Top

Oral and Maxillofacial Surgery

Published in:

18-09-2021 | Original Article

Microcomputed tomographic analysis of bone microarchitecture after sinus augmentation with hyaluronic matrix: a case–control study

Authors: Ezgi Gurbuz, Erhan Dursun, Alper Vatansever, Feriha Caglayan

Published in: Oral and Maxillofacial Surgery | Issue 3/2022

Abstract

Background

The aim of this study was to analyze trabecular microarchitecture of augmented sinuses with hyaluronic matrix and xenograft by microcomputed tomography, and to investigate whether hyaluronic matrix has an effect on the newly formed bone quality.

Materials and methods

Thirteen patients undergoing maxillary sinus augmentation were included in this split-mouth study. Right and left sinus sites were randomly assigned to test and control group. In test group, the sinus was grafted with hyaluronic matrix and xenograft; in control group, only with xenograft. Four months after augmentation, bone samples were harvested during implant placement and analyzed for the following trabecular microarchitecture parameters using microcomputed tomography: bone volume (BV), total volume (TV), bone volume fraction (BV/TV), bone surface (BS), specific bone surface (BS/BV), bone surface density (BS/TV), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), trabecular pattern factor (Tb.Pf), and fractal dimension (FD).

Results

There was statistically significant difference only for BS/TV parameter between two groups. BS/TV was higher in hyaluronic matrix group compared with control group.

Conclusions

Addition of hyaluronic matrix to xenograft may enhance bone quality in terms of bone surface density. However, more research investigating the microstructural variation of augmented sinuses is needed with a greater sample.

Wallace SS, Tarnow DP, Froum SJ, Cho S-C, Zadeh HH, Stoupel J et al (2012) Maxillary sinus elevation by lateral window approach: evolution of technology and technique. J Evid Based Dent Pract 12:161–171PubMedCrossRef

Moy PK, Lundgren S, Holmes RE (1993) Maxillary sinus augmentation: histomorphometric analysis of graft materials for maxillary sinus floor augmentation. J Oral Maxillofac Surg 51:857–862PubMedCrossRef

Scarano A, Degidi M, Iezzi G, Pecora G, Piattelli M, Orsini G et al (2006) Maxillary sinus augmentation with different biomaterials: a comparative histologic and histomorphometric study in man. Implant Dent 15:197–207PubMedCrossRef

Miron RJ, Zhang Q, Sculean A, Buser D, Pippenger BE, Dard M et al (2016) Osteoinductive potential of 4 commonly employed bone grafts. Clin Oral Investig 20:2259–2265PubMedCrossRef

Froum SJ, Wallace S, Cho S-C, Rosenberg E, Froum S, Schoor R et al (2013) A histomorphometric comparison of Bio-Oss alone versus Bio-Oss and platelet-derived growth factor for sinus augmentation: a postsurgical assessment. Int J Periodontics Restorative Dent 33:268–279

Zhao N, Wang X, Qin L, Zhai M, Yuan J, Chen J et al (2016) Effect of hyaluronic acid in bone formation and its applications in dentistry. J Biomed Mater Res A 104:1560–1569PubMedCrossRef

Toole BP (2001) Hyaluronan in morphogenesis. Semin Cell Dev Biol 12:79–87PubMedCrossRef

Sasaki T, Watanabe C (1995) Stimulation of osteoinduction in bone wound healing by high-molecular hyaluronic acid. Bone 16:9–15PubMedCrossRef

Dogan E, Dursun E, Tosun E, Bilgic E, Akman AC, Orhan K et al (2017) Evaluation of hyaluronic matrix efficacy in sinus augmentation: a randomized-controlled histomorphometric and micro-computed tomography analysis. Int J Oral Maxillofac Surg 46:931–937PubMedCrossRef

10.

Emam H, Beheiri G, Elsalanty M, Sharawy M (2011) Microcomputed tomographic and histologic analysis of anorganic bone matrix coupled with cell-binding peptide suspended in sodium hyaluronate carrier after sinus augmentation: a clinical study. Int J Oral Maxillofac Implants 26:561–570PubMed

11.

