A quantification of regenerated bone tissue in human sinus biopsies: influences of anatomical region, age and sex

Reich, Karoline Maria; Heimel, Patrick; Ulm, Christian; Redl, Heinz; Tangl, Stefan

doi:10.1111/clr.12627

Cited by 12 publications

(19 citation statements)

References 43 publications

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“…Thus, from a clinical perspective, healing (i.e., bone regeneration) in the majority of premolars sites would be expected to occur faster compared with molar sites, at an extent/height relevant for implant placement (i.e., in the first 8–10 mm within the MS). As mentioned earlier graft consolidation after MSFA requires angiogenic/osteogenic factors and cells sprouting into the augmentation material from the surrounding recipient bone, that is, bony walls of the MS and the residual alveolar ridge, and less from the Schneiderian membrane (Jungner et al, ; Reich et al, ; Rong, Li, Chen, Zhu, & Huang, ; Scala et al, ). Hence, a larger distance between the buccal and palatal MS wall (i.e., a wide MS) might delay graft consolidation due to the longer distance angiogenic/osteogenic factors and cells need to cover to populate the graft.…”

Section: Discussionmentioning

confidence: 98%

“…In perspective, SW should also be considered during treatment planning and/or decision making together with the various systemic and local parameters known to influence the outcome of MSFA and especially the timeframe of bone regeneration and/or graft consolidation, for example, presence of systemic diseases, smoking status, gender, age, augmentation material (i.e., no material vs. autogenous bone vs. bone substitutes vs. combinations thereof), use of growth factors, manipulation of the surgical site (e.g., perforation of the sinus floor for improved blood supply), use of a membrane to seal the lateral window, etc. (Esposito et al, ; Reich et al, ; Rios, Avila, Galindo, Bratu, & Wang, ; Shanbhag, Shanbhag, & Stavropoulos, ; Ulm et al, ). For example, longer healing time as well as the use of autologous bone and/or a growth factor might be preferably considered in a wide MS, while in a narrow sinus, a shorter healing time and/or use of bone substitutes may be considered.…”

Section: Discussionmentioning

confidence: 99%

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Variation in bucco‐palatal maxillary sinus width does not permit a meaningful sinus classification

Bertl

Mick

Heimel

et al. 2018

Clinical Oral Implants Res

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Objectives The bucco‐palatal sinus width (SW) appears as relevant factor for graft consolidation after maxillary sinus (MS) floor augmentation. The present study aimed to assess (a) SW at different height levels of posterior teeth, (b) possible factors influencing SW, and (c) whether a simple/meaningful sinus classification based on SW is possible. Methods The following parameters were recorded on computed tomographies of 76 edentulous and 86 partially edentulous maxillary quadrants displaying 383 tooth sites in total: (a) alveolar ridge height, (b) ‐area, (c) ‐width 2 mm apical to the alveolar crest, (d) ‐width at the sinus floor, and (e) SW and sinus area at a level 2, 4, 6, 8, and 10 mm above the sinus floor. The possible influence of gender, tooth position [i.e., premolar (PM); molar (M)], tooth‐gap extent, and residual alveolar ridge dimensions on SW was assessed. Further, based on percentiles of average values or on the frequency distribution of SW <10, 10–15, or >15 mm, it was attempted to classify the sinus at each given site into narrow, average, or wide. Results Gender and tooth‐gap extent presented no relevant impact on MS dimensions; however, significant differences were observed among the various tooth positions regarding all evaluated parameters. The lower the residual alveolar ridge, the wider the MS at 4–10 mm height, while the wider the residual alveolar ridge, the wider the MS. Large variation in SW classes among the different height levels within the same tooth position and among tooth positions within the same person was observed, irrespective of the threshold applied. Further, at a MS height of 10 mm at PM1, PM2, M1, and M2, SW was <10 mm in 68%, 33%, 0%, and 7% of the cases, respectively, while in 3%, 21%, 65%, and 57%, respectively, SW was >15 mm. Conclusions There is a large variation in SW depending on the height level within the sinus and on tooth position, which does not permit a simple/meaningful classification of each sinus as “narrow,” “average,” or “wide.” Nevertheless, narrow sinuses (<10 mm) are rather prevalent in the premolar region, while wide sinuses (>15 mm) in the molar region; further, a wider and shorter residual alveolar ridge is associated with a wider SW.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Variation in bucco‐palatal maxillary sinus width does not permit a meaningful sinus classification

