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Evaluation of a new biphasic calcium phosphate for maxillary sinus floor elevation: Micro‐CT and histomorphometrical analyses
Author(s) -
Helder Marco N.,
Esterik Fransisca A. S.,
Kwehandjaja Mardi D.,
Bruggenkate Christiaan M.,
KleinNulend Jenneke,
Schulten Engelbert A. J. M.
Publication year - 2018
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 - 10.1111/clr.13146
Subject(s) - osteoid , maxillary sinus , bone remodeling , medicine , dentistry , calcium , urology , neovascularization , angiogenesis
Objectives Synthetic biphasic calcium phosphate ( BCP ) with a hydroxyapatite/ß‐tricalcium phosphate ( HA /ß‐ TCP ) ratio of 60/40 ( BCP 60/40) is successfully used as alternative for autologous bone in patients undergoing maxillary sinus floor elevation ( MSFE ) for dental implant placement. A high percentage of HA in BCP 60/40 may hamper efficient scaffold remodeling. Osteogenesis and neovascularization are pivotal in effective bone regeneration. We aimed to investigate whether differences exist in osteogenic and/or vasculogenic potential of BCP 60/40 and BCP 20/80 in patients undergoing MSFE . Materials and methods Twenty patients undergoing MSFE were treated with BCP 60/40 ( n = 10) or BCP 20/80 ( n = 10). Bone and graft volumes were determined by micro‐computed tomography and histomorphometrical analysis of biopsies of the augmented region. Osteoid volumes, number of osteoclasts, and blood vessels were determined by histomorphometrical analysis. The biopsies were taken 6.5 months (26 weeks) postoperatively prior to dental implant placement. Results Bone and osteoid volumes were 9.7% and 0.8% higher at the most cranial side of the BCP 20/80 biopsies compared to the BCP 60/40 biopsies. Graft volumes, number of osteoclasts, and blood vessels were similar in both groups. Conclusions BCP 20/80 showed enhanced osteogenic potential in patients undergoing MSFE compared to BCP 60/40, due to either a faster bone remodeling rate or an earlier start of bone formation in BCP 20/80‐treated patients, suggesting that a higher TCP content positively contributes to the bone remodeling rate. Therefore, BCP 20/80 might perform better, at least in the short term, as a scaffold for bone augmentation in the MSFE model than BCP 60/40 as more bone is formed, and more osteoid is deposited at the cranial side in BCP 20/80‐treated patients compared to BCP 60/40‐treated patients. However, catch‐up of BCP 60/40 in the long term cannot be ruled out.