Maxillary sinus lift with solely autogenous bone compared to a combination of autogenous bone and growth factors or (solely) bone substitutes. A systematic review

Abstract

A., Vissink, A., & Raghoebar, G. M. (2012). Maxillary sinus lift with solely autogenous bone compared to a combination of autogenous bone and growth factors or (solely) bone substitutes. A systematic review: a systematic review.

Bioactive-glass in periodontal surgery and implant dentistry

“…Maxilla grafting with composite grafts of B-G granules and autogenous bone chips was shown to be as good as the treatment with autogenous bone alone, yielding the same quality and volume of mineralized tissue when a reasonable healing period (5-6 months) is allowed (Fig. 4) 23,30,36,37) . Bone formation in defects filled with a given osteoconductive bone substitute, like B-G, originates from the margins of the defect and proceeds up to a certain distance, but not necessarily throughout the defect space 38) .…”

“…Also, their resorption may be unpredictable 21) and the bone tissue from the same individual may be contaminated by microorganisms when harvested in the oral cavity 22) . When not enough autogenous bone is available, this is combined with particles or granules (granules are large particles) of a bone graft extender material 23) . Surgeons also tend to mix particles with blood from the patient to create a putty-like material, which is pressed easily into the osseous defect.…”

“…Following tooth loss, the maxillary alveolar ridge is affected by extensive buccolingual and/or apicoocclusal resorption and its trabecular bone substance undergoes intense remodelling processes, including enlargement of the maxillary sinus. As oral implantology developed, a surgical modification/reduction of this anatomical structure, called maxillary sinus lift, became a popular solution to increase vertical bone height, allow for reliable implant placement and obtain primary stability in the posterior atrophic maxilla 23) . It aims at regenerating bone in the lower border of the sinus cavity and is often achieved using graft materials that are placed inside a subantral space created between the residual alveolar ridge and the elevated membranous lining of the maxillary sinus 37) .…”

“…Thus, complete bone healing would depend primarily on the dimensions and configuration of the defect, i.e., smaller defects and/or with more bone walls would heal more readily than larger defects and/or with fewer bone walls. This means that harvesting of autogenous bone may be still necessary, but the amount of bone needed is considerably decreased and donor site morbidity is alleviated 23) . The use of autogenous bone is dictated by its osteogenic potential related to the number of surviving osteoblasts and osteoinductive effect brought about by the release of bone morphogenic proteins and other growth factors, which have the capacity to accelerate deposition of new bone along the graft material 37) .…”

A Minimally Invasive Sinus Augmentation Technique using a Novel Bone Graft Delivery System

“…5 Several bone grafting materials have been used in sinus lift procedures including autogenous bone, freeze dried bone, demineralized freeze dried bone, xenogeneic bone and alloplastic bone substitutes. 6,7 Bone substitutes displaying a putty consistency are becoming more popular for bone grafting procedures. 8,9 The handling characteristics of putty bone substitutes have expanded the available treatment options for bone grafting in narrow spaces and their physical properties can be exploited to increase the safety and predictability of sinus lift procedures.…”