Materials and methods : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [2]
Through an extra-oral approach, an oblique incision was made bilaterally along the sagittal axis between the facial tuberosity and the inferior orbital rim. The skin and periosteum were elevated separately, and the bony facial sinus wall was exposed on both sides of the maxilla (Fig. 1a).
A 12-mm large and 8-mm high antrostomy was prepared using a burr (H254E Komet Dental, Trophagener Weg 25, Lemgo, Germany) and the bone plate was removed bilaterally (Fig. 1b). The sinus mucosa was subsequently carefully elevated with sinus floor elevators, exposing the medial bony plate of the maxillary sinus (Fig. 1c). A landmark was positioned, twisting a steel wire through a hole above the access window (Fig. 1d).
After sinus mucosa elevation, the obtained space was filled with a biphasic calcium phosphate (60% HA, 40% β-TCP) (Easy-graftTM CRYSTAL; Sunstar GUIDOR, Etoy, Switzerland) on both sides (Fig. 1d).
Experimental and control sites were randomly chosen. The control site was covered with a polylactic acid blended with a citric acid ester membrane (GUIDOR® matrix barrier; Sunstar Americas Inc., Chicago, IL, USA) and secured with a minimum amount of cyanoacrylate glue (Indermil® x fine; Henkel-Loctite Corp. Dublin, Republic of Ireland) accurately positioned in four points (one at each corner; Fig. 1e, f). Cyanoacrylate glue was stored at 4 °C and used immediately after leaving the refrigerator, to keep the viscosity low. At the experimental site, similar procedures were applied (Fig. 2a–c), and the bony window was repositioned in place and secured with the four points of cyanoacrylate (one at each corner; Fig. 2d). Suturing in layers was then performed.
Gentamicin (Gentamicin-5® Bela-Pharm GmbH, Vechta, Germany) 8 mL/100 kg was administered every 12 h during the first postoperative day, and every 24 h during the following 3 days. The sheep were kept in an animal house individually, in a roofed shed to reduce distress after surgery, with a concrete floor. The boxes were cleaned daily and the animals had free access to water. The diet was based on a balanced specific food made of cereals, protein, and concentrates of vitamins and minerals, with added green forages. The wounds were cleaned by the veterinarians of the centre every day during the first week, and then inspected three times per week for clinical signs of complications for the duration of the experiment.
Serial posts:
- Abstract : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- Introduction : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [1]
- Introduction : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [2]
- Materials and methods : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [1]
- Materials and methods : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [2]
- Materials and methods : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [3]
- Materials and methods : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [4]
- Results : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [1]
- Results : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [2]
- Discussion : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [1]
- Discussion : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [2]
- Discussion : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [3]
- Conclusion : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- Availability of data and materials : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- Abbreviations : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- References : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [1]
- References : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [2]
- References : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [3]
- References : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [4]
- Acknowledgements : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- Funding : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- Author information : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [1]
- Author information : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep [2]
- Ethics declarations : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- Additional information : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- Rights and permissions : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- About this article : Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep
- Table 1 Percentages of the various tissues within the elevated area after 4 months of healing. Mean values ± standard deviations (P values) and median (25%; 75% percentiles) : Bone plate repositioned
- Table 2 Percentages of various tissues in the antrostomy area after 4 months of healing. Mean values ± standard deviations (P values) and median (25%; 75% percentiles) : Bone plate repositioned over
- Fig. 1. Clinical view at a membrane site. a Skin and periosteum were separately elevated, and the facial sinus wall exposed. b A 12 × 8-mm window was cut and removed. c The Schneiderian membrane was carefully elevated. d A twisted wire was inserted in the middle of the long side of the window and the elevated sinus was grafted. e At the control site, a resorbable membrane was placed and secured with cyanoacrylate. f Membrane in situ : Bone plate repositioned over the antrostomy after
- Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire was placed. c The elevated sinus was grafted. d The access bony window was repositioned and secured with cyanoacrylate : Bone plate repositioned over the antrostomy after
- Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal : Bone plate repositioned over the antrostomy after
- Fig. 4. Photomicrographs of ground sections after 4 months of healing. a Bone formed from the base of the sinus. b Bone plate connected by bridges of the new bone to the close-to-window region. c Particle of the graft surrounded by new bone. d Overexposed image to show the new bone ingrowth within the granules of biomaterial : Bone plate repositioned over the antrostomy after
- Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found : Bone plate repositioned over the antrostomy after
- Fig. 6. Graph representing new bone and composite bone percentages within the elevated area : Bone plate repositioned over the antrostomy after