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      Histological and micro-computed tomographic observations after maxillary sinus augmentation with porous hydroxyapatite alloplasts: a clinical case series

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          Abstract

          Background

          It is important to visualize the phenomenon which occurs in actual clinical cases to decide the timing of implant placement subsequently after sinus graft. Although several clinical cases of bone augmentation using xenograft have been evaluated, the number of those reports which have described bone remodeling by alloplasty are not sufficient.

          Findings

          In the present report, to investigate bone remodeling histologically after maxillary sinus augmentation with porous hydroxyapatite alloplast, bone cores from the sinus floor of three female nonsmoking patients (aged 64–73 years) were collected 6 months after sinus lift surgery, embedded in methyl methacrylate resin, and prepared by conventional methods. Bone architecture and graft residues were evaluated by micro-computed tomography of the same specimens. Hematoxylin–eosin and Villanueva–Goldner staining revealed mature osteoblasts and multinucleated osteoclasts on the grafted sinus floor and surface of residual hydroxyapatite particles. The particulate interspace was partially filled with osteoid and calcified tissue and showed active vascularization.

          Conclusion

          The results suggested that bone regeneration and angiogenesis within and between porous hydroxyapatite particles were sufficiently found after 6 month histologically in the grafted sinus floor.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s40064-016-1885-2) contains supplementary material, which is available to authorized users.

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          Most cited references21

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          Grafting of the maxillary sinus floor with autogenous marrow and bone.

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            Maxillary and sinus implant reconstructions.

            H. Tatum (1986)
            The root and sinus series of the Omnii system have been used extensively since 1981. They are very versatile in their ability to be used within edentulous areas of the maxilla. Their design attempts to maximize the use of the available bone, and placement techniques allow the manipulation of bone to form sockets in otherwise deficient areas of bone. The root implants can be used as free-standing implants or as multiple abutments. The sinus implant is always used as an abutment. It may be used in conjunction with other implants or with natural abutments. Maxillary implants are not loaded until a 6-month healing time has elapsed following placement. An understanding of the different qualities of bone found in the maxilla is important to achieving the successful loading of these implants. Different times are required to allow physiologic loading in different qualities of maxillary bone. Restorative treatment is normally done with fixed bridge work, and the use of any type of stress breaker attachments is not recommended.
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              Increasing the pore sizes of bone-mimetic electrospun scaffolds comprised of polycaprolactone, collagen I and hydroxyapatite to enhance cell infiltration.

              Bone-mimetic electrospun scaffolds consisting of polycaprolactone (PCL), collagen I and nanoparticulate hydroxyapatite (HA) have previously been shown to support the adhesion, integrin-related signaling and proliferation of mesenchymal stem cells (MSCs), suggesting these matrices serve as promising degradable substrates for osteoregeneration. However, the small pore sizes in electrospun scaffolds hinder cell infiltration in vitro and tissue-ingrowth into the scaffold in vivo, limiting their clinical potential. In this study, three separate techniques were evaluated for their capability to increase the pore size of the PCL/col I/nanoHA scaffolds: limited protease digestion, decreasing the fiber packing density during electrospinning, and inclusion of sacrificial fibers of the water-soluble polymer PEO. The PEO sacrificial fiber approach was found to be the most effective in increasing scaffold pore size. Furthermore, the use of sacrificial fibers promoted increased MSC infiltration into the scaffolds, as well as greater infiltration of endogenous cells within bone upon placement of scaffolds within calvarial organ cultures. These collective findings support the use of sacrificial PEO fibers as a means to increase the porosity of complex, bone-mimicking electrospun scaffolds, thereby enhancing tissue regenerative processes that depend upon cell infiltration, such as vascularization and replacement of the scaffold with native bone tissue. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                hidemi.irm@tmd.ac.jp
                +81 3 5803 4656 , skuroda.mfc@tmd.ac.jp
                ntachikawa.impl@tmd.ac.jp
                imeo23@hotmail.com
                makatsuka.irm@tmd.ac.jp
                kas.mfc@tmd.ac.jp
                hkondo@iwate-med.ac.jp
                Journal
                Springerplus
                Springerplus
                SpringerPlus
                Springer International Publishing (Cham )
                2193-1801
                2 March 2016
                2 March 2016
                2016
                : 5
                : 260
                Affiliations
                [ ]Department of Prosthodontics and Oral Implantology, Dental Hospital, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate Japan
                [ ]Department Oral Implantology and Regenerative Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Bunkyo-ku, Yushima, Tokyo, 113-8510 Japan
                Article
                1885
                10.1186/s40064-016-1885-2
                4775718
                27006869
                5f3f595f-82c7-4ea9-8fc4-9beed777af95
                © Nakata et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 13 July 2015
                : 16 February 2016
                Funding
                Funded by: Japanese Society for the Promotion of Science
                Award ID: #24659871
                Award Recipient :
                Categories
                Short Report
                Custom metadata
                © The Author(s) 2016

                Uncategorized
                sinus lift,alloplast,bone regeneration,micro-computed tomography,porous hydroxyapatite

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