Advantages of Porcine Xenograft over Autograft in Sinus Lift: A Randomised Clinical Trial.

Francisco Correia,António Campos Felino,Ricardo Faria-Almeida,Daniel Humberto Pozza,Sónia Gouveia

doi:10.3390/ma14123439

Abstract

This study aimed to compare the performance of intra-oral autologous bone grafts versus porcine xenografts in a two-step lateral window sinus lift. This split-mouth randomised controlled trial sequentially enrolled 12 patients with a 6-month follow-up. For each patient, a simultaneous randomised bilateral maxillary sinus lift was performed and filled with autologous bone from the mandible (control) or a porcine xenograft (test). A bone biopsy sample was collected during the implant placement for histological and histomorphometric analysis. CT scans were performed at the beginning and at the end of the trial to assess radiological evolution. A comparison of initial and six-month CT scans indicated statistically significant increases in bone level for both materials (7.8 ± 2.4 mm for autologous and 8.7 ± 2.2 mm for xenograft, p < 0.05), and there were no significant differences between the performance of the two materials over time (p = 0.26). The histological analysis showed various stages of the remodelling process and no cells or other signs of inflammation or infection were visible in both groups. The porcine xenografts presented similar results for the studied variables when compared to autologous bone, being a reasonable alternative for a sinus lift.

Highlights

The maxillary double direction reabsorption, due to centripetal loss of the alveolar bone and sinus pneumatisation, together with thin cortex and low trabecular density, poses a challenge for oral rehabilitation with dental implants [1,2]
Or simultaneously to implant placement, maxillary sinus elevations can be performed by lateral osteotomy or maxillary sinus elevation with osteotomes [8,9]
A total of 24 sinus elevations were evaluated from 12 patients with an average age of 59.7 ± 8.7 years old

Summary

Introduction

The maxillary double direction reabsorption, due to centripetal loss of the alveolar bone and sinus pneumatisation, together with thin cortex and low trabecular density, poses a challenge for oral rehabilitation with dental implants [1,2]. This resorptive process is dependent on the number of lost teeth [3] and may lead to a remaining bone height of less than 1 mm [4]. A limited amount of alveolar bone available may result in a lack of primary stability and difficulty in achieving osteointegration.

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Discussion

Conclusion