Abstract
Several grafting materials have been used in sinus augmentation procedures including autogenous bone, demineralized freeze-dried bone (DFDBA), hydroxyapatite, β-tricalcium phosphate (β-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.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.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.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.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.
Highlights
From a clinical point of view, the use of autogenous bone is advantageous if a prosthetic rehabilitation is expected within 9 months
Since the external sinus floor elevation technique was first introduced by Boyne [1] and Tatum [2] several grafting materials have been used in sinus augmentation procedures including autogenous bone [1,2,3], demineralized freeze-dried bone (DFDBA)[4,5], hydroxyapatite [6], βtricalcium phosphate (β-TCP) [7], anorganic deproteinized bovine bone [8] and combination of these and others [9]
The aim of this study is to provide a body of evidence-based data regarding grafting materials in external sinus floor elevation to assist surgeons to make an informed choice between those materials, through a meta-analysis of the available literature
Summary
Since the external sinus floor elevation technique was first introduced by Boyne [1] and Tatum [2] several grafting materials have been used in sinus augmentation procedures including autogenous bone [1,2,3], demineralized freeze-dried bone (DFDBA)[4,5], hydroxyapatite [6], βtricalcium phosphate (β-TCP) [7], anorganic deproteinized bovine bone [8] and combination of these and others [9]. According to Kent and Block [3] an ideal grafting material should fulfil the following criteria amongst other things: Osteoinduction papers using autogenous bone, demineralized freezedried bone (DFDBA), hydroxyapatite, β-tricalcium phosphate (β-TCP), anorganic deproteinized bovine bone (Bio Oss®, Geistlich Biomaterials, Wolhusen, Switzerland) [8] and combination of these materials were included. In addition to review articles, interviews and editorials were excluded
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