Palabras clave
elevación sinusal, hueso mineral bovino desproteinizado,histomorfometría, cirugía piezoeléctrica.
Cómo citar
Ensayo clínico aleatorizado de elevación sinusal por abordaje lateral con hueso mineral bovino desproteinizado (hmbd) comparando dos tamaños de partículas: resultados clínicos e histológicos. (2019). Odontoestomatología, 19(especial), 57-67. https://www.odon.edu.uy/ojs/index.php/ode/article/view/178
Resumen
El tratamiento del maxilar superior edéntulo presenta frecuentemente limitaciones de disponibilidad ósea en el sector posterior. Los procedimientos
de elevación sinusal adquieren una relevancia notoria para su resolución. La utilización de hueso mineral bovino desproteinizado como oseoconductor está ampliamente documentada. El presente estudio de boca dividida comparó en 20 pacientes la formación ósea en senos elevados, utilizando
aleatoriamente, partículas S (0,25-1 mm) vs. partículas L (1-2 mm). El análisis histomorfométrico de las biopsias obtenidas de los sitios a implantar
mostró para el grupo S un 42.6 % de nuevo hueso, 42.5% de tejidos no mineralizados y 14.4 % de partículas. El grupo L exhibió un 47.2%, 38.3% y 13.7%, respectivamente. Al aplicar la prueba de los rangos con signo de Wilcoxon se observó un valor P=0.1454 (signifcación 0,5), no existiendo diferencia estadísticamente signifcativa entre ambos grupos. No existió rotura de membrana atribuible a la osteotomía produciéndose en dos casos durante el decolamiento. La tasa de supervivencia de los implantes fue del 100% en 1 año.
Referencias
1.Trisi P, Rau W. Bone classifcation: Clinicalhitomorphometric comparison. Clin Oral Implant Res. 1990;10:1-7.
2. Conrad HJ, Jung J, Barczak M, Basu S, Seong WJ. Retrospective cohort study of predictors of implant failure in the posterior maxilla.J Oral Maxillofac Implant. 2011;26:154-162.
3. Felice P, Checchi L, Barausse C, Pistilli R, Sammartino G, Masi I, Ippolito DR, Esposito M. Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: One-year post-loading results from a multicenter randomised controlled trial. Eur J Oral Implant. 2016;9(1):35-45.
4. Grant B, Pancko F, Kraut R. Outcomes of placing short dental impants in the posterior mandible: A retrospective study of 124 cases. J Oral Maxillofac Surg. 2009;67:713-717.
5. Fortin T, Isidori M, BouchetH.. Placement of posterior maxilary implants in partially edentulous patients with severe bone defciency using CAD-CAM guidance to avoid sinus grafting: A clinical report of procedure. Int J Oral Maxillofac Implant. 2009;24:96-102.
6. Peñarocha M, Carillo C, Boronat C, Peñarocha M. Retrospective study of 68 implants placed in the pterygomaxillary region using drills and osteotomes. Int J Oral Maxillofac Implant. 2009;24:720-772.
7. Chiapasco M, Zaniboni M, Rimondini L. Dental implants placed in grafted maxillary sinuses: a retrospective analysis of clinical outcome according to the initial clinical situation and a proposal of defect classifcation. Clin Oral Implant Res. 2008;19:416-428.
8. Summers R. A new concept in maxillary implant surgery: Te osteotome technique. CompendContinEduc Dent. 1994;15:698-708.
9. Cosci F, Luccioloi M. A new sinus lift technique in conjuction with placement of 265 implants: a 6-year retrospective study. Implant Dent. 2000;9:363-368.
10. Trombelli L, Franceschetti G, Stacchi C, Minenna L, Riccardi O, Di Raimondo R, Rizzi A, Farina R. Minimally invasive transcrestal sinus floor elevation with deproteinized bovine bone or β-tricalcium phosphate: a multicenter, double-blind, randomized, controlled clinical trial. J ClinPeriodontol. 2014;41:311-319.
