Sinus floor augmentation using mixture of mineralized cortical bone and cancellous bone allografts: Radiographic and histomorphometric evaluation

Abstract

Background/purpose Due to the pneumatization of the maxillary sinus, the sinus floor augmentation is often performed to implant placement in the maxillary posterior region. The aim was to perform radiographic and histomorphometric evaluation after placement of mixed allografts (cortical freeze-dried bone allograft [FDBA] 50%:cancellous FDBA 50%) during sinus floor augmentation. Materials and methods In 37 patients, anorganic bovine bone (ABB, sites = 16), mineralized cancellous bone allograft (MCBA, sites = 15), and mixed allografts (Mixed AG, sites = 20) were placed during sinus floor elevation via the lateral approach (LSFE), at total 51 sites with residual alveolar bone height (RBH) < 5 mm. Cone-beam computed tomography images were obtained before LSFE (T0), after surgery (T1), and 6 months after surgery (T2) for radiographic analysis. After a 6-month healing period, core biopsies were harvested and histomorphometric analysis was performed. Results The mean augmented bone height (ABH) of ABB, MCBA, and mixed AG groups after surgery was similar (13.86 ± 4.19 mm, 13.99 ± 4.07 mm, and 14.20 ± 3.12 mm, respectively; P > 0.05). The mean ABH of ABB, MCBA, and mixed AG groups after 6 months was similar (13.72 ± 4.55 mm, 11.83 ± 3.31 mm, and 12.53 ± 2.97 mm, respectively; P > 0.05). In the ABB, MCBA, and mixed AG groups, the proportion of newly formed bone (NB) was similar (36.13 ± 10.01%, 39.26 ± 10.72%, and 31.27 ± 18.31%, respectively; P > 0.05). Conclusion This result demonstrated that mixed AG led to sufficient bone augmentation and histologically comparable NB formation as compared to ABB and MCBA for sinus floor augmentation.

Residual Bone Height and New Bone Formation after Maxillary Sinus Augmentation Procedure Using Biomaterials: A Network Meta-Analysis of Clinical Trials

“…In total, 266 records did not meet the inclusion criteria based on titles and abstract were excluded. Upon full text assessment by two authors, 84 studies were selected for data extraction for qualitative analysis [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 ...…”

Radiographic and Histomorphometric Evaluation of Sinus Floor Augmentation Using Biomimetic Octacalcium Phosphate Alloplasts: A Prospective Pilot Study

“…Similarly, our recent study showed almost no change in VBH, with a decrease of only 0.14 mm after 6 months of sinus grafting using DBBM. On the other hand, when 100% cancellous freeze-dried bone allograft (FDBA) and mixed FDBA (cortical FDBA 50%: cancellous FDBA 50%) were used, 2.16 mm and 1.30 mm decreases in VBH were observed 6 months after surgery, respectively [5]. In the case of synthetic bone substitute materials, biphasic calcium phosphate (BCP) bioceramics, which consist of HA and beta-tricalcium phosphate, are currently the most widely used [18].…”

“…Allografts, xenografts, and synthetic grafts are considered attractive alternatives that could be employed in order to overcome the shortcomings of autologous bone grafts [4]. Our previous study has shown histologically comparable new bone formation and sufficient sinus floor augmentation using allografts rather than xenografts [5]. Synthetic bone graft materials, mainly made of ceramic, tricalcium phosphate, and hydroxyapatite (HA), have the advantages of mass production, the control of properties, and no risk of cross-infection.…”

Current Options and Future Perspectives on Bone Graft and Biomaterials Substitutes for Bone Repair, from Clinical Needs to Advanced Biomaterials Research

“…The use of fragmented bone in the form of small pieces of spongy or cortical bone is indicated with encouraging results due to the increased osteoconductive potential, especially in the case of larger defects in the posterior maxillary area that require performing operations to lift the sinus membrane. These small fragments of spongy and cortical bone are usually used in a mixture with each other or with other categories of augmentation materials due to the increased risk of resorption of the spongy bone [40]. Demineralized bone matrix (DBM) is a decalcified product for which obtaining an acidic solution is used to remove mineral components, leaving behind collagen, other proteins, bone morphogenic proteins (BMP), variable percentages of calcium phosphate and a small percentage of cell debris.…”