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J. Funct. Biomater. 2017, 8(3), 31; doi:10.3390/jfb8030031

Effect of a Particulate and a Putty-Like Tricalcium Phosphate-Based Bone-grafting Material on Bone Formation, Volume Stability and Osteogenic Marker Expression after Bilateral Sinus Floor Augmentation in Humans

1
Department of Experimental Orofacial Medicine, Philipps University, 35039 Marburg, Germany
2
Department of Oral Periodontology, School of Dentistry, Ain Shams University, Cairo 11772, Egypt
3
European Center of Dental Implantology (ECDI), 14193 Berlin, Germany
Authors have contributed equally.
*
Author to whom correspondence should be addressed.
Received: 22 June 2017 / Revised: 25 July 2017 / Accepted: 25 July 2017 / Published: 29 July 2017
(This article belongs to the Special Issue Biodegradable Scaffolds)
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Abstract

This study examines the effect of a hyaluronic acid (HyAc) containing tricalcium phosphate putty scaffold material (TCP-P) and of a particulate tricalcium phosphate (TCP-G) graft on bone formation, volume stability and osteogenic marker expression in biopsies sampled 6 months after bilateral sinus floor augmentation (SFA) in 7 patients applying a split-mouth design. 10% autogenous bone chips were added to the grafting material during surgery. The grain size of the TCP granules was 700 to 1400 µm for TCP-G and 125 to 250 µm and 500 to 700 µm (ratio 1:1) for TCP-P. Biopsies were processed for immunohistochemical analysis of resin-embedded sections. Sections were stained for collagen type I (Col I), alkaline phosphatase (ALP), osteocalcin (OC) and bone sialoprotein (BSP). Furthermore, the bone area and biomaterial area fraction were determined histomorphometrically. Cone-beam CT data recorded after SFA and 6 months later were used for calculating the graft volume at these two time points. TCP-P displayed more advantageous surgical handling properties and a significantly greater bone area fraction and smaller biomaterial area fraction. This was accompanied by significantly greater expression of Col I and BSP and in osteoblasts and osteoid and a less pronounced reduction in grafting volume with TCP-P. SFA using both types of materials resulted in formation of sufficient bone volume for facilitating stable dental implant placement with all dental implants having been in function without any complications for 6 years. Since TCP-P displayed superior surgical handling properties and greater bone formation than TCP-G, without the HyAc hydrogel matrix having any adverse effect on bone formation or graft volume stability, TCP-P can be regarded as excellent grafting material for SFA in a clinical setting. The greater bone formation observed with TCP-P may be related to the difference in grain size of the TCP granules and/or the addition of the HyAc. View Full-Text
Keywords: tricalcium phosphate putty scaffold; bioactive ceramics; bone formation; osteogenesis; osteogenic markers; hard tissue histology; immunohistochemical analysis; split-mouth design; sinus floor augmentation; bone-grafting materials tricalcium phosphate putty scaffold; bioactive ceramics; bone formation; osteogenesis; osteogenic markers; hard tissue histology; immunohistochemical analysis; split-mouth design; sinus floor augmentation; bone-grafting materials
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MDPI and ACS Style

Knabe, C.; Khattab, D.A.; Kluk, E.; Struck, R.; Stiller, M. Effect of a Particulate and a Putty-Like Tricalcium Phosphate-Based Bone-grafting Material on Bone Formation, Volume Stability and Osteogenic Marker Expression after Bilateral Sinus Floor Augmentation in Humans. J. Funct. Biomater. 2017, 8, 31.

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