Histomorphometric Evaluation of Bone-Guided Regeneration in Maxillary Sinus Floor Augmentation Using Nano-Hydroxyapatite/Beta-Tricalcium Phosphate Composite Biomaterial: A Case Report

Saulo Henrique Salviano; João Carlos Amorim Lopes; Igor da Silva Brum; Lúcio Frigo; Mario José Dos Santos; Sílvio Roberto Consonni; Jorge José de Carvalho

doi:10.2147/IMCRJ.S315757

Histomorphometric Evaluation of Bone-Guided Regeneration in Maxillary Sinus Floor Augmentation Using Nano-Hydroxyapatite/Beta-Tricalcium Phosphate Composite Biomaterial: A Case Report

Int Med Case Rep J. 2021 Sep 29:14:697-706. doi: 10.2147/IMCRJ.S315757. eCollection 2021.

Authors

Saulo Henrique Salviano¹, João Carlos Amorim Lopes², Igor da Silva Brum³, Lúcio Frigo⁴, Mario José Dos Santos⁵, Sílvio Roberto Consonni⁶, Jorge José de Carvalho⁷

Affiliations

¹ Implantology Department, University São Leopoldo Mandic, Campinas, São Paulo, Brazil.
² Implantology Department, Portuguese Catholic University, Lisboa, Portugal.
³ Implantology Department, State University of Rio de Janeiro, Rio de Janeiro, 20550-900, Brazil.
⁴ Periodontology Department, Universidade Guarulhos, Guarulhos, São Paulo, 07023-070, Brazil.
⁵ Biology Department, State University of Rio de Janeiro, Rio de Janeiro, 20550-900, Brazil.
⁶ Department of Biochemistry and Tissue Biology, Institute of Biology, State University of Campinas (UNICAMP), Campinas, São Paulo, 13083-862, Brazil.
⁷ Laboratory of Ultrastructure and Tissue Biology, Department of Histology and Embryology, State University of Rio de Janeiro, Rio de Janeiro, 20550-900, Brazil.

Abstract

Background: The development of techniques in biomaterials design and production added to advanced surgical procedures which enabled better and more predictable clinical outcomes. Maxillary sinus floor augmentation (MSFA) is among the more studied bone-guided regeneration procedure in the literature. The MSFA could be considered the gold standard procedure for bone-guided regeneration as it provides suitable functional and aesthetic solutions to alveolar ridge atrophy due to tooth loss.

Purpose: This study aimed to conduct a detailed histomorphometric evaluation of collagen production in SFAs bone-guided regeneration, using nano-hydroxyapatite/ß-tricalcium phosphate (nano-HA/ß-TCP) composite.

Patients and methods: A 52-year-old female had the left upper second premolar condemned due to periodontal disease, then a tooth implant replacement was planned. Due to maxillary sinus pneumatization, the MSFA had to be done before implant placement. Nano-HA/ß-TCP composite (2g) was used in the MSFA procedure. After nine months of the healing process, during the Cone Morse implant installation process, bone samples were collected for histologic analysis (sirius red, hematoxylin/eosin, polarized microscopy). Six months after implant installation, a ceramic crown was installed according to the patient's request.

Results: Proper masticatory function and aesthetics were re-established. The histomorphometric evaluation indicated that nano-HA/ß-TCP composite did not show any area devoid of cellular activity in sirius red or hematoxylin/eosin staining and the percentage (%) of new bone collagen fibers was achieved using polarization technique evaluation.

Conclusion: According to these results, nano-HA/ß-TCP composite presented clinical and histomorphometric properties suit to be used as bone-guided regeneration biomaterial in MSFA. Furthermore, nano-HA/β-TCP composite provided a favorable nano-environment to bone cells, enhancing bone matrix production.

Keywords: alloplastic; graft; implants; nanohydroxyapatite; sinus lift; sirius red.

Publication types

Case Reports

Grants and funding

This research received financial support from the Brazilian agencies CNPq, FAPERJ, CAPES, LUBT, Fisclinex and UERJ.