Sinus Mucosal Damage Triggered by Synthetic or Xenogeneic Bone Substitutes: A Histological Analysis in Rabbits

Abstract

Background: It has been shown in rabbit models that the sinus mucosa in contact with graft particles might experience a progressive thinning and perforations. The phenomenon depends on the graft used. Hence, the aim of the present study was to compare the damaging effects of a synthetic of a xenogeneic graft. Methods: Forty New Zealand rabbits received a bilateral sinus elevation. Both sinuses of twenty rabbits were grafted with a biphasic 60% hydroxyapatite and 40% β-tricalcium phosphate while the other twenty received a deproteinized bovine bone mineral graft. Thinned sites (<40 µm) and perforations on the mucosa in contact with graft particles were evaluated after 2 and 10 weeks (ten animals each period). The width of the pseudostratified epithelium was also measured as control. Results: After 2 weeks of healing, 61 thinned sites were detected in the Synthetic group and 49 in the Xenogeneic group. After 10 weeks, the number of thinned mucosae increased to 79 sites in the Synthetic group (p = 0.222 between periods), and to 114 sites in the Xenogeneic group (p = 0.030 between groups; p = 0.001 between periods). Perforations were few in the 2-week period, two in two sinuses out of 20 in the Synthetic group, and four in two sinuses out of 20 in the Xenogeneic group (p = 0.721). In the 10-week period, the perforations increased to eight in the Synthetic group, distributed in six sinuses out of 20, and to sixteen in the Xenogeneic group, distributed in 11 sinuses out of 20 (p = 0.082). The pseudostratified epithelium presented a reduced width at the thinned sites. Conclusions: The contact with synthetic or xenogeneic grafts will induce thinning and possible perforations of the sinus mucosa. This effect will increase over time, and it is stronger at the xenogeneic than the synthetic graft.

Schneiderian Membrane Collateral Damage Caused by Collagenated and Non-Collagenated Xenografts: A Histological Study in Rabbits

“…It has been shown that damage occurs in the mucosa in contact with granules of biomaterial [17][18][19][20] or even with implant apexes and threads [18,21]. It has also been shown that grafts with a lower resorption rate present more damage than those with a higher resorption rate [17][18][19][20]. The results of these experiments suggest that resorption and surface characteristics might play an important role in the possible damage to the SM.…”

“…This damage, represented by thinning of the SM and perforations, has been observed in a rabbit model. It has been shown that damage occurs in the mucosa in contact with granules of biomaterial [17][18][19][20] or even with implant apexes and threads [18,21]. It has also been shown that grafts with a lower resorption rate present more damage than those with a higher resorption rate [17][18][19][20].…”

Evaluation of Two Configurations of Hydroxyapatite and Beta-Tricalcium Phosphate in Sinus Grafts with Simultaneous Implant Installation: An Experimental Study in Rabbits

“…This outcome of the complete absence of perforations is not in agreement with the reported outcomes of similar studies. In these studies, it was shown that sharpened edges of the granules [32][33][34][35] and implant apexes and threads [33,36] in contact with sinus mucosae produced thinning and possibly perforations over time. These differences are due to the different analytical methods applied.…”

Correction: Omori et al. Sinus Mucosal Damage Triggered by Synthetic or Xenogeneic Bone Substitutes: A Histological Analysis in Rabbits. J. Funct. Biomater. 2022, 13, 257

“…In the original publication [1], there was a mistake in the legend for Figure 1. The legend of Figure 1a was wrong because it did not describe the correct figure that should have been used.…”