Histologic and Histomorphometric Evaluation of Maxillary Sinus Floor Elevation Using Nanobone® and Easy-Grafttm Crystal: A Split-Mouth Clinical Trial

Maxillary sinus floor elevation is an effective method for bone augmentation in the posterior maxilla. Due to the limitations of autogenous bone grafts, bone substitutes are often used for this purpose. This study sought to compare the histologic and histomorphometric results of using NanoBone® and easy-graft™CRYSTAL for maxillary sinus floor elevation. This randomized double-blind split-mouth clinical trial was conducted on nine healthy patients requiring bilateral (n=18) sinus floor augmentation. Dental implants were placed six months after sinus floor elevation. Biopsy samples were taken at the time of implant surgery and analyzed using HistoMorphoMeter Ver.1.0 software. Histomorphometric analysis indicated that NanoBone® and easy-graft™ residues accounted for 32.71±10.39% and 26.61±9.48% of the bioptical volume, respectively. The amount of new bone formation was 25.29±7.29% and 18.69±5.63% in the NanoBone® and easy-graft™ groups, respectively. Paired samples t-test showed significant differences between the two groups in this respect (P=0.0001). Wellmineralized regenerated bone with lamellar parallel-fibered structure and Haversian systems surrounded the particles in both groups. Both tested materials yielded acceptable histological outcomes six months after surgery. NanoBone® caused superior new bone formation. Although longer follow-ups and larger sample size are needed, these preliminary results encourage further research in this respect

Histomorphometric and Histologic Evaluation of Nano-HA with and without PRGF in Bilateral Sinus Lift Augmentation: A Randomized Clinical Trial

Background and Aim: Positive results were reported after application of plasma-rich in growth factors (PRGF) in sinus elevation augmentations. Furthermore, PRGF products are available in different formulations and using them along with different graft biomaterials possibly induces bone formation and remodeling. This study assessed the histologic and histomorphometric results of NanoBone® biomaterial with and without PRGF in bilateral sinus augmentations. Materials and Methods: In this randomized split-mouth clinical trial, 10 patients who needed sinus floor elevation were selected and activated liquid PRGF was obtained through centrifuge of their blood. The space between alveolar process and sinus floor were filled with NanoBone® + PRGF (test site) or NanoBone® alone (control site) post-surgery. After 6 months, the implants were inserted in the regions and bone specimens were obtained using trephine burs. The sections were prepared by the standard techniques and bone remodeling was examined in both groups. The data were subjected to paired t test. Results: In case sites, the mean new bone formation percentages were 30.29%±8.54 and 30.84% ±6.76 in control sites. The mean remnant particles were 26.16%±10.03 and 26.18%±10.09 in case and control sites respectively. No significant differences were noted between case and control sites regarding mean new bone formation and remnant particles. Chronic inflammation was noted in all specimens with dominant range of 10-30%. The giant cells were evident and all specimens showed bones of lamellar and woven types. Conclusion: Although no significant differences existed between the sites filling using NanoBone® with and without PRGF in bilateral sinus augmentations, the results are probably related to the lengthy time periods for specimen preparation and the type of bone materials used. Conclusion was that PRGF did not induce bone formation in the aforementioned period of time

Evaluation of Periodontal Status in Diabetes Mellitus Type 2 Patients Based on HbA1c and CRP

Introduction: During the last decades, there has been an increasing interest in the relationship between diabetes mellitus (DM) and periodontitis. Some evidence has suggested that inflammatory factors like C-reactive protein (CRP) can be contributing factors to both periodontitis and diabetes. This study was aimed at assessing periodontal position in diabetes mellitus type 2 patients based on HbA1c and CRP. Materials and Methods: 76 patients with diabetes mellitus2 (DM2) were divided based on glycemic control: 35 subjects with HbA1c less than 7% and 41 subjects with HbA1c≥7%. The following measurements were conducted: Serum HbA1c and C-reactive protein (CRP), gingival Index (GI), plaque Index (PI), clinical attachment loss (CAL), bleeding on probing (BOP), and probing depth (PD). Moreover, age, gender and duration of diabetes of the patients were also analyzed. Results: In this study, 24 women and 11 men by mean age of 55/31±8/37 were in a good diabetic patients’ group (HbA1c<7%) and 30 females and 11 males by the mean age of 53/76±9/91 were in poor control diabetic patients (HbA1c≥7%). A significant correlation between the elevation of CRP and increased level of HbA1c was observed (P<0/001). The patients` age was associated with the duration of diabetes (P=0/024) and women had significantly more duration of diabetes than men (P=0/012). Regarding PD, CAL, BOP and PI, there was no significant difference between the analyzed groups. Also, no significant relationship between CRP and periodontal parameters has been found. Conclusion: CRP was found as a predictor of HbA1c in patients with poor glycemic control. This implies higher infection rates due to diabetes