Back-scattered electron imaging and elemental analysis of retrieved bone tissue following sinus augmentation with deproteinized bovine bone or biphasic calcium phosphate
2010 (English)In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 21, no 9, 924-930 p.Article in journal (Refereed) Published
Objectives: To compare resorption of a synthetic biphasic calcium phosphate (BCP) bone–graft substitute with deproteinized bovine bone (DBB) used for human maxillary sinus augmentation.
Materials and methods: Eleven patients underwent bilateral maxillary sinus floor augmentation with DBB in one side and a BCP (40%β-tricalcium phosphate (β-TCP) and 60% hydroxyapatite) in the contralateral side. Simultaneously, with the augmentation on each side a microimplant was placed vertically from the top of the alveolar crest penetrating the residual bone and the grafting material. Eight months after initial surgery the microimplants were retrieved with a surrounding bone core. The composition of residual graft material and surrounding bone was analysed by scanning electron microscopy and energy dispersive X-ray spectroscopy.
Results: Residual graft material of both types was present as 10–500 μm particles in direct contact with, or completely surrounded by, newly formed bone; smaller particles were also present in non-mineralized tissue. In the case of BCP the bone–graft substitute interface showed evidence of superficial disintegration of particles into individual grains. Median Ca/P ratios (at.%), determined from >200 discreet sites within residual graft particles and adjacent bone, were: DBB: 1.61 (confidence interval [CI] 1.59–1.64); BCP: 1.5 (CI 1.45–1.52); DBB-augmented bone: 1.62 (CI 1.59–1.66); BCP-augmented bone: 1.52 (CI 1.47–1.55); P=0.028 for DBB vs. BCP and DBB- vs. BCP-augmented bone. The reduction in Ca/P ratio for BCP over the healing period is consistent with the dissolution of β-TCP and reprecipitation on the surface of calcium-deficient hydroxyapatite.
Conclusion: The β-TCP component of BCP may be gradually substituted by calcium-deficient hydroxyapatite over the healing period. This process and superficial degranulation of BCP particles may influence the progress of resorption and healing.
Place, publisher, year, edition, pages
2010. Vol. 21, no 9, 924-930 p.
bone implant interactions, bone substitutes, sinus elevation
IdentifiersURN: urn:nbn:se:umu:diva-109685DOI: 10.1111/j.1600-0501.2010.01933.xISI: 000280630200007PubMedID: 20491837OAI: oai:DiVA.org:umu-109685DiVA: diva2:859144