Two Techniques for the Preparation of Cell-Scaffold Constructs Suitable for Sinus Augmentation: Steps into Clinical Application

• Published in: Tissue engineering Vol. 12; no. 9; pp. 2649 - 2656
• Main Authors: Springer, Ingo N., Nocini, Pier F., Schlegel, Karl A., Santis, Daniele De, Park, Jung, Warnke, Patrick H., Terheyden, Hendrik, Zimmermann, Robert, Chiarini, Luigi, Gardner, Klaus, Ferrari, Francesca, Wiltfang, Jörg
• Format: Journal Article
• Language: English
• Published: United States Mary Ann Liebert, Inc 01.09.2006
• Subjects: Adult; Aged; Animals; Atrophy - therapy; Bioprosthesis; Bone Substitutes; Bones; Cell Transplantation - methods; Clinical trials; Comparative studies; Follow-Up Studies; Humans; Male; Maxilla - pathology; Maxilla - surgery; Maxillary Diseases - therapy; Maxillary Sinus - pathology; Maxillary Sinus - surgery; Middle Aged; Osseointegration; Periosteum - pathology; Periosteum - transplantation; Sinuses; Skin & tissue grafts; Tissue engineering; Tissue Engineering - methods; Transplantation, Autologous; Transplants & implants
• ISSN: 1076-3279; 1557-8690
• DOI: 10.1089/ten.2006.12.2649

The objective of this clinical trial was the analysis of 2 methods for engineering of autologous bone grafts for maxillary sinus augmentation with secondary implant placement. Group 1 (8 patients, 12 sinuses): cells of mandibular periosteum were cultured in a good manufacturing practice laboratory (2 weeks) with autologous serum and then transferred onto a collagen matrix. After another week, these composites were transplanted into the sinuses. In group 2A (2 patients, 3 sinuses), cells of maxillary bone were cultivated with autologous serum for 2 weeks, seeded onto natural bone mineral (NBM, diameter [Ø] = 8 mm) blocks, and cultivated for another 1.5 months. These composites were transplanted into the sinuses. Group 2B (control, 3 patients, 5 sinuses) received NBM blocks alone. In the course of implant placement 6 (group 1) and 8 (group 2) months later, core biopsy were taken. Clinical follow-up period was 1 to 2.5 years in group 1 and approximately 7 years in groups 2A and 2B. New vital bone was found in all cases at median densities of 38% ( n = 12) in group 1, 32% in group 2A ( n = 3), and 25% in group 2B ( n = 5). Differences between group 1 and 2B as well as 2A and 2B were statistically significant ( p = 0.025). No adverse effects were seen. All methods described were capable of creating new bone tissue with sufficient stability for successful implant placement.