Maxillary sinus augmentation procedures through equine-derived biomaterial or calvaria autologous bone: immunohistochemical evaluation of OPG/RANKL in humans

Abstract

Autologous bone is considered the gold standard for bone regeneration, even if different heterologous bone substitutes have been proposed to overcome the limits related to its use. The aim of this study was to analyze and to compare the molecular events switched on by autologous or heterologous bone graft insertion, focusing on TGFβ1 expression and OPG/RANKL ratio, to analyze resorption process, and estimating graft vascularization, new bone tissue deposition and its mineralization, through VEGF, BSP and SPARC expression evaluation, respectively. Patients needing pre-prosthetic rehabilitation of the posterior maxilla were treated using an equine-derived biomaterial (Group 1) or calvaria autologous bone (Group 2), according to the morphology of the bone defect. Bone graft integration was evaluated on bone samples obtained from the treated areas at the moment of dental implant insertion, by morphological and immunohistochemical analyses for TGFβ1, OPG, RANKL, VEGF, BSP, and SPARC expression. Morpho - logical analysis shows the presence of biomaterial residual granules in Group 1, in parallel to a good integration between graft and host tissue. Moderate TGFβ1 expression is seen in both Group 1 and Group 2. OPG/RANKL ratio appears higher in Group 1; VEGF expression appears very strong in Group 1 and strong in Group 2, while BSP and SPARC expression results weak in Group 1 and moderate in Group 2. Our results reveal the good integration between both types of graft and the host tissue, even though autologous graft seems to produce a faster regenerative process, as evidenced by the different expression of the investigated molecules. According to these observations, the clinical use of heterologous particulate equine-derived biomaterial may ensure long-term predictability of implantprosthetic rehabilitation, comparable to that obtained with autologous bone graft.

Histological and Histomorphometric Human Results of HA-Beta-TCP 30/70 Compared to Three Different Biomaterials in Maxillary Sinus Augmentation at 6 Months: A Preliminary Report

“…The EB sample showed some trabeculae bridged by newly formed bone. Our results are comparable to other investigations [ 12 , 13 ]. It is evident resorption phenomena, and its ability to achieve a more rapid and intense vascularization is very important also in influencing long-term integration and predictability of implant-prosthetic rehabilitation in regenerated sites.…”

“…In the present preliminary investigation, to examine the bone regenerative potential of a newly biphasic calcium phosphate ceramic, the histologic process of healing and bone formation of HA- β -TCP (30/70) was compared to those of the most frequently used and well documented biomaterials after six months from sinus augmentation [ 10 – 13 , 17 – 20 ]. The present scaffold was developed by the direct rapid prototyping technique dispense-plotting, as previously described by Deisinger et al [ 38 ] and Mangano et al [ 18 ].…”

“…Equine-derived bone (EB) is an equine-derived bone tissue deantigenated by a proteolytic low-temperature process that eliminates the organic components but leaves the mineral structure of the hydroxyapatite unaltered, saving the resorption potential [ 12 ]. Recent investigations showed that also the equine-derived bone (EB) is able to induce bone formation in maxillary sinus augmentations [ 12 , 13 , 34 , 35 ].…”

Comparative Investigation of Cutting Devices on Bone Blocks: An SEM Morphological Analysis

“…Allografts and xenografts are osteoconductive but not osteoinductive [4,5], unlike other xenograft equine-derived biomaterials. They are used successfully in several fields of oral surgery [6][7][8][9][10][11][12][13][14] and should be preferred for being resistant to prion infections (i.e., Bovine Spongiform Encephalopathies) [15,16].…”

Equine and Porcine Bone Substitutes in Maxillary Sinus Augmentation

“…3,4 In recent years, different materials have been proposed and used to ensure bone regeneration through grafting the maxillary sinus: intraoral or extraoral autologous bone, homologous grafts, heterologous grafts, alloplastic grafts, or a combination of these. [5][6][7][8] Autologous bone graft is still considered the gold standard for bone regeneration. However, the morbidity involved with its use may induce many patients to refuse this treatment.…”