Healing Patterns of Non-Collagenated Bovine and Collagenated Porcine Xenografts Used for Sinus Floor Elevation: A Histological Study in Rabbits

Abstract

Objective: To compare healing of collagenated and non-collagenated xenografts used for maxillary sinus floor elevation. Materials and Methods: Two different xenografts were used: deproteinized bovine bone (DBBM group) and collagenated corticocancellous porcine bone (collagenated group). Healing was studied after 2, 4, and 8 weeks. The loss of dimensions of the elevated area and the percentages of new bone, xenograft remnants, osteoclastic zones, vessels, inflammatory infiltrates, and soft tissues were analyzed. Three regions were evaluated: close to the bone walls (bone wall region), subjacent the sinus mucosa (submucosa region), and the center of the elevated area (middle region). The primary variables were the percentage of new bone and xenograft remnants. Results: Between 2 and 8 weeks, the elevated areas showed a reduction of 16.3% and 52.2% in the DBBM and collagenated groups, respectively (p < 0.01 between the two areas after 8 weeks). After 8 weeks, the highest content of new bone was observed in the bone wall region, which was higher in the collagenated group than in the DBBM group (41.6% and 28.6%, respectively; p < 0.01). A similar quantity of new bone was found between the two groups in other regions. A higher percentage of vessels in all regions evaluated (p < 0.01) and soft tissue in the sub-mucosa region (p < 0.05) was found in the collagenated group than in the DBBM group. Conclusions: The present study showed that both xenografts allowed new bone formation. In comparison with the non-collagenated xenograft, the collagenated xenograft underwent higher resorption, resulting in greater shrinkage of the elevated space after sinus lifting and a higher content of new bone in the regions close to the bone walls. Clinical relevance: In this study, the region adjacent to the bone wall showed the highest new bone content. This region resembles the base of the sinus, closest to the sinus floor and walls, and is the most important region from a clinical point of view because it is where the implant will be installed. Residues of the biomaterial remained after 8 weeks of healing. Other reports have shown that these biomaterial residues may interfere with the integration of implants.

Schneiderian Membrane Collateral Damage Caused by Collagenated and Non-Collagenated Xenografts: A Histological Study in Rabbits

“…The percentages reported in previously published articles of residual graft after 8 weeks of healing were 7.8-9.6% for the collagenated graft [22], and 28.3-42.4%, for the DBBM graft [23]. The higher content of osteoclastic zones and higher rate of resorption of the collagenated graft with respect to DBBM were also confirmed by another report [41]. The protective effect of the collagen membrane adjacent to SM could not be confirmed because of the low incidence of thinned mucosae and perforations in the collagenated group.…”

Prehydrated collagenated cortico‐cancellous heterologous bone gel and papillae tunneling for isolated intrabony defects: 12‐month noninferiority trial

“…This regenerative ability could be similar to that of demineralized freeze‐dried bone allografts or freeze‐dried bone allograft materials, which are not approved in Europe due to regulatory concerns. Although there is a lack of comparative studies in periodontology, collagenized bone grafts appear to show increased remodeling and decreased graft stability when used as a filling material in sinus lifts (Miyauchi et al, 2022 ). However, they do not show inferior performance in maintaining the alveolar ridge after socket sealing (Fukuba et al, 2021 ).…”

“…The procedure resulted in a decrease in total porosity (33%), interparticle porosity (21%), and mineral content (65%) compared to standard bovine bone, deproteinized with strong alkalis and organic solvents and treated at a higher temperature of 300°C (total porosity 64%, interparticle porosity 51%, and mineral content 95%). This probably led to a faster remodeling process (Miyauchi et al, 2022) and a higher amount of new bone formation (Lim et al, 2023). For this reason, dual phase xenogenic bone matrix substitutes containing a xenogenic mineral bone phase, and an organic collagen phase represent a gradually resorbable biomaterial for bone and periodontal ligament b Independent samples t-test.…”

The Added Value of a Collagenated Thermosensitive Bone Substitute as a Scaffold for Bone Regeneration

“…During the healing process, collagen enhances neovascularization by providing support to the adhesion of endothelial cells through interaction of endothelial cell α2β1integrin binding sites with collagen RGD sequences. This leads to the development of a new vascular network within the material, as demonstrated in vitro [8,9] and in histological studies in vivo [10]. Additionally, collagen hydrolysis and release during the material remodeling process provides a chemotactic gradient, which plays a pivotal role in the recruitment of human bone marrow mesenchymal stem cells (hMSC) by haptotaxis to the bone resorption site to synthesize the new bone [11].…”