Discussion : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [3]
The lower phylogenetic level of the animals compared to humans was the main limitation of the present study. An increased number of animals might allow reaching a statistical difference in favor of the treated sites also in the antrostomy region. Nevertheless, the outcomes obtained, allow to performing studies in humans that might demonstrate the advantages of applying autologous bone on the antrostomy.
Some features of autologous bone grafts may be relevant to the resorption process such as its form (block or particulate) [23], its microarchitecture (cortical or cancellous) [24], or the embryogenesis of the donor sites (intramembranous or endochondral ossification) [25].
The present study harvested autologous bone from the rabbit tibia, i.e., endochondral ossification. In humans, this type of ossification has demonstrated less dimensional stability than intraoral grafts that present intramembranous ossification [24, 25]. For this reason, and because of the less patient morbidity and risk of complications, intraoral autogenous bone harvesting is routinely used [26, 27]. Intraoral particulated bone (intramembranous origin) can be obtained from the cortical bone of the lateral window [28] or from neighbor intraoral areas (e.g., from the ramus, or the chin, or retromolar area). The difference in the origin of the autograft should be taken into consideration when interpreting the results of the present preclinical study.
It can be concluded that the placement of autogenous bone in the antrostomy and the subjacent region after maxillary sinus elevation, provides slightly better new bone formation compared with sites only grafted with xenograft. Though, only the subjacent close-to window region showed a statistical significance within treated sites at 8 weeks of healing. Despite the limitations of the present study and due to its preclinical nature, results should be extrapolated to humans with caution.
Serial posts:
- Abstract : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits
- Introduction : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [1]
- Introduction : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [2]
- Materials and methods : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [1]
- Materials and methods : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [2]
- Materials and methods : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [3]
- Results : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [1]
- Results : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [2]
- Discussion : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [1]
- Discussion : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [2]
- Discussion : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [3]
- Availability of data and materials : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits
- Abbreviations : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits
- References : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [1]
- References : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [2]
- References : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [3]
- References : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits [4]
- Funding : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits
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- About this article : Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits
- Table 1 Histomorphometric analysis. Tissues evaluated in the various regions after 1 week of healing : Influence of the use of autogenous bone particles to close the access window after maxillary
- Table 2 Histomorphometric analysis. Tissues evaluated in the various regions after 8 weeks of healing : Influence of the use of autogenous bone particles to close the access window after maxillary
- Fig. 1. Clinical view of the surgical procedures. a Tibial bone exposed for autogenous bone harvesting using a bone scraper. b Antrostomies prepared. c Autogenous bone particles placed in the antrostomy. d Xenograft and bone particles (red arrow) at the antrostomies. e Collagen membranes placed on the antrostomies. f Wounds closed with sutures : Influence of the use of autogenous bone particles
- Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone walls (red arrow); middle (white arrow); sub-mucosa (yellow arrow); close-to-window (orange arrow). The antrostomy region was also evaluated at the medial and lateral edges (dark green arrows) and in the middle aspect (light green arrow) : Influence of the use of autogenous bone particles
- Fig. 3. Photomicrographs of decalcified sections illustrating the healing after 1 week. a Treated site. Bone strips occupying the antrostomy and the subjacent area (close-to-window region). b Untreated site. Note the new bone-forming from the sinus bone walls. Scarlet-acid fuchsine and toluidine blue stain. Images grabbed at × 20 magnification : Influence of the use of autogenous bone particles
- Fig. 4. Photomicrographs of ground sections. a) Treated site. Bone residues (examples in yellow asterisks) included in soft tissue containing fibroblast-like cells and inflammatory cells. b) Untreated site. Xenograft residues (examples in red asterisks) surrounded by soft tissue rich in fibroblast-like cells. Scarlet-acid fuchsine and toluidine blue stain. a) 200 x magnification.; b) 100 x magnification : Influence of the use of autogenous bone particles
- Fig. 5. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. Both at the treated (a) and untreated (b) sites, the antrostomy was closed in most cases, presenting residual defects of various dimensions in the outer side. New bone was connecting the lateral and medial sinus walls. The middle and sub-mucosa regions were not healed completely yet. Scarlet-acid fuchsine and toluidine blue stain. Images grabbed at × 20 magnification : Influence of the use of autogenous bone particles
- Fig. 6. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. a Treated site. Most of the antrostomies presented remaining defects in the outer contour. b, c Untreated sites. Two antrostomies of the treated sites and four of the untreated sites appeared not closed with corticalized bone and presented connective tissue interposed between the edges of the antrostomy. Scarlet-acid fuchsine and toluidine blue stain. a Image grabbed at × 20 magnification. b, c Images grabbed at × 40 magnification : Influence of the use of autogenous bone particles
- Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference : Influence of the use of autogenous bone particles
- Fig. 8. Photomicrographs of decalcified sections. a Untreated site. Woven bone formed from the sinus walls after 1 week of healing. b Treated site. After 8 weeks, woven bone was still found forming ridges towards residues of provisional matrix, showing that the healing was not completed yet. Scarlet-acid fuchsine and toluidine blue stain. a × 100 magnification. b × 20 magnification : Influence of the use of autogenous bone particles