Clinical Assessment of Biphasic Calcium Phosphate in Granules and Paste Forms in Human Maxillary Sinus Bone Augmentation: A Randomized, Split-Mouth Clinical Trial.

The aim of the present study is to compare the biphasic calcium phosphate (BCP) using two different forms-(1) granules and (2) paste-in human maxillary sinus bone reconstruction as a split-mouth study using histomorphometric and immunolabeling for osteocalcin. Ten patients with bilateral maxillary posterior partial edentulism were selected in order to reconstruct bone height. They were divided into two groups: BCPG and BCP-P. After six months of bone healing, biopsies were harvested to assess the new bone formation and immunostaining for osteocalcin. The BCP g group had the following results: mean of bone formation in pristine bone 49.4 ± 21.6%, intermediate 49.4 ± 16.2%, and apical 55.3 ± 21.4%. The group BCP-P had a mean of 41.9 ± 17.3% in the pristine bone region, 37.5 ± 7.8% for intermediate, and 39.0 ± 13.5% for apical. The osteocalcin immunolabeling was high for both groups, demonstrating bone calcification. Thus, the two biomaterials present suitable results for the placement of dental implants.

Bioactive glass added to autogenous bone graft in maxillary sinus augmentation: a prospective histomorphometric, immunohistochemical, and bone graft resorption assessment.

OBJECTIVE: The aim of this study was to compare the bone resorption rate, histomorphometry and immunohistochemical findings of bioactive glass (Biogran; Biomet, Warsaw, IN, USA) mixed with autogenous bone grafts (1:1) and autogenous bone graft isolate in maxillary sinus elevation surgery. MATERIAL AND METHODS: A total of 9 maxillary sinuses were grafted with Biogran with autogenous bone graft (group 1) and 12 were mixed with autogenous bone graft (group 2). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T1), and 6 months later, another CBCT scan was performed to evaluate the final graft volume (T2) and determine the graft resorption rate. The resorption outcomes were 37.9%±18.9% in group 1 and 45.7%±18.5% in group 2 (P=0.82). After 6 months, biopsies were obtained concurrent with the placement of dental implants; these implants were subjected to histomorphometric analysis and immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). RESULTS: The average bone formation in group 1 was 36.6%±12.9 in the pristine bone region, 33.2%±13.3 in the intermediate region, and 45.8%±13.8 in the apical region; in group 2, the values were 34.4%±14.4, 35.0%±13.9, and 42.0%±16.6 of new bone formation in the pristine bone, intermediate, and apical regions, respectively. Immunostaining for TRAP showed poor clastic activity in both groups, which can indicate that those were in the remodeling phase. CONCLUSIONS: The similarity between the groups in the formation and maintenance of the graft volume after 6 months suggests that the bioactive glass mixed with autogenous bone (1:1) can be used safely as a bone substitute for the maxillary sinus lift.

Bioactive glass added to autogenous bone graft in maxillary sinus augmentation: a prospective histomorphometric, immunohistochemical, and bone graft resorption assessment

Abstract Objective The aim of this study was to compare the bone resorption rate, histomorphometry and immunohistochemical findings of bioactive glass (Biogran; Biomet, Warsaw, IN, USA) mixed with autogenous bone grafts (1:1) and autogenous bone graft isolate in maxillary sinus elevation surgery. Material and Methods A total of 9 maxillary sinuses were grafted with Biogran with autogenous bone graft (group 1) and 12 were mixed with autogenous bone graft (group 2). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T1), and 6 months later, another CBCT scan was performed to evaluate the final graft volume (T2) and determine the graft resorption rate. The resorption outcomes were 37.9%±18.9% in group 1 and 45.7%±18.5% in group 2 (P=0.82). After 6 months, biopsies were obtained concurrent with the placement of dental implants; these implants were subjected to histomorphometric analysis and immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). Results The average bone formation in group 1 was 36.6%±12.9 in the pristine bone region, 33.2%±13.3 in the intermediate region, and 45.8%±13.8 in the apical region; in group 2, the values were 34.4%±14.4, 35.0%±13.9, and 42.0%±16.6 of new bone formation in the pristine bone, intermediate, and apical regions, respectively. Immunostaining for TRAP showed poor clastic activity in both groups, which can indicate that those were in the remodeling phase. Conclusions The similarity between the groups in the formation and maintenance of the graft volume after 6 months suggests that the bioactive glass mixed with autogenous bone (1:1) can be used safely as a bone substitute for the maxillary sinus lift.

Histomorphometric and immunohistochemical assessment of RUNX2 and VEGF of Biogran™ and autogenous bone graft in human maxillary sinus bone augmentation: A prospective and randomized study.

BACKGROUND: Few studies have been conducted to assess new bone formation using Biogran, a bioactive glass, in maxillary sinus bone augmentation through a prospective and randomized evaluation. Moreover, there are no studies that evaluate cellular behavior by immunohistochemical assessment for osteoblastic and vascular activity during bone repair. PURPOSE: The aim of this study is to compare new bone formation and cellular behavior with Biogran alone, a 1:1 combination of Biogran and autogenous bone graft, and autogenous bone graft alone in human maxillary sinuses. MATERIALS AND METHODS: Ten maxillary sinuses were grafted with Biogran (Group 1), 10 grafted with Biogran added to autogenous bone graft in a 1:1 ratio (Group 2), and 10 grafted with autogenous bone graft alone (Group 3). After 6 months of bone healing, samples were obtained concurrent to the dental implants' placement to be evaluated by histomorphometric and immunohistochemical assessment for RUNX2 and vascular endothelial growth factor (VEGF). RESULTS: The amount of new bone formation in Group 1 was 42.0 ± 7.3% in the pristine bone region, 40.7 ± 14.0% in the intermediate region, and 45.6 ± 13.5% in apical region. In Group 2, for pristine bone, intermediate, and apical regions, new bone formation was 36.6 ± 12.9%, 33.2 ± 13.3%, and 45.8 ± 13.9%, respectively. Group 3 showed new bone formation of 37.3 ± 11.6%, 35.3 ± 14.7%, and 39.9 ± 15.8% in pristine bone, intermediate, and apical regions, respectively. The immunolabeling for RUNX2 showed low cellular activity in osteoblasts for all groups, and the VEGF assessment demonstrated moderate cellular activity in Groups 1 and 2; however, Group 3 presented with low activity in the pristine bone region, followed by moderate activity in the intermediate and apical region. CONCLUSION: This study demonstrates that Biogran and its combination with autogenous bone graft 1:1 are good bone substitutes due to their similarity to autogenous bone graft.