Maxillary Sinus Grafting with a Nano-Structured Biomaterial: Preliminary Clinical and Histological Results

Abstract

Background: In this study the potential of a new and entirely synthetic, nano-structured hydroxyapatite-based biomaterial for sinus floor augmentation is evaluated. Methods: 20 sinus floor elevations were carried out in a total of 20 patients. After a healing period of 6 months, in 10 cases cylinder-shaped bone biopsies were taken from the augmented maxillary region using trephine burs. Results: The healing period progressed without any complications. General and specific histological analysis of the bone biopsies showed a high osteoclast activity at the margin of the biomaterial which was well integrated into the newly formed bone. Conclusion: This study demonstrates that new trabecular bone is formed after grafting with the nanocrystalline bone substitute after 6 months. Ongoing histomorphological studies are necessary to quantify the biomaterial-bone ratio and the exact amount of newly built bone in the augmented cavity after 6 months.

Synthetic bone substitute material comparable with xenogeneic material for bone tissue regeneration in oral cancer patients: First and preliminary histological, histomorphometrical and clinical results

“…Similar to the previous finding in animal soft-tissues, multi-nucleated giant cells were detected. [6] This study was, however, not able to determine whether the bone formation observed in all parts of the biopsy was related to an osteoinductive or an osteoconductive process. Accordingly, another clinical investigation was conducted to analyze the potential osteoinductive property of NB through histological observation of samples obtained 3 and 6 months after sinus augmentation.…”

“…Recently, our workgroup has thoroughly investigated the tissue reactions and clinical outcome of a fully synthetic nanocrystalline hydroxyapatite (HA) bone substitute material (NanoBone ® [NB], Artoss, Germany) embedded in a matrix of structured silica gel in numerous studies in animals and humans. [4567] In an animal experimental trial, NB was implanted subcutaneously in Wistar rats to assess the vascularization and biodegradation of the biomaterial histologically and histomorphometrically. Although, there was no sign of new bone formation in this ectopic tissue, the graft material showed lower vessel density and vascularization than other synthetic bone substitute materials.…”

Nanotechnology in Plastic Surgery

“…30 During facial fracture cases, sinus floor elevation has been performed in conjunction with nano-structured hydroxyapatite-based biomaterials. Stubinger et al 31 reported new trabecular bone formation within 6 months without the need for autogenous bone grafting. Furthermore, this material exhibited excellent tissue biocompatibility, and histologic analysis demonstrated no evidence of marked foreign body reaction.…”

Volumetric analysis of bone substitute material performance within the human sinus cavity of former head and neck cancer patients: A prospective, randomized clinical trial

“…In several clinical trials, the high biocompatibility, as well as the support of new bone formation after augmentation in dental and maxillofacial surgery, was demonstrated for these materials. [789101112]…”

“…Qualitative histologic analysis of biopsies taken after an integration period of 6 months revealed integration of the biomaterial within the sinus cavity and a high osteoclast activity, resulting in formation of new bone at the margin of the biomaterial. [10]…”