Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2026
Does Systemic Bifidobacterium longum Improve Bone Formation After Maxillary Sinus Floor Elevation Under Osteoporotic Conditions? An Experimental Rabbit Study.
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Bayraktar Anıl, Bilge Suheyb, Ümit Kadir Kaan, Ermiş Mustafa, Lekesizcan Ayça, Demirbaş Ahmet Emin
Аннотация
BACKGROUND: Osteoporosis impairs bone microarchitecture and reduces the success of preprosthetic alveolar augmentation. Whether systemic probiotics improve bone formation after maxillary sinus floor elevation (MSFE) under osteoporotic conditions is unknown.
PURPOSE: To measure and compare new bone formation after MSFE in rabbits with and without induced osteoporosis and with and without systemic Bifidobacterium longum supplementation.
STUDY DESIGN, SETTING, AND SAMPLE: Prospective experimental animal study at a university research center (Kayseri, Türkiye). Adult female New Zealand white rabbits underwent bilateral MSFE with deproteinized bovine bone graft; those with sinus pathology or systemic illness were excluded.
PREDICTOR VARIABLES: Osteoporosis induction status (yes/no) and systemic B longum supplementation (yes/no), crossed to produce 4 groups (n = 6 each).
MAIN OUTCOME VARIABLES: Primary - micro-computed tomography trabecular microarchitecture at 8 weeks: trabecular number, trabecular separation, bone surface density, and bone mineral density. Secondary - qualitative histological bone maturity.
COVARIATES: None.
ANALYSES: According to distribution, four-group comparisons used one-way analysis of variance with the Tukey honestly significant difference test or the Kruskal-Wallis test with the Dunn-Bonferroni test. All pairwise comparisons were corrected for multiple comparisons; statistical significance was set at P ≤ .05.
RESULTS: Twenty-four rabbits (n = 6 per group) completed the study. Under osteoporotic conditions, animals receiving B longum had statistically significantly higher trabecular number [3.83 (0.12) versus 3.19 (0.32) mm-1; P = .011], bone surface density [16.22 (0.36) versus 14.18 (0.92) mm-1; P = .005] and lower trabecular separation [202 (4) versus 235 (24) μm; P = .009] than those not receiving probiotics. Bone mineral density and closed porosity percentage did not differ statistically significantly (P ≥ .5). No micro-computed tomography parameter differed between the osteoporosis + probiotic and control groups (all P ≥ .1). Histologically, the osteoporosis + probiotic group showed more mature bone than the osteoporosis-only group.
CONCLUSIONS AND RELEVANCE: Within the limits of this rabbit model, systemic B longum improved trabecular microarchitecture after MSFE under osteoporotic conditions, approaching healthy control values. Probiotics may be a low-morbidity adjunct in osteoporotic patients undergoing preimplant augmentation; clinical translation requires further study.
PURPOSE: To measure and compare new bone formation after MSFE in rabbits with and without induced osteoporosis and with and without systemic Bifidobacterium longum supplementation.
STUDY DESIGN, SETTING, AND SAMPLE: Prospective experimental animal study at a university research center (Kayseri, Türkiye). Adult female New Zealand white rabbits underwent bilateral MSFE with deproteinized bovine bone graft; those with sinus pathology or systemic illness were excluded.
PREDICTOR VARIABLES: Osteoporosis induction status (yes/no) and systemic B longum supplementation (yes/no), crossed to produce 4 groups (n = 6 each).
MAIN OUTCOME VARIABLES: Primary - micro-computed tomography trabecular microarchitecture at 8 weeks: trabecular number, trabecular separation, bone surface density, and bone mineral density. Secondary - qualitative histological bone maturity.
COVARIATES: None.
ANALYSES: According to distribution, four-group comparisons used one-way analysis of variance with the Tukey honestly significant difference test or the Kruskal-Wallis test with the Dunn-Bonferroni test. All pairwise comparisons were corrected for multiple comparisons; statistical significance was set at P ≤ .05.
RESULTS: Twenty-four rabbits (n = 6 per group) completed the study. Under osteoporotic conditions, animals receiving B longum had statistically significantly higher trabecular number [3.83 (0.12) versus 3.19 (0.32) mm-1; P = .011], bone surface density [16.22 (0.36) versus 14.18 (0.92) mm-1; P = .005] and lower trabecular separation [202 (4) versus 235 (24) μm; P = .009] than those not receiving probiotics. Bone mineral density and closed porosity percentage did not differ statistically significantly (P ≥ .5). No micro-computed tomography parameter differed between the osteoporosis + probiotic and control groups (all P ≥ .1). Histologically, the osteoporosis + probiotic group showed more mature bone than the osteoporosis-only group.
CONCLUSIONS AND RELEVANCE: Within the limits of this rabbit model, systemic B longum improved trabecular microarchitecture after MSFE under osteoporotic conditions, approaching healthy control values. Probiotics may be a low-morbidity adjunct in osteoporotic patients undergoing preimplant augmentation; clinical translation requires further study.