Coral hydroxyapatite versus tricalcium phosphate β in sinus augmentation: A comparative clinical study

Abstract

Tatum [2] described the enlargement of the maxillary sinus for the insertion of implants in this region for the first time. This surgical procedure allows the implant to be placed by increasing the height of the alveolar bone in this area. A variety of graft materials have been used to enlarge the bottom of the maxillary sinus. Autogenic bone grafts are considered the gold standard because they are not immunogenic and have osteogenic, osteoinductive and osteoconductive properties [1, 3-6]. However, there are several disadvantages, including donor site morbidity, lameness when the graft is removed from the iliac crest, prolonged healing time, second surgery, the need for general and hospital anesthesia, higher treatment costs, and unpredictable absorption of the graft [7, 8]. These disadvantages have led to the search for suitable graft materials, which are a biocompatible, and osteoinductive or at least osteoconductive alternative to autogenous bone replacement in the procedure for enlarging the sinus floor. Various bone graft materials such as alloplastics (hydroxyapatite, b-tricalcium phosphate and bioactive glass) [9-14] , xenografts (bovine or coral hydroxyapatite) [15-20] , or allografts (freeze-dried demineralized bone) [21] are currently in use as an alternative or supplement to autogenous bone. These biomaterials serve as a scaffold for additional bone formation. However, bone reconstruction is slower than with autogenous bone grafts [22]. Coral hydroxyapatite (CHA), a type of xenograft, has proven to be a safe and biocompatible bone graft material with osteoconductive properties [23-25]. In addition, several experimental and clinical studies have shown positive results with CHA graft materials in augmentation of the maxillary sinus floor [22]. Another popular graft material that has shown promising results with osteoconductive properties is beta-ABSTRACT Background: Choosing augmentation equipment is a critical factor in maxillary sinus augmentation. The choice of one of these materials for sinus augmentation remains controversial. Purpose: The aim of this clinical study was to compare the biological performance of the new coral hydroxyapatite (CHA) graft material and the synthetic material made from tricalcium phosphate (b-TCP) in sinus augmentation. Materials and Methods: The study consisted of 20 patients (10 men and 10 women) who were edentulous or partially edentulous in the posterior maxilla and required the placement of implants. A total of (20) sinus transplants were performed in a single step using implant installation procedures. CHA was used in 10 patients and b-TCP in 10 patients. Results: An average increase in the height of the mineralized tissue of 7.1 ± 1.1 mm in the b-TCP group and 4.6 ± 1.17 mm in the CHA group was when comparing the preoperative CT scan with that after 9 Months. After the maxillary sinus augmentation procedure. The average percentage of the density of the transplanted area after 9 months, based on the initial alveolar ridge density at the implantation site, was 63.6 % ...