Histologic and Histometric Evaluation of Bovine Cancellous Bone and Beta-Tricalcium Phosphate 45 Months After Grafting in Maxillary Sinus
The aim of this report is to determine the long-term histologic and histometric evaluation of beta-tricalcium phosphate (beta-TCP) and bovine cancellous bone grafted into the left maxillary sinus of a patient in order to augment the sinus floor to prepare it for receiving an implant. Beta-TCP and bovine cancellous bone (BCB) were grafted into the left maxillary sinus at the extracted sites of maxillary left first and second molars of a 62-year-old male patient. Using osteotome technique, 45 months later, core biopsies were taken for histologic and histometric comparison of the newly formed bone. Histometric and histologic evaluation of both specimens revealed a normal maxillary bone structure with 23.08% calcified bone and 76.92% marrow and connective tissue for the beta-TCP grafted site, and 24.81% calcified bone with 75.19% marrow and connective tissue for the BCB grafted site. No residual grafting material was seen in either specimen. Both beta-TCP and BCB were completely resorbed and replaced by new bone 45 months after grafting. Histologic results of the newly formed bone were similar for both grafting materials.
(a) Preoperative radiograph of maxillary left region shows less than 1 mm of bone remained at the extracted site of the maxillary left first molar (tooth no. 14) and 3–4 mm at the maxillary left second molar (tooth no. 15). (b) Immediate post sinus grafting radiograph. (c) Forty-five months postgrafting X ray shows 3–4 mm of bone at the extracted site of the maxillary left first molar (tooth no. 14) and 6–7 mm at the maxillary left second molar (tooth no. 15). (d) Four months after regrafting and implant placement.
Histologic sections at 45 months (hematoxylin and eosin). (a) Histologic view of beta-TCP grafted site with large marrow space (original magnification ×100). (b) Higher magnification of the TCP site shows lamellar bone with osteocyte lacuna and large marrow and connective tissue with no TCP residue (original magnification ×200). (c) Histologic view of BCB (Tutodent) grafted site (original magnification ×100). (d) Higher magnification of BCB site demonstrates lamellar bone with osteocyte lacuna, marrow with blood vessels, and mild inflammatory cells infiltration and no BCP residue (original magnification ×200).
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