Sequential healing of the elevated sinus floor with different size of antrostomy: a histomorphometric study in rabbits
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ORIGINAL ARTICLE
Sequential healing of the elevated sinus floor with different size of antrostomy: a histomorphometric study in rabbits Alessandro Scala 1 & Jose Viña-Almunia 2 & Carmen Carda 3,4 & José Javier Martín de Llano 3 & David Soto-Peñaloza 2 & Maria Peñarrocha-Diago 2 & Miguel Peñarrocha-Diago 2 & Daniele Botticelli 1 Received: 10 February 2020 / Accepted: 29 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To study the influence of the access window dimensions on the healing at the antrostomy and within the augmented maxillary sinus. Material and methods A maxillary sinus augmentation was performed in twenty-four albino New Zealand rabbits. Antrostomies of 3 × 6 mm (small) or 5 × 6 mm (large) in dimensions were randomly prepared in each animal. A collagenated cortico-cancellous porcine bone was used to fill the elevated region, and an equine collagen membrane was placed on the antrostomies. Three different groups were formed, based on the time of euthanasia, i.e., 2, 4, and 8 weeks from surgery. Results No relevant changes of the height of the augmented sinus were detected over time. Mineralized bone increased between 2 and 4 weeks of healing while remained stable between 4 and 8 weeks. The highest amounts of new bone were found close to the sinus bone walls. No antrostomies were found healed with an even layer of corticalized bone, while large amounts of connective tissue were occupying the antrostomy in both groups. Conclusion Antrostomies of different dimensions resulted in similar outcome in bone formation both in the antrostomy regions and within the elevated sinus. Keywords Sinus floor elevation . Xenograft . Antrostomy . Collagen membrane . Osteoconductivity
Introduction The posterior maxilla region is often considered a compromised region for implant treatment, due to the low bone quality frequently found and the inadequate bone volume after tooth extraction to install implants. Maxillary sinus elevation has become a well-accepted surgical procedure to facilitate
* Jose Viña-Almunia [email protected] 1
ARDEC Academy, Rimini, Italy
2
Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
3
Department of Pathology and Health Research Institute of the Hospital Clínico (INCLIVA), Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
4
Ciber-BBN, Instituto de Salud Carlos III, Valencia, Spain
implant placement in that region [1], and its clinical effectiveness has been shown in various reviews [2–5]. Several clinical studies have been performed to describe the healing after sinus floor augmentation using a lateral access window. The healing was described using tomographic [6–8] or histological methods [9–11]. Experimental studies as well have been carried out, describing the healing both histologically [12–18] and using microCT analysis [18–21]. The influences of the dimensions of the antrostomy on the healing after sinus floor elevation have been also evaluated in randomized clinical
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