Short-term healing of autogenous and allogeneic bone grafts after sinus augmentation: a report of 2 cases.
Sinus augmentation to facilitate the placement of cylindrical endosseous implants in the posterior maxilla has become more commonplace, and many different materials have been used for the sinus graft. The results of two sinus augmentation procedures, one grafted with demineralized freeze-dried bone (DFDB) and the other with autogenous iliac bone, are presented. Bone cores were obtained with a trephine drill from the grafted regions at the time of implant placement. Eight implants were placed into the grafted areas in each subject. The sample from the sinus grafted with autogenous bone was obtained 8 months postoperatively and the bone core from the sinus grafted with DFDB was taken 16 months postoperatively. The bone specimens were subsequently examined under light microscopy. The autogenous specimens demonstrated new bone formation with increased quantity and improved quality when compared to the specimens obtained from the sites grafted with allogeneic bone. All 8 implants placed into the autogenous grafts were clinically osseointegrated at stage 2. At 16-months postsurgery, the bone core taken from the site grafted with DFDB demonstrated poor bone quality and still contained remnants of the graft material in the region approximating the sinus membrane. Two of the 8 implants placed into the allogeneic grafts failed at stage 2. These findings suggest that autogenous sinus grafts produce bone of adequate quantity and quality for implant placement, whereas DFDB sinus grafts are not completely remodeled by the host and may produce bone of insufficient quality and quantity for predictable implant placement.
Nishibori
M
M
Department of Periodontology, University of Pennsylvania School of Dental Medicine, Philadelphia.
Betts
N J
NJ
Salama
H
H
Listgarten
M A
MA
D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016025:Bone Transplantation / Q000000981:diagnostic imaging / Q000379:methods* / Q000473:pathology; D003648:Decalcification Technique; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D005612:Freeze Drying; D006801:Humans; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration; D010012:Osteogenesis; D011475:Prosthesis Failure; D011859:Radiography; D014021:Tissue Preservation; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014945:Wound Healing
D015921:Dental Implants