A histomorphometric meta-analysis of sinus elevation with various grafting materials.
Several grafting materials have been used in sinus augmentation procedures including autogenous bone, demineralized freeze-dried bone (DFDBA), hydroxyapatite, beta-tricalcium phosphate (beta-TCP), anorganic deproteinized bovine bone and combination of these and others. Up to now a subject of controversy in maxillofacial surgery and dentistry is, what is the most appropriate graft material for sinus floor augmentation.


OBJECTIVE
The aim of this study is to provide a body of evidence-based data regarding grafting materials in external sinus floor elevation concerning the fate of the augmented material at the histomorphological level, through a meta-analysis of the available literature.


METHODS
The literature searches were performed using the National Library of Medicine. The search covered all English and German literature from 1995 until 2006. For analyzing the amount of bone the parameter "Total Bone Volume" (TBV) was assessed. TBV is determined as the percentage of the section consisting of bone tissue.


RESULTS
In a relatively early phase after implantation the autogenous bone shows the highest TBV values. Interestingly, the different TBV levels approximate during the time. After 9 months no statistically significant differences can be detected between the various grafting materials.


CONCLUSIONS
From a clinical point of view, the use of autogenous bone is advantageous if a prosthetic rehabilitation (with functional loading) is expected within 9 months. In other cases the use of anorganic deproteinized bovine bone in combination with autogenous bone seems to be preferable. Donor side morbidity is ignored in this conclusion.
Handschel
Jörg
J
Department for Cranio- and Maxillofacial Surgery, Heinrich-Heine-Universität, Moorenstr, 5, D-40225 Düsseldorf, Germany. handschel@med.uni-duesseldorf.de
Simonowska
Melani
M
Naujoks
Christian
C
Depprich
Rita A
RA
Ommerborn
Michelle A
MA
Meyer
Ulrich
U
Kübler
Norbert R
NR
D001672:Biocompatible Materials / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods / Q000473:pathology; D006801:Humans; D015201:Meta-Analysis as Topic; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D019737:Transplants; D016896:Treatment Outcome
D001672:Biocompatible Materials; D018786:Bone Substitutes