Maxillary sinus floor augmentation with vegetal hydroxyapatite "versus" demineralized bovine bone: A randomized clinical study with a split-mouth design

Abstract

Purpose: The objective of this paper was to compare histologically and histomorphometrically a hydroxyapatite originated by algae (Algipore) versus demineralized bovine bone (Bio-Oss Geistlich Pharma, Wolhusen, Switzerland) utilised as bone substitutes in maxillary sinus floor elevation with a split-mouth design. Materials and Methods: Five healthy patients underwent a bilateral maxillary sinus floor elevation procedure under local anesthesia. In each case, residual posterior maxillary bone height was between 2 mm and 5 mm. The original bone was augmented with a split-mouth design with 100% Algipore on the test side and 100% Bio-Oss on the contralateral control side. After a healing period of 6-8 months during the re-opening surgery biopsies were retrieved and Xive Implants (Dentsply Implants, Mannheim, Germany) were placed. Results: At microscopic level both Bio-Oss and Algipore blocks resulted well osseointegrated, without inflammatory infiltrate, with an high level of mineralization, without gap between the bone and biomaterial interfaces that resulted indistinguishable. A close contact between the two faces was observed without the presence of slits. Histomorphometrical analysis showed that, on average, the percentage of medullary space was higher for the Bio-Oss compared with Algipore (38.61% ±8.90% vs. 29.23% ±7.89%). In contrast, the mean value of residual particles of biomaterials was higher in Algipore than in Bio-Oss specimens (42.86% ±18.61% vs. 22.30% ±6.40% respectively). Conclusions: The data confirmed that sinus lift carried out with Algipore performed in a similar way of that carried out with Bio-Oss and that this material is safe, predictable and without invasiveness.

Do osteoconductive bone substitutes result in similar bone regeneration for maxillary sinus augmentation when compared to osteogenic and osteoinductive bone grafts? A systematic review and frequentist network meta-analysis

“…For the outcome of overall NBF, the total sample consisted of 1483 biopsies in 52 RCTs on MSA . The grafting materials were AB alone (n = 16 trials; 215 biopsies) 37,39,41,43,44,52,54,58,65,68,71,73,76,80,81,83 , AG alone (n = 6 trials; 78 biopsies) 47,49,57,73,74,83 , XG alone (n = 27 trials; 365 biopsies) 36,38,42,43,45,46,[48][49][50][51]53,55,56,59,60,[62][63][64]66,67,73,75,[77][78][79]82,85 , AP alone (n = 19 trials, 263 biopsies) 35,…”

“…For the mean percentage NBF with a healing time of !6 months, a total of 872 biopsies were included in 37 RCTs consisting of 10 groups. These RCTs compared different bone grafting materials and investigated the amount of new bone after at least 6 months following MS Q16 A 36,38,[40][41][42][43][44][47][48][49][50][51][52][53][54]57,[59][60][61][62][63][64][65]67,[74][75][76][77][78][79][80][81][82][83][84][85][86] . There was statistically significant superiority of AB with respect to AP alone (WMD = À7.06%, 95% CI À 12.59% to À1.52%).…”

“…With regard to the overall mean percentage RG (over a duration of 3-15 months), a total of 1159 biopsies in 38 RCTs consisting of 11 groups were included 35,36,40,42,[44][45][46][47][48][49][50][51][52][53][55][56][57][59][60][61][62][63][64]66,67,69,70,[72][73][74][75][76][81][82][83][84][85][86] . There was a statistically significant difference between AB and XG (WMD = 9.62%, 95% CI 0.40% to 18.84%), but not with respect to the other groups ( Fig.…”

“…For the mean percentage RG with a healing time of !6 months, a total of 616 biopsies in 27 RCTs involving 10 groups were included 40,42,44,[47][48][49][50][51][52][53]57,[59][60][61][62][63][64]67,[74][75][76][81][82][83][84][85][86] . There was a statistically significant difference between AB alone and AP alone (WMD = 12.03%, 95% CI 3.04% to 21.03%), XG alone (WMD = 14.62%, 95% CI 4.25% to 24.98%), and GFs (WMD = 12.32%, 95% CI 0.04% to 24.60%).…”

15‐Year Retrospective Study on the Success Rate of Maxillary Sinus Augmentation and Implants: Influence of Bone Substitute Type, Presurgical Bone Height, and Membrane Perforation during Sinus Lift

“…Reducing the volume of grafts with autogenous bone does not seem to compromise the placement or success of implants [ 19 , 20 ]. Alloplastic, homogenous, and xenogenous bone substitutes cause less morbidity to the patient [ 25 ] and can be safely used [ 16 , 26 , 27 ] when they are immunologically inactive, physiologically stable, and biocompatible, enabling osteogenesis and osteoconductivity [ 28 ]. Although beta-tricalcium phosphate ( β -TCP) is an acceptable bone substitute to augment the maxillary sinus [ 29 ], the bone formation rate can be slower than in autogenous bone due to its low osteoconductivity [ 25 , 30 ].…”