Maxillary sinus augmentation with Bio‐Oss® particles: A light, scanning, and transmission electron microscopy study in man

Abstract

Biological interactions occurring at the bone-biomaterial interface are critical for long-term clinical success. Bio-Oss is a deproteinized, sterilized bovine bone that has been extensively used in bone regeneration procedures. The aim of the present study was a comparative light, scanning, and electron microscopy evaluation of the interface between Bio-Oss and bone in specimens retrieved after sinus augmentation procedures. Under light microscopy, most of the particles were surrounded by newly formed bone, while in a few cases, at the interface of some particles it was possible to observe marrow spaces and biological fluids. Under scanning electron microscopy, in most cases, the particle perimeter appeared lined by bone that was tightly adherent to the biomaterial surface. Transmission electron microscopy showed that the bone tissue around the biomaterial showed all the phases of the bone healing process. In some areas, randomly organized collagen fibers were present, while in other areas, newly formed compact bone was present. In the first bone lamella collagen fibers contacting the Bio-Oss surface were oriented at 243.73 +/- 7.12 degrees (mean +/- SD), while in the rest of the lamella they were oriented at 288.05 +/- 4.86 degrees (mean +/- SD) with a statistically significant difference of 44.32 degrees (p < 0.001). In the same areas the intensity of gray value was 172.56 +/- 18.15 (mean +/- SD) near the biomaterial surface and 158.71 +/- 21.95 (mean +/- SD) in the other part of the lamella with an unstatistically significant difference of 13.79 (p = 0.071). At the bone-biomaterial interface there was also an electron-dense layer similar to cement lines. This layer had a variable morphology being, in some areas, a thin line, and in other areas, a thick irregular band. The analyses showed that Bio-Oss particles do not interfere with the normal osseous healing process after sinus lift procedures and promote new bone formation. In conclusion, this study serves as a better understanding of the morphologic characteristics of Bio-Oss and its interaction with the surrounding tissues.

SEM-EDX Study of the Degradation Process of Two Xenograft Materials Used in Sinus Lift Procedures

“…The present study's findings are consistent with several reports found in the literature [65][66][67] in which an SEM analysis revealed a close relationship between the newly formed bone matrix and the bovine xenograft particle surface. Although histological and histomorphometric findings have often corroborated the clinical success of bovine bone mineral, the published literature includes afew descriptions of its ultrastructural features.…”

“…However, other research [65] works done with human biopsies following maxillary sinus elevation with bovine bone have reported few signs of resorption after 6 months, with histological results indicating only initial biomaterial resorption. In the current study, we found an incomplete bone graft resorption phenomenon, whereby the biomaterial was seen to partially decrease.…”

“…Early studies reported that bovine xenografts are non resorbable [68]. Taylor´s study describes signs of resorption [69], whereas others reportthat they are lacking [62,65]. Traini´s study discovered bovine bone biomaterial remnants remaining for as long as 9 years.…”

Biomateriais de substituição óssea para procedimentos de reconstrução alveolar em implantodontia

“…[28][29][30] Uma vez que que seja estabelecido em que situações clínicas os procedimentos de reconstrução óssea serão necessários, ao considerar a escolha da técnica cirúrgica e do biomaterial, pode ser dado prioridade às intervenções que pareçam mais simples, menos invasivas, que envolvam menos riscos de complicações, mas que alcancem seus objetivos de maneira efetiva dentro do prazo mais favorável ao tratamento. Deve ser levado em conta que os pacientes apresentam diferentes características, como idade, presença de doenças sistêmicas, exposição à radioterapia e medicamentos, além de hábitos como o tabagismo que podem influenciar no resultado.…”

Osso autógeno associado a osso bovino inorgânico (GenOx Inorg®) para aumento do soalho do seio maxilar e instalação de implantes: análise comparativa do potencial osteogênico de culturas de células derivadas do sítio doador e do sítio de implantação

“…Contudo, a utilização do enxerto de ossos autógenos em combinação materiais de enxertia poderia reduzir a manipulação tecidual durante o procedimento cirúrgico da área doadora, assim limitando a morbidade cirúrgica ao paciente (Chaushu et al 2009;Sbordone et al 2009;Kahnberg et al 2011). Um dos materiais de enxertia para essa aplicação é o osso bovino inorgânico (OBI), que apresenta as mesmas propriedades químicas e físicas do osso humano (Orsini et al 2005). Adicionalmente agindo como material de preenchimento de cavidades, o OBI pode facilitar o reparo ósseo como demonstrado em analíses histológicas, que mostra a formação de novo tecido ósseo em contato direto com as partículas de OBI (Galindo-Moreno et al 2010;Bernabé et al 2012).…”