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A 3-year clinical follow-up of implants placed in two different biomaterials used for sinus augmentation.
Department of Oral and Maxillofacial Surgery, Gäve Country Hospital, Sweden.
Department of Oral and Maxillofacial Surgery, Gävle, County Hospital, Sweden/Dept of Biomaterials, Institute of Clinical Sciences, Göteborg University, Sweden.
School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
Department of Oral and Maxillofacial Surgery, Gävle, County Hospital, Sweden/Department of Oral & Maxillofacial Surgery, Umeå University, Umeå Sweden and Center for Research and Development, Uppsala University/Gävleborg County Council, Swede.
2012 (English)In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 27, no 5, p. 1151-1162Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aims of the present study were to compare a novel biphasic calcium phosphate (BCP) with deproteinized bovine bone (DBB) for maxillary sinus floor augmentation in a split-mouth design and to perform a clinical follow-up of dental implants placed in the augmented sinuses.

MATERIALS AND METHODS: Partially or completely edentulous patients requiring bilateral sinus augmentation were included in the study. The patients were randomized for augmentation with BCP (test) and DBB (control) in the contralateral side. Eight months after grafting, dental implants were placed. After 3 years of graft healing, core biopsy specimens were obtained from the grafted areas for histologic and histomorphometric analyses. After 3 years of functional implant loading, implant survival/success rates and clinical indices were assessed and radiographic examination and resonance frequency analysis were performed.

RESULTS: Nine completely edentulous patients and two partially edentulous patients (mean age, 67 years) who required bilateral sinus augmentation were included in the study, and 62 implants were placed. The mean values for the area of newly formed bone in the retrieved specimens were 29% ± 14.3% and 32% ± 18.0% for BCP and DBB, respectively; the percentage of graft particles in contact with bone was 38% ± 10.9% in the BCP group and 44% ± 12.1% in the DBB group (no statistical significant differences between groups). The mean values for the area of BCP particles and DBB particles were 20% ± 7.5% and 24% ± 13.5%, respectively (difference not significant). One dental implant was lost from each group, resulting in an overall implant survival rate of 96.8% after 3 years of loading.

CONCLUSION: After 3 years, a similar amount of newly formed bone was present regardless of the biomaterial used. The choice of biomaterial did not seem to influence implant survival rates.

Place, publisher, year, edition, pages
Quintessence , 2012. Vol. 27, no 5, p. 1151-1162
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-26317ISI: 000310395900021PubMedID: 23057029OAI: oai:DiVA.org:mau-26317DiVA, id: diva2:1488525
Available from: 2020-11-03 Created: 2020-11-03 Last updated: 2024-04-30Bibliographically approved
In thesis
1. On tissue reactions to and resorption of bone substitutes
Open this publication in new window or tab >>On tissue reactions to and resorption of bone substitutes
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The increasing need for bone grafting procedures inimplant dentistry and the introduction of a variety of bone substitutesrequire a deeper understanding of the biological response and shortandlong-term behaviour of these materials to choose the adequategraft and surgical procedure for the intended clinical application.Aims: The overall aim was to clinically and histologically studythe short- and long-term tissue reactions to and resorption of bonesubstitutes after bone augmentation.Material and methods: In paper I, dentin blocks with different demineralizationtimes were placed subperiostally in 40 rat skulls. Aftera healing period of 4 weeks the rats were sacrificed and the healingof the dentin blocks were evaluated. In paper II, eleven patients weretreated with bilateral sinus floor augmentation using biphasic calciumphosphate (BCP) on one side and deproteinized bovine bone (DPBB)on the contralateral side, acting as control. After 3 years, biopsieswere retrieved from the grafted area for histological evaluation andhistomorphometry and 62 dental implants, placed 8 months aftergraft healing, were clinically evaluated. In paper III and IV, fourteen(22 sinuses) of the included 20 patients (30 sinuses) treated withsinus floor augmentation with a mixture of 80% DPBB and 20%autogenous bone (AB) from the chin were followed throughout the10 years study period. These patients had 53 implants placed ingrafted sites and 15 implants placed in non-grafted bone. Clinicaland radiographic examinations were performed. Biopsies wereretrieved from the grafted sinuses after 11 years of graft healing for16histological evaluation and histomorphometry. The particle sizeswere compared with samples retrieved after 6 months from the samepatients and pristine particles from the manufacturer. In paper V, 13patients (14 jaws) were treated with lateral ridge augmentation using2 different mixtures of DPBB:AB (90:10 and 60:40) in a randomizedand controlled trial, designed as a split mouth study. The width andvolume changes were evaluated after 7.5 months by means of conebeam computed tomography. After 8 months of graft healing, at thetime of implant placement, biopsies were retrieved for histologicalevaluation and histomorphometry.Results: Resorption increased with increasing degree of demineralizationof dentin blocks while bone formation increased with increasingdegree of demineralization, in the latter case provided inflammationwas compensated for (paper I). After 3 years of healing the BCPparticles showed different levels of dissolution, in contrast to DPBBparticles that showed no signs of resorption. The overall implantsurvival rate was 96.8% and the success rate for implants placed inBCP and DPBB was 91.7% and 95.7% respectively (paper II). Thecumulative survival rate of the implants after 10 years was 86% andthe marginal bone loss was 1.6 mm. There was only a reduction ingraft height between 3 months and 2 years but no further reductionup to 10 years (paper III). There was no difference between the sizeof DPBB particles after 11 years compared to those measured after6 months or to particles from the manufacturer (paper IV). Thegain in width of the alveolar crest was 3.5 mm and 2.9 mm and thereduction of the grafts were 37% and 47% for the 60:40 mixtureand 90:10 mixture respectively (significant differences). There wereno histomorphometrical differences between the groups (paper V).Conclusions: Partial demineralization may provide a method foroptimizing the integration of dentin onlays. A similar degree of boneformation and bone-to-graft contact for BCP and DBB was found 3years after maxillary sinus augmentation with similar success ratesfor implants placed in both grafting materials. At 10 years follow-upafter sinus floor augmentation with 80:20 (DPBB:AB) graft, theremaining implants presented good clinical and radiological resultsand there seems to be no further graft resorption after 2 years of17graft healing. DPBB particles were found to be well integrated inlamellar bone, showing no apparent signs of resorption after 11 yearsin humans. Despite a small difference in width changes after lateralridge augmentation, the amount of AB added to DPBB did not seemto have a major impact on the graft healing and graft reduction, thusmaking it possible to install implants in all grafted sites.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology, 2013. p. 122
Series
Doctoral Dissertation in Odontology
Keywords
bone graft, bone substitutes, sinus floor augmentation, lateral ridge augmentation
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7677 (URN)15114 (Local ID)978-91-7104-393-1 (ISBN)15114 (Archive number)15114 (OAI)
Note

Note: The papers are not included in the fulltext online.

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-06Bibliographically approved

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