title: Bone marrow concentrate and bovine bone mineral for sinus floor augmentation: a controlled, randomized, single-blinded clinical and histological trial--per-protocol analysis.
abstract: OBJECTIVE
  The purpose of this work was to evaluate the potential of substituting autogenous bone (AB) by bone marrow aspirate concentrate (BMAC). Both AB and BMAC were tested in combination with a bovine bone mineral (BBM) for their ability of new bone formation (NBF) in a multicentric, randomized, controlled, clinical and histological noninferiority trial.
  
  
  METHODS
  Forty-five severely atrophied maxillary sinus from 26 patients were evaluated in a partial cross-over design. As test arm, 34 sinus of 25 patients were augmented with BBM and BMAC containing mesenchymal stem cells. Eleven control sinus from 11 patients were augmented with a mixture of 70% BBM and 30% AB. Biopsies were obtained after a 3-4-month healing period at time of implant placement and histomorphometrically analyzed for NBF.
  
  
  RESULTS
  NBF was 14.3%±1.8% for the control and nonsignificantly lower (12.6%±1.7%) for the test (90% confidence interval: -4.6 to 1.2). Values for BBM (31.3%±2.7%) were significantly higher for the test compared with control (19.3%±2.5%) (p<0.0001). Nonmineralized tissue was lower by 3.3% in the test compared with control (57.6%; p=0.137).
  
  
  CONCLUSIONS
  NBF after 3-4 months is equivalent in sinus, augmented with BMAC and BBM or a mixture of AB and BBM. This technique could be an alternative for using autografts to stimulate bone formation.
authors.affiliation: Department of Oral and Craniomaxillofacial Surgery, University Hospital Freiburg, Albert-Ludwigs University, Freiburg, Germany. sebastian.sauerbier@uniklinik-freiburg.de
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sauerbier
authors.forename: Daniela
authors.initials: D
authors.lastname: Rickert
authors.forename: Ralf
authors.initials: R
authors.lastname: Gutwald
authors.forename: Heiner
authors.initials: H
authors.lastname: Nagursky
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Oshima
authors.forename: Samuel P
authors.initials: SP
authors.lastname: Xavier
authors.forename: Johannes
authors.initials: J
authors.lastname: Christmann
authors.forename: Patrick
authors.initials: P
authors.lastname: Kurz
authors.forename: Dieter
authors.initials: D
authors.lastname: Menne
authors.forename: Arjan
authors.initials: A
authors.lastname: Vissink
authors.forename: Gerry
authors.initials: G
authors.lastname: Raghoebar
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmelzeisen
authors.forename: Wilfried
authors.initials: W
authors.lastname: Wagner
authors.forename: Felix P
authors.initials: FP
authors.lastname: Koch
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001853:Bone Marrow / Q000378:metabolism*; D001861:Bone Regeneration / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology; D016037:Single-Blind Method; D059546:Sinus Floor Augmentation / Q000379:methods*
chemical_list: D018786:Bone Substitutes