Histomorphometric Study of Sinus Bone Graft using Various Graft Material

다양한 골이식재료를 이용한 상악동 골이식 4개월 후 조직형태계측학적 평가

  • Lee, Ji-Young (Department of Oral and Maxillofacial Surgery, Section of dentistry, Seoul National University Bundang Hospital) ;
  • Kim, Young-Kyun (Department of Oral and Maxillofacial Surgery, Section of dentistry, Seoul National University Bundang Hospital) ;
  • Kim, Su-Gwan (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Lim, Sung-Chul (Department of Pathology, School of Medicine, Chosun University)
  • 이지영 (분당서울대학교 병원 치과 구강악안면외과) ;
  • 김영균 (분당서울대학교 병원 치과 구강악안면외과) ;
  • 김수관 (조선대학교 치의학전문대학원 구강악안면외과) ;
  • 임성철 (조선대학교 의학전문대학원 병리과)
  • Received : 2011.04.05
  • Accepted : 2011.06.25
  • Published : 2011.06.30

Abstract

The aim of this study was to evaluate histomorphometrically and compare the efficiency of various bone graft material and autogenous tooth bone graft material which were used in sinus bone graft procedure. Subjects were the 24 patients who had treated with sinus bone graft using lateral approach from October 2007 to September 2009 at SNUBH. The average age was $52.51{\pm}11.86$ years. All cases was taken after 4month of procedure and divided into 3 groups according to bone graft material. Group 1: autogenous tooth bone graft material, Group 2: OrthoblastII(integra lifescience corp. Irvine, US)+Biocera(Osscotec, seoul, korea), group 3: DBX(Synthes, USA)+BioOss(Geistlich Pharm AG, Wolhusen, Switzerland). Total 37 implant placement area were included and evaluated(7 in group 1, 10 in group 2, 20 in group 3). Evaluation of new bone formation, ratio of woven bone to lamellar bone, ratio of new bone to graft material were performed on each tissue section. Kruskal-Wallis test was used for statistical analysis(SPSS Ver. 12.0, USA). New bone formation were $52.5{\pm}10.7%$ in group 1, $52.0{\pm}23.4%$ in group 2, $51.0{\pm}18.3%$ in group 3. There were no statistical significant differences between each groups. Ratio of woven bone to lamella bone were $82.8{\pm}15.3%$ in group 1, $36.7{\pm}59.3%$ in group 2, $31.0{\pm} 51.2%$ in group 3. Ratio of new bone to graft material were $81.3{\pm}10.4%$ in group 1, $72.5{\pm}28.8%$ in group 2, $80.3{\pm}24.0%$ in group 3. After 4 month of healing period, all group showed favorable new bone formation and around graft material and implant. Within limitation of our study, it is suggested that autogenous tooth bone graft material might be used as novel bone graft material for sinus bone graft.

본 연구는 상악동골이식술에 사용된 다양한 골이식재와 자가치아골이식재의 효율성을 비교하고 조직형태계측학적으로 평가하는 것이다. 2007년 10월부터 2009년 9월까지 분당서울대학교병원에서 상악동골이식술을 시행 받은 24명의 환자들을 대상으로 하였다. 환자들의 평균 나이는 $52.51{\pm}11.86$세였다. 모든 증례들은 사용된 골이식재의 종류에 따라 3그룹으로 분류되었다. 1군: 자가치아골이식재, 2군: OrthoblastII(integra lifescience corp. Irvine, US)+Biocera(Osscotec, seoul, korea), 3군: DBX(Synthes, USA)+BioOss(Geistlich Pharm AG, Wolhusen, Switzerland). 총 37개의 임프란트가 식립되었다(1군: 7, 2군: 10, 3군: 20). 신생골 형성, 직골과 층판골의 비율, 신생골과 골이식재의 비율을 조직형태계측학적으로 평가하였다. 통계처리는 SPSS Ver. 12.0을 사용하여 Kruskal-Wallis test를 시행하였다. 신생골 형성 비율은 1군 $52.5{\pm}10.7$, 2군 $52.0{\pm}23.4$, 3군 $51.0{\pm}18.3$였고 통계적으로 유의성 있는 차이는 없었다. 직골과 층판골의 비율은 1군 $82.8{\pm}15.3$, 2군 $36.7{\pm}59.3$, 3군 $31.0{\pm}51.2$였다. 신생골과 잔존골이식재의 비율은 1군 $81.3{\pm}10.4$, 2군 $72.5{\pm}28.8$, 3군 $80.3{\pm}24.0$였다. 4개월의 치유기간 후에 모든 군에서 양호한 신생골 형성이 이루어졌다. 본 연구의 제한적인 범위 내에서 자가치아골이식재는 상악동골이식에 사용될 수 있는 새로운 골이식재료라고 사료된다.

Keywords

References

  1. Kim YK. Kim SG. Lee BG. Bone graft and implant. Vol 2-2. Clinical application of a variety of bone graftSeoul. Korea. Narea pub. 2007, p.160-261.
  2. Kolerman R, Tal H, Moses O. Histomorphometric analysis of newly formed bone after maxillary sinus floor augmentation using ground cortical bone allograft and internal collagen membrane. J Periodontol. 2008;79:2104-11 https://doi.org/10.1902/jop.2008.080117
  3. Del Fabbro M, Testori T, Francetti L,Weinstein R. Systematic review of survival rates for implants placed in the grafted maxillary sinus. Int J Periodontics Restorative Dent. 2004;24:565-77
  4. Kim YK, Lee HJ, Kim SG, et al. Analysis of inorganic component and SEM analysis of autogenous teeth bone graft material and histomorphometric analysis after graft. The J Korean Acad Implant Dent. 2009;28:1-9.
  5. Kim YK, Lee JY. The evaluation of postoperative safety of autogenous teeth bone graft. The J Kor Acad Implant Dent. 2009;28 :29-35.
  6. Kim YK. Kim SG. Lee BG. Bone graft and implant. Seoul. Korea. Narea pub. 2007. p.166-197.
  7. Norton MR, Odell EW, Thompson ID, Cook RJ. Efficacy of bovine bone mineral for alveolar augmentation: a human histologic study. Clin Oral Implants Res. 2003;14:775-83. https://doi.org/10.1046/j.0905-7161.2003.00952.x
  8. Kim YK, Lee HJ, Kim SG, Um IW. Guided Bone Regeneration using autogenous teeth(Ahto BT). Dental Success. 2009;29:92633.
  9. Kim YK, Kim SG, Byeon JH et al. Development of a novel bone grafting material using autogenous teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:496-503. https://doi.org/10.1016/j.tripleo.2009.10.017
  10. Nannmark U, Sennerby L. The bone tissue responses to prehydrated and collagenated cortico-cancellous porcine bone grafts: a study in rabbit maxillary defects. Clin Implant Dent Relat Res. 2008;10: 264-70.
  11. Mizuno M, Kuboki Y. Osteoblast-related gene expression of bone marrow cells during the osteoblastic differentiation induced by type I collagen. J Biochem. 2001;129:133-8. https://doi.org/10.1093/oxfordjournals.jbchem.a002824
  12. Wang LC, Takahashi I, Sasano Y et al. Osteoclastogenic activity during mandibular distraction osteogenesis. J Dent Res. 2005;84:1010-5. https://doi.org/10.1177/154405910508401108
  13. Giachelli CM, Steitz S. Osteopontin: a versatile regulator of inflammation and biomineralization. Matrix Biol. 2000;19:615-22. https://doi.org/10.1016/S0945-053X(00)00108-6