title: A histomorphometric assessment of collagen-stabilized anorganic bovine bone mineral in maxillary sinus augmentation - a prospective clinical trial.
abstract: OBJECTIVE
  To histomorphometrically compare the use of collagen-stabilized anorganic bovine bone (ABBM-C) (test) to anorganic bovine bone + autogenous bone (ABBM + AB) (control) in maxillary sinus augmentation.
  
  
  METHODS
  Forty (n = 40 sinuses) patients underwent sinus augmentation and received either control (20 sinuses) or test bone graft (20 sinuses). Bone samples were harvested from the augmented sinuses 5 months postgrafting. The samples were processed for histomorphometry, which assessed within the primary region of interest (ROI-1), the area fraction of new bone (%NB), graft particle osseointegration (% OI), residual graft (%RG), and soft tissue components (% STM). The same analysis was also carried out in a second region of interest (ROI-2) located in a zone 1 mm proximal to the previous maxillary sinus floor.
  
  
  RESULTS
  In both ROI-1 and ROI-2, the mean % NB, %RG, and %STM in the control group were similar to mean values in the test group. The % OI was significantly greater in the control group (42.0 +/- 26.8) when compared to the test group (19.6 +/- 27.3) in ROI-2 (P < 0.05). No statistically significant differences were seen when ROI-1 and ROI-2 were compared except for improved %OI in ROI-2 in the control group. The mean proportion of lamellar bone to woven bone in the control group (1.22 ± 1.48) was significantly greater than the test group (0.38 ± 0.29) (P < 0.05).
  
  
  CONCLUSIONS
  ABBM-C exhibited very similar histomorphometric parameters to the composite graft of ABBM + AB. The ABBM + AB group was more mature as indicated by the significantly greater proportion of lamellar bone when compared to the ABBM-C. Improved % OI was seen in the zone proximal to the resident bony floor in the ABBM + AB group. Based on histological assessment, ABBM-C is a suitable bone substitute for the purposes of maxillary sinus augmentation. Its clinical utility may be indicated in cases of sinus membrane perforation and insufficient autogenous bone in the local area.
authors.affiliation: School of Dentistry and Oral Health, Centre for Medicine and Oral Health, Griffith University, Southport, Australia.
authors.forename: Jamil
authors.initials: J
authors.lastname: Alayan
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia.
authors.forename: Cedryck
authors.initials: C
authors.lastname: Vaquette
authors.affiliation: UQ Centre for Clinical Research, University of Queensland, Brisbane, Australia.
authors.forename: Camile
authors.initials: C
authors.lastname: Farah
authors.affiliation: School of Dentistry and Oral Health, Centre for Medicine and Oral Health, Griffith University, Southport, Australia.
authors.forename: Saso
authors.initials: S
authors.lastname: Ivanovski
mesh_terms: D000818:Animals; D002417:Cattle; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D013516:Oral Surgical Procedures, Preprosthetic; D016348:Osseointegration; D011446:Prospective Studies; D059546:Sinus Floor Augmentation; D014183:Transplantation, Heterologous
keywords: Bio-Oss; Bio-Oss Collagen; anorganic bovine bone; bone grafting; bone regeneration; bone substitute; clinical trial; histomorphometry; maxillary sinus augmentation; sinus floor elevation