Effect of a Rapidly Resorbable Calcium Alkali Phosphate Bone Grafting Material on Osteogenesis after Sinus Floor Augmentation in Humans


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Sinus floor augmentation (SFA) has become a well-established pre-implantology procedure for alveolar ridge augmentation of the posterior maxilla. Using bioceramic bone substitutes avoids second-site surgery for autograft harvesting. Compared to the bone substitutes which are currently clinically available, there is a significant need for bone substitutes which degrade more rapidly, but still stimulate osteogenesis at the same time. This has led to the development of bioactive, rapidly resorbable calcium alkali orthophosphate (CAOP) materials, which have a greater solubility than tricalcium phosphate. In this study the biodegradability and effect of a silica containing CAOP (Si-CAOP) on osteogenesis was evaluated in human biopsies sampled 6 months after SFA and compared to that of TCP utilizing hard tissue histology, histomorphometry and immunohistochemical analysis of osteogenic marker expression. Both materials facilitated bone formation and matrix mineralization, which were still actively progressing from the sinus floor in an apical direction 6 months after SFA. With the Si-CAOP grafting material however, bone formation, the bone-biomaterial-contact, i.e. bone-bonding, and particle degradation were significantly greater compared to TCP in the apical region of the biopsies, i.e. at the largest distance from the native bone of the sinus floor. This was accompanied by greater expression of Col I, BSP and OC in the newly formed bone tissue in the Si-CAP samples compared to TCP. Six months after implantation Si-CAOP facilitated greater bone formation and biodegradability than the TCP graft material, whose excellent osteoconductive properties have been widely documented. Consequently, Si-CAOP can be regarded as excellent grafting material for SFA in a clinical setting.



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Edited by:

Christian Rey, Christèle Combes and Christophe Drouet




C. Knabe et al., "Effect of a Rapidly Resorbable Calcium Alkali Phosphate Bone Grafting Material on Osteogenesis after Sinus Floor Augmentation in Humans", Key Engineering Materials, Vol. 758, pp. 239-244, 2017

Online since:

November 2017




* - Corresponding Author

[1] C. Knabe, M. Stiller, P. Ducheyne (2011), Dental graft materials In: P. Ducheyne, K. Healy, D. Hutmacher, D. W. Grainger, J. P. Kirkpatrick, (Eds. ) Comprehensive Biomaterials, Volume 6, Chapter 6. 620., Elsevier, Oxford UK, 2011, pp.305-324.

DOI: https://doi.org/10.1016/b978-0-08-055294-1.00224-5

[2] C. Knabe, C. Koch, A. Rack, M. Stiller, Effect of beta-tricalcium phosphate particles with varying porosity on osteogenesis after sinus floor augmentation in humans, Biomaterials 29 (2008) 2249-58.

DOI: https://doi.org/10.1016/j.biomaterials.2008.01.026

[3] C. Knabe, A. Mele, P.H. Kann, B. Peleska, D. Adel-Khattab, H. Renz, A. Reuss, M. Bohner, M. Stiller, Effect of sex-hormone levels, sex, body mass index and other host factors on human craniofacial bone regeneration with bioactive tricalcium phosphate grafts, Biomaterials 123 (2017).

DOI: https://doi.org/10.1016/j.biomaterials.2017.01.035

[4] G. Berger, R. Gildenhaar, U. Ploska U, Rapid resorbable, glassy crystalline materials on the basis of calcium alkali orthophosphates, Biomaterials 16 (1995) 1241-1248.

DOI: https://doi.org/10.1016/0142-9612(95)98131-w

[5] C. Knabe, A. Houshmand, G. Berger, P. Ducheyne, R. Gildenhaar, M. Stiller, Effect of . rapidly resorbable bone substitute materials on the temporal expression of the osteoblastic phenotype in vitro, J Biomed Mater Res A 15 (2008) 856-68.

DOI: https://doi.org/10.1002/jbm.a.31383

[6] C. Knabe, M. A. Lopez Heredia, D. Barnewitz, A. Genzel, F. Peters, W. D. Hübner, Effect of silicon-doped calcium phosphate bone substitute materials on bone formation and osteoblastic phenotype expression in vivo, Key Engineering Materials 614 (2014).

DOI: https://doi.org/10.4028/www.scientific.net/kem.614.31

[7] C. Knabe, B. Kraska, C. Koch, U. Gross, H. Zreiqat, M. Stiller, A method for immunohistochemical detection of osteogenic markers in undecalcified bone sections, Biotechnic & Histochemistry. 81 (2006) 31-39.

DOI: https://doi.org/10.1080/10520290600725474

[8] C. Knabe, P. Ducheyne P (2011) Bioactivity – mechanisms In: P. Ducheyne, K. Healy, D. Hutmacher, D.W. Grainger, J. P. Kirkpatrick, (Eds. ) Comprehensive Biomaterials, Volume 1, Chapter 1. 114., Elsevier, Oxford, UK, 2011, pp.245-258.

DOI: https://doi.org/10.1016/b978-0-08-055294-1.00026-x