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Selected Publication:
Sokolowski, A.
Histologic assessment of two phycogenic bone graft materials used in sinus floor elevation.
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Graz Medical University; 2020. pp. 83
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- Authors Med Uni Graz:
- Sokolowski Alwin
- Advisor:
- Lorenzoni Martin
- Madreiter-Sokolowski Corina
- Wegscheider Walther
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- Abstract:
- Aim: A wide range of bone substitute materials is used for sinus augmentation. This study aimed to evaluate a phycogenic biphasic bone graft material consisting of 80% ß-tricalcium phosphate and 20% hydroxyapatite (ß-TCP/HA) versus almost pure phycogenic hydroxyapatite (HA) in sinus floor elevation regarding their histologic features 3 and 6 months after surgery in a randomized clinical trial. Methods: 20 patients requiring two-stage sinus grafting were included in the study and randomized into a ß-TCP/HA and an HA group. Sinus floor elevation was performed under local anesthesia, utilizing the lateral window approach and the group-specific grafting material. Biopsies were taken at two adjacent areas 3 months after sinus augmentation and 6 months after augmentation during implant placement. For histological evaluation, one undecalcified thin ground section was obtained per biopsy and stained according to Laczko & Levai 1975. All 40 slices were scanned with a scanning light microscope for further image analysis. The parameters measured were newly formed bone area, old bone area, tissue area, bone substitute area, new bone infiltration area in bone substitute, new bone to bone substitute contact and penetration depth. Results: ß-TCP/HA showed a higher amount of newly formed bone after 6 months than HA. HA showed a higher relative ratio of residual material after 6 months. The contact area of new bone to bone substitute was higher in the HA group. Bone substitute surrounded and infiltrated by new bone showed a more severe alteration and smaller particle size in the ß-TCP/HA group compared to the HA group. More resorption in the ß-TCP/HA group led to a smaller new bone-to-bone substitute contact length but a higher infiltration ratio. Conclusion: The histological evaluation showed signs of proper healing in both groups; the augmentation material served as a guide for new bone formation. In particular, it could be observed that newly formed bone preferred to grow through the crushed ß-TCP/HA particles, showing in this case a high degree of osteoconductivity and resorption of the graft material. HA, on the other hand, showed high material stability without significant signs of resorption but a high contact area between the substitute material and newly formed bone after 6 months.