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Histomorphometrical analysis of bone formed in human maxillary sinus floor elevations grafted with OP‐1 device, demineralized bone matrix or autogenous bone. Comparison with non‐grafted sites in a series of case reports.
Author(s) -
Groeneveld Erika H. J.,
Van Den Bergh Johan P. A.,
Holzmann Paulien,
Ten Bruggenkate Chris M.,
Bram Tuinzing D.,
Burge Elisabeth II.
Publication year - 1999
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1034/j.1600-0501.1999.100608.x
Subject(s) - osteoid , demineralized bone matrix , medicine , bone grafting , dentistry , trephine , maxillary sinus , bone healing , sinus (botany) , anatomy , surgery , dbm , materials science , biology , amplifier , optoelectronics , cmos , botany , genus
Bone morphogenetic proteins have proven to be effective bone inductors in animals and are therefore promising as inductors of bone formation in humans. In the present study we investigated the tissue formed after grafting osteogenic protein 1 on a collagen carrier (OP‐l‐device) in the human sinus floor elevation procedure. Three patients were grafted with OP‐1 device. For comparison 3 groups of 3 patients were included in the study receiving respectively, autogenous bone, human freeze‐dried demineralized bone matrix (DBM) or no graft. This last group had a sufficient alveolar bone height for dental implantation. Six months after grafting, at the time of implantation, biopsies were taken from the grafted area and/or the future dental positions. Undecalcified sections were used for histological and histomorphometrical analysis. All grafted sinuses showed an increased osteoid percentage when compared to non‐grafted sinuses. Autogenous bone grafts all showed lamellar bone formation. In the DBM grafts mostly woven bone had been formed, predominantly by what appeared to be osteo‐conduction. The OP‐1 device gave rise to bone formation in 2 of the 3 patients. After 6 months implants could only be placed in 1 out of the 3 patients treated with OP‐1 device. This patient showed mature lamellar bone formation, comparable to autogenous bone grafts. In the second patient all bone found was woven and the presence of a high osteoid percentage and large osteoeyte lacunae indicated that this was recently‐formed bone. Remnants of the collagen carrier were rare and new bone was never found against them, suggesting that this bone was formed by osteo‐induction. In the third patient no new bone had been formed. The device had been encapsulated with fibrous tissue and in‐flammatory reaction was present. We conclude that in the human sinus floor elevation OP‐1 has potential bone inductive capacity, but that results in the 3 patients tested with the current OP‐1 device are inconsistent.