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A Collagenated Porcine Bone Substitute for Augmentation at Neoss Implant Sites: A Prospective 1-Year Multicenter Case Series Study with Histology.

Artikel i vetenskaplig tidskrift
Författare Luca Pagliani
Peter Andersson
Massimiliano Lanza
Antonio Nappo
Damiano Verrocchi
Stefano Volpe
Lars Sennerby
Publicerad i Clinical implant dentistry and related research
Volym 14
Nummer/häfte 5
Sidor 746–758
ISSN 1708-8208
Publiceringsår 2012
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för biomaterialvetenskap
Sidor 746–758
Språk en
Länkar dx.doi.org/10.1111/j.1708-8208.2010...
Ämnesord bone defects; bone substitute; clinical study; dental implants; histology; maxillary sinus floor augmentation
Ämneskategorier Patologi, Biomaterial

Sammanfattning

Background: The presence of localized defects and/or small amounts of bone below the maxillary sinus is a common finding, which may compromise implant placement. There is therefore a need for predictable techniques for bone augmentation in such situations. Purpose: The study aims to clinically and histologically evaluate a porcine bone (PB) substitute used for augmentation of the alveolar crest or the maxillary sinus floor prior to or in conjunction with implant placement. Materials and Methods: Nineteen patients were treated with a porcine bone substitute and barrier membranes (OsteoBiol, Tecnoss Dental, Turin, Italy) for lateral bone augmentation (Group 1a) and healing of bone defects (Group 1b) or for augmentation of the maxillary sinus floor using either a replaceable (Group 2a) or an infractured bone window (Group 2b). A total of 34 implants (Neoss Ltd., Harrogate, UK) were placed in conjunction or 5 to 7 months after the procedure. Implants were followed with implant stability measurements at placement and abutment connection, and with intraoral radiographs at abutment connection and after at least 1 year of loading. A biopsy for histology and morphometry was taken at the first reentry operation. Results: All but one of the procedures was successful (94.7%) as one maxillary sinus procedure (Group 2a) resulted in insufficient bone for implant placement. One of the 34 implants failed, giving an implant survival rate of 97.1% after 1 year. Implant stability measurements showed a mean stability of 71.9 ± 7.7 implant stability quotient (ISQ) at placement, which significantly increased to 75.3 ± 6.8 ISQ at abutment connection (p = .03). The average bone loss was 0.5 ± 0.7 mm during 1 year. Histology revealed new bone formation at the PB surface, which formed bridges between particles and between particles and preexisting bone. The presence of scalloped resorption lacunae and new osteons inside the particles indicated ongoing resorption/remodeling of the particles. The histomorphometric analyses showed that the total specimen area consisted of, in average, 56.5 ± 15.7% mineralized tissue of which 24.8 ± 13.9% of the total area was PB particles. Conclusion: This study showed good clinical results when using a PB substitute and barrier membranes for augmentation of the alveolar crest and maxillary sinus. Histology revealed bone condensation properties and indicated that the material can be resorbed with time.

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