Histological observations on biopsies harvested following sinus floor elevation using a bioactive glass material of narrow size range

Abstract

We evaluated the bone augmenting capacity of bioactive glass particles, size range 300-355 microns (BG-particles), in human sinus floor elevations using histomorphometrical methods. A total of 10 patients underwent bilateral grafting, using a 1:1 mixture of autogenous bone particles (from iliac crest) and BG-particles at one side (experimental side), and bone particles only at the other side (control side, split mouth design). A total of 72 bone biopsies were taken at the time of fixture installation; that is, 3 patients at 4 months, 3 at 5 months and 3 at 6 months after grafting and 1 patient at 16 months (when she presented again). In each case 6 biopsies were taken, 3 left and 3 right. Histomorphometry showed that in grafts at control sides, trabecular bone was present after 4 months, comprising almost 41% of the tissue volume. This bone contained viable osteocytes and was of mature lamellar type and showed a mature histological appearance. Bone volume continued to increase slightly, to 42% at 5 months, 44% at 6 months and 45% at 16 months. The graft volume at experimental sides consisted at 4 months for 28% of woven and some lamellar bone, and increased to 35% at 5 months and 38% at 6 months, when mainly lamellar bone was found. At 16 months a lamellar bone volume of 45% was found. The BG-particles transformed and became excavated with time, starting at 4 months, and their centers gradually filled with bone tissue. All BG-particles had disappeared by resorption at 16 months after grafting and had been replaced by bone tissue. Parameters of bone turnover (% osteoid surface, % resorption surface, mineral apposition rate as measured by tetracycline labeling) indicated that bone remodeling was very active at both sides, during more than 6 months, despite the mature histological appearance of the bone tissue. From these histological observations, we conclude that a 1:1 mixture of autogenous bone/BG-particles seems a promising alternative to autogenous bone only, when low amounts of bone tissue are available for sinus augmentation.

Maxillary sinus lift with solely autogenous bone compared to a combination of autogenous bone and growth factors or (solely) bone substitutes. A systematic review

“…Authors who did not describe randomization clearly were contacted via e-mail for additional information. When a proper randomization procedure was applied, these studies were added to the results 1,11,21,28 .…”

“…Regarding bioactive glass TADJOEDIN et al 28 showed that augmentation with autogenous bone had resulted in a significantly higher bone fraction (42%) than treatment with bioactive glass (35%) 4 and 5 months after sinus floor elevation. TURUNEN et al 35 presented comparable results for both groups after 4 months of healing.…”

“…When applied in the size range of 300-355 mm, bioactive glass showed osteoconductive properties 28,29 . TURUNEN et al 35 showed that the combined use of bioactive glass granules with autogenous bone chips for augmentation of the maxillary sinus floor diminished the amount of bone needed for augmentation and resulted in the same quantity of bone as when autogenous bone chips alone were used.…”

“…TURUNEN et al 35 showed that the combined use of bioactive glass granules with autogenous bone chips for augmentation of the maxillary sinus floor diminished the amount of bone needed for augmentation and resulted in the same quantity of bone as when autogenous bone chips alone were used. TADJOEDIN et al 28 showed in the control group, using bioactive glass particles in combination with autogenous bone, that new bone formation increased rapidly within 2 months, from 29% at 4 months to 38% at 6 months. As the healing period is sufficiently long (5 months), there are no differences in treatment and bioactive glass particles seem to be a good alternative for autogenous bone.…”

Sinus Floor Augmentation Surgery Using Autologous Bone Grafts from Various Donor Sites: A Meta-Analysis of the Total Bone Volume

“…Before preparation of the implant bed to install dental implants, a biopsy of the reconstructed area can be easily taken, which implicates no extra burden for the patient. 28,29 Moreover, all surgical procedures, except the extraoral grafting procedure, can be performed under local anesthesia. The selection of a donor site is often made on considerations driven by the quantity needed for the individual case.…”