Use of engineered bone for sinus augmentation.
BACKGROUND
Tissue-engineered bone grafts represent an appealing alternative for maxillary sinus augmentation because they eliminate the significant drawbacks associated with extra- and intraoral bone-harvesting procedures. In the present case series, we document the outcomes of sinus augmentation surgery using tissue-engineered bone grafts.


METHODS
Three patients requiring bilateral sinus augmentation received tissue-engineered bone grafts combined with xenograft prior to implant placement. Implants were placed and loaded 6 and 12 months postaugmentation, respectively. Radiographs were taken and clinical examinations were performed preoperatively and at 4, 6, 12, and 18 months postaugmentation. Biopsies were obtained at 4 and 6 months postaugmentation. Standardized orthopantomograms were used to measure the posterior maxilla bone height.


RESULTS
None of the patients experienced untoward complications during or following the therapeutic procedures. Ten implants were inserted into the augmented sinuses and loaded. Biopsies revealed a lack of inflammation or pathology; newly formed fibrous bone with osteoblastic activity and xenograft particles was evident. Compared to 4 months postaugmentation, augmented tissue was more mature at 6 months. The postoperative (18 months) bone height in augmented areas was significantly greater than the preoperative height (P <0.0001), representing an approximately 4.5-fold increase in bone height.


CONCLUSIONS
Sinus augmentation using tissue-engineered bone grafts was successful in all three cases, permitting the subsequent insertion and loading of dental implants. The present cases demonstrated the feasibility of using engineered bone for sinus augmentation. Controlled clinical trials will be required to evaluate this new and evolving treatment modality.
Beaumont
Christian
C
BioTissue Technologies, Freiburg, Germany.
Schmidt
Roswitha J
RJ
Tatakis
Dimitris N
DN
Zafiropoulos
Gregory-George
GG
D001857:Bone Matrix / Q000637:transplantation*; D001861:Bone Regeneration; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D013516:Oral Surgical Procedures, Preprosthetic / Q000379:methods*; D010006:Osteoblasts / Q000502:physiology; D010521:Periosteum / Q000166:cytology*; D011098:Polyglactin 910; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds
D011098:Polyglactin 910