Journal of Prevention and Treatment for Stomatological Diseases ›› 2020, Vol. 28 ›› Issue (8): 477-486.doi: 10.12016/j.issn.2096-1456.2020.08.001

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The role of the membrane of the maxillary sinus in space osteogenesis under the sinus floor after elevation of the sinus floor

CHEN Songling(),ZHU Shuangxi   

  1. Department of Stomatology, The First Affiliated Hospital, SunYat-sen University, Guangzhou 510080, China
  • Received:2019-08-11 Revised:2020-02-14 Online:2020-08-20 Published:2020-07-15
  • Contact: Songling CHEN E-mail:chensongling@hotmail.com

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Abstract:

With the continuous development of maxillary sinus floor elevation technology, the osteogenesis mechanism of maxillary sinus floor elevation has always been a concern of scholars. The membrane of the maxillary sinus is an indispensable physiological structure in the process of space osteogenesis under the sinus floor after elevation of the sinus floor. In recent years, the role of the maxillary sinus floor mucosa in sinus floor space osteogenesis has been a research hotspot. Recent studies have found that the maxillary sinus floor membrane plays a role as a natural biological barrier membrane in the process of sinus floor space osteogenesis after maxillary sinus floor elevation; in addition, it has the ability to undergo osteogenesis. It has also been found that maxillary sinus membrane stem cells (MSMSCs) derived from the maxillary sinus floor membrane have characteristics of mesenchymal stem cells, which can differentiate into osteoblasts and participate in sinus floor space osteogenesis after maxillary sinus floor elevation. New studies have also found that small RNAs such as microRNAs, long noncoding RNAs and circular RNAs can regulate the osteogenic differentiation of MSMSCs, which may be important biological targets for promoting osteogenesis in the sinus floor space. In this paper, the relationship between the maxillary sinus floor mucosa and bone formation after maxillary sinus floor elevation, the barrier and osteogenic function of the maxillary sinus floor mucosa, the sources of osteoblasts involved in osteogenesis of the sinus floor space, and the molecular regulatory mechanisms of stem cells derived from maxillary sinus mucosa will be elucidated step by step.

Key words: dental implantation, maxillary sinus floor elevation, maxillary sinus floor membrane, maxillary sinus membrane stem cells, microRNAs, long non-coding RNAs, circular RNAs, osteogenic differentiation

CLC Number: 

  • R783

Figure 1

The stability and tightness of the sinus floor space after transcrestal sinus floor elevation are conducive to osteogenesis a: schematic diagram of internal maxillary sinus floor elevation; b: maxillary sinus floor elevation postsurgery; c: 12 months after maxillary sinus floor elevation"

Figure 2

The stability and tightness of the sinus floor space after lateral window sinus floor elevation are conducive to osteogenesis a: maxillary sinus floor elevation presurgery; b&c: lateral window for maxillary sinus floor elevation; d: bone powder was implanted through the bone window; e: the bone window was closed by biofilm; f: 6 months after maxillary sinus floor elevation"

Figure 3

New bone formation did not exceed the level of the top of the implant a: before the operation; b: immediately after the operation; c: 9 months after the operation; d: 12 months after the operation; e: 24 months after the operation; new bone formation did not exceed the level of the top of the implant, after internal maxillary sinus floor elevation and simultaneous implantation without bone grafting"

Figure 4

Experimental study on osteogenesis after sinus floor elevation and simultaneous dental implantation in dogs with or without bone grafting a: no new bone covered the top of the implant 6 months after the operation without bone grafting; b: new bone covered the top of the implant 6 months after the operation with bone grafting"

Figure 5

Sampling of the maxillary sinus membrane a: histological diagram of the maxillary sinus membrane, whether its innermost layer is called the periosteum or not; the latest consensus and conclusions have not been found; b: oral panorama of clinical specimens; c: materials of the human maxillary sinus membrane obtained during the operation"

Figure 6

Maxillary sinus membrane stem cells have chondrogenic capacity a: cell pellets after 4 weeks of chondrogenic induction in each group; b: comparison of cell pellet wet weight in each group; c: histology of pellets in each group; d: comparison of COL-2 expression in cell pellets of each group; e~f: quantitative comparison of chondroitin sulfate and hyaluronan in the cell pellets of each group; MSMSCs: maxillary sinus mesenchymal stem cells; BMSSCs: bone marrow stromal stem cells; DPSCs: dental pulp stem cells; PDLSCs: periodontal ligament stem cells"

Figure 7

Maxillary sinus membrane stem cells have osteogenic capacity a: the comparison of calcium nodule formation by alizarin red staining after 4 weeks of osteogenic induction in each group; b: the quantitative comparison of calcium nodule formation by alizarin red staining（ARS） after 4 weeks of osteogenic induction in each group; c: the comparison of calcium concentration in each group after 4 weeks of osteogenic induction; d: the comparison of alkaline phosphatase activity in each group after 4 weeks of osteogenic induction; e: the comparison of osteogenic factor protein expression in each group after 4 weeks of osteogenic induction; MSMSCs: maxillary sinus mesenchymal stem cells; BMSSCs: bone marrow stromal stem cells; DPSCs: dental pulp stem cells; PDLSCs: periodontal ligament stem cells"

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