Comparative evaluation between Endobon® and autogenous graft in human maxillary sinus: histomorphometric, imunohistochemical and Micro-CT analyze.

Author(s)

Eduardo Dallazen

• Document type: Master's Dissertation
• Press: Araçatuba. 2022-02-25.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Odontologia. Araçatuba
• Defense date: 2022-02-22
• Advisor: Eduardo Hochuli Vieira

Abstract

The progressive bone resorption and pneumatization of the maxillary sinus can prevent the placement of dental implants and prosthetic rehabilitation in the posterior region of the maxilla. Surgical techniques for sinus membrane elevation and use of grafts allow bone reconstruction of this region. Autogenous bone graft represents the gold standard for reconstruction of areas that show bone defects due to its osteogenic, osteoinductive and osteoconductive properties. However, due to the need for a second surgical site, biomaterials, such as hydroxyapatite derived from bovine cortical bone, are being used as a bone substitute with promising results. Endobon® represents a biomaterial option that has molecular characteristics similar to human medullary bone. Therefore, the objective of this study was to prospectively evaluate the behavior and dynamics of Endobon® bone repair, added or not to autogenous bone in a 1:1 ratio after grafting the posterior region of the maxilla by the membrane elevation technique of the human maxillary sinus. Twenty-two patients were included, totaling 34 maxillary sinuses undergoing grafting using the three types of bone graft proposed in this study: Endobon® (END), Endobon® plus autogenous bone graft (END+AUT) and pure autogenous graft (AUT). After 6 months of grafting, biopsies of the grafted region were performed and these underwent processing in order to allow the histomorphometric analysis to calculate the percentage of newly formed bone, connective tissue and remaining biomaterial, the immunohistochemical analysis and the computed microtomography (Micro-CT). In the histomorphometric analysis, 49.9% of new bone formation was observed in the AUT group, with a statistical difference from the END+AUT group, which presented 33.2% of new bone formation (p<0.05). No other statistical differences were observed in the histomorphometric analysis. Analyzing the END+AUT group, histological and immunohistochemical signs of less bone neoformation were observed. This group did not show differences in Micro-CT compared to the END group. Thus, the isolated use of the biomaterial should be considered for bone gain in the posterior region of the maxilla using the maxillary sinus membrane elevation technique, since the use of pure Endobon® showed no differences for the control group (AUT) Keywords: Maxillary sinus. Bone transplantation. Immunohistochemistry. (AU)

• FAPESP's process: 20/06626-2 - Comparative evaluation between Endobon® and autogenous graft in human maxillary sinus: histomorphometric, imunohistochemical and Micro-CT analyze
• Grantee: Eduardo Dallazen
• Support Opportunities: Scholarships in Brazil - Master