Compston J (2006) Bone quality: what is it and how is it measured? Arq Bras Endocrinol Metabol 50:579–585PubMedCrossRef

12.

Bouxsein ML (2005) Determinants of skeletal fragility. Best Pract Res Clin Rheumatol 19:897–911PubMedCrossRef

13.

Müller R (2003) Bone microarchitecture assessment: current and future trends. Osteoporos Int 14:89–99CrossRef

14.

Iwaniec UT, Wronski TJ, Turner RT (2008) Histological analysis of bone. Methods Mol Biol 447:325–341PubMedCrossRef

15.

Feldkamp LA, Goldstein SA, Parfitt MA, Jesion G, Kleerekoper M (1989) The direct examination of three-dimensional bone architecture in vitro by computed tomography. J Bone Miner Res 4:3–11PubMedCrossRef

16.

Kühl S, Götz H, Hansen T, Kreisler M, Behneke A, Heil U et al (2010) Three-dimensional analysis of bone formation after maxillary sinus augmentation by means of microcomputed tomography: a pilot study. Int J Oral Maxillofac Implants 25:930–938PubMed

17.

Rickham PP (1964) Human Experimentation. Code of Ethics of the World Medical Association. Declaration of Helsinki. Br Med J. 2:177PubMedCrossRef

18.

Palacios R (2013) Post-trial access and the new version of the Declaration of Helsinki. Colomb Med (Cali) 44:206–207CrossRef

19.

Tatum H Jr (1986) Maxillary and sinus implant reconstructions. Dent Clin North Am 30:207–229PubMedCrossRef

20.

Parfitt AM, Drezner MK, Glorieux FH, Kanis JA, Malluche H, Meunier PJ et al (1987) Bone histomorphometry: standardization of nomenclature, symbols, and units: report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res 2:595–610PubMedCrossRef

21.

Bouxsein ML, Boyd SK, Christiansen BA, Guldberg RE, Jepsen KJ, Müller R (2010) Guidelines for assessment of bone microstructure in rodents using micro–computed tomography. J Bone Miner Res 25:1468–1486PubMedCrossRef

22.

Ulm C, Kneissel M, Schedle A, Solar P, Matejka M, Schneider B et al (1999) Characteristic features of trabecular bone in edentulous maxillae. Clin Oral Implants Res 10:459–467PubMedCrossRef

23.

Ibrahim N, Parsa A, Hassan B, van der Stelt P, Aartman IH, Wismeijer D (2014) Accuracy of trabecular bone microstructural measurement at planned dental implant sites using cone-beam CT datasets. Clin Oral Implants Res 25:941–945PubMedCrossRef

24.

Pereira R, Menezes J, Bonardi J, Griza G, Okamoto R, Hochuli-Vieira E (2018) Comparative study of volumetric changes and trabecular microarchitecture in human maxillary sinus bone augmentation with bioactive glass and autogenous bone graft: a prospective and randomized assessment. Int J Oral Maxillofac Surg 47:665–671PubMedCrossRef

25.

Monje A, Monje F, González-García R, Suarez F, Galindo-Moreno P, García-Nogales A et al (2015) Influence of atrophic posterior maxilla ridge height on bone density and microarchitecture. Clin Implant Dent Relat Res 17:111–119PubMedCrossRef

26.

Dursun E, Dursun CK, Eratalay K, Orhan K, Celik HH, Tözüm TF (2015) Do porous titanium granule grafts affect bone microarchitecture at augmented maxillary sinus sites? a pilot split-mouth human study. Implant Dent 24:427–433PubMedCrossRef

27.

Huang HL, Chen MY, Hsu JT, Li YF, Chang CH, Chen KT (2012) Three-dimensional bone structure and bone mineral density evaluations of autogenous bone graft after sinus augmentation: a microcomputed tomography analysis. Clin Oral Implants Res 23:1098–1103PubMedCrossRef

28.

Márton K, Tamás SB, Orsolya N, Béla C, Ferenc D, Péter N et al (2018) Microarchitecture of the augmented bone following sinus elevation with an albumin impregnated demineralized freeze-dried bone allograft (BoneAlbumin) versus anorganic bovine bone mineral: a randomized prospective clinical, histomorphometric, and micro-computed tomography study. Materials 11:202PubMedCentralCrossRef

29.

