Clinical and histologic comparison of two different composite grafts for sinus augmentation: a pilot clinical trial.
OBJECTIVE
Sinus augmentation is a procedure used for augmenting insufficient bone height that is often observed in the maxillary posterior areas. Many different techniques as well as bone graft regimens have been suggested for performing this procedure. It was the goal of this study to compare, clinically and histologically, two different composite grafting regimens used for sinus augmentation.


METHODS
Five patients, needing a bilateral sinus augmentation to allow implant placement, were recruited for this study. Right sinuses were grafted with cortical bone (collected from overlying the sinus membrane) and bovine hydroxyapatite (HA), while the left side sinuses were grafted with overlying autologous bone plus a bioglass (BG) material. Bone core biopsies were taken at 6 months after sinus graft or at the time of implant insertion. A waiting period of 6 additional months was granted to allow healing, before prosthetic restoration and functional loading. The level of peri-implant bone was evaluated 12 months after loading. A comparative histomorphometric analysis was conducted and a statistical analysis was performed.


RESULTS
All implants in both groups were functional after a 12-month loading period. No bone loss was observed radiographically or clinically in both groups. Histologic analysis revealed that both composite grafts had a high biocompatibility. In the bovine HA-containing group, minimal xenogenic graft absorption was noted. In contrast, BG group samples presented a high absorption rate with some remaining particles imbedded in new normal bone.


CONCLUSIONS
Sinus augmentation using a combination of autogenous bone plus either bovine HA or BG is a predictable technique.
Oral Surgery Department, School of Dentistry, University of Granada, Granada, Spain. pgalindo@ugr.es
Pablo
P
Galindo-Moreno
Gustavo
G
Avila
Juan Emilio
JE
Fernández-Barbero
Francisco
F
Mesa
Francisco
F
O'Valle-Ravassa
Hom-Lay
HL
Wang
D000368:Aged; D016301:Alveolar Bone Loss / Q000473:pathology / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use; D001857:Bone Matrix / Q000637:transplantation; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D002516:Ceramics / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D003793:Dental Restoration, Permanent / Q000379:methods; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D013516:Oral Surgical Procedures, Preprosthetic / Q000379:methods*; D010865:Pilot Projects; D016896:Treatment Outcome
C077540:Bio-Oss; D001672:Biocompatible Materials; C022107:Bioglass; D018786:Bone Substitutes; D015921:Dental Implants; D008903:Minerals