Maxillary sinus augmentation with different biomaterials: a comparative histologic and histomorphometric study in man.
OBJECTIVE
Rehabilitation of the edentulous posterior maxilla with dental implants can be difficult because of insufficient bone volume caused by pneumatization of the maxillary sinus and crestal bone resorption. Different biomaterials have been used for sinus augmentation. The aim of the study was to compare different materials in maxillary sinus augmentation in man.


METHODS
A total of 94 patients participated in this study. Inclusion criteria were maxillary partial (unilateral or bilateral) edentulism involving the premolar/molar areas, and the presence of 3-5-mm crestal bone between the sinus floor and alveolar ridge. A total of 362 implants were inserted. There were 9 biomaterials used in the sinus augmentation procedures. Each patient underwent 1 biopsy after 6 months. A total of 144 specimens were retrieved.


RESULTS
None of the 94 patients had complications. All implants were stable, and x-ray examination showed dense bone around the implants. Mean follow-up was 4 years. There were 7 implants that failed. Histologic resultsshowed that almost all the particles of the different biomaterials (i.e., autologous bone, demineralized freeze-dried bone allograft Biocoral [Inoteb, St. Gonnery, France], Bioglass [US Biomaterials, Alachua, FL], Fisiograft [Ghimas, Bologna, Italy], PepGen P-15 [Dentsply Friadent CeraMed, Lakewood, CO], calcium sulfate, Bio-Oss [Geistlich Pharma AG, Wohlhusen, Switzerland], and hydroxyapatite) were surrounded by bone. Some biomaterials were more resorbable than others. Included are the histomorphometry clarified features of the newly formed bone around the different grafted particles.


CONCLUSIONS
All biomaterials examined resulted in being biocompatible and seemed to improve new bone formation in maxillary sinus lift. No signs of inflammation were present. The data are very encouraging because of the high number of successfully treated patients and the good quality of bone found in the retrieved specimens.
Scarano
Antonio
A
University of Chieti-Pescara, Pescara, Italy.
Degidi
Marco
M
Iezzi
Giovanna
G
Pecora
Gabriele
G
Piattelli
Maurizio
M
Orsini
Giovanna
G
Caputi
Sergio
S
Perrotti
Vittoria
V
Mangano
Carlo
C
Piattelli
Adriano
A
D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001672:Biocompatible Materials / Q000737:chemistry / Q000627:therapeutic use*; D003758:Dental Implantation, Endosseous / Q000379:methods*; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged
D001672:Biocompatible Materials