11. Smiler D, Johnson P, Lozada J, Misch C, Tatum O, Wagner J. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36(1):151-186.
12. Fugazzoto P, Vlassis J. Long-term success of sinus agumentation using various surgical approaches and grafting materials. Int J Oral Maxillofac Implant. 1998;13(1):52-58.
13. Kirmeier R, Payer M, Wehrschuetz M, Jakse N, Platzer S, Lorenzoni M. Evaluation of three dimensional changes after sinus floor augmentation with different grafting materials. Clin Oral Implant Res. 2008;19:366-372.
14. Brazaitis M, Mirvis S, Greenberg J. Severe retroperitoneal hemorrage complicating anterior iliac bone graft acquisition. J Oral Maxillofac Surg. 1994;52(2):314-316.
15. Nkenke E, St lzle F. Clinical outcomes of sinus floor augmentation for implant placement using autogenous bone or bone subsitutes: A sistematic review. Clin Oral Implant Res. 2009;20:124-133.
16. Shanbhag S, Shanbhag V, Stavropoulos A. Volumen changes of maxillary sinus augmentations over time: a systematic review. Int J Oral Maxillofac Implants. 2014;29:881-892.
17. Chackartchi T, Iezzi G, Goldstein M, Klinger A, Soskolne A, Piattelli A, Shapira L. Sinus floor augmentation using large (1-2 mm) or small (0.25-1 mm) bovine bone mineral particles: a prospective, intra-individual controlled clinical, micro-computerized tomography and histomorphometric study. Clin Oral Implant Res. 2011;22:473-480.
18. Papone V. Manual de Bioseguridad en Odontología. Universidad de la República. 2010.
19. Fugazzotto P, Vlassis J. A simplifed classifcation and repair system for sinus membrane perforations. J Periodontol. 2003;74(10):1534-1541.
20. Wallace SS, Froum SJ, Cho SC, Elian N, Monteiro D, Kim BS, Tarnow DP. Sinus augmentation utilizing anorganic bovine bone (Bio-Oss) with absorbable and nonabsorbable membranes placed over the lateral window: histomorphometric and clinical analyses. Int J Periodontics Restor Dent. 2005;25(6):551-
559.
21. Albrektsson T, Zarb G, Worthington P, Eriksson A. Te long-term, efcacy of currently used dental implants: a review and proposed criteria of succes. Int J Oral Maxillofac Implant. 2003;74:1534-1541.
22. Wilcoxon F. Individual Comparisons by Ranking Methods.Biometrics Bull. 1945;1(6):80-83.
23. Wallace S, Mazor Z, Froum S, Cho S, Tarnow D. Schneiderian membrane perforation rate during sinus elevation using piezosurgery: clinical results of 100 consecutive cases. Int J Periodontics Restor Dent. 2007;27(5):413-419.
24. Atieh M, Alsabeeha N, Tawse-Smith A, Faggion C, Duncan W. Piezoelectric Surgery vs Rotatory Instruments for Lateral Maxillary Sinus Floor Elevation: A Systematic Review and Meta-Analysis of Intra- and Postoperative Complications. Int J Oral Maxillofac Implant. 2015;30:1262-1271.
25. Suárez-López Del Amo F, Ortega-Oller I, Catena A, Monje A, Khoshkam V, TorrecillasMartínez L, Wang HL, Galindo-Moreno P. Effect of barrier membranes on the outcomes of maxillary sinus floor augmentation: a metaanalysis of histomorphometric outcomes. Int J Oral Maxillofac Implant. 2015;30(3):607-618.
26. Di Stefano D, Gastaldi G, Vinci R, Cinci L, Pieri L, Gherlone E. Histomorhometric Comparison of Enzyme-Deantigenic Equine Bone and Anorganic Bovine in Sinus Augmentation: A Randomized Clinical Trial with 3-Year Follow-up. Int J Oral Maxillofac Implant. 2015;30:1161-1167.
