Abstract
PurposeThis study aimed to evaluate the quality and quantity of newly generated bone in the maxillary sinus grafted with stem cell-based allograft material.MethodsThis study was a single site, prospective, blinded, randomized, and controlled clinical trial. Eleven subjects with 18 edentulous posterior maxillary sites requiring sinus augmentation for delayed implant placement using a lateral window approach were enrolled. At the time of sinus augmentation, test sinus was grafted with stem cell-based allograft (Osteocel Plus; NuVasive Therapeutics), while the control sinus was grafted with conventional cortico-cancellous allograft (alloOss; ACE Surgical). Cone beam computer tomography (CBCT) scan was taken before and 14 weeks post-sinus augmentation procedure, i.e., 2 weeks before implant placement. Thirty-six trephined core bone biopsies were harvested from the anterior and posterior grafted lateral-window osteotomy sites at the time of implant placement.ResultsThe results showed a statistically significant difference in the vital bone percentage between the test and the control groups at the posterior grafted sites (p = 0.03). There was no significant difference in the percentage of vital bone between the anterior and posterior grafted sites within the test and control groups (p > .05). The CBCT analysis showed that the maxillary sinuses at the posterior grafted sites were statistically wider than those at the anterior grafted sites in both groups (p < .05).ConclusionsDifferent allograft bone materials can be used in the maxillary sinus augmentation procedures. Stem cell allograft has more osteogenic potential with a better outcome in the wide posterior sinus.
Highlights
The maxillary sinus is pyramidal in shape, where the anterior part is narrower than the posterior one
Hard and soft tissue defects arise as a sequela of tooth extraction if no ridge preservation is attempted and maxillary sinus hyper-pneumatization poses a clinical challenge for proper implant placement [3]
The results show that the test group has significantly higher posterior vital bone than the control group (p value 0.03) (Table 1)
Summary
The maxillary sinus is pyramidal in shape, where the anterior part is narrower than the posterior one. Studies reported bone resorption of 0.7–1.5 mm and 4.0–4.5 mm at vertical and horizontal alveolar bone dimensions, respectively [4,5,6]. Most of these changes occurred during the first 3 months of healing [5]. A more significant amount of expansion was measured after second molars extraction or extractions of two or more adjacent posterior teeth as compared to first molars [3] To overcome such clinical limitations, several regenerative surgical techniques and materials have been introduced in the literature [3,4,5,6]. Allograft materials have been used successfully as scaffolding materials in clinical studies; they lack cells with osteogenic potential [8]
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