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.
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.
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对用 OP-1 装置、脱矿骨基质或自体骨移植的人上颌窦底高位形成的骨进行组织形态计量学分析。
DOI：
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发表时间：
1999
影响因子：
4.3
通讯作者：
Elisabeth II. Burge
中科院分区：
文献类型：
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作者：
Erika H. J. Groeneveld;Johan P. A. Van Den Bergh;Paulien Holzmann;C. T. ten Bruggenkate;D. Bram Tuinzing;Elisabeth II. Burge
骨形态发生蛋白已被证明是有效的动物骨诱导剂，因此有望作为人类骨形成的诱导剂。在本研究中，我们研究了在人类窦底抬高手术中，在胶原载体（op -1装置）上移植成骨蛋白1后形成的组织。3例患者移植OP-1装置。作为比较，3组3例患者分别接受自体骨、人冻干脱矿骨基质（DBM）和不移植骨。最后一组有足够的牙槽骨高度进行种植。移植后6个月，在种植时，从移植区域和/或未来的牙齿位置进行活检。未钙化切片用于组织学和组织形态计量学分析。与未移植鼻窦相比，所有移植鼻窦的类骨百分比均有所增加。自体骨移植均显示板层骨形成。在DBM移植物中，大部分编织骨形成，主要是通过骨传导形成的。OP-1装置使3例患者中的2例出现骨形成。6个月后，使用OP-1装置治疗的3例患者中只有1例可以植入植入物。该患者显示成熟的板层骨形成，与自体骨移植相当。在第二例患者中发现的所有骨都是编织的，并且存在高的类骨百分比和大的骨细胞腔隙表明这是最近形成的骨。胶原蛋白载体的残余物很少见，而且从未发现与之相对应的新骨，这表明该骨是通过骨诱导形成的。第三个病人没有新骨形成。器械被纤维组织包裹，有炎症反应。我们得出结论，在人鼻窦底抬高处OP-1具有潜在的骨诱导能力，但目前使用OP-1装置测试的3例患者的结果不一致。
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-1-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 osteocyte 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 inflammatory 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.