Untersuchung des Einflusses hormoneller, alters-, geschlechtsbedingter und lebensstilassoziierter Parameter auf die craniofaziale Knochenregeneration

Background The aim of the present study was to investigate the relationships between constitutional factors as sex, body mass index (BMI), smoking behavior and the hormonal situation in bone regeneration using bone substitute materials in craniofacial area. Materials and Methods We conducted a prospective study in which 60 men and 60 women were given as part of a twostage sinus lift procedure dental implants. In the re-entry after 6 months the accumulating bone of the jaw sections was examined by histomorphometry and immunohistochemistry. Coinciding with the surgery the BMI was evaluated, inquired of nicotine consumption and performed a measurement of estradiol, testosterone and SHBG by radioimmunoassay and Eletrochemolumineszenzimmunoassay and the androgen index. Results Obese patients with increasing BMI (> 25) showed a significant higher bone regeneration (p = 0.0255) and greater marker Expressions than non-obese patients. This difference could be observed mainly in the group of men with a statistically significant p-value of 0.0301 in the overweight men. Whereas in the group of women this difference was not significant. The Spearman correlation and linear regression analysis revealed significant associations between the estradiol serum levels (Log E2) and of bone formation in men. In addition, the non smokers showed compared to smokers with a p-value of 0.0957 to a high tendency in bone regeneration and the osteogenic marker expression. There was also found a slight, but not significant trend (p = 0.21, Wilcoxon U test) for better bone formation in the group of men compared to women. Conclusions The present study initially verified in a clinical-histological comparison gender-typical and constitutional aspects for the intramembranous ossifications and regenerations modus. It seems that with respect to the osseous regenerative potential men towards women at an advantage. Despite the knowledge of the negative effects of increased BMI it seems that BMI has a positive impact on the regenerative capacity of the bone in the elderly. Furthermore, it was observed a negative but non statistically significant influence of smoking on bone regeneration.