Sequential healing of the elevated sinus floor after applying autologous bone grafting: an experimental study in minipigs
Sequential healing of the elevated sinus floor after applying autologous bone grafting: an experimental study in minipigs
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DOI：
10.1111/clr.12378
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发表时间：
2015-04-01
影响因子：
4.3
通讯作者：
Botticelli, Daniele
中科院分区：
文献类型：
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作者：
Scala, Alessandro;Lang, Niklaus P.;Botticelli, Daniele
目的描述上颌窦粘膜提升后应用外侧入路技术，使用无膜自体骨移植封闭截骨术入路后的顺序愈合。材料和方法上颌窦Schneiderian膜提升后，立即在10头小型猪中应用外侧入路技术，从下颌磨牙区域的侧面采集自体骨，并用骨磨机研磨成颗粒。施奈德膜下的空间充满了这种移植物。入路截骨处未放置膜。分别于术后15、30、90、180天观察愈合情况。结果愈合15天后，隆起区主要由临时基质、新生骨和部分骨碎片残留物填充，体积较手术时缩小。愈合30天后，发现抬高空间的高度进一步收缩，不同组织成分的百分比相似。90和180天后，Schneiderian膜下的区域体积缩小，并向窦底收缩。矿化和非矿化部分的骨组织似乎更成熟，而结缔组织占据了20%的空间，最有可能的原因是在手术时没有使用封闭通道的膜。结论：当自体骨片用作填充物时，记录了关于窦底膜下空间增大的次优愈合结果，而当自体骨片用作填充物时，应用膜覆盖通路。
AimTo describe the sequential healing after elevation of the maxillary sinus mucosa applying the lateral access technique with the use of autogenous bone grafting without membrane to occlude the osteotomy access.Material and methodsImmediately after the elevation of the maxillary sinus Schneiderian membrane, applying the lateral access technique in 10 minipigs, autologous bone was harvested from the lateral aspect of the mandibular molar region and ground into particles with a bone mill. The space under the Schneiderian membrane was filled with this graft. No membranes were placed onto the access osteotomy. The healing was evaluated after 15, 30, 90 and 180days. Paraffin sections were prepared and analyzed histologically.ResultsAfter 15days of healing, the elevated area was mainly filled with provisional matrix, newly formed bone and some remnants of bone chips, and appeared reduced in volume compared with that at the time of surgery. After 30days of healing, further shrinkage of the height of the elevated space was found, with similar percentages of the different tissue components. After 90 and 180days, the area underneath the Schneiderian membrane appeared reduced in volume and condensed toward the base of the sinus. The bone tissues appeared to be more mature, both for the mineralized and the non-mineralized portions, while connective tissue occupied 20% of the space, most likely related to the lack of the use of a membrane occluding the access at the time of surgery.ConclusionsSuboptimal healing outcomes with respect to augmentation of the space under the sinus floor membrane were documented when autologous bone chips were used as a filler and no membrane was applied to cover the access.