J Korean Assoc Oral Maxillofac Surg.  2013 Jun;39(3):120-126. 10.5125/jkaoms.2013.39.3.120.

Porcine study on the efficacy of autogenous tooth bone in the maxillary sinus

• Lee DH
• Yang KY
• Lee JK

• KMID: 1430479
• DOI: http://doi.org/10.5125/jkaoms.2013.39.3.120

Abstract

OBJECTIVES
This study sought to elucidate the effect of autogenous tooth bone material by experimenting on minipig's maxillary sinus and performing histological and histomorphometric analyses.
MATERIALS AND METHODS
Five 18-24 month-old male minipigs were selected, and right maxillary sinuses were grafted with bone graft material made of their respective autogenous teeth extracted eight weeks earlier. The left sides were grafted with synthetic hydroxyapatite as control groups. All minipigs were sacrificed at 12 weeks after bone graft, which was known to be 1 sigma (sigma) period for pigs. Specimens were evaluated histologically under a light microscope after haematoxylin-eosin staining followed by semi-quantitative study via histomorphometric analysis. The ratio of new bone to total area was evaluated using digital software for calculation of area.
RESULTS
All specimens were available, except one on the right side (experimental group), which was missing during specimen preparation. This study demonstrated new bone at the periphery of the existing bone in both groups, showing evidence of bone remodeling, however, encroachment of new bone on the central part of the graft at the 1 sigma period was observed only in the autogenous tooth bone group (experimental group). Histomorphometric analysis showed more new bone formation in the experimental group compared to the control group. Although the difference was not statistically significant (P>0.05), the mean percentage area for new bone for the experimental and control groups were 57.19%+/-11.16% and 34.07%+/-13.09%, respectively.
CONCLUSION
The novel bone graft material using autogenous tooth is a good alternative to autogenous bone, comparable to autogenous bone, and outperforming synthetic hydroxyapatite bone graft materials in terms of bone regeneration capacity. Augmentation with autogenous tooth bone materials will reduce donor site morbidity without hampering the safety of the autogenous bone graft.

Keyword

Autogenous tooth bone; Miniature pig; Histomorphometric study; Maxillary sinus

MeSH Terms

Bone Regeneration
Bone Remodeling
Durapatite
Humans
Light
Male
Maxillary Sinus
Osteogenesis
Swine
Swine, Miniature
Tissue Donors
Tooth
Transplants
Durapatite

Figure

• 

  Fig. 1 Surgical procedure (lateral window approach) with the outfracture osteotomy sinus graft technique. After extraoral skin incision on the infraorbital area, careful dissection was done until we reached the lateral maxillary sinus wall. After bony window opening, the autogenous tooth-derived material was grafted in the floor of the maxillary sinus. The same procedure was done on the left side of the same animal, except the graft material wherein the synthetic hydroxyapatite was grafted. The same procedure was repeated in the remaining 4 experimental animals on the same day. The area of interest was marked(*) on the floor of the maxillary sinus area.

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  Fig. 2 Typical example of the experimental group at magnification of ×100 (H&E staining). Autogenous tooth-derived graft materials (asterisks) showing multiple linear streaks of the dentinal tubular structure were surrounded by the new bone (arrowheads) growing at the periphery of the graft materials.

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  Fig. 3 Another typical example of the experimental group at higher magnification of ×400 (H&E staining). Multinucleated giant cells (arrowhead) were seen at the periphery of the material of multiple linear streaks. This suggests osteoclastic activity at the periphery of the grafted material, which is an evidence of bone remodeling.

• 

  Fig. 4 Another typical example of the experimental group at magnification of ×100 (H&E staining). New bone (arrowhead) was encroaching on the autogenous tooth-derived graft material (asterisk) from the periphery into the center.

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  Fig. 5 Typical example of the control group at magnification of ×100 (H&E staining). New bone was also found at the periphery of the grafted hydroxyapatite (arrowheads), but not in the inner portion of the graft space (asterisk).

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