ANÁLISE DO BIOGRAN E BIO-OSS EM SEIOS MAXILARES DE HUMANOS: ESTUDO CLÍNICO, PROSPECTIVO E HISTOMORFOMÉTRICO
Palavras-chave:
Seio maxilar, Substitutos ósseos, Implantes dentáriosResumo
Introdução: A reabilitação de pacientes edêntulos em região posterior da maxila apresentou-se, por muito tempo, como um desafio aos cirurgiões dentistas. A deficiência óssea vertical proveniente da pneumatização do seio maxilar impossibilita a instalação de implantes dentais necessários para a reabilitação protética. Técnicas cirúrgicas para a elevação da membrana sinusal e biomateriais para enxertia óssea permitiram que essa deficiência pudesse ser reparada. Dentre os materiais utilizados para este fim destaca-se, até a atualidade, o enxerto ósseo autógeno pois é considerado o mais previsível e, o padrão ouro nas reconstruções maxilofaciais. Por demandar de um outro procedimento cirúrgico para sua coleta, biomateriais como a hidroxiapatita derivada de cortical óssea bovina e o vidro bioativo tem sido amplamente utilizada como substitutos ósseos em seios maxilares. Contudo, estudos comparando esses substitutos ósseos ainda são escassos na literatura o que poderia ajudar a elucidar dúvidas do cirurgião dentista na clínica diária.
Objetivo: Este estudo se justifica pelo objetivo de avaliar, prospectivamente, o comportamento e a dinâmica do reparo ósseo do Biogran, adicionado ou não ao osso autógeno no seio maxilar de humanos comparando-o com o Bio-Oss, Bio-Oss adicionado ao osso autógeno e o osso autógeno puro. Para isso, após 6 meses de reparo ósseo, a neoformação óssea.
Resultados: A taxa de neoformação em percentual para o grupo 1 (Biogran®) foi de 43% em região de leito, 35% para região intermediária e 48% para região apical. Para o grupo 2 (Biogran® + Osso autógeno) a taxa de neoformação foi de 39%, 35% e 37% de osso neoformado para leito, intermediário e apical respectivamente. Para o grupo 3 (Bio-Oss®) houve 33%, 33% e 34% de neoformação nas regiões de leito, intermediário e apical. No grupo 4 (Bio-Oss® + Osso autógeno) em leito formou 36%, intermediário 38% e em apical 30%. No grupo 5 (Osso autógeno – controle) houve 39% de osso no leito, 39% na intermediaria e 32% na apical. Não houve diferença estatística para neoformação óssea nos grupos estudados e nem entre as regiões avaliadas (p<0,05).
Conclusão: Com o presente estudo conclui-se que todos os biomateriais estudados possuem características histomorfométricas semelhantes, provando serem ótimos substitutos ao osso autógeno, independente de estarem em sua forma pura ou associados ao mesmo.
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