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

Abstract

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.

Sinus augmentation using rhBMP‐2/ACS in a mini‐pig model: Influence of an adjunctive ceramic bone biomaterial

“…In a previous study, we used a Cynomolgus monkey platform and a 24‐week healing interval to evaluate sinus augmentation following surgical implantation of rhBMP‐2/ACS. Considerable bone gain averaging 6 mm was observed following implantation of rhBMP‐2/ACS vs. 2.6 mm for the ACS control (Hanisch et al., ) much like that found using the mini‐pig platform and an 8‐week healing interval, bone formation averaging 8.6 mm for rhBMP‐2/ACS versus 2.6 mm for the sham‐surgery control (Susin et al., ). Importantly rhBMP‐2/ACS‐induced bone formation extended beyond the apices of the dental implants inserted into the sinus offering robust bone support/osseointegration versus that of the sham‐surgery control, native bone limitedly extending from the sinus wall along the implants providing incomplete bone support/osseointegration.…”

“…None of the three rhBMP‐2/ACS‐ceramic ratios evaluated induced noteworthy increased bone formation/osseointegration over rhBMP‐2/ACS alone. In perspective, rhBMP‐2/ACS and the rhBMP‐2/ACS—ceramic component protocols all provided significantly enhanced bone formation over the ceramic biomaterial as a stand‐alone technology pointing to limitations of the ceramic technology for sinus augmentation (Susin et al., ).…”

“…Previous studies from our laboratory have used five (Lee et al., ) and six (Susin et al., ) animals for contra‐lateral comparisons between rhBMP‐2/ACS, autogenous bone graft and bone biomaterials. We previously estimated that a sample size of six achieves 83% power to detect a mean of paired differences in 3.0 ± 2.0 mm (effect size 1.5) in new bone height at a significance level of 5% using a two‐sided paired t‐test.…”

“…Nevertheless, radiographs and core biopsies only provide a limited appreciation of bioclinical events essential to dental implant osseointegration. Using the mini‐pig sinus augmentation model including immediate dental implants, we have shown that rhBMP‐2/ACS significantly enhances local bone formation/osseointegration as a stand‐alone protocol over that of an autogenous bone graft (Lee et al., ) or representative bone biomaterials (Susin et al., ) showing incomplete dental implant support. The objective of this study was to evaluate local bone formation/dental implant osseointegration following surgical implantation of rhBMP‐2/ACS when combined with a ceramic bone biomaterial using the mini‐pig sinus augmentation model.…”

Bone formation following sinus grafting with an alloplastic biphasic calcium phosphate in Lanyu Taiwanese mini‐pigs

“…50,51 Complete resorption of this graft material is questionable; however, Sartori et al proved in their 10-year study that resorption of DBBM is a slow but continuous process. [57][58][59] For instance, the bone remodeling rates were quantitatively measured and the rates of 1.0 to 1.5 mm/day, 1.2 to 1.5 mm/day, and 1.5 to 2.0 mm/day reported for in humans, mini-pigs, and dogs, respectively. In sinus augmentation, the prevention of unwanted early resorption of graft material is an added advantage with this graft material.…”