Abstract
Objectives: This study evaluated, through histological and immunohistochemical analysis the bone formation and remodeling after a maxillary sinus lift. Material and methods: 25 patients from 41 to 65 years of age, with inadequate bone volume in the posterior maxillary region and remaining native bone less than or equal to 5 mm, as measured radiographically, were selected and underwent maxillary sinus lift surgery, through the open technique. They were distributed in 3 groups: A - particulate, autogenous bone, AB - autogenous and heterogeneous bone, and B - only heterogeneous bone. Six months after this intervention, the patients were submitted to a surgery for the installation of implants and concomitant removal of the grafted bone sample from the surgical site. Results: The histological evaluation showed bone formation in the three groups, with presence of mature bone. In groups B and AB, the presence of granules of the biomaterial surrounded by bone tissue was observed. A statistical analysis showed significant difference (ANOVA p=0,002), suggesting greater bone formation in the autogenous group. In an immunohistochemical evaluation, no statistically significant differences were observed in the comparison between the experimental groups (A, B and AB), as well as in the proteins analyzed (OC: p= 0.657; VEGF: p= 0,133; TRAP: p= 0.163). Conclusion: The use of Bio-Oss ®, whether or not associated to autogenous bone, for a maxillary sinus lift through the side window technique results in bone repair. A predictable amount of bone formation is attained when this osteoconductive biomaterial is used.
Highlights
The treatment of maxillary edentulous jaws with osseointegrated implants is often complex for the pneumatization of the maxillary sinus and for the remaining low-bone density and volume
38 bone tissue samples of the patients were collected during the alveolar ridge perforation and subjected to histological and immunohistochemical processing for the detection of osteocalcin protein, vascular endothelial growth factor (VEGF) and tryptophan-activated RNA binding attenuation protein (TRAP) in the the analyzed bone tissue
Speaking, no statistically significant differences were observed in the comparison between the experimental groups (A, B and AB), as well as the analyzed proteins (OC: p = 0.657; VEGF: p = 0.133; TRAP: p = 0.163)
Summary
The treatment of maxillary edentulous jaws with osseointegrated implants is often complex for the pneumatization of the maxillary sinus and for the remaining low-bone density and volume. The bone resorption, consequent to the loss of the dental elements, determines atrophy in height and thickness, by reducing the available bone to perform the implant (Stacchi et al, 2017; Beretta et al, 2012). The maxillary sinus is a large pyramidal cavity with thin walls corresponding to alveolar, orbital, facial and infratemporal aspects of the maxilla. The size, shape, and wall thickness of the sinus varies from one to another even on the 2 sides of the pacient. The maxillary sinus lift is a widely used technique to restore bone volume in the posterior region of the maxilla for dental implant placement (Jensen et al, 2012; Abrahams & Hayt, 2000). The classic technique consists in a lateral access to the maxillary sinus, detachment of the Schneider membrane, and maintenance of the distance from the membrane to the sinus floor
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