Abstract
Serum albumin has been identified as an endogenous protein that is integral to early bone regeneration. We hypothesized that albumin addition to allografts may result in better bone remodeling than what can be achieved with anorganic xenografts. Sinus elevations were performed at 32 sites of 18 patients with the lateral window technique. Sites either received filling with an anorganic bovine bone mineral (ABBM, BioOss, Geistlich, CH) or albumin impregnated allograft (BoneAlbumin, OrthoSera, AT). After 6-months patients received dental implants and 16 bone core biopsy samples were obtained from the ABBM filled, and 16 from the BoneAlbumin augmented sites. The biopsies were examined by histomorphometry and µCT. Percentage of the residual graft in the BoneAlbumin group was 0–12.7%, median 5.4% vs. ABBM 6.3–35.9%, median 16.9%, p < 0.05. Results of the µCT analysis showed that the microarchitecture of the augmented bone in the BoneAlbumin group resembles that of the native maxilla in morphometric parameters Trabecular Pattern Factor and Connectivity. Our data show that while ABBM successfully integrates into the newly formed bone tissue as persisting particles, BoneAlbumin is underway towards complete remodeling with new bone closely resembling that of the intact maxilla.
Highlights
Development of the alveolar ridge is dependent on tooth eruption and loss of teeth results in its subsequent resorption
In both study groups the bone substitute material integrated in the augmented areas with up in the entire study (BoneAlbumin group); the cause of failure was the lack of osseointegration no sign of inflammation or foreign body reaction
Both histomorphometry and μCT analysis confirmed that the new bone formed parallel with the resorption of BoneAlbumin and had a structure closely resembling that of the native maxilla
Summary
Development of the alveolar ridge is dependent on tooth eruption and loss of teeth results in its subsequent resorption. During the first year after tooth removal, there is a 25% decrease in the volume of the ridge, and its width reduces by 40–60% in the first three years [5,6]. Maxillary sinus pneumatization is characterized by the maxillary sinus extension into the adjacent bone structure. Sinus pneumatization and alveolar atrophy frequently cause insufficient bone volume for dental implant placement in the edentulous posterior maxilla. Maxillary sinus floor augmentation with the lateral window technique is a safe and predictable surgical intervention to restore the bone volume of the maxillary premolar and molar area [9]. New surgical techniques have been reported to prevent intraoperative bleeding during sinus augmentation [10,11,12]
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