Bone vitality and vascularization of mandibular and maxillary bone grafts in maxillary sinus floor elevation: A retrospective cohort study

Vivian Wu, Engelbert A.J.M. Schulten, Marco N. Helder, Christiaan M. ten Bruggenkate, Nathalie Bravenboer, Jenneke Klein-Nulend*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Objectives: Mandibular retromolar (predominantly cortical) and maxillary tuberosity (predominantly cancellous) bone grafts are used in patients undergoing maxillary sinus floor elevation (MSFE) for dental implant placement. The aim of this retrospective cohort study was to investigate whether differences exist in bone formation and vascularization after grafting with either bone source in patients undergoing MSFE. Methods: Fifteen patients undergoing MSFE were treated with retromolar (n = 9) or tuberosity (n = 6) bone grafts. Biopsies were taken 4 months postoperatively prior to dental implant placement, and histomorphometrically analyzed to quantify bone and osteoid area, number of total, apoptotic, and receptor activator of nuclear factor-κB ligand (RANKL)-positive osteocytes, small and large-sized blood vessels, and osteoclasts. The grafted area was divided in three regions (caudal-cranial): RI, RII, and RIII. Results: Bone volume was 40% (RII, RIII) higher and osteoid volume 10% (RII) lower in retromolar compared to tuberosity-grafted areas. Total osteocyte number and number of RANKL-positive osteocytes were 23% (RII) and 90% (RI, RII) lower, but osteoclast number was higher (retromolar: 12, tuberosity: 0) in retromolar-grafted areas. The total number of blood vessels was 80% (RI) to 60% (RIII) lower, while the percentage of large-sized blood vessels was 86% (RI) to 25% (RIII) higher in retromolar-grafted areas. Number of osteocyte lacunae and apoptotic osteocytes were similar in both bone grafts used. Conclusions: Compared to the retromolar bone, tuberosity bone showed increased bone vitality and vascularization in patients undergoing MSFE, likely due to faster bone remodeling or earlier start of new bone formation. Therefore, tuberosity bone grafts might perform better in enhancing bone regeneration.

Original languageEnglish
Pages (from-to)141-151
Number of pages11
JournalClinical Implant Dentistry and related research
Volume25
Issue number1
Early online date10 Oct 2022
DOIs
Publication statusPublished - Feb 2023

Bibliographical note

Publisher Copyright:
© 2022 The Authors. Clinical Implant Dentistry and Related Research published by Wiley Periodicals LLC.

Funding

This work was granted by Health-Holland (project no. LSHM19016, “BB”). The authors thank H. W. van Essen and M. A. van Duin for assistance in histological processing and histomorphometrical analysis.

FundersFunder number
Health~HollandLSHM19016

    Keywords

    • autografts
    • bone regeneration
    • bone vitality
    • mandibular bone
    • maxillary bone
    • maxillary sinus floor elevation
    • vascularization

    Fingerprint

    Dive into the research topics of 'Bone vitality and vascularization of mandibular and maxillary bone grafts in maxillary sinus floor elevation: A retrospective cohort study'. Together they form a unique fingerprint.

    Cite this