Sinus Membrane Elevation with Heterologous Cortical Lamina: A Randomized Study of a New Surgical Technique for Maxillary Sinus Floor Augmentation without Bone Graft

Abstract

Background: The aim of this randomized controlled clinical trial was to compare the efficacy of two different techniques for maxillary sinus augmentation using a lateral window approach: Heterologous cortical lamina without any grafting material versus 100% collagenated granular collagen porcine bone. Methods: Twenty-three healthy patients with not relevant past medical history (14 women and 9 men, non-smokers, mean age 52 years, range 48–65 years) were included. In Group I, the sinus was filled with collagen porcine bone (Geno-os, OsteoBiol, Turin, Italy) and a collagen membrane (Evolution, OsteoBiol, Turin, Italy) was used to close the lateral window of the sinus. In Group II, the sinus was treated with heterologous cortical lamina only (Lamina, OsteoBiol, Turin, Italy). Results: There was a statistically significant difference in the surgical time required to complete the augmentation procedures: 18.3 ± 2.1 min for lamina treated sites versus 12.5 ± 3.1 min for porcine bone treated sites. In Group I, the mean volume of the graft was 3101 ± 321 mm3 in the immediate postoperative examination (5–7 days), while after a six-month healing period it was 2716.7 ± 432 mm3. Conclusion: This study demonstrates that the use of heterologous cortical lamina is a valid technique for the mechanical support of sinus membranes resulting in only bone tissue formation and not mixed with the graft. The graft material was biocompatible and not completely resorbed after six months, although the remains were integrated into the bone.

The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis

“…After the surgery, we may assess the primary stability of the placed implants, a value that indicates the contact of the implant surface with the surrounding bone [ 42 ]; after this, the secondary stability will follow, which is reached after the processes of remodeling and healing of the bone [ 43 ]; usually, the achievement of good primary stability will be followed by correct secondary stability [ 44 ]. In this way, the dynamic functional response of the bone tissue is determined by the bone-to-implant contact percentage (BIC), which is constantly interested in remodeling processes under the functional loading [ 25 , 26 , 40 , 41 , 42 , 43 , 45 , 46 , 47 , 48 ]. In order to assess the implant stability, we may use an index called the implant stability quotient (ISQ), a unit of measurement, which allows us to assess the degree of integration of the placed implants [ 49 ]; the clinical range of the ISQ is ranged between 55 and 80, and if the value is higher than 65, it is commonly accepted as a favorable situation for implant stability; on the contrary, values under 45 are considered as insufficient implant stability [ 42 ].…”

Synthetic Scaffold/Dental Pulp Stem Cell (DPSC) Tissue Engineering Constructs for Bone Defect Treatment: An Animal Studies Literature Review

“…Osteoconduction is a process correlated to the capability of a biomaterial to create the physical space-maintaining of the regenerative space, to create the stability of the blood clot in the healing period and to provide the reparative growth of the native bone [ 11 , 12 , 13 , 14 , 15 ]. Osteoinduction is a process in which the biomaterial shows the capability to stimulate the recruitment, proliferation and the differentiation of the osteoprogenitor cells, inducing new bone formation [ 11 , 16 , 17 , 18 , 19 , 20 ]. The osteogenesis property is typical of biomaterials self-provided by osteoprogenitors cells, such as autologous graft that represents the gold standard for bone regeneration [ 11 , 16 , 21 ].…”

Guided Bone Regeneration of an Atrophic Maxilla Using Heterologous Cortical Lamina

“…Showing a different application for the cortical lamina, Scarano et al [11] performed a randomized clinical study among twenty patients in which two different techniques of maxillary sinus floor elevation with lateral window were used. In one group, heterologous cortical lamina was used and the sinus cavity was not filled up with any biomaterial.…”