Bertl

Mick

Heimel

et al. 2018

Clinical Oral Implants Res

Self Cite

View full text Add to dashboard Cite

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“…Patients' age, gender, and the residual bone height were reported as relevant factors for the assessment of regenerated bone quantitatively using the bone biopsies obtained from augmented sinus area (Reich et al., ). In the present study, to control certain factors, the same therapist/periodontist carried out all surgical procedures, the particle size was identical in all cases, and the biopsy regions were distributed similarly with identical residual bone heights.…”

Section: Discussionmentioning

confidence: 99%

Maxillary sinus augmentation with leukocyte and platelet‐rich fibrin and deproteinized bovine bone mineral: A split‐mouth histological and histomorphometric study

Nizam

Eren

Akcalı

et al. 2017

Clinical Oral Implants Res

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“…e trauma connected with this process leads to a second surge of bone formation that could utilize the free surfaces of the granules to lay down new bone tissue, thereby increasing the overall rate of osseointegration. e lower regenerative potential of the medullary compartment allows conclusions about how bone substitute materials might perform in areas with impaired healing like the deeper regions of a sinus lift [61], while the cortical area can serve as a model for fast, high-powered bone regeneration.…”

Section: Discussionmentioning

confidence: 99%

Porous Titanium Granules in comparison with Autogenous Bone Graft in Femoral Osseous Defects: A Histomorphometric Study of Bone Regeneration and Osseointegration in Rabbits

Pepelassi

Perrea

Dontas

et al. 2019

BioMed Research International

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Background. The high resorption rate of autogenous bone is a well-documented phenomenon that can lead to insufficient bone quality and quantity in an augmented area. Nonresorbable bone substitutes might perform better than autogenous bone in certain applications if they are able to provide adequate bone formation and graft osseointegration. Purpose. The aim of this study was to compare the osseous regeneration and graft integration in standardized defects in the rabbit femur treated either with porous titanium granules or autogenous osseous graft. Materials and Methods. Standardized femoral osseous defects were surgically induced in 45 New Zealand rabbits. Fifteen were treated with porous titanium granules (TIGRAN™-PTG) and membrane (PTGM), 15 with autogenous graft and membrane (AGM), and 15 with membrane alone (CM, control). At six weeks, the defects were assessed histologically and histomorphometrically. Results. PTGM as compared to AGM presented similar percentages of newly formed bone tissue, but a significantly higher fraction of the region of interest was filled with the bone substitute material. Accordingly, the composite of new bone plus bone substitute material showed significantly higher volumes for PTGM. Yet, the smaller amount of remaining autogenous bone was far better osseointegrated than the titanium granules, which in large regions showed no connection to newly formed bone. Both PTGM and AGM as compared to CM presented higher values of newly formed bone. Conclusions. This study demonstrated that PTG was similarly effective as autogenous osseous graft in achieving osseous regeneration while PTG performed markedly better in graft volume stability. The resulting higher total percentage of new bone combined with the bone substitute material in PTG could provide a superior foundation for implant placement.

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A quantification of regenerated bone tissue in human sinus biopsies: influences of anatomical region, age and sex

Abstract: These empirical results derived from a large human sample, link factors that influence the quality of biomaterial integration to the known clinical risks for the success of dental implants.

Cited by 12 publications

References 43 publications

Variation in bucco‐palatal maxillary sinus width does not permit a meaningful sinus classification

Variation in bucco‐palatal maxillary sinus width does not permit a meaningful sinus classification

Maxillary sinus augmentation with leukocyte and platelet‐rich fibrin and deproteinized bovine bone mineral: A split‐mouth histological and histomorphometric study

Porous Titanium Granules in comparison with Autogenous Bone Graft in Femoral Osseous Defects: A Histomorphometric Study of Bone Regeneration and Osseointegration in Rabbits

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