Sinus floor augmentation with simultaneous placement of dental implants using a combination of deproteinized bone xenografts and recombinant human osteogenic protein-1 - A histometric study in miniature pigs
H. Terheyden et al., Sinus floor augmentation with simultaneous placement of dental implants using a combination of deproteinized bone xenografts and recombinant human osteogenic protein-1 - A histometric study in miniature pigs, CLIN OR IMP, 10(6), 1999, pp. 510-521
Maxillary sinus floor augmentation with autogenous bone has become a widely
accepted procedure in implant dentistry. The use of osteoconductive bone s
ubstitutes in this indication is controversial, since their use can lead to
a prolonged healing time, inhomogenous ossification, foreign body reaction
, migration of particles and low bone-implant contact (BIC). The purpose of
this study was to examine whether the combination of an osteoinductive pro
tein (recombinant human osteogenic protein-1 (rhOP-1 = bone morphogenetic p
rotein-7) with natural bovine bone mineral (BioOss(R)) would improve ossifi
cation and the bone-implant contact (BIC) in a sinus floor augmentation wit
h simultaneous placement of implants. In this study, the maxillary sinus fl
oors in 5 miniature pigs were augmented with 3 mi BioOss(R) containing 420
mu g rhOP-1 on the test side and 3 mi BioOss(R) alone on the control side.
At the time of augmentation a titanium implant (ITI(R)) was inserted from a
laterocaudal direction. After 6 months of healing the sites of augmentatio
n were removed and examined in non-decalcified sections by microradiography
, fluorescence microscopy of sequentially labelled specimens and by histome
try. On both sides, significant amounts of newly-formed bone were observed.
However, on the test sites, the percentage of BIC in the augmented area wa
s 80.0% versus 38.6% on control sites. It can be concluded that the applica
tion of bone morphogenetic proteins caused a more rapid and enhanced osseoi
ntegration of simultaneously placed implants when compared to the bone subs
titute alone. Therefore recombinant human osteogenic protein-1 delivered by
natural bone mineral has the potential to become a clinical alternative fo
r autogenous bone grafts in sinus floor augmentation.