Histological and immunohistochemical analysis of a nanobiomaterial in a maxillary sinus lift surgery: A case report  

Objective: the objective of this study was to histologically and immunologically analyze the level of bone substitution and the presence of new blood vessels in a nanobiomaterial composed of hydroxyapatite and BTCP in a maxillary sinus lift surgery. Methods: A case of a maxillary sinus lift was investigated. The patient had a 1.0 mm bone remnant on the left side and 2 grams of nanobiomaterial (80% hydroxyapatite and 20% β-tricalcium phosphate) were grafted into the pneumatized sinus. After 6 months, during dental implant placement surgery, grafted bone samples were collected with 4 mm trephines. These samples were sent to the laboratory for analysis where they were stained with masson's trichrome and immunostained with osteonectin and osteopontin. Results: after 6 months of bone regeneration a result of 14 mm of bone gain was reached, the analyzes in masson's trichrome showed an excellent gain of newly formed bone, in addition to a very high percentage of blood vessels. In the immunostaining, a very large number of osteoblasts and osteoclasts was observed, signaling an excellent osteoconductive and osteoinductive potential of the studied nanobiomaterial. Conclusions: the maxillary sinus lift surgery with nanobiomaterial provided a very favorable bone height and thickness gain, as well as the high vascularity and cellularity, which enabled the patient's oral rehabilitation with osseointegrated dental implants and permanent ceramic prostheses.