Late-term healing in an augmented sinus with different ratios of biphasic calcium phosphate: a pilot study using a rabbit sinus model

Abstract

PurposeThe aim of this pilot study was to determine the osteoconductivity and dimensional stability of augmented sinuses using different ratios of biphasic calcium phosphate (BCP) in a rabbit sinus model.MethodsEach sinus of New Zealand white rabbits (2.5–3.5 kg) was assigned to one of two groups: BCP with a hydroxyapatite to β-tricalcium phosphate (HA:β-TCP) ratio of 70:30 (group TCP30) and BCP with an HA:β-TCP ratio of 30:70 (group TCP70). After preparing a window in the antral wall of a sinus, the Schneiderian membrane was elevated, and the applicable material was grafted. A fluorochrome calcein green was injected five days before euthanizing the animals at four months post-surgery. The specimens were analyzed histologically, histomorphometrically, and by using micro-computed tomography (micro-CT).ResultsMicro-CT analysis revealed that the total augmented volume and the new bone volume did not differ significantly between the two groups whereas the resorption of materials was greater in the TCP70 group. The trabecular thickness, number, and separation also did not differ significantly between the two groups. Histomorphometrically, the areas of total augmentation, new bone, and residual material, as well as the ratio of new-bone-material contact did not differ significantly between the groups. Histologically, the residual particles were more scattered in the TCP70 group than in the TCP30 group. The fluorescence of the calcein green did not differ notably between the two groups.ConclusionsThe osteoconductivity and dimensional stability of the two BCPs with different ratios tested in this study were comparable after four months of healing. Therefore, we conclude that both BCPs show promise as a bone substitute for sinus augmentation.

Report of a human autopsy case in maxillary sinuses augmented using a synthetic bone substitute: Micro‐computed tomographic and histologic observations

“…Despite initial shrinkage of the grafted volume, the present human autopsy study confirmed that the grafted volume could be maintained over 6 years with abundant bone regeneration within the maxillary sinus. This is consistent with a previous preclinical in vivo study finding that BCP showed osteoconductivity and long‐term dimensional stability in a rabbit sinus augmentation model regardless of the tricalcium phosphate ratio (Lim, Hong, Lee, Jung, & Choi, ). Similarly, Cha et al.…”

Effectiveness of strontium‐doped brushite, bovine‐derived hydroxyapatite and synthetic hydroxyapatite in rabbit sinus augmentation with simultaneous implant installation

“…Numerous clinical and experimental studies have demonstrated that the space‐keeping capacity is critical for successful SA (Choi et al, 2012; Kim et al, 2010; Kim et al, 2012; Lim et al, 2015; Yildirim et al, 2000). Bone substitutes should present good space‐keeping ability to resist air pressure imposed on them, otherwise the decreased sinus space will lead to protrusion of implants into the sinus and eventually complicate the load‐bearing capacity of dental implants (Kim et al, 2010; Lambert et al, 2011; Lim et al, 2016; Sbordone et al, 2009; Trbakovic et al, 2018; Xia et al, 2011). In the present study, the space‐keeping capacity of the Sr‐DCPD, bHA and sHA were evaluated by total augmented volume (TV) using micro‐CT examination, and total augmented sinus area (TSA) in the histological analysis.…”

“…Third, a bone substitute should be a good osteoconductor to facilitate bone formation as much as possible. Various materials have been applied in SA and, while both exciting and disappointing results have been obtained (Browaeys et al, 2007; Choi et al, 2012; Kim et al, 2010; Kim et al, 2014; Lambert et al, 2011; Lambert et al, 2017; Lim et al, 2015; Lim, Hong, Lee, Jung, & Choi, 2016; Sbordone et al, 2009; Trbakovic et al, 2018; Wanschitz et al, 2006; Xia et al, 2011), their space‐keeping capacity, resorption rate, osteoconductivity, especially the mechanical property of regenerated bone, remain less understood.…”

Increased osteoinductivity and mineralization by minimal concentration of bone morphogenetic protein-2 loaded onto biphasic calcium phosphate in a rabbit sinus

“…Lim et al [18] recently reported that BCP with low and high proportions of TCP had similar effects on bone regeneration and space-maintaining capabilities in a rabbit sinus for up to 8 weeks. Likewise, in the present study, the BCP was well maintained in its structure even at the higher ratio of TCP (80%).…”