Volumetric Analysis of Bone Substitute Material Performance Within the Human Sinus Cavity of Former Head and Neck Cancer Patients: A Prospective, Randomized Clinical Trial

Overview

Journal Ann Maxillofac Surg

Date 2017 Mar 17

PMID 28299254

Authors

Jonas Lorenz

Kathrin Eichler

Mike Barbeck

Henriette Lerner

Stefan Stubinger

Catherine Seipel

Thomas J Vogl

Adorjan F Kovacs

Shahram Ghanaati

Robert A Sader

Affiliations

Soon will be listed here.

Abstract

Background: In numerous animal and human studies, it could be detected that in bone augmentation procedures, material's physicochemical characteristics can influence the cellular inflammatory pattern and therefore the integration in the host tissue. Histological, histomorphometrical, and clinical analyses of the integration of the biomaterial in the surrounding tissue are well established methodologies; however, they do not make a statement on volume and density changes of the augmented biomaterial.

Aims: The aim of the present study was to assess the volume and density of a xenogeneic (Bio-Oss, BO) and a synthetic (NanoBone, NB) bone substitute material in split-mouth sinus augmentations in former tumor patients to complete histological and histomorphometrical assessment.

Methods: Immediately and 6 months after sinus augmentation computed tomography scans were recorded, bone grafts were marked, and the volume was calculated with radiologic RIS-PACS software (General Electric Healthcare, Chalfont St. Giles, Great Britain) to determine the integration and degradation behavior of both biomaterials.

Results: Radiographic analysis revealed a volume reduction of the initial augmented bone substitute material (i.e. 100%) to 77.36 (±11.68) % in the BO-group, respectively, 75.82 (±22.28) % in the NB-group six months after augmentation. In both materials, the volume reduction was not significant. Bone density significantly increased in both groups.

Conclusion: The presented radiological investigation presents a favorable method to obtain clinically relevant information concerning the integration and degradation behavior of bone substitute materials.

References

Younger E, Chapman M . Morbidity at bone graft donor sites. J Orthop Trauma. 1989; 3(3):192-5. DOI: 10.1097/00005131-198909000-00002. View

Valentini P, Abensur D . Maxillary sinus floor elevation for implant placement with demineralized freeze-dried bone and bovine bone (Bio-Oss): a clinical study of 20 patients. Int J Periodontics Restorative Dent. 1997; 17(3):232-41. View

Javed F, Al-Hezaimi K, Al-Rasheed A, Almas K, Romanos G . Implant survival rate after oral cancer therapy: a review. Oral Oncol. 2010; 46(12):854-9. DOI: 10.1016/j.oraloncology.2010.10.004. View

Jensen S, Aaboe M, Pinholt E, Hjorting-Hansen E, Melsen F, Ruyter I . Tissue reaction and material characteristics of four bone substitutes. Int J Oral Maxillofac Implants. 1996; 11(1):55-66. View

Kovacs A . The fate of osseointegrated implants in patients following oral cancer surgery and mandibular reconstruction. Head Neck. 2000; 22(2):111-9. DOI: 10.1002/(sici)1097-0347(200003)22:2<111::aid-hed2>3.0.co;2-v. View

Houser B, Mellonig J, Brunsvold M, Cochran D, Meffert R, Alder M . Clinical evaluation of anorganic bovine bone xenograft with a bioabsorbable collagen barrier in the treatment of molar furcation defects. Int J Periodontics Restorative Dent. 2002; 21(2):161-9. View

Ghanaati S, Barbeck M, Lorenz J, Stuebinger S, Seitz O, Landes C . Synthetic bone substitute material comparable with xenogeneic material for bone tissue regeneration in oral cancer patients: First and preliminary histological, histomorphometrical and clinical results. Ann Maxillofac Surg. 2013; 3(2):126-38. PMC: 3814660. DOI: 10.4103/2231-0746.119221. View

Norton M, Odell E, Thompson I, Cook R . Efficacy of bovine bone mineral for alveolar augmentation: a human histologic study. Clin Oral Implants Res. 2004; 14(6):775-83. DOI: 10.1046/j.0905-7161.2003.00952.x. View

Ghanaati S, Barbeck M, Willershausen I, Thimm B, Stuebinger S, Korzinskas T . Nanocrystalline hydroxyapatite bone substitute leads to sufficient bone tissue formation already after 3 months: histological and histomorphometrical analysis 3 and 6 months following human sinus cavity augmentation. Clin Implant Dent Relat Res. 2012; 15(6):883-92. DOI: 10.1111/j.1708-8208.2011.00433.x. View

10.

Akoglu B, Ucankale M, Ozkan Y, Kulak-Ozkan Y . Five-year treatment outcomes with three brands of implants supporting mandibular overdentures. Int J Oral Maxillofac Implants. 2011; 26(1):188-94. View

11.

Damien C, Parsons J . Bone graft and bone graft substitutes: a review of current technology and applications. J Appl Biomater. 1991; 2(3):187-208. DOI: 10.1002/jab.770020307. View

12.

Lorenz J, Kubesch A, Korzinskas T, Barbeck M, Landes C, Sader R . TRAP-Positive Multinucleated Giant Cells Are Foreign Body Giant Cells Rather Than Osteoclasts: Results From a Split-Mouth Study in Humans. J Oral Implantol. 2014; 41(6):e257-66. DOI: 10.1563/aaid-joi-D-14-00273. View

13.

Ghanaati S, Orth C, Barbeck M, Willershausen I, Thimm B, Booms P . Histological and histomorphometrical analysis of a silica matrix embedded nanocrystalline hydroxyapatite bone substitute using the subcutaneous implantation model in Wistar rats. Biomed Mater. 2010; 5(3):35005. DOI: 10.1088/1748-6041/5/3/035005. View

14.

Gerike W, Bienengraber V, Henkel K, Bayerlein T, Proff P, Gedrange T . The manufacture of synthetic non-sintered and degradable bone grafting substitutes. Folia Morphol (Warsz). 2006; 65(1):54-5. View

15.

Eppley B, Pietrzak W, Blanton M . Allograft and alloplastic bone substitutes: a review of science and technology for the craniomaxillofacial surgeon. J Craniofac Surg. 2005; 16(6):981-9. DOI: 10.1097/01.scs.0000179662.38172.dd. View

16.

Hoexter D . Bone regeneration graft materials. J Oral Implantol. 2002; 28(6):290-4. DOI: 10.1563/1548-1336(2002)028<0290:BRGM>2.3.CO;2. View

17.

Stubinger S, Ghanaati S, Orth C, Hilbig U, Saldamli B, Biesterfeld S . Maxillary sinus grafting with a nano-structured biomaterial: preliminary clinical and histological results. Eur Surg Res. 2009; 42(3):143-9. DOI: 10.1159/000197215. View

18.

Valentini P, Abensur D . Maxillary sinus grafting with anorganic bovine bone: a clinical report of long-term results. Int J Oral Maxillofac Implants. 2003; 18(4):556-60. View

19.

Schlee M, Dehner J, Baukloh K, Happe A, Seitz O, Sader R . Esthetic outcome of implant-based reconstructions in augmented bone: comparison of autologous and allogeneic bone block grafting with the pink esthetic score (PES). Head Face Med. 2014; 10:21. PMC: 4070637. DOI: 10.1186/1746-160X-10-21. View