Prospective and Randomized Evaluation of ChronOS and Bio-Oss in Human Maxillary Sinuses: Histomorphometric and Immunohistochemical Assignment for Runx 2, Vascular Endothelial Growth Factor, and Osteocalcin.

João Paulo Bonardi, Rodrigo Dos Santos Pereira, Fernanda Brasil Daura Jorge Boos Lima, Leonardo Perez Faverani, Geraldo Luiz Griza, Roberta Okamoto, Eduardo Hochuli-Vieira

Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2019;76(2):325-335

PMID: 29100829

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Abstract

PURPOSE

The aim of this study was to compare ChronOS (β-tricalcium phosphate), Bio-Oss, and their addition to an autogenous bone graft in a 1:1 ratio in human maxillary sinus bone augmentation.

MATERIALS AND METHODS

Thirty maxillary sinuses were divided in 5 groups: group 1 included 6 maxillary sinuses grafted with autogenous bone graft alone; group 2 included 6 maxillary sinuses grafted with ChronOS; group 3 included 6 maxillary sinuses grafted with ChronOS and autogenous bone graft in a 1:1 ratio; group 4 included 6 maxillary sinuses grafted with Bio-Oss; and group 5 included 6 maxillary sinuses grafted with Bio-Oss and autogenous bone graft in a 1:1 ratio. The number of samples for each group was determined by the statistical power test.

RESULTS

The median areas of new bone formation in groups 1, 2, 3, 4, and 5 were 121,917.0, 83,787.0, 99,295.0, 65,717.0, and 56,230.0 μm, respectively. Statistically significant differences were found between groups 3 and 5, groups 1 and 4, and groups 1 and 5 (P < .05). The median areas of remaining biomaterial were 2,900.5, 5,291.0, 2,662.0, 56,258.5, and 64,753.5 μm in groups 1, 2, 3, 4 and 5, respectively. Statistically significant differences occurred between groups 1 and 5, groups 3 and 5, and groups 2 and 5 (P < .05). Areas of connective tissue were 67,829.0 ± 22,984.6 μm in group 1, 97,445.9 ± 18,983.3 μm in group 2, 88,256.0 ± 21,820.5 μm in group 3, 65,501.8 ± 6,297.6 in group 4, and 70,203.2 ± 13,421.3 μm in group 5.

CONCLUSIONS

ChronOS combined with autogenous bone graft presented a behavior similar to that of autogenous bone graft alone. However, the groups treated with Bio-Oss showed immuno-labeling results indicating maturation of grafted bone.

Address: PhD Student, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil.; Oral and Maxillofacial Surgeon, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil. Electronic address: [email protected].; Oral and Maxillofacial Surgeon, Universidade Federal de Minas Gerais, Department of Clinics, Pathology and Surgery, Pampulha, Belo Horizonte - MG, Brazil.; Oral and Maxillofacial Surgery Professor, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil.; Oral and Maxillofacial Surgeon, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil.; Anatomy Professor, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil.

DOI: 10.1016/j.joms.2017.09.020

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MeSH Terms: Bone Substitutes, Bone Transplantation, Calcium Phosphates, Core Binding Factor Alpha 1 Subunit, Humans, Immunohistochemistry, Minerals, Osteocalcin, Prospective Studies, Sinus Floor Augmentation, Vascular Endothelial Growth Factor A