Bio-Oss~材料在上颌窦外提升中的组织学研究

The histomorphometrical analysis of maxillary sinus augmentation using inorganic bovine Bio-Oss~ in human

目的通过临床组织形态学检测来评估运用100%Bio-Oss充填材料进行上颌窦外提升的实际成骨率。方法对12例上颌窦区的剩余垂直牙槽骨量不足(平均<3mm)的患者(平均56岁)进行上颌窦外提升术。术后6.5个月用Trephine牙钻分别从这12个术区钻取骨质标本,且同期将12颗Bego种植钉植入取骨区。钻取标本参照Donath&Breuner(1982)的标准方法进行切片及染色处理。结果组织形态学分析测定表明样本的新骨生成量为4.33%～24.05%,平均12.56%±5.03%;Bio-Oss颗粒平均存余量为26.78%±6.19%;Bio-Oss颗粒表面平均有57.03%±8.07%的区域与新生骨组织有直接接触。二期手术时植入的12颗Bego种植钉负重1年后的存活率为100%。结论 Bio-Oss是一种理想的、成骨性能较稳定的骨替代材料,适合我国人群的使用。

Objective To evaluate bone formation following maxillary sinus augmentation using 100% bovine bone substitute material （Bio-Oss） by means of histologic and histomorphometric examination of human biopsies. Methods Twelve sinus floor elevation procedures were carried out on 12 patients （average age of 56 years） . The subantral sinus cavity was augmented using 100% Bio-Oss. After an average healing phase of 6.5 months, Trephine burrs were used to take 12 bone biopsies from the augmented sinus region. Then 12 Bego implants were inserted in the osteotomies resulting from bone sampling. Histomorphometric analysis of ground sections from the bone biopsies prepared according to the standard method of Donath Breuner （1982） was carried out. Results It produced an average percentage of newly-formed bone of 12. 56% ± 5. 03% and a proportion of residual xenogenic bone substitute material of 26.78% ± 6.19%. Some 57.03% ± 8.07% of the surface of the Bio-Oss granulate was in direct contact with newly- formed bone. Histologically, newly-developed bone became evident, partly invaginating the particles of apatite and forming bridges in the form of trabeculae between the individual Bio-Oss particles. And the result of implants clinical survival rate with prosthetic loading after 1 year was 100%. Conclusions Bio-Oss is a suitable material for sinus floor elevation in the severely atrophic human maxilla.