The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times
Abstract Background This study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% ß-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-07-01
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| Series: | International Journal of Implant Dentistry |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40729-017-0099-x |
| _version_ | 1818191730759958528 |
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| author | W. F. Bouwman N. Bravenboer J. W. F. H. Frenken C. M. ten Bruggenkate E. A. J. M. Schulten |
| author_facet | W. F. Bouwman N. Bravenboer J. W. F. H. Frenken C. M. ten Bruggenkate E. A. J. M. Schulten |
| author_sort | W. F. Bouwman |
| collection | DOAJ |
| description | Abstract Background This study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% ß-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-month healing time. Methods A unilateral MSFE procedure, using 100% BCP, was performed in two series of five patients with healing times of 9 and 12 months respectively. Clinical and radiological parameters were measured up to 5 years postoperatively. Biopsy retrieval was carried out during dental implants placement. Histology and histomorphometry were performed on 5-μm sections of undecalcified bone biopsies. Results The MSFE procedure with BCP showed uneventful healing in all cases. All dental implants appeared to be well osseointegrated after 3 months. Radiological evaluation showed less than 1 mm tissue height loss from MSFE to the 5-year follow-up examination. No signs of inflammation were detected on histological examination. Newly formed mineralized tissue was found cranially from the native bone. The BCP particles were surrounded by connective tissue, osteoid islands, and newly formed bone. Mineralized bone tissue was in intimate contact with the BCP particles. After 12 months, remnants of BCP were still present. The newly formed bone had a trabecular structure. Bone maturation was demonstrated by the presence of lamellar bone. Histomorphometric analysis showed at 9 and 12 months respectively an average vital bone volume/total volume of 35.2 and 28.2%, bone surface/total volume of 4.2 mm2/mm3 and 8.3 mm2/mm3, trabecular thickness of 224.7 and 66.7 μm, osteoid volume/bone volume of 8.8 and 3.4%, osteoid surface/bone surface (OS/BS) of 42.4 and 8.2%, and osteoid thickness of 93.9 and 13.6 μm. Conclusions MFSE with BCP resulted in new bone formation within the augmented sinus floor and allowed the osseointegration of dental implants in both groups. From a histological and histomorphometric perspective, a 9-month healing time for this type of BCP may be the optimal time for placement of dental implants. |
| first_indexed | 2024-12-12T00:19:15Z |
| format | Article |
| id | doaj.art-48ea93ccc4634357accaf3d9919d47e5 |
| institution | Directory Open Access Journal |
| issn | 2198-4034 |
| language | English |
| last_indexed | 2024-12-12T00:19:15Z |
| publishDate | 2017-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Implant Dentistry |
| spelling | doaj.art-48ea93ccc4634357accaf3d9919d47e52022-12-22T00:44:46ZengSpringerOpenInternational Journal of Implant Dentistry2198-40342017-07-01311910.1186/s40729-017-0099-xThe use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing timesW. F. Bouwman0N. Bravenboer1J. W. F. H. Frenken2C. M. ten Bruggenkate3E. A. J. M. Schulten4Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA)Department of Clinical Chemistry, VU University Medical CenterDepartment of Oral and Maxillofacial Surgery, St. Antonius HospitalDepartment of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA)Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA)Abstract Background This study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% ß-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-month healing time. Methods A unilateral MSFE procedure, using 100% BCP, was performed in two series of five patients with healing times of 9 and 12 months respectively. Clinical and radiological parameters were measured up to 5 years postoperatively. Biopsy retrieval was carried out during dental implants placement. Histology and histomorphometry were performed on 5-μm sections of undecalcified bone biopsies. Results The MSFE procedure with BCP showed uneventful healing in all cases. All dental implants appeared to be well osseointegrated after 3 months. Radiological evaluation showed less than 1 mm tissue height loss from MSFE to the 5-year follow-up examination. No signs of inflammation were detected on histological examination. Newly formed mineralized tissue was found cranially from the native bone. The BCP particles were surrounded by connective tissue, osteoid islands, and newly formed bone. Mineralized bone tissue was in intimate contact with the BCP particles. After 12 months, remnants of BCP were still present. The newly formed bone had a trabecular structure. Bone maturation was demonstrated by the presence of lamellar bone. Histomorphometric analysis showed at 9 and 12 months respectively an average vital bone volume/total volume of 35.2 and 28.2%, bone surface/total volume of 4.2 mm2/mm3 and 8.3 mm2/mm3, trabecular thickness of 224.7 and 66.7 μm, osteoid volume/bone volume of 8.8 and 3.4%, osteoid surface/bone surface (OS/BS) of 42.4 and 8.2%, and osteoid thickness of 93.9 and 13.6 μm. Conclusions MFSE with BCP resulted in new bone formation within the augmented sinus floor and allowed the osseointegration of dental implants in both groups. From a histological and histomorphometric perspective, a 9-month healing time for this type of BCP may be the optimal time for placement of dental implants.http://link.springer.com/article/10.1186/s40729-017-0099-xBiphasic calcium phosphateBone substituteSinus augmentationSinus floor elevation |
| spellingShingle | W. F. Bouwman N. Bravenboer J. W. F. H. Frenken C. M. ten Bruggenkate E. A. J. M. Schulten The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times International Journal of Implant Dentistry Biphasic calcium phosphate Bone substitute Sinus augmentation Sinus floor elevation |
| title | The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times |
| title_full | The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times |
| title_fullStr | The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times |
| title_full_unstemmed | The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times |
| title_short | The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times |
| title_sort | use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure a clinical radiological histological and histomorphometric evaluation with 9 and 12 month healing times |
| topic | Biphasic calcium phosphate Bone substitute Sinus augmentation Sinus floor elevation |
| url | http://link.springer.com/article/10.1186/s40729-017-0099-x |
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