Freeze-dried bone for maxillary sinus augmentation in sheep. Part II: biomechanical findings

Clin Oral Implants Res. 2002 Dec;13(6):581-6. doi: 10.1034/j.1600-0501.2002.130602.x.

Abstract

This study examines the biomechanical loading capacity of dental implants placed in the posterior maxilla in conjunction with subantral augmentation with either homogeneous demineralized freeze-dried bone from sheep (s-DFDB) or heterogeneous demineralized freeze-dried human bone (h-DFDB) as grafting material in sheep. In 36 adult female mountain sheep, the Schneiderian membrane was elevated extraorally in both maxillary sinuses, and two titanium plasma-flame-sprayed cylindrical implants were inserted in each lateral antral wall. Three groups of 18 maxillary sinuses each were augmented with s-DFDB, h-DFDB and autogenous bone from the illiac crest, respectively. In the remaining 18 sinuses, the subantral hollow space was left empty. Pull-out tests were carried out after intervals of 12, 16 and 26 weeks. The mean pull-out force needed, irrespective of time, was 259.3 N in the empty control group, 356.7 N in the group augmented with autogenous bone, 278.1 N in the test group augmented with h-DFDB and 365.2 N in the group augmented with s-DFDB, revealing no significant difference between the individual groups (P > 0.05). The implants of the group augmented with autogenous bone showed an increase in the mean pull-out force from 223.8 N after 12 weeks to 523.7 N after 26 weeks. The nonaugmented control group yielded values of 248 N after 12 weeks, which rose to 269.8 N at the last test, while the values of the h-DFDB group increased from 275.4 N to 325.4 N. The highest initial pull-out values were obtained in the s-DFDB group. They amounted to 310.5 N after 12 weeks and rose to 481.4 N after 26 weeks. Time thus proved to have a significant influence on the pull-out forces (P = 0.014) with a statistically proven linear trend (P = 0.007). The findings of this experimental study indicate that the use of homogeneous DFDB in one-stage sinus lift procedures results in a mechanical loading capacity of implants comparable to that achieved by autogenous cancellous bone from the iliac crest. In contrast, the use of heterogenous-DFDB resulted in only slightly higher pull-out forces than those observed in the nonaugmented control group after 26 weeks.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alveolar Ridge Augmentation / methods*
  • Analysis of Variance
  • Animals
  • Biomechanical Phenomena
  • Bone Substitutes / therapeutic use
  • Bone Transplantation / methods*
  • Coated Materials, Biocompatible / chemistry
  • Confidence Intervals
  • Dental Implants
  • Dental Prosthesis Design
  • Female
  • Freeze Drying
  • Humans
  • Matched-Pair Analysis
  • Maxilla / surgery*
  • Maxillary Sinus / surgery*
  • Sheep
  • Statistics as Topic
  • Stress, Mechanical
  • Time Factors
  • Tissue Preservation
  • Titanium / chemistry
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Weight-Bearing

Substances

  • Bone Substitutes
  • Coated Materials, Biocompatible
  • Dental Implants
  • Titanium