title: A quantification of regenerated bone tissue in human sinus biopsies: influences of anatomical region, age and sex.
abstract: OBJECTIVE
  Sinus augmentation is a standard procedure to increase vertical bone supply for dental implants in the atrophic posterior maxilla. Despite the longstanding application of this method, information about some basic factors that could potentially influence bone regeneration after sinus augmentation is rare. The objective of this study was therefore to quantify the impact of the maxillary region (premolar/molar) and patients' age and sex on bone regeneration after sinus grafting.
  
  
  METHODS
  Sinus augmentation procedures were performed in 107 patients (66 female: 52.8 ± 11.0 years, 41 male: 50.6 ± 11.3 years). After 6 ± 1 months, 201 sinus biopsies were harvested and histomorphometrically analysed. Height (oldHt) and bone volume fraction of pristine bone (oldBV/TV), as well as the amount of new bone (newBV/TV) and bone-to-bone substitute contact (BBSC) in the augmentation area, were assessed.
  
  
  RESULTS
  In women, newBV/TV in the augmented sinus decreased significantly by 0.22 ± 0.08% per year. In men, no similar trend was observed. There were strong influences of the maxillary region and the dimensions of the host bone. In the premolar region, newBV/TV was 23.1 ± 7.9% and 25.1 ± 10.1%; in the molar region, newBV/TV averaged 20.4 ± 9.4% and 17.8 ± 8.8% for women and men, respectively. The greater the thickness of the wall of the sinus floor (mainly in the former premolar region), the greater was the amount of new bone tissue formed in the spaces in-between bone substitute particles.
  
  
  CONCLUSIONS
  These empirical results derived from a large human sample, link factors that influence the quality of biomaterial integration to the known clinical risks for the success of dental implants.
authors.affiliation: Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.|Austrian Cluster for Tissue Regeneration, Vienna, Austria.
authors.forename: Karoline Maria
authors.initials: KM
authors.lastname: Reich
authors.affiliation: Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.|Austrian Cluster for Tissue Regeneration, Vienna, Austria.
authors.forename: Christian Domitian
authors.initials: CD
authors.lastname: Huber
authors.affiliation: Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.|Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in the Trauma Research Center of AUVA, Vienna, Austria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Heimel
authors.affiliation: Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Ulm
authors.affiliation: Austrian Cluster for Tissue Regeneration, Vienna, Austria.|Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in the Trauma Research Center of AUVA, Vienna, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Redl
authors.affiliation: Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.|Austrian Cluster for Tissue Regeneration, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Tangl
mesh_terms: D000328:Adult; D001706:Biopsy; D001861:Bone Regeneration; D018786:Bone Substitutes; D003758:Dental Implantation, Endosseous; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D012737:Sex Factors; D059546:Sinus Floor Augmentation
chemical_list: D018786:Bone Substitutes
keywords: age- and sex-dependency; bone quality; bone regeneration potential; bone substitute material; maxillary region; sinus augmentation