β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies

Abstract

BackgroundIt is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans.MethodsIn ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the other side using only β-TCP/HA (BC). After 6 months, biopsies were harvested from grafted areas during implant installation, being histologically and histomorphometrically analyzed. Differences between the groups considering new bone formation, soft tissues, and remaining BC were statistically evaluated.ResultsAll patients showed uneventful healing after MSFA, and dental implant installation was possible in all patients after 6 months. Histological analysis showed newly formed bone that was primarily woven in nature; it was organized in thin trabeculae, and it was occasionally in contact with residual bone substitute particles, which appeared in various forms and sizes and in advanced stage of degradation. Mean bone area was 43.4% (CI95 38.9; 47.8) for the BC group and 43.0% (CI95 36.6; 49.5) for the BC + EMD group. Mean soft tissue area was 21.3% (CI95 16.5; 26.2) for BC group and 21.5% (CI95 17.7; 25.3) for BC + EMD group, while the remaining biomaterial was 35.3% (CI95 36.6; 49.5) and 35.5% (CI95 29.6; 41.3) for BC and BC + EMD group, respectively.ConclusionsMSFA with BC resulted in adequate amounts of new bone formation allowing successful implant installation; adding EMD did not have a significant effect.

Enamel Matrix Derivatives for Periodontal Regeneration: Recent Developments and Future Perspectives

“…Studies showed that when comparing augmentation of the maxillary sinus floor with β -TCP/HA without or with EMD, it was found that the combination of Bone Ceramic® and maxillary sinus floor augmentation had resulted in high bone formation and thus installation of the implant successfully and that EMD did not lead to a significant effect [ 64 ]. Potent angiogenic and mitogenic activity is exhibited by fibroblast growth factor (FGF)-2 in mesenchymal cells inside the periodontal ligament and is found effective in periodontal tissue regeneration in animal models.…”

Relative performance of various biomaterials used for maxillary sinus augmentation: A Bayesian network meta‐analysis

“…The total sample consisted of 842 MSAs from 34 RCTs (Batas et al., 2019; Bettega et al., 2009; Cordaro et al., 2008; Felice et al., 2009; Flichy‐Fernández et al., 2019; Galindo‐Moreno et al., 2008, 2011; Jelusic et al., 2017; Khairy et al., 2013; Kılıç et al., 2017; Kurkcu et al., 2012; Lee et al., 2017; Lindgren et al., 2009; Kivovics et al., 2018; Meimandi et al., 2017; Menezes et al., 2018; Meymandi et al., 2017; Nery et al., 2017; Nizam et al., 2018; Oh et al., 2019; de Oliveira et al., 2016; Pasquali et al., 2015; Payer et al., 2014; Pereira, Gorla, et al, 2017; Pereira, Menezes, et al, 2017; Stacchi et al., 2017; Szabó et al., 2005; Theodoro et al., 2018; Torres et al., 2009; Wagner et al., 2012; Wildburger et al., 2014; Wiltfang et al., 2003; Zerbo et al., 2004; Zhang et al., 2012).…”

“…(Cordaro et al., 2008; Flichy‐Fernández et al., 2019; Jelusic et al., 2017; Lindgren et al., 2009; Meymandi et al., 2017; Nery et al., 2017; Oh et al., 2019)…”

The use of bioactive factors to enhance bone regeneration: A narrative review

“…Recently, the 6‐month histomorphometric analysis of sinuses grafted with β‐TCP/HA with or without EMD showed that EMD did not enhance new bone formation (Nery, Pereira, Guimaraes, Scardueli & Franca, ).…”