Osteoinductive calcium phosphate with submicron topography as bone graft substitute for maxillary sinus floor augmentation: A translational study.

OBJECTIVES: The aim of this study was the preclinical and clinical evaluation of osteoinductive calcium phosphate with submicron surface topography as a bone graft substitute for maxillary sinus floor augmentation (MSFA). MATERIAL AND METHODS: A preclinical sheep model of MSFA was used to compare a calcium phosphate with submicron needle-shaped topography (BCPN , MagnetOs Granules, Kuros Biosciences BV) to a calcium phosphate with submicron grain-shaped topography (BCPG ) and autologous bone graft (ABG) as controls. Secondly, a 10-patient, prospective, randomized, controlled trial was performed to compare BCPN to ABG in MSFA with two-stage implant placement. RESULTS: The pre-clinical study demonstrated that both BCPN and BCPG were highly biocompatible, supported bony ingrowth with direct bone apposition against the material, and exhibited bone formation as early as 3 weeks post-implantation. However, BCPN demonstrated significantly more bone formation than BCPG at the study endpoint of 12 weeks. Only BCPN reached an equivalent amount of bone formation in the available space and a greater proportion of calcified material (bone + graft material) in the maxillary sinus compared to the "gold standard" ABG after 12 weeks. These results were validated in a small prospective clinical study, in which BCPN was found comparable to ABG in implant stability, bone height, new bone formation in trephine core biopsies, and overall clinical outcome. CONCLUSION: This translational work demonstrates that osteoinductive calcium phosphates are promising bone graft substitutes for MSFA, whereas their bone-forming potential depends on the design of their surface features. Netherlands Trial Register, NL6436.

[Small carcinoma of the lip with big consequences]. / Kleine lipcarcinomen met grote gevolgen.

A 79-year-old man, an 81-year-old woman and a 60-year-old woman were referred to our oral and maxillofacial surgery clinic with a large submandibular swelling. All three patients had a history of prior excision of a small carcinoma of the lower lip. Primary treatment had been carried out by a number of different medical specialists. In the first two patients, none of the caregivers had recognized this swelling as a possible lymph node metastasis. Oncological follow-up had not been performed and the patients were unaware of the metastatic potential of their cancers. Although in the third patient follow-up was adequate, there was too much delay between confirmation of the metastasis and planning of the surgery. All three patients died of a small lip carcinoma. Stage I lip carcinomas generally have a good prognosis. However, patients have to be informed about the risk of lymph node metastasis and need to be followed up on a routine basis.