Sinus augmentation using a mini-pig model: Effect of ceramic and allogeneic bone biomaterials

J Clin Periodontol. 2017 Oct;44(10):1059-1066. doi: 10.1111/jcpe.12766. Epub 2017 Aug 30.

Abstract

Background: Present clinical practice broadly relies on off-the-shelf allogeneic, xenogeneic or synthetic bone biomaterials in support of sinus augmentation. Also, recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support clinically relevant bone formation when used to augment the maxillary sinus.

Objectives: To evaluate local bone formation/dental implant osseointegration following implantation of two particulate bone biomaterials using the mini-pig sinus augmentation model.

Methods: Nine adult Göttingen mini-pigs were used for evaluation of a biphasic ceramic (15%/85% HA/ß-TCP) and an allogeneic mineralized bone biomaterial. Treatments randomized to contralateral sinus sites included sham-surgery (control) and biomaterials. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each sinus site. The animals were euthanized at 8 weeks for histologic analysis.

Results: Execution of the surgical protocol and healing was unremarkable. Limited infraorbital swelling was observed until suture removal. The biphasic ceramic and allogeneic bone biomaterials produced significantly increased bone formation (5.2 ± 1.9 mm and 4.9 ± 1.6 mm vs. 2.6 ± 0.5 mm, p < 0.05) and osseointegration (18.0 ± 6.0% and 25.1 ± 18.2% vs. 10.1 ± 8.0%, p < 0.05) over the sham-surgery control. No significant differences were observed between biomaterials.

Conclusions: Implantation of biphasic ceramic or allogeneic bone biomaterials enhances bone formation in the mini-pig maxillary sinus, however, dental implant bone support is incomplete resulting in overall limited osseointegration.

Keywords: bone biomaterials; bone morphogenetic protein-2; mini-pig model; osseointegration; sinus augmentation.

MeSH terms

  • Animals
  • Biocompatible Materials / pharmacology*
  • Bone Density
  • Bone Morphogenetic Protein 2 / pharmacology
  • Bone Substitutes / pharmacology*
  • Ceramics / pharmacology*
  • Dental Implantation, Endosseous / methods*
  • Dental Implants*
  • Osseointegration / drug effects*
  • Osteogenesis / drug effects
  • Random Allocation
  • Recombinant Proteins / pharmacology
  • Sinus Floor Augmentation / methods*
  • Swine
  • Swine, Miniature
  • Transforming Growth Factor beta / pharmacology

Substances

  • Biocompatible Materials
  • Bone Morphogenetic Protein 2
  • Bone Substitutes
  • Dental Implants
  • Recombinant Proteins
  • Transforming Growth Factor beta
  • recombinant human bone morphogenetic protein-2