title: Volumetric analysis of bone substitute material performance within the human sinus cavity of former head and neck cancer patients: A prospective, randomized clinical trial.
abstract: BACKGROUND
  In numerous animal and human studies, it could be detected that in bone augmentation procedures, material's physicochemical characteristics can influence the cellular inflammatory pattern and therefore the integration in the host tissue. Histological, histomorphometrical, and clinical analyses of the integration of the biomaterial in the surrounding tissue are well established methodologies; however, they do not make a statement on volume and density changes of the augmented biomaterial.
  
  
  OBJECTIVE
  The aim of the present study was to assess the volume and density of a xenogeneic (Bio-Oss®, BO) and a synthetic (NanoBone®, NB) bone substitute material in split-mouth sinus augmentations in former tumor patients to complete histological and histomorphometrical assessment.
  
  
  METHODS
  Immediately and 6 months after sinus augmentation computed tomography scans were recorded, bone grafts were marked, and the volume was calculated with radiologic RIS-PACS software (General Electric Healthcare, Chalfont St. Giles, Great Britain) to determine the integration and degradation behavior of both biomaterials.
  
  
  RESULTS
  Radiographic analysis revealed a volume reduction of the initial augmented bone substitute material (i.e. 100%) to 77.36 (±11.68) % in the BO-group, respectively, 75.82 (±22.28) % in the NB-group six months after augmentation. In both materials, the volume reduction was not significant. Bone density significantly increased in both groups.
  
  
  CONCLUSIONS
  The presented radiological investigation presents a favorable method to obtain clinically relevant information concerning the integration and degradation behavior of bone substitute materials.
authors.affiliation: Department for Oral, Cranio-maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University, Frankfurt am Main, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Lorenz
authors.affiliation: Department for Diagnostic and Interventional Radiology, Medical Center of the Goethe University, Frankfurt am Main, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Eichler
authors.affiliation: Department for Oral, Cranio-maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University, Frankfurt am Main, Germany.
authors.forename: Mike
authors.initials: M
authors.lastname: Barbeck
authors.affiliation: Department for Oral, Cranio-maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University, Frankfurt am Main, Germany.
authors.forename: Henriette
authors.initials: H
authors.lastname: Lerner
authors.affiliation: Hightech Research Center of Cranio-Maxillofacial Surgery, University of Basel, Basel, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Stübinger
authors.affiliation: Department for Oral, Cranio-maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University, Frankfurt am Main, Germany.
authors.forename: Catherine
authors.initials: C
authors.lastname: Seipel
authors.affiliation: Department for Diagnostic and Interventional Radiology, Medical Center of the Goethe University, Frankfurt am Main, Germany.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.affiliation: Private Practice, Nauheim, Germany.
authors.forename: Adorján F
authors.initials: AF
authors.lastname: Kovács
authors.affiliation: Department for Oral, Cranio-maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University, Frankfurt am Main, Germany.
authors.forename: Shahram
authors.initials: S
authors.lastname: Ghanaati
authors.affiliation: Department for Oral, Cranio-maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University, Frankfurt am Main, Germany.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sader
keywords: Bio-Oss; NanoBone®; bone substitute material; graft density; graft volume; radiologic analysis; sinus augmentation