, residual particle and fibrous formation. Patients in both groups were subjected to clinical and radiographic evaluation to examine the implant failure rate.
Results: Micro CT analysis showed significantly more bone volume in specimen grafted with coarse-grained particle (7.04mm3) compared to specimen grafted with fine-grained particle (4.17mm3) at p value= 0.04. Histological data showed more significantly newly-formed bone in coarse-grained particle group (21.8%) compared to 13% in fine-grained particle group(p value=0.003). In addition, more residual particle of xenograft in the specimens grafted with coarse-grained particle was observed (p value=0.02). On the other hand, abundant fibrous tissue was identified in specimens grafted with fine-grained particle (75.47%) compared to small portion of fibrous tissue in specimens grafted with coarse-grained particle (38.44%) at p value=0.006. The specimens showed a strong expression of osteopontin (OPN) in the newly-formed bone and fibrous tissue. In addition vascular endothelial growth factor (VEGF) was expressed in grafted specimen. No report of implant failure in all patients ( at least 1 year after implant placement).
Conclusions: The data suggested that large particle size (1-2mm) of xenograft (Bio-Oss) can promote more bone healing compare to small particle (0.25-1mm).
Methods: Randomized, double blind, clinical trial was performed in twenty-two patients. Candidates were divided into 2 groups randomly, group I; twelve patients were subjected to sinus lift procedure using Gelstlich Bio-Oss ® small granule grafting (0.25-1mm), group II; ten patients were subjected to sinus lift procedure using Bio-Oss® coarse granule grafting (1-2mm). After sinus augmentation for 6 months, bone specimens were harvested before dental implant placement procedure. Specimens were subjected to micro CT analysis and histological analysis in aspects of newly formed bone, residual particle and fibrous formation. Patients in both groups were subjected to clinical and radiographic evaluation to examine the implant failure rate.
Results: Micro CT analysis showed significantly more bone volume in specimen grafted with coarse-grained particle (7.04mm3) compared to specimen grafted with fine-grained particle (4.17mm3) at p value= 0.04. Histological data showed more significantly newly-formed bone in coarse-grained particle group (21.8%) compared to 13% in fine-grained particle group(p value=0.003). In addition, more residual particle of xenograft in the specimens grafted with coarse-grained particle was observed (p value=0.02). On the other hand, abundant fibrous tissue was identified in specimens grafted with fine-grained particle (75.47%) compared to small portion of fibrous tissue in specimens grafted with coarse-grained particle (38.44%) at p value=0.006. The specimens showed a strong expression of osteopontin (OPN) in the newly-formed bone and fibrous tissue. In addition vascular endothelial growth factor (VEGF) was expressed in grafted specimen. No report of implant failure in all patients ( at least 1 year after implant placement).
Conclusions: The data suggested that large particle size (1-2mm) of xenograft (Bio-Oss) can promote more bone healing compare to small particle (0.25-1mm).