Chackartchi T, Iezzi G, Goldstein M, Klinger A, Soskolne A, Piattelli A et al (2011) Sinus floor augmentation using large (1–2 mm) or small (0.25–1 mm) bovine bone mineral particles: a prospective, intra‐individual controlled clinical, micro‐computerized tomography and histomorphometric study. Clin Oral Implants Res. 22:473–480PubMedCrossRef

30.

Caubet J, Ramis JM, Ramos-Murguialday M, Morey MÁ, Monjo M (2015) Gene expression and morphometric parameters of human bone biopsies after maxillary sinus floor elevation with autologous bone combined with Bio-Oss® or BoneCeramic®. Clin Oral Implants Res 26:727–735PubMedCrossRef

31.

Chopra PM, Johnson M, Nagy TR, Lemons JE (2009) Micro-computed tomographic analysis of bone healing subsequent to graft placement. J Biomed Mater Res B Appl Biomater 88:611–618PubMedCrossRef

32.

Rebaudi A, Maltoni AA, Pretto M, Benedicenti S (2010) Sinus grafting with magnesium-enriched bioceramic granules and autogenous bone: a microcomputed tomographic evaluation of 11 patients. Int J Periodontics Restorative Dent 30:53–61PubMed

33.

Wang F, Zhou W, Monje A, Huang W, Wang Y, Wu Y (2017) Influence of healing period upon bone turn over on maxillary sinus floor augmentation grafted solely with deproteinized bovine bone mineral: a prospective human histological and clinical trial. Clin Implant Dent Relat Res 19:341–350PubMedCrossRef

34.

Pilloni A, Bernard GW (1992) Low molecular weight hyaluronic acid increases osteogenesis in vitro. J Dent Res. 71:574(IADR abstract #471}

35.

Huang L, Cheng Y, Koo P, Lee K, Qin L, Cheng J et al (2003) The effect of hyaluronan on osteoblast proliferation and differentiation in rat calvarial-derived cell cultures. J Biomed Mater Res A 66:880–884PubMedCrossRef

36.

Stiller M, Kluk E, Bohner M, Lopez-Heredia MA, Müller-Mai C, Knabe C (2014) Performance of β-tricalcium phosphate granules and putty, bone grafting materials after bilateral sinus floor augmentation in humans. Biomaterials 35:3154–3163PubMedCrossRef

37.

Raines AL, Sunwoo M, Gertzman AA, Thacker K, Guldberg RE, Schwartz Z et al (2011) Hyaluronic acid stimulates neovascularization during the regeneration of bone marrow after ablation. J Biomed Mater Res A 96:575–583PubMedPubMedCentralCrossRef

38.

Jaffin RA, Berman CL (1991) The excessive loss of Branemark fixtures in type IV bone: a 5-year analysis. J Periodontol 62:2–4PubMedCrossRef

Title: Microcomputed tomographic analysis of bone microarchitecture after sinus augmentation with hyaluronic matrix: a case–control study
Authors: Ezgi Gurbuz
Erhan Dursun
Alper Vatansever
Feriha Caglayan
Publication date: 18-09-2021
Publisher: Springer Berlin Heidelberg
Published in: Oral and Maxillofacial Surgery / Issue 3/2022
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-021-01002-5

At a glance: The STEP trials

Springer Medicine

Microcomputed tomographic analysis of bone microarchitecture after sinus augmentation with hyaluronic matrix: a case–control study

Abstract

Background

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2022

Quality of life following maxillofacial trauma in the elderly: a multicenter, prospective study

Efficacy of Hilotherapy face mask in improving the trend of edema after orthognathic surgery: a 3D analysis of the face using a facial scan app for iPhone

Treatment costs of mandibular fractures in a Nigerian hospital

Treatment of tophaceous pseudogout in the temporomandibular joint with resection and alloplastic reconstruction: a single-staged approach

The neurosensory deficit of inferior alveolar nerve following bilateral sagittal split osteotomy: a prospective study

Rare clear cell odontogenic carcinoma associated with impacted tooth in a young patient: case report and literature review