engleski

Monophasic ß-TCP vs. biphasic HA/ß-TCP in two- stage sinus floor augmentation procedures - a prospective randomized clinical trial

Objectives: To compare a monophasic (100% ß- TCP) and a biphasic (60% HA and 40% ß-TCP) bone substitute material (BSM) regarding biocompatibility, osteoconductivity and implant stability using histological, radiological and resonance frequency analysis. Material and Methods: Sixty-seven sinus floor elevations were performed in 60 patients. One patient group (monophasic bone substitute [MBS], 30 patients, 32 sinuses) was augmented by the use of the monophasic material (Bioresorb_, Sybron Implant Solutions, Bremen, Germany), while the second group (biphasic bone substitute (BBS), 30 patients, 35 sinuses) received a biphasic material (Maxresorb_, Botiss Biomaterials, Berlin, Germany). Cone beam CT images were taken immediately after augmentation and prior to implant placement after 6 months. Trephines were harvested, while the implant bed was prepared. Resonance frequency analysis was performed immediately after implant placement and 6 months later. Descriptive analysis was performed on all augmented sinus (n = 67). For statistical comparison of the groups, one sinus of each bilaterally treated patient was randomly excluded, resulting in 30 sinuses grafted with MBS and 30 sinuses grafted with BBS (n = 60). Results: Histomorphometrical analysis of all sinuses displayed comparable results for both groups regarding new bone matrix (MBS 36.16 _ 19.37%, BBS 38.42 _ 12.61%), residual BSM (MBS 30.26 _ 11.7%, BBS 32.66 _ 12.57%) and non- mineralized tissue (MBS 34.29 _ 18.32%, BBS 28.92 _ 15.04) %) (P > 0.05, respectively). Radiological volume of BBS was significantly more stable (volume loss of 22.2% for MBS, 6.66% for BBS ; P < 0.001), and homogeneity of the graft after 6 months was higher for BBS than that for MBS (P < 0.05). Resonance frequency analysis endorsed a higher implant stability quotient for BBS after 6 months than that for MBS (MBS 78.31 _ 5.81, BBS 80.42 _ 6.31 ; P < 0.05, Mann–Whitney U- test, respectively). Conclusion: Both monophasic and biphasic materials show good biocompatibility and osteoconductivity with satisfactory support on implant stability. BBS remains more stable in terms of volume maintenance and radiological graft homogeneity after a healing period of 6 months.

augmentation ; biphasic ; bone substitute ; hydroxyapatite ; implantology ; sinus lift ; b-tricalcium phosphate

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