27. Felice P, Pistilli R, Piattelli M, Soardi E, Barause C, Esposito M. 1-stage versus 2-stage lateral sinus lift procedures: 1-year post-loading results of a ulticentrerandomised controlled trial. Eur J Oral Implant. 2014;7(1):65-75.
28. Oliveira T, Aloise A, Orosz J, Oliveira R, Carvalho P, Pelegrne A. Double Centrifugation Versus Single Centrifugation of Bone Marrow Aspirate Concentrate in Sinus Floor Elevation: A Pilot Study. Int J Oral Maxillofac Implant. 2016;31:216-222.
29. Meloni SM, Jovanovic SA, Lolli FM, Cassisa C, De Riu G, Pisano M, Lumbau A, Lugliè PF, Tullio A. Grafting after sinus lift with anorganicvovine bone alone compared with 50:50 anorganic bovine bone and autologous bone: results of a pilot randomised trial at one year. Br J Oral Maxillofac Surg. 2015;53:436-441.
2. Conrad HJ, Jung J, Barczak M, Basu S, Seong WJ. Retrospective cohort study of predictors of implant failure in the posterior maxilla.J Oral Maxillofac Implant. 2011;26:154-162.
3. Felice P, Checchi L, Barausse C, Pistilli R, Sammartino G, Masi I, Ippolito DR, Esposito M. Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: One-year post-loading results from a multicenter randomised controlled trial. Eur J Oral Implant. 2016;9(1):35-45.
4. Grant B, Pancko F, Kraut R. Outcomes of placing short dental impants in the posterior mandible: A retrospective study of 124 cases. J Oral Maxillofac Surg. 2009;67:713-717.
5. Fortin T, Isidori M, BouchetH.. Placement of posterior maxilary implants in partially edentulous patients with severe bone defciency using CAD-CAM guidance to avoid sinus grafting: A clinical report of procedure. Int J Oral Maxillofac Implant. 2009;24:96-102.
6. Peñarocha M, Carillo C, Boronat C, Peñarocha M. Retrospective study of 68 implants placed in the pterygomaxillary region using drills and osteotomes. Int J Oral Maxillofac Implant. 2009;24:720-772.
7. Chiapasco M, Zaniboni M, Rimondini L. Dental implants placed in grafted maxillary sinuses: a retrospective analysis of clinical outcome according to the initial clinical situation and a proposal of defect classifcation. Clin Oral Implant Res. 2008;19:416-428.
8. Summers R. A new concept in maxillary implant surgery: Te osteotome technique. CompendContinEduc Dent. 1994;15:698-708.
9. Cosci F, Luccioloi M. A new sinus lift technique in conjuction with placement of 265 implants: a 6-year retrospective study. Implant Dent. 2000;9:363-368.
10. Trombelli L, Franceschetti G, Stacchi C, Minenna L, Riccardi O, Di Raimondo R, Rizzi A, Farina R. Minimally invasive transcrestal sinus floor elevation with deproteinized bovine bone or β-tricalcium phosphate: a multicenter, double-blind, randomized, controlled clinical trial. J ClinPeriodontol. 2014;41:311-319.
11. Smiler D, Johnson P, Lozada J, Misch C, Tatum O, Wagner J. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36(1):151-186.
12. Fugazzoto P, Vlassis J. Long-term success of sinus agumentation using various surgical approaches and grafting materials. Int J Oral Maxillofac Implant. 1998;13(1):52-58.
13. Kirmeier R, Payer M, Wehrschuetz M, Jakse N, Platzer S, Lorenzoni M. Evaluation of three dimensional changes after sinus floor augmentation with different grafting materials. Clin Oral Implant Res. 2008;19:366-372.
14. Brazaitis M, Mirvis S, Greenberg J. Severe retroperitoneal hemorrage complicating anterior iliac bone graft acquisition. J Oral Maxillofac Surg. 1994;52(2):314-316.
15. Nkenke E, St lzle F. Clinical outcomes of sinus floor augmentation for implant placement using autogenous bone or bone subsitutes: A sistematic review. Clin Oral Implant Res. 2009;20:124-133.
