Purely cancellous vs. corticocancellous bone in sinus floor augmentation with autogenous iliac crest: a prospective clinical trial.
OBJECTIVE
Among the different graft materials being applied in sinus elevation surgery autogenous bone, especially from the iliac crest, is considered to be the graft of choice. The goal of this prospective study was to investigate whether purely cancellous transplants of this donor site lead to significantly better results regarding bone quantity and quality when compared to corticocancellous iliac bone grafts.


METHODS
Fifteen patients suffering from extreme maxillary atrophy underwent bilateral sinus floor augmentation with grafts from the iliac crest consisting of purely cancellous bone (PCB) for the right side and a mixture of 50% cancellous and 50% cortical bone for the left side, respectively. Bone samples that were taken during implant insertion were examined histologically for semiquantitative assessment. In addition, bone density was measured histomorphometrically. Data were statistically analyzed by a repeated measures analysis of covariance model and post hoc paired t-tests as well as Pearson's correlation analysis.


RESULTS
Semiquantitative analysis of bone quality resulted in comparable results for both graft preparations while bone density was significantly higher in the PCB group. Without consideration of the different transplant groups, there was neither a significant correlation between patients' age and bone density nor bone quality. Differences between the genders could not be observed either.


CONCLUSIONS
Because of better bone density, the PCB graft from the iliac crest remains our gold standard. Even in elderly patients, autogenous grafts can be utilized without losses in the properties of the resulting bone.
Gerressen
Marcus
M
Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of the Aachen University (RWTH), Aachen, Germany. marcus.geressen@post.rwth-aachen.de
Hermanns-Sachweh
Benita
B
Riediger
Dieter
D
Hilgers
Ralf-Dieter
RD
Spiekermann
Hubertus
H
Ghassemi
Alireza
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D001706:Biopsy; D015519:Bone Density / Q000502:physiology; D001857:Bone Matrix / Q000473:pathology; D016723:Bone Remodeling / Q000502:physiology; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology / Q000502:physiology; D005260:Female; D006801:Humans; D007085:Ilium; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D010006:Osteoblasts / Q000473:pathology; D010011:Osteocytes / Q000473:pathology; D010012:Osteogenesis / Q000502:physiology; D011446:Prospective Studies; D012737:Sex Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D014182:Transplantation, Autologous