Maxillary sinus grafting with Bio-Oss or Straumann Bone Ceramic: histomorphometric results from a randomized controlled multicenter clinical trial.
BACKGROUND
This investigation was designed to compare the histomorphometric results from sinus floor augmentation with anorganic bovine bone (ABB) and a new biphasic calcium phosphate, Straumann Bone Ceramic (BCP).


METHODS
Forty-eight maxillary sinuses were treated in 37 patients. Residual bone width was > or =6 mm and height was > or =3 mm and <8 mm. Lateral sinus augmentation was used, with grafting using either ABB (control group; 23 sinuses) or BCP (test group; 25 sinuses); sites were randomly assigned to the control or test groups. After 180-240 days of healing, implant sites were created and biopsies taken for histological and histomorphometric analyses. The parameters assessed were (1) area fraction of new bone, soft tissue, and graft substitute material in the grafted region; (2) area fraction of bone and soft tissue components in the residual alveolar ridge compartment; and (3) the percentage of surface contact between the graft substitute material and new bone.


RESULTS
Measurable biopsies were available from 56% of the test and 81.8% of the control sites. Histology showed close contact between new bone and graft particles for both groups, with no significant differences in the amount of mineralized bone (21.6+/-10.0% for BCP vs. 19.8+/-7.9% for ABB; P=0.53) in the biopsy treatment compartment of test and control site. The bone-to-graft contact was found to be significantly greater for ABB (48.2+/-12.9% vs. 34.0+/-14.0% for BCP). Significantly less remaining percentage of graft substitute material was found in the BCP group (26.6+/-5.2% vs. 37.7+/-8.5% for ABB; P=0.001), with more soft tissue components (46.4+/-7.7% vs. 40.4+/-7.3% for ABB; P=0.07). However, the amount of soft tissue components for both groups was found not to be greater than in the residual alveolar ridge.


CONCLUSIONS
Both ABB and BCP produced similar amounts of newly formed bone, with similar histologic appearance, indicating that both materials are suitable for sinus augmentation for the placement of dental implants. The potential clinical relevance of more soft tissue components and different resorption characteristics of BCP requires further investigation.
Cordaro
Luca
L
Department of Periodontology and Implant Dentistry, Eastman Dental Hospital, Rome, Italy. lucacordaro@usa.net
Bosshardt
Dieter D
DD
Palattella
Piermario
P
Rao
Walter
W
Serino
Giuseppe
G
Chiapasco
Matteo
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000473:pathology / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001672:Biocompatible Materials / Q000627:therapeutic use; D001857:Bone Matrix / Q000637:transplantation; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods; D002516:Ceramics / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D003793:Dental Restoration, Permanent / Q000379:methods; D006801:Humans; 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; D016348:Osseointegration / Q000502:physiology*; D010012:Osteogenesis / Q000502:physiology*; D018709:Statistics, Nonparametric
C077540:Bio-Oss; D001672:Biocompatible Materials; D018786:Bone Substitutes; D015921:Dental Implants; D008903:Minerals