16. Shanbhag S, Shanbhag V, Stavropoulos A. Volumen changes of maxillary sinus augmentations over time: a systematic review. Int J Oral Maxillofac Implants. 2014;29:881-892.
17. Chackartchi T, Iezzi G, Goldstein M, Klinger A, Soskolne A, Piattelli A, Shapira L. Sinus floor augmentation using large (1-2 mm) or small (0.25-1 mm) bovine bone mineral particles: a prospective, intra-individual controlled clinical, micro-computerized tomography and histomorphometric study. Clin Oral Implant Res. 2011;22:473-480.
18. Papone V. Manual de Bioseguridad en Odontología. Universidad de la República. 2010.
19. Fugazzotto P, Vlassis J. A simplifed classifcation and repair system for sinus membrane perforations. J Periodontol. 2003;74(10):1534-1541.
20. Wallace SS, Froum SJ, Cho SC, Elian N, Monteiro D, Kim BS, Tarnow DP. Sinus augmentation utilizing anorganic bovine bone (Bio-Oss) with absorbable and nonabsorbable membranes placed over the lateral window: histomorphometric and clinical analyses. Int J Periodontics Restor Dent. 2005;25(6):551-
559.
21. Albrektsson T, Zarb G, Worthington P, Eriksson A. Te long-term, efcacy of currently used dental implants: a review and proposed criteria of succes. Int J Oral Maxillofac Implant. 2003;74:1534-1541.
22. Wilcoxon F. Individual Comparisons by Ranking Methods.Biometrics Bull. 1945;1(6):80-83.
23. Wallace S, Mazor Z, Froum S, Cho S, Tarnow D. Schneiderian membrane perforation rate during sinus elevation using piezosurgery: clinical results of 100 consecutive cases. Int J Periodontics Restor Dent. 2007;27(5):413-419.
24. Atieh M, Alsabeeha N, Tawse-Smith A, Faggion C, Duncan W. Piezoelectric Surgery vs Rotatory Instruments for Lateral Maxillary Sinus Floor Elevation: A Systematic Review and Meta-Analysis of Intra- and Postoperative Complications. Int J Oral Maxillofac Implant. 2015;30:1262-1271.
25. Suárez-López Del Amo F, Ortega-Oller I, Catena A, Monje A, Khoshkam V, TorrecillasMartínez L, Wang HL, Galindo-Moreno P. Effect of barrier membranes on the outcomes of maxillary sinus floor augmentation: a metaanalysis of histomorphometric outcomes. Int J Oral Maxillofac Implant. 2015;30(3):607-618.
26. Di Stefano D, Gastaldi G, Vinci R, Cinci L, Pieri L, Gherlone E. Histomorhometric Comparison of Enzyme-Deantigenic Equine Bone and Anorganic Bovine in Sinus Augmentation: A Randomized Clinical Trial with 3-Year Follow-up. Int J Oral Maxillofac Implant. 2015;30:1161-1167.
27. Felice P, Pistilli R, Piattelli M, Soardi E, Barause C, Esposito M. 1-stage versus 2-stage lateral sinus lift procedures: 1-year post-loading results of a ulticentrerandomised controlled trial. Eur J Oral Implant. 2014;7(1):65-75.
28. Oliveira T, Aloise A, Orosz J, Oliveira R, Carvalho P, Pelegrne A. Double Centrifugation Versus Single Centrifugation of Bone Marrow Aspirate Concentrate in Sinus Floor Elevation: A Pilot Study. Int J Oral Maxillofac Implant. 2016;31:216-222.
29. Meloni SM, Jovanovic SA, Lolli FM, Cassisa C, De Riu G, Pisano M, Lumbau A, Lugliè PF, Tullio A. Grafting after sinus lift with anorganicvovine bone alone compared with 50:50 anorganic bovine bone and autologous bone: results of a pilot randomised trial at one year. Br J Oral Maxillofac Surg. 2015;53:436-441.