The aim of this study was to evaluate clinically, histologically and histometrically the use of anorganic bovine bone matrix (i.e. Bio-oss) as a grafting material for maxillary sinus augmentation procedures. In 4 adult male rhesus monkeys (i.e. Macaca mulatta) the 1st, 2nd and 3rd maxillary molars on one side of the jaws were extracted. The remaining bone between the alveolar crest and the bottom of the sinus was then reduced to 3-4 mm. After 3 months, maxillary sinus augmentation procedures were performed on one side of the jaws in each monkey and the sinuses were grafted with the bovine bone matrix. At that time, 2 IMZ pure titanium plasma coated implants were immediately placed into the augmented sinuses (i.e. simultaneous implants-loaded group). After 4 months, 2 additional similar implants were placed into these previously augmented sinuses (i.e. delayed implants-loaded group). Four months later, the abutment connection was performed and all 4 implants were loaded with a gold-alloy bridge for 6 months (i.e. until sacrifice of the animals). The contralateral side of each monkey received the same treatment with the exception that the extractions were performed 7 months after those in the opposite side and that the implants in this side were not loaded. Thus, 2 additional study groups (i.e. simultaneous implants-unloaded group and delayed implants-unloaded group) were obtained. Clinically, all loaded implants were stable at the day of sacrifice. Histologically, the grafted sinuses exhibited significant bone formation with integration of the bovine bone matrix particles to the new bone. Direct mineralized bone-to-implant contact was greater for the delayed implant placement groups than for the implants installed simultaneously with the sinus augmentation. Furthermore, the percentage of direct mineralized bone-to-implant contact was greater in the residual bone than in the augmented area. It was concluded that the anorganic bovine bone matrix facilitated bone formation and implant osseointegration in the augmented sinuses and that the delayed implant placement in combination with the sinus augmentation procedure seemed to be preferable.

Within the limits of the present study, it was concluded that both CAM and CPS implants revealed crestal bone-level changes after 28 days of healing.

The aim of the present study was to investigate bone formation to recombinant human bone morphogenetic protein-2 (rhBMP-2)-biocoated and rhBMP-2-nonbiocoated titanium implants after implantation in dogs. Implantation of sand-blasted and acid-etched (C), chromosulfuric acid surface-enhanced (CSA), and rhBMP-2-biocoated CSA [BMP-A: noncovalently immobilized rhBMP-2 (596 ng/cm 2 ), BMP-B: covalently immobilized rhBMP-2 (819 ng/cm 2 )] implants was performed in both the mandible and tibia of dogs. After 4 weeks of healing, the percentage of direct bone to implant contact (BIC) and the induced bone density (BD) at a distance of less than and greater than 1 mm adjacent to each implant was assessed. Histomorphometric analysis of implants inserted in the mandible and tibia revealed that BIC values appeared to be highest in the BMP-B group, followed by BMP-A, CSA, and C. BD as measured at a distance of <1 mm revealed obvious differences between groups: BMP-B>BMP-A>CSA>C. However, no differences between groups were observed at a distance of >1 mm. Within the limits of the present study, it may be concluded that rhBMP-2 immobilized by covalent and noncovalent methods on CSA-treated implant surfaces seemed to be stable and promoted direct bone apposition in a concentrationdependant manner.

The aim of this study was to evaluate clinically, histologically, and histometrically the use of autogenous bone combined with porous hydroxyapatite (Interpore 200) as a grafting material for maxillary sinus augmentation procedures. In 4 adult male rhesus monkeys (Macaca mulatta) the 1st, 2nd and 3rd maxillary molars on one side of the jaws were extracted. After a healing period of 3 months, maxillary sinus augmentation procedures were performed in each monkey, and the sinuses were grafted with autogenous bone from the monkeys' tibia mixed in a 3:1 ratio with porous hydroxyapatite. At the same time, 2 pure titanium plasma-sprayed IMZ cylinder implants were immediately placed into the augmented sinuses (i.e. simultaneous implants-loaded group). After 4 months, 2 additional similar implants were placed into the previously augmented sinuses (i.e. delayed implants-loaded group). Four months later, the abutment connection was performed and all 4 implants were loaded with a gold-alloy bridge for 6 months (i.e. until sacrifice of the animals). The contralateral side of each monkey received similar treatment with the exception that the extractions were performed 7 months after those in the opposite side and that the implants were not loaded. Thus, 2 additional study groups (i.e. simultaneous implants unloaded group and delayed implants unloaded group) were obtained. Clinically, all loaded implants were stable at the day of sacrifice. Histologically, the grafted sinuses exhibited a significant amount of new bone formation. The porous hydroxyapatite granules appeared integrated with the newly formed bone. Histometric analyses revealed that delayed implant placement resulted in a greater amount of direct mineralized bone-to-implant contact in the augmented area than the simultaneous implant placement. Furthermore, the percentage of direct mineralized bone-to-implant contact was far more significant in the residual bone than in the augmented area. It was concluded that the autogenous bone/porous hydroxyapatite graft combination enhanced bone formation and mineralized bone-to-implant contact in the augmented sinuses and that the delayed implant placement may be favorable for sinus augmentation procedures.

The aim of this study was to evaluate clinically, histologically and histometrically the use of porous hydroxyapatite (i.e. Interpore-200) as a bone grafting material for maxillary sinus augmentation procedures. In 4 adult male rhesus monkeys (i.e. Macaca mulatta) the 1st, 2nd and 3rd maxillary molars on one side of the jaws were extracted and the remaining bone between the alveolar crest and the bottom of the sinus was reduced to 3-4 mm. After 3 months, maxillary sinus augmentation procedures were performed on one side of the jaws in each monkey, and the sinuses grafted with the porous hydroxyapatite. Two IMZ titanium plasma-sprayed cylinder implants were then immediately placed into the augmented sinus (i.e. simultaneous implants-loaded group). After 4 months, 2 additional similar implants were placed into the previously augmented sinuses (i.e. delayed implants-loaded group). Four months later, the abutment connection was performed and all 4 implants were loaded with a gold-alloy bridge for 6 months (i.e. until sacrifice). The contralateral side of each monkey received the same treatment with the exception that the extractions were performed 7 months after those in the opposite side and that the implants in this side were not loaded. Thus, 2 additional study groups (i.e. simultaneous implants-unloaded group and delayed implants-unloaded group) were obtained. Clinically, all loaded implants were stable at the day of sacrifice. Histologic analysis demonstrated a significant amount of new bone formation in the augmented sinuses. Porous hydroxyapatite graft particles appeared to be integrated to the new bone. The percentage of direct mineralized bone-to-implant contact in the augmented area was greater on the delayed-placed implants than on the simultaneously-placed implants. Also, the percentage of direct mineralized bone-to-implant contact was greater in the residual bone than in the augmented area. It was concluded that this porous hydroxyapatite bone graft enhanced bone formation and bone-to-implant contact in the augmented sinuses and that the delayed implant placement in combination with the sinus augmentation procedure appears to result in a higher percentage of direct mineralized bone-to